Sitras, V; Fenton, C; Acharya, G
2015-02-01
Cardiovascular disease (CVD) and preeclampsia (PE) share common clinical features. We aimed to identify common transcriptomic signatures involved in CVD and PE in humans. Meta-analysis of individual raw microarray data deposited in GEO, obtained from blood samples of patients with CVD versus controls and placental samples from women with PE versus healthy women with uncomplicated pregnancies. Annotation of cases versus control samples was taken directly from the microarray documentation. Genes that showed a significant differential expression in the majority of experiments were selected for subsequent analysis. Hypergeometric gene list analysis was performed using Bioconductor GOstats package. Bioinformatic analysis was performed in PANTHER. Seven studies in CVD and 5 studies in PE were eligible for meta-analysis. A total of 181 genes were found to be differentially expressed in microarray studies investigating gene expression in blood samples obtained from patients with CVD compared to controls and 925 genes were differentially expressed between preeclamptic and healthy placentas. Among these differentially expressed genes, 22 were common between CVD and PE. Bioinformatic analysis of these genes revealed oxidative stress, p-53 pathway feedback, inflammation mediated by chemokines and cytokines, interleukin signaling, B-cell activation, PDGF signaling, Wnt signaling, integrin signaling and Alzheimer disease pathways to be involved in the pathophysiology of both CVD and PE. Metabolism, development, response to stimulus, immune response and cell communication were the associated biologic processes in both conditions. Gene set enrichment analysis showed the following overlapping pathways between CVD and PE: TGF-β-signaling, apoptosis, graft-versus-host disease, allograft rejection, chemokine signaling, steroid hormone synthesis, type I and II diabetes mellitus, VEGF signaling, pathways in cancer, GNRH signaling, Huntingtons disease and Notch signaling. CVD and PE share same common traits in their gene expression profile indicating common pathways in their pathophysiology. Copyright © 2014 Elsevier Ltd. All rights reserved.
Simple Chemical Vapor Deposition Experiment
ERIC Educational Resources Information Center
Pedersen, Henrik
2014-01-01
Chemical vapor deposition (CVD) is a process commonly used for the synthesis of thin films for several important technological applications, for example, microelectronics, hard coatings, and smart windows. Unfortunately, the complexity and prohibitive cost of CVD equipment makes it seldom available for undergraduate chemistry students. Here, a…
Xie, Bo; Su, Zhaohui; Zhang, Wenhui
2017-01-01
Background China has a large population with cardiovascular disease (CVD) that requires extensive self-management. Mobile health (mHealth) apps may be a useful tool for CVD self-management. Little is currently known about the types and quality of health information provided in Chinese CVD mobile apps and whether app functions are conducive to promoting CVD self-management. Objective We undertook a systematic review to evaluate the types and quality of health information provided in Chinese CVD mobile apps and interactive app functions for promoting CVD self-management. Methods Mobile apps targeting end users in China with CVD conditions were selected in February 2017 through a multi-stage process. Three frameworks were used to evaluate the selected apps: (1) types of health information offered were assessed using our Health Information Wants framework, which encompasses 7 types of information; (2) quality of information provided in the apps was assessed using the 11 guidelines recommended by the National Library of Medicine of the National Institutes of Health; and (3) types of interactive app functions for CVD self-management were assessed using a 15-item framework adapted from the literature, including our own prior work. Results Of 578 apps identified, 82 were eligible for final review. Among these, information about self-care (67/82, 82%) and information specifically regarding CVD (63/82, 77%) were the most common types of information provided, while information about health care providers (22/82, 27%) and laboratory tests (5/82, 6%) were least common. The most common indicators of information quality were the revealing of apps’ providers (82/82, 100%) and purpose (82/82, 100%), while the least common quality indicators were the revealing of how apps’ information was selected (1/82, 1%) and app sponsorship (0/82, 0%). The most common interactive functions for CVD self-management were those that enabled user interaction with the app provider (57/82, 70%) and with health care providers (36/82, 44%), while the least common interactive functions were those that enabled lifestyle management (13/82, 16%) and psychological health management (6/82, 7%). None of the apps covered all 7 types of health information, all 11 indicators of information quality, or all 15 interactive functions for CVD self-management. Conclusions Chinese CVD apps are insufficient in providing comprehensive health information, high-quality information, and interactive functions to facilitate CVD self-management. End users should exercise caution when using existing apps. Health care professionals and app developers should collaborate to better understand end users’ preferences and follow evidence-based guidelines to develop mHealth apps conducive to CVD self-management. PMID:29242176
Xie, Bo; Su, Zhaohui; Zhang, Wenhui; Cai, Run
2017-12-14
China has a large population with cardiovascular disease (CVD) that requires extensive self-management. Mobile health (mHealth) apps may be a useful tool for CVD self-management. Little is currently known about the types and quality of health information provided in Chinese CVD mobile apps and whether app functions are conducive to promoting CVD self-management. We undertook a systematic review to evaluate the types and quality of health information provided in Chinese CVD mobile apps and interactive app functions for promoting CVD self-management. Mobile apps targeting end users in China with CVD conditions were selected in February 2017 through a multi-stage process. Three frameworks were used to evaluate the selected apps: (1) types of health information offered were assessed using our Health Information Wants framework, which encompasses 7 types of information; (2) quality of information provided in the apps was assessed using the 11 guidelines recommended by the National Library of Medicine of the National Institutes of Health; and (3) types of interactive app functions for CVD self-management were assessed using a 15-item framework adapted from the literature, including our own prior work. Of 578 apps identified, 82 were eligible for final review. Among these, information about self-care (67/82, 82%) and information specifically regarding CVD (63/82, 77%) were the most common types of information provided, while information about health care providers (22/82, 27%) and laboratory tests (5/82, 6%) were least common. The most common indicators of information quality were the revealing of apps' providers (82/82, 100%) and purpose (82/82, 100%), while the least common quality indicators were the revealing of how apps' information was selected (1/82, 1%) and app sponsorship (0/82, 0%). The most common interactive functions for CVD self-management were those that enabled user interaction with the app provider (57/82, 70%) and with health care providers (36/82, 44%), while the least common interactive functions were those that enabled lifestyle management (13/82, 16%) and psychological health management (6/82, 7%). None of the apps covered all 7 types of health information, all 11 indicators of information quality, or all 15 interactive functions for CVD self-management. Chinese CVD apps are insufficient in providing comprehensive health information, high-quality information, and interactive functions to facilitate CVD self-management. End users should exercise caution when using existing apps. Health care professionals and app developers should collaborate to better understand end users' preferences and follow evidence-based guidelines to develop mHealth apps conducive to CVD self-management. ©Bo Xie, Zhaohui Su, Wenhui Zhang, Run Cai. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 14.12.2017.
Patterns of population differentiation of candidate genes for cardiovascular disease.
Kullo, Iftikhar J; Ding, Keyue
2007-07-12
The basis for ethnic differences in cardiovascular disease (CVD) susceptibility is not fully understood. We investigated patterns of population differentiation (FST) of a set of genes in etiologic pathways of CVD among 3 ethnic groups: Yoruba in Nigeria (YRI), Utah residents with European ancestry (CEU), and Han Chinese (CHB) + Japanese (JPT). We identified 37 pathways implicated in CVD based on the PANTHER classification and 416 genes in these pathways were further studied; these genes belonged to 6 biological processes (apoptosis, blood circulation and gas exchange, blood clotting, homeostasis, immune response, and lipoprotein metabolism). Genotype data were obtained from the HapMap database. We calculated FST for 15,559 common SNPs (minor allele frequency > or = 0.10 in at least one population) in genes that co-segregated among the populations, as well as an average-weighted FST for each gene. SNPs were classified as putatively functional (non-synonymous and untranslated regions) or non-functional (intronic and synonymous sites). Mean FST values for common putatively functional variants were significantly higher than FST values for nonfunctional variants. A significant variation in FST was also seen based on biological processes; the processes of 'apoptosis' and 'lipoprotein metabolism' showed an excess of genes with high FST. Thus, putative functional SNPs in genes in etiologic pathways for CVD show greater population differentiation than non-functional SNPs and a significant variance of FST values was noted among pairwise population comparisons for different biological processes. These results suggest a possible basis for varying susceptibility to CVD among ethnic groups.
Patterns of population differentiation of candidate genes for cardiovascular disease
Kullo, Iftikhar J; Ding, Keyue
2007-01-01
Background The basis for ethnic differences in cardiovascular disease (CVD) susceptibility is not fully understood. We investigated patterns of population differentiation (FST) of a set of genes in etiologic pathways of CVD among 3 ethnic groups: Yoruba in Nigeria (YRI), Utah residents with European ancestry (CEU), and Han Chinese (CHB) + Japanese (JPT). We identified 37 pathways implicated in CVD based on the PANTHER classification and 416 genes in these pathways were further studied; these genes belonged to 6 biological processes (apoptosis, blood circulation and gas exchange, blood clotting, homeostasis, immune response, and lipoprotein metabolism). Genotype data were obtained from the HapMap database. Results We calculated FST for 15,559 common SNPs (minor allele frequency ≥ 0.10 in at least one population) in genes that co-segregated among the populations, as well as an average-weighted FST for each gene. SNPs were classified as putatively functional (non-synonymous and untranslated regions) or non-functional (intronic and synonymous sites). Mean FST values for common putatively functional variants were significantly higher than FST values for nonfunctional variants. A significant variation in FST was also seen based on biological processes; the processes of 'apoptosis' and 'lipoprotein metabolism' showed an excess of genes with high FST. Thus, putative functional SNPs in genes in etiologic pathways for CVD show greater population differentiation than non-functional SNPs and a significant variance of FST values was noted among pairwise population comparisons for different biological processes. Conclusion These results suggest a possible basis for varying susceptibility to CVD among ethnic groups. PMID:17626638
Chan, Kei Hang K; Huang, Yen-Tsung; Meng, Qingying; Wu, Chunyuan; Reiner, Alexander; Sobel, Eric M; Tinker, Lesley; Lusis, Aldons J; Yang, Xia; Liu, Simin
2014-12-01
Although cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D) share many common risk factors, potential molecular mechanisms that may also be shared for these 2 disorders remain unknown. Using an integrative pathway and network analysis, we performed genome-wide association studies in 8155 blacks, 3494 Hispanic American, and 3697 Caucasian American women who participated in the national Women's Health Initiative single-nucleotide polymorphism (SNP) Health Association Resource and the Genomics and Randomized Trials Network. Eight top pathways and gene networks related to cardiomyopathy, calcium signaling, axon guidance, cell adhesion, and extracellular matrix seemed to be commonly shared between CVD and T2D across all 3 ethnic groups. We also identified ethnicity-specific pathways, such as cell cycle (specific for Hispanic American and Caucasian American) and tight junction (CVD and combined CVD and T2D in Hispanic American). In network analysis of gene-gene or protein-protein interactions, we identified key drivers that included COL1A1, COL3A1, and ELN in the shared pathways for both CVD and T2D. These key driver genes were cross-validated in multiple mouse models of diabetes mellitus and atherosclerosis. Our integrative analysis of American women of 3 ethnicities identified multiple shared biological pathways and key regulatory genes for the development of CVD and T2D. These prospective findings also support the notion that ethnicity-specific susceptibility genes and process are involved in the pathogenesis of CVD and T2D. © 2014 American Heart Association, Inc.
Zhang, Guanglin; Codoni, Veronica; Yang, Jun; Wilson, James G.; Levy, Daniel; Lusis, Aldons J.; Liu, Simin; Yang, Xia
2017-01-01
Cardiovascular diseases (CVD) and type 2 diabetes (T2D) are closely interrelated complex diseases likely sharing overlapping pathogenesis driven by aberrant activities in gene networks. However, the molecular circuitries underlying the pathogenic commonalities remain poorly understood. We sought to identify the shared gene networks and their key intervening drivers for both CVD and T2D by conducting a comprehensive integrative analysis driven by five multi-ethnic genome-wide association studies (GWAS) for CVD and T2D, expression quantitative trait loci (eQTLs), ENCODE, and tissue-specific gene network models (both co-expression and graphical models) from CVD and T2D relevant tissues. We identified pathways regulating the metabolism of lipids, glucose, and branched-chain amino acids, along with those governing oxidation, extracellular matrix, immune response, and neuronal system as shared pathogenic processes for both diseases. Further, we uncovered 15 key drivers including HMGCR, CAV1, IGF1 and PCOLCE, whose network neighbors collectively account for approximately 35% of known GWAS hits for CVD and 22% for T2D. Finally, we cross-validated the regulatory role of the top key drivers using in vitro siRNA knockdown, in vivo gene knockout, and two Hybrid Mouse Diversity Panels each comprised of >100 strains. Findings from this in-depth assessment of genetic and functional data from multiple human cohorts provide strong support that common sets of tissue-specific molecular networks drive the pathogenesis of both CVD and T2D across ethnicities and help prioritize new therapeutic avenues for both CVD and T2D. PMID:28957322
Advanced purification of petroleum refinery wastewater by catalytic vacuum distillation.
Yan, Long; Ma, Hongzhu; Wang, Bo; Mao, Wei; Chen, Yashao
2010-06-15
In our work, a new process, catalytic vacuum distillation (CVD) was utilized for purification of petroleum refinery wastewater that was characteristic of high chemical oxygen demand (COD) and salinity. Moreover, various common promoters, like FeCl(3), kaolin, H(2)SO(4) and NaOH were investigated to improve the purification efficiency of CVD. Here, the purification efficiency was estimated by COD testing, electrolytic conductivity, UV-vis spectrum, gas chromatography-mass spectrometry (GC-MS) and pH value. The results showed that NaOH promoted CVD displayed higher efficiency in purification of refinery wastewater than other systems, where the pellucid effluents with low salinity and high COD removal efficiency (99%) were obtained after treatment, and the corresponding pH values of effluents varied from 7 to 9. Furthermore, environment estimation was also tested and the results showed that the effluent had no influence on plant growth. Thus, based on satisfied removal efficiency of COD and salinity achieved simultaneously, NaOH promoted CVD process is an effective approach to purify petroleum refinery wastewater. Copyright 2010 Elsevier B.V. All rights reserved.
Nelson, Pauline A; Kane, Karen; Chisholm, Anna; Pearce, Christina J; Keyworth, Christopher; Rutter, Martin K; Chew-Graham, Carolyn A; Griffiths, Christopher E M; Cordingley, Lis
2016-10-01
Unhealthy lifestyle is common in psoriasis, contributing to worsening disease and increased cardiovascular disease (CVD) risk. CVD risk communication should improve patients' understanding of risk and risk-reducing behaviours; however, the effectiveness of risk screening is debated and evaluation currently limited. To examine the process of assessing for and communicating about CVD risk in the context of psoriasis. Mixed-methods study in English general practices to (i) determine proportions of CVD risk factors among patients with psoriasis at risk assessment and (ii) examine patient and practitioner experiences of risk communication to identify salient 'process' issues. Audio recordings of consultations informed in-depth interviews with patients and practitioners using tape-assisted recall, analysed with framework analysis. Patients with psoriasis (n = 287) undergoing CVD risk assessment; 29 patients and 12 practitioners interviewed. A high proportion of patients had risk factor levels apparent at risk assessment above NICE recommendations: very high waist circumference (52%), obesity (35%), raised blood pressure (29%), smoking (18%) and excess alcohol consumption (18%). There was little evidence of personalized discussion about CVD risk and behaviour change support in consultations. Professionals reported a lack of training in behaviour change, while patients wanted to discuss CVD risk/risk reduction and believed practitioners to be influential in supporting lifestyle management. Despite high levels of risk factors identified, opportunities may be missed in consultations to support patients with psoriasis to understand CVD risk/risk reduction. Practitioners need training in behaviour change techniques to capitalize on 'teachable moments' and increase the effectiveness of risk screening. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.
2010-01-01
Background Cardiovascular disease (CVD) is a leading cause of mortality in the United States as well as globally. Epidemiological studies show that regular fruit and vegetable consumption reduces CVD risk, in part, due to antioxidant activity and immunomodulation since oxidative stress and inflammation are features of atherogenesis. Accumulating evidence also shows that dietary fungi, viz., mushrooms, can protect against chronic disease by altering inflammatory environments such as those associated with CVD although most research has focused on specialty mushrooms. In this study, we tested the ability of both common and specialty mushrooms to inhibit cellular processes associated with CVD. Methods Human aortic endothelial cells (HAEC) were incubated overnight with control media with dimethylsulfoxide (DMSO) vehicle (1% v/v) or containing DMSO extracts of whole dehydrated mushrooms (0.1 mg/mL), which included Agaricus bisporus (white button and crimini), Lentinula edodes (shiitake), Pleurotus ostreatus (oyster), and Grifola frondosa (maitake). Monolayers were subsequently washed and incubated with medium alone or containing the pro-inflammatory cytokine IL-1β (5 ng/mL) for 6 h to upregulate pro-atherosclerotic adhesion molecules (AM). AM expression was assayed by ELISA and binding of U937 human monocytes pre-loaded with fluorescent dye was determined. Results White button mushrooms consistently reduced (p < 0.05) VCAM-1, ICAM-1, and E-selectin-1 expression, whereas other test mushrooms significantly modulated AM expression singly, collectively, or combinatorially. All mushrooms, however, significantly reduced binding of monocytes to both quiescent and cytokine-stimulated monolayers. Conclusion These data provide evidence that dietary mushrooms can inhibit cellular processes such as adhesion molecule expression and ultimate binding of monocytes to the endothelium under pro-inflammatory conditions, which are associated with CVD. As a result, these findings support the notion that dietary mushrooms can be protective against CVD. PMID:20637088
Sedaghat, Sanaz; van Sloten, Thomas T; Laurent, Stéphane; London, Gérard M; Pannier, Bruno; Kavousi, Maryam; Mattace-Raso, Francesco; Franco, Oscar H; Boutouyrie, Pierre; Ikram, M Arfan; Stehouwer, Coen D A
2018-05-21
Carotid arterial diameter enlargement is a manifestation of arterial remodeling and may be a risk factor for cardiovascular disease (CVD). We evaluated the association between carotid artery diameter and risk of stroke, coronary heart disease, CVD, and all-cause mortality and explored whether the associations could be explained by processes involved in arterial remodeling, that is, blood pressure-related media thickening, arterial stiffness, arterial wall stress, and atherosclerosis. We included 4887 participants (mean age 67±9 years; 54% women) from 4 cohort studies: Rotterdam Study, NEPHROTEST, Hoorn Study, and a study by Blacher et al. Common carotid artery properties were measured using echotracking. Incident cases were recorded based on medical records. We used Cox proportional hazard models adjusting for cardiovascular risk factors and estimates of processes underlying arterial remodeling. During follow-up (mean, 11 years), 379 (8%) individuals had a stroke, 516 had a (11%) coronary heart disease, 807 had a (17%) CVD, and 1486 (30%) had died. After adjustment for cardiovascular risk factors, individuals in the highest tertile of carotid diameter (diameter >8 mm) compared with those in the lowest tertile (diameter <7 mm) had a higher incidence of stroke (hazard ratio, 1.5; 95% confidence interval, 1.1-2.0). From all estimates of processes underlying arterial remodeling, adjustment for carotid intima-media thickness attenuated this association (hazard ratio after adjustment for intima-media thickness, 1.2; 95% confidence interval, 0.9-1.6). Larger carotid diameter was associated with risk of CVD and mortality but not clearly with coronary heart disease risk. We showed that a larger carotid diameter is associated with incident stroke, CVD, and mortality. Carotid intima-media thickness, a measure of blood pressure-related media thickening, partially explained the association with stroke incidence. © 2018 American Heart Association, Inc.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ho, P.; Johannes, J.; Kudriavtsev, V.
The use of computational modeling to improve equipment and process designs for chemical vapor deposition (CVD) reactors is becoming increasingly common. Commercial codes are available that facilitate the modeling of chemically-reacting flows, but chemical reaction mechanisms must be separately developed for each system of interest. One f the products of the Watkins-Johnson Company (WJ) is a reactor marketed to semiconductor manufacturers for the atmospheric-pressure chemical vapor deposition (APCVD) of silicon oxide films. In this process, TEOS (tetraethoxysilane, Si(OC{sub 2}H{sub 5}){sub 4}) and ozone (O{sub 3}) are injected (in nitrogen and oxygen carrier gases) over hot silicon wafers that are beingmore » carried through the system on a moving belt. As part of their equipment improvement process, WJ is developing computational models of this tool. In this effort, they are collaborating with Sandia National Laboratories (SNL) to draw on Sandia`s experience base in understanding and modeling the chemistry of CVD processes.« less
Vilaró, Ignasi; Yagüe, Jose L; Borrós, Salvador
2017-01-11
Due to continuous miniaturization and increasing number of electrical components in electronics, copper interconnections have become critical for the design of 3D integrated circuits. However, corrosion attack on the copper metal can affect the electronic performance of the material. Superhydrophobic coatings are a commonly used strategy to prevent this undesired effect. In this work, a solventless two-steps process was developed to fabricate superhydrophobic copper surfaces using chemical vapor deposition (CVD) methods. The superhydrophobic state was achieved through the design of a hierarchical structure, combining micro-/nanoscale domains. In the first step, O 2 - and Ar-plasma etchings were performed on the copper substrate to generate microroughness. Afterward, a conformal copolymer, 1H,1H,2H,2H-perfluorodecyl acrylate-ethylene glycol diacrylate [p(PFDA-co-EGDA)], was deposited on top of the metal via initiated CVD (iCVD) to lower the surface energy of the surface. The copolymer topography exhibited a very characteristic and unique nanoworm-like structure. The combination of the nanofeatures of the polymer with the microroughness of the copper led to achievement of the superhydrophobic state. AFM, SEM, and XPS were used to characterize the evolution in topography and chemical composition during the CVD processes. The modified copper showed water contact angles as high as 163° and hysteresis as low as 1°. The coating withstood exposure to aggressive media for extended periods of time. Tafel analysis was used to compare the corrosion rates between bare and modified copper. Results indicated that iCVD-coated copper corrodes 3 orders of magnitude slower than untreated copper. The surface modification process yielded repeatable and robust superhydrophobic coatings with remarkable anticorrosion properties.
CVD and obesity in transitional Syria: a perspective from the Middle East
Barakat, Hani; Barakat, Hanniya; Baaj, Mohamad K
2012-01-01
Purpose Syria is caught in the middle of a disruptive nutritional transition. Its healthcare system is distracted by challenges and successes in other areas while neglecting to address the onslaught of Syria’s cardiovascular disease (CVD) epidemic. Despite the official viewpoint touting improvement in health indicators, current trends jeopardize population health, and several surveys in the Syrian population signal the epidemic spreading far and wide. The goal is to counteract the indifference towards obesity as a threat to Syrian’s health, as the country is slowly becoming a leader in CVD mortality globally. Methods PubMed, World Health Organization, and official government websites were searched for primary surveys in Syria related to CVD morbidity, mortality, and risk factors. Inclusion criteria ensured that results maximized relevance while producing comparable studies. Statistical analysis was applied to detect the most common risk factor and significant differences in risk factor prevalence and CVD rates. Results Obesity remained the prevailing CVD risk factor except in older Syrian men, where smoking and hypertension were more common. CVD mortality was more common in males due to coronary disease, while stroke dominated female mortality. The young workforce is especially impacted, with 50% of CVD mortality occurring before age 65 years and an 81% prevalence of obesity in women over 45 years. Conclusion Syria can overcome its slow response to the CVD epidemic and curb further deterioration by reducing obesity and, thus, inheritance and clustering of risk factors. This can be achieved via multilayered awareness and intensive parental and familial involvement. Extinguishing the CVD epidemic is readily achievable as demonstrated in other countries. PMID:22454558
CVD and obesity in transitional Syria: a perspective from the Middle East.
Barakat, Hani; Barakat, Hanniya; Baaj, Mohamad K
2012-01-01
Syria is caught in the middle of a disruptive nutritional transition. Its healthcare system is distracted by challenges and successes in other areas while neglecting to address the onslaught of Syria's cardiovascular disease (CVD) epidemic. Despite the official viewpoint touting improvement in health indicators, current trends jeopardize population health, and several surveys in the Syrian population signal the epidemic spreading far and wide. The goal is to counteract the indifference towards obesity as a threat to Syrian's health, as the country is slowly becoming a leader in CVD mortality globally. PubMed, World Health Organization, and official government websites were searched for primary surveys in Syria related to CVD morbidity, mortality, and risk factors. Inclusion criteria ensured that results maximized relevance while producing comparable studies. Statistical analysis was applied to detect the most common risk factor and significant differences in risk factor prevalence and CVD rates. Obesity remained the prevailing CVD risk factor except in older Syrian men, where smoking and hypertension were more common. CVD mortality was more common in males due to coronary disease, while stroke dominated female mortality. The young workforce is especially impacted, with 50% of CVD mortality occurring before age 65 years and an 81% prevalence of obesity in women over 45 years. Syria can overcome its slow response to the CVD epidemic and curb further deterioration by reducing obesity and, thus, inheritance and clustering of risk factors. This can be achieved via multilayered awareness and intensive parental and familial involvement. Extinguishing the CVD epidemic is readily achievable as demonstrated in other countries.
Estrogen Receptors and Chronic Venous Disease.
Serra, R; Gallelli, L; Perri, P; De Francesco, E M; Rigiracciolo, D C; Mastroroberto, P; Maggiolini, M; de Franciscis, S
2016-07-01
Chronic venous disease (CVD) is a common and relevant problem affecting Western people. The role of estrogens and their receptors in the venous wall seems to support the major prevalence of CVD in women. The effects of the estrogens are mediated by three estrogen receptors (ERs): ERα, ERβ, and G protein-coupled ER (GPER). The expression of ERs in the vessel walls of varicose veins is evaluated. In this prospective study, patients of both sexes, with CVD and varicose veins undergoing open venous surgery procedures, were enrolled in order to obtain vein samples. To obtain control samples of healthy veins, patients of both sexes without CVD undergoing coronary artery bypass grafting with autologous saphenous vein were recruited (control group). Samples were processed in order to evaluate gene expression. Forty patients with CVD (10 men [25%], 30 women [75%], mean age 54.3 years [median 52 years, range 33-74 years]) were enrolled. Five patients without CVD (three men, two women [aged 61-73 years]) were enrolled as the control group. A significant increase of tissue expression of ERα, ERβ and GPER in patients with CVD was recorded (p < .01), which was also related to the severity of venous disease. ERs seem to play a role in CVD; in this study, the expression of ERs correlated with the severity of the disease, and their expression was correlated with the clinical stage. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Concentration variance decay during magma mixing: a volcanic chronometer.
Perugini, Diego; De Campos, Cristina P; Petrelli, Maurizio; Dingwell, Donald B
2015-09-21
The mixing of magmas is a common phenomenon in explosive eruptions. Concentration variance is a useful metric of this process and its decay (CVD) with time is an inevitable consequence during the progress of magma mixing. In order to calibrate this petrological/volcanological clock we have performed a time-series of high temperature experiments of magma mixing. The results of these experiments demonstrate that compositional variance decays exponentially with time. With this calibration the CVD rate (CVD-R) becomes a new geochronometer for the time lapse from initiation of mixing to eruption. The resultant novel technique is fully independent of the typically unknown advective history of mixing - a notorious uncertainty which plagues the application of many diffusional analyses of magmatic history. Using the calibrated CVD-R technique we have obtained mingling-to-eruption times for three explosive volcanic eruptions from Campi Flegrei (Italy) in the range of tens of minutes. These in turn imply ascent velocities of 5-8 meters per second. We anticipate the routine application of the CVD-R geochronometer to the eruptive products of active volcanoes in future in order to constrain typical "mixing to eruption" time lapses such that monitoring activities can be targeted at relevant timescales and signals during volcanic unrest.
The Burden of Cardiovascular Diseases Among US States, 1990-2016.
Roth, Gregory A; Johnson, Catherine O; Abate, Kalkidan Hassen; Abd-Allah, Foad; Ahmed, Muktar; Alam, Khurshid; Alam, Tahiya; Alvis-Guzman, Nelson; Ansari, Hossein; Ärnlöv, Johan; Atey, Tesfay Mehari; Awasthi, Ashish; Awoke, Tadesse; Barac, Aleksandra; Bärnighausen, Till; Bedi, Neeraj; Bennett, Derrick; Bensenor, Isabela; Biadgilign, Sibhatu; Castañeda-Orjuela, Carlos; Catalá-López, Ferrán; Davletov, Kairat; Dharmaratne, Samath; Ding, Eric L; Dubey, Manisha; Faraon, Emerito Jose Aquino; Farid, Talha; Farvid, Maryam S; Feigin, Valery; Fernandes, João; Frostad, Joseph; Gebru, Alemseged; Geleijnse, Johanna M; Gona, Philimon Nyakauru; Griswold, Max; Hailu, Gessessew Bugssa; Hankey, Graeme J; Hassen, Hamid Yimam; Havmoeller, Rasmus; Hay, Simon; Heckbert, Susan R; Irvine, Caleb Mackay Salpeter; James, Spencer Lewis; Jara, Dube; Kasaeian, Amir; Khan, Abdur Rahman; Khera, Sahil; Khoja, Abdullah T; Khubchandani, Jagdish; Kim, Daniel; Kolte, Dhaval; Lal, Dharmesh; Larsson, Anders; Linn, Shai; Lotufo, Paulo A; Magdy Abd El Razek, Hassan; Mazidi, Mohsen; Meier, Toni; Mendoza, Walter; Mensah, George A; Meretoja, Atte; Mezgebe, Haftay Berhane; Mirrakhimov, Erkin; Mohammed, Shafiu; Moran, Andrew Edward; Nguyen, Grant; Nguyen, Minh; Ong, Kanyin Liane; Owolabi, Mayowa; Pletcher, Martin; Pourmalek, Farshad; Purcell, Caroline A; Qorbani, Mostafa; Rahman, Mahfuzar; Rai, Rajesh Kumar; Ram, Usha; Reitsma, Marissa Bettay; Renzaho, Andre M N; Rios-Blancas, Maria Jesus; Safiri, Saeid; Salomon, Joshua A; Sartorius, Benn; Sepanlou, Sadaf Ghajarieh; Shaikh, Masood Ali; Silva, Diego; Stranges, Saverio; Tabarés-Seisdedos, Rafael; Tadele Atnafu, Niguse; Thakur, J S; Topor-Madry, Roman; Truelsen, Thomas; Tuzcu, E Murat; Tyrovolas, Stefanos; Ukwaja, Kingsley Nnanna; Vasankari, Tommi; Vlassov, Vasiliy; Vollset, Stein Emil; Wakayo, Tolassa; Weintraub, Robert; Wolfe, Charles; Workicho, Abdulhalik; Xu, Gelin; Yadgir, Simon; Yano, Yuichiro; Yip, Paul; Yonemoto, Naohiro; Younis, Mustafa; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zipkin, Ben; Afshin, Ashkan; Gakidou, Emmanuela; Lim, Stephen S; Mokdad, Ali H; Naghavi, Mohsen; Vos, Theo; Murray, Christopher J L
2018-04-11
Cardiovascular disease (CVD) is the leading cause of death in the United States, but regional variation within the United States is large. Comparable and consistent state-level measures of total CVD burden and risk factors have not been produced previously. To quantify and describe levels and trends of lost health due to CVD within the United States from 1990 to 2016 as well as risk factors driving these changes. Using the Global Burden of Disease methodology, cardiovascular disease mortality, nonfatal health outcomes, and associated risk factors were analyzed by age group, sex, and year from 1990 to 2016 for all residents in the United States using standardized approaches for data processing and statistical modeling. Burden of disease was estimated for 10 groupings of CVD, and comparative risk analysis was performed. Data were analyzed from August 2016 to July 2017. Residing in the United States. Cardiovascular disease disability-adjusted life-years (DALYs). Between 1990 and 2016, age-standardized CVD DALYs for all states decreased. Several states had large rises in their relative rank ordering for total CVD DALYs among states, including Arkansas, Oklahoma, Alabama, Kentucky, Missouri, Indiana, Kansas, Alaska, and Iowa. The rate of decline varied widely across states, and CVD burden increased for a small number of states in the most recent years. Cardiovascular disease DALYs remained twice as large among men compared with women. Ischemic heart disease was the leading cause of CVD DALYs in all states, but the second most common varied by state. Trends were driven by 12 groups of risk factors, with the largest attributable CVD burden due to dietary risk exposures followed by high systolic blood pressure, high body mass index, high total cholesterol level, high fasting plasma glucose level, tobacco smoking, and low levels of physical activity. Increases in risk-deleted CVD DALY rates between 2006 and 2016 in 16 states suggest additional unmeasured risks beyond these traditional factors. Large disparities in total burden of CVD persist between US states despite marked improvements in CVD burden. Differences in CVD burden are largely attributable to modifiable risk exposures.
Bakris, George; Vassalotti, Joseph; Ritz, Eberhard; Wanner, Christoph; Stergiou, George; Molitch, Mark; Nesto, Richard; Kaysen, George A; Sowers, James R
2010-10-01
Cardiovascular disease (CVD) is the most common cause of death in industrialized nations. Type 2 diabetes is a CVD risk factor that confers risk similar to a previous myocardial infarction in an individual who does not have diabetes. In addition, the most common cause of chronic kidney disease (CKD) is diabetes. Together, diabetes and hypertension account for more than two-thirds of CVD risk, and other risk factors such as dyslipidemia contribute to the remainder of CVD risk. CKD, particularly with presence of significant albuminuria, should be considered an additional cardiovascular risk factor. There is no consensus on how to assess and stratify risk for patients with kidney disease across subspecialties that commonly treat such patients. This paper summarizes the results of a consensus conference utilizing a patient case to discuss the integrated management of hypertension, kidney disease, dyslipidemia, diabetes, and heart failure across disciplines.
Type 2 Diabetes Mellitus and Cardiovascular Disease: Genetic and Epigenetic Links.
De Rosa, Salvatore; Arcidiacono, Biagio; Chiefari, Eusebio; Brunetti, Antonio; Indolfi, Ciro; Foti, Daniela P
2018-01-01
Type 2 diabetes mellitus (DM) is a common metabolic disorder predisposing to diabetic cardiomyopathy and atherosclerotic cardiovascular disease (CVD), which could lead to heart failure through a variety of mechanisms, including myocardial infarction and chronic pressure overload. Pathogenetic mechanisms, mainly linked to hyperglycemia and chronic sustained hyperinsulinemia, include changes in metabolic profiles, intracellular signaling pathways, energy production, redox status, increased susceptibility to ischemia, and extracellular matrix remodeling. The close relationship between type 2 DM and CVD has led to the common soil hypothesis, postulating that both conditions share common genetic and environmental factors influencing this association. However, although the common risk factors of both CVD and type 2 DM, such as obesity, insulin resistance, dyslipidemia, inflammation, and thrombophilia, can be identified in the majority of affected patients, less is known about how these factors influence both conditions, so that efforts are still needed for a more comprehensive understanding of this relationship. The genetic, epigenetic, and environmental backgrounds of both type 2 DM and CVD have been more recently studied and updated. However, the underlying pathogenetic mechanisms have seldom been investigated within the broader shared background, but rather studied in the specific context of type 2 DM or CVD, separately. As the precise pathophysiological links between type 2 DM and CVD are not entirely understood and many aspects still require elucidation, an integrated description of the genetic, epigenetic, and environmental influences involved in the concomitant development of both diseases is of paramount importance to shed new light on the interlinks between type 2 DM and CVD. This review addresses the current knowledge of overlapping genetic and epigenetic aspects in type 2 DM and CVD, including microRNAs and long non-coding RNAs, whose abnormal regulation has been implicated in both disease conditions, either etiologically or as cause for their progression. Understanding the links between these disorders may help to drive future research toward an integrated pathophysiological approach and to provide future directions in the field.
Shared Risk Factors in Cardiovascular Disease and Cancer.
Koene, Ryan J; Prizment, Anna E; Blaes, Anne; Konety, Suma H
2016-03-15
Cardiovascular disease (CVD) and cancer are the 2 leading causes of death worldwide. Although commonly thought of as 2 separate disease entities, CVD and cancer possess various similarities and possible interactions, including a number of similar risk factors (eg, obesity, diabetes mellitus), suggesting a shared biology for which there is emerging evidence. Although chronic inflammation is an indispensable feature of the pathogenesis and progression of both CVD and cancer, additional mechanisms can be found at their intersection. Therapeutic advances, despite improving longevity, have increased the overlap between these diseases, with millions of cancer survivors now at risk of developing CVD. Cardiac risk factors have a major impact on subsequent treatment-related cardiotoxicity. In this review, we explore the risk factors common to both CVD and cancer, highlighting the major epidemiological studies and potential biological mechanisms that account for them. © 2016 American Heart Association, Inc.
Concentration variance decay during magma mixing: a volcanic chronometer
Perugini, Diego; De Campos, Cristina P.; Petrelli, Maurizio; Dingwell, Donald B.
2015-01-01
The mixing of magmas is a common phenomenon in explosive eruptions. Concentration variance is a useful metric of this process and its decay (CVD) with time is an inevitable consequence during the progress of magma mixing. In order to calibrate this petrological/volcanological clock we have performed a time-series of high temperature experiments of magma mixing. The results of these experiments demonstrate that compositional variance decays exponentially with time. With this calibration the CVD rate (CVD-R) becomes a new geochronometer for the time lapse from initiation of mixing to eruption. The resultant novel technique is fully independent of the typically unknown advective history of mixing – a notorious uncertainty which plagues the application of many diffusional analyses of magmatic history. Using the calibrated CVD-R technique we have obtained mingling-to-eruption times for three explosive volcanic eruptions from Campi Flegrei (Italy) in the range of tens of minutes. These in turn imply ascent velocities of 5-8 meters per second. We anticipate the routine application of the CVD-R geochronometer to the eruptive products of active volcanoes in future in order to constrain typical “mixing to eruption” time lapses such that monitoring activities can be targeted at relevant timescales and signals during volcanic unrest. PMID:26387555
Universal Design: Supporting Students with Color Vision Deficiency (CVD) in Medical Education
ERIC Educational Resources Information Center
Meeks, Lisa M.; Jain, Neera R.; Herzer, Kurt R.
2016-01-01
Color Vision Deficiency (CVD) is a commonly occurring condition in the general population. For medical students, it has the potential to create unique challenges in the classroom and clinical environments. Few studies have provided medical educators with comprehensive recommendations to assist students with CVD. This article presents a focused…
Risk factors for cardiovascular disease in subclinical hypothyroidism.
Decandia, F
2018-02-01
Subclinical hypothyroidism (SH), defined as an increased serum thyrotropin (TSH) level and normal plasma-free thyroid hormones' concentrations, is common in the general population, in particular, among elderly women. Its prevalence ranges from 4 to 15% and up to 20% among females aged > 60 year. Although SH has been associated with atherosclerotic cardiovascular disease (CVD), it is acknowledged that the high prevalence of dyslipidemia in elderly people is considered a common biochemical condition. Therefore, whether SH is associated with a higher risk for CVD is still controversial. At the moment, no consensus exists on the clinical significance and treatment of the mild form of thyroid failure, although available data suggest that only patients with plasma TSH levels above 10 mU/L may have an increased risk of CVD. However, treatment of SH in older individual requires special consideration with regard to thyroid hormone replacement therapy and expected clinical outcomes, since the increase of TSH observed in this population may represent a physiological process. It is likely that age affects TSH levels, and some studies suggest that modified reference limits for elderly populations should be considered in the diagnosis of mild thyroid failure.
Depression and cardiovascular disease: a clinical review.
Hare, David L; Toukhsati, Samia R; Johansson, Peter; Jaarsma, Tiny
2014-06-01
Cardiovascular disease (CVD) and depression are common. Patients with CVD have more depression than the general population. Persons with depression are more likely to eventually develop CVD and also have a higher mortality rate than the general population. Patients with CVD, who are also depressed, have a worse outcome than those patients who are not depressed. There is a graded relationship: the more severe the depression, the higher the subsequent risk of mortality and other cardiovascular events. It is possible that depression is only a marker for more severe CVD which so far cannot be detected using our currently available investigations. However, given the increased prevalence of depression in patients with CVD, a causal relationship with either CVD causing more depression or depression causing more CVD and a worse prognosis for CVD is probable. There are many possible pathogenetic mechanisms that have been described, which are plausible and that might well be important. However, whether or not there is a causal relationship, depression is the main driver of quality of life and requires prevention, detection, and management in its own right. Depression after an acute cardiac event is commonly an adjustment disorder than can improve spontaneously with comprehensive cardiac management. Additional management strategies for depressed cardiac patients include cardiac rehabilitation and exercise programmes, general support, cognitive behavioural therapy, antidepressant medication, combined approaches, and probably disease management programmes. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email: journals.permissions@oup.com.
CVD Polymers for Devices and Device Fabrication.
Wang, Minghui; Wang, Xiaoxue; Moni, Priya; Liu, Andong; Kim, Do Han; Jo, Won Jun; Sojoudi, Hossein; Gleason, Karen K
2017-03-01
Chemical vapor deposition (CVD) polymerization directly synthesizes organic thin films on a substrate from vapor phase reactants. Dielectric, semiconducting, electrically conducting, and ionically conducting CVD polymers have all been readily integrated into devices. The absence of solvent in the CVD process enables the growth of high-purity layers and avoids the potential of dewetting phenomena, which lead to pinhole defects. By limiting contaminants and defects, ultrathin (<10 nm) CVD polymeric device layers have been fabricated in multiple laboratories. The CVD method is particularly suitable for synthesizing insoluble conductive polymers, layers with high densities of organic functional groups, and robust crosslinked networks. Additionally, CVD polymers are prized for the ability to conformally cover rough surfaces, like those of paper and textile substrates, as well as the complex geometries of micro- and nanostructured devices. By employing low processing temperatures, CVD polymerization avoids damaging substrates and underlying device layers. This report discusses the mechanisms of the major CVD polymerization techniques and the recent progress of their applications in devices and device fabrication, with emphasis on initiated CVD (iCVD) and oxidative CVD (oCVD) polymerization. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Lorenz, Matthias W; Gao, Lu; Ziegelbauer, Kathrin; Norata, Giuseppe Danilo; Empana, Jean Philippe; Schmidtmann, Irene; Lin, Hung-Ju; McLachlan, Stela; Bokemark, Lena; Ronkainen, Kimmo; Amato, Mauro; Schminke, Ulf; Srinivasan, Sathanur R; Lind, Lars; Okazaki, Shuhei; Stehouwer, Coen D A; Willeit, Peter; Polak, Joseph F; Steinmetz, Helmuth; Sander, Dirk; Poppert, Holger; Desvarieux, Moise; Ikram, M Arfan; Johnsen, Stein Harald; Staub, Daniel; Sirtori, Cesare R; Iglseder, Bernhard; Beloqui, Oscar; Engström, Gunnar; Friera, Alfonso; Rozza, Francesco; Xie, Wuxiang; Parraga, Grace; Grigore, Liliana; Plichart, Matthieu; Blankenberg, Stefan; Su, Ta-Chen; Schmidt, Caroline; Tuomainen, Tomi-Pekka; Veglia, Fabrizio; Völzke, Henry; Nijpels, Giel; Willeit, Johann; Sacco, Ralph L; Franco, Oscar H; Uthoff, Heiko; Hedblad, Bo; Suarez, Carmen; Izzo, Raffaele; Zhao, Dong; Wannarong, Thapat; Catapano, Alberico; Ducimetiere, Pierre; Espinola-Klein, Christine; Chien, Kuo-Liong; Price, Jackie F; Bergström, Göran; Kauhanen, Jussi; Tremoli, Elena; Dörr, Marcus; Berenson, Gerald; Kitagawa, Kazuo; Dekker, Jacqueline M; Kiechl, Stefan; Sitzer, Matthias; Bickel, Horst; Rundek, Tatjana; Hofman, Albert; Mathiesen, Ellisiv B; Castelnuovo, Samuela; Landecho, Manuel F; Rosvall, Maria; Gabriel, Rafael; de Luca, Nicola; Liu, Jing; Baldassarre, Damiano; Kavousi, Maryam; de Groot, Eric; Bots, Michiel L; Yanez, David N; Thompson, Simon G
2018-01-01
Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk. From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C. We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.
Women and heart disease: the role of diabetes and hyperglycemia.
Barrett-Connor, Elizabeth; Giardina, Elsa-Grace V; Gitt, Anselm K; Gudat, Uwe; Steinberg, Helmut O; Tschoepe, Diethelm
2004-05-10
Cardiovascular disease (CVD) is the primary cause of death in women, and women with type 2 diabetes mellitus are at greater risk of CVD compared with nondiabetic women. The increment in risk attributable to diabetes is greater in women than in men. The extent to which hyperglycemia contributes to heart disease risk has been examined in observational studies and clinical trials, although most included only men or did not analyze sex differences. The probable adverse influence of hyperglycemia is potentially mediated by impaired endothelial function, and/or by other mechanisms. Beyond high blood glucose level, a number of other common risk factors for CVD, including hypertension, dyslipidemia, and cigarette smoking, are seen in women with diabetes and require special attention. Presentation and diagnosis of CVD may differ between women and men, regardless of the presence of diabetes. Recognizing the potential for atypical presentation of CVD in women and the limitations of common diagnostic tools are important in preventing unnecessary delay in initiating proper treatment. Based on what we know today, treatment of CVD should be at least as aggressive in women-and especially in those with diabetes-as it is in men. Future trials should generate specific data on CVD in women, either by design of female-only studies or by subgroup analysis by sex.
Price, Hermione C; Dudley, Christina; Barrow, Beryl; Kennedy, Ian; Griffin, Simon J; Holman, Rury R
2009-10-01
People need to perceive a risk in order to build an intention-to-change behaviour yet our ability to interpret information about risk is highly variable. We aimed to use a user-centred design process to develop an animated interface for the UK Prospective Diabetes Study (UKPDS) Risk Engine to illustrate cardiovascular disease (CVD) risk and the potential to reduce this risk. In addition, we sought to use the same approach to develop a brief lifestyle advice intervention. Three focus groups were held. Participants were provided with examples of materials used to communicate CVD risk and a leaflet containing a draft brief lifestyle advice intervention and considered their potential to increase motivation-to-change behaviours including diet, physical activity, and smoking in order to reduce CVD risk. Discussions were tape-recorded, transcribed and coded and recurring themes sought. Sixty-two percent of participants were male, mean age was 66 years (range = 47-76 years) and median age at leaving full-time education was 18 years (range = 15-40 years). Sixteen had type 2 diabetes and none had a prior history of CVD. Recurring themes from focus group discussions included the following: being less numerate is common, CVD risk reduction is important and a clear visual representation aids comprehension. A simple animated interface of the UKPDS Risk Engine to illustrate CVD risk and the potential for reducing this risk has been developed for use as a motivational tool, along with a brief lifestyle advice intervention. Future work will investigate whether use of this interactive version of the UKPDS Risk Engine and brief lifestyle advice is associated with increased behavioural intentions and changes in health behaviours designed to reduce CVD risk.
Wells, Sue; Rafter, Natasha; Kenealy, Timothy; Herd, Geoff; Eggleton, Kyle; Lightfoot, Rose; Arcus, Kim; Wadham, Angela; Jiang, Yannan; Bullen, Chris
2017-01-01
To assess the effect of a point of care (POC) device for testing lipids and HbA1c in addition to testing by community laboratory facilities (usual practice) on the completion of cardiovascular disease (CVD) risk assessments in general practice. We conducted a pragmatic, cluster randomised controlled trial in 20 New Zealand general practices stratified by size and rurality and randomised to POC device plus usual practice or usual practice alone (controls). Patients aged 35-79 years were eligible if they met national guideline criteria for CVD risk assessment. Data on CVD risk assessments were aggregated using a web-based decision support programme common to each practice. Data entered into the on-line CVD risk assessment form could be saved pending blood test results. The primary outcome was the proportion of completed CVD risk assessments. Qualitative data on practice processes for CVD risk assessment and feasibility of POC testing were collected at the end of the study by interviews and questionnaire. The POC testing was supported by a comprehensive quality assurance programme. A CVD risk assessment entry was recorded for 7421 patients in 10 POC practices and 6217 patients in 10 control practices; 99.5% of CVD risk assessments had complete data in both groups (adjusted odds ratio 1.02 [95%CI 0.61-1.69]). There were major external influences that affected the trial: including a national performance target for CVD risk assessment and changes to CVD guidelines. All practices had invested in systems and dedicated staff time to identify and follow up patients to completion. However, the POC device was viewed by most as an additional tool rather than as an opportunity to review practice work flow and leverage the immediate test results for patient education and CVD risk management discussions. Shortly after commencement, the trial was halted due to a change in the HbA1c test assay performance. The trial restarted after the manufacturing issue was rectified but this affected the end use of the device. Performance incentives and external influences were more powerful modifiers of practice behaviours than the POC device in relation to CVD risk assessment completion. The promise of combining risk assessment, communication and management within one consultation was not realised. With shifts in policy focus, the utility of POC devices for patient engagement in CVD preventive care may be demonstrated if fully integrated into the clinical setting. Australian New Zealand Clinical Trials Registry ACTRN12613000607774.
Dimensionless Numbers Expressed in Terms of Common CVD Process Parameters
NASA Technical Reports Server (NTRS)
Kuczmarski, Maria A.
1999-01-01
A variety of dimensionless numbers related to momentum and heat transfer are useful in Chemical Vapor Deposition (CVD) analysis. These numbers are not traditionally calculated by directly using reactor operating parameters, such as temperature and pressure. In this paper, these numbers have been expressed in a form that explicitly shows their dependence upon the carrier gas, reactor geometry, and reactor operation conditions. These expressions were derived for both monatomic and diatomic gases using estimation techniques for viscosity, thermal conductivity, and heat capacity. Values calculated from these expressions compared well to previously published values. These expressions provide a relatively quick method for predicting changes in the flow patterns resulting from changes in the reactor operating conditions.
Public knowledge of cardiovascular disease and its risk factors in Kuwait: a cross-sectional survey.
Awad, Abdelmoneim; Al-Nafisi, Hala
2014-11-04
Cardiovascular disease (CVD) is estimated to cause 46% of all mortalities in Kuwait. To design effective primary and secondary prevention programs, an assessment of a population's prior CVD knowledge is of paramount importance. There is scarcity of data on the existing CVD knowledge among the general Kuwaiti population. Hence, this study was performed to assess the level of knowledge towards CVD types, warning symptoms of heart attack or stroke, and CVD risk factors. It also explored public views on the community pharmacists' role in CVD prevention and management. A descriptive cross-sectional survey was performed using a pretested self-administered questionnaire on a sample of 900 randomly selected Kuwaiti individuals. Descriptive and multivariate logistic regression analysis were used in data analysis. The response rate was 90.7%. Respondents' knowledge about types of CVD, heart attack or stroke symptoms was low. Almost 60% of respondents did not know any type of CVD, and coronary heart disease was the commonest identified type (29.0%). Two-fifths of participants were not aware of any heart attack symptoms, and the most commonly known were chest pain (50.4%) and shortness of breath (48.0%). Approximately half of respondents did not recognize any stroke symptoms, and the most commonly recognized were 'confusion or trouble speaking' (36.4%) and 'numbness or weakness' (34.7%). Respondents' knowledge regarding CVD risk factors was moderate. The commonest factors identified by over four-fifths of participants were smoking, obesity, unhealthy diet and physical inactivity. In the multivariate logistic regression analysis, independent predictors of better level of CVD knowledge were females, age 50-59 years, high level of education, regular eating of healthy diet, and had a family history of CVD. Most of respondents only identified the role that pharmacists had to play is to help patients manage their medications, with a minimal role in other aspects of CVD prevention and management. There are deficiencies in CVD knowledge among Kuwaiti population, which could turn into insufficient preventative behaviours and suboptimal patient outcomes. There is an apparent need to establish more wide-spread and effective educational interventions, which should be sensitive to the perceptions, attitudes, and abilities of targeted individuals.
Deposition and micro electrical discharge machining of CVD-diamond layers incorporated with silicon
NASA Astrophysics Data System (ADS)
Kühn, R.; Berger, T.; Prieske, M.; Börner, R.; Hackert-Oschätzchen, M.; Zeidler, H.; Schubert, A.
2017-10-01
In metal forming, lubricants have to be used to prevent corrosion or to reduce friction and tool wear. From an economical and ecological point of view, the aim is to avoid the usage of lubricants. For dry deep drawing of aluminum sheets it is intended to apply locally micro-structured wear-resistant carbon based coatings onto steel tools. One type of these coatings are diamond layers prepared by chemical vapor deposition (CVD). Due to the high strength of diamond, milling processes are unsuitable for micro-structuring of these layers. In contrast to this, micro electrical discharge machining (micro EDM) is a suitable process for micro-structuring CVD-diamond layers. Due to its non-contact nature and its process principle of ablating material by melting and evaporating, it is independent of the hardness, brittleness or toughness of the workpiece material. In this study the deposition and micro electrical discharge machining of silicon incorporated CVD-diamond (Si-CVD-diamond) layers were presented. For this, 10 µm thick layers were deposited on molybdenum plates by a laser-induced plasma CVD process (LaPlas-CVD). For the characterization of the coatings RAMAN- and EDX-analyses were conducted. Experiments in EDM were carried out with a tungsten carbide tool electrode with a diameter of 90 µm to investigate the micro-structuring of Si-CVD-diamond. The impact of voltage, discharge energy and tool polarity on process speed and resulting erosion geometry were analyzed. The results show that micro EDM is a suitable technology for micro-structuring of silicon incorporated CVD-diamond layers.
Al-Serri, Ahmad; Ismael, Fatma G; Al-Bustan, Suzanne A; Al-Rashdan, Ibrahim
2015-12-01
The D allele of the common angiotensin-converting enzyme (ACE) I/D gene polymorphism (rs4646994) predisposes to type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). However, results on which allele predisposes to disease susceptibility remain controversial in Asian populations. This study was performed to evaluate the association of the common ACE I/D gene polymorphism with both T2DM and CVD susceptibility in an Arab population. We genotyped the ACE I/D polymorphisms by direct allele-specific PCR in 183 healthy controls and 400 CVD patients with diabetes (n=204) and without (n=196). Statistical analysis comparing between the different groups were conducted using R statistic package "SNPassoc". Two genetic models were used: the additive and co-dominant models. The I allele was found to be associated with T2DM (OR=1.84, p=0.00009) after adjusting for age, sex and body mass index. However, there was no association with CVD susceptibility (p>0.05). The ACE I allele is found to be associated with T2DM; however, no association was observed with CVD. The inconsistency between studies is suggested to be attributed to genetic diversity due to the existence of sub-populations found in Asian populations. © The Author(s) 2015.
Hamer, Mark; Batty, G David; Stamatakis, Emmanuel; Kivimaki, Mika
2010-12-01
Common mental disorders, such as anxiety and depression, are risk factors for mortality among cardiac patients, although this topic has gained little attention in individuals with hypertension. We examined the combined effects of hypertension and common mental disorder on mortality in participants with both treated and untreated hypertension. In a representative, prospective study of 31 495 adults (aged 52.5 ± 12.5 years, 45.7% men) we measured baseline levels of common mental disorder using the 12-item General Health Questionnaire (GHQ-12) and collected data on blood pressure, history of hypertension diagnosis, and medication use. High blood pressure (systolic/diastolic >140/90 mmHg) in study members with an existing diagnosis of hypertension indicated uncontrolled hypertension and, in undiagnosed individuals, untreated hypertension. There were 3200 deaths from all causes [943 cardiovascular disease (CVD)] over 8.4 years follow-up. As expected, the risk of CVD was elevated in participants with controlled [multivariate hazard ratio = 1.63, 95% confidence interval (CI) 1.26-2.12] and uncontrolled (multivariate hazard ratio = 1.57, 95% CI 1.08-2.27) hypertension compared with normotensive participants. Common mental disorder (GHQ-12 score of ≥4) was also associated with CVD death (multivariate hazard ratio = 1.60, 95% CI 1.35-1.90). The risk of CVD death was highest in participants with both diagnosed hypertension and common mental disorder, especially in study members with controlled (multivariate hazard ratio = 2.32, 95% CI 1.70-3.17) hypertension but also in uncontrolled hypertension (multivariate hazard ratio = 1.90, 95% CI 1.18-3.05). The combined effect of common mental disorder was also apparent in participants with undiagnosed (untreated) hypertension, especially for all-cause mortality. These findings suggest that the association of hypertension with total and CVD mortality is stronger when combined with common mental disorder.
Ageing, metabolism and cardiovascular disease.
Costantino, Sarah; Paneni, Francesco; Cosentino, Francesco
2016-04-15
Age is one of the major risk factors associated with cardiovascular disease (CVD). About one-fifth of the world population will be aged 65 or older by 2030, with an exponential increase in CVD prevalence. It is well established that environmental factors (overnutrition, smoking, pollution, sedentary lifestyles) may lead to premature defects in mitochondrial functionality, insulin signalling, endothelial homeostasis and redox balance, fostering early senescent features. Over the last few years, molecular investigations have unveiled common signalling networks which may link the ageing process with deterioration of cardiovascular homeostasis and metabolic disturbances, namely insulin resistance. These different processes seem to be highly interconnected and their interplay may favour adverse vascular and cardiac phenotypes responsible for myocardial infarction, stroke and heart failure. In the present review, we carefully describe novel molecular cues underpinning ageing, metabolism and CVD. In particular, we describe a dynamic interplay between emerging pathways such as FOXOs, AMPK, SIRT1, p66(Shc) , JunD and NF-kB. This overview will provide the background for attractive molecular targets to prevent age-driven pathology in the vasculature and the heart. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.
Maas, Angela H E M; Leiner, Tim
2016-04-01
Cardiovascular diseases (CVD) have a large variety of clinical manifestations with multiple medical professionals involved. The focus of clinical endpoint trials has often been restricted to limited vascular territories, ignoring many other common manifestations of CVD. In addition, the lack of sex and gender- awareness among healthcare professionals has contributed to the underestimation of CVD risk in especially younger women. We plead for a more multidisciplinary and life-course approach to CVD risk assessment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Bartels, Christie M; Roberts, Tonya J; Hansen, Karen E; Jacobs, Elizabeth A; Gilmore, Andrea; Maxcy, Courtney; Bowers, Barbara J
2016-04-01
Despite increased cardiovascular disease (CVD) risk, rheumatoid arthritis (RA) patients often lack CVD preventive care. We examined CVD preventive care processes from RA patient and provider perspectives to develop a process map for identifying targets for future interventions to improve CVD preventive care. Thirty-one participants (15 patients, 7 rheumatologists, and 9 primary care physicians [PCPs]) participated in interviews that were coded using NVivo software and analyzed using grounded theory techniques. Patients and providers reported that receipt of preventive care depends upon identifying and acting on risk factors, although most noted that both processes rarely occurred. Engagement in these processes was influenced by various provider-, system-, visit-, and patient-related conditions, such as patient activation or patients' knowledge about their risk. While nearly half of patients and PCPs were unaware of RA-CVD risk, all rheumatologists were aware of risk. Rheumatologists reported not systematically identifying risk factors, or, if identified, they described communicating about CVD risk factors via clinic notes to PCPs instead of acting directly due to perceived role boundaries. PCPs suggested that scheduling PCP visits could improve CVD risk management, and all participants viewed comanagement positively. Findings from this study illustrate important gaps and opportunities to support identifying and acting on CVD risk factors in RA patients from the provider, system, visit, and patient levels. Future work should investigate professional role support through improved guidelines, patient activation, and system-based RA-CVD preventive care strategies. © 2016, American College of Rheumatology.
Chemical vapor deposition growth
NASA Technical Reports Server (NTRS)
Ruth, R. P.; Manasevit, H. M.; Campbell, A. G.; Johnson, R. E.; Kenty, J. L.; Moudy, L. A.; Shaw, G. L.; Simpson, W. I.; Yang, J. J.
1978-01-01
The objective was to investigate and develop chemical vapor deposition (CVD) techniques for the growth of large areas of Si sheet on inexpensive substrate materials, with resulting sheet properties suitable for fabricating solar cells that would meet the technical goals of the Low Cost Silicon Solar Array Project. The program involved six main technical tasks: (1) modification and test of an existing vertical-chamber CVD reactor system; (2) identification and/or development of suitable inexpensive substrate materials; (3) experimental investigation of CVD process parameters using various candidate substrate materials; (4) preparation of Si sheet samples for various special studies, including solar cell fabrication; (5) evaluation of the properties of the Si sheet material produced by the CVD process; and (6) fabrication and evaluation of experimental solar cell structures, using impurity diffusion and other standard and near-standard processing techniques supplemented late in the program by the in situ CVD growth of n(+)/p/p(+) sheet structures subsequently processed into experimental cells.
Chemical vapor deposition growth
NASA Technical Reports Server (NTRS)
Ruth, R. P.; Manasevit, H. M.; Kenty, J. L.; Moudy, L. A.; Simpson, W. I.; Yang, J. J.
1976-01-01
The chemical vapor deposition (CVD) method for the growth of Si sheet on inexpensive substrate materials is investigated. The objective is to develop CVD techniques for producing large areas of Si sheet on inexpensive substrate materials, with sheet properties suitable for fabricating solar cells meeting the technical goals of the Low Cost Silicon Solar Array Project. Specific areas covered include: (1) modification and test of existing CVD reactor system; (2) identification and/or development of suitable inexpensive substrate materials; (3) experimental investigation of CVD process parameters using various candidate substrate materials; (4) preparation of Si sheet samples for various special studies, including solar cell fabrication; (5) evaluation of the properties of the Si sheet material produced by the CVD process; and (6) fabrication and evaluation of experimental solar cell structures, using standard and near-standard processing techniques.
Chemical vapor deposition modeling for high temperature materials
NASA Technical Reports Server (NTRS)
Gokoglu, Suleyman A.
1992-01-01
The formalism for the accurate modeling of chemical vapor deposition (CVD) processes has matured based on the well established principles of transport phenomena and chemical kinetics in the gas phase and on surfaces. The utility and limitations of such models are discussed in practical applications for high temperature structural materials. Attention is drawn to the complexities and uncertainties in chemical kinetics. Traditional approaches based on only equilibrium thermochemistry and/or transport phenomena are defended as useful tools, within their validity, for engineering purposes. The role of modeling is discussed within the context of establishing the link between CVD process parameters and material microstructures/properties. It is argued that CVD modeling is an essential part of designing CVD equipment and controlling/optimizing CVD processes for the production and/or coating of high performance structural materials.
Surface structuring of boron doped CVD diamond by micro electrical discharge machining
NASA Astrophysics Data System (ADS)
Schubert, A.; Berger, T.; Martin, A.; Hackert-Oschätzchen, M.; Treffkorn, N.; Kühn, R.
2018-05-01
Boron doped diamond materials, which are generated by Chemical Vapor Deposition (CVD), offer a great potential for the application on highly stressed tools, e. g. in cutting or forming processes. As a result of the CVD process rough surfaces arise, which require a finishing treatment in particular for the application in forming tools. Cutting techniques such as milling and grinding are hardly applicable for the finish machining because of the high strength of diamond. Due to its process principle of ablating material by melting and evaporating, Electrical Discharge Machining (EDM) is independent of hardness, brittleness or toughness of the workpiece material. EDM is a suitable technology for machining and structuring CVD diamond, since boron doped CVD diamond is electrically conductive. In this study the ablation characteristics of boron doped CVD diamond by micro electrical discharge machining are investigated. Experiments were carried out to investigate the influence of different process parameters on the machining result. The impact of tool-polarity, voltage and discharge energy on the resulting erosion geometry and the tool wear was analyzed. A variation in path overlapping during the erosion of planar areas leads to different microstructures. The results show that micro EDM is a suitable technology for finishing of boron doped CVD diamond.
Cardiovascular disease and cognitive function in maintenance hemodialysis patients
USDA-ARS?s Scientific Manuscript database
Cardiovascular disease (CVD) and cognitive impairment are common in dialysis patients. Given the proposed role of microvascular disease on cognitive function, particularly cognitive domains that incorporate executive functions, we hypothesized that prevalent systemic CVD would be associated with wor...
Anxiety sensitivity in smokers with indicators of cardiovascular disease.
Farris, Samantha G; Abrantes, Ana M
2017-09-01
There is growing recognition of the importance of understanding the nature of the associations between anxiety and cardiovascular disease (CVD), although limited research has examined mechanisms that may explain the anxiety-CVD link. Anxiety sensitivity (fear of anxiety-relevant somatic sensations) is a cognitive-affective risk factor implicated in the development of anxiety psychopathology and various behavioral risk factors for CVD, although has not been examined among individuals with CVD. Adult daily smokers (n = 619; 50.9% female; M age = 44.0, SD = 13.67) completed an online survey that included the Anxiety Sensitivity Index-3 (ASI-3) and the Patient Health Questionnaire (PHQ). The presence of CVD was assessed via the presence of ≥1 of the following: heart attack, heart murmur, positive stress test, heart valve abnormality, angina, and heart failure. Smokers with CVD indicators (n = 66, 10.7%) had significantly higher scores on the ASI-3 (M = 33.5, SD = 22.15), relative to smokers without CVD (M = 22.0, SD = 17.92; Cohen's d = .57). Those with CVD were significantly more likely to have moderate or high anxiety sensitivity (66.7%) relative to those without CVD (49.4%). Physical and social concerns about the meaning of somatic sensations were common among smokers with CVD.
Advanced methods for processing ceramics
DOE Office of Scientific and Technical Information (OSTI.GOV)
Carter, W.B.
1997-04-01
Combustion chemical vapor deposition (combustion CVD) is being developed for the deposition of high temperature oxide coatings. The process is being evaluated as an alternative to more capital intensive conventional coating processes. The thrusts during this reporting period were the development of the combustion CVD process for depositing lanthanum monazite, the determination of the influence of aerosol size on coating morphology, the incorporation of combustion CVD coatings into thermal barrier coatings (TBCs) and related oxidation research, and continued work on the deposition of zirconia-yttria coatings.
Fent, Graham J; Greenwood, John P; Plein, Sven; Buch, Maya H
2017-07-01
This review assesses the risk assessment of cardiovascular disease (CVD) in rheumatoid arthritis (RA) and how non-invasive imaging modalities may improve risk stratification in future. RA is common and patients are at greater risk of CVD than the general population. Cardiovascular (CV) risk stratification is recommended in European guidelines for patients at high and very high CV risk in order to commence preventative therapy. Ideally, such an assessment should be carried out immediately after diagnosis and as part of ongoing long-term patient care in order to improve patient outcomes. The risk profile in RA is different from the general population and is not well estimated using conventional clinical CVD risk algorithms, particularly in patients estimated as intermediate CVD risk. Non-invasive imaging techniques may therefore play an important role in improving risk assessment. However, there are currently very limited prognostic data specific to patients with RA to guide clinicians in risk stratification using these imaging techniques. RA is associated with increased risk of CV mortality, mainly attributable to atherosclerotic disease, though in addition, RA is associated with many other disease processes which further contribute to increased CV mortality. There is reasonable evidence for using carotid ultrasound in patients estimated to be at intermediate risk of CV mortality using clinical CVD risk algorithms. Newer imaging techniques such as cardiovascular magnetic resonance and CT offer the potential to improve risk stratification further; however, longitudinal data with hard CVD outcomes are currently lacking. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Increased oxidative stress and compromised antioxidant status are common pathologic factors of cardiovascular diseases (CVD). It is hypothesized that individuals with chronic CVD are more susceptible to environmental exposures due to underlying oxidative stress. To determine the ...
Oresko, Joseph J; Duschl, Heather; Cheng, Allen C
2010-05-01
Cardiovascular disease (CVD) is the single leading cause of global mortality and is projected to remain so. Cardiac arrhythmia is a very common type of CVD and may indicate an increased risk of stroke or sudden cardiac death. The ECG is the most widely adopted clinical tool to diagnose and assess the risk of arrhythmia. ECGs measure and display the electrical activity of the heart from the body surface. During patients' hospital visits, however, arrhythmias may not be detected on standard resting ECG machines, since the condition may not be present at that moment in time. While Holter-based portable monitoring solutions offer 24-48 h ECG recording, they lack the capability of providing any real-time feedback for the thousands of heart beats they record, which must be tediously analyzed offline. In this paper, we seek to unite the portability of Holter monitors and the real-time processing capability of state-of-the-art resting ECG machines to provide an assistive diagnosis solution using smartphones. Specifically, we developed two smartphone-based wearable CVD-detection platforms capable of performing real-time ECG acquisition and display, feature extraction, and beat classification. Furthermore, the same statistical summaries available on resting ECG machines are provided.
Jones, Katherine M; Carter, Michele M; Schulkin, Jay
2015-06-01
African American and Hispanic women are disproportionately affected by cardiovascular disease (CVD) and its many risk factors. Obstetrician-gynecologists (OB/GYNs) play an integral role in well-woman care and have a unique opportunity to provide CVD counseling and screening to these at-risk and underserved groups. To assess whether OB/GYN race/ethnicity and OB/GYN practices with increasing minority patient populations predicted differences in OB/GYNs' knowledge, attitudes, and practice patterns relevant to racial/ethnic disparities in CVD. This study also sought to determine provider and patient-related barriers to CVD care. A questionnaire on CVD was mailed to 273 members of The American College of Obstetricians and Gynecologists in March-July 2013. African American and Hispanic OB/GYNs and OB/GYN practices with increasing minority patient populations were more knowledgeable of CVD disparities. These OB/GYNs reported greater concern for minority women's CVD risk relative to White OB/GYNs. Overall, OB/GYNs appear less knowledgeable and concerned with Hispanics' increased CVD risk relative to African Americans'. The most commonly reported provider and patient-related barriers to CVD care were time constraints, patient nonadherence to treatment recommendations, and inadequate training. It is likely that minority OB/GYNs and those with practices with increasing minority patient populations have greater exposure to women at risk for CVD. Dissemination of educational information regarding Hispanic women's CVD risk profile may improve OB/GYN knowledge, counseling, and screening. Increased training in CVD and multicultural competency during medical school and residency should help OB/GYNs overcome what they report as primary barriers to CVD care.
Automatic chemical vapor deposition
NASA Technical Reports Server (NTRS)
Kennedy, B. W.
1981-01-01
Report reviews chemical vapor deposition (CVD) for processing integrated circuits and describes fully automatic machine for CVD. CVD proceeds at relatively low temperature, allows wide choice of film compositions (including graded or abruptly changing compositions), and deposits uniform films of controllable thickness at fairly high growth rate. Report gives overview of hardware, reactants, and temperature ranges used with CVD machine.
Young, Lufei; Montgomery, Melody; Barnason, Sue; Schmidt, Cindy; Do, Van
2015-08-01
Rural residents diagnosed with cardiovascular disease (CVD) or with CVD-related risks are underrepresented in behavioral intervention trials based on an extensive review of published studies. The low participation rate of rural residents weakens both the internal and external validity of published studies. Moreover, compared to urban residents, limited research exists to describe the unique barriers that limit the participation of rural residents in behavioral intervention trials. The purpose of this review is to identify a conceptual framework (CF) underpinning common barriers faced by rural CVD patients to enroll in behavioral intervention trials. We conducted a literature review using several electronic databases to obtain a representative sample of research articles, synthesized the evidence, and developed a CF to explain the barriers that may affect the research participation rate of rural residents with CVD or related risks. We found our evidence-based CF well explained the barriers for rural CVD patients to take part in behavioral intervention trials. Besides contextual factors (i.e. patient, community and research levels), other common factors impacting rural patients' intent to enroll are lack of awareness and understanding about behavioral trials, limited support from their healthcare providers and social circles, unfavorable attitudes, and the lack of opportunity to participating research. The findings demonstrate the evidence-based model consisting of interlinked multi-level factors may help our understanding of the barriers encountered by rural CVD patients participating interventions to promote behavioral change. The implication for researchers is that identifying and developing strategies to overcome the barriers precedes conducting studies in rural communities.
The CRDS method application for study of the gas-phase processes in the hot CVD diamond thin film.
NASA Astrophysics Data System (ADS)
Buzaianumakarov, Vladimir; Hidalgo, Arturo; Morell, Gerardo; Weiner, Brad; Buzaianu, Madalina
2006-03-01
For detailed analysis of problem related to the hot CVD carbon-containing nano-material growing, we have to detect different intermediate species forming during the growing process as well as investigate dependences of concentrations of these species on different experimental parameters (concentrations of the CJH4, H2S stable chemical compounds and distance from the filament system to the substrate surface). In the present study, the HS and CS radicals were detected using the Cavity Ring Down Spectroscopic (CRDS) method in the hot CVD diamond thin film for the CH4(0.4 %) + H2 mixture doped by H2S (400 ppm). The absolute absorption density spectra of the HS and CS radicals were obtained as a function of different experimental parameters. This study proofs that the HS and CS radicals are an intermediate, which forms during the hot filament CVD process. The kinetics approach was developed for detailed analysis of the experimental data obtained. The kinetics scheme includes homogenous and heterogenous processes as well as processes of the chemical species transport in the CVD chamber.
NASA Technical Reports Server (NTRS)
Pickering, Michael A.; Taylor, Raymond L.; Goela, Jitendra S.; Desai, Hemant D.
1992-01-01
Subatmospheric pressure CVD processes have been developed to produce theoretically dense, highly pure, void-free and large area bulk materials, SiC, Si, ZnSe, ZnS and ZnS(x)Se(1-x). These materials are used for optical elements, such as mirrors, lenses and windows, over a wide spectral range from the VUV to the IR. We discuss the effect of CVD process conditions on the microstructure and properties of these materials, with emphasis on optical performance. In addition, we discuss the effect of chemical composition on the properties of the composite material ZnS(x)Se(1-x). We first present a general overview of the bulk CVD process and the relationship between process conditions, such as temperature, pressure, reactant gas concentration and growth rate, and the microstructure, morphology and properties of CVD-grown materials. Then we discuss specific results for CVD-grown SiC, Si, ZnSe, ZnS and ZnS(x)Se(1-x).
Under- treatment and under diagnosis of hypertension: a serious problem in the United Arab Emirates
Abdulle, Abdishakur M; Nagelkerke, Nico JD; Abouchacra, Samra; Pathan, Javed Y; Adem, Abdu; Obineche, Enyioma N
2006-01-01
Background Hypertension, notably untreated or uncontrolled, is a major risk factor for cardiovascular diseases (CVD) morbidity and mortality. In countries in transition, little is known about the epidemiology of hypertension, and its biochemical correlates. This study was carried out in Al Ain, United Arab Emirates, to characterize self-reported (SR) normotensives and hypertensives in terms of actual hypertension status, demographic variables, CVD risk factors, treatment, and sequalae. Methods A sample, stratified by SR hypertensive status, of 349 SR hypertensives (Mean age ± SD; 50.8 ± 9.2 yrs; Male: 226) and 640 SR normotensives (42.9 ± 9.3 yrs, Male: 444) among nationals and expatriates was used. Hypertensives and normotensive subjects were recruited from various outpatient clinics and government organizations in Al-Ain city, United Arab Emirates (UAE) respectively. Anthropometric and demographic variables were measured by conventional methods. Results Both under-diagnosis of hypertension (33%) and under-treatment (76%) were common. Characteristics of undiagnosed hypertensives were intermediate between normotensives and SR hypertensives. Under-diagnosis of hypertension was more common among foreigners than among nationals. Risk factors for CVD were more prevalent among SR hypertensives. Obesity, lack of exercise and smoking were found as major risk factors for CVD among hypertensives in this population. Conclusion Hypertension, even severe, is commonly under-diagnosed and under-treated in the UAE. Preventive strategies, better diagnosis and proper treatment compliance should be emphasized to reduce incidence of CVD in this population. PMID:16753071
Delaminated Transfer of CVD Graphene
NASA Astrophysics Data System (ADS)
Clavijo, Alexis; Mao, Jinhai; Tilak, Nikhil; Altvater, Michael; Andrei, Eva
Single layer graphene is commonly synthesized by dissociation of a carbonaceous gas at high temperatures in the presence of a metallic catalyst in a process known as Chemical Vapor Deposition or CVD. Although it is possible to achieve high quality graphene by CVD, the standard transfer technique of etching away the metallic catalyst is wasteful and jeopardizes the quality of the graphene film by contamination from etchants. Thus, development of a clean transfer technique and preservation of the parent substrate remain prominent hurdles to overcome. In this study, we employ a copper pretreatment technique and optimized parameters for growth of high quality single layer graphene at atmospheric pressure. We address the transfer challenge by utilizing the adhesive properties between a polymer film and graphene to achieve etchant-free transfer of graphene films from a copper substrate. Based on this concept we developed a technique for dry delamination and transferring of graphene to hexagonal boron nitride substrates, which produced high quality graphene films while at the same time preserving the integrity of the copper catalyst for reuse. DOE-FG02-99ER45742, Ronald E. McNair Postbaccalaureate Achievement Program.
Exposure monitoring of graphene nanoplatelets manufacturing workplaces.
Lee, Ji Hyun; Han, Jong Hun; Kim, Jae Hyun; Kim, Boowook; Bello, Dhimiter; Kim, Jin Kwon; Lee, Gun Ho; Sohn, Eun Kyung; Lee, Kyungmin; Ahn, Kangho; Faustman, Elaine M; Yu, Il Je
2016-01-01
Graphenes have emerged as a highly promising, two-dimensional engineered nanomaterial that can possibly substitute carbon nanotubes. They are being explored in numerous R&D and industrial applications in laboratories across the globe, leading to possible human and environmental exposures to them. Yet, there are no published data on graphene exposures in occupational settings and no readily available methods for their detection and quantitation exist. This study investigates for the first time the potential exposure of workers and research personnel to graphenes in two research facilities and evaluates the status of the control measures. One facility manufactures graphene using graphite exfoliation and chemical vapor deposition (CVD), while the other facility grows graphene on a copper plate using CVD, which is then transferred to a polyethylene terephthalate (PET) sheet. Graphene exposures and process emissions were investigated for three tasks - CVD growth, exfoliation, and transfer - using a multi-metric approach, which utilizes several direct reading instruments, integrated sampling, and chemical and morphological analysis. Real-time instruments included a dust monitor, condensation particle counter (CPC), nanoparticle surface area monitor, scanning mobility particle sizer, and an aethalometer. Morphologically, graphenes and other nanostructures released from the work process were investigated using a transmission electron microscope (TEM). Graphenes were quantified in airborne respirable samples as elemental carbon via thermo-optical analysis. The mass concentrations of total suspended particulate at Workplaces A and B were very low, and elemental carbon concentrations were mostly below the detection limit, indicating very low exposure to graphene or any other particles. The real-time monitoring, especially the aethalometer, showed a good response to the released black carbon, providing a signature of the graphene released during the opening of the CVD reactor at Workplace A. The TEM observation of the samples obtained from Workplaces A and B showed graphene-like structures and aggregated/agglomerated carbon structures. Taken together, the current findings on common scenarios (exfoliation, CVD growth, and transfer), while not inclusive of all graphene manufacturing processes, indicate very minimal graphene or particle exposure at facilities manufacturing graphenes with good manufacturing practices.
Zinc Oxide Grown by CVD Process as Transparent Contact for Thin Film Solar Cell Applications
NASA Astrophysics Data System (ADS)
Faÿ, S.; Shah, A.
Metalorganic chemical vapor deposition of ZnO films (MOCVD) [1] started to be comprehensively investigated in the 1980s, when thin film industries were looking for ZnO deposition processes especially useful for large-scale coatings at high growth rates. Later on, when TCO for thin film solar cells started to be developed, another advantage of growing TCO films by the CVD process has been highlighted: the surface roughness. Indeed, a large number of studies on CVD ZnO revealed that an as-grown rough surface cn be obtained with this deposition process [2-4]. A rough surface induces a light scattering effect, which can significantly improve light trapping (and therefore current photo-generation) within thin film silicon solar cells. The CVD process, indeed, directly leads to as-grown rough ZnO films without any post-etching step (the latter is often introduced to obtain a rough surface, when working with as-deposited flat sputtered ZnO). This fact could turn out to be a significant advantage when upscaling the manufacturing process for actual commercial production of thin film solar modules. The zinc and oxygen sources for CVD growth of ZnO films are given in Table 6.1.
2012-11-01
microwave plasma-enhanced CVD (MPE-CVD) with presputtered metal catalyst, and floating catalyst thermal CVD (FCT-CVD) with xylene and ferrocene liquid...processes with nickel and iron catalysts, respectively. For the FCT-CVD approach, ferrocene is used as an iron source to promoteCNT growth. Based on...furnace is ramped up to the growth temperature of 750∘C. Ferrocene was dissolved into a xylene solvent in a 0.008 : 1molar volume ratio.The xylene
Development of CVD Diamond for Industrial Applications Final Report CRADA No. TC-2047-02
DOE Office of Scientific and Technical Information (OSTI.GOV)
Caplan, M.; Olstad, R.; Jory, H.
2017-09-08
This project was a collaborative effort to develop and demonstrate a new millimeter microwave assisted chemical vapor deposition(CVD) process for manufacturing large diamond disks with greatly reduced processing times and costs from those now available. In the CVD process, carbon based gases (methane) and hydrogen are dissociated into plasma using microwave discharge and then deposited layer by layer as polycrystalline diamond onto a substrate. The available low frequency (2.45GHz) microwave sources used elsewhere (De Beers) result in low density plasmas and low deposition rates: 4 inch diamond disks take 6-8 weeks to process. The new system developed in this projectmore » uses a high frequency 30GHz Gyrotron as the microwave source and a quasi-optical CVD chamber resulting in a much higher density plasma which greatly reduced the diamond processing times (1-2 weeks)« less
Metabolic syndrome: A review of the role of vitamin D in mediating susceptibility and outcome
Strange, Richard C; Shipman, Kate E; Ramachandran, Sudarshan
2015-01-01
Despite the well-recognised role of vitamin D in a wide range of physiological processes, hypovitaminosis is common worldwide (prevalence 30%-50%) presumably arising from inadequate exposure to ultraviolet radiation and insufficient consumption. While generally not at the very low levels associated with rickets, hypovitaminosis D has been implicated in various very different, pathophysiological processes. These include putative effects on the pathogenesis of neoplastic change, inflammatory and demyelinating conditions, cardiovascular disease (CVD) and diabetes. This review focuses on the association between hypovitaminosis D and the metabolic syndrome as well as its component characteristics which are central obesity, glucose homeostasis, insulin resistance, hypertension and atherogenic dyslipidaemia. We also consider the effects of hypovitaminosis D on outcomes associated with the metabolic syndrome such as CVD, diabetes and non-alcoholic fatty liver disease. We structure this review into 3 distinct sections; the metabolic syndrome, vitamin D biochemistry and the putative association between hypovitaminosis D, the metabolic syndrome and cardiovascular risk. PMID:26185598
A tragic triad: coronary artery disease, nicotine addiction, and depression.
Thorndike, Anne N; Rigotti, Nancy A
2009-09-01
Despite the availability of multiple resources for treating smoking in patients with cardiovascular disease (CVD) and the well known risks of continued smoking, a majority of smokers resume smoking after hospitalization for acute CVD. Depression is common among patients with CVD and is associated with failure to follow recommendations to reduce cardiac risk. This review examines the complex relationship between smoking and depression in patients with CVD and current evidence for treating this triad. The prevalence of depressive symptoms among smokers hospitalized with CVD is 22-24%. Smokers with depressive symptoms are more likely to return to smoking after hospital discharge compared with nondepressed smokers. Stronger nicotine withdrawal symptoms among the depressed smokers contribute to relapse. Secondary analyses suggest that bupropion SR and cognitive behavioral therapy may be effective treatments for smokers with depression and CVD. A systematic review of smoking interventions in hospitalized patients found that only intensive counseling interventions with follow-up for more than 1 month were effective for smokers with CVD. Clinicians should consider screening all smokers with CVD for depression, particularly during hospitalization for an acute event. Smokers hospitalized with CVD need intensive counseling lasting more than 1 month after discharge, and smokers with depressive symptoms need even more prolonged treatment for quitting. The addition of pharmacotherapy to long-term counseling has the potential to further improve cessation rates.
Black-Shinn, Jennifer L.; Kinney, Gregory L.; Wise, Anastasia L.; Regan, Elizabeth A.; Make, Barry; Krantz, Mori J.; Barr, R. Graham; Murphy, James R.; Lynch, David; Silverman, Edwin K.; Crapo, James D.; Hokanson, John E.
2015-01-01
Introduction Smoking is a major risk factor for both cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD). More individuals with COPD die from CVD than respiratory causes and the risk of developing CVD appears to be independent of smoking burden. Although CVD is a common comorbid condition within COPD, the nature of its relationships to COPD affection status and severity, and functional status is not well understood. Methods The first 2,500 members of the COPDGene cohort were evaluated. Subjects were current and former smokers with a minimum 10 pack year history of cigarette smoking. COPD was defined by spirometry as an FEV1/FVC < lower limit of normal (LLN) with further identification of severity by FEV1 percent of predicted (GOLD stages 2, 3, and 4) for the main analysis. The presence of physician-diagnosed self-reported CVD was determined from a medical history questionnaire administered by a trained staff member. Results A total of 384 (15%) had pre-existing CVD. Self-reported CVD was independently related to COPD (Odds Ratio=1.61, 95% CI=1.18–2.20, p=0.01) after adjustment for covariates with CHF having the greatest association with COPD. Within subjects with COPD, pre-existing self-reported CVD placed subjects at greater risk of hospitalization due to exacerbation, higher BODE index, and greater St. George’s questionnaire score. The presence of self-reported CVD was associated with a shorter six-minute walk distance in those with COPD (p<0.05). Conclusions Self-reported CVD was independently related to COPD with presence of both self-reported CVD and COPD associated with a markedly reduced functional status and reduced quality of life. Identification of CVD in those with COPD is an important consideration in determining functional status. PMID:24831864
Work stress and cardiovascular disease: a life course perspective.
Li, Jian; Loerbroks, Adrian; Bosma, Hans; Angerer, Peter
2016-05-25
Individuals in employment experience stress at work, and numerous epidemiological studies have documented its negative health effects, particularly on cardiovascular disease (CVD). Although evidence on the various interrelationships between work stress and CVD has been accumulated, those observations have not yet been conceptualized in terms of a life course perspective. Using the chain of risk model, we would like to propose a theoretical model incorporating six steps: (1) work stress increases the risk of incident CVD in healthy workers. (2) Among those whose work ability is not fully and permanently damaged, work stress acts as a determinant of the process of return to work after CVD onset. (3) CVD patients experience higher work stress after return to work. (4) Work stress increases the risk of recurrent CVD in workers with prior CVD. (5) CVD patients who fully lose their work ability transit to disability retirement. (6) Disability retirees due to CVD have an elevated risk of CVD mortality. The life course perspective might facilitate an in-depth understanding of the diverse interrelationships between work stress and CVD, thereby leading to work stress management interventions at each period of the lifespan and three-level prevention of CVD.
Retinal vascular imaging in early life: insights into processes and risk of cardiovascular disease
Li, Ling‐Jun; Ikram, Mohammad Kamran
2015-01-01
Abstract Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. In recent years, studies have shown that the origins of CVD may be traced to vascular and metabolic processes in early life. Retinal vascular imaging is a new technology that allows detailed non‐invasive in vivo assessment and monitoring of the microvasculature. In this systematic review, we described the application of retinal vascular imaging in children and adolescents, and we examined the use of retinal vascular imaging in understanding CVD risk in early life. We reviewed all publications with quantitative retinal vascular assessment in two databases: PubMed and Scopus. Early life CVD risk factors were classified into four groups: birth risk factors, environmental risk factors, systemic risk factors and conditions linked to future CVD development. Retinal vascular changes were associated with lower birth weight, shorter gestational age, low‐fibre and high‐sugar diet, lesser physical activity, parental hypertension history, childhood hypertension, childhood overweight/obesity, childhood depression/anxiety and childhood type 1 diabetes mellitus. In summary, there is increasing evidence supporting the view that structural changes in the retinal microvasculature are associated with CVD risk factors in early life. Thus, the retina is a useful site for pre‐clinical assessment of microvascular processes that may underlie the future development of CVD in adulthood. PMID:26435039
Kraakman, Michael J; Dragoljevic, Dragana; Kammoun, Helene L; Murphy, Andrew J
2016-01-01
Cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Atherosclerosis is the most common form of CVD, which is complex and multifactorial with an elevated risk observed in people with either metabolic or inflammatory diseases. Accumulating evidence now links obesity with a state of chronic low-grade inflammation and has renewed our understanding of this condition and its associated comorbidities. An emerging theme linking disease states with atherosclerosis is the increased production of myeloid cells, which can initiate and exacerbate atherogenesis. Although anti-inflammatory drug treatments exist and have been successfully used to treat inflammatory conditions such as rheumatoid arthritis (RA), a commonly observed side effect is dyslipidemia, inadvertently, a major risk factor for the development of atherosclerosis. The mechanisms leading to dyslipidemia associated with anti-inflammatory drug use and whether CVD risk is actually increased by this dyslipidemia are of great therapeutic importance and currently remain poorly understood. Here we review recent data providing links between inflammation, hematopoiesis, dyslipidemia and CVD risk in the context of anti-inflammatory drug use. PMID:27350883
Treatment and Response to Statins: Gender-related Differences.
Raparelli, Valeria; Pannitteri, Gaetano; Todisco, Tommaso; Toriello, Filippo; Napoleone, Laura; Manfredini, Roberto; Basili, Stefania
2017-01-01
Response to drug administration is a primary determinant for treatment success. Sex and gender disparities play a role in determining the efficacy and safety of the most commonly used medications suggesting the need for a sex-tailored approach in prescription. Statins are a cost-effective strategy for cardiovascular disease (CVD) prevention. While statins are similarly effective in secondary CVD prevention, some concerns raised by conflicting data reported in primary CVD prevention clinical trials. The small representation of women in clinical trials and the fewer rates of events due to the lower female baseline CVD risk may have conditioned contradictory meta-analysis findings. Specifically, benefits outweigh disadvantages of statin therapy in women with a high CVD risk, while several doubts exist for the primary prevention of women at low-intermediate CVD risk. Furthermore, disparities between women and men in medication adherence may influence statin efficacy in CVD prevention. The sex-dependent impact of adverse side effects is one of the reasons advocated for explaining the gender gap, but it is not evidence-proved. The present review summarizes the sex and gender differences in the use of statins, pointing out new perspectives and opening issues in sex-tailored CVD prevention strategy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
Tobias, Deirdre K; Lawler, Patrick R; Harada, Paulo H; Demler, Olga V; Ridker, Paul M; Manson, JoAnn E; Cheng, Susan; Mora, Samia
2018-04-01
Circulating branched-chain amino acids (BCAAs; isoleucine, leucine, and valine) are strong predictors of type 2 diabetes mellitus (T2D), but their association with cardiovascular disease (CVD) is uncertain. We hypothesized that plasma BCAAs are positively associated with CVD risk and evaluated whether this was dependent on an intermediate diagnosis of T2D. Participants in the Women's Health Study prospective cohort were eligible if free of CVD at baseline blood collection (n=27 041). Plasma metabolites were measured via nuclear magnetic resonance spectroscopy. Multivariable Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for BCAAs with incident CVD (myocardial infarction, stroke, and coronary revascularization). We confirmed 2207 CVD events over a mean 18.6 years of follow-up. Adjusting for age, body mass index, and other established CVD risk factors, total BCAAs were positively associated with CVD (per SD: HR, 1.13; 95% CI, 1.08-1.18), comparable to LDL-C (low-density lipoprotein cholesterol) with CVD (per SD: HR, 1.12; 95% CI, 1.07-1.17). BCAAs were associated with coronary events (myocardial infarction: HR, 1.16; 95% CI, 1.06-1.26; revascularization: HR, 1.17; 95% CI, 1.11-1.25), and borderline significant association with stroke (HR, 1.07; 95% CI, 0.99-1.15). The BCAA-CVD association was greater ( P interaction=0.036) among women who developed T2D before CVD (HR, 1.20; 95% CI, 1.08-1.32) versus women without T2D (HR, 1.08; 95% CI, 1.03-1.14). Adjusting for LDL-C, an established CVD risk factor, did not attenuate these findings; however, adjusting for HbA1c and insulin resistance eliminated the associations of BCAAs with CVD. Circulating plasma BCAAs were positively associated with incident CVD in women. Impaired BCAA metabolism may capture the long-term risk of the common cause underlying T2D and CVD. © 2018 American Heart Association, Inc.
El Hajj, Maguy Saffouh; Mahfoud, Ziyad R; Al Suwaidi, Jassim; Alkhiyami, Dania; Alasmar, Aya Riyad
2016-06-01
In Qatar, cardiovascular diseases (CVD) have recently become the leading cause of morbidity and mortality. Prevention, detection and management of CVD risk factors reduce CVD chance. The study objectives were to assess Qatar pharmacists' involvement in CVD health promotion, to identify the activities that they currently provide to patients with CVD risk factors, to describe their attitudes towards their involvement in CVD prevention and to assess their perceived barriers for provision of CVD prevention services We conducted a cross-sectional survey of community and ambulatory pharmacists in Qatar. Pharmacist characteristics, involvement in CVD-related activities along with their attitudes and perceived barriers were analysed using frequency distributions. Bivariate linear regression models were used to test for associations between CVD health promotion activity score and each variable. Variables with a P-value of 0.20 or less were included in the multivariate model. A total of 141 pharmacists completed the survey (response rate 60%). More than 70% responded with rarely or never to 6 out of the 10 CVD health promotion activities. Eighty-four per cent and 68% always or often describe to patients the appropriate time to take antihypertensive medications and the common medication adverse effects, respectively. Yet, 50% rarely or never review the medication refill history or provide adherence interventions. Lack of CVD educational materials was the top perceived barrier (55%) in addition to lack of having private counselling area (44.6%), and lack of time (38.3%). Females and community pharmacists were more involved in CVD health promotion (P = 0.046 and P = 0.017, respectively) than their counterparts. Health promotion practice increased with increasing attitudes score and decreased with increased barriers score (P = 0.012 and P = 0.001). The scope of pharmacy practice in CVD prevention is limited in Qatar. Efforts need to be exerted to increase pharmacists' involvement in CVD prevention. © 2015 John Wiley & Sons, Ltd.
Gori, Mauro; Gupta, Deepak K.; Claggett, Brian; Selvin, Elizabeth; Folsom, Aaron R.; Matsushita, Kunihiro; Bello, Natalie A.; Cheng, Susan; Shah, Amil; Skali, Hicham; Vardeny, Orly; Ni, Hanyu; Ballantyne, Christie M.; Astor, Brad C.; Klein, Barbara E.; Aguilar, David
2016-01-01
OBJECTIVE Cardiovascular disease (CVD) is the major cause of morbidity and mortality in diabetes; yet, heterogeneity in CVD risk has been suggested in diabetes, providing a compelling rationale for improving diabetes risk stratification. We hypothesized that N-terminal prohormone brain natriuretic peptide (NTproBNP) and high-sensitivity troponin T may enhance CVD risk stratification beyond commonly used markers of risk and that CVD risk is heterogeneous in diabetes. RESEARCH DESIGN AND METHODS Among 8,402 participants without prevalent CVD at visit 4 (1996–1998) of the Atherosclerosis Risk in Communities (ARIC) study there were 1,510 subjects with diabetes (mean age 63 years, 52% women, 31% African American, and 60% hypertensive). RESULTS Over a median follow-up of 13.1 years, there were 540 incident fatal/nonfatal CVD events (coronary heart disease, heart failure, and stroke). Both troponin T ≥14 ng/L (hazard ratio [HR] 1.96 [95% CI 1.57–2.46]) and NTproBNP >125 pg/mL (1.61 [1.29–1.99]) were independent predictors of incident CVD events at multivariable Cox proportional hazard models. Addition of circulating cardiac biomarkers to traditional risk factors, abnormal electrocardiogram (ECG), and conventional markers of diabetes complications including retinopathy, nephropathy, and peripheral arterial disease significantly improved CVD risk prediction (net reclassification index 0.16 [95% CI 0.07–0.22]). Compared with individuals without diabetes, subjects with diabetes had 1.6-fold higher adjusted risk of incident CVD. However, participants with diabetes with normal cardiac biomarkers and no conventional complications/abnormal ECG (n = 725 [48%]) were at low risk (HR 1.12 [95% CI 0.95–1.31]), while those with abnormal cardiac biomarkers, alone (n = 186 [12%]) or in combination with conventional complications/abnormal ECG (n = 243 [16%]), were at greater risk (1.99 [1.59–2.50] and 2.80 [2.34–3.35], respectively). CONCLUSIONS Abnormal levels of NTproBNP and troponin T may help to distinguish individuals with high diabetes risk from those with low diabetes risk, providing incremental risk prediction beyond commonly used markers of risk. PMID:26740635
Kałka, Dariusz; Gebala, Jana; Smoliński, Ryszard; Rusiecki, Lesław; Pilecki, Witold; Zdrojowy, Romuald
2017-11-01
Patients with cardiovascular disease (CVD) are prone to developing erectile dysfunction (ED) owing to the common risk factors and pathogenesis underlying ED and CVD. As a result, ED affects nearly 80% of male patients with CVD. The efficacy of phosphodiesterase type 5 inhibitors, vacuum erection devices, or intracavernosal injection of vasodilating agents is well established in the treatment of ED; however, their use is limited. Low-energy shock wave therapy is a novel modality that may become a causative treatment for ED. This review aims to assess the efficacy and safety of low-energy shock wave therapy in the treatment of ED in men with CVD. Copyright © 2017 Elsevier Inc. All rights reserved.
Grams, Morgan E; Sang, Yingying; Ballew, Shoshana H; Carrero, Juan Jesus; Djurdjev, Ognjenka; Heerspink, Hiddo J L; Ho, Kevin; Ito, Sadayoshi; Marks, Angharad; Naimark, David; Nash, Danielle M; Navaneethan, Sankar D; Sarnak, Mark; Stengel, Benedicte; Visseren, Frank L J; Wang, Angela Yee-Moon; Köttgen, Anna; Levey, Andrew S; Woodward, Mark; Eckardt, Kai-Uwe; Hemmelgarn, Brenda; Coresh, Josef
2018-06-01
Patients with chronic kidney disease and severely decreased glomerular filtration rate (GFR) are at high risk for kidney failure, cardiovascular disease (CVD) and death. Accurate estimates of risk and timing of these clinical outcomes could guide patient counseling and therapy. Therefore, we developed models using data of 264,296 individuals in 30 countries participating in the international Chronic Kidney Disease Prognosis Consortium with estimated GFR (eGFR)s under 30 ml/min/1.73m 2 . Median participant eGFR and urine albumin-to-creatinine ratio were 24 ml/min/1.73m 2 and 168 mg/g, respectively. Using competing-risk regression, random-effect meta-analysis, and Markov processes with Monte Carlo simulations, we developed two- and four-year models of the probability and timing of kidney failure requiring kidney replacement therapy (KRT), a non-fatal CVD event, and death according to age, sex, race, eGFR, albumin-to-creatinine ratio, systolic blood pressure, smoking status, diabetes mellitus, and history of CVD. Hypothetically applied to a 60-year-old white male with a history of CVD, a systolic blood pressure of 140 mmHg, an eGFR of 25 ml/min/1.73m 2 and a urine albumin-to-creatinine ratio of 1000 mg/g, the four-year model predicted a 17% chance of survival after KRT, a 17% chance of survival after a CVD event, a 4% chance of survival after both, and a 28% chance of death (9% as a first event, and 19% after another CVD event or KRT). Risk predictions for KRT showed good overall agreement with the published kidney failure risk equation, and both models were well calibrated with observed risk. Thus, commonly-measured clinical characteristics can predict the timing and occurrence of clinical outcomes in patients with severely decreased GFR. Copyright © 2018 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
A cross-sectional analysis of cardiovascular disease in the hemophilia population
Sood, Suman L.; Cheng, Dunlei; Ragni, Margaret; Kessler, Craig M.; Quon, Doris; Shapiro, Amy D.; Key, Nigel S.; Manco-Johnson, Marilyn J.; Cuker, Adam; Kempton, Christine; Wang, Tzu-Fei; Eyster, M. Elaine; Kuriakose, Philip; von Drygalski, Annette; Gill, Joan Cox; Wheeler, Allison; Kouides, Peter; Escobar, Miguel A.; Leissinger, Cindy; Galdzicka, Sarah; Corson, Marshall; Watson, Crystal
2018-01-01
Men with hemophilia were initially thought to be protected from cardiovascular disease (CVD), but it is now clear that atherothrombotic events occur. The primary objective of the CVD in Hemophilia study was to determine the prevalence of CVD and CVD risk factors in US older men with moderate and severe hemophilia and to compare findings with those reported in age-comparable men in the Atherosclerosis Risk in Communities (ARIC) cohort. We hypothesized if lower factor levels are protective from CVD, we would see a difference in CVD rates between more severely affected and unaffected men. Beginning in October 2012, 200 patients with moderate or severe hemophilia A or B (factor VIII or IX level ≤ 5%), aged 54 to 73 years, were enrolled at 19 US hemophilia treatment centers. Data were collected from patient interview and medical records. A fasting blood sample and electrocardiogram (ECG) were obtained and assayed and read centrally. CVD was defined as any angina, any myocardial infarction by ECG or physician diagnosis, any self-reported nonhemorrhagic stroke or transient ischemic attack verified by physicians, or any history of coronary bypass graft surgery or coronary artery angioplasty. CVD risk factors were common in the population. Compared with men of similar age in the ARIC cohort, patients with hemophilia had significantly less CVD (15% vs 25.8%; P < .001). However, on an individual patient level, CVD events occur and efforts to prevent cardiovascular events are warranted. Few men were receiving secondary prophylaxis with low-dose aspirin, despite published opinion that it can be used safely in this patient population. PMID:29895623
Amaya-Amaya, Jenny; Rojas-Villarraga, Adriana; Molano-Gonzalez, Nicolas; Montoya-Sánchez, Laura; Nath, Swapan K.; Anaya, Juan-Manuel
2015-01-01
Objective. Rheumatoid arthritis (RA) is the most common autoimmune arthropathy worldwide. The increased prevalence of cardiovascular disease (CVD) in RA is not fully explained by classic risk factors. The aim of this study was to determine the influence of rs1058587 SNP within GDF15(MIC1) gene on the risk of CVD in a Colombian RA population. Methods. This was a cross-sectional analytical study in which 310 consecutive Colombian patients with RA and 228 age- and sex-matched controls were included and assessed for variables associated with CVD. The mixed cluster methodology based on multivariate descriptive methods such as principal components analysis and multiple correspondence analyses and regression tree (CART) predictive model were performed. Results. Of the 310 patients, 87.4% were women and CVD was reported in 69.5%. Significant differences concerning GDF15 polymorphism were not observed between patients and controls. Mean arterial pressure, current smoking, and some clusters were significantly associated with CVD. Conclusion. GDF15 (rs1058587) does not influence the development of CVD in the population studied. PMID:26090487
Cervantes Gracia, Karla; Llanas-Cornejo, Daniel; Husi, Holger
2017-01-01
Nowadays, it is known that oxidative stress plays at least two roles within the cell, the generation of cellular damage and the involvement in several signaling pathways in its balanced normal state. So far, a substantial amount of time and effort has been expended in the search for a clear link between cardiovascular disease (CVD) and the effects of oxidative stress. Here, we present an overview of the different sources and types of reactive oxygen species in CVD, highlight the relationship between CVD and oxidative stress and discuss the most prominent molecules that play an important role in CVD pathophysiology. Details are given regarding common pharmacological treatments used for cardiovascular distress and how some of them are acting upon ROS-related pathways and molecules. Novel therapies, recently proposed ROS biomarkers, as well as future challenges in the field are addressed. It is apparent that the search for a better understanding of how ROS are contributing to the pathophysiology of CVD is far from over, and new approaches and more suitable biomarkers are needed for the latter to be accomplished. PMID:28230726
Curry, Susan J; Krist, Alex H; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Kubik, Martha; Landefeld, C Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen; Wong, John B
2018-06-12
Cardiovascular disease (CVD), which encompasses atherosclerotic conditions such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease, is the most common cause of death among adults in the United States. Treatment to prevent CVD events by modifying risk factors is currently informed by CVD risk assessment with tools such as the Framingham Risk Score or the Pooled Cohort Equations, which stratify individual risk to inform treatment decisions. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on screening for coronary heart disease with electrocardiography (ECG). The USPSTF reviewed the evidence on whether screening with resting or exercise ECG improves health outcomes compared with the use of traditional CVD risk assessment alone in asymptomatic adults. For asymptomatic adults at low risk of CVD events (individuals with a 10-year CVD event risk less than 10%), it is very unlikely that the information from resting or exercise ECG (beyond that obtained with conventional CVD risk factors) will result in a change in the patient's risk category as assessed by the Framingham Risk Score or Pooled Cohort Equations that would lead to a change in treatment and ultimately improve health outcomes. Possible harms are associated with screening with resting or exercise ECG, specifically the potential adverse effects of subsequent invasive testing. For asymptomatic adults at intermediate or high risk of CVD events, there is insufficient evidence to determine the extent to which information from resting or exercise ECG adds to current CVD risk assessment models and whether information from the ECG results in a change in risk management and ultimately reduces CVD events. As with low-risk adults, possible harms are associated with screening with resting or exercise ECG in asymptomatic adults at intermediate or high risk of CVD events. The USPSTF recommends against screening with resting or exercise ECG to prevent CVD events in asymptomatic adults at low risk of CVD events. (D recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening with resting or exercise ECG to prevent CVD events in asymptomatic adults at intermediate or high risk of CVD events. (I statement).
NASA Astrophysics Data System (ADS)
Lee, Jinil
In SiC/SiC ceramic matrix composites, toughness is obtained by adding a fiber coating which provides a weak interface for crack deflection and debonding between the fiber and the matrix. However, the most commonly used fiber coatings, carbon and boron nitride, are unstable in oxidative environments. In the present study, the feasibility of using a chemically vapor deposited zirconia (CVD-ZrO 2) fiber coating as an oxidation-resistant interphase for SiC/SiC composites was investigated. The feasibility of the CVD-ZrO2 coating as a useful interphase for SiC/SiC composites was investigated with emphasis on developing critical processing-microstructure relationships. A study of morphological evolution in the CVD-ZrO2 coating suggested that a size-controlled displacive phase transformation from tetragonal ZrO2 (t-ZrO2) to monoclinic ZrO2 (m-ZrO2) was the key mechanism responsible for the weak interface behavior exhibited by the ZrO2 coating. The pre-delamination occurred as a result of (i) continuous formation of t-ZrO2 nuclei on the deposition surface; (ii) martensitic transformation of the tetragonal phase to a monoclinic phase upon reaching a critical grain size; and (iii) development of significant compressive hoop stresses due to the volume dilation associated with the transformation. We also discovered that low oxygen partial pressure in the CVD reactor was required for the nucleation of t-ZrO2 and was ultimately responsible for the delamination behavior. The effects of oxygen partial pressure on the nucleation behavior of the CVD-ZrO2 coating was systematically studied by intentionally adding the controlled amount of O2 into the CVD chamber. Characterization results suggested that the number density of t-ZrO2 nuclei apparently decreased with increasing the oxygen partial pressure from 0.004 to 1.6 Pa. Also, the coating layer became more columnar and contained larger m-ZrO2 grains. The observed relationships between the oxygen partial pressure and the morphological characteristics of the ZrO 2 coating were explained in the context of the grain size and oxygen deficiency effects which have been previously reported to cause the stabilization of the t-ZrO2 phase in bulk ZrO2 specimens.
Wassel, Christina L.; Pankow, James S.; Peralta, Carmen A.; Choudhry, Shweta; Seldin, Michael F.; Arnett, Donna K.
2009-01-01
Background Differences in cardiovascular disease (CVD) burden exist among racial/ethnic groups in the United States, with African Americans having the highest prevalence. Subclinical CVD measures have also been shown to differ by race/ethnicity. In the United States, there has been significant intermixing among racial/ethnic groups creating admixed populations. Very little research exists on the relationship of genetic ancestry and subclinical CVD measures. Methods and Results These associations were investigated in 712 African-American and 705 Hispanic participants from the MESA candidate gene sub-study. Individual ancestry was estimated from 199 genetic markers using STRUCTURE. Associations of ancestry and coronary artery calcium (CAC) and common and internal carotid intima media thickness (cIMT) were evaluated using log-binomial and linear regression models. Splines indicated linear associations of ancestry with subclinical CVD measures in African-Americans, but presence of threshold effects in Hispanics. Among African Americans, each standard deviation (SD) increase in European ancestry was associated with an 8% (95% CI (1.02, 1.15), p=0.01) greater CAC prevalence. Each SD increase in European ancestry was also associated with a 2% (95% CI (−3.4%, −0.5%), p=0.008) lower common cIMT in African Americans. Among Hispanics, the highest tertile of European ancestry was associated with a 34% greater CAC prevalence, p=0.02 as compared to lowest tertile. Conclusions The linear association of ancestry and subclinical CVD suggests that genetic effects may be important in determining CAC and cIMT among African-Americans. Our results also suggest that CAC and common cIMT may be important phenotypes for further study with admixture mapping. PMID:20031644
Cerebrovascular disease, beta-amyloid and cognition in aging
Marchant, Natalie L.; Reed, Bruce R.; DeCarli, Charles S.; Madison, Cindee M.; Weiner, Michael W.; Chui, Helena C.; Jagust, William J.
2011-01-01
The present study evaluated cerebrovascular disease (CVD), β-amyloid (Aβ), and cognition in clinically normal elderly adults. Fifty-four participants underwent MRI, PIB-PET imaging, and neuropsychological evaluation. High white matter hyperintensity burden and/or presence of infarct defined CVD status (CVD−: N = 27; CVD+: N = 27). PIB-PET ratios of Aβ deposition were extracted using Logan plotting (cerebellar reference). Presence of high levels of Aβ in prespecified regions determined PIB status (PIB−: N = 33; PIB+: N = 21). Executive functioning and episodic memory were measured using composite scales. CVD and Aβ, defined as dichotomous or continuous variables, were unrelated to one another. CVD+ participants showed lower executive functioning (P = 0.001) when compared to CVD− individuals. Neither PIB status nor amount of Aβ affected cognition (Ps ≥ .45), and there was no statistical interaction between CVD and PIB on either cognitive measure. Within this spectrum of normal aging CVD and Aβ aggregation appear to be independent processes with CVD primarily affecting cognition. PMID:22048124
USDA-ARS?s Scientific Manuscript database
Background: Overweight, obesity, metabolic syndrome (MetS), and postprandial inflammation are all independent risk factors for cardiovascular disease (CVD). To reduce CVD risk, palm oil has become a common substitute for both hydrogenated unsaturated fats, that contain trans fatty acids, and animal ...
USDA-ARS?s Scientific Manuscript database
Cardiovascular disease (CVD) and osteoporosis are 2 major public health problems that share common pathophysiological mechanisms. It is possible that strategies to reduce CVD risk may also benefit bone health. We tested the hypothesis that adherence to the 2006 American Heart Association Diet and Li...
Using multilevel, multisource needs assessment data for planning community interventions.
Levy, Susan R; Anderson, Emily E; Issel, L Michele; Willis, Marilyn A; Dancy, Barbara L; Jacobson, Kristin M; Fleming, Shirley G; Copper, Elizabeth S; Berrios, Nerida M; Sciammarella, Esther; Ochoa, Mónica; Hebert-Beirne, Jennifer
2004-01-01
African Americans and Latinos share higher rates of cardiovascular disease (CVD) and diabetes compared with Whites. These diseases have common risk factors that are amenable to primary and secondary prevention. The goal of the Chicago REACH 2010-Lawndale Health Promotion Project is to eliminate disparities related to CVD and diabetes experienced by African Americans and Latinos in two contiguous Chicago neighborhoods using a community-based prevention approach. This article shares findings from the Phase 1 participatory planning process and discusses the implications these findings and lessons learned may have for programs aiming to reduce health disparities in multiethnic communities. The triangulation of data sources from the planning phase enriched interpretation and led to more creative and feasible suggestions for programmatic interventions across the four levels of the ecological framework. Multisource data yielded useful information for program planning and a better understanding of the cultural differences and similarities between African Americans and Latinos.
Efficacy of dietary behavior modification for preserving cardiovascular health and longevity.
Pryde, Moira McAllister; Kannel, William Bernard
2010-12-28
Cardiovascular disease (CVD) and its predisposing risk factors are major lifestyle and behavioral determinants of longevity. Dietary lifestyle choices such as a heart healthy diet, regular exercise, a lean weight, moderate alcohol consumption, and smoking cessation have been shown to substantially reduce CVD and increase longevity. Recent research has shown that men and women who adhere to this lifestyle can substantially reduce their risk of coronary heart disease (CHD). The preventive benefits of maintaining a healthy lifestyle exceed those reported for using medication and procedures. Among the modifiable preventive measures, diet is of paramount importance, and recent data suggest some misconceptions and uncertainties that require reconsideration. These include commonly accepted recommendations about polyunsaturated fat intake, processed meat consumption, fish choices and preparation, transfatty acids, low carbohydrate diets, egg consumption, coffee, added sugar, soft drink beverages, glycemic load, chocolate, orange juice, nut consumption, vitamin D supplements, food portion size, and alcohol.
Vargas, Jose D; Manichaikul, Ani; Wang, Xin-Qun; Rich, Stephen S; Rotter, Jerome I; Post, Wendy S; Polak, Joseph F; Budoff, Matthew J; Bluemke, David A
2016-02-01
Subclinical atherosclerosis (sCVD), measured by coronary artery calcium (CAC) and carotid intima media thickness (CIMT) is associated with cardiovascular disease (CVD). Genome-Wide Association Studies (GWAS) of sCVD and CVD have focused primarily on Caucasian populations. We hypothesized that these associations may differ in populations from distinct genetic backgrounds. The associations between sCVD and 66 single nucleotide polymorphisms (SNPs) from published GWAS of sCVD and CVD were tested in 8224 Multi-Ethnic Study of Atherosclerosis (MESA) and MESA Family participants [2329 Caucasians (EUA), 691 Chinese (CHN), 2482 African Americans (AFA), and 2012 Hispanic (HIS)] using an additive model adjusting for CVD risk factors, with SNP significance defined by a Bonferroni-corrected p < 7.6 × 10(-4) (0.05/66). In EUA there were significant associations for CAC with SNPs in 9p21 (rs1333049, P = 2 × 10(-9); rs4977574, P = 4 × 10(-9)), COL4A1 (rs9515203, P = 9 × 10(-6)), and PHACTR1 (rs9349379, P = 4 × 10(-4)). In HIS, CAC was associated with SNPs in 9p21 (rs1333049, P = 8 × 10(-5); rs4977574, P = 5 × 10(-5)), APOA5 (rs964184, P = 2 × 10(-4)), and ADAMTS7 (rs7173743, P = 4 × 10(-4)). There were no associations between CAC and 9p21 SNPs for AFA and CHN. Fine mapping of the 9p21 region revealed SNPs with robust associations with CAC in EUA and HIS but no significant associations in AFA and CHN. Our results suggest some shared genetic architecture for sCVD across ethnic groups, while also underscoring the possibility of novel variants and/or pathways in risk of CVD in ethnically diverse populations. Published by Elsevier Ireland Ltd.
Rutledge, Thomas; Linke, Sarah E; Krantz, David S; Johnson, B Delia; Bittner, Vera; Eastwood, Jo-Ann; Eteiba, Wafia; Pepine, Carl J; Vaccarino, Viola; Francis, Jennifer; Vido, Diane A; Merz, C Noel Bairey
2009-11-01
To study the independent and interactive effects of depression and anxiety symptoms as predictors of cardiovascular disease (CVD) events in a sample of women with suspected myocardial ischemia. Symptoms of depression and anxiety overlap strongly and are independent predictors of CVD events. Although these symptoms commonly co-occur in medical patients, little is known about combined effects of depression and anxiety on CVD risk. A total of 489 women completed a baseline protocol including coronary angiogram, CVD risk factor assessment, and questionnaire-based measures of depression and anxiety symptoms, using the Beck Depression Inventory (BDI) and State Trait Anxiety Inventory (STAI), respectively. Participants were followed for a median 5.9 years to track the prevalence of CVD events (stroke, myocardial infarction, heart failure, and CVD-related mortality). We tested the BDI x STAI interaction effect in addition to the BDI and STAI main effects. Seventy-five women (15.3% of sample) experienced a CVD event, of which 18 were deaths attributed to cardiovascular causes. Results using Cox regression indicated a significant BDI x STAI interaction effect in the prediction of CVD events (p = .02) after covariate adjustment. Simple effect analyses indicated that depression scores were significant predictors of CVD events among women with low anxiety scores (hazard ratio [HR] = 2.3 [in standard deviation units]; 95% Confidence Interval [CI] = 1.3-3.9; p = .005) but not among women with higher levels of anxiety (HR = 0.99; 95% CI = 0.70-1.4; p = .95). Among women with suspected myocardial ischemia, the value of depression symptoms for predicting CVD events varied by the severity of comorbid anxiety. These results suggest that the clinical utility of depression measures may be improved by using them in combination with measures of anxiety.
Rothschild, Matan; Jetty, Vybhav; Mahida, Christopher; Wang, Ping; Prince, Marloe; Goldenberg, Naila; Glueck, Charles J
2017-11-01
In 35 patients with 116 severe premature cardiovascular disease (CVD) events (median age: 48 years), 14 having worsening CVD despite maximal intervention, we evaluated thrombophilia and speculated that anticoagulation might arrest-reverse progressive thrombophilic-atherothrombotic CVD. Thrombophilia-hypofibrinolysis in the 35 patients was compared to 110 patients with venous thromboembolism (VTE) without CVD and to 110 healthy normal controls. Efficacy-safety of anticoagulation was prospectively assessed in 14 of the 35 patients whose CVD worsened over 2 years despite maximal medical-surgical intervention. At entry on maximally tolerated lipid-lowering therapy, median low-density lipoprotein was 88 mg/dL. Measures of thrombophilia-hypofibrinolysis in the 35 cases differed from 110 VTE controls only for the lupus anticoagulant, present in 6 (21%) of 28 cases versus 4 (4%) of 91 VTE controls ( P = .01), and for high anticardiolipin antibodies (ACLAs) immunoglobulin G, 5 (14%) of 35 cases versus 4 of 108 VTE controls (4%), P = .04. The 14 patients who were anticoagulated differed from 110 VTE controls only for the lupus anticoagulant, 38% versus 4%, P = .001, and for high lipoprotein (a), 46% versus 17%, P = .028, respectively. The 14 patients with atherothrombosis having inexorably worsening CAD despite maximal medical-surgical therapy were anticoagulated for 6.5 years (median), with clinical CVD progression arrested in 12 (86%), and all 12 became asymptomatic. In the 35 patients with premature CVD, thrombophilia was pervasive, comparable to or more severe than in VTE controls without CVD. When CVD progressively worsens despite maximal intervention, thrombophilia and atherosclerosis (atherothrombosis) are commonly concurrent, and the downhill course of CVD may be arrested-stabilized by anticoagulation.
Imes, Christopher C.; Lewis, Frances Marcus
2012-01-01
Background Over 82 million Americans have one or more forms of cardiovascular disease (CVD), accounting for 32.8% of all deaths in the United States. Although the evidence for the familial aggregation of CVD is strong, the relationship between family history (FH) of CVD, perceived risk for CVD and their relationship to health-related behavior is poorly understood. Objective The objective of this article is to review and summarize the published research on the relationship between a FH of CVD, an individual’s perceived risk, and health-related behavior in order to make recommendations for clinical practice and future research. Methods A literature search was conducted using PubMed, CINAHL Plus, and PsycINFO to identify articles that examined the relationship between a FH of CVD, perceived CVD risk, and health-promoting behaviors. A total of 263 unique articles were reviewed. Two hundred thirty-eight were excluded, resulting in a total of 25 articles included in the paper. Results There was a positive relationship between a reported FH of CVD and perceived risk. However, the relationship between a FH of CVD and health-related behavior change and perceived risk and behavior change was inconsistent. Conclusions A person’s awareness of their FH of CVD or their own risk for CVD is not a sufficient predictor of changes in their health-related behavior. Future studies are needed to better explain the processes by which perceived CVD risk or FH of CVD can be used to affect health-related behavior changes. It appears that both FH and perceived personal risk for CVD are necessary but not sufficient conditions to change health-related behavior in high-risk populations. Future studies should also test interventions that help individuals with a FH of CVD attribute increased personal risk to themselves for developing CVD, while providing lifestyle management options to minimize their risk. PMID:23321782
Risk stratification of patients with familial hypercholesterolemia in a multi-ethnic cohort
2014-01-01
Background Heterozygous Familial hypercholesterolemia (FH) is a common autosomal dominant disorder resulting in in very high blood cholesterol levels and premature cardiovascular disease (CVD). However, there is a wide variation in the occurrence of CVD in these patients. The aim of this study is to determine risk factors that are responsible for the variability of CVD events in FH patients. Methods This is a retrospective analysis of a large multiethnic cohort of patients with definite FH attending the Healthy Heart Prevention Clinic in Vancouver, Canada. Cox proportional hazard regression analysis was used to assess the association of the risk factors to the hard cardiovascular outcomes. Results 409 patients were identified as having “definite” FH, according to the Dutch Lipid Clinic Network Criteria (DLCNC), with 111 (27%) having evidence of CVD. Male sex, family history of premature CVD, diabetes mellitus, low high density lipoprotein cholesterol (HDL-C) and high lipoprotein (a) (Lp (a)) were significant, independent risk factors for CVD. In men, family history, diabetes and low levels of HDL-C were significant risk factors while in women smoking, diabetes mellitus and high Lp (a) were significant risk factors for CVD. There were no significant differences in risk factors between ethnicities. Conclusion In conclusion, men and women differ in the impact of the risk factors on the presence of CVD with family history of CVD and low HDL-C being a significant factor in men while smoking and increased Lp (a) were significant factors in women. Diabetes was a significant factor in both men and women. PMID:24712315
Defining the relationship between COPD and CVD: what are the implications for clinical practice?
Morgan, Ann D; Zakeri, Rosita; Quint, Jennifer K
2018-01-01
Cardiovascular diseases (CVDs) are arguably the most important comorbidities in chronic obstructive pulmonary disease (COPD). CVDs are common in people with COPD, and their presence is associated with increased risk for hospitalization, longer length of stay and all-cause and CVD-related mortality. The economic burden associated with CVD in this population is considerable and the cumulative cost of treating comorbidities may even exceed that of treating COPD itself. Our understanding of the biological mechanisms that link COPD and various forms of CVD has improved significantly over the past decade. But despite broad acceptance of the prognostic significance of CVDs in COPD, there remains widespread under-recognition and undertreatment of comorbid CVD in this population. The reasons for this are unclear; however institutional barriers and a lack of evidence-based guidelines for the management of CVD in people with COPD may be contributory factors. In this review, we summarize current knowledge relating to the prevalence and incidence of CVD in people with COPD and the mechanisms that underlie their coexistence. We discuss the implications for clinical practice and highlight opportunities for improved prevention and treatment of CVD in people with COPD. While we advocate more active assessment for signs of cardiovascular conditions across all age groups and all stages of COPD severity, we suggest targeting those aged under 65 years. Evidence indicates that the increased risks for CVD are particularly pronounced in COPD patients in mid-to-late-middle-age and thus it is in this age group that the benefits of early intervention may prove to be the most effective. PMID:29355081
Evaluation of infrared thermography as a diagnostic tool in CVD applications
NASA Astrophysics Data System (ADS)
Johnson, E. J.; Hyer, P. V.; Culotta, P. W.; Clark, I. O.
1998-05-01
This research is focused on the feasibility of using infrared temperature measurements on the exterior of a chemical vapor deposition (CVD) reactor to ascertain both real-time information on the operating characteristics of a CVD system and provide data which could be post-processed to provide quantitative information for research and development on CVD processes. Infrared thermography techniques were used to measure temperatures on a horizontal CVD reactor of rectangular cross section which were correlated with the internal gas flow field, as measured with the laser velocimetry (LV) techniques. For the reactor tested, thermal profiles were well correlated with the gas flow field inside the reactor. Correlations are presented for nitrogen and hydrogen carrier gas flows. The infrared data were available to the operators in real time with sufficient sensitivity to the internal flow field so that small variations such as misalignment of the reactor inlet could be observed. The same data were post-processed to yield temperature measurements at known locations on the reactor surface. For the experiments described herein, temperatures associated with approximately 3.3 mm 2 areas on the reactor surface were obtained with a precision of ±2°C. These temperature measurements were well suited for monitoring a CVD production reactor, development of improved thermal boundary conditions for use in CFD models of reactors, and for verification of expected thermal conditions.
A Call for Considering Color Vision Deficiency When Creating Graphics for Psychology Reports.
Frane, Andrew
2015-01-01
Although color vision deficiency (CVD) is fairly common, it is often not adequately considered when data is presented in color graphics. This study found that CVD tends to be mentioned neither in the author guidelines of psychology journals nor in the standard publication manuals of the field (e.g., the publication manuals of the American Psychological Association and the American Medical Association). To illustrate the relevance of this problem, a panel of scholars with CVD was used to evaluate the color figures in three respected psychological science journals. Results suggested that a substantial proportion of those figures were needlessly confusing for viewers with CVD and could have been easily improved through simple adjustments. Based on prior literature and on feedback from the panelists, recommendations are made for improving the accessibility of graphics in psychology reports.
Phelan, Cynthia H.; Lauver, Diane R.; Bratzke, Lisa C.
2016-01-01
Purpose/ Objectives Sleep-related breathing disorders (SRBDs), including obstructive sleep apnea and central sleep apnea, are common among patients with cardiovascular disease (CVD), but clinicians often do not pay enough attention to SRBDs. The purpose of this narrative review is to update advanced practice registered nurses (APRNs) on the literature focusing on the relationship between SRBDs and CVD (e.g., hypertension, heart failure, coronary artery disease, arrhythmias, and stroke) and on treatments that can improve SRBDs in patients with CVD. Description of the project We conducted an electronic search of the literature published between1980 and 2016 from PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Academic Search Premier, and related health resources websites to address the aims of this study. Outcomes Fifty-six primary research articles (42 observational studies and 14 experimental and quasi-experimental studies) were selected based on our study aims and inclusion criteria. The studies revealed that individuals with CVD are at a greater risk for SRBDs and that SRBDs can worsen CVD. The findings from the studies also suggest that positive airway treatment could improve both SRBDs and CVD. Conclusions This review found a close relationship between SRBDs and CVD. APRNs are in key positions to identify and help patients manage SRBDs. In particular, APRNs can educate staff and establish standards of practice to improve outcomes for CVD patients. PMID:27753673
Moon, Chooza; Phelan, Cynthia H; Lauver, Diane R; Bratzke, Lisa C
Sleep-related breathing disorders (SRBDs), including obstructive sleep apnea and central sleep apnea, are common among patients with cardiovascular disease (CVD), but clinicians often do not pay enough attention to SRBDs. The purpose of this narrative review is to update advanced practice registered nurses on the literature focusing on the relationship between SRBDs and CVD (eg, hypertension, heart failure, coronary artery disease, arrhythmias, and stroke) and on treatments that can improve SRBDs in patients with CVD. We conducted an electronic search of the literature published between 1980 and 2016 from PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Academic Search Premier, and related health resource Web sites to address the aims of this study. Fifty-six primary research articles (42 observational studies and 14 experimental and quasi-experimental studies) were selected based on our study aims and inclusion criteria. The studies revealed that individuals with CVD are at a greater risk for SRBDs and that SRBDs can worsen CVD. The findings from the studies also suggest that positive airway treatment could improve both SRBDs and CVD. This review found a close relationship between SRBDs and CVD. Advanced practice registered nurses are in key positions to identify and help patients manage SRBDs. In particular, advanced practice registered nurses can educate staff and establish standards of practice to improve outcomes for patients with CVD.
The role of nutraceuticals in the prevention of cardiovascular disease.
Sosnowska, Bozena; Penson, Peter; Banach, Maciej
2017-04-01
Cardiovascular disease (CVD) ranks among the most common health-related and economic issues worldwide. Dietary factors are important contributors to cardiovascular risk, either directly, or through their effects on other cardiovascular risk factors including hypertension, dyslipidemia and diabetes mellitus. Nutraceuticals are natural nutritional compounds, which have been shown to be efficacious in preventative medicine or in the treatment of disease. Several foods and dietary supplements have been shown to protect against the development of CVD. The aim of this review is to present an update on the most recent evidence relating to the use of nutraceuticals in the context of the prevention and treatment of CVD.
The role of nutraceuticals in the prevention of cardiovascular disease
Sosnowska, Bozena; Penson, Peter
2017-01-01
Cardiovascular disease (CVD) ranks among the most common health-related and economic issues worldwide. Dietary factors are important contributors to cardiovascular risk, either directly, or through their effects on other cardiovascular risk factors including hypertension, dyslipidemia and diabetes mellitus. Nutraceuticals are natural nutritional compounds, which have been shown to be efficacious in preventative medicine or in the treatment of disease. Several foods and dietary supplements have been shown to protect against the development of CVD. The aim of this review is to present an update on the most recent evidence relating to the use of nutraceuticals in the context of the prevention and treatment of CVD. PMID:28529919
The Chemistry of Inorganic Precursors during the Chemical Deposition of Films on Solid Surfaces.
Barry, Seán T; Teplyakov, Andrew V; Zaera, Francisco
2018-03-20
The deposition of thin solid films is central to many industrial applications, and chemical vapor deposition (CVD) methods are particularly useful for this task. For one, the isotropic nature of the adsorption of chemical species affords even coverages on surfaces with rough topographies, an increasingly common requirement in microelectronics. Furthermore, by splitting the overall film-depositing reactions into two or more complementary and self-limiting steps, as it is done in atomic layer depositions (ALD), film thicknesses can be controlled down to the sub-monolayer level. Thanks to the availability of a vast array of inorganic and metalorganic precursors, CVD and ALD are quite versatile and can be engineered to deposit virtually any type of solid material. On the negative side, the surface chemistry that takes place in these processes is often complex, and can include undesirable side reactions leading to the incorporation of impurities in the growing films. Appropriate precursors and deposition conditions need to be chosen to minimize these problems, and that requires a proper understanding of the underlying surface chemistry. The precursors for CVD and ALD are often designed and chosen based on their known thermal chemistry from inorganic chemistry studies, taking advantage of the vast knowledge developed in that field over the years. Although a good first approximation, however, this approach can lead to wrong choices, because the reactions of these precursors at gas-solid interfaces can be quite different from what is seen in solution. For one, solvents often aid in the displacement of ligands in metalorganic compounds, providing the right dielectric environment, temporarily coordinating to the metal, or facilitating multiple ligand-complex interactions to increase reaction probabilities; these options are not available in the gas-solid reactions associated with CVD and ALD. Moreover, solid surfaces act as unique "ligands", if these reactions are to be viewed from the point of view of the metalorganic complexes used as precursors: they are bulky and rigid, can provide multiple binding sites for a single reaction, and can promote unique bonding modes, especially on metals, which have delocalized electronic structures. The differences between the molecular and surface chemistry of CVD and ALD precursors can result in significant variations in their reactivity, ultimately leading to unpredictable properties in the newly grown films. In this Account, we discuss some of the main similarities and differences in chemistry that CVD/ALD precursors follow on surfaces when contrasted against their known behavior in solution, with emphasis on our own work but also referencing other key contributions. Our approach is unique in that it combines expertise from the inorganic, surface science, and quantum-mechanics fields to better understand the mechanistic details of the chemistry of CVD and ALD processes and to identify new criteria to consider when designing CVD/ALD precursors.
NASA Astrophysics Data System (ADS)
Iwasaki, Tomohiro; Makino, Yuri; Fukukawa, Makoto; Nakamura, Hideya; Watano, Satoru
2016-11-01
To synthesize nitrogen-doped carbon nanofibers (N-CNFs) at high growth rates and low temperatures less than 673 K, nickel species (metallic nickel and nickel oxide) supported on alumina particles were used as the catalysts for an acetonitrile catalytic chemical vapor deposition (CVD) process. The nickel:alumina mass ratio in the catalysts was fixed at 0.05:1. The catalyst precursors were prepared from various nickel salts (nitrate, chloride, sulfate, acetate, and lactate) and then calcined at 1073 K for 1 h in oxidative (air), reductive (hydrogen-containing argon), or inert (pure argon) atmospheres to activate the nickel-based catalysts. The effects of precursors and calcination atmosphere on the catalyst activity at low temperatures were studied. We found that the catalysts derived from nickel nitrate had relatively small crystallite sizes of nickel species and provided N-CNFs at high growth rates of 57 ± 4 g-CNF/g-Ni/h at 673 K in the CVD process using 10 vol% hydrogen-containing argon as the carrier gas of acetonitrile vapor, which were approximately 4 times larger than that of a conventional CVD process. The obtained results reveal that nitrate ions in the catalyst precursor and hydrogen in the carrier gas can contribute effectively to the activation of catalysts in low-temperature CVD. The fiber diameter and nitrogen content of N-CNFs synthesized at high growth rates were several tens of nanometers and 3.5 ± 0.3 at.%, respectively. Our catalysts and CVD process may lead to cost reductions in the production of N-CNFs.
Wolterink, Jelmer M; Leiner, Tim; de Vos, Bob D; Coatrieux, Jean-Louis; Kelm, B Michael; Kondo, Satoshi; Salgado, Rodrigo A; Shahzad, Rahil; Shu, Huazhong; Snoeren, Miranda; Takx, Richard A P; van Vliet, Lucas J; van Walsum, Theo; Willems, Tineke P; Yang, Guanyu; Zheng, Yefeng; Viergever, Max A; Išgum, Ivana
2016-05-01
The amount of coronary artery calcification (CAC) is a strong and independent predictor of cardiovascular disease (CVD) events. In clinical practice, CAC is manually identified and automatically quantified in cardiac CT using commercially available software. This is a tedious and time-consuming process in large-scale studies. Therefore, a number of automatic methods that require no interaction and semiautomatic methods that require very limited interaction for the identification of CAC in cardiac CT have been proposed. Thus far, a comparison of their performance has been lacking. The objective of this study was to perform an independent evaluation of (semi)automatic methods for CAC scoring in cardiac CT using a publicly available standardized framework. Cardiac CT exams of 72 patients distributed over four CVD risk categories were provided for (semi)automatic CAC scoring. Each exam consisted of a noncontrast-enhanced calcium scoring CT (CSCT) and a corresponding coronary CT angiography (CCTA) scan. The exams were acquired in four different hospitals using state-of-the-art equipment from four major CT scanner vendors. The data were divided into 32 training exams and 40 test exams. A reference standard for CAC in CSCT was defined by consensus of two experts following a clinical protocol. The framework organizers evaluated the performance of (semi)automatic methods on test CSCT scans, per lesion, artery, and patient. Five (semi)automatic methods were evaluated. Four methods used both CSCT and CCTA to identify CAC, and one method used only CSCT. The evaluated methods correctly detected between 52% and 94% of CAC lesions with positive predictive values between 65% and 96%. Lesions in distal coronary arteries were most commonly missed and aortic calcifications close to the coronary ostia were the most common false positive errors. The majority (between 88% and 98%) of correctly identified CAC lesions were assigned to the correct artery. Linearly weighted Cohen's kappa for patient CVD risk categorization by the evaluated methods ranged from 0.80 to 1.00. A publicly available standardized framework for the evaluation of (semi)automatic methods for CAC identification in cardiac CT is described. An evaluation of five (semi)automatic methods within this framework shows that automatic per patient CVD risk categorization is feasible. CAC lesions at ambiguous locations such as the coronary ostia remain challenging, but their detection had limited impact on CVD risk determination.
Processed red meat contribution to dietary patterns and the associated cardio-metabolic outcomes.
Lenighan, Yvonne M; Nugent, Anne P; Li, Kaifeng F; Brennan, Lorraine; Walton, Janette; Flynn, Albert; Roche, Helen M; McNulty, Breige A
2017-08-01
Evidence suggests that processed red meat consumption is a risk factor for CVD and type 2 diabetes (T2D). This analysis investigates the association between dietary patterns, their processed red meat contributions, and association with blood biomarkers of CVD and T2D, in 786 Irish adults (18-90 years) using cross-sectional data from a 2011 national food consumption survey. All meat-containing foods consumed were assigned to four food groups (n 502) on the basis of whether they contained red or white meat and whether they were processed or unprocessed. The remaining foods (n 2050) were assigned to twenty-nine food groups. Two-step and k-means cluster analyses were applied to derive dietary patterns. Nutrient intakes, plasma fatty acids and biomarkers of CVD and T2D were assessed. A total of four dietary patterns were derived. In comparison with the pattern with lower contributions from processed red meat, the dietary pattern with greater processed red meat intakes presented a poorer Alternate Healthy Eating Index (21·2 (sd 7·7)), a greater proportion of smokers (29 %) and lower plasma EPA (1·34 (sd 0·72) %) and DHA (2·21 (sd 0·84) %) levels (P<0·001). There were no differences in classical biomarkers of CVD and T2D, including serum cholesterol and insulin, across dietary patterns. This suggests that the consideration of processed red meat consumption as a risk factor for CVD and T2D may need to be re-assessed.
A Walk (or Cycle) to the Park: Active Transit to Neighborhood Amenities, the CARDIA Study
Boone-Heinonen, Janne; Jacobs, David R.; Sidney, Stephen; Sternfeld, Barbara; Lewis, Cora E.; Gordon-Larsen, Penny
2009-01-01
Background Building on known associations between active commuting and reduced cardiovascular disease (CVD) risk, this study examines active transit to neighborhood amenities and differences between walking versus cycling for transportation. Method Year 20 data from the Coronary Artery Risk Development in Young Adults (CARDIA) study (3549 black and white adults aged 38–50 years in 2005–06) were analyzed in 2008–2009. Sociodemographic correlates of transportation mode (car-only, walk-only, any cycling, other) to neighborhood amenities were examined in multivariable multinomial logistic models. Gender-stratified, multivariable linear or multinomial regression models compared CVD risk factors across transit modes. Results Active transit was most common to parks and public transit stops; walking was more common than cycling. Among those who used each amenity, active transit (walk-only and any cycling versus car-only transit) was more common in men and those with no live-in partner and less than full-time employment [significant OR's (95% CI) ranging from 1.56 (1.08, 2.27) to 4.52 (1.70, 12.14)], and less common in those with children. Active transit to any neighborhood amenity was associated with more favorable BMI, waist circumference, and fitness [largest coefficient (95% CI) −1.68 (−2.81, −0.55) for BMI, −3.41 (−5.71, −1.11) for waist circumference (cm), and 36.65 (17.99, 55.31) for treadmill test duration (sec)]. Only cycling was associated with lower lifetime CVD risk classification. Conclusion Active transit to neighborhood amenities was related to sociodemographics and CVD risk factors. Variation in health-related benefits by active transit mode, if validated in prospective studies, may have implications for transportation planning and research. PMID:19765499
Continuous patient engagement in cardiovascular disease clinical comparative effectiveness research.
Vandigo, Joseph; Oloyede, Ebenezer; Aly, Abdalla; Laird, Aurelia L; Cooke, Catherine E; Mullins, C Daniel
2016-01-01
Researchers have produced evidence that identifies interventions that reduce cardiovascular disease (CVD) risk; however, despite a significant investment in research CVD remains the leading cause of death. Engaging patients in the research process has the potential to ensure that evidence-based treatments are adopted in real-world practice to improve patient outcomes. The Patient-Centered Outcomes Research Institute has created an Engagement Rubric to guide meaningful engagement in the research process. A 10-step systematic framework to enhance patient engagement throughout the comparative effectiveness research process also has been proposed. This special report identifies the relationship between these two approaches to patient engagement and describes examples of how patients could be engaged in a hypothetical CVD study.
Cardiovascular disease in women.
Lee, L Veronica; Foody, Joanne Micale
2008-08-01
The rates of cardiovascular disease (CVD) have decreased significantly for men over the past few decades, but similar reductions have not occurred in women. Consequently, CVD remains the leading killer of women in the United States. Men usually develop heart disease earlier than women, but women develop heart disease more rapidly once menopause has occurred. A review of risk factors that are common between men and women demonstrates some notable sex-dependent differences. Many of these changes appear related to the hormonal changes that occur in menopause, such as the development of hypertension, changes in lipid concentrations, and central adiposity. In addition, diabetes is a more significant risk factor for CVD in women than men. Sociologic and physiologic factors need to be considered in treatment of risk factors, such as smoking, lack of exercise, obesity, and depression. Prevention is known to significantly reduce CVD risk, but new goals are being established for women as the sex-dependent differences have become apparent.
Applegate, Kara Arnold; Thiese, Matthew S; Merryweather, Andrew S; Kapellusch, Jay; Drury, David L; Wood, Eric; Kendall, Richard; Foster, James; Garg, Arun; Hegmann, Kurt T
2017-02-01
Recent evidence has found potential associations between cardiovascular disease (CVD) risk factors and common musculoskeletal disorders. We evaluated possible associations between risk factors and both glenohumeral joint pain and rotator cuff tendinopathy. Data from WISTAH hand study participants (n = 1226) were assessed for associations between Framingham Heart Study CVD risk factors and both health outcomes. A strong association was observed between CVD risk scores and both glenohumeral joint pain and rotator cuff tendinopathy. Peak odds ratios (ORs) of the adjusted models were 4.55 [95% confidence interval (95% CI) 1.97 to 10.31] and 5.97 (95% CI 2.12 to 16.83), respectively. The results show a dose-response trend of increasing risk. Individual risk factors were associated with both outcomes. Combined, CVD risk factors demonstrated a strong correlation with glenohumeral joint pain and an even stronger correlation with rotator cuff tendinopathy. Results suggest a potentially modifiable disease mechanism.
Masood, Durr-e-Nayab; Roach, Emir C.; Beauregard, Katie G.; Khalil, Raouf A.
2010-01-01
Epidemiological studies have shown that cardiovascular disease (CVD) is less common in pre-menopausal women (Pre-MW) compared to men of the same age or post-menopausal women (Post-MW), suggesting cardiovascular benefits of estrogen. Estrogen receptors (ERs) have been identified in the vasculature, and experimental studies have demonstrated vasodilator effects of estrogen/ER on the endothelium, vascular smooth muscle (VSM) and extracellular matrix. Several natural and synthetic estrogenic preparations have been developed for relief of menopausal vasomotor symptoms. However, whether menopausal hormone therapy (MHT) is beneficial in postmenopausal CVD remains controversial. Despite reports of vascular benefits of MHT from observational and experimental studies, randomized clinical trials (RCTs), such as the Heart and Estrogen/progestin Replacement Study (HERS) and the Women’s Health Initiative (WHI), have suggested that, contrary to expectations, MHT may increase the risk of CVD. These discrepancies could be due to age-related changes in sex hormone synthesis and metabolism, which would influence the effective dose of MHT and the sex hormone environment in Post-MW. Age-related changes in the vascular ER subtype, structure, expression, distribution, and post-ER signaling pathways in the endothelium and VSM, along with factors related to the design of RCTs, preexisting CVD condition, and structural changes in the blood vessels architecture have also been suggested as possible causes of MHT failure in CVD. Careful examination of these factors should help in identifying the causes of the changes in the vascular effects of estrogen with age. The sex hormone metabolic pathways, the active versus inactive estrogen metabolites, and their effects on vascular function, the mitochondria, the inflammatory process and angiogenesis should be further examined. Also, the genomic and non-genomic effects of estrogenic compounds should be viewed as integrated rather than discrete responses. The complex interactions between these factors highlight the importance of careful design of MHT RCTs, and the need of a more customized approach for each individual patient in order to enhance the vascular benefits of MHT in postmenopausal CVD. PMID:21189141
Fibrinogen concentration and its role in CVD risk in black South Africans--effect of urbanisation.
Pieters, Marlien; de Maat, Moniek P M; Jerling, Johann C; Hoekstra, Tiny; Kruger, Annamarie
2011-09-01
The aim of this study was to investigate correlates of fibrinogen concentration in black South Africans, as well as its association with cardiovascular disease (CVD) risk and whether urbanisation influences this association. A total of 1,006 rural and 1,004 urban black South Africans from the PURE study were cross-sectionally analysed. The association of fibrinogen with CVD risk was determined by investigating the association of fibrinogen with other CVD risk markers as well as with predicted CVD risk using the Reynolds Risk score. The rural group had a significantly higher fibrinogen concentration than the urban group, despite higher levels of risk factors and increased predicted CVD risk in the urban group. Increased levels of CVD risk factors were, however, still associated with increased fibrinogen concentration. Fibrinogen correlated significantly, but weakly, with overall predicted CVD risk. This correlation was stronger in the urban than in the rural group. Multiple regression analysis showed that a smaller percentage of the variance in fibrinogen is explained by the traditional CVD risk factors in the rural than in the urban group. In conclusion, fibrinogen is weakly associated with CVD risk (predicted overall risk as well with individual risk factors) in black South Africans, and is related to the degree of urbanisation. Increased fibrinogen concentration, in black South Africans, especially in rural areas, is largely unexplained, and likely not strongly correlated with traditional CVD-related lifestyle and pathophysiological processes. This does, however, not exclude the possibility that once increased, the fibrinogen concentration contributes to future development of CVD.
High early cardiovascular mortality following liver transplantation
VanWagner, Lisa B.; Lapin, Brittany; Levitsky, Josh; Wilkins, John T.; Abecassis, Michael M.; Skaro, Anton I.; Lloyd-Jones, Donald M.
2014-01-01
Cardiovascular disease (CVD) contributes to excess long-term mortality after liver transplantation (LT), however little is known about early post-operative CVD mortality in the current era. In addition, there is no model to predict early post-operative CVD mortality across centers. We analyzed adult recipients of primary LT in the Organ Procurement and Transplantation Network (OPTN) database between February 2002 and December 2012 to assess prevalence and predictors of early (30-day) CVD mortality, defined as death from arrhythmia, heart failure, myocardial infarction, cardiac arrest, thromboembolism, and/or stroke. We performed logistic regression with stepwise selection to develop a predictive model of early CVD mortality. Sex and center volume were forced into the final model, which was validated using bootstrapping techniques. Among 54,697 LT recipients, there were 1576 (2.9%) deaths within 30 days. CVD death was the leading cause of 30-day mortality (42.1%), followed by infection (27.9%) and graft failure (12.2%). In multivariate analysis, 9 (6 recipient, 2 donor, 1 operative) significant covariates were identified: age, pre-operative hospitalization, ICU and ventilator status, calculated MELD score, portal vein thrombosis, national organ sharing, donor BMI and cold ischemia time. The model showed moderate discrimination (c-statistic 0.66, 95% CI: 0.63–0.68). We provide the first multicenter prognostic model for the prediction of early post-LT CVD death, the most common cause of early post-LT mortality in the current transplant era. However, evaluation of additional CVD-related variables not collected by the OPTN are needed in order to improve model accuracy and potential clinical utility. PMID:25044256
Leigh, J. Adam; O’Neal, Wesley T.; Soliman, Elsayed Z.
2016-01-01
Left ventricular hypertrophy (LVH) diagnosed by electrocardiography (ECG-LVH) and echocardiography (echo-LVH) are independently associated with an increased risk of cardiovascular disease (CVD) events. However, it is unknown if ECG-LVH retains its predictive properties independent of left ventricular anatomy. We compared the risk of CVD associated with ECG-LVH and echo-LVH in 4,076 participants (41% male, 86% white) from the Cardiovascular Health Study (CHS), who were free of baseline CVD. ECG-LVH was defined with Minnesota ECG Classification criteria from baseline ECG data. Echo-LVH was defined by sex-specific left ventricular mass values normalized to body surface area (male: >102 g/m2; female: >88 g/m2). ECG-LVH was detected in 144 (3.5%) participants and echo-LVH in 430 (11%) participants. Over a median follow-up of 10.6 years, 2,274 CVD events occurred. In a multivariable Cox regression analysis adjusted for common CVD risk factors, ECG-LVH (HR=1.84, 95%CI=1.51, 2.24) and echo-LVH (HR=1.35, 95%CI=1.19, 1.54) were associated with an increased risk for CVD events. The association between ECG-LVH and CVD events was not substantively altered with further adjustment for echo-LVH (HR=1.76, 95%CI=1.45, 2.15). In conclusion, the association of ECG-LVH with CVD events is not dependent on echo-LVH. This finding provides support to the concept that ECG-LVH is an electrophysiologic marker with predictive properties independent of left ventricular anatomy. PMID:27067620
Risk of future cardiovascular disease in women with prior preeclampsia: a focus group study.
Seely, Ellen W; Rich-Edwards, Janet; Lui, Janet; Nicklas, Jacinda M; Saxena, Aditi; Tsigas, Eleni; Levkoff, Sue E
2013-12-21
A history of preeclampsia is a risk factor for the future development of hypertension and cardiovascular disease (CVD). The objective of this study was to assess, in women with prior preeclampsia, the level of knowledge regarding the link between preeclampsia and CVD, motivators for and barriers to lifestyle change and interest in a lifestyle modification program to decrease CVD risk following a pregnancy complicated by preeclampsia. Twenty women with a history of preeclampsia participated in 5 phone-based focus groups. Focus groups were recorded, transcribed, and analyzed. Qualitative content analysis was used to identify common themes across focus groups. Consensus was reached on a representative set of themes describing the data. Women with prior preeclampsia were in general unaware of the link between preeclampsia and future CVD but eager to learn about this link and motivated to achieve a healthy lifestyle. Major perceived barriers to lifestyle change were lack of time, cost of healthy foods and family responsibilities. Perceived facilitators included knowledge of the link between preeclampsia and CVD, a desire to stay healthy, and creating a healthy home for their children. Women with prior preeclampsia were interested in the idea of a web-based program focused on lifestyle strategies to decrease CVD risk in women. Women with prior preeclampsia were eager to learn about the link between preeclampsia and CVD and to take steps to reduce CVD risk. A web-based program to help women with prior preeclampsia adopt a healthy lifestyle may be an appropriate strategy for this population.
CVD2014-A Database for Evaluating No-Reference Video Quality Assessment Algorithms.
Nuutinen, Mikko; Virtanen, Toni; Vaahteranoksa, Mikko; Vuori, Tero; Oittinen, Pirkko; Hakkinen, Jukka
2016-07-01
In this paper, we present a new video database: CVD2014-Camera Video Database. In contrast to previous video databases, this database uses real cameras rather than introducing distortions via post-processing, which results in a complex distortion space in regard to the video acquisition process. CVD2014 contains a total of 234 videos that are recorded using 78 different cameras. Moreover, this database contains the observer-specific quality evaluation scores rather than only providing mean opinion scores. We have also collected open-ended quality descriptions that are provided by the observers. These descriptions were used to define the quality dimensions for the videos in CVD2014. The dimensions included sharpness, graininess, color balance, darkness, and jerkiness. At the end of this paper, a performance study of image and video quality algorithms for predicting the subjective video quality is reported. For this performance study, we proposed a new performance measure that accounts for observer variance. The performance study revealed that there is room for improvement regarding the video quality assessment algorithms. The CVD2014 video database has been made publicly available for the research community. All video sequences and corresponding subjective ratings can be obtained from the CVD2014 project page (http://www.helsinki.fi/psychology/groups/visualcognition/).
SIRT1 and SIRT6 Signaling Pathways in Cardiovascular Disease Protection
D'Onofrio, Nunzia; Servillo, Luigi
2018-01-01
Abstract Significance: Oxidative stress represents the common hallmark of pathological conditions associated with cardiovascular disease (CVD), including atherosclerosis, heart failure, hypertension, aging, diabetes, and other vascular system-related diseases. The sirtuin (SIRT) family, comprising seven proteins (SIRT1–SIRT7) sharing a highly conserved nicotinamide adenine dinucleotide (NAD+)-binding catalytic domain, attracted a great attention for the past few years as stress adaptor and epigenetic enzymes involved in the cellular events controlling aging-related disorder, cancer, and CVD. Recent Advances: Among sirtuins, SIRT1 and SIRT6 are the best characterized for their protective roles against inflammation, vascular aging, heart disease, and atherosclerotic plaque development. This latest role has been only recently unveiled for SIRT6. Of interest, in recent years, complex signaling networks controlled by SIRT1 and SIRT6 common to stress resistance, vascular aging, and CVD have emerged. Critical Issues: We provide a comprehensive overview of recent developments on the molecular signaling pathways controlled by SIRT1 and SIRT6, two post-translational modifiers proven to be valuable tools to dampen inflammation and oxidative stress at the cardiovascular level. Future Directions: A deeper understanding of the epigenetic mechanisms through which SIRT1 and SIRT6 act in the signalings responsible for onset and development CVD is a prime scientific endeavor of the upcoming years. Multiple “omic” technologies will have widespread implications in understanding such mechanisms, speeding up the achievement of selective and efficient pharmacological modulation of sirtuins for future applications in the prevention and treatment of CVD. Antioxid. Redox Signal. 28, 711–732. PMID:28661724
Chemical vapor deposition of mullite coatings
Sarin, Vinod; Mulpuri, Rao
1998-01-01
This invention is directed to the creation of crystalline mullite coatings having uniform microstructure by chemical vapor deposition (CVD). The process comprises the steps of establishing a flow of reactants which will yield mullite in a CVD reactor, and depositing a crystalline coating from the reactant flow. The process will yield crystalline coatings which are dense and of uniform thickness.
Bailey, Regan L; Fakhouri, Tala H; Park, Yikyung; Dwyer, Johanna T; Thomas, Paul R; Gahche, Jaime J; Miller, Paige E; Dodd, Kevin W; Sempos, Christopher T; Murray, David M
2015-03-01
Multivitamin-mineral (MVM) products are the most commonly used supplements in the United States, followed by multivitamin (MV) products. Two randomized clinical trials (RCTs) did not show an effect of MVMs or MVs on cardiovascular disease (CVD) mortality; however, no clinical trial data are available for women with MVM supplement use and CVD mortality. The objective of this research was to examine the association between MVM and MV use and CVD-specific mortality among US adults without CVD. A nationally representative sample of adults from the restricted data NHANES III (1988-1994; n = 8678; age ≥40 y) were matched with mortality data reported by the National Death Index through 2011 to examine associations between MVM and MV use and CVD mortality by using Cox proportional hazards models, adjusting for multiple potential confounders. We observed no significant association between CVD mortality and users of MVMs or MVs compared with nonusers; however, when users were classified by the reported length of time products were used, a significant association was found with MVM use of >3 y compared with nonusers (HR: 0.65; 95% CI: 0.49, 0.85). This finding was largely driven by the significant association among women (HR: 0.56; 95% CI: 0.37, 0.85) but not men (HR: 0.79; 95% CI: 0.44, 1.42). No significant association was observed for MV products and CVD mortality in fully adjusted models. In this nationally representative data set with detailed information on supplement use and CVD mortality data ∼20 y later, we found an association between MVM use of >3 y and reduced CVD mortality risk for women when models controlled for age, race, education, body mass index, alcohol, aspirin use, serum lipids, blood pressure, and blood glucose/glycated hemoglobin. Our results are consistent with the 1 available RCT in men, indicating no relation with MVM use and CVD mortality. © 2015 American Society for Nutrition.
NASA Astrophysics Data System (ADS)
Yazdanfar, M.; Stenberg, P.; Booker, I. D.; Ivanov, I. G.; Kordina, O.; Pedersen, H.; Janzén, E.
2013-10-01
The development of a chemical vapor deposition (CVD) process for very thick silicon carbide (SiC) epitaxial layers suitable for high power devices is demonstrated by epitaxial growth of 200 μm thick, low doped 4H-SiC layers with excellent morphology at growth rates exceeding 100 μm/h. The process development was done in a hot wall CVD reactor without rotation using both SiCl4 and SiH4+HCl precursor approaches to chloride based growth chemistry. A C/Si ratio <1 and an optimized in-situ etch are shown to be the key parameters to achieve 200 μm thick, low doped epitaxial layers with excellent morphology.
Athyros, Vasilios G; Alexandrides, Theodore K; Bilianou, Helen; Cholongitas, Evangelos; Doumas, Michael; Ganotakis, Emmanuel S; Goudevenos, John; Elisaf, Moses S; Germanidis, Georgios; Giouleme, Olga; Karagiannis, Asterios; Karvounis, Charalambos; Katsiki, Niki; Kotsis, Vasilios; Kountouras, Jannis; Liberopoulos, Evangelos; Pitsavos, Christos; Polyzos, Stergios; Rallidis, Loukianos S; Richter, Dimitrios; Tsapas, Apostolos G; Tselepis, Alexandros D; Tsioufis, Konstantinos; Tziomalos, Konstantinos; Tzotzas, Themistoklis; Vasiliadis, Themistoklis G; Vlachopoulos, Charalambos; Mikhailidis, Dimitri P; Mantzoros, Christos
2017-06-01
Non-alcoholic fatty liver disease (NAFLD), the most common liver disease, is characterized by accumulation of fat (>5% of the liver tissue), in the absence of alcohol abuse or other chronic liver diseases. It is closely related to the epidemic of obesity, metabolic syndrome or type 2 diabetes mellitus (T2DM). NAFLD can cause liver inflammation and progress to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis or hepatocellular cancer (HCC). Nevertheless, cardiovascular disease (CVD) is the most common cause of death in NAFLD/NASH patients. Current guidelines suggest the use of pioglitazone both in patients with T2DM and in those without. The use of statins, though considered safe by the guidelines, have very limited use; only 10% in high CVD risk patients are on statins by tertiary centers in the US. There are data from several animal studies, 5 post hoc analyses of prospective long-term survival studies, and 5 rather small biopsy proven NASH studies, one at baseline and on at the end of the study. All these studies provide data for biochemical and histological improvement of NAFLD/NASH with statins and in the clinical studies large reductions in CVD events in comparison with those also on statins and normal liver. Ezetimibe was also reported to improve NAFLD. Drugs currently in clinical trials seem to have potential for slowing down the evolution of NAFLD and for reducing liver- and CVD-related morbidity and mortality, but it will take time before they are ready to be used in everyday clinical practice. The suggestion of this Expert Panel is that, pending forthcoming randomized clinical trials, physicians should consider using a PPARgamma agonist, such as pioglitazone, or, statin use in those with NAFLD/NASH at high CVD or HCC risk, alone and/or preferably in combination with each other or with ezetimibe, for the primary or secondary prevention of CVD, and the avoidance of cirrhosis, liver transplantation or HCC, bearing in mind that CVD is the main cause of death in NAFLD/NASH patients. Copyright © 2017 Elsevier Inc. All rights reserved.
Injection doping of ultrathin microcrystalline silicon films prepared by CC-CVD
DOE Office of Scientific and Technical Information (OSTI.GOV)
Koynov, S.; Grebner, S.; Schwarz, R.
1997-07-01
Recently, the authors have proposed a cyclic method, referred to as Closed Chamber CVD (CC-CVD), for the preparation of {micro}c-Si films of high crystalline fraction at increased deposition rates. In this work, they first report new process conditions of CC-CVD, which result in growth of highly crystalline films with a sharp interface on a foreign substrate. Then these conditions are further used together with a pulsed injection of B{sub 2}H{sub 6} in an appropriate moment of each cycle, so that the disturbance of the crystallization process is prevented. A series of ultrathin {micro}c-Si films, doped by this technique, is characterizedmore » by conductivity measurements, SEM, Raman Scattering, optical transmission and UV reflection. A strong reduction of the transient interface layer is achieved and conductivity as high as 2 S/cm
Fermented dairy food and CVD risk.
Tapsell, Linda C
2015-04-01
Fermented dairy foods such as yoghurt and cheese are commonly found in the Mediterranean diet. Recent landmark research has confirmed the effect of the Mediterranean diet on reducing the CVD risk, but the relative contributions of fermented dairy foods have not been fully articulated. The present study provides a review of the relationship between fermented dairy foods consumption and CVD risk in the context of the whole diet. Studies show that people who eat healthier diets may be more likely to consume yoghurt, so there is a challenge in attributing separate effects to yoghurt. Analyses from large population studies list yoghurt as the food most negatively associated with the risk of weight gain (a problem that may lead to CVD). There is some suggestion that fermented dairy foods consumption (yoghurt or cheese) may be associated with reduced inflammatory biomarkers associated with the development of CVD. Dietary trials suggest that cheese may not have the same effect on raising LDL-cholesterol levels as butter with the same saturated fat content. The same might be stated for yoghurt. The use of different probiotic cultures and other aspects of study design remain a problem for research. Nevertheless, population studies from a range of countries have shown that a reduced risk of CVD occurs with the consumption of fermented dairy foods. A combination of evidence is necessary, and more research is always valuable, but indications remain that fermented dairy foods such as cheese and yoghurt are integral to diets that are protective against CVD.
Effect of obesity on cardiovascular disease risk factors in African American women.
Henry-Okafor, Queen; Cowan, Patricia A; Wicks, Mona N; Rice, Muriel; Husch, Donna S; Khoo, Michelle S C
2012-04-01
Obesity is a growing health care concern with implications for cardiovascular disease (CVD). Obesity and CVD morbidity and mortality are highly prevalent among African American women. This pilot study examined the association between obesity and the traditional and emerging CVD risk factors in a sample of African American women. Participants comprised 48 women (27 obese, 21 normal weight) aged 18-45. with no known history of CVD. The women completed demographic and 7-day physical activity recall questionnaires. Height and weight were used to determine body mass index (BMI). Hypertension risk was assessed using the average of two resting blood pressure (BP) measurements. Lipid profile, blood glucose, fibrinogen, high-sensitivity C-reactive protein (hs-CRP), plasminogen activator inhibitor-1 (PAI-1), soluble intercellular adhesion molecule-1 (sICAM-1), and E-selectin (eSel) levels were assessed using fasting blood samples. Laboratory findings were interpreted using the American Diabetes Association (ADA) and Adult Treatment Panel (ATP) III reference guidelines as well as manufacturers' reference ranges for the novel CVD risk factors. The most common traditional risk factors were physical inactivity (72.9%), positive family history of CVD (58.3%), and obesity (56.3%). Obese individuals had elevated systolic BP (p = .0002), diastolic BP (p = .0007) and HDL-cholesterol (p = .01), triglyceride (p = .02), hs-CRP (p = .002), and fibrinogen (p = .01), when compared with normal-weight women. The findings suggest an association between obesity and higher prevalence of both traditional and emerging CVD risk factors in young African American women.
Huffman, Mark D.; Rao, Krishna D.; Pichon-Riviere, Andres; Zhao, Dong; Harikrishnan, S.; Ramaiya, Kaushik; Ajay, V. S.; Goenka, Shifalika; Calcagno, Juan I.; Caporale, Joaquín E.; Niu, Shaoli; Li, Yan; Liu, Jing; Thankappan, K. R.; Daivadanam, Meena; van Esch, Jan; Murphy, Adrianna; Moran, Andrew E.; Gaziano, Thomas A.; Suhrcke, Marc; Reddy, K. Srinath; Leeder, Stephen; Prabhakaran, Dorairaj
2011-01-01
Objective To estimate individual and household economic impact of cardiovascular disease (CVD) in selected low- and middle-income countries (LMIC). Background Empirical evidence on the microeconomic consequences of CVD in LMIC is scarce. Methods and Findings We surveyed 1,657 recently hospitalized CVD patients (66% male; mean age 55.8 years) from Argentina, China, India, and Tanzania to evaluate the microeconomic and functional/productivity impact of CVD hospitalization. Respondents were stratified into three income groups. Median out-of-pocket expenditures for CVD treatment over 15 month follow-up ranged from 354 international dollars (2007 INT$, Tanzania, low-income) to INT$2,917 (India, high-income). Catastrophic health spending (CHS) was present in >50% of respondents in China, India, and Tanzania. Distress financing (DF) and lost income were more common in low-income respondents. After adjustment, lack of health insurance was associated with CHS in Argentina (OR 4.73 [2.56, 8.76], India (OR 3.93 [2.23, 6.90], and Tanzania (OR 3.68 [1.86, 7.26] with a marginal association in China (OR 2.05 [0.82, 5.11]). These economic effects were accompanied by substantial decreases in individual functional health and productivity. Conclusions Individuals in selected LMIC bear significant financial burdens following CVD hospitalization, yet with substantial variation across and within countries. Lack of insurance may drive much of the financial stress of CVD in LMIC patients and their families. PMID:21695127
Challenges of developing a cardiovascular risk calculator for patients with rheumatoid arthritis.
Crowson, Cynthia S; Rollefstad, Silvia; Kitas, George D; van Riel, Piet L C M; Gabriel, Sherine E; Semb, Anne Grete
2017-01-01
Cardiovascular disease (CVD) risk calculators designed for use in the general population do not accurately predict the risk of CVD among patients with rheumatoid arthritis (RA), who are at increased risk of CVD. The process of developing risk prediction models involves numerous issues. Our goal was to develop a CVD risk calculator for patients with RA. Thirteen cohorts of patients with RA originating from 10 different countries (UK, Norway, Netherlands, USA, Sweden, Greece, South Africa, Spain, Canada and Mexico) were combined. CVD risk factors and RA characteristics at baseline, in addition to information on CVD outcomes were collected. Cox models were used to develop a CVD risk calculator, considering traditional CVD risk factors and RA characteristics. Model performance was assessed using measures of discrimination and calibration with 10-fold cross-validation. A total of 5638 RA patients without prior CVD were included (mean age: 55 [SD: 14] years, 76% female). During a mean follow-up of 5.8 years (30139 person years), 389 patients developed a CVD event. Event rates varied between cohorts, necessitating inclusion of high and low risk strata in the models. The multivariable analyses revealed 2 risk prediction models including either a disease activity score including a 28 joint count and erythrocyte sedimentation rate (DAS28ESR) or a health assessment questionnaire (HAQ) along with age, sex, presence of hypertension, current smoking and ratio of total cholesterol to high-density lipoprotein cholesterol. Unfortunately, performance of these models was similar to general population CVD risk calculators. Efforts to develop a specific CVD risk calculator for patients with RA yielded 2 potential models including RA disease characteristics, but neither demonstrated improved performance compared to risk calculators designed for use in the general population. Challenges encountered and lessons learned are discussed in detail.
Making Ceramic Fibers By Chemical Vapor
NASA Technical Reports Server (NTRS)
Revankar, Vithal V. S.; Hlavacek, Vladimir
1994-01-01
Research and development of fabrication techniques for chemical vapor deposition (CVD) of ceramic fibers presented in two reports. Fibers of SiC, TiB2, TiC, B4C, and CrB2 intended for use as reinforcements in metal-matrix composite materials. CVD offers important advantages over other processes: fibers purer and stronger and processed at temperatures below melting points of constituent materials.
Advances in the Development of a WCl6 CVD System for Coating UO2 Powders with Tungsten
NASA Technical Reports Server (NTRS)
Mireles, Omar R.; Tieman, Alyssa; Broadway, Jeramie; Hickman, Robert
2013-01-01
Demonstrated viability and utilization of: a) Fluidized powder bed. b) WCl6 CVD process. c) Coated spherical particles with tungsten. The highly corrosive nature of the WCl6 solid reagent limits material of construction. Indications that identifying optimized process variables with require substantial effort and will likely vary with changes in fuel requirements.
2013-01-01
Background All rigorous primary cardiovascular disease (CVD) prevention guidelines recommend absolute CVD risk scores to identify high- and low-risk patients, but laboratory testing can be impractical in low- and middle-income countries. The purpose of this study was to compare the ranking performance of a simple, non-laboratory-based risk score to laboratory-based scores in various South African populations. Methods We calculated and compared 10-year CVD (or coronary heart disease (CHD)) risk for 14,772 adults from thirteen cross-sectional South African populations (data collected from 1987 to 2009). Risk characterization performance for the non-laboratory-based score was assessed by comparing rankings of risk with six laboratory-based scores (three versions of Framingham risk, SCORE for high- and low-risk countries, and CUORE) using Spearman rank correlation and percent of population equivalently characterized as ‘high’ or ‘low’ risk. Total 10-year non-laboratory-based risk of CVD death was also calculated for a representative cross-section from the 1998 South African Demographic Health Survey (DHS, n = 9,379) to estimate the national burden of CVD mortality risk. Results Spearman correlation coefficients for the non-laboratory-based score with the laboratory-based scores ranged from 0.88 to 0.986. Using conventional thresholds for CVD risk (10% to 20% 10-year CVD risk), 90% to 92% of men and 94% to 97% of women were equivalently characterized as ‘high’ or ‘low’ risk using the non-laboratory-based and Framingham (2008) CVD risk score. These results were robust across the six risk scores evaluated and the thirteen cross-sectional datasets, with few exceptions (lower agreement between the non-laboratory-based and Framingham (1991) CHD risk scores). Approximately 18% of adults in the DHS population were characterized as ‘high CVD risk’ (10-year CVD death risk >20%) using the non-laboratory-based score. Conclusions We found a high level of correlation between a simple, non-laboratory-based CVD risk score and commonly-used laboratory-based risk scores. The burden of CVD mortality risk was high for men and women in South Africa. The policy and clinical implications are that fast, low-cost screening tools can lead to similar risk assessment results compared to time- and resource-intensive approaches. Until setting-specific cohort studies can derive and validate country-specific risk scores, non-laboratory-based CVD risk assessment could be an effective and efficient primary CVD screening approach in South Africa. PMID:23880010
Leigh, J Adam; O'Neal, Wesley T; Soliman, Elsayed Z
2016-06-01
Left ventricular hypertrophy (LVH) diagnosed by electrocardiography (ECG-LVH) and echocardiography (echo-LVH) are independently associated with an increased risk of cardiovascular disease (CVD) events. However, it is unknown if ECG-LVH retains its predictive properties independent of LV anatomy. We compared the risk of CVD associated with ECG-LVH and echo-LVH in 4,076 participants (41% men, 86% white) from the Cardiovascular Health Study, who were free of baseline CVD. ECG-LVH was defined with Minnesota ECG Classification criteria from baseline ECG data. Echo-LVH was defined by gender-specific LV mass values normalized to body surface area (male: >102 g/m(2); female: >88 g/m(2)). ECG-LVH was detected in 144 participants (3.5%) and echo-LVH in 430 participants (11%). Over a median follow-up of 10.6 years, 2,274 CVD events occurred. In a multivariate Cox regression analysis adjusted for common CVD risk factors, ECG-LVH (hazard ratio [HR] 1.84, 95% CI 1.51 to 2.24) and echo-LVH (HR 1.35, 95% CI 1.19 to 1.54) were associated with an increased risk for CVD events. The association between ECG-LVH and CVD events was not substantively altered with further adjustment for echo-LVH (HR 1.76, 95% CI 1.45 to 2.15). In conclusion, the association of ECG-LVH with CVD events is not dependent on echo-LVH. This finding provides support to the concept that ECG-LVH is an electrophysiological marker with predictive properties independent of LV anatomy. Copyright © 2016 Elsevier Inc. All rights reserved.
Process in manufacturing high efficiency AlGaAs/GaAs solar cells by MO-CVD
NASA Technical Reports Server (NTRS)
Yeh, Y. C. M.; Chang, K. I.; Tandon, J.
1984-01-01
Manufacturing technology for mass producing high efficiency GaAs solar cells is discussed. A progress using a high throughput MO-CVD reactor to produce high efficiency GaAs solar cells is discussed. Thickness and doping concentration uniformity of metal oxide chemical vapor deposition (MO-CVD) GaAs and AlGaAs layer growth are discussed. In addition, new tooling designs are given which increase the throughput of solar cell processing. To date, 2cm x 2cm AlGaAs/GaAs solar cells with efficiency up to 16.5% were produced. In order to meet throughput goals for mass producing GaAs solar cells, a large MO-CVD system (Cambridge Instrument Model MR-200) with a susceptor which was initially capable of processing 20 wafers (up to 75 mm diameter) during a single growth run was installed. In the MR-200, the sequencing of the gases and the heating power are controlled by a microprocessor-based programmable control console. Hence, operator errors can be reduced, leading to a more reproducible production sequence.
Loucks, Eric B; Schuman-Olivier, Zev; Britton, Willoughby B; Fresco, David M; Desbordes, Gaelle; Brewer, Judson A; Fulwiler, Carl
2015-12-01
The purpose of this review is to provide (1) a synopsis on relations of mindfulness with cardiovascular disease (CVD) and major CVD risk factors, and (2) an initial consensus-based overview of mechanisms and theoretical framework by which mindfulness might influence CVD. Initial evidence, often of limited methodological quality, suggests possible impacts of mindfulness on CVD risk factors including physical activity, smoking, diet, obesity, blood pressure, and diabetes regulation. Plausible mechanisms include (1) improved attention control (e.g., ability to hold attention on experiences related to CVD risk, such as smoking, diet, physical activity, and medication adherence), (2) emotion regulation (e.g., improved stress response, self-efficacy, and skills to manage craving for cigarettes, palatable foods, and sedentary activities), and (3) self-awareness (e.g., self-referential processing and awareness of physical sensations due to CVD risk factors). Understanding mechanisms and theoretical framework should improve etiologic knowledge, providing customized mindfulness intervention targets that could enable greater mindfulness intervention efficacy.
Schuman-Olivier, Zev; Britton, Willoughby B.; Fresco, David M.; Desbordes, Gaelle; Brewer, Judson A.; Fulwiler, Carl
2016-01-01
The purpose of this review is to provide (1) a synopsis on relations of mindfulness with cardiovascular disease (CVD) and major CVD risk factors, and (2) an initial consensus-based overview of mechanisms and theoretical framework by which mindfulness might influence CVD. Initial evidence, often of limited methodological quality, suggests possible impacts of mindfulness on CVD risk factors including physical activity, smoking, diet, obesity, blood pressure, and diabetes regulation. Plausible mechanisms include (1) improved attention control (e.g., ability to hold attention on experiences related to CVD risk, such as smoking, diet, physical activity, and medication adherence), (2) emotion regulation (e.g., improved stress response, self-efficacy, and skills to manage craving for cigarettes, palatable foods, and sedentary activities), and (3) self-awareness (e.g., self-referential processing and awareness of physical sensations due to CVD risk factors). Understanding mechanisms and theoretical framework should improve etiologic knowledge, providing customized mindfulness intervention targets that could enable greater mindfulness intervention efficacy. PMID:26482755
Prevalence of Refractive Errors in Students with and without Color Vision Deficiency
Ostadimoghaddam, Hadi; Yekta, Abbas Ali; Heravian, Javad; Azimi, Abbas; Hosseini, Seyed Mahdi Ahmadi; Vatandoust, Sakineh; Sharifi, Fatemeh; Abolbashari, Fereshteh
2014-01-01
Purpose: To evaluate refractive errors in school age children with color vision deficiency (CVD) and those with normal color vision (NCV) in order to make a better understanding of the emmetropization process. Methods: A total of 4,400 primary school students aged 7–12 years were screened for color vision using Ishihara pseudoisochromatic color vision plate sets. Of these, 160 (3.6%) students had CVD. A total of 400 age- and sex-matched students with NCV were selected as controls. Refractive status was evaluated using objective cyclorefraction. Results: The CVD group included 136 male (85%) and 24 female (15%) subjects with mean age of 10.1 ± 1.8 years. The NCV group comprised of 336 male (84%) and 64 female (16%) subjects with mean age of 10.5 ± 1.2 years. The prevalence of myopia (7.7% vs. 13.9%, P < 0.001) and hyperopia (41% vs. 57.4%, P = 0.03) was significantly lower in the CVD group. Furthermore, subjects with CVD subjects demonstrated a lower magnitude of refractive errors as compared to the CVD group (mean refractive error: +0.54 ± 0.19 D versus + 0.74 ± 1.12 D, P < 0.001). Conclusion: Although the lower prevalence of myopia in subjects with CVD group supports the role of longitudinal chromatic aberration in the development of refractive errors; the lower prevalence of hyperopia in this group is an opposing finding. Myopia is a multifactorial disorder and longitudinal chromatic aberration is not the only factor influencing the emmetropization process. PMID:25709775
Jawien, Arkadiusz; Bouskela, Eliete; Allaert, François A; Nicolaïdes, Andrew N
2017-02-01
Despite continuous improvement in our knowledge and management of chronic venous disease (CVD), certain areas, such as the role of muscarinic receptors in the pathology and treatment of CVD, remain unexplored. The symposium "The place of Ruscus extract, hesperidin methyl chalcone, and vitamin C in the management of CVD", held at the Annual Meeting of the European Venous Forum on 7-9 July 2016 in London, presented an update on the pathophysiology of CVD and highlighted how the combination of Ruscus extract, hesperidin methyl chalcone, and vitamin C (Ruscus/HMC/VitC; Cyclo 3® Fort), may counteract the deleterious processes underlying CVD. The data presented during this symposium are reported here. The pathophysiology of CVD is driven by a complex process involving numerous factors, with the two key players being venous hypertension and the inflammatory response. The cascade of reactions induced by disturbed venous flow, inflammation, and tissue alterations results in the early appearance of symptoms and progressive development of clinical signs of disease. Previous studies have shown that Ruscus extract acts at three levels: on the veins, capillaries and lymphatics, and has anti-inflammatory properties. A series of recent experiments has shed new light on the mechanism of action of the combination of Ruscus/HMC/VitC. The efficacy of Ruscus/HMC/VitC in CVD is supported by clinical studies, while two meta-analyses have confirmed a significant decrease of several symptoms and ankle circumference in response to treatment with this agent, leading to the conclusion that Ruscus/HMC/VitC deserves a Grade A rating.
Silicon-on-Insulator Pin Diodes.
1987-12-01
Thin (0.5 Micron) Silicon-on-Oxidized Silicon Fig. 2.8 SEM Photographs of CVD Silicon Dioxide on Aluminum 28 After 1500 0 C Anneal in Oxygen...silicon nitride over the silicon dioxide encapsu- -9- lation layer and by depositing the silicon dioxide with a plasma CVD process which uses N20 as...relief via thermal expansion matching varies lin- -27- A B Figure 2.8: SEM Photographs of CVD Silicon Dioxide on Aluminum after 15000 C Anneal in Oxygen
Enhanced cold wall CVD reactor growth of horizontally aligned single-walled carbon nanotubes
NASA Astrophysics Data System (ADS)
Mu, Wei; Kwak, Eun-Hye; Chen, Bingan; Huang, Shirong; Edwards, Michael; Fu, Yifeng; Jeppson, Kjell; Teo, Kenneth; Jeong, Goo-Hwan; Liu, Johan
2016-05-01
HASynthesis of horizontally-aligned single-walled carbon nanotubes (HA-SWCNTs) by chemical vapor deposition (CVD) directly on quartz seems very promising for the fabrication of future nanoelectronic devices. In comparison to hot-wall CVD, synthesis of HA-SWCNTs in a cold-wall CVD chamber not only means shorter heating, cooling and growth periods, but also prevents contamination of the chamber. However, since most synthesis of HA-SWCNTs is performed in hot-wall reactors, adapting this well-established process to a cold-wall chamber becomes extremely crucial. Here, in order to transfer the CVD growth technology from a hot-wall to a cold-wall chamber, a systematic investigation has been conducted to determine the influence of process parameters on the HA-SWCNT's growth. For two reasons, the cold-wall CVD chamber was upgraded with a top heater to complement the bottom substrate heater; the first reason to maintain a more uniform temperature profile during HA-SWCNTs growth, and the second reason to preheat the precursor gas flow before projecting it onto the catalyst. Our results show that the addition of a top heater had a significant effect on the synthesis. Characterization of the CNTs shows that the average density of HA-SWCNTs is around 1 - 2 tubes/ μm with high growth quality as shown by Raman analysis. [Figure not available: see fulltext.
Large Area CVD MoS2 RF transistors with GHz performance
NASA Astrophysics Data System (ADS)
Nagavalli Yogeesh, Maruthi; Sanne, Atresh; Park, Saungeun; Akinwade, Deji; Banerjee, Sanjay
Molybdenum disulfide (MoS2) is a 2D semiconductor in the family of transition metal dichalcogenides (TMDs). Its single layer direct bandgap of 1.8 eV allows for high ION/IOFF metal-oxide semiconducting field-effect transistors (FETs). More relevant for radio frequency (RF) wireless applications, theoretical studies predict MoS2 to have saturation velocities, vsat >3×106 cm/s. Facilitated by cm-scale CVD MoS2, here we design and fabricate both top-gated and embedded gate short channel MoS2 RF transistors, and provide a systematic comparison of channel length scaling, extrinsic doping from oxygen-deficient dielectrics, and a gate-first gate-last process flow. The intrinsic fT (fmax) obtained from the embedded gate transistors shows 3X (2X) improvement over top-gated CVD MoS2 RF FETs, and the largest high-field saturation velocity, vsat = 1.88 ×106 cm/s, in MoS2 reported so far. The gate-first approach, offers enhancement mode operation, ION/IOFF ratio of 10, 8< and the highest reported transconductance (gm) of 70 μS/ μm. By manipulating the interfacial oxygen vacancies in atomic layer deposited (ALD) HfO2-x we are able to achieve 2X current density over stoichiometric Al2O3. We demonstrate a common-source (CS) amplifier with voltage gain of 14 dB and an active frequency mixer with conversion gain of -15 dB. Our results of gigahertz frequency performance as well as analog circuit operation show that large area CVD MoS2 may be suitable for industrial-scale electronic applications.
Prevalence of congenital color vision defects in Saudi females of Arab origin.
Alabdelmoneam, Mussaed
2011-09-01
Inherited color vision deficiencies (CVD) vary in prevalence by population and by sex. The most common CVD is X chromosome-linked anomalous trichromacy. Prevalence varies significantly by sex and race. The frequency of color vision defects in Saudi females has not been studied previously. This study surveyed the prevalence of congenital color vision defects in Saudi females of Arab origin. Seven thousand four hundred sixty-seven female subjects (N = 7,467) from the Kingdom of Saudi Arabia were screened using both Ishihara pseudoisochromatic plates and the Farnsworth Dichotomous test (D-15). CVD subjects were tested further with the Farnsworth-Munsell 100 Hue test. Of 7,467 female subjects tested, 26 subjects were found to have defective color vision, for a prevalence of 0.35%. Sixteen subjects had a deutan defect, and 10 had a protan defect. Arab females have significantly lower prevalence of CVD when compared with published data from females of other races. Analysis of the 5 regions of Saudi Arabia showed no significant difference between the regions. Prevalence of CVD among Saudi females of Arab origin is 0.35% and is among the lowest of all published data. Copyright © 2011 American Optometric Association. Published by Elsevier Inc. All rights reserved.
HeartBeat Connections: A Rural Community of Solution for Cardiovascular Health.
Benson, Gretchen A; Sidebottom, Abbey; VanWormer, Jeffrey J; Boucher, Jackie L; Stephens, Charles; Krikava, Joan
2013-01-01
Cardiovascular disease (CVD) continues to be the leading cause of death among Americans. National guidelines emphasize early identification and control of CVD risk factors, but challenges remain in the primary care setting in terms of engaging patients and improving medical therapy adherence. The rapid growth of electronic health records (EHRs) provides a new way to proactively identify populations of high-risk patients and target them with prevention strategies. The HeartBeat Connections (HBC) program was developed as part of a population-based demonstration project aimed at reducing myocardial infarctions. HBC uses EHR data to identify residents at high CVD risk in a rural community. Participants receive coaching from a registered dietitian or a registered nurse focused on lifestyle behavior changes and preventive medication initiation/titration. HBC provides patients with access to nonprescribing professionals on a more frequent basis than typical office visits, and it is focused specifically on helping patients improve lifestyle behaviors and medication adherence as they relate to the primary prevention of CVD. Innovative population health approaches that use EHR data to address common barriers to CVD prevention and engage communities in addressing population health needs are needed to help more patients prevent coronary events.
Kouvari, Matina; Yannakoulia, Mary; Souliotis, Kyriakos; Panagiotakos, Demosthenes B
2018-01-01
The recognition of cardiovascular disease (CVD) as a "male" privilege has been a commonly held concept. However, emerging data describe another reality. Heterogeneities have been convincingly demonstrated regarding CVD manifestations, risk factor burden, and prognosis between males and females. The aim of the present narrative review was to highlight sex- and gender-related discrepancies in primary and secondary CVD prevention, underscoring plausible underlying mechanisms. Manifestation of CVD in women is characterized by atypical symptoms/signs and inadequately studied pathophysiology features challenging accurate diagnosis and effective treatment. Regarding CVD risk assessment, the burden and effect size of conventional, novel, and female-specific risk factors needs better clarification. Hitherto outcomes are nonconsistent, while most importantly, the interpretation of the attendant metabolic paths remains a challenge; the interactions among genetic, metabolic, and environmental factors are of high complexity regulated by genomic and nongenomic sex hormones effects. To deal with these key points, the National Institutes of Health currently calls upon investigators to provide a sex- and gender-specific reporting in all health research hypotheses. The implementation of high-quality studies addressing these issues is an imperative need to maximize cost-effectiveness in prevention and management strategies.
Shen, Jiayun; Shang, Qing; Tam, Lai-Shan
2016-01-01
Patients with inflammatory arthritis have increased risk of cardiovascular diseases (CVDs) compared with the general population. Subclinical carotid atherosclerosis and increased arterial stiffness are also common in these patients, which may serve as surrogate end points for cardiovascular (CV) events in clinical trials. Although exact mechanisms are still unclear, persistent systemic inflammation in patients with inflammatory arthritis may contribute to the development of CVD. Dysregulated innate immunity pathways in these patients may also play a role in accelerating atherosclerosis. During the last decade, effective suppression of inflammation by biological disease-modifying antirheumatic drugs has improved the disease outcome dramatically in patients with inflammatory arthritis. Growing evidence suggests that antitumor necrosis factor (TNF) therapy may prevent CVD in patients with rheumatoid arthritis. Nonetheless, data on non-TNF biologics are limited. Whether anti-TNF therapy may prevent CVD in patients with spondyloarthritis also remained unclear. In this review, we summarized the effect of both anti-TNF and non-TNF biologics on the CV system, including traditional CVD risk factors, endothelial function, arterial stiffness, subclinical atherosclerosis, and clinical CVD in patients with inflammatory arthritis. Copyright © 2016 Elsevier Inc. All rights reserved.
Cusimano, Maria C; Pudwell, Jessica; Roddy, Michelle; Cho, Chan-Kyung Jane; Smith, Graeme N
2014-05-01
Women who develop certain common pregnancy complications have a greater chance of developing cardiovascular disease (CVD) later in life. However, most health care providers do not provide postpartum cardiovascular risk counselling or follow-up. The Maternal Health Clinic was established to address this gap in care. It targets women at increased risk of CVD to inspire lifestyle changes, encourage long-term follow-up, and initiate primary prevention. Here, we summarize results from the first 17 months of completed clinic visits. Patients experiencing at least one relevant complication in their index pregnancy were referred to the Maternal Health Clinic through standard postpartum order sheets. Patients underwent a complete assessment including screening history, physical examination, fasting bloodwork, and urinalysis. Lifetime and 30-year CVD risk estimates, along with a metabolic syndrome calculation, were determined for each patient. Complications most commonly leading to referral were gestational diabetes or impaired glucose tolerance (32.7%), preeclampsia (29.3%), preterm birth (29.3%), and gestational hypertension (19.6%). The clinic analysis group (n = 92) was compared with a healthy control group from the PreEclampsia New Emerging Team study (n = 118). Patients in the clinic analysis group had significantly increased lifetime and 30-year CVD risk estimates compared with healthy controls (P < .0001). Furthermore, 17.4% of the clinic analysis group had metabolic syndrome, compared with 6.78% of healthy controls (P < .05). This study demonstrates that the Maternal Health Clinic accurately identifies postpartum patients that have underlying cardiovascular risks which make them susceptible to CVD. The clinic may serve as an effective primary prevention strategy. Copyright © 2014 Mosby, Inc. All rights reserved.
Oztuzcu, Serdar; Ergun, Sercan; Ulaşlı, Mustafa; Nacarkahya, Gülper; Iğci, Yusuf Ziya; Iğci, Mehri; Bayraktar, Recep; Tamer, Ali; Çakmak, Ecir Ali; Arslan, Ahmet
2014-06-01
Cardiovascular disease (CVD) risk factors, such as arterial hypertension, obesity, dyslipidemia or diabetes mellitus, as well as CVDs, including myocardial infarction, coronary artery disease or stroke, are the most prevalent diseases and account for the major causes of death worldwide. In the present study, 4,709 unrelated patients subjected to CVD panel in south-east part of Turkey between the years 2010 and 2013 were enrolled and DNA was isolated from the blood samples of these patients. Mutation analyses were conducted using the real-time polymerase chain reaction method to screen six common mutations (Factor V G1691A, PT G20210A, Factor XIII V34L, MTHFR A1298C and C677T and PAI-1 -675 4G/5G) found in CVD panel. The prevalence of these mutations were 0.57, 0.25, 2.61, 13.78, 9.34 and 24.27 % in homozygous form, respectively. Similarly, the mutation percent of them in heterozygous form were 7.43, 3.44, 24.91, 44.94, 41.09 and 45.66%, respectively. No mutation was detected in 92 (1.95%) patients in total. Because of the fact that this is the first study to screen six common mutations in CVD panel in south-east region of Turkey, it has a considerable value on the diagnosis and treatment of these diseases. Upon the results of the present and previous studied a careful examination for these genetic variants should be carried out in thrombophilia screening programs, particularly in Turkish population.
Shara, Nawar M; Resnick, Helaine E; Lu, Li; Xu, Jiaqiong; Vupputuri, Suma; Howard, Barbara V; Umans, Jason G
2009-01-01
Kidney function, expressed as glomerular filtration rate (GFR), is commonly estimated from serum creatinine (Scr) and, when decreased, may serve as a nonclassical risk factor for incident cardiovascular disease (CVD). The ability of estimated GFR (eGFR) to predict CVD events during 5-10 years of follow-up is assessed using data from the Strong Heart Study (SHS), a large cohort with a high prevalence of diabetes. eGFRs were calculated with the abbreviated Modification of Diet in Renal Disease study (MDRD) and the Cockcroft-Gault (CG) equations. These estimates were compared in participants with normal and abnormal Scr. The association between eGFR and incident CVD was assessed. More subjects were labeled as having low eGFR (<60 ml/min per 1.73 m2) by the MDRD or CG equation, than by Scr alone. When Scr was in the normal range, both equations labeled similar numbers of participants as having low eGFRs, although concordance between the equations was poor. However, when Scr was elevated, the MDRD equation labeled more subjects as having low eGFR. Persons with low eGFR had increased risk of CVD. The MDRD and CG equations labeled more participants as having decreased GFR than did Scr alone. Decreased eGFR was predictive of CVD in this American Indian population with a high prevalence of obesity and type 2 diabetes mellitus.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nemtsev, G., E-mail: g.nemtsev@iterrf.ru; Amosov, V.; Meshchaninov, S.
We present the results of analysis of triton burn-up process using the data from diamond detector. Neutron monitor based on CVD diamond was installed in JET torus hall close to the plasma center. We measure the part of 14 MeV neutrons in scenarios where plasma current varies in a range of 1-3 MA. In this experiment diamond neutron monitor was also able to detect strong gamma bursts produced by runaway electrons arising during the disruptions. We can conclude that CVD diamond detector will contribute to the study of fast particles confinement and help predict the disruption events in future tokamaks.
Chemical vapor deposition fluid flow simulation modelling tool
NASA Technical Reports Server (NTRS)
Bullister, Edward T.
1992-01-01
Accurate numerical simulation of chemical vapor deposition (CVD) processes requires a general purpose computational fluid dynamics package combined with specialized capabilities for high temperature chemistry. In this report, we describe the implementation of these specialized capabilities in the spectral element code NEKTON. The thermal expansion of the gases involved is shown to be accurately approximated by the low Mach number perturbation expansion of the incompressible Navier-Stokes equations. The radiative heat transfer between multiple interacting radiating surfaces is shown to be tractable using the method of Gebhart. The disparate rates of reaction and diffusion in CVD processes are calculated via a point-implicit time integration scheme. We demonstrate the use above capabilities on prototypical CVD applications.
Graphene Synthesis by Plasma-Enhanced CVD Growth with Ethanol
Campo, Teresa; Cotto, María; Márquez, Francisco; ...
2016-03-01
A modified route to synthesize graphene flakes is proposed using the Chemical Vapor Deposition (CVD) technique, by using copper substrates as supports. The carbon source used was ethanol, the synthesis temperature was 950°C and the pressure was controlled along the whole process. In this CVD synthesis process the incorporation of the carbon source was produced at low pressure and 950°C inducing the appearance of a plasma blue flash inside the quartz tube. Apparently, the presence of this plasma blue flash is required for obtaining graphene flakes. The synthesized graphene was characterized by different techniques, showing the presence of non-oxidized graphenemore » with high purity.« less
Nettleton, Jennifer A; Steffen, Lyn M; Schulze, Matthias B; Jenny, Nancy S; Barr, R Graham; Bertoni, Alain G; Jacobs, David R
2010-01-01
Background The association between diet and cardiovascular disease (CVD) may be mediated partly through inflammatory processes and reflected by markers of subclinical atherosclerosis. Objective We investigated whether empirically derived dietary patterns are associated with coronary artery calcium (CAC) and common and internal carotid artery intima media thickness (IMT) and whether prior information about inflammatory processes would increase the strength of the associations. Design At baseline, dietary patterns were derived with the use of a food-frequency questionnaire, and inflammatory biomarkers, CAC, and IMT were measured in 5089 participants aged 45–84 y, who had no clinical CVD or diabetes, in the Multi-Ethnic Study of Atherosclerosis. Dietary patterns based on variations in C-reactive protein, interleukin-6, homocysteine, and fibrinogen concentrations were created with reduced rank regression (RRR). Dietary patterns based on variations in food group intake were created with principal components analysis (PCA). Results The primary RRR(RRR 1) and PCA(PCA factor 1) dietary patterns were high in total and saturated fat and low in fiber and micronutrients. However, the food sources of these nutrients differed between the dietary patterns. RRR 1 was positively associated with CAC [Agatston score >0: OR(95% CI) for quartile 5 compared with quartile 1 = 1.34 (1.05, 1.71); ln(Agatston score = 1): P for trend = 0.023] and with common carotid IMT [≥1.0 mm: OR (95% CI) for quartile 5 compared with quartile 1 = 1.33 (0.99, 1.79); ln(common carotid IMT): P for trend = 0.006]. PCA 1 was not associated with CAC or IMT. Conclusion The results suggest that subtle differences in dietary pattern composition, realized by incorporating measures of inflammatory processes, affect associations with markers of subclinical atherosclerosis. PMID:17556701
Trakada, Georgia; Economou, Nicholas-Tiberio; Nena, Evangelia; Trakada, Athanasia; Zarogoulidis, Pavlos; Steiropoulos, Paschalis
2015-05-01
Obstructive sleep apnea syndrome (OSAS) is common in adult population and it is associated with increased morbidity and mortality, especially due to cardiovascular disease (CVD). Both diagnosis, based on polysomnography, and treatment with continuous positive airway pressure (CPAP), carry a potentially high cost. The present study aims to analyze the cost-effectiveness of CPAP treatment versus no treatment, in the long-term, as it examines the effect of this treatment on the incidence of CVD. A Markov model was constructed to observe the disease evolution in patients with OSAS based on published evidence. Data on treatment costs were collected from public hospitals in Greece. Within each cycle of the model, each patient may remain free of CVD, may develop CVD, may die due to a cause related to CVD, or may die from other causes. The model begins at the age of 55 years in a severe OSAS patient (apnea-hypopnea index ≥30/h) and lasts for 45 years. Within the limitation of the model, CPAP was found to be a cost-effective strategy versus no treatment, due to the reduction of the cost for the CVD treatment, when the analysis was restricted to the male population. Moreover, CPAP was found to be clinically more effective than no treatment, as it increases life expectancy in both males and females. CPAP was found to be clinically more effective therapy than no treatment in relation to CVD and a cost-effective strategy in males with severe OSAS.
Knowledge, attitudes, and related practices of Filipino seafarers regarding cardiovascular diseases.
Gregorio, Ernesto Ramos; Kobayashi, Jun; Medina, John Robert Carabeo; Simbulan, Nymia Pimentel
2016-01-01
Globally, cardiovascular diseases (CVD) remain the leading cause of mortality. Due to the nature of their work and lifestyle on board, Filipino seafarers have a high propensity towards acquiring CVD. This study aimed to determine the knowledge, attitudes, and practices related to CVD of Filipino seafarers. This study utilised a descriptive cross-sectional study design. Self-administered questionnaires were distributed among 136 male seafarers who went into a private general hospital for their pre-employment medical examination. Eating fatty foods (77.0%), cigarette smoking (68.4%) and lack of exercise (65.4%) were identified by the respondents as the top three most common risk factors for CVD. Avoiding fatty or oily foods (85.3%) and exercising regularly (83.1%) were identified by the respondents as preventive measures for CVD. High blood pressure and shortness of breath were identified by more than half of the respondents as a sign and symptom of CVD, respectively. But the respondents failed to identify other equally important signs and symptoms. Majority of the respondents (> 80%) had high level of perception with respect to the six constructs of the health belief model. Some respondents had admitted engagement in risk-taking behaviours such as smoking (36.0%) and physical inactivity (27.2%). Majority were into high fat and salt diet (70.6%) and current alcohol consumption (79.4%). Although the respondents had favourable attitudes towards CVD, there were knowledge gaps in risk factors, preventive measures, and recognition of signs and symptoms. Hence, some were still engaging in risk-taking behaviours such as smoking, irregular involvement in physical activity, unbalanced diet, and alcohol intake.
Sabin, C A; d'Arminio Monforte, A; Friis-Moller, N; Weber, R; El-Sadr, W M; Reiss, P; Kirk, O; Mercie, P; Law, M G; De Wit, S; Pradier, C; Phillips, A N; Lundgren, J D
2008-04-01
Because of the known relationship between exposure to combination antiretroviral therapy and cardiovascular disease (CVD), it has become increasingly important to intervene against risk of CVD in human immunodeficiency virus (HIV)-infected patients. We evaluated changes in risk factors for CVD and the use of lipid-lowering therapy in HIV-infected individuals and assessed the impact of any changes on the incidence of myocardial infarction. The Data Collection on Adverse Events of Anti-HIV Drugs Study is a collaboration of 11 cohorts of HIV-infected patients that included follow-up for 33,389 HIV-infected patients from December 1999 through February 2006. The proportion of patients at high risk of CVD increased from 35.3% during 1999-2000 to 41.3% during 2005-2006. Of 28,985 patients, 2801 (9.7%) initiated lipid-lowering therapy; initiation of lipid-lowering therapy was more common for those with abnormal lipid values and those with traditional risk factors for CVD (male sex, older age, higher body mass index [calculated as the weight in kilograms divided by the square of the height in meters], family and personal history of CVD, and diabetes mellitus). After controlling for these, use of lipid-lowering drugs became relatively less common over time. The incidence of myocardial infarction (0.32 cases per 100 person-years [PY]; 95% confidence interval [CI], 0.29-0.35 cases per 100 PY) appeared to remain stable. However, after controlling for changes in risk factors for CVD, the rate decreased over time (relative rate in 2003 [compared with 1999-2000], 0.73 cases per 100 PY [95% CI, 0.50-1.05 cases per 100 PY]; in 2004, 0.64 cases per 100 PY [95% CI, 0.44-0.94 cases per 100 PY]; in 2005-2006, 0.36 cases per 100 PY [95% CI, 0.24-0.56 cases per 100 PY]). Further adjustment for lipid levels attenuated the relative rates towards unity (relative rate in 2003 [compared with 1999-2000], 1.06 cases per 100 PY [95% CI, 0.63-1.77 cases per 100 PY]; in 2004, 1.02 cases per 100 PY [95% CI, 0.61-1.71 cases per 100 PY]; in 2005-2006, 0.63 cases per 100 PY [95% CI, 0.36-1.09 cases per 100 PY]). Although the CVD risk profile among patients in the Data Collection on Adverse Events of Anti-HIV Drugs Study has decreased since 1999, rates have remained relatively stable, possibly as a result of a more aggressive approach towards managing the risk of CVD.
Transport Imaging in the One Dimensional Limit
2006-06-01
Spatial luminescence from single bottom-up GaN and ZnO nanowires deposited by metal initiated metal -organic CVD on Au and SiO2 substrates is imaged. CL...this thesis were deposited by metal initiated metal -organic CVD on Au and SiO2 substrates . The process was carried out with different reagents in...are reported. Spatial luminescence from single bottom-up GaN and ZnO nanowires deposited by metal initiated metal -organic CVD on Au and SiO2
Coffee consumption and mortality in women with cardiovasculardisease123
Lopez-Garcia, Esther; Rodriguez-Artalejo, Fernando; Li, Tricia Y; Mukamal, Kenneth J; Hu, Frank B; van Dam, Rob M
2011-01-01
Background: Coffee is commonly consumed among populations of all ages and conditions. The few studies that have examined the association between coffee consumption and mortality in patients with cardiovascular disease (CVD) have obtained conflicting results. Objective: The objective was to assess the association between filtered caffeinated coffee consumption and all-cause and CVD mortality during up to 24 y of follow-up in women with CVD from the Nurses’ Health Study. Design: The Nurses’ Health Study included 11,697 women. Coffee consumption was first assessed in 1980 with a food-frequency questionnaire (FFQ) and then repeatedly every 2–4 y. Cumulative consumption was calculated with all available FFQs from the diagnosis of CVD to the end of the follow-up in 2004 to assess long-term effects. In addition, the most recent coffee measurement was related to mortality in the subsequent 2 y to assess shorter-term effects. Analyses were performed by using Cox regression models. Results: We documented 1159 deaths, of which 579 were due to CVD. The relative risks [RRs (95% CI)] of all-cause mortality across categories of cumulative coffee consumption [<1 cup (240 mL or 8 oz)/mo, 1 cup/mo to 4 cups/wk, 5–7 cups/wk, 2–3 cups/d, and ≥4 cups/d] were 1, 1.04 (0.86, 1.27), 1.13 (0.95, 1.36), 1.01 (0.86, 1.18), and 1.18 (0.89, 1.56), respectively (P for trend = 0.91). The RRs of CVD mortality across the same categories of coffee intake were 1, 0.99 (0.75, 1.31), 1.03 (0.80, 1.35), 0.97 (0.78, 1.21), and 1.25 (0.85, 1.84), respectively (P for trend = 0.76). Similarly, caffeine intake was not associated with total or CVD mortality. Finally, we observed no association of the most recent coffee and caffeine intakes with total and CVD mortality in the subsequent 2 y. Conclusion: Consumption of filtered caffeinated coffee was not associated with CVD or all-cause mortality in women with CVD. PMID:21562090
CVD diamond substrate for microelectronics. Final report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Burden, J.; Gat, R.
1996-11-01
Chemical Vapor Deposition (CVD) of diamond films has evolved dramatically in recent years, and commercial opportunities for diamond substrates in thermal management applications are promising. The objective of this technology transfer initiative (TTI) is for Applied Science and Technology, Inc. (ASTEX) and AlliedSignal Federal Manufacturing and Technologies (FM&T) to jointly develop and document the manufacturing processes and procedures required for the fabrication of multichip module circuits using CVD diamond substrates, with the major emphasis of the project concentrating on lapping/polishing prior to metallization. ASTEX would provide diamond films for the study, and FM&T would use its experience in lapping, polishing,more » and substrate metallization to perform secondary processing on the parts. The primary goal of the project was to establish manufacturing processes that lower the manufacturing cost sufficiently to enable broad commercialization of the technology.« less
Observation of twinning in diamond CVD films
NASA Astrophysics Data System (ADS)
Marciniak, W.; Fabisiak, K.; Orzeszko, S.; Rozploch, F.
1992-10-01
Diamond particles prepared by dc-glow-discharge enhanced HF-CVD hybrid method, from a mixture of acetone vapor and hydrogen gas have been examined by TEM, RHEED and dark field method of observation. Results suggest the presence of twinned diamond particles, which can be reconstructed by a sequence of twinning operations. Contrary to the 'stick model' of the lattice, very common five-fold symmetry of diamond microcrystals may be obtained by applying a number of edge dislocations rather than the continuous deformation of many tetrahedral C-C bonds.
NASA Astrophysics Data System (ADS)
Chang, Sung-Jin; Hyun, Moon Seop; Myung, Sung; Kang, Min-A.; Yoo, Jung Ho; Lee, Kyoung G.; Choi, Bong Gill; Cho, Youngji; Lee, Gaehang; Park, Tae Jung
2016-03-01
Understanding the underlying mechanisms involved in graphene growth via chemical vapour deposition (CVD) is critical for precise control of the characteristics of graphene. Despite much effort, the actual processes behind graphene synthesis still remain to be elucidated in a large number of aspects. Herein, we report the evolution of graphene properties during in-plane growth of graphene from reduced graphene oxide (RGO) on copper (Cu) via methane CVD. While graphene is laterally grown from RGO flakes on Cu foils up to a few hundred nanometres during CVD process, it shows appreciable improvement in structural quality. The monotonous enhancement of the structural quality of the graphene with increasing length of the graphene growth from RGO suggests that seeded CVD growth of graphene from RGO on Cu surface is accompanied by the restoration of graphitic structure. The finding provides insight into graphene growth and defect reconstruction useful for the production of tailored carbon nanostructures with required properties.
Chang, Sung-Jin; Hyun, Moon Seop; Myung, Sung; Kang, Min-A; Yoo, Jung Ho; Lee, Kyoung G; Choi, Bong Gill; Cho, Youngji; Lee, Gaehang; Park, Tae Jung
2016-03-10
Understanding the underlying mechanisms involved in graphene growth via chemical vapour deposition (CVD) is critical for precise control of the characteristics of graphene. Despite much effort, the actual processes behind graphene synthesis still remain to be elucidated in a large number of aspects. Herein, we report the evolution of graphene properties during in-plane growth of graphene from reduced graphene oxide (RGO) on copper (Cu) via methane CVD. While graphene is laterally grown from RGO flakes on Cu foils up to a few hundred nanometres during CVD process, it shows appreciable improvement in structural quality. The monotonous enhancement of the structural quality of the graphene with increasing length of the graphene growth from RGO suggests that seeded CVD growth of graphene from RGO on Cu surface is accompanied by the restoration of graphitic structure. The finding provides insight into graphene growth and defect reconstruction useful for the production of tailored carbon nanostructures with required properties.
Chang, Sung-Jin; Hyun, Moon Seop; Myung, Sung; Kang, Min-A; Yoo, Jung Ho; Lee, Kyoung G.; Choi, Bong Gill; Cho, Youngji; Lee, Gaehang; Park, Tae Jung
2016-01-01
Understanding the underlying mechanisms involved in graphene growth via chemical vapour deposition (CVD) is critical for precise control of the characteristics of graphene. Despite much effort, the actual processes behind graphene synthesis still remain to be elucidated in a large number of aspects. Herein, we report the evolution of graphene properties during in-plane growth of graphene from reduced graphene oxide (RGO) on copper (Cu) via methane CVD. While graphene is laterally grown from RGO flakes on Cu foils up to a few hundred nanometres during CVD process, it shows appreciable improvement in structural quality. The monotonous enhancement of the structural quality of the graphene with increasing length of the graphene growth from RGO suggests that seeded CVD growth of graphene from RGO on Cu surface is accompanied by the restoration of graphitic structure. The finding provides insight into graphene growth and defect reconstruction useful for the production of tailored carbon nanostructures with required properties. PMID:26961409
Improved synthesis of carbon-clad silica stationary phases.
Haidar Ahmad, Imad A; Carr, Peter W
2013-12-17
Previously, we described a novel method for cladding elemental carbon onto the surface of catalytically activated silica by a chemical vapor deposition (CVD) method using hexane as the carbon source and its use as a substitute for carbon-clad zirconia.1,2 In that method, we showed that very close to exactly one uniform monolayer of Al (III) was deposited on the silica by a process analogous to precipitation from homogeneous solution in order to preclude pore blockage. The purpose of the Al(III) monolayer is to activate the surface for subsequent CVD of carbon. In this work, we present an improved procedure for preparing the carbon-clad silica (denoted CCSi) phases along with a new column packing process. The new method yields CCSi phases having better efficiency, peak symmetry, and higher retentivity compared to carbon-clad zirconia. The enhancements were achieved by modifying the original procedure in three ways: First, the kinetics of the deposition of Al(III) were more stringently controlled. Second, the CVD chamber was flushed with a mixture of hydrogen and nitrogen gas during the carbon cladding process to minimize generation of polar sites by oxygen incorporation. Third, the fine particles generated during the CVD process were exhaustively removed by flotation in an appropriate solvent.
Moreira, Patrícia Vl; Hyseni, Lirije; Moubarac, Jean-Claude; Martins, Ana Paula B; Baraldi, Larissa G; Capewell, Simon; O'Flaherty, Martin; Guzman-Castillo, Maria
2018-01-01
To estimate the impact of reducing saturated fat, trans-fat, salt and added sugar from processed culinary ingredients and ultra-processed foods in the Brazilian diet on preventing cardiovascular deaths by 2030. A modelling study. Data were obtained from the Brazilian Household Budget Survey 2008/2009. All food items purchased were categorized into food groups according to the NOVA classification. We estimated the energy and nutrient profile of foods then used the IMPACT Food Policy model to estimate the reduction in deaths from CVD up to 2030 in three scenarios. In Scenario A, we assumed that the intakes of saturated fat, trans-fat, salt and added sugar from ultra-processed foods and processed culinary ingredients were reduced by a quarter. In Scenario B, we assumed a reduction of 50 % of the same nutrients in ultra-processed foods and processed culinary ingredients. In Scenario C, we reduced the same nutrients in ultra-processed foods by 75 % and in processed culinary ingredients by 50 %. Approximately 390 400 CVD deaths might be expected in 2030 if current mortality patterns persist. Under Scenarios A, B and C, CVD mortality can be reduced by 5·5, 11·0 and 29·0 %, respectively. The main impact is on stroke with a reduction of approximately 6·0, 12·6 and 32·0 %, respectively. Substantial potential exists for reducing the CVD burden through overall improvements of the Brazilian diet. This might require reducing the penetration of ultra-processed foods by means of regulatory policies, as well as improving the access to and promotion of fresh and minimally processed foods.
Photo-oxidation of Polymers Synthesized by Plasma and Initiated CVD
Baxamusa, Salmaan H.; Suresh, Aravind; Ehrmann, Paul; ...
2015-11-09
Plasma polymers are often limited by their susceptibility to spontaneous and photo-oxidation. We show that the unusual photoluminescence (PL) behavior of a plasma polymer of trans-2-butene is correlated with its photoluminescence strength. These photo-processes occur under blue light illumination (λ=405 nm), distinguishing them from traditional ultraviolet degradation of polymers. These photo-active defects are likely formed during the plasma deposition process and we show that a polymer synthesized using initiated (i)CVD, non-plasma method, has 1000× lower PL signal and enhanced photo-stability. In conclusion, non-plasma methods such as iCVD may therefore be a route to overcoming material aging issues that limit themore » adoption of plasma polymers.« less
Tanno, Kozo; Sakata, Kiyomi
2007-01-01
Psychological factors may have an influence on disease processes and therefore they were investigated in the Japan Collaborative Cohort Study. Overall there were very few consistent associations with cancer death. Persons with 'ikigai', defined as 'that which most makes one's life seem worth living', demonstrated decreased risk of mortality from all causes, ischemic heart disease (IHD) and cerebrovascular disease (CVD).There was no consistent link with being quick to judge, although those answering no to quick judgement were at increased risk of all cause, IHD and CVD mortality. psychological stress was related to a slightly elevated risk of all cause death, IHD in men and CVD in women. However, a sense of hurry was linked to a slightly reduced risk for mortality from all causes and CVD. Persons who were likely to be angry had an increased risk for mortality from all causes. In women not likely to be angry there were also positive links to death from cancers like breast. Joyfulness was associated with decreased mortality, especially from CVD. A feeling of being trusted was also protective, again particularly for CVD.
Grajeda-Iglesias, Claudia; Aviram, Michael
2018-06-20
The strong relationship between cardiovascular diseases (CVD), atherosclerosis, and endogenous or exogenous lipids has been recognized for decades, underestimating the contribution of other dietary components, such as amino acids, to the initiation of the underlying inflammatory disease. Recently, specific amino acids have been associated with incident cardiovascular disorders, suggesting their significant role in the pathogenesis of CVD. Special attention has been paid to the group of branched-chain amino acids (BCAA), leucine, isoleucine, and valine, since their plasma values are frequently found in high concentrations in individuals with CVD risk. Nevertheless, dietary BCAA, leucine in particular, have been associated with improved indicators of atherosclerosis. Therefore, their potential role in the process of atherogenesis and concomitant CVD development remains unclear. Macrophages play pivotal roles in the development of atherosclerosis. They can accumulate high amounts of circulating lipids, through a process known as macrophage foam cell formation, and initiate the atherogenesis process. We have recently screened for anti- or pro-atherogenic amino acids in the macrophage model system. Our study showed that glycine, cysteine, alanine, leucine, glutamate, and glutamine significantly affected macrophage atherogenicity mainly through modulation of the cellular triglyceride metabolism. The anti-atherogenic properties of glycine and leucine, and the pro-atherogenic effects of glutamine, were also confirmed in vivo. Further investigation is warranted to define the role of these amino acids in atherosclerosis and CVD, which may serve as a basis for the development of anti-atherogenic nutritional and therapeutic approaches.
Gender Differences in Genetic Risk Profiles for Cardiovascular Disease
Silander, Kaisa; Saarela, Olli; Ripatti, Samuli; Auro, Kirsi; Karvanen, Juha; Kulathinal, Sangita; Niemelä, Matti; Ellonen, Pekka; Vartiainen, Erkki; Jousilahti, Pekka; Saarela, Janna; Kuulasmaa, Kari; Evans, Alun; Perola, Markus; Salomaa, Veikko; Peltonen, Leena
2008-01-01
Background Cardiovascular disease (CVD) incidence, complications and burden differ markedly between women and men. Although there is variation in the distribution of lifestyle factors between the genders, they do not fully explain the differences in CVD incidence and suggest the existence of gender-specific genetic risk factors. We aimed to estimate whether the genetic risk profiles of coronary heart disease (CHD), ischemic stroke and the composite end-point of CVD differ between the genders. Methodology/Principal Findings We studied in two Finnish population cohorts, using the case-cohort design the association between common variation in 46 candidate genes and CHD, ischemic stroke, CVD, and CVD-related quantitative risk factors. We analyzed men and women jointly and also conducted genotype-gender interaction analysis. Several allelic variants conferred disease risk for men and women jointly, including rs1801020 in coagulation factor XII (HR = 1.31 (1.08–1.60) for CVD, uncorrected p = 0.006 multiplicative model). Variant rs11673407 in the fucosyltransferase 3 gene was strongly associated with waist/hip ratio (uncorrected p = 0.00005) in joint analysis. In interaction analysis we found statistical evidence of variant-gender interaction conferring risk of CHD and CVD: rs3742264 in the carboxypeptidase B2 gene, p(interaction) = 0.009 for CHD, and rs2774279 in the upstream stimulatory factor 1 gene, p(interaction) = 0.007 for CHD and CVD, showed strong association in women but not in men, while rs2069840 in interleukin 6 gene, p(interaction) = 0.004 for CVD, showed strong association in men but not in women (uncorrected p-values). Also, two variants in the selenoprotein S gene conferred risk for ischemic stroke in women, p(interaction) = 0.003 and 0.007. Importantly, we identified a larger number of gender-specific effects for women than for men. Conclusions/Significance A false discovery rate analysis suggests that we may expect half of the reported findings for combined gender analysis to be true positives, while at least third of the reported genotype-gender interaction results are true positives. The asymmetry in positive findings between the genders could imply that genetic risk loci for CVD are more readily detectable in women, while for men they are more confounded by environmental/lifestyle risk factors. The possible differences in genetic risk profiles between the genders should be addressed in more detail in genetic studies of CVD, and more focus on female CVD risk is also warranted in genome-wide association studies. PMID:18974842
Chemical Vapor Deposition of Aluminum Oxide Thin Films
ERIC Educational Resources Information Center
Vohs, Jason K.; Bentz, Amy; Eleamos, Krystal; Poole, John; Fahlman, Bradley D.
2010-01-01
Chemical vapor deposition (CVD) is a process routinely used to produce thin films of materials via decomposition of volatile precursor molecules. Unfortunately, the equipment required for a conventional CVD experiment is not practical or affordable for many undergraduate chemistry laboratories, especially at smaller institutions. In an effort to…
Fabrication of lightweight Si/SiC LIDAR mirrors
NASA Technical Reports Server (NTRS)
Goela, Jitendra S.; Taylor, Raymond L.
1991-01-01
A new, chemical vapor deposition (CVD) process was developed for fabricating lightweight, polycrystalline silicon/silicon-carbide (Si/SiC) mirrors. The process involves three CVD steps: (1) to produce the mirror faceplate; (2) to form the lightweight backstructure, which is deposited integral to the faceplate; and (3) to deposit a layer of optical-grade material, e.g., Si, onto the front surface of the faceplate. The mirror figure and finish are fabricated into the faceplate.
Catalano, Orlando; de Lutio di Castelguidone, Elisabetta; Sandomenico, Claudia; Petrillo, Mario; Aprea, Pasquale; Granata, Vincenza; D'Errico, Adolfo Gallipoli
2011-03-01
Venous thrombosis is a common occurrence in cancer patients, developing spontaneously or in combination with indwelling central venous devices (CVD). To analyze the multidetector CT (MDCT) prevalence, appearance, and significance of catheter-related thoracic venous thrombosis in oncologic patients and to determine the percentage of thrombi identified in the original reports. Five hundred consecutive patients were considered. Inclusion criteria were: presence of a CVD; availability of a contrast-enhanced MDCT; and cancer history. Exclusion criteria were: direct tumor compression/infiltration of the veins; poor image quality; device tip not in the scanned volume; and missing clinical data. Seventeen (3.5%) out of the final 481 patients had a diagnosis of venous thrombosis. Factors showing the highest correlation with thrombosis included peripherally-inserted CVD, right brachiocephalic vein tip location, patient performance status 3, metastatic stage disease, ongoing chemotherapy, and longstanding CVD. The highest prevalence was in patients with lymphoma, lung carcinoma, melanoma, and gynecologic malignancies. Eleven out of 17 cases had not been identified in the original report. CVD-related thrombosis is not uncommon in cancer patients and can also be observed in outpatients with a good performance status and a non-metastatic disease. Thrombi can be very tiny. Radiologists should be aware of the possibility to identify (or overlook) small thrombi.
Association between Epicondylitis and Cardiovascular Risk Factors in Pooled Occupational Cohorts.
Hegmann, Kurt T; Thiese, Matthew S; Kapellusch, Jay; Merryweather, Andrew; Bao, Stephen; Silverstein, Barbara; Wood, Eric M; Kendall, Richard; Foster, James; Drury, David L; Garg, Arun
2017-05-30
The pathophysiology of lateral epicondylitis (LE) is unclear. Recent evidence suggests some common musculoskeletal disorders may have a basis in cardiovascular disease (CVD) risk factors. Thus, we examined CVD risks as potential LE risks. Workers (n = 1824) were enrolled in two large prospective studies and underwent structured interviews and physical examinations at baseline. Analysis of pooled baseline data assessed the relationships separately between a modified Framingham Heart Study CVD risk score and three prevalence outcomes of: 1) lateral elbow pain, 2) positive resisted wrist or middle finger extension, and 3) a combination of both symptoms and at least one resisted maneuver. Quantified job exposures, personal and psychosocial confounders were statistically controlled. Odds ratios (ORs) and 95% Confidence Intervals (CIs) were calculated. There was a strong relationship between CVD risk score and lateral elbow symptoms, resisted wrist or middle finger extension and LE after adjustment for confounders. The adjusted ORs for symptoms were as high as 3.81 (95% CI 2.11, 6.85), for positive examination with adjusted odds ratios as high as 2.85 (95% CI 1.59, 5.12) and for combined symptoms and physical examination 6.20 (95% CI 2.04, 18.82). Relationships trended higher with higher CVD risk scores. These data suggest a potentially modifiable disease mechanism for LE.
Effect of ultrasonic tip and root-end filling material on bond strength.
Vivan, Rodrigo Ricci; Guerreiro-Tanomaru, Juliane Maria; Bernardes, Ricardo Affonso; Reis, José Mauricio Santos Nunes; Hungaro Duarte, Marco Antonio; Tanomaru-Filho, Mário
2016-11-01
The objective of this study was to evaluate the bond strength of three root-end filling materials (MTAA-MTA Angelus, MTAS-experimental MTA Sealer, and ZOE- zinc oxide and eugenol cement) in retrograde preparations performed with different ultrasonic tips (CVD, Trinity, and Satelec). Ninety 2-mm root sections from single-rooted human teeth were used. The retrograde cavities were prepared by using the ultrasonic tips, coupled to a device for position standardization. The specimens were randomly divided into nine groups: CVD MTAA; CVD MTAS; CVD ZOE; Trinity MTAA; Trinity MTAS; Trinity ZOE; Satelec MTAA; Satelec MTAS; Satelec ZOE. Each resin disc/dentin/root-end filling material was placed in the machine to perform the push-out test. The specimens were examined in a stereomicroscope to evaluate the type of failure. Data were submitted to statistical analysis using ANOVA and Tukey tests (α = 0.05). The highest bond strength was observed for the CVD tip irrespective of the material used (P < 0.05). There was no significant difference for the Trinity TU-18 diamond and S12 Satelec tips (P > 0.05). MTAA and MTAS showed highest bond strength. The most common type of failure was adhesion between the filling material and dentin wall, except for ZOE, where mixed failure was predominant. The CVD tip favored higher bond strength of the root-end filling materials. MTA Angelus and experimental MTAS presented bond strength to dentin prepared with ultrasonic tips. Root-end preparation with the CVD tip positively influences the bond strength of root-end filling materials. MTA Angelus and experimental MTAS present bond strength to be used as root-end filling materials.
Johansson, Peter; Svensson, Erland; Alehagen, Urban; Dahlström, Ulf; Jaarsma, Tiny; Broström, Anders
2015-03-01
Inflammation can induce a cluster of symptoms, referred to as sickness behaviour (e.g., depressive symptoms, sleep disturbances, pain and fatigue). Cardiovascular disease (CVD) and sleep disordered breathing (SDB) are common in older adults. CVD is associated with an increased inflammatory activity and in SDB, hypoxia can also increase inflammation. The purpose of this study is to explore if SDB-related hypoxia is associated differently with inflammation and the presence of sickness behaviour in older adults with and without CVD. Three hundred and thirty-one older adults, whose mean age is 78 years, underwent one-night polygraphic recording to measure SDB and hypoxia. CVD was established by a clinical investigation. Questionnaires were used to measure sickness behaviour and depressive symptoms. High sensitivity C-reactive protein was used as a marker of inflammation. Structural Equation Modelling showed that SDB-related hypoxia was associated with inflammation (β > 0.40) which mediated indirect associations with sickness behaviour (β = 0.19) and depressive symptoms (β = 0.11), but only in those with CVD (n = 119). In this model, inflammation had a direct effect on sickness behaviour (β = 0.43) and an indirect effect on depressive symptoms (β = 0.24). Hypoxia had the strongest effect (i.e., β = 0.41; significant) on inflammation, whereas the AHI or ODI had weak and non-significant effects (β = 0.03 and β = 0.15). Older adults with CVD and SDB are at a particular risk of developing sickness behaviour and depressive symptoms. The effect of SDB was mainly caused by hypoxia, suggesting that hypoxia is an important marker of SDB severity in older adults with CVD.
Robson, Joanna C; Kiran, Amit; Maskell, Joe; Hutchings, Andrew; Arden, Nigel; Dasgupta, Bhaskar; Hamilton, William; Emin, Akan; Culliford, David; Luqmani, Raashid
2016-06-01
To evaluate the risk of cerebrovascular disease and cardiovascular disease (CVD) in patients with giant cell arteritis (GCA), and to identify predictors. The UK Clinical Practice Research Datalink 1991-2010 was used for a parallel cohort study of 5827 patients with GCA and 37,090 age-, sex-, and location-matched controls. A multivariable competing risk model (non-cerebrovascular/CV-related death as the competing risk) determined the relative risk [subhazard ratio (SHR)] between patients with GCA compared with background controls for cerebrovascular disease, CVD, or either. Each cohort (GCA and controls) was then analyzed individually using the same multivariable model, with age and sex now present, to identify predictors of CVD or cerebrovascular disease. Patients with GCA, compared with controls, had an increased risk SHR (95% CI) of cerebrovascular disease (1.45, 1.31-1.60), CVD (1.49, 1.37-1.62), or either (1.47, 1.37-1.57). In the GCA cohort, predictors of "cerebrovascular disease or CVD" included increasing age, > 80 years versus < 65 years (1.98, 1.62-2.42), male sex (1.20, 1.05-1.38), and socioeconomic status, most deprived quintile versus least deprived (1.34, 1.01-1.78). These predictors were also present within the non-GCA cohort. Patients with GCA are more likely to develop cerebrovascular disease or CVD than age-, sex-, and location-matched controls. In common with the non-GCA cohort, patients who are older, male, and from the most deprived compared with least deprived areas have a higher risk of cerebrovascular disease or CVD. Further work is needed to understand how this risk may be mediated by specific behavioral, social, and economic factors.
[Cardiovascular diseases risk factors knowledge among soldiers of the Polish army].
Olszewski, Robert; Grabysa, Radosław; Kwasiborski, Przemysław J; Makowski, Tomasz; Warmiński, Janusz; Szczechowicz, Robert; Kubik, Leszek
2009-10-01
Cardiovascular diseases (CVDs) are the main cause of death and disability in Poland. There are many risk factors of CVD which are modifiable due to preventive strategies. Knowledge about these factors among population at risk of CVD is the most important condition for success of them. To evaluate the knowledge of CVD risk factors among soldiers of the Polish Army and try to identify a demographic factors influenced on them. Authors investigated the level of knowledge about CVD risk factors among 644 soldiers (aged between 18 to 62 years) using the special questionnaire. Whole group was analyzed according to a place of origin: city, town and village and according to a function: professionals and conscripts. Soldiers achieved a total score of 58.4% correct answers. Commonly known risk factors of CVD (average 82% of correct answers) in studied group were: obesity, tobacco smoking, high level of cholesterol and hypertension. Knowledge about above risk factors was significantly higher (p < 0.01) than about other. Lesser known risk factors (average 54% of correct answers) were: male gender, abnormal diet, sedentary lifestyle, family history of CVDs, diabetes, family history of heart infarction below 55 yrs and peripheral atherosclerosis. residents achieved 64.5% correct answers, town--61.5%, and village--58%. Professionals achieved 65.1% vs. 58.8% for conscripts. The level of knowledge about CVD risk factors are significantly higher among professionals than in urban population. Our data confirm the need of continuation and developing new CVDs preventive strategies in Poland, especially among poor educated and village populations. There is a need to emphasize the role of lesser known, modifiable CVD risk factors (e.g., obesity, sedentary lifestyle) in existing and future health programs.
Hospitalizations for cardiovascular disease in African Americans and whites with HIV/AIDS.
Oramasionwu, Christine U; Morse, Gene D; Lawson, Kenneth A; Brown, Carolyn M; Koeller, Jim M; Frei, Christopher R
2013-06-01
Therapeutic advances have resulted in an epidemiological shift in the predominant causes of hospitalization for patients with HIV/AIDS. An emerging cause for hospitalization in this patient population is cardiovascular disease (CVD); however, data are limited regarding how this shift affects different racial groups. The objective of this observational, retrospective study was to evaluate the association between race and hospitalization for CVD in African Americans and whites with HIV/AIDS and to compare the types of CVD-related hospitalizations between African Americans and whites with HIV/AIDS. Approximately 1.5 million hospital discharges from the US National Hospital Discharge Surveys for the years of 1996 to 2008 were identified. After controlling for potential confounders, the odds of CVD-related hospitalization in patients with HIV/AIDS were 45% higher for African Americans than whites (odds ratio [OR]=1.45, 95% CI, 1.39-1.51). Other covariates that were associated with increased odds of hospitalization for CVD included chronic kidney disease (OR=1.43, 95% CI, 1.36-1.51), age≥50 years (OR=3.22, 95% CI, 2.94-3.54), region in the Southern United States (OR=1.17, 95% CI, 1.11-1.23), and Medicare insurance coverage (OR=1.71, 95% CI, 1.60-1.83). Male sex was not significantly associated with the study outcome (OR=0.99, 95% CI, 0.96-1.02). Compared to whites with HIV/AIDS, African Americans with HIV/AIDS had more hospitalizations for heart failure and hypertension, but fewer hospitalizations for stroke and coronary heart disease. In conclusion, African Americans with HIV/AIDS have increased odds of CVD-related hospitalization as compared to whites with HIV/AIDS. Furthermore, the most common types of CVD-related hospitalizations differ significantly in African Americans and whites.
Tain, You-Lin; Hsu, Chien-Ning
2017-01-01
Cardiovascular disease (CVD) presents a global health burden, despite recent advances in management. CVD can originate from early life by so-called “developmental origins of health and disease” (DOHaD). Epidemiological and experimental evidence supports that early-life insults can induce programming of later CVD. Underlying the DOHaD concept, early intervention may offset programming process to prevent the development of CVD, namely reprogramming. Oxidative stress and nutrient sensing signals have been considered to be major mechanisms of cardiovascular programming, while the interplay between these two mechanisms have not been examined in detail. This review summarizes current evidence that supports the link between oxidative stress and nutrient sensing signaling to cardiovascular programming, with an emphasis on the l-arginine–asymmetric dimethylarginine (ADMA)–nitric oxide (NO) pathway. This review provides an overview of evidence from human studies supporting fetal programming of CVD, insight from animal models of cardiovascular programming and oxidative stress, impact of the l-arginine–ADMA–NO pathway in cardiovascular programming, the crosstalk between l-arginine metabolism and nutrient sensing signals, and application of reprogramming interventions to prevent the programming of CVD. A greater understanding of the mechanisms underlying cardiovascular programming is essential to developing early reprogramming interventions to combat the globally growing epidemic of CVD. PMID:28420139
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ioakeimidis, Apostolos; Christodoulou, Christos; Lux-Steiner, Martha
In this work we fabricate all-vacuum processed methyl ammonium lead halide perovskite by a sequence of physical vapour deposition of PbI{sub 2} and chemical vapour deposition (CVD) of CH{sub 3}NH{sub 3}I under a static atmosphere. We demonstrate that for higher deposition rate the (001) planes of PbI{sub 2} film show a higher degree of alignment parallel to the sample's surface. From X-ray diffraction data of the resulted perovskite film we derive that the intercalation rate of CH{sub 3}NH{sub 3}I is fostered for PbI{sub 2} films with higher degree of (001) planes alignment. The stoichiometry of the produced perovskite film ismore » also studied by Hard X-ray photoelectron spectroscopy measurements. Complete all-vacuum perovskite solar cells were fabricated on glass/ITO substrates coated by an ultra-thin (5 nm) Zn-phthalocyanine film as hole selective layer. A dependence of residual PbI{sub 2} on the solar cells performance is displayed, while photovoltaic devices with efficiency up to η=11.6% were achieved. - Graphical abstract: A two-step PVD/CVD processed perovskite film with the CVD intercalation rate of CH{sub 3}NCH{sub 3} molecules been fostered by increasing the PVD rate of PbI{sub 2} and prolonging the CVD time. - Highlights: • A simple PVD/CVD process for perovskite film production. • Increased PVD rate yields better alignment of the PbI{sub 2} (001) crystallite planes. • CH{sub 3}NH{sub 3}I intercalation process fostered by increased PbI{sub 2} PVD rate. • Stoichiometric CH{sub 3}NH{sub 3}PbI{sub 3} suitable as absorber in photovoltaic applications • Reduced PbI{sub 2} residue at the bottom of CH{sub 3}NH{sub 3}PbI{sub 3} improves device performance.« less
APOC3 induces endothelial dysfunction through TNF-α and JAM-1.
Tao, Yun; Xiong, Yisong; Wang, Huimin; Chu, Shaopeng; Zhong, Renqian; Wang, Jianxin; Wang, Guihua; Ren, Xiumei; Yu, Juan
2016-09-13
The fatality rate for cardiovascular disease (CVD) has increased in recent years and higher levels of triglyceride have been shown to be an independent risk factor for atherosclerotic CVD. Dysfunction of endothelial cells (ECs) is also a key factor of CVD. APOC3 is an important molecule in lipid metabolism that is closely associated with hyperlipidemia and an increased risk of developing CVD. But the direct effects of APOC3 on ECs were still unknown. This study was aimed at determining the effects of APOC3 on inflammation, chemotaxis and exudation in ECs. ELISA, qRT-PCR, immunofluorescence, flow cytometry and transwell assays were used to investigate the effects of APOC3 on human umbilical vein endothelial cells (HUVECs). SiRNA-induced TNF-α and JAM-1 silencing were used to observe how APOC3 influenced the inflammatory process in the ECs. Our results showed that APOC3 was closely associated with the inflammatory process in ECs, and that this process was characterized by the increased expression of TNF-α. Inflammatory processes further disrupted the tight junctions (TJs) between HUVECs by causing increased expression of JAM-1. JAM-1 was involved in maintaining the integrity of TJs, and it promoted the assembly of platelets and the exudation of leukocytes. Changes in its expression promoted chemotaxis and the exudation of ECs, which contributed to atherosclerosis. While the integrity of the TJs was disrupted, the adhesion of THP-1 cells to HUVECs was also increased by APOC3. In this study, we describe the mechanism by which APOC3 causes inflammation, chemotaxis and the exudation of ECs, and we suggest that controlling the inflammatory reactions that are caused by APOC3 may be a new method to treat CVD.
Ouyang, Xiao-Jun; Zhang, Yong-Qing; Chen, Ji-Hai; Li, Ting; Lu, Tian-Tian; Bian, Rong-Wen
2018-02-05
Comprehensive management of diabetes should include management of its comorbid conditions, especially cardiovascular complications, which are the leading cause of morbidity and mortality among patients with diabetes. Dyslipidemia is a comorbid condition of diabetes and a risk factor for cardiovascular complications. Therefore, lipid level management is a key of managing patients with diabetes successfully. However, it is not clear that how well dyslipidemia is managed in patients with diabetes in local Chinese health-care communities. This study aimed to assess how well low-density lipoprotein cholesterol (LDL-C) was managed in Nanjing community hospitals, China. We reviewed clinical records of 7364 diabetic patients who were treated in eleven community hospitals in Nanjing from October 2005 to October 2014. Information regarding LDL-C level, cardiovascular risk factors, and use of lipid-lowering agents were collected. In patients without history of cardiovascular disease (CVD), 92.1% had one or more CVD risk factors, and the most common CVD risk factor was dyslipidemia. The overall average LDL-C level was 2.80 ± 0.88 mmol/L, which was 2.62 ± 0.90 mmol/L and 2.82 ± 0.87 mmol/L in patients with and without CVD history respectively. Only 38% of all patients met the target goal and 37.3% of patients who took lipid-lowering agents met target goal. Overall, 24.5% of all patients were on lipid-lowering medication, and 36.3% of patients with a CVD history and 20.9% of patients without CVD history took statins for LDL-C management. The mean statin dosage was 13.9 ± 8.9 mg. Only a small portion of patients achieved target LDL-C level, and the rate of using statins to control LDL-C was low. Managing LDL-C with statins in patients with diabetes should be promoted, especially in patients without a CVD history and with one or more CVD risk factors.
Bai, Johnny W; Boulet, Geneviève; Halpern, Elise M; Lovblom, Leif E; Eldelekli, Devrim; Keenan, Hillary A; Brent, Michael; Paul, Narinder; Bril, Vera; Cherney, David Z I; Weisman, Alanna; Perkins, Bruce A
2016-01-25
Older patients with longstanding type 1 diabetes have high cardiovascular disease (CVD) risk such that statin therapy is recommended independent of prior CVD events. We aimed to determine self-reported CVD prevention guideline adherence in patients with longstanding diabetes. 309 Canadians with over 50 years of type 1 diabetes completed a medical questionnaire for presence of lifestyle and pharmacological interventions, stratified into primary or secondary CVD prevention subgroups based on absence or presence of self-reported CVD events, respectively. Associations with statin use were analyzed using multivariable logistic regression. The 309 participants had mean ± SD age 65.7 ± 8.5 years, median diabetes duration 54.0 [IQR 51.0, 59.0] years, and HbA1c of 7.5 ± 1.1 % (58 mmol/mol). 159 (52.7 %) participants reported diet adherence, 296 (95.8 %) smoking avoidance, 217 (70.5 %) physical activity, 218 (71.5 %) renin-angiotensin-system inhibitor use, and 220 (72.1 %) statin use. Physical activity was reported as less common in the secondary prevention subgroup, and current statin use was significantly lower in the primary prevention subgroup (65.5 % vs. 84.8 %, p = 0.0004). In multivariable logistic regression, the odds of statin use was 0.38 [95 % CI 0.15-0.95] in members of the primary compared to the secondary prevention subgroup, adjusting for age, sex, hypertension history, body mass, HbA1c, cholesterol, microvascular complications, acetylsalicylic acid use, and renin-angiotensin system inhibitor use. Despite good self-reported adherence to general CVD prevention guidelines, against the principles of these guidelines we found that statin use was substantially lower in those without CVD history. Interventions are needed to improve statin use in older type 1 diabetes patients without a history of CVD.
Development of CVD mullite coatings for Si-based ceramics
NASA Astrophysics Data System (ADS)
Auger, Michael Lawrence
1999-09-01
To raise fuel efficiencies, the next generation of engines and fuel systems must be lighter and operate at higher temperatures. Ceramic-based materials, which are considerably lighter than metals and can withstand working temperatures of up to 1400sp°C, have been targeted to replace traditional metal-based components. The materials used in combustion environments must also be capable of withstanding erosion and corrosion caused by combustion gases, particulates, and deposit-forming corrodants. With these demanding criteria, silicon-based ceramics are the leading candidate materials for high temperature engine and heat exchanger structural components. However, these materials are limited in gaseous environments and in the presence of molten salts since they form liquid silicates on exposed surfaces at temperatures as low as 800sp°C. Protective coatings that can withstand higher operating temperatures and corrosive atmospheres must be developed for silicon-based ceramics. Mullite (3Alsb2Osb3{*}2SiOsb2) was targeted as a potential coating material due to its unique ability to resist corrosion, retain its strength, resist creep, and avoid thermal shock failure at elevated temperatures. Several attempts to deposit mullite coatings by various processing methods have met with limited success and usually resulted in coatings that have had pores, cracks, poor adherence, and required thermal post-treatments. To overcome these deficiencies, the direct formation of chemically vapor deposited (CVD) mullite coatings has been developed. CVD is a high temperature atomistic deposition technique that results in dense, adherent crystalline coatings. The object of this dissertation was to further the understanding of the CVD mullite deposition process and resultant coating. The kinetics of CVD mullite deposition were investigated as a function of the following process parameters: temperature, pressure, and the deposition reactor system. An empirical kinetic model was developed indicating that an intermediate gaseous reaction is significant to the growth rate of mullite. CVD mullite coatings were deposited on SiC and Sisb3Nsb4 substrates and subjected to both simulated coal gasification and simulated jet fuel combustion conditions. Corrosion resistance of CVD mullite coated ceramics was superior to traditional refractory materials including alumina, solid mullite, Sisb3Nsb4, and silicon carbide.
Evaluation of Frailty in Older Adults With Cardiovascular Disease
Gary, Rebecca
2013-01-01
Rapid growth in the numbers of older adults with cardiovascular disease (CVD) is raising awareness and concern of the impact that common geriatric syndromes such as frailty may have on clinical outcomes, health-related quality of life, and rising economic burden associated with healthcare. Increasingly, frailty is recognized to be a highly prevalent and important risk factor that is associated with adverse cardiovascular outcomes. A limitation of previous studies in patients with CVD has been the lack of a consistent definition and measures to evaluate frailty. In this review, building upon the work of Fried and colleagues, a definition of frailty is provided that is applicable for evaluating frailty in older adults with CVD. Simple, well-established performance-based measures widely used in comprehensive geriatric assessment are recommended that can be readily implemented by nurses in most practice settings. The limited studies conducted in older adults with CVD have shown physical performance measures to be highly predictive of clinical outcomes. Implications for practice and areas for future research are described for the growing numbers of elderly cardiac patients who are frail frailty and at risk for disability. PMID:22334147
Atherosclerotic Cardiovascular Disease Beginning in Childhood
2010-01-01
Although the clinical manifestations of cardiovascular disease (CVD), such as myocardial infarction, stroke, and peripheral vascular disease, appear from middle age, the process of atherosclerosis can begin early in childhood. The early stage and progression of atherosclerosis in youth are influenced by risk factors that include obesity, hypertension, dyslipidemia, and smoking, and by the presence of specific diseases, such as diabetes mellitus and Kawasaki disease (KD). The existing evidence indicates that primary prevention of atherosclerotic disease should begin in childhood. Identification of children at risk for atherosclerosis may allow early intervention to decrease the atherosclerotic process, thereby preventing or delaying CVD. This review will describe the origin and progression of atherosclerosis in childhood, and the identification and management of known risk factors for atherosclerotic CVD in children and young adults. PMID:20111646
2012-01-01
In this work, we report a direct synthesis of vertically aligned ZnO nanowires on fluorine-doped tin oxide-coated substrates using the chemical vapor deposition (CVD) method. ZnO nanowires with a length of more than 30 μm were synthesized, and dye-sensitized solar cells (DSSCs) based on the as-grown nanowires were fabricated, which showed improvement of the device performance compared to those fabricated using transferred ZnO nanowires. Dependence of the cell performance on nanowire length and annealing temperature was also examined. This synthesis method provided a straightforward, one-step CVD process to grow relatively long ZnO nanowires and avoided subsequent nanowire transfer process, which simplified DSSC fabrication and improved cell performance. PMID:22673046
Kassi, E; Diamanti-Kandarakis, E
2008-12-01
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in pre-menopausal women characterized by menstrual cycle disturbances, chronic anovulation, and clinical and/or biochemical hyperandrogenism. Although, the primary etiology of PCOS remains unknown, insulin resistance/hyperinsulinemia plays a pivotal role in the pathogenesis of the syndrome. A growing body of recent data support that women with PCOS have displayed an increased prevelance of cardiovascular disease (CVD) risk factors putting potentially at a hight risk for heart disease. Most of these CVD risk factors are etiologically correlated with insulin resistance/hyperinsulinemia, highlighting the role of insulin sensitizers in the therapeutic quiver for the chronic treatment of PCOS. In this review, we discuss the current literature on the CVD risk factors in PCOS and the influence of insulin sensitizers upon these risk factors.
Enhanced B doping in CVD-grown GeSn:B using B δ-doping layers
NASA Astrophysics Data System (ADS)
Kohen, David; Vohra, Anurag; Loo, Roger; Vandervorst, Wilfried; Bhargava, Nupur; Margetis, Joe; Tolle, John
2018-02-01
Highly doped GeSn material is interesting for both electronic and optical applications. GeSn:B is a candidate for source-drain material in future Ge pMOS device because Sn adds compressive strain with respect to pure Ge, and therefore can boost the Ge channel performances. A high B concentration is required to obtain low contact resistivity between the source-drain material and the metal contact. To achieve high performance, it is therefore highly desirable to maximize both the Sn content and the B concentration. However, it has been shown than CVD-grown GeSn:B shows a trade-off between the Sn incorporation and the B concentration (increasing B doping reduces Sn incorporation). Furthermore, the highest B concentration of CVD-grown GeSn:B process reported in the literature has been limited to below 1 × 1020 cm-3. Here, we demonstrate a CVD process where B δ-doping layers are inserted in the GeSn layer. We studied the influence of the thickness between each δ-doping layers and the δ-doping layers process conditions on the crystalline quality and the doping density of the GeSn:B layers. For the same Sn content, the δ-doping process results in a 4-times higher B doping than the co-flow process. In addition, a B doping concentration of 2 × 1021 cm-3 with an active concentration of 5 × 1020 cm-3 is achieved.
Observation of Charge Generation and Transfer during CVD Growth of Carbon Nanotubes.
Wang, Jiangtao; Liu, Peng; Xia, Bingyu; Wei, Haoming; Wei, Yang; Wu, Yang; Liu, Kai; Zhang, Lina; Wang, Jiaping; Li, Qunqing; Fan, Shoushan; Jiang, Kaili
2016-07-13
Carbon nanotube (CNT) is believed to be the most promising material for next generation IC industries with the prerequisite of chirality specific growth. For various approaches to controlling the chiral indices of CNTs, the key is to deepen the understanding of the catalytic growth mechanism in chemical vapor deposition (CVD). Here we show our discovery that the as-grown CNTs are all negatively charged after Fe-catalyzed CVD process. The extra electrons come from the charge generation and transfer during the growth of CNTs, which indicates that an electrochemical process happens in the surface reaction step. We then designed an in situ measurement equipment, verifying that the CVD growth of CNTs can be regarded as a primary battery system. Furthermore, we found that the variation of the Fermi level in Fe catalysts have a significant impact on the chirality of CNTs when different external electric fields are applied. These findings not only provide a new perspective on the growth of CNTs but also open up new possibilities for controlling the growth of CNTs by electrochemical methods.
Development of the Champlain primary care cardiovascular disease prevention and management guideline
Montoya, Lorraine; Liddy, Clare; Hogg, William; Papadakis, Sophia; Dojeiji, Laurie; Russell, Grant; Akbari, Ayub; Pipe, Andrew; Higginson, Lyall
2011-01-01
Abstract Problem addressed A well documented gap remains between evidence and practice for clinical practice guidelines in cardiovascular disease (CVD) care. Objective of program As part of the Champlain CVD Prevention Strategy, practitioners in the Champlain District of Ontario launched a large quality-improvement initiative that focused on increasing the uptake in primary care practice settings of clinical guidelines for heart disease, stroke, diabetes, and CVD risk factors. Program description The Champlain Primary Care CVD Prevention and Management Guideline is a desktop resource for primary care clinicians working in the Champlain District. The guideline was developed by more than 45 local experts to summarize the latest evidence-based strategies for CVD prevention and management, as well as to increase awareness of local community-based programs and services. Conclusion Evidence suggests that tailored strategies are important when implementing specific practice guidelines. This article describes the process of creating an integrated clinical guideline for improvement in the delivery of cardiovascular care. PMID:21673196
Process simulation for advanced composites production
DOE Office of Scientific and Technical Information (OSTI.GOV)
Allendorf, M.D.; Ferko, S.M.; Griffiths, S.
1997-04-01
The objective of this project is to improve the efficiency and lower the cost of chemical vapor deposition (CVD) processes used to manufacture advanced ceramics by providing the physical and chemical understanding necessary to optimize and control these processes. Project deliverables include: numerical process models; databases of thermodynamic and kinetic information related to the deposition process; and process sensors and software algorithms that can be used for process control. Target manufacturing techniques include CVD fiber coating technologies (used to deposit interfacial coatings on continuous fiber ceramic preforms), chemical vapor infiltration, thin-film deposition processes used in the glass industry, and coatingmore » techniques used to deposit wear-, abrasion-, and corrosion-resistant coatings for use in the pulp and paper, metals processing, and aluminum industries.« less
Low-temperature graphene synthesis using microwave plasma CVD
NASA Astrophysics Data System (ADS)
Yamada, Takatoshi; Kim, Jaeho; Ishihara, Masatou; Hasegawa, Masataka
2013-02-01
The graphene chemical vapour deposition (CVD) technique at substrate temperatures around 300 °C by a microwave plasma sustained by surface waves (surface wave plasma chemical vapour deposition, SWP-CVD) is discussed. A low-temperature, large-area and high-deposition-rate CVD process for graphene films was developed. It was found from Raman spectra that the deposited films on copper (Cu) substrates consisted of high-quality graphene flakes. The fabricated graphene transparent conductive electrode showed uniform optical transmittance and sheet resistance, which suggests the possibility of graphene for practical electrical and optoelectronic applications. It is intriguing that graphene was successfully deposited on aluminium (Al) substrates, for which we did not expect the catalytic effect to decompose hydrocarbon and hydrogen molecules. We developed a roll-to-roll SWP-CVD system for continuous graphene film deposition towards industrial mass production. A pair of winder and unwinder systems of Cu film was installed in the plasma CVD apparatus. Uniform Raman spectra were confirmed over the whole width of 297 mm of Cu films. We successfully transferred the deposited graphene onto PET films, and confirmed a transmittance of about 95% and a sheet resistance of less than 7 × 105 Ω/sq.
Nse, Odunaiya; Quinette, Louw; Okechukwu, Ogah
2015-09-01
Well developed and validated lifestyle cardiovascular disease (CVD) risk factors questionnaires is the key to obtaining accurate information to enable planning of CVD prevention program which is a necessity in developing countries. We conducted this review to assess methods and processes used for development and content validation of lifestyle CVD risk factors questionnaires and possibly develop an evidence based guideline for development and content validation of lifestyle CVD risk factors questionnaires. Relevant databases at the Stellenbosch University library were searched for studies conducted between 2008 and 2012, in English language and among humans. Using the following databases; pubmed, cinahl, psyc info and proquest. Search terms used were CVD risk factors, questionnaires, smoking, alcohol, physical activity and diet. Methods identified for development of lifestyle CVD risk factors were; review of literature either systematic or traditional, involvement of expert and /or target population using focus group discussion/interview, clinical experience of authors and deductive reasoning of authors. For validation, methods used were; the involvement of expert panel, the use of target population and factor analysis. Combination of methods produces questionnaires with good content validity and other psychometric properties which we consider good.
Postmortem heart weight: relation to body size and effects of cardiovascular disease and cancer.
Kumar, Neena Theresa; Liestøl, Knut; Løberg, Else Marit; Reims, Henrik Mikael; Mæhlen, Jan
2014-01-01
Gender, body weight, and cardiovascular disease (CVD) are all variables known to influence human heart weight. The impact of cancer is less studied, and the influence of age is not unequivocal. We aimed to describe the relationship between body size and heart weight in a large autopsy cohort and to compare heart weight in patients with cancer, CVD, and other diseases. Registered information, including cause of death, evidence of cancer and/or CVD, heart weight, body weight, and height, was extracted from the autopsy reports of 1410 persons (805 men, mean age 66.5 years and 605 women, mean age 70.6 years). The study population was divided in four groups according to cause of death; cancer (n=349), CVD (n=470), mixed group who died from cancer and CVD and/or lung disease (n=263), and a reference group with patients who did not die from any of these conditions (n=328). In this last group, heart weight correlated only slightly better with body surface area than body weight, and nomograms based on body weight are presented. Compared to the reference group (mean heart weight: 426 g and 351 g in men and women, respectively), heart weight was significantly lower (men: P<.05, women: P<.001) in cancer patients (men: 392 g, women: 309 g) and higher (P<.001) in patients who died from CVD (men: 550 g, women: 430 g). Similar results were obtained in linear regression models adjusted for body weight and age. Among CVD, heart valve disease had the greatest impact on heart weight, followed by old myocardial infarction, coronary atherosclerosis, and hypertension. Absolute heart weight decreased with age, but we demonstrated an increase relative to body weight. The weight of the human heart is influenced by various disease processes, in addition to body weight, gender, and age. While the most prevalent types of CVD are associated with increased heart weight, patients who die from cancer have lower average heart weight than other patient groups. The latter finding, however, is diminished when adjusting for body weight. The present study demonstrates that the weight of the human heart is influenced by various disease processes like cancer and CVD, in addition to body weight, gender and, possibly, age. © 2013.
Folta, Sara C; Goldberg, Jeanne P; Lichtenstein, Alice H; Seguin, Rebecca; Reed, Peter N; Nelson, Miriam E
2008-01-01
Cardiovascular disease (CVD) is the leading cause of death for women in the United States. A healthy diet and appropriate physical activity can help reduce the risk for CVD. However, many women do not follow recommendations for these behaviors. In this study, we used qualitative methods to better understand knowledge and awareness about CVD in women, perceived threat of CVD, barriers to heart-healthy eating and physical activity, and intervention strategies for behavior change. We conducted four focus groups with 38 white women aged 40 years or older in Kansas and Arkansas. We also interviewed 25 Cooperative State Research, Education, and Extension Service agents in those states. Environmental audits of grocery stores and the physical environment were done in three communities. Most women were aware of the modifiable risk factors for CVD. Although they realized they were susceptible, they thought CVD was something they could overcome. Common barriers to achieving a heart-healthy diet included time and concern about wasting food. Most women had positive attitudes toward physical activity and reported exercising in the past, but found it difficult to resume when their routine was disrupted. The environmental audits suggested that there are opportunities to be physically active and that with the exception of fresh fish in Kansas, healthful foods are readily available in local food stores. Interventions to change behavior should be hands-on, have a goal-setting component, and include opportunities for social interaction. It is especially important to offer interventions as awareness increases and women seek opportunities to build skills to change behavior.
Salivary Biomarkers of Chronic Psychosocial Stress and CVD Risks: A Systematic Review.
An, Kyungeh; Salyer, Jeanne; Brown, Roy E; Kao, Hsueh-Fen Sabrina; Starkweather, Angela; Shim, Insop
2016-05-01
The use of salivary biomarkers in stress research is increasing, and the precision and accuracy with which researchers are able to measure these biomarkers have dramatically improved. Chronic psychosocial stress is often linked to the pathogenesis of cardiovascular disease (CVD). Salivary biomarkers represent a noninvasive biological method of characterizing the stress phenomenon that may help to more fully describe the mechanism by which stress contributes to the pathogenesis and outcomes of CVD. We conducted a systematic review of 40 research articles to identify the salivary biomarkers researchers have most commonly used to help describe the biological impact of chronic psychosocial stress and explore its associations with CVD risk. We address strengths and weaknesses of specimen collection and measurement. We used PubMed, CINAHL, EBSCOhost, Web of Science, BIOSIS Previews, Biological Sciences (ProQuest), and Dissertations/Theses (ProQuest) to retrieve 387 initial articles. Once we applied our inclusion/exclusion criteria to specifically target adult human studies dealing with chronic stress rather than acute/laboratory-induced stress, 40 studies remained, which we synthesized using Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Cortisol was the biomarker used most frequently. Sources of psychosocial stress included job strain, low socioeconomic status, and environmental factors. Overall, psychosocial stress was associated with CVD risks such as vascular pathology (hypertension, blood pressure fluctuation, and carotid artery plaque) as well as metabolic factors such as abnormal blood glucose, dyslipidemia, and elevated cardiac enzymes. Diverse salivary biomarkers have been useful in stress research, particularly when linked to CVD risks. © The Author(s) 2015.
Schumacher, Tracy L; Burrows, Tracy L; Neubeck, Lis; Redfern, Julie; Callister, Robin; Collins, Clare E
2017-01-01
CVD is a leading cause of mortality and morbidity, and nutrition is an important lifestyle factor. The aim of the present systematic review was to synthesise the literature relating to knowledge translation (KT) of dietary evidence for the prevention and treatment of CVD into practice in populations with or at high risk of CVD. A systematic search of six electronic databases (CINAHL, Cochrane, EMBASE, MEDLINE, PsycINFO and Scopus) was performed. Studies were included if a nutrition or dietary KT was demonstrated to occur with a relevant separate measureable outcome. Quality was assessed using a tool adapted from two quality checklists. Population with or at high risk of CVD or clinicians likely to treat this population. A total of 4420 titles and abstracts were screened for inclusion, with 354 full texts retrieved to assess inclusion. Forty-three articles were included in the review, relating to thirty-five separate studies. No studies specifically stated their aim to be KT. Thirty-one studies were in patient or high-risk populations and four targeted health professionals. Few studies stated a theory on which the intervention was based (n 10) and provision of instruction was the most common behaviour change strategy used (n 26). KT in nutrition and dietary studies has been inferred, not stated, with few details provided regarding how dietary knowledge is translated to the end user. This presents challenges for implementation by clinicians and policy and decision makers. Consequently a need exists to improve the quality of publications in this area.
Optimal Magnetorheological Fluid for Finishing of Chemical-Vapor-Deposited Zinc Sulfide
NASA Astrophysics Data System (ADS)
Salzman, Sivan
Magnetorheological finishing (MRF) of polycrystalline, chemical-vapor- deposited zinc sulfide (ZnS) optics leaves visible surface artifacts known as "pebbles". These artifacts are a direct result of the material's inner structure that consists of cone-like features that grow larger (up to a few millimeters in size) as deposition takes place, and manifest on the top deposited surface as "pebbles". Polishing the pebble features from a CVD ZnS substrate to a flat, smooth surface to below 10 nm root-mean-square is challenging, especially for a non-destructive polishing process such as MRF. This work explores ways to improve the surface finish of CVD ZnS processed with MRF through modification of the magnetorheological (MR) fluid's properties. A materials science approach is presented to define the anisotropy of CVD ZnS through a combination of chemical and mechanical experiments and theoretical predictions. Magnetorheological finishing experiments with single crystal samples of ZnS, whose cuts and orientations represent most of the facets known to occur in the polycrystalline CVD ZnS, were performed to explore the influence of material anisotropy on the material removal rate during MRF. By adjusting the fluid's viscosity, abrasive type concentration, and pH to find the chemo-mechanical conditions that equalize removal rates among all single crystal facets during MRF, we established an optimized, novel MR formulation to polish CVD ZnS without degrading the surface finish of the optic.
Chemical vapor deposition modeling: An assessment of current status
NASA Technical Reports Server (NTRS)
Gokoglu, Suleyman A.
1991-01-01
The shortcomings of earlier approaches that assumed thermochemical equilibrium and used chemical vapor deposition (CVD) phase diagrams are pointed out. Significant advancements in predictive capabilities due to recent computational developments, especially those for deposition rates controlled by gas phase mass transport, are demonstrated. The importance of using the proper boundary conditions is stressed, and the availability and reliability of gas phase and surface chemical kinetic information are emphasized as the most limiting factors. Future directions for CVD are proposed on the basis of current needs for efficient and effective progress in CVD process design and optimization.
CVD Growth of Carbon Nanotubes: Structure, Catalyst, and Growth
NASA Technical Reports Server (NTRS)
Delzeit, Lance
2003-01-01
Carbon nanotubes (CNTs) exhibit extraordinary mechanical and unique electronic properties and hence have been receiving much attention in recent years for their potential in nanoelectronics, field emission devices, scanning probes, high strength composites and many more applications. Catalytic decomposition of hydrocarbon feedstock with the aid of supported transition metal catalysts - also known as chemical vapor deposition (CVD) - has become popular to produce single-walled and multi-walled nanotubes (SWNTs, MWNTs) and multiwalled nanofibers (MWNFs). The ability to grow CNTs on patterned substrates and in vertically aligned arrays, and the simplicity of the process, has made CVD growth of CNTs an attractive approach.
Cold Vacuum Drying facility civil structural system design description (SYS 06)
DOE Office of Scientific and Technical Information (OSTI.GOV)
PITKOFF, C.C.
This document describes the Cold Vacuum Drying (CVD) Facility civil - structural system. This system consists of the facility structure, including the administrative and process areas. The system's primary purpose is to provide for a facility to house the CVD process and personnel and to provide a tertiary level of containment. The document provides a description of the facility and demonstrates how the design meets the various requirements imposed by the safety analysis report and the design requirements document.
Chemical Vapor Deposited Zinc Sulfide. SPIE Press Monograph
DOE Office of Scientific and Technical Information (OSTI.GOV)
McCloy, John S.; Tustison, Randal W.
2013-04-22
Zinc sulfide has shown unequaled utility for infrared windows that require a combination of long-wavelength infrared transparency, mechanical durability, and elevated-temperature performance. This book reviews the physical properties of chemical vapor deposited ZnS and their relationship to the CVD process that produced them. An in-depth look at the material microstructure is included, along with a discussion of the material's optical properties. Finally, because the CVD process itself is central to the development of this material, a brief history is presented.
NASA Technical Reports Server (NTRS)
1992-01-01
Under a NASA contract, MI-CVD developed a process for producing bulk silicon carbide by means of a chemical vapor deposition process. The technology allows growth of a high purity material with superior mechanical/thermal properties and high polishability - ideal for mirror applications. The company employed the technology to develop three research mirrors for NASA Langley and is now marketing it as CVD SILICON CARBIDE. Its advantages include light weight, thermal stability and high reflectivity. The material has nuclear research facility applications and is of interest to industrial users of high power lasers.
Vitamin D and cardiometabolic risk factors and diseases.
Mousa, A; Naderpoor, N; Teede, H J; De Courten, M P J; Scragg, R; De Courten, B
2015-09-01
Obesity, type 2 diabetes, and cardiovascular disease (CVD) are the most common preventable causes of morbidity and mortality worldwide. Insulin resistance, which is a shared feature in these conditions, is also strongly linked to the development of polycystic ovary syndrome (PCOS), which is the most common endocrine disease in women of reproductive age and a major cause of infertility. Vitamin D deficiency has reached epidemic proportions worldwide, primarily due to the shift to sedentary, indoor lifestyles and sun avoidance behaviours to protect against skin cancer. In recent years, vitamin D deficiency has been implicated in the aetiology of type 2 diabetes, PCOS and CVD, and has been shown to be associated with their risk factors including obesity, insulin resistance, hypertension, as well as chronic low-grade inflammation. Treating vitamin D deficiency may offer a feasible and cost-effective means of reducing cardiometabolic risk factors at a population level in order to prevent the development of type 2 diabetes and CVD. However, not all intervention studies show that vitamin D supplementation alleviates these risk factors. Importantly, there is significant heterogeneity in existing studies with regards to doses and drug regimens used, populations studied (i.e. vitamin D deficient or sufficient), and the lengths of supplementation, and only few studies have directly examined the effect of vitamin D on insulin secretion and resistance with the use of clamp methods. Therefore, there is a need for well-designed large scale trials to clarify the role of vitamin D supplementation in the prevention of type 2 diabetes, PCOS, and CVD.
Khan, Maheer; Lamelas, Pablo; Musa, Hadi; Paty, Jared; McCready, Tara; Nieuwlaat, Robby; Ng, Eleonor; Lopez-Jaramillo, Patricio; Lopez-Lopez, Jose; Yusoff, Khalid; Majid, Fadhlina A; Ng, Kien Keat; Garis, Len; Onuma, Oyere; Yusuf, Salim; Schwalm, Jon-David
2018-01-10
Cardiovascular disease (CVD) is the leading cause of death worldwide. The need to address CVD is greatest in low- and middle-income countries where there is a shortage of trained health workers in CVD detection, prevention, and control. Based on the growing evidence that many elements of chronic disease management can be shifted to nonphysician health care workers (NPHW), the HOPE-4 (Heart Outcomes Prevention and Evaluation Program) aimed to develop, test, and implement a training curriculum on CVD prevention and control in Colombia, Malaysia, and low-resource settings in Canada. Curriculum development followed an iterative and phased approach where evidence-based guidelines, revised blood pressure treatment algorithms, and culturally relevant risk factor counseling were incorporated. Through a pilot-training process with high school students in Canada, the curriculum was further refined. Implementation of the curriculum in Colombia, Malaysia, and Canada occurred through partner organizations as the HOPE-4 team coordinated the program from Hamilton, Ontario, Canada. In addition to content on the burden of disease, cardiovascular system pathophysiology, and CVD risk factors, the curriculum also included evaluations such as module tests, in-class exercises, and observed structured clinical examinations, which were administered by the local partner organizations. These evaluations served as indicators of adequate uptake of curriculum content as well as readiness to work as an NPHW in the field. Overall, 51 NPHW successfully completed the training curriculum with an average score of 93.19% on module tests and 84.76% on the observed structured clinical examinations. Since implementation, the curriculum has also been adapted to the World Health Organization's HEARTS Technical Package, which was launched in 2016 to improve management of CVD in primary health care. The robust curriculum development, testing, and implementation process described affirm that NPHW in diverse settings can be trained in implementing measures for CVD prevention and control. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
Piotrowski, Walerian; Waśkiewicz, Anna; Cicha-Mikołajczyk, Alicja
2016-01-01
To develop a global cardiovascular disease (CVD) mortality risk model for the Polish population and to verify these data in the context of the SCORE risk algorithm. We analysed data obtained in two multicentre national population studies, the WOBASZ study which was conducted in 2003-2005 and included 14,769 subjects aged 20-74 years, and the WOBASZ Senior study which was conducted in 2007 and included 1096 subjects above 74 years of age. All these subjects were followed for survival status until 2012 and the cause of death was determined. The mean duration of follow-up was 8.2 years for WOBASZ study participants and about 5 years for WOBASZ Senior study participants. Overall, 1436 subjects died, including 568 due to CVD. For the purpose of our analysis of overall and CVD mortality, 15 established risk factors were selected. Survival was analysed separately in WOBASZ and WOBASZ Senior study participants. Statistical methods included descriptive statistics, Kaplan-Meier curves, Cox proportional hazard models, and the SCORE risk algorithm. Measure of incompatibility of the SCORE risk model to the Polish population was determined as the difference between mortality rates by the SCORE risk quartiles and the Cox approach. During the 8-year follow-up of the WOBASZ study population, mortality due to CVD was 38% among men and 31% among women. The most common causes of CVD mortality were ischaemic heart disease (IHD, 33%) followed by cerebro-vascular disease (17%) in men, and cerebrovascular disease (31%) followed by IHD (23%) in women. We found significant differences between men and women in regard to survival curves for both overall mortality and CVD mortality (p < 0.0001). For overall mortality among men and women, nearly all selected risk factors were shown to be significant in univariate analyses, except for high density lipoprotein cholesterol (HDL-C) level and the total cholesterol/HDL-C ratio in men, and smoking status in women. In multivariate analysis, independent predictors in men included age, glucose level, systolic blood pressure, and smoking status. In women, independent predictors were age, smoking status, and diabetes. During the 5-year follow-up of the WOBASZ Senior study population, mortality due to CVD was 48% among men and 58% among women. The most common cause of CVD mortality in both men and women was IHD (29% and 24%, respectively), followed by cerebrovascular disease (16% and 21%, respectively). We found significant differences between men and women in regard to survival curves for overall mortality (p < 0.0001) but not for CVD mortality (p = 0.0755). Due to the fact that survival curves for CVD mortality did not differ between men and women, we estimated the cut-off age for no survival difference in the WOBASZ study. By selecting the oldest patients and adding them to the WOBASZ Senior cohort, we obtained the cut-off age of 70 years above which the survival curves were not significantly different between men and women. In univariate analyses, independent predictors in men were age and creatinine level. These factors remained significant in multivariate analysis. In women above 74 years of age, independent predictors in univariate analyses included age, HDL-C level, creatinine level, total cholesterol/HDL-C ratio, and smoking status. Age, HDL-C level, creatinine level, and smoking status remained independent predictors of overall mortality in multivariate analysis. For CVD mortality, significant predictors were the same as for overall mortality. In women, significant predictors in uni- and multivariate analyses were age and smoking status. Overall disagreement between CVD mortality rates by the SCORE risk model and the Cox model was 5.7% in men and 2% in women. 1. Long-term follow-up of WOBASZ and WOBASZ Senior study participants allowed assessment of the inde-pendent association of the evaluated cardiovascular risk factors with CVD mortality in the Polish population. 2. Validation of the SCORE risk algorithm to estimate individual global CVD risk in the Polish population showed a high predictive value of this algorithm.
Pollard, Harvey B.; Shivakumar, Chittari; Starr, Joshua; Eidelman, Ofer; Jacobowitz, David M.; Dalgard, Clifton L.; Srivastava, Meera; Wilkerson, Matthew D.; Stein, Murray B.; Ursano, Robert J.
2016-01-01
“Soldier's Heart,” is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test (P = 3 × 10−54). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test (P = 1.8 × 10−16). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation. PMID:27721742
Pollard, Harvey B; Shivakumar, Chittari; Starr, Joshua; Eidelman, Ofer; Jacobowitz, David M; Dalgard, Clifton L; Srivastava, Meera; Wilkerson, Matthew D; Stein, Murray B; Ursano, Robert J
2016-01-01
"Soldier's Heart," is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test ( P = 3 × 10 -54 ). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test ( P = 1.8 × 10 -16 ). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation.
Wing, Rena R.; Tate, Deborah F.; Garcia, Katelyn R.; Bahnson, Judy; Lewis, Cora E.; Espeland, Mark A.
2017-01-01
Objective Weight gain occurs commonly in young adults and increases cardiovascular (CVD) risk. We previously reported that two self-regulation interventions reduced weight gain relative to control. Here we examine whether these interventions also benefit CVD risk factors. Methods SNAP (Study of Novel Approaches to Weight Gain Prevention) was a randomized trial in 2 academic settings (N=599; 18–35 years; body mass index 21–30 kg/m2) comparing two interventions (Self-Regulation with Small Changes; Self-Regulation with Large Changes) and Control. Small Changes taught participants to make daily small changes (approximately 100 calorie) in intake and activity. Large Changes taught participants to initially lose 5–10 pounds to buffer anticipated weight gains. CVD risk factors were assessed at baseline and 2 years in 471 participants. Results Although Large Changes was associated with more beneficial changes in glucose, insulin, and HOMA-IR than Control, these differences were not significant after adjusting for multiple comparisons or 2-year weight change. Comparison of participants grouped by percent weight change baseline to 2 years showed significant differences for several CVD risk factors, with no interaction with treatment condition. Conclusions Magnitude of weight change, rather than specific weight gain prevention interventions, was related to changes in CVD risk factors in young adults. PMID:28782918
Rexrode, Kathryn M; Ridker, Paul M; Hegener, Hillary H; Buring, Julie E; Manson, JoAnn E; Zee, Robert Y L
2008-05-01
Androgen receptors (AR) are expressed in endothelial cells and vascular smooth-muscle cells. Some studies suggest an association between AR gene variation and risk of cardiovascular disease (CVD) in men; however, the relationship has not been examined in women. Six haplotype block-tagging single nucleotide polymorphisms (rs962458, rs6152, rs1204038, rs2361634, rs1337080, rs1337082), as well as the cysteine, adenine, guanine (CAG) microsatellite in exon 1, of the AR gene were evaluated among 300 white postmenopausal women who developed CVD (158 myocardial infarctions and 142 ischemic strokes) and an equal number of matched controls within the Women's Health Study. Genotype distributions were similar between cases and controls, and genotypes were not significantly related to risk of CVD, myocardial infarctions or ischemic stroke in conditional logistic regression models. Seven common haplotypes were observed, but distributions did not differ between cases and controls nor were significant associations observed in logistic regression analysis. The median CAG repeat length was 21. In conditional logistic regression, there was no association between the number of alleles with CAG repeat length >or=21 (or >or=22) and risk of CVD, myocardial infarctions or ischemic stroke. No association between AR genetic variation, as measured by haplotype-tagging single nucleotide polymorphisms and CAG repeat number, and risk of CVD was observed in women.
NASA Astrophysics Data System (ADS)
Oulachgar, El Hassane
As the semiconductors industry is moving toward nanodevices, there is growing need to develop new materials and thin films deposition processes which could enable strict control of the atomic composition and structure of thin film materials in order to achieve precise control on their electrical and optical properties. The accurate control of thin film characteristics will become increasingly important as the miniaturization of semiconductor devices continue. There is no doubt that chemical synthesis of new materials and their self assembly will play a major role in the design and fabrication of next generation semiconductor devices. The objective of this work is to investigate the chemical vapor deposition (CVD) process of thin film using a polymeric precursor as a source material. This process offers many advantages including low deposition cost, hazard free working environment, and most importantly the ability to customize the polymer source material through polymer synthesis and polymer functionalization. The combination between polymer synthesis and CVD process will enable the design of new generation of complex thin film materials with a wide range of improved chemical, mechanical, electrical and optical properties which cannot be easily achieved through conventional CVD processes based on gases and small molecule precursors. In this thesis we mainly focused on polysilanes polymers and more specifically poly(dimethylsilanes). The interest in these polymers is motivated by their distinctive electronic and photonic properties which are attributed to the delocalization of the sigma-electron along the Si-Si backbone chain. These characteristics make polysilane polymers very promising in a broad range of applications as a dielectric, a semiconductor and a conductor. The polymer-based CVD process could be eventually extended to other polymer source materials such as polygermanes, as well as and a variety of other inorganic and hybrid organic-inorganic polymers. This work has demonstrated that a polysilane polymeric source can be used to deposit a wide range of thin film materials exhibiting similar properties with conventional ceramic materials such as silicon carbide (SiC), silicon oxynitride (SiON), silicon oxycarbide (SiOC) silicon dioxide (SiO2) and silicon nitride (Si3N4). The strict control of the deposition process allows precise control of the electrical, optical and chemical properties of polymer-based thin films within a broad range. This work has also demonstrated for the first time that poly(dimethylsilmaes) polymers deposited by CVD can be used to effectively passivate both silicon and gallium arsenide MOS devices. This finding makes polymer-based thin films obtained by CVD very promising for the development of high-kappa dielectric materials for next generation high-mobility CMOS technology. Keywords. Thin films, Polymers, Vapor Phase Deposition, CVD, Nanodielectrics, Organosilanes, Polysilanes, GaAs Passivation, MOSFET, Silicon Oxynitride, Integrated Waveguide, Silicon Carbide, Compound Semiconductors.
Cocoa, Blood Pressure, and Vascular Function
Ludovici, Valeria; Barthelmes, Jens; Nägele, Matthias P.; Enseleit, Frank; Ferri, Claudio; Flammer, Andreas J.; Ruschitzka, Frank; Sudano, Isabella
2017-01-01
Cardiovascular disease (CVD) represents the most common cause of death worldwide. The consumption of natural polyphenol-rich foods, and cocoa in particular, has been related to a reduced risk of CVD, including coronary heart disease and stroke. Intervention studies strongly suggest that cocoa exerts a beneficial impact on cardiovascular health, through the reduction of blood pressure (BP), improvement of vascular function, modulation of lipid and glucose metabolism, and reduction of platelet aggregation. These potentially beneficial effects have been shown in healthy subjects as well as in patients with risk factors (arterial hypertension, diabetes, and smoking) or established CVD (coronary heart disease or heart failure). Several potential mechanisms are supposed to be responsible for the positive effect of cocoa; among them activation of nitric oxide (NO) synthase, increased bioavailability of NO as well as antioxidant, and anti-inflammatory properties. It is the aim of this review to summarize the findings of cocoa and chocolate on BP and vascular function. PMID:28824916
NASA Astrophysics Data System (ADS)
Seo, Hyunju; Han, Jeong-Yeol; Kim, Sug-Whan; Seong, Sehyun; Yoon, Siyoung; Lee, Kyungmook; Lee, Haengbok
2015-09-01
Today, CVD SiC mirrors are readily available in the market. However, it is well known to the community that the key surface fabrication processes and, in particular, the material removal characteristics of the CVD SiC mirror surface varies sensitively depending on the shop floor polishing and figuring variables. We investigated the material removal characteristics of CVD SiC mirror surfaces using a new and patented polishing tool called orthogonal velocity tool (OVT) that employs two orthogonal velocity fields generated simultaneously during polishing and figuring machine runs. We built an in-house OVT machine and its operating principle allows for generation of pseudo Gaussian shapes of material removal from the target surface. The shapes are very similar to the tool influence functions (TIFs) of other polishing machine such as IRP series polishing machines from Zeeko. Using two CVD SiC mirrors of 150 mm in diameter and flat surface, we ran trial material removal experiments over the machine run parameter ranges from 12.901 to 25.867 psi in pressure, 0.086 m/sec to 0.147 m/sec in tool linear velocity, and 5 to 15 sec in dwell time. An in-house developed data analysis program was used to obtain a number of Gaussian shaped TIFs and the resulting material removal coefficient varies from 3.35 to 9.46 um/psi hour m/sec with the mean value to 5.90 ± 1.26(standard deviation). We report the technical details of the new OVT machine, of the data analysis program, of the experiments and the results together with the implications to the future development of the OVT machine and process for large CVD SiC mirror surfaces.
Status of the secondary mirrors (M2) for the Gemini 8-m telescopes
NASA Astrophysics Data System (ADS)
Knohl, Ernst-Dieter; Schoeppach, Armin; Pickering, Michael A.
1998-08-01
The 1-m diameter lightweight secondary mirrors (M2) for the Gemini 8-m telescopes will be the largest CVD-SiC mirrors ever produced. The design and manufacture of these mirrors is a very challenging task. In this paper we will discuss the mirror design, structural and mechanical analysis, and the CVD manufacturing process used to produce the mirror blanks. The lightweight design consist of a thin faceplate (4-mm) and triangular backstructure cells with ribs of varying heights. The main drivers in the design were weight (40 kg) and manufacturing limitations imposed on the backstructure cells and mirror mounts. Finite element modeling predicts that the mirror design will meet all of the Gemini M2 requirements for weight, mechanical integrity, resonances, and optical performance. Special design considerations were necessary to avoid stress concentration in the mounting areas and to meet the requirement that the mirror survive an 8-g earthquake. The highest risk step in the mirror blank manufacturing process is the near-net-shape CVD deposition of the thin, curved faceplate. Special tooling and procedures had to be developed to produce faceplates free of fractures, cracks, and stress during the cool-down from deposition temperature (1350 C) to room temperature. Due to time delay with the CVD manufacturing process in the meantime a backup solution from Zerodur has been started. This mirror is now in the advanced polishing process. Because the design of both mirrors is very similar an excellent comparison of both solutions is possible.
Synthesis of Sr2Si5N8:Ce3+ phosphors for white LEDs via an efficient chemical deposition
Yang, Che-Yuan; Som, Sudipta; Das, Subrata; Lu, Chung-Hsin
2017-01-01
Novel chemical vapor deposition (CVD) process was successfully developed for the growth of Sr2Si5N8:Ce3+ phosphors with elevated luminescent properties. Metallic strontium was used as a vapor source for producing Sr3N2 vapor to react with Si3N4 powder via a homogeneous gas-solid reaction. The phosphors prepared via the CVD process showed high crystallinity, homogeneous particle size ranging from 8 to 10 μm, and high luminescence properties. In contrast, the phosphors prepared via the conventional solid-state reaction process exhibited relative low crystallinity, non-uniform particle size in the range of 0.5–5 μm and relatively lower luminescent properties than the phosphors synthesized via the CVD process. Upon the blue light excitation, Sr2−xCexSi5N8 phosphors exhibited a broad yellow band. A red shift of the emission band from 535 to 556 nm was observed with the increment in the doping amount of Ce3+ ions from x = 0.02 to x = 0.10. The maximum emission was observed at x = 0.06, and the external and internal quantum efficiencies were calculated to be 51% and 71%, respectively. Furthermore, the CVD derived optimum Sr1.94Ce0.06Si5N8 phosphor exhibited sufficient thermal stability for blue-LEDs and the activation energy was calculated to be 0.33 eV. The results demonstrate a potential synthesis process for nitride phosphors suitable for light emitting diodes. PMID:28361999
Synthesis of Sr2Si5N8:Ce3+ phosphors for white LEDs via an efficient chemical deposition
NASA Astrophysics Data System (ADS)
Yang, Che-Yuan; Som, Sudipta; Das, Subrata; Lu, Chung-Hsin
2017-03-01
Novel chemical vapor deposition (CVD) process was successfully developed for the growth of Sr2Si5N8:Ce3+ phosphors with elevated luminescent properties. Metallic strontium was used as a vapor source for producing Sr3N2 vapor to react with Si3N4 powder via a homogeneous gas-solid reaction. The phosphors prepared via the CVD process showed high crystallinity, homogeneous particle size ranging from 8 to 10 μm, and high luminescence properties. In contrast, the phosphors prepared via the conventional solid-state reaction process exhibited relative low crystallinity, non-uniform particle size in the range of 0.5-5 μm and relatively lower luminescent properties than the phosphors synthesized via the CVD process. Upon the blue light excitation, Sr2-xCexSi5N8 phosphors exhibited a broad yellow band. A red shift of the emission band from 535 to 556 nm was observed with the increment in the doping amount of Ce3+ ions from x = 0.02 to x = 0.10. The maximum emission was observed at x = 0.06, and the external and internal quantum efficiencies were calculated to be 51% and 71%, respectively. Furthermore, the CVD derived optimum Sr1.94Ce0.06Si5N8 phosphor exhibited sufficient thermal stability for blue-LEDs and the activation energy was calculated to be 0.33 eV. The results demonstrate a potential synthesis process for nitride phosphors suitable for light emitting diodes.
Spin-on metal oxide materials with high etch selectivity and wet strippability
NASA Astrophysics Data System (ADS)
Yao, Huirong; Mullen, Salem; Wolfer, Elizabeth; McKenzie, Douglas; Rahman, Dalil; Cho, JoonYeon; Padmanaban, Munirathna; Petermann, Claire; Hong, SungEun; Her, YoungJun
2016-03-01
Metal oxide or metal nitride films are used as hard mask materials in semiconductor industry for patterning purposes due to their excellent etch resistances against the plasma etches. Chemical vapor deposition (CVD) or atomic layer deposition (ALD) techniques are usually used to deposit the metal containing materials on substrates or underlying films, which uses specialized equipment and can lead to high cost-of-ownership and low throughput. We have reported novel spin-on coatings that provide simple and cost effective method to generate metal oxide films possessing good etch selectivity and can be removed by chemical agents. In this paper, new spin-on Al oxide and Zr oxide hard mask formulations are reported. The new metal oxide formulations provide higher metal content compared to previously reported material of specific metal oxides under similar processing conditions. These metal oxide films demonstrate ultra-high etch selectivity and good pattern transfer capability. The cured films can be removed by various chemical agents such as developer, solvents or wet etchants/strippers commonly used in the fab environment. With high metal MHM material as an underlayer, the pattern transfer process is simplified by reducing the number of layers in the stack and the size of the nano structure is minimized by replacement of a thicker film ACL. Therefore, these novel AZ® spinon metal oxide hard mask materials can potentially be used to replace any CVD or ALD metal, metal oxide, metal nitride or spin-on silicon-containing hard mask films in 193 nm or EUV process.
Ezeamama, Amara E; Viali, Satupaitea; Tuitele, John; McGarvey, Stephen T
2006-11-01
Early in economic development there are positive associations between socioeconomic status (SES) and cardiovascular disease (CVD) risk factors, and in the most developed market economy societies there are negative associations. The purpose of this report is to describe cross-sectional and longitudinal associations between indicators of SES and CVD risk factors in a genetically homogenous population of Samoans at different levels of economic development. At baseline 1289 participants 25-58yrs, and at 4-year follow-up, 963 participants were studied in less economically developed Samoa and in more developed American Samoa. SES was assessed by education, occupation, and material lifestyle at baseline. The CVD risk factors, obesity, type-2 diabetes and hypertension were measured at baseline and 4-year follow-up, and an index of any incident CVD risk factor at follow-up was calculated. Sex and location (Samoa and American Samoa) specific multivariable logistic regression models were used to test for relationships between SES and CVD risk factors at baseline after adjustment for age and the other SES indicators. In addition an ordinal SES index was constructed for each individual based on all three SES indicators, and used in a multivariable model to estimate the predicted probability of CVD risk factors across the SES index for the two locations. In both the models using specific SES measures and CVD risk factor outcomes, and the models using the ordinal SES index and predicted probabilities of CVD risk factors, we detected a pattern of high SES associated with: (1) elevated odds of CVD risk factors in less developed Samoa, and (2) decreased odds of CVD risk factors in more developed American Samoa. We conclude that the pattern of inverse associations between SES and CVD risk factors in Samoa and direct associations in American Samoa is attributable to the heterogeneity across the Samoas in specific exposures to social processes of economic development and the natural history of individual CVD risk factors. The findings suggest that interventions on non-communicable diseases in the Samoas must be devised based on the level of economic development, the socio-economic context of risk factor exposures, and individual characteristics such as age, sex and education level.
Complexity of mechanisms among human proprotein convertase subtilisin-kexin type 9 variants.
Dron, Jacqueline S; Hegele, Robert A
2017-04-01
There are many reports of human variants in proprotein convertase subtilisin-kexin type 9 (PCSK9) that are either gain-of-function (GOF) or loss-of-function (LOF), with downstream effects on LDL cholesterol and cardiovascular disease (CVD) risk. However, data on particular mechanisms have only been minimally curated. GOF variants are individually ultrarare, affect all domains of the protein, act to reduce LDL receptor expression through several mechanisms, are a minor cause of familial hypercholesterolemia, have been reported mainly within families, have variable LDL cholesterol-raising effects, and are associated with increased CVD risk mainly through observational studies in families and small cohorts. In contrast, LOF variants can be either ultrarare mutations or relatively more common polymorphisms seen in populations, affect all domains of the protein, act to increase LDL receptor expression through several mechanisms, have variable LDL cholesterol-lowering effects, and have been associated with decreased CVD risk mainly through Mendelian randomization studies in epidemiologic populations. There is considerable complexity underlying the clinical concept of both LOF and GOF variants of PCSK9. But despite the underlying mechanistic heterogeneity, altered PCSK9 secretion or function is ultimately correlated with plasma LDL cholesterol level, which is also the driver of CVD outcomes.
Consensus Review of the Treatment of Cardiovascular Disease in People With Hemophilia A and B
Boral, Leonard I.; Cohen, Alice J.; Smyth, Susan S.; White, Gilbert C.
2015-01-01
With advances in care, increasing numbers of people with hemophilia (PWH) achieve near-normal life expectancies and present with typical age-related cardiovascular conditions. Evidence-based guidelines for medical or surgical management of cardiovascular conditions in individuals with hemophilia are limited. Published recommendations exist for the management of some common cardiovascular conditions (eg, ischemic heart disease, atrial fibrillation), but identifying optimal strategies for anticoagulant or antithrombotic therapy constitutes the primary challenge of managing nonoperative cardiovascular disease (CVD) in PWH. In general, as long as factor concentrates or other hemostatic therapies maintain adequate hemostasis, the recommended medical and surgical management of CVD in PWH parallels that in individuals without hemophilia. The presence of factor inhibitors complicates hemophilia management. Published outcomes of CVD treatment in PWH are similar to those in the general population. Specific knowledge about factor replacement, factor inhibitors, and disease-specific treatment distinguishes the cardiovascular care of PWH from similar care of individuals without this rare bleeding disorder. Furthermore, a multidisciplinary approach incorporating a hematologist with an onsite coagulation laboratory, ideally associated with a hemophilia treatment center, is integral to the management of CVD in PWH. PMID:25436468
Gary, Rebecca
2012-01-01
Rapid growth in the numbers of older adults with cardiovascular disease (CVD) is raising awareness and concern of the impact that common geriatric syndromes such as frailty may have on clinical outcomes, health-related quality of life, and rising economic burden associated with healthcare. Increasingly, frailty is recognized to be a highly prevalent and important risk factor that is associated with adverse cardiovascular outcomes. A limitation of previous studies in patients with CVD has been the lack of a consistent definition and measures to evaluate frailty. In this review, building upon the work of Fried and colleagues, a definition of frailty is provided that is applicable for evaluating frailty in older adults with CVD. Simple, well-established performance-based measures widely used in comprehensive geriatric assessment are recommended that can be readily implemented by nurses in most practice settings. The limited studies conducted in older adults with CVD have shown physical performance measures to be highly predictive of clinical outcomes. Implications for practice and areas for future research are described for the growing numbers of elderly cardiac patients who are frail frailty and at risk for disability.
Cardiovascular disease prevention and lifestyle interventions: effectiveness and efficacy.
Haskell, William L
2003-01-01
Over the past half century scientific data support the strong relationship between the way a person or population lives and their risk for developing or dying from cardiovascular disease (CVD). While heredity can be a major factor for some people, their personal health habits and environmental/cultural exposure are more important factors. CVD is a multifactor process that is contributed to by a variety of biological and behavioral characteristics of the person including a number of well-established and emerging risk factors. Not smoking, being physically active, eating a heart healthy diet, staying reasonably lean, and avoiding major stress and depression are the major components of an effective CVD prevention program. For people at high risk of CVD, medications frequently need to be added to a healthy lifestyle to minimize their risk of a heart attack or stroke, particularly in persons with conditions such as hypertension, hypercholesterolemia, or hyperglycemia. Maintaining an effective CVD prevention program in technologically advanced societies cannot be achieved by many high-risk persons without effective and sustained support from a well-organized health care system. Nurse-provided or nurse-coordinated care management programs using an integrated or multifactor approach have been highly effective in reducing CVD morbidity and mortality of high-risk persons.
NASA Astrophysics Data System (ADS)
Jang, Jisu; Son, Myungwoo; Chung, Sunki; Kim, Kihyeun; Cho, Chunhum; Lee, Byoung Hun; Ham, Moon-Ho
2015-12-01
There is significant interest in synthesizing large-area graphene films at low temperatures by chemical vapor deposition (CVD) for nanoelectronic and flexible device applications. However, to date, low-temperature CVD methods have suffered from lower surface coverage because micro-sized graphene flakes are produced. Here, we demonstrate a modified CVD technique for the production of large-area, continuous monolayer graphene films from benzene on Cu at 100-300 °C at ambient pressure. In this method, we extended the graphene growth step in the absence of residual oxidizing species by introducing pumping and purging cycles prior to growth. This led to continuous monolayer graphene films with full surface coverage and excellent quality, which were comparable to those achieved with high-temperature CVD; for example, the surface coverage, transmittance, and carrier mobilities of the graphene grown at 300 °C were 100%, 97.6%, and 1,900-2,500 cm2 V-1 s-1, respectively. In addition, the growth temperature was substantially reduced to as low as 100 °C, which is the lowest temperature reported to date for pristine graphene produced by CVD. Our modified CVD method is expected to allow the direct growth of graphene in device manufacturing processes for practical applications while keeping underlying devices intact.
Puoane, Thandi; Abrahams-Gessel, Shafika; Gaziano, Thomas A; Levitt, Naomi
2017-01-01
Summary Introduction This article describes a training process to equip community health workers (CHWs) with knowledge and skills to identify individuals at high risk for cardiovascular disease (CVD) in a township in Cape Town. Methods: CHWs were employed by a non-governmental organisation (NGO) primarily focusing on non-communicable diseases (NCDs). They were trained in the theory of CVD, including physiological changes and related risk factors and in obtaining anthropometric and blood pressure measurements. Pre- and post-training tests assessed learning needs and the effectiveness of imparting knowledge about CVD, respectively. Results: Training increased knowledge about CVD risk factors. CHWs were able to screen and identify those at risk for CVD and refer them to health professionals for validation of scores. The initial one-week training was too short, given the amount of information covered. Some CHWs had difficulty with English as the primary instruction medium and as the only language in which tests were offered. Conclusion: Although CHWs could be trained to screen for CVD risk, increased training time was required to impart the knowledge. The language used during training and testing presented challenges for those trainees whose dominant, spoken language was not English. PMID:28759089
Wang, Hulian; Zhu, Dancheng; Jiang, Feng; Zhao, Pei; Wang, Hongtao; Zhang, Ze; Chen, Xin; Jin, Chuanhong
2018-08-03
Understanding the microscopic mechanisms for the nucleation and growth of two-dimensional molybdenum diselenide (2D MoSe 2 ) via chemical vapor deposition (CVD) is crucial towards the precisely controlled growth of the 2D material. In this work, we employed a joint use of transmission electron microscopy and CVD, in which the 2D MoSe 2 were directly grown on a graphene membrane based on grids, that enables the microstructural characterization of as-grown MoSe 2 flakes. We further explore the role of hydrogen gas and find: in an argon ambient, the primary products are few-layer MoSe 2 flakes, along with MoO x nanoparticles; while with the introduction of H 2 , single-layer MoSe 2 became the dominant product during the CVD growth. Quantitative analysis of the effects of H 2 flow rate on the flake sizes, and areal coverage was also given. Nevertheless, we further illuminated the evolution of shape morphology and edge structures of single-layer MoSe 2 , and proposed the associated growth routes during a typical CVD process.
[Time analysis of mortality from cerebrovascular diseases in Andalucia (1975-1999)].
Cayuela-Domínguez, A; Rodríguez-Domínguez, S; Iglesias-Bonilla, P; Mir-Rivera, P; Martínez-Fernández, E
In previous publications we analysed the tendency of mortality from cerebrovascular diseases (CVD) in Andalusia over the period 1975-1992, and we observed a marked decrease in the mortality rates in both sexes. AIMS. To describe the evolution of mortality from CVD in Andalusia throughout the period 1975-1999. Deaths from CVD over the period 1975 1999 were obtained from the Instituto Andaluz de Estadística. We employed the direct method of standardisation of rates (world standard population). The rates were subjected to logarithmic transformations and the regression lines were adjusted. A considerable decrease was found in the rates: 3.9% in males and 4.0% in females. The drop in truncated rates (35 64 years old) was greater in women ( 5.9%) than in men ( 4.3%). Our work shows a marked and continuous decrease in mortality from CVD in Andalusia (1975-1999). In accordance with the process of aging of the population, the magnitude of CVD measured in terms of deaths, invalidity and health costs still represents a great challenge for preventative and health care policies.
Abrahams-Gessel, Shafika; Denman, Catalina A; Montano, Carlos Mendoza; Gaziano, Thomas A; Levitt, Naomi; Rivera-Andrade, Alvaro; Carrasco, Diana Munguía; Zulu, Jabu; Khanam, Masuma Akter; Puoane, Thandi
2015-03-01
Cardiovascular disease (CVD) is on the rise in low- and middle-income countries and is proving difficult to combat due to the emphasis on improving outcomes in maternal and child health and infectious diseases against a backdrop of severe human resource and infrastructure constraints. Effective task-sharing from physicians or nurses to community health workers (CHW) to conduct population-based screening for persons at risk has the potential to mitigate the impact of CVD on vulnerable populations. CHW in Bangladesh, Guatemala, Mexico, and South Africa were trained to conduct noninvasive population-based screening for persons at high risk for CVD. This study sought to quantitatively assess the performance of CHW during training and to qualitatively capture their training and fieldwork experiences while conducting noninvasive screening for CVD risk in their communities. Written tests were used to assess CHW's acquisition of content knowledge during training, and focus group discussions were conducted to capture their training and fieldwork experiences. Training was effective at increasing the CHW's content knowledge of CVD, and this knowledge was largely retained up to 6 months after the completion of fieldwork. Common themes that need to be addressed when designing task-sharing with CHW in chronic diseases are identified, including language, respect, and compensation. The importance of having intimate knowledge of the community receiving services from design to implementation is underscored. Effective training for screening for CVD in community settings should have a strong didactic core that is supplemented with culture-specific adaptations in the delivery of instruction. The incorporation of expert and intimate knowledge of the communities themselves is critical, from the design to implementation phases of training. Challenges such as role definition, defining career paths, and providing adequate remuneration must be addressed. Copyright © 2015 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.
Hospitalizations for Cardiovascular Disease in African Americans and Whites with HIV/AIDS
Oramasionwu, Christine U.; Morse, Gene D.; Lawson, Kenneth A.; Brown, Carolyn M.; Koeller, Jim M.
2013-01-01
Abstract Therapeutic advances have resulted in an epidemiological shift in the predominant causes of hospitalization for patients with HIV/AIDS. An emerging cause for hospitalization in this patient population is cardiovascular disease (CVD); however, data are limited regarding how this shift affects different racial groups. The objective of this observational, retrospective study was to evaluate the association between race and hospitalization for CVD in African Americans and whites with HIV/AIDS and to compare the types of CVD-related hospitalizations between African Americans and whites with HIV/AIDS. Approximately 1.5 million hospital discharges from the US National Hospital Discharge Surveys for the years of 1996 to 2008 were identified. After controlling for potential confounders, the odds of CVD-related hospitalization in patients with HIV/AIDS were 45% higher for African Americans than whites (odds ratio [OR]=1.45, 95% CI, 1.39–1.51). Other covariates that were associated with increased odds of hospitalization for CVD included chronic kidney disease (OR=1.43, 95% CI, 1.36–1.51), age≥50 years (OR=3.22, 95% CI, 2.94–3.54), region in the Southern United States (OR=1.17, 95% CI, 1.11–1.23), and Medicare insurance coverage (OR=1.71, 95% CI, 1.60–1.83). Male sex was not significantly associated with the study outcome (OR=0.99, 95% CI, 0.96–1.02). Compared to whites with HIV/AIDS, African Americans with HIV/AIDS had more hospitalizations for heart failure and hypertension, but fewer hospitalizations for stroke and coronary heart disease. In conclusion, African Americans with HIV/AIDS have increased odds of CVD-related hospitalization as compared to whites with HIV/AIDS. Furthermore, the most common types of CVD-related hospitalizations differ significantly in African Americans and whites. (Population Health Management 2012;16:201–207) PMID:23194035
Bonner, Carissa; Fajardo, Michael Anthony; Hui, Samuel; Stubbs, Renee; Trevena, Lyndal
2018-02-01
Online health information is particularly important for cardiovascular disease (CVD) prevention, where lifestyle changes are recommended until risk becomes high enough to warrant pharmacological intervention. Online information is abundant, but the quality is often poor and many people do not have adequate health literacy to access, understand, and use it effectively. This project aimed to review and evaluate the suitability of online CVD risk calculators for use by low health literate consumers in terms of clinical validity, understandability, and actionability. This systematic review of public websites from August to November 2016 used evaluation of clinical validity based on a high-risk patient profile and assessment of understandability and actionability using Patient Education Material Evaluation Tool for Print Materials. A total of 67 unique webpages and 73 unique CVD risk calculators were identified. The same high-risk patient profile produced widely variable CVD risk estimates, ranging from as little as 3% to as high as a 43% risk of a CVD event over the next 10 years. One-quarter (25%) of risk calculators did not specify what model these estimates were based on. The most common clinical model was Framingham (44%), and most calculators (77%) provided a 10-year CVD risk estimate. The calculators scored moderately on understandability (mean score 64%) and poorly on actionability (mean score 19%). The absolute percentage risk was stated in most (but not all) calculators (79%), and only 18% included graphical formats consistent with recommended risk communication guidelines. There is a plethora of online CVD risk calculators available, but they are not readily understandable and their actionability is poor. Entering the same clinical information produces widely varying results with little explanation. Developers need to address actionability as well as clinical validity and understandability to improve usefulness to consumers with low health literacy. ©Carissa Bonner, Michael Anthony Fajardo, Samuel Hui, Renee Stubbs, Lyndal Trevena. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.02.2018.
Einarson, Thomas R; Acs, Annabel; Ludwig, Craig; Panton, Ulrik H
2018-06-08
Cardiovascular disease (CVD) is a common comorbidity in type 2 diabetes (T2DM). CVD's prevalence has been growing over time. To estimate the current prevalence of CVD among adults with T2DM by reviewing literature published within the last 10 years (2007-March 2017). We searched Medline, Embase, and proceedings of major scientific meetings for original research documenting the prevalence of CVD in T2DM. CVD included stroke, myocardial infarction, angina pectoris, heart failure, ischemic heart disease, cardiovascular disease, coronary heart disease, atherosclerosis, and cardiovascular death. No restrictions were placed on country of origin or publication language. Two reviewers independently searched for articles and extracted data, adjudicating results through consensus. Data were summarized descriptively. Risk of bias was examined by applying the STROBE checklist. We analyzed data from 57 articles with 4,549,481 persons having T2DM. Europe produced the most articles (46%), followed by the Western Pacific/China (21%), and North America (13%). Overall in 4,549,481 persons with T2DM, 52.0% were male, 47.0% were obese, aged 63.6 ± 6.9 years old, with T2DM duration of 10.4 ± 3.7 years. CVD affected 32.2% overall (53 studies, N = 4,289,140); 29.1% had atherosclerosis (4 studies, N = 1153), 21.2% had coronary heart disease (42 articles, N = 3,833,200), 14.9% heart failure (14 studies, N = 601,154), 14.6% angina (4 studies, N = 354,743), 10.0% myocardial infarction (13 studies, N = 3,518,833) and 7.6% stroke (39 studies, N = 3,901,505). CVD was the cause of death in 9.9% of T2DM patients (representing 50.3% of all deaths). Risk of bias was low; 80 ± 12% of STROBE checklist items were adequately addressed. Globally, overall CVD affects approximately 32.2% of all persons with T2DM. CVD is a major cause of mortality among people with T2DM, accounting for approximately half of all deaths over the study period. Coronary artery disease and stroke were the major contributors.
NASA Astrophysics Data System (ADS)
Honda, Kazuhiro; Ohdaira, Keisuke; Matsumura, Hideki
2008-05-01
In catalytic chemical vapor deposition (Cat-CVD), often called hot-wire CVD, source gases are decomposed by catalytic cracking reactions with heated catalyzing metal wires. In the case of silicon (Si) film deposition, such metal wires are often converted to silicide, which shortens the lifetime of catalyzing wires. As a catalyzer, tungsten (W) is widely used. Thus, the process of silicidation of a W catalyzer at temperatures over 1650 °C, which is the temperature used in Cat-CVD for Si film deposition, was studied extensively in various experiments. It is found that two phases of tungsten-silicide, WSi2 and W5Si3, are formed at this temperature, and that the radiation emissivity of WSi2 is 1.2 to 1.7 times higher than that of W5Si3 and pure W. The increase of surface emissivity due to the formation of WSi2 decreases the catalyzer surface temperature which induces further growth of the tungsten-silicide layer. It is also found that the suppression of WSi2 formation by elevating catalyzer temperatures over 1750 °C is a key to extending the lifetime of the W catalyzer in Cat-CVD.
NASA Astrophysics Data System (ADS)
Laxminarayana, Karthik; Jalili, Nader
2004-07-01
Nanocrystals and nanostructures will be the building blocks for future materials that will exhibit enhanced or entirely new combinations of properties with tremendous opportunity for novel technologies that can have far-reaching impact on our society. It is, however, realized that a major challenge for the near future is the design, synthesis and integration of nanostructures to develop functional nanosystems. In view of this, this exploratory research seeks to facilitate the development of a controlled and deterministic framework for nanomanufacturing of nanotubes as the most suitable choice among nanostructures for a plethora of potential applications in areas such as nanoelectronic devices, biological probes, fuel cell electrodes, supercapacitors and filed emission devices. Specifically, this paper proposes to control and maintain the most common nanotube growth parameters (i.e., reaction temperature and gas flow rate) through both software and hardware modifications. The influence of such growth parameters in a CVD process on some of the most vital and crucial aspects of nanotubes (e.g., length, diameter, yield, growth rate and structure) can be utilized to arrive at some unique and remarkable properties for the nanotubes. The objective here is, therefore, to control the process parameters to pinpoint accuracy, which would enable us to fabricate nanotubes having the desired properties and thereby maximize their ability to function at its fullest potential. To achieve this and in order to provide for experimental validation of the proposed research program, an experimental test-bed using the nanotube processing test chamber and a mechatronics workstation are being constructed.
Nguyen, Quang Ngoc; Pham, Son Thai; Do, Loi Doan; Nguyen, Viet Lan; Wall, Stig; Weinehall, Lars; Bonita, Ruth; Byass, Peter
2012-01-01
Background. Data on cardiovascular disease risk factors (CVDRFs) in Vietnam are limited. This study explores the prevalence of each CVDRF and how they cluster to evaluate CVDRF burdens and potential prevention strategies. Methods. A cross-sectional survey in 2009 (2,130 adults) was done to collect data on behavioural CVDRF, anthropometry and blood pressure, lipidaemia profiles, and oral glucose tolerance tests. Four metabolic CVDRFs (hypertension, dyslipidaemia, diabetes, and obesity) and five behavioural CVDRFs (smoking, excessive alcohol intake, unhealthy diet, physical inactivity, and stress) were analysed to identify their prevalence, cluster patterns, and social predictors. Framingham scores were applied to estimate the global 10-year CVD risks and potential benefits of CVD prevention strategies. Results. The age-standardised prevalence of having at least 2/4 metabolic, 2/5 behavioural, or 4/9 major CVDRF was 28%, 27%, 13% in women and 32%, 62%, 34% in men. Within-individual clustering of metabolic factors was more common among older women and in urban areas. High overall CVD risk (≥20% over 10 years) identified 20% of men and 5% of women-especially at higher ages-who had coexisting CVDRF. Conclusion. Multiple CVDRFs were common in Vietnamese adults with different clustering patterns across sex/age groups. Tackling any single risk factor would not be efficient.
Ion beam figuring of CVD silicon carbide mirrors
NASA Astrophysics Data System (ADS)
Gailly, P.; Collette, J.-P.; Fleury Frenette, K.; Jamar, C.
2017-11-01
Optical and structural elements made of silicon carbide are increasingly found in space instruments. Chemical vapor deposited silicon carbide (CVD-SiC) is used as a reflective coating on SiC optics in reason of its good behavior under polishing. The advantage of applying ion beam figuring (IBF) to CVD-SiC over other surface figure-improving techniques is discussed herein. The results of an IBF sequence performed at the Centre Spatial de Liège on a 100 mm CVD-SiC mirror are reported. The process allowed to reduce the mirror surface errors from 243 nm to 13 nm rms . Beside the surface figure, roughness is another critical feature to consider in order to preserve the optical quality of CVD-SiC . Thus, experiments focusing on the evolution of roughness were performed in various ion beam etching conditions. The roughness of samples etched at different depths down to 3 ≠m was determined with an optical profilometer. These measurements emphasize the importance of selecting the right combination of gas and beam energy to keep roughness at a low level. Kaufman-type ion sources are generally used to perform IBF but the performance of an end-Hall ion source in figuring CVD-SiC mirrors was also evaluated in this study. In order to do so, ion beam etching profiles obtained with the end-Hall source on CVD-SiC were measured and used as a basis for IBF simulations.
Bhuyan, Soumitra S; Shiyanbola, Olayinka; Kedia, Satish; Chandak, Aastha; Wang, Yang; Isehunwa, Oluwaseyi O; Anunobi, Nnamdi; Ebuenyi, Ikenna; Deka, Pallav; Ahn, SangNam; Chang, Cyril F
Cardiovascular disease (CVD) is a leading cause of death and disability as well as a major burden on the U.S. healthcare system. Cost-related medication nonadherence (CRN) to prescribed medications is common among patients with CVD. This study examines the gender differences in CRN among CVD patients. We used 2011 to 2014 data from the National Health Interview Survey, an annual, cross-sectional, nationally representative household survey of the noninstitutionalized U.S. civilian population (≥18 years of age). Based on Andersen's model of health services utilization, multivariate logistic regressions were estimated to examine the effect of gender on the primary composite outcome of CRN which was identified if any of the following types of CRN were reported: 1) skipped medication doses to save money, 2) took less medication to save money, and 3) delayed prescription filling to save money. Among CVD patients who had used a prescription medication in the last 12 months, 10.0% skipped medication doses, 10.6% took less medication, and 12.8% delayed filling their prescriptions. After adjusting for confounding factors, gender was found to be significantly associated with the composite outcome of CRN among CVD patients. Women were 1.54 times (95% confidence interval, 1.33-1.77) more likely to have any of the types of CRN compared with men. There are significant gender disparities in CRN among CVD patients. More support for and closer monitoring of CRN is needed for disadvantaged groups, especially women with limited resources. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Vitamin D and cardiometabolic health: a review of the evidence.
Muldowney, Siobhan; Kiely, Mairead
2011-06-01
The cardiometabolic syndrome (MetS) is a clustering of related metabolic abnormalities including abdominal adiposity, insulin resistance, hypertension, dyslipidaemia and increased inflammatory and thrombotic markers, which is linked to increased risk of type 2 diabetes, CVD and overall mortality. Several cross-sectional and prospective studies have shown an association between low vitamin D status, as indicated by concentrations of serum 25-hydroxyvitamin D (s25(OH)D), and increased prevalence of the MetS and individual CVD risk factors. These epidemiological observations are supported by mechanistic studies but experimental data are limited. The available data from intervention studies are largely confounded as most vitamin D supplementation trials were mainly carried out to explore the role of Ca in CVD and include Ca in the treatment arms. Inadequate consideration of seasonal effects on s25(OH)D concentrations is also a common design flaw in most studies. Further complications arise from shared risk factors such as adiposity and ageing, which predispose individuals to exhibit both a more pronounced risk profile and relatively lower s25(OH)D concentrations. In conclusion, while epidemiological associations are promising and a rationale for low vitamin D status as a potentially modifiable risk factor for CVD is supported by mechanistic data, suitable experimental data from appropriately designed trials are just beginning to emerge. As yet, this body of literature is too immature to draw firm conclusions on the role of vitamin D in CVD prevention. Carefully controlled vitamin D trials in well-described population groups using intervention doses that are titrated against target s25(OH)D concentrations could yield potentially valuable outcomes that may have a positive impact on CVD risk modification.
Mosca, Lori; Mochari-Greenberger, Heidi; Dolor, Rowena J.; Newby, L. Kristin; Robb, Karen J.
2010-01-01
Background Awareness of cardiovascular disease (CVD) risk has been linked to taking preventive action in women. The purpose of this study was to assess contemporary awareness of CVD risk and barriers to prevention in a nationally representative sample of women and to evaluate trends since 1997 from similar triennial surveys. Methods and Results A standardized survey about awareness of CVD risk was completed in 2009 by 1142 women ≥25 years of age, contacted through random digit dialing oversampled for racial/ethnic minorities, and by 1158 women contacted online. There was a significant increase in the proportion of women aware that CVD is the leading cause of death since 1997 (P for trend=<0.0001). Awareness among telephone participants was greater in 2009 compared with 1997 (54% versus 30%, P<0.0001) but not different from 2006 (57%). In multivariate analysis, African American and Hispanic women were significantly less aware than white women, although the gap has narrowed since 1997. Only 53% of women said they would call 9-1-1 if they thought they were having symptoms of a heart attack. The majority of women cited therapies to prevent CVD that are not evidence-based. Common barriers to prevention were family/caretaking responsibilities (51%) and confusion in the media (42%). Community-level changes women thought would be helpful were access to healthy foods (91%), public recreation facilities (80%), and nutrition information in restaurants (79%). Conclusions Awareness of CVD as the leading cause of death among women has nearly doubled since 1997 but is stabilizing and continues to lag in racial/ethnic minorities. Numerous misperceptions and barriers to prevention persist and women strongly favored environmental approaches to facilitate preventive action. PMID:20147489
Advances in the Development of a WCl6 CVD System for Coating UO2 Powders with Tungsten
NASA Technical Reports Server (NTRS)
Mireles, Omar R.; Tieman, Alyssa; Broadway, Jeramie; Hickman, Robert
2013-01-01
W-UO2 CERMET fuels are under development to enable Nuclear Thermal Propulsion (NTP) for deep space exploration. Research efforts with an emphasis on fuel fabrication, testing, and identification of potential risks is underway. One primary risk is fuel loss due to CTE mismatch between W and UO2 and the grain boundary structure of W particles resulting in higher thermal stresses. Mechanical failure can result in significant reduction of the UO2 by hot hydrogen. Fuel loss can be mitigated if the UO2 particles are coated with a layer of high density tungsten before the consolidation process. This paper discusses the work to date, results, and advances of a fluidized bed chemical vapor deposition (CVD) system that utilizes the H2-WCl6 reduction process. Keywords: Space, Nuclear, Thermal, Propulsion, Fuel, CERMET, CVD, Tungsten, Uranium
Chen, Nan; Reeja-Jayan, B; Liu, Andong; Lau, Jonathan; Dunn, Bruce; Gleason, Karen K
2016-03-01
A group of crosslinked cyclic siloxane (Si-O) and silazane (Si-N) polymers are synthesized via solvent-free initiated chemical vapor deposition (iCVD). Notably, this is the first report of cyclic polysilazanes synthesized via the gas-phase iCVD method. The deposited nanoscale thin films are thermally stable and chemically inert. By iCVD, they can uniformly and conformally cover nonplanar surfaces having complex geometry. Although polysiloxanes are traditionally utilized as dielectric materials and insulators, our research shows these cyclic organosilicon polymers can conduct lithium ions (Li(+) ) at room temperature. The conformal coating and the room temperature ionic conductivity make these cyclic organosilicon polymers attractive for use as thin-film electrolytes in solid-state batteries. Also, their synthesis process and properties have been systemically studied and discussed. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
NASA Technical Reports Server (NTRS)
Biaglow, James A.
1995-01-01
Tensile data were obtained from four different types of rhenium at ambient and elevated temperatures. The four types of rhenium included chemical vapor deposition (CVD) and three powder metallurgy (PM) types, i.e., rolled sheet and pressed and sintered bars, with and without hot isostatic pressure (HIP) treatment. Results revealed a wide range of values with ultimate strengths at ambient temperatures varying from 663 MPa for CVD rhenium to 943 MPa for rolled sheet. A similar spread was also obtained for material tested at 1088 K and 1644 K. The wide variance observed with the different materials indicated that the rhenium manufacturing process, material composition and prior handling strongly dictated its properties. In addition to tensile properties, CVD, pressed and sintered material and HIP rhenium successfully completed 100 cycles of low cycle fatigue. Creep data were also obtained showing that CVD and pressed and sintered rhenium could sustain five hours of testing under a tension of 27.5 MPa at 1922 K.
Chemical reactivity of CVC and CVD SiC with UO2 at high temperatures
NASA Astrophysics Data System (ADS)
Silva, Chinthaka M.; Katoh, Yutai; Voit, Stewart L.; Snead, Lance L.
2015-05-01
Two types of silicon carbide (SiC) synthesized using two different vapor deposition processes were embedded in UO2 pellets and evaluated for their potential chemical reaction with UO2. While minor reactivity between chemical-vapor-composited (CVC) SiC and UO2 was observed at comparatively low temperatures of 1100 and 1300 °C, chemical-vapor-deposited (CVD) SiC did not show any such reactivity. However, both CVD and CVC SiCs showed some reaction with UO2 at a higher temperature (1500 °C). Elemental maps supported by phase maps obtained using electron backscatter diffraction indicated that CVC SiC was more reactive than CVD SiC at 1500 °C. Furthermore, this investigation indicated the formation of uranium carbides and uranium silicide chemical phases such as UC, USi2, and U3Si2 as a result of SiC reaction with UO2.
Iridium-coated rhenium thrusters by CVD
NASA Technical Reports Server (NTRS)
Harding, J. T.; Kazaroff, J. M.; Appel, M. A.
1989-01-01
Operation of spacecraft thrusters at increased temperature reduces propellant requirements. Inasmuch as propellant comprises the bulk of a satellite's mass, even a small percentage reduction makes possible a significant enhancement of the mission in terms of increased payload. Because of its excellent high temperature strength, rhenium is often the structural material of choice. It can be fabricated into free-standing shapes by chemical vapor deposition (CVD) onto an expendable mandrel. What rhenium lacks is oxidation resistance, but this can be provided by a coating of iridium, also by CVD. This paper describes the process used by Ultramet to fabricate 22-N (5-lbf) and, more recently, 445-N (100-lbf) Ir/Re thrusters; characterizes the CVD-deposited materials; and summarizes the materials effects of firing these thrusters. Optimal propellant mixture ratios can be employed because the materials withstand an oxidizing environment up to the melting temperature of iridium, 2400 C (4350 F).
Iridium-coated rhenium thrusters by CVD
NASA Technical Reports Server (NTRS)
Harding, John T.; Kazaroff, John M.; Appel, Marshall A.
1988-01-01
Operation of spacecraft thrusters at increased temperature reduces propellant requirements. Inasmuch as propellant comprises the bulk of a satellite's mass, even a small percentage reduction makes possible a significant enhancement of the mission in terms of increased payload. Because of its excellent high temperature strength, rhenium is often the structural material of choice. It can be fabricated into free-standing shapes by chemical vapor deposition (CVD) onto an expendable mandrel. What rhenium lacks is oxidation resistance, but this can be provided by a coating of iridium, also by CVD. This paper describes the process used by Ultramet to fabricate 22-N (5-lbf) and, more recently, 445-N (100-lbf) Ir/Re thrusters; characterizes the CVD-deposited materials; and summarizes the materials effects of firing these thrusters. Optimal propellant mixture ratios can be employed because the materials withstand an oxidizing environment up to the meltimg temperature of iridium, 2400 C (4350 F).
Gaalas/Gaas Solar Cell Process Study
NASA Technical Reports Server (NTRS)
Almgren, D. W.; Csigi, K. I.
1980-01-01
Available information on liquid phase, vapor phase (including chemical vapor deposition) and molecular beam epitaxy growth procedures that could be used to fabricate single crystal, heteroface, (AlGa) As/GaAs solar cells, for space applications is summarized. A comparison of the basic cost elements of the epitaxy growth processes shows that the current infinite melt LPE process has the lower cost per cell for an annual production rate of 10,000 cells. The metal organic chemical vapor deposition (MO-CVD) process has the potential for low cost production of solar cells but there is currently a significant uncertainty in process yield, i.e., the fraction of active material in the input gas stream that ends up in the cell. Additional work is needed to optimize and document the process parameters for the MO-CVD process.
Sleep as a Potential Fundamental Contributor to Cardiovascular Health Disparities
Jackson, Chandra L.; Redline, Susan; Emmons, Karen M.
2016-01-01
Optimal sleep is integral to health but is commonly not obtained. Despite its wide ranging public health impact, sleep health is under-appreciated by the general public and is only rarely considered by policy makers, employers, schools, and others whose policies and structures can adversely affect sleep. Inadequate sleep duration and quality are prevalent in minority and low-income populations and may play a fundamental role in racial and socioeconomic status (SES) inequities for a wide range of health conditions including cardiovascular disease (CVD).The goal of this review is to examine the relationship between sleep and CVD health disparities. To this end, we describe the overall public health importance of sleep and the role of sleep duration as well as the two most common disorders (sleep apnea and insomnia) as risk factors for a number of chronic diseases. We then focus on the potential link between sleep and CVD disparities. A multilevel model developed for the analysis of population health and health disparities as a part of the National Cancer Institute’s Centers on Population Health and Health Disparities served as our conceptual framework. It is based on the notion that individual behaviors, like sleep, are influenced by complex and dynamic interrelations among the individual and his or her physical and social environments across the lifespan. Using this model, we describe modifiable factors that contribute to insufficient sleep and circadian misalignment, propose potential interventions in various sectors (e.g. neighborhoods, schools, workplaces) that address social structures that contribute to disparities, and conclude by recommending critical areas for future sleep research. We ultimately suggest that integrating sleep into public health research will identify novel approaches for closing the gap in health disparities, such as CVD. PMID:25785893
Ricardo, Ana C.; Fischer, Michael J.; Lora, Claudia M.; Budoff, Matthew; Keane, Martin G.; Kusek, John W.; Martinez, Monica; Nessel, Lisa; Stamos, Thomas; Ojo, Akinlolu; Rahman, Mahboob; Soliman, Elsayed Z.; Yang, Wei; Feldman, Harold I.; Go, Alan S.
2011-01-01
Summary Background and objectives Hispanics are the largest minority group in the United States. The leading cause of death in patients with chronic kidney disease (CKD) is cardiovascular disease (CVD), yet little is known about its prevalence among Hispanics with CKD. Design, setting, participants, & measurements We conducted cross-sectional analyses of prevalent self-reported clinical and subclinical measures of CVD among 497 Hispanics, 1638 non-Hispanic Caucasians, and 1650 non-Hispanic African Americans, aged 21 to 74 years, with mild-to-moderate CKD at enrollment in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic CRIC (HCRIC) studies. Measures of subclinical CVD included left ventricular hypertrophy (LVH), coronary artery calcification (CAC), and ankle-brachial index. Results Self-reported coronary heart disease (CHD) was lower in Hispanics compared with non-Hispanic Caucasians (18% versus 23%, P = 0.02). Compared with non-Hispanic Caucasians, Hispanics had a lower prevalence of CAC >100 (41% versus 34%, P = 0.03) and CAC >400 (26% versus 19%, P = 0.02). However, after adjusting for sociodemographic factors, these differences were no longer significant. In adjusted analyses, Hispanics had a higher odds of LVH compared with non-Hispanic Caucasians (odds ratio 1.97, 95% confidence interval, 1.22 to 3.17, P = 0.005), and a higher odds of CAC >400 compared with non-Hispanic African Americans (odds ratio, 2.49, 95% confidence interval, 1.11 to 5.58, P = 0.03). Hispanic ethnicity was not independently associated with any other CVD measures. Conclusions Prevalent LVH was more common among Hispanics than non-Hispanic Caucasians, and elevated CAC score was more common among Hispanics than non-Hispanic African Americans. Understanding reasons for these racial/ethnic differences and their association with long-term clinical outcomes is needed. PMID:21896829
Onishi, Katsuya
2017-08-01
Patients with cardiovascular disease (CVD) often have multiple comorbid conditions that may interact with each other, confound the choice of treatments, and reduce mortality. Chronic obstructive pulmonary disease (COPD) is one of the most important comorbidities of CVD, which causes serious consequences in patients with ischemic heart disease, stroke, arrhythmia, and heart failure. COPD shares common risk factors such as tobacco smoking and aging with CVD, is associated with less physical activity, and produces systemic inflammation and oxidative stress. Overall, patients with COPD have a 2-3-fold increased risk of CVD as compared to age-matched controls when adjusted for tobacco smoking. Chronic heart failure (HF) is a frequent and important comorbidity which has a significant impact on prognosis in COPD, and vice versa. HF overlaps in symptoms and signs and has a common comorbidity with COPD, so that diagnosis of COPD is difficult in patients with HF. The combination of HF and COPD presents many therapeutic challenges including beta-blockers (BBs) and beta-agonists. Inhaled long-acting bronchodilators including beta2-agonists and anticholinergics for COPD would not worsen HF. Diuretics are relatively safe, and angiotensin-converting enzyme inhibitors are preferred to treat HF accompanied with COPD. BBs are only relatively contraindicated in asthma, but not in COPD. Low doses of cardioselective BBs should be aggressively initiated in clinically stable patients with HF accompanied with COPD combined with close monitoring for signs of airway obstruction and gradually up-titrated to the maximum tolerated dose. Encouraging appropriate and aggressive treatment for both HF and COPD should be recommended to improve quality of life and mortality in HF patients with COPD. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Koller, Kathryn R.; Wolfe, Abbie W.; Metzger, Jesse S.; Austin, Melissa A.; Hopkins, Scarlett E.; Kaufmann, Cristiane; Jolly, Stacey E.; Ebbesson, Sven O.E.; Umans, Jason G.; Howard, Barbara V.; Boyer, Bert B.
2013-01-01
Background According to health status reports, chronic disease prevalence appears to be rising in western Alaska Native (AN) people, and accurate population-based data are needed. Four cohort studies of western AN people were conducted in the Norton Sound and Yukon-Kuskokwim regions, but none have been large enough to allow reliable estimates of rates of chronic diseases and evaluate their risk factors. Objective In this article, the methods used to combine 4 major cohort studies of rural western AN people are described and the benefits and challenges encountered in combining data and standardizing surveillance methods for these studies are discussed. Design Tribal permission was obtained for each cohort study and the consolidated study. Data from baseline exams were directly combined or harmonized into new variables. Common surveillance methods were developed and implemented to identify incidence and risk factors for cardiovascular disease (CVD) events and type 2 diabetes. Results A cohort of 4,569 western AN participants (2,116 men and 2,453 women), aged 18–95 years, was established to study CVD and diabetes prevalence. Prospective surveillance data over an average 6.7-year follow-up can now be used to study CVD and diabetes incidence and associated risk factors in a subset of 2,754 western AN participants (1,218 men and 1,536 women) who consented to initial surveillance. Conclusions The combined cohort provides statistical power to examine incidence rates and risk factors for CVD and diabetes and allows for analyses by geographic region. The data can be used to develop intervention programmes in these populations and others. PMID:23671836
Kinetics of low pressure CVD growth of SiO2 on InP and Si
NASA Technical Reports Server (NTRS)
Iyer, R.; Lile, D. L.
1988-01-01
The kinetics of low pressure CVD growth of SiO2 from SiH4 and O2 has been investigated for the case of an indirect (remote) plasma process. Homogeneous (gas phase) and heterogeneous operating ranges have been experimentally identified. The process was shown to be consistent within the heterogeneous surface-reaction dominated range of operation. A kinetic rate equation is given for growth at 14 W RF power input and 400 mtorr total pressure on both InP and Si substrates. The process exhibits an activation energy of 8.4 + or - 0.6 kcal/mol.
Agca, R; Heslinga, S C; Rollefstad, S; Heslinga, M; McInnes, I B; Peters, M J L; Kvien, T K; Dougados, M; Radner, H; Atzeni, F; Primdahl, J; Södergren, A; Wallberg Jonsson, S; van Rompay, J; Zabalan, C; Pedersen, T R; Jacobsson, L; de Vlam, K; Gonzalez-Gay, M A; Semb, A G; Kitas, G D; Smulders, Y M; Szekanecz, Z; Sattar, N; Symmons, D P M; Nurmohamed, M T
2017-01-01
Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base. A multidisciplinary steering committee (representing 13 European countries) comprised 26 members including patient representatives, rheumatologists, cardiologists, internists, epidemiologists, a health professional and fellows. Systematic literature searches were performed and evidence was categorised according to standard guidelines. The evidence was discussed and summarised by the experts in the course of a consensus finding and voting process. Three overarching principles were defined. First, there is a higher risk for CVD in patients with RA, and this may also apply to ankylosing spondylitis and psoriatic arthritis. Second, the rheumatologist is responsible for CVD risk management in patients with IJD. Third, the use of non-steroidal anti-inflammatory drugs and corticosteroids should be in accordance with treatment-specific recommendations from EULAR and Assessment of Spondyloarthritis International Society. Ten recommendations were defined, of which one is new and six were changed compared with the 2009 recommendations. Each designated an appropriate evidence support level. The present update extends on the evidence that CVD risk in the whole spectrum of IJD is increased. This underscores the need for CVD risk management in these patients. These recommendations are defined to provide assistance in CVD risk management in IJD, based on expert opinion and scientific evidence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Chew, Kew-Kim; Bremner, Alexandra; Stuckey, Bronwyn; Earle, Carolyn; Jamrozik, Konrad
2009-01-01
Cigarette smoking has been implicated in the pathophysiology of cardiovascular disease (CVD) and as a risk factor for erectile dysfunction (ED). However, various aspects of the associations between cigarette smoking, ED, and CVD need further elucidation. We explored the relationship between cigarette smoking, ED, and CVD using data from a population-based cross-sectional study of 1,580 participants. Postal questionnaires were sent to randomly selected age-stratified male population samples obtained from the Western Australia Electoral Roll. In addition to items covering sociodemographic and self-reported clinical information and smoking habits, the 5-item International Index of Erectile Function was used to assess erectile function. Compared with never smokers, the odds of ED, adjusted for age, square of age, and CVD, were significantly higher among current smokers (odds ratio [OR] = 1.40; 95% confidence interval [CI] 1.02, 1.92) and ever smokers (OR = 1.57; 95% CI 1.02, 2.42). Similarly, the adjusted odds of severe ED were significantly higher among former smokers. Albeit not statistically significant, the age-adjusted odds of ED among current smokers increased with the number of cigarettes smoked. Among former smokers, the age-adjusted odds of ED were significantly higher 6-10 years following cessation of smoking than < or = 5 or > 10 years. Compared with never smokers without CVD, the age-adjusted odds of ED among former smokers and ever smokers without CVD were about 1.6. Regardless of smoking, these odds were significantly higher among participants with CVD. Compared with never smokers, former smokers and ever smokers have significantly higher odds of ED. The relationship between smoking and ED is independent of that between smoking and CVD, and not because of confounding by CVD. Patterns of ED in former smokers suggest that there may be a latent interval between active smoking and symptomatic ED, involving a process initially triggered by smoking.
The link between chronic kidney disease and cardiovascular disease.
Said, Sarmad; Hernandez, German T
2014-07-01
It is well known that patients with chronic kidney disease (CKD) have a strong risk of cardiovascular disease (CVD). However, the excess risk of cardiovascular disease in patients with CKD is only partially explained by the presence of traditional risk factors, such as hypertension and diabetes mellitus. Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO and Web of Science has been searched. Chronic kidney disease even in its early stages can cause hypertension and potentiate the risk for cardiovascular disease. However, the practice of intensive blood pressure lowering was criticized in recent systematic reviews. Available evidence is inconclusive but does not prove that a blood pressure target of less than 130/80 mmHg as recommended in the guidelines improves clinical outcomes more than a target of less than 140/90 mmHg in adults with CKD. The association between CKD and CVD has been extensively documented in the literature. Both CKD and CVD share common traditional risk factors, such as smoking, obesity, hypertension, diabetes mellitus, and dyslipidemia. However, cardiovascular disease remains often underdiagnosed und undertreated in patients with CKD. It is imperative that as clinicians, we recognize that patients with CKD are a group at high risk for developing CVD and cardiovascular events. Additional studies devoted to further understand the risk factors for CVD in patients with CKD are necessary to develop and institute preventative and treatment strategies to reduce the high morbidity and mortality in patients with CKD.
The link between chronic kidney disease and cardiovascular disease
Said, Sarmad; Hernandez, German T.
2014-01-01
Context: It is well known that patients with chronic kidney disease (CKD) have a strong risk of cardiovascular disease (CVD). However, the excess risk of cardiovascular disease in patients with CKD is only partially explained by the presence of traditional risk factors, such as hypertension and diabetes mellitus. Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO and Web of Science has been searched. Results: Chronic kidney disease even in its early stages can cause hypertension and potentiate the risk for cardiovascular disease. However, the practice of intensive blood pressure lowering was criticized in recent systematic reviews. Available evidence is inconclusive but does not prove that a blood pressure target of less than 130/80 mmHg as recommended in the guidelines improves clinical outcomes more than a target of less than 140/90 mmHg in adults with CKD. Conclusions: The association between CKD and CVD has been extensively documented in the literature. Both CKD and CVD share common traditional risk factors, such as smoking, obesity, hypertension, diabetes mellitus, and dyslipidemia. However, cardiovascular disease remains often underdiagnosed und undertreated in patients with CKD. It is imperative that as clinicians, we recognize that patients with CKD are a group at high risk for developing CVD and cardiovascular events. Additional studies devoted to further understand the risk factors for CVD in patients with CKD are necessary to develop and institute preventative and treatment strategies to reduce the high morbidity and mortality in patients with CKD. PMID:25093157
Buchan, Duncan S; Ollis, Stewart; Thomas, Non-Eleri; Simpson, Alan; Young, John D; Cooper, Stephen-Mark; Malina, Robert M; Cockcroft, John R; Baker, Julien S
2012-10-01
Information on the health status and physical activity of Scottish adolescents is limited. This study examines the prevalence of cardiovascular disease (CVD) risk in Scottish adolescents by socioeconomic status (SES). Participants were recruited from two high schools that differed in the SES of the students in attendance. The sample included 73 boys and 34 girls (16.4 ± 0.6 years). Variables included anthropometry, physical activity, physical fitness, blood pressure, diet, and 11 metabolic markers of CVD risk. Significant sex differences (P ≤ 0.01) were noted for stature, waist circumference, waist-hip ratio, physical activity, cardiorespiratory fitness, muscular power, sprint speed, and several CVD risk factors: high-density lipoprotein (HDL), low-density lipoprotein (LDL), interleukin-6 (IL-6), and C-reactive protein (CRP) levels. Boys from a lower SES had significantly higher levels of glucose and plasminogen activator inhibitor-1 (PAI-1) but lower levels of adiponectin compared with boys from a higher SES. Girls from a lower SES had significantly (P ≤ 0.01) higher glucose and PAI-1 levels but lower levels of insulin and adiponectin than girls from a higher SES. High fat diets, low physical activity levels, and elevated CRP and total cholesterol levels were the CVD risk factors most commonly identified as being at-risk levels in this cohort, regardless of sex or SES. SES differences were not consistently apparent, but several CVD risk factors were identified as elevated in this sample of adolescents, regardless of sex or SES.
Nonalcoholic fatty liver disease - A multisystem disease?
Mikolasevic, Ivana; Milic, Sandra; Turk Wensveen, Tamara; Grgic, Ivana; Jakopcic, Ivan; Stimac, Davor; Wensveen, Felix; Orlic, Lidija
2016-01-01
Non-alcoholic fatty liver disease (NAFLD) is one of the most common comorbidities associated with overweight and metabolic syndrome (MetS). Importantly, NAFLD is one of its most dangerous complications because it can lead to severe liver pathologies, including fibrosis, cirrhosis and hepatic cellular carcinoma. Given the increasing worldwide prevalence of obesity, NAFLD has become the most common cause of chronic liver disease and therefore is a major global health problem. Currently, NAFLD is predominantly regarded as a hepatic manifestation of MetS. However, accumulating evidence indicates that the effects of NAFLD extend beyond the liver and are negatively associated with a range of chronic diseases, most notably cardiovascular disease (CVD), diabetes mellitus type 2 (T2DM) and chronic kidney disease (CKD). It is becoming increasingly clear that these diseases are the result of the same underlying pathophysiological processes associated with MetS, such as insulin resistance, chronic systemic inflammation and dyslipidemia. As a result, they have been shown to be independent reciprocal risk factors. In addition, recent data have shown that NAFLD actively contributes to aggravation of the pathophysiology of CVD, T2DM, and CKD, as well as several other pathologies. Thus, NAFLD is a direct cause of many chronic diseases associated with MetS, and better detection and treatment of fatty liver disease is therefore urgently needed. As non-invasive screening methods for liver disease become increasingly available, detection and treatment of NAFLD in patients with MetS should therefore be considered by both (sub-) specialists and primary care physicians. PMID:27920470
Carbon Nanotube based Nanotechnolgy
NASA Astrophysics Data System (ADS)
Meyyappan, M.
2000-10-01
Carbon nanotube(CNT) was discovered in the early 1990s and is an off-spring of C60(the fullerene or buckyball). CNT, depending on chirality and diameter, can be metallic or semiconductor and thus allows formation of metal-semiconductor and semiconductor-semiconductor junctions. CNT exhibits extraordinary electrical and mechanical properties and offers remarkable potential for revolutionary applications in electronics devices, computing and data storage technology, sensors, composites, storage of hydrogen or lithium for battery development, nanoelectromechanical systems(NEMS), and as tip in scanning probe microscopy(SPM) for imaging and nanolithography. Thus the CNT synthesis, characterization and applications touch upon all disciplines of science and engineering. A common growth method now is based on CVD though surface catalysis is key to synthesis, in contrast to many CVD applications common in microelectronics. A plasma based variation is gaining some attention. This talk will provide an overview of CNT properties, growth methods, applications, and research challenges and opportunities ahead.
Crengle, Sue; Smylie, Janet; Kelaher, Margaret; Lambert, Michelle; Reid, Susan; Luke, Joanne; Anderson, Ian; Harré Hindmarsh, Jennie; Harwood, Matire
2014-07-12
Cardiovascular diseases (CVD) are leading causes of mortality and morbidity among Indigenous people in New Zealand, Australia and Canada and are a major driver of the inequities in life expectancy between Indigenous and non-Indigenous people in these countries. Evidence-based pharmaceutical management of CVD can significantly reduce mortality and morbidity for persons diagnosed with CVD or for those at intermediate or high risk of CVD. Health literacy has been identified as a major barrier in the communication and implementation of appropriate pharmaceutical management plans for CVD. Addressing health literacy is particularly relevant in Indigenous populations where there are unique health and adult literacy challenges. This study will examine the effect of a customized, structured CVD medication programme, delivered by health professionals, on the health literacy of Indigenous people with, or at risk, of CVD. Primary outcomes are patient's knowledge about CVD medications; secondary outcomes examine changes in health literacy skills and practices. The study will employ a multi-site pre-post design with multiple measurement points to assess intervention efficacy. Participants will be recruited from four Indigenous primary care services in Australia, Canada and New Zealand. Three educational sessions will be delivered over four weeks. A tablet application will support the education sessions and produce a customized pill card for each participant. Participants will be provided with written information about CVD medications. Medication knowledge scores, and specific health literacy skills and practices will be assessed before and after the three sessions. Statistical analyses will identify significant changes in outcomes over each session, and from the pre-session one to post-session three time points. This study will make an important contribution to understanding the effect of a structured primary care-based intervention on CVD health literacy in Indigenous populations. The study also illustrates the incorporation of Indigenous health research principles and processes in clinical trials and provides insights that may be useful in other contexts. Australian and New Zealand Clinical Trials Register (ACTRN12612001309875; date of registration 18/12/2012).
Radio frequency and microwave plasma for optical thin-film deposition
NASA Astrophysics Data System (ADS)
Otto, Juergen; Paquet, Volker; Kersten, Ralf T.; Etzkorn, Heinz-Werner; Brusasco, Raymond M.; Britten, Jerald A.; Campbell, Jack H.; Thorsness, J. B.
1990-12-01
For the next generation of fusion lasers reflecting mirrors with laser damage thresholds of at least 40 J/cm2 for 1 0 ns laser pulses at 1 .064 pm are needed. Up to now, no deposition technique has been developed to produce such mirrors. Best R&D-values realized today are around 30 J/cm2 for e-beam evaporated mirrors. R&D on conventional e-beam coating processes over the last 1 0 years has come up with marginal improvements in laser damage thresholds only. However, new technologies, like PICVD (Plasma-Impulse CVD) developed for the fabrication of ultra-low loss fiber preforms, seem to offer the potential to solve this problem. First results have been reported already [1-3]. It is well known that fused silica produced by CVD processes can have laser damage thresholds as high as 80 J/cm2. However, the thickness of a single deposited film is in the pm-range for most of the CVD-processes used for preform manufacturing; since interference optics need films in the ; /4n range (where n is the refractive index of the dielectric material) the use of preform-fabrication processes for the purpose of interference mirror fabrication is limited to a few plasma based CVD technologies, namely PCVD (Plasma-CVD, Philips [4]; PICVD, SCHOTT [5]). Especially PICVD is a very powerful technology to fabricate thin film multilayers for interference mirrors, because this technique is able to produce films down to monolayer thickness with nearly perfect stoichiometry and morphology. In first and preliminary experiments the usual deposition in a circular tube at high temperatures has been used for simplicity. However, to produce large area high quality laser mirrors this principle know-how has to be transfered from circular to planar geometry. Experiments showed, that there may be some limitations with respect to the homogeneity of a planar deposition using microwave excitation for the plasma. Therefore experiments have been performed in parallel with both RF and microwave excitation for comparison. In the following we will restrict ourselves to the description and discussions of the planar processes; the principle and details of the PICVD-process are described elsewhere [5] while RF-plasma technology is a well known process.
Guasch-Ferré, Marta; Babio, Nancy; Martínez-González, Miguel A; Corella, Dolores; Ros, Emilio; Martín-Peláez, Sandra; Estruch, Ramon; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Santos-Lozano, José M; Serra-Majem, Lluís; Bulló, Mònica; Toledo, Estefanía; Barragán, Rocío; Fitó, Montserrat; Gea, Alfredo; Salas-Salvadó, Jordi
2015-12-01
Dietary fat quality and fat replacement are more important for cardiovascular disease (CVD) prevention than is total dietary fat intake. The aim was to evaluate the association between total fat intake and fat subtypes with the risk of CVD (myocardial infarction, stroke, or death from cardiovascular causes) and cardiovascular and all-cause death. We also examined the hypothetical effect of the isocaloric substitution of one macronutrient for another. We prospectively studied 7038 participants at high CVD risk from the PREvención con DIeta MEDiterránea (PREDIMED) study. The trial was conducted from 2003 to 2010, but the present analysis was based on an expanded follow-up until 2012. At baseline and yearly thereafter, total and specific fat subtypes were repeatedly measured by using validated food-frequency questionnaires. Time-dependent Cox proportional hazards models were used. After 6 y of follow-up, we documented 336 CVD cases and 414 total deaths. HRs (95% CIs) for CVD for those in the highest quintile of total fat, monounsaturated fatty acid (MUFA), and polyunsaturated fatty acid (PUFA) intake compared with those in the lowest quintile were 0.58 (0.39, 0.86), 0.50 (0.31, 0.81), and 0.68 (0.48, 0.96), respectively. In the comparison between extreme quintiles, higher saturated fatty acid (SFA) and trans-fat intakes were associated with 81% (HR: 1.81; 95% CI: 1.05, 3.13) and 67% (HR: 1.67; 95% CI: 1.09, 2.57) higher risk of CVD. Inverse associations with all-cause death were also observed for PUFA and MUFA intakes. Isocaloric replacements of SFAs with MUFAs and PUFAs or trans fat with MUFAs were associated with a lower risk of CVD. SFAs from pastries and processed foods were associated with a higher risk of CVD. Intakes of MUFAs and PUFAs were associated with a lower risk of CVD and death, whereas SFA and trans-fat intakes were associated with a higher risk of CVD. The replacement of SFAs with MUFAs and PUFAs or of trans fat with MUFAs was inversely associated with CVD. This trial was registered at www.controlled-trials.com as ISRCTN 35739639. © 2015 American Society for Nutrition.
Common genetic risk factors for coronary artery disease: new opportunities for prevention?
Hamrefors, Viktor
2017-05-01
Atherosclerotic cardiovascular disease (CVD) is a leading cause of mortality and morbidity worldwide, with coronary artery disease (CAD) being the single leading cause of death. Better control of risk factors, enhanced diagnostic techniques and improved medical therapies have all substantially decreased the mortality of CAD in developed countries. However, CAD and other forms of atherosclerotic CVD are projected to remain the leading cause of death by 2030 and we face a number of challenges if the outcomes of CAD are to be further improved. The fact that a substantial fraction of high-risk subjects do not reach treatment goals for important risk factors is one of these challenges. At the same time, there is also a non-negotiable fraction of 'concealed' high-risk subjects who are not detected by current risk algorithms and diagnostic modalities. In recent years, we have started to rapidly increase our knowledge of the framework of common genetics underlying CAD and atherosclerotic CVD in the population. In conjunction with modern diagnostic and therapeutic options, this new genetic knowledge may provide a valuable tool for further improvements in prevention. This review summarizes the recent findings from the search for common genetic risk factors for CAD. Furthermore, the author discusses how such recent findings could potentially be used in a number of clinical applications within CAD prevention, including in clinical risk stratification, in prediction of drug treatment response and in the search for targets for novel preventive therapies. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.
Diffusion mechanisms in chemical vapor-deposited iridium coated on chemical vapor-deposited rhenium
NASA Technical Reports Server (NTRS)
Hamilton, J. C.; Yang, N. Y. C.; Clift, W. M.; Boehme, D. R.; Mccarty, K. F.; Franklin, J. E.
1992-01-01
Radiation-cooled rocket thruster chambers have been developed which use CVD Re coated with CVD Ir on the interior surface that is exposed to hot combustion gases. The Ir serves as an oxidation barrier which protects the structural integrity-maintaining Re at elevated temperatures. The diffusion kinetics of CVD materials at elevated temperatures is presently studied with a view to the prediction and extension of these thrusters' performance limits. Line scans for Ir and Re were fit on the basis of a diffusion model, in order to extract relevant diffusion constants; the fastest diffusion process is grain-boundary diffusion, where Re diffuses down grain boundaries in the Ir overlayer.
NASA Technical Reports Server (NTRS)
Revankar, Vithal; Hlavacek, Vladimir
1991-01-01
The chemical vapor deposition (CVD) synthesis of fibers capable of effectively reinforcing intermetallic matrices at elevated temperatures which can be used for potential applications in high temperature composite materials is described. This process was used due to its advantage over other fiber synthesis processes. It is extremely important to produce these fibers with good reproducible and controlled growth rates. However, the complex interplay of mass and energy transfer, blended with the fluid dynamics makes this a formidable task. The design and development of CVD reactor assembly and system to synthesize TiB2, CrB, B4C, and TiC fibers was performed. Residual thermal analysis for estimating stresses arising form thermal expansion mismatch were determined. Various techniques to improve the mechanical properties were also performed. Various techniques for improving the fiber properties were elaborated. The crystal structure and its orientation for TiB2 fiber is discussed. An overall view of the CVD process to develop CrB2, TiB2, and other high performance ceramic fibers is presented.
NASA Astrophysics Data System (ADS)
Guo, Yingnan; Ong, Thiam Min Brian; Levchenko, I.; Xu, Shuyan
2018-01-01
A comparative study on the application of two quite different plasma-based techniques to the preparation of amorphous/crystalline silicon (a-Si:H/c-Si) interfaces for solar cells is presented. The interfaces were fabricated and processed by hydrogen plasma treatment using the conventional plasma-enhanced chemical vacuum deposition (PECVD) and inductively coupled plasma chemical vapour deposition (ICP-CVD) methods The influence of processing temperature, radio-frequency power, treatment duration and other parameters on interface properties and degree of surface passivation were studied. It was found that passivation could be improved by post-deposition treatment using both ICP-CVD and PECVD, but PECVD treatment is more efficient for the improvement on passivation quality, whereas the minority carrier lifetime increased from 1.65 × 10-4 to 2.25 × 10-4 and 3.35 × 10-4 s after the hydrogen plasma treatment by ICP-CVD and PECVD, respectively. In addition to the improvement of carrier lifetimes at low temperatures, low RF powers and short processing times, both techniques are efficient in band gap adjustment at sophisticated interfaces.
"One Big Family": Pastoral Care and Treatment Seeking in an Egyptian Coptic Church in England.
Shenouda, John E A; Cooper, Maxwell J F
2017-08-01
Little is known about Coptic migrants' chronic disease health beliefs and treatment-seeking behaviours. Interviews to explore these issues and their relationship with church membership were conducted with 15 Coptic migrants in Southern England. Obesity and cardiovascular disease (CVD) were most frequently identified as health risks for Coptic migrants. CVD was ascribed to stress and considered amenable to spiritual healing. Lay referral to medical practitioners who were church members was common but may devalue perceptions of family medicine. The Coptic Church functions as a community that addresses members' wider vulnerability. Central to this is the "parish nurse" role of the priest.
Shah, Seema; Singh, Kavita; Ali, Mohammed K.; Mohan, V.; Kadir, Muhammad Masood; Unnikrishnan, A.G.; Sahay, Rakesh Kumar; Varthakavi, Premlata; Dharmalingam, Mala; Viswanathan, Vijay; Masood, Qamar; Bantwal, Ganapathi; Khadgawat, Rajesh; Desai, Ankush; Sethi, Bipin Kumar; Shivashankar, Roopa; Ajay, Vamadevan S; Reddy, K. Srinath; Narayan, K.M. Venkat; Prabhakaran, Dorairaj; Tandon, Nikhil
2012-01-01
Aims Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in people with diabetes in South Asia. The CARRS translation trial tests the effectiveness, cost-effectiveness, and sustainability of a clinic-based multi-component CVD risk reduction intervention among people with diabetes in India and Pakistan. Methods We randomly assigned 1,146 adults with diabetes recruited from 10 urban clinic sites, to receive usual care by physicians or to receive an integrated multi-component CVD risk reduction intervention. The intervention involves electronic health record management, decision-support prompts to the healthcare team, and the support of a care coordinator to actively facilitate patient and provider adherence to evidence-based guidelines. The primary outcome is a composite of multiple CVD risk factor control (blood glucose and either blood pressure or cholesterol, or all three). Other outcomes include control of the individual CVD risk factors, process and patient-centered measures, cost-effectiveness, and acceptability/feasibility. Conclusion The CARRS translation trial tests a low-cost diabetes care delivery model in urban South Asia to achieve comprehensive cardio-metabolic disease case-management of high-risk patients (clinicaltrials.gov number: NCT01212328). PMID:23084280
DOE Office of Scientific and Technical Information (OSTI.GOV)
Feldman, A.; Horowitz, D.; Waxter, R.M.
1979-02-01
Data obtained as part of the Optical Materials Characterization Program are summarized in this report. Room temperature values of refractive index as a function of wavelength are presented for the following materials: commercially grown KCl, reactive atmosphere processed (RAP) KCl, KCl nominally doped with 1.5% KI, hot forged CaF2, fusion cast CaF2, CaF2 doped with Er (0.001% to 3% Er), SrF2, chemical vapor deposited (CVD) ZnSe (2 specimens), and ZnS (CVD, 2 specimens). Data for the thermo-optic constant (dn/dT) and the linear thermal expansion coefficient are given for the following materials over the temperature range -180 degrees C to 200more » degrees C: Al2O3, BaF2, CaF2, CdF2, KBr, KCl, LiF, MgF2, NaCl, NaF, SrF2, ZnS (CVD), and ZnSe (CVD). The piezo-optic constants of the following materials are presented: As2S3 glass, CaF2, BaF2, Ge, KCl, fused SiO2, SrF2, a chalcogenide glass (Ge 33%, As 12%, Se 55%) and ZnSe (CVD).« less
Tran, Jenny; Norton, Robyn; Conrad, Nathalie; Rahimian, Fatemeh; Canoy, Dexter; Nazarzadeh, Milad; Rahimi, Kazem
2018-03-01
Multimorbidity in people with cardiovascular disease (CVD) is common, but large-scale contemporary reports of patterns and trends in patients with incident CVD are limited. We investigated the burden of comorbidities in patients with incident CVD, how it changed between 2000 and 2014, and how it varied by age, sex, and socioeconomic status (SES). We used the UK Clinical Practice Research Datalink with linkage to Hospital Episode Statistics, a population-based dataset from 674 UK general practices covering approximately 7% of the current UK population. We estimated crude and age/sex-standardised (to the 2013 European Standard Population) prevalence and 95% confidence intervals for 56 major comorbidities in individuals with incident non-fatal CVD. We further assessed temporal trends and patterns by age, sex, and SES groups, between 2000 and 2014. Among a total of 4,198,039 people aged 16 to 113 years, 229,205 incident cases of non-fatal CVD, defined as first diagnosis of ischaemic heart disease, stroke, or transient ischaemic attack, were identified. Although the age/sex-standardised incidence of CVD decreased by 34% between 2000 to 2014, the proportion of CVD patients with higher numbers of comorbidities increased. The prevalence of having 5 or more comorbidities increased 4-fold, rising from 6.3% (95% CI 5.6%-17.0%) in 2000 to 24.3% (22.1%-34.8%) in 2014 in age/sex-standardised models. The most common comorbidities in age/sex-standardised models were hypertension (28.9% [95% CI 27.7%-31.4%]), depression (23.0% [21.3%-26.0%]), arthritis (20.9% [19.5%-23.5%]), asthma (17.7% [15.8%-20.8%]), and anxiety (15.0% [13.7%-17.6%]). Cardiometabolic conditions and arthritis were highly prevalent among patients aged over 40 years, and mental illnesses were highly prevalent in patients aged 30-59 years. The age-standardised prevalence of having 5 or more comorbidities was 19.1% (95% CI 17.2%-22.7%) in women and 12.5% (12.0%-13.9%) in men, and women had twice the age-standardised prevalence of depression (31.1% [28.3%-35.5%] versus 15.0% [14.3%-16.5%]) and anxiety (19.6% [17.6%-23.3%] versus 10.4% [9.8%-11.8%]). The prevalence of depression was 46% higher in the most deprived fifth of SES compared with the least deprived fifth (age/sex-standardised prevalence of 38.4% [31.2%-62.0%] versus 26.3% [23.1%-34.5%], respectively). This is a descriptive study of routine electronic health records in the UK, which might underestimate the true prevalence of diseases. The burden of multimorbidity and comorbidity in patients with incident non-fatal CVD increased between 2000 and 2014. On average, older patients, women, and socioeconomically deprived groups had higher numbers of comorbidities, but the type of comorbidities varied by age and sex. Cardiometabolic conditions contributed substantially to the burden, but 4 out of the 10 top comorbidities were non-cardiometabolic. The current single-disease paradigm in CVD management needs to broaden and incorporate the large and increasing burden of comorbidities.
Suppression of Defects and Deep Levels Using Isoelectronic Tungsten Substitution in Monolayer MoSe 2
Li, Xufan; Puretzky, Alexander A.; Sang, Xiahan; ...
2017-05-18
Chemical vapor deposition (CVD) is one of the most promising, scalable synthetic techniques to enable large-area synthesis of two-dimensional (2D) transition metal dichalcogenides (TMDs) for the realization of next generation optoelectronic devices. However, defects formed during the CVD growth process currently limit the quality and electronic properties of 2D TMDs. Effective synthesis and processing strategies to suppress defects and enhance the quality of 2D TMDs are urgently needed. In this work, isoelectrnic doping to produce stable alloy is presented as a new strategy to suppress defects and enhance photoluminescence (PL) in CVD-grown TMD monolayers. The random, isoelectronic substitution of Wmore » atoms for Mo atoms in CVD-grown monolayers of Mo 1-xW xSe 2 (02 monolayers. The resultant decrease in defect-medicated non-radiative recombination in the Mo 0.82W 0.18Se 2 monolayers yielded ~10 times more intense PL and extended the carrier lifetime by a factor of 3 compared to pristine CVD-grown MoSe 2 monolayers grown under similar conditions. Low temperatures (4 125 K) PL from defect-related localized states confirms theoretical predictions that isoelectronic W alloying should suppress deep levels in MoSe 2, showing that the defect levels in Mo 1-xW xSe 2 monolayers are higher in energy and quenched more quickly than in MoSe 2. Isoelectronic substitution therefore appears to be a promising synthetic method to control the heterogeneity of 2D TMDs to realize the scalable production of high performance optoelectronic and electronic devices.« less
Suppression of Defects and Deep Levels Using Isoelectronic Tungsten Substitution in Monolayer MoSe 2
DOE Office of Scientific and Technical Information (OSTI.GOV)
Li, Xufan; Puretzky, Alexander A.; Sang, Xiahan
Chemical vapor deposition (CVD) is one of the most promising, scalable synthetic techniques to enable large-area synthesis of two-dimensional (2D) transition metal dichalcogenides (TMDs) for the realization of next generation optoelectronic devices. However, defects formed during the CVD growth process currently limit the quality and electronic properties of 2D TMDs. Effective synthesis and processing strategies to suppress defects and enhance the quality of 2D TMDs are urgently needed. In this work, isoelectrnic doping to produce stable alloy is presented as a new strategy to suppress defects and enhance photoluminescence (PL) in CVD-grown TMD monolayers. The random, isoelectronic substitution of Wmore » atoms for Mo atoms in CVD-grown monolayers of Mo 1-xW xSe 2 (02 monolayers. The resultant decrease in defect-medicated non-radiative recombination in the Mo 0.82W 0.18Se 2 monolayers yielded ~10 times more intense PL and extended the carrier lifetime by a factor of 3 compared to pristine CVD-grown MoSe 2 monolayers grown under similar conditions. Low temperatures (4 125 K) PL from defect-related localized states confirms theoretical predictions that isoelectronic W alloying should suppress deep levels in MoSe 2, showing that the defect levels in Mo 1-xW xSe 2 monolayers are higher in energy and quenched more quickly than in MoSe 2. Isoelectronic substitution therefore appears to be a promising synthetic method to control the heterogeneity of 2D TMDs to realize the scalable production of high performance optoelectronic and electronic devices.« less
Chemical vapour deposition growth and Raman characterization of graphene layers and carbon nanotubes
NASA Astrophysics Data System (ADS)
Lai, Y.-C.; Rafailov, P. M.; Vlaikova, E.; Marinova, V.; Lin, S. H.; Yu, P.; Yu, S.-C.; Chi, G. C.; Dimitrov, D.; Sveshtarov, P.; Mehandjiev, V.; Gospodinov, M. M.
2016-02-01
Single-layer graphene films were grown by chemical vapour deposition (CVD) on Cu foil. The CVD process was complemented by plasma enhancement to grow also vertically aligned multiwalled carbon nanotubes using Ni nanoparticles as catalyst. The obtained samples were characterized by Raman spectroscopy analysis. Nature of defects in the samples and optimal growth conditions leading to achieve high quality of graphene and carbon nanotubes are discussed.
Scalable graphene coatings for enhanced condensation heat transfer.
Preston, Daniel J; Mafra, Daniela L; Miljkovic, Nenad; Kong, Jing; Wang, Evelyn N
2015-05-13
Water vapor condensation is commonly observed in nature and routinely used as an effective means of transferring heat with dropwise condensation on nonwetting surfaces exhibiting heat transfer improvement compared to filmwise condensation on wetting surfaces. However, state-of-the-art techniques to promote dropwise condensation rely on functional hydrophobic coatings that either have challenges with chemical stability or are so thick that any potential heat transfer improvement is negated due to the added thermal resistance of the coating. In this work, we show the effectiveness of ultrathin scalable chemical vapor deposited (CVD) graphene coatings to promote dropwise condensation while offering robust chemical stability and maintaining low thermal resistance. Heat transfer enhancements of 4× were demonstrated compared to filmwise condensation, and the robustness of these CVD coatings was superior to typical hydrophobic monolayer coatings. Our results indicate that graphene is a promising surface coating to promote dropwise condensation of water in industrial conditions with the potential for scalable application via CVD.
Metabolic, autonomic and immune markers for cardiovascular disease in posttraumatic stress disorder
Kibler, Jeffrey L; Tursich, Mischa; Ma, Mindy; Malcolm, Lydia; Greenbarg, Rachel
2014-01-01
Posttraumatic stress disorder (PTSD) has been associated with significantly greater incidence of heart disease. Numerous studies have indicated that health problems for individuals with PTSD occur earlier in life than in the general population. Multiple mechanistic pathways have been suggested to explain cardiovascular disese (CVD) risk in PTSD, including neurochemical, behavioral, and immunological changes. The present paper is a review of recent research that examines cardiovascular and immune risk profiles of individuals with PTSD. First, we address the relatively new evidence that the constellation of risk factors commonly experienced in PTSD fits the profile of metabolic syndrome. Next we examine the findings concerning hypertension/blood pressure in particular. The literature on sympathetic and parasympathetic responsivity in PTSD is reviewed. Last, we discuss recent findings concerning immune functioning in PTSD that may have a bearing on the high rates of CVD and other illnesses. Our primary goal is to synthesize the existing literature by examining factors that overlap mechanistically to increase the risk of developing CVD in PTSD. PMID:24976918
Amiri, Mohammadreza; Majid, Hazreen Abdul; Hairi, FarizahMohd; Thangiah, Nithiah; Bulgiba, Awang; Su, Tin Tin
2014-01-01
The objectives are to assess the prevalence and determinants of cardiovascular disease (CVD) risk factors among the residents of Community Housing Projects in metropolitan Kuala Lumpur, Malaysia. By using simple random sampling, we selected and surveyed 833 households which comprised of 3,722 individuals. Out of the 2,360 adults, 50.5% participated in blood sampling and anthropometric measurement sessions. Uni and bivariate data analysis and multivariate binary logistic regression were applied to identify demographic and socioeconomic determinants of the existence of having at least one CVD risk factor. As a Result, while obesity (54.8%), hypercholesterolemia (51.5%), and hypertension (39.3%) were the most common CVD risk factors among the low-income respondents, smoking (16.3%), diabetes mellitus (7.8%) and alcohol consumption (1.4%) were the least prevalent. Finally, the results from the multivariate binary logistic model illustrated that compared to the Malays, the Indians were 41% less likely to have at least one of the CVD risk factors (OR = 0.59; 95% CI: 0.37 - 0.93). In Conclusion, the low-income individuals were at higher risk of developing CVDs. Prospective policies addressing preventive actions and increased awareness focusing on low-income communities are highly recommended and to consider age, gender, ethnic backgrounds, and occupation classes.
Cerebrovascular diseases and depression: epidemiology, mechanisms and treatment.
Göthe, F; Enache, D; Wahlund, L O; Winblad, B; Crisby, M; Lökk, J; Aarsland, D
2012-09-01
Both cerebrovascular disease (CVD) and depression are common conditions in the elderly, and there is emerging evidence of a bi-directional relationship: 1) depression can cause CVD and stroke, transient ischemic attack; and 2) subcortical CVD are associated with increased risk for depression. The frequency of poststroke depression is highest during the first month after the stroke, but remains high even after several years. Depression is associated with poorer functional prognosis and higher mortality after stroke. There is good evidence that severity of functional impairment, high neuroticism, low social support as well as genetic factors are associated with an increased risk for post-stroke depression. Deep white matter lesions are the most consistent imaging correlate of depression. Potential mechanisms mediating the association between depression and CVD are neuroinflammation and HPA-axis activation, fronto-subcortical circuit lesions, and serotonergic dysfunction. Antidepressants have demonstrated effect on poststroke depression in meta-analyses, and such drugs as well as vitamin B can reduce the incidence of depression in stroke survivors. In addition, serotonergic drugs may strengthen poststroke motor and cognitive recovery, potentially through restorative mechanisms. Psychotherapeutic strategies such as problem-solving therapy seem to be effective. There is emerging evidence that treatment of cardiovascular disease and risk-factors can reduce the risk for late-life depression, but more studies are needed to test this hypothesis.
Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk
Dobrosielski, Devon A.; Papandreou, Christopher; Patil, Susheel P.; Salas-Salvadó, Jordi
2017-01-01
Obstructive sleep apnoea (OSA) is associated with increased cardiovascular disease (CVD) morbidity and mortality. It is accepted that OSA and obesity commonly coexist. The American Academy of Sleep Medicine recommends dietary-induced weight loss and exercise as lifestyle treatment options for OSA. However, most clinical trials upon which this recommendation is based have focused on establishing the effectiveness of calorie-restricted, often low-fat diets for improving OSA severity, whereas less attention has been given to the means through which weight loss is achieved (e.g. altered dietary quality) or whether diet or exercise mediates the associations between reduced weight, improved OSA severity and the CVD substrate. The current evidence suggests that the benefits of a low-carbohydrate or Mediterranean diet in overweight and obese individuals go beyond the recognised benefits of weight reduction. In addition, exercise has an independent protective effect on vascular health, which may counter the increased oxidative stress, inflammation and sympathetic activation that occur in OSA patients. This review aims to expand our understanding of the effects of diet and exercise on OSA and associated CVD complications, and sets the stage for continued research designed to explore optimal lifestyle strategies for reducing the CVD burden in OSA patients. PMID:28659501
Karwalajtys, Tina; Kaczorowski, Janusz
2010-01-01
Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.
Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk.
Dobrosielski, Devon A; Papandreou, Christopher; Patil, Susheel P; Salas-Salvadó, Jordi
2017-06-30
Obstructive sleep apnoea (OSA) is associated with increased cardiovascular disease (CVD) morbidity and mortality. It is accepted that OSA and obesity commonly coexist. The American Academy of Sleep Medicine recommends dietary-induced weight loss and exercise as lifestyle treatment options for OSA. However, most clinical trials upon which this recommendation is based have focused on establishing the effectiveness of calorie-restricted, often low-fat diets for improving OSA severity, whereas less attention has been given to the means through which weight loss is achieved ( e.g. altered dietary quality) or whether diet or exercise mediates the associations between reduced weight, improved OSA severity and the CVD substrate. The current evidence suggests that the benefits of a low-carbohydrate or Mediterranean diet in overweight and obese individuals go beyond the recognised benefits of weight reduction. In addition, exercise has an independent protective effect on vascular health, which may counter the increased oxidative stress, inflammation and sympathetic activation that occur in OSA patients. This review aims to expand our understanding of the effects of diet and exercise on OSA and associated CVD complications, and sets the stage for continued research designed to explore optimal lifestyle strategies for reducing the CVD burden in OSA patients. Copyright ©ERS 2017.
Work-related cerebro-cardiovascular diseases in Korea.
Kim, Dae-Seong; Kang, Seong-Kyu
2010-12-01
Cerebro-cardiovascular disease (CVD) is one of compensable occupational diseases in Korea as in Japan or Taiwan. However, most countries accept only cardiovascular diseases (ischemic heart diseases) as compensable occupational diseases if any, but not cerebrovascular diseases. Korea has a prescribed list of compensable occupational diseases. CVD was not included in the list until 1993. In the early 1990s, a case of cerebral infarction was accepted as occupational disease by the Supreme Court. The decision was based on the concept that workers' compensation system is one of the social security systems. In 1994, the government has established a diagnostic criterion of CVD. The crude rate of compensated cerebrovascular disease decreased by 60.0% from 18.5 in 2003 to 7.4 in 2008 per 100,000 workers, and that of compensated coronary heart disease decreased by 60.5% from 3.8 in 2003 to 1.5 in 2008 per 100,000 workers. The compensated cases of CVD dramatically increased and reached its peak in 2003. Since many preventive activities were performed by the government and employers, the compensated cases have slowly decreased since 2003 and sharply decreased after 2008 when the diagnostic criterion was amended. The strategic approach is needed essentially because CVDs are common, serious and preventable diseases which lead to economic burden.
Work-related Cerebro-Cardiovascular Diseases in Korea
Kang, Seong-Kyu
2010-01-01
Cerebro-cardiovascular disease (CVD) is one of compensable occupational diseases in Korea as in Japan or Taiwan. However, most countries accept only cardiovascular diseases (ischemic heart diseases) as compensable occupational diseases if any, but not cerebrovascular diseases. Korea has a prescribed list of compensable occupational diseases. CVD was not included in the list until 1993. In the early 1990s, a case of cerebral infarction was accepted as occupational disease by the Supreme Court. The decision was based on the concept that workers' compensation system is one of the social security systems. In 1994, the government has established a diagnostic criterion of CVD. The crude rate of compensated cerebrovascular disease decreased by 60.0% from 18.5 in 2003 to 7.4 in 2008 per 100,000 workers, and that of compensated coronary heart disease decreased by 60.5% from 3.8 in 2003 to 1.5 in 2008 per 100,000 workers. The compensated cases of CVD dramatically increased and reached its peak in 2003. Since many preventive activities were performed by the government and employers, the compensated cases have slowly decreased since 2003 and sharply decreased after 2008 when the diagnostic criterion was amended. The strategic approach is needed essentially because CVDs are common, serious and preventable diseases which lead to economic burden. PMID:21258582
Radio Frequency Transistors and Circuits Based on CVD MoS2.
Sanne, Atresh; Ghosh, Rudresh; Rai, Amritesh; Yogeesh, Maruthi Nagavalli; Shin, Seung Heon; Sharma, Ankit; Jarvis, Karalee; Mathew, Leo; Rao, Rajesh; Akinwande, Deji; Banerjee, Sanjay
2015-08-12
We report on the gigahertz radio frequency (RF) performance of chemical vapor deposited (CVD) monolayer MoS2 field-effect transistors (FETs). Initial DC characterizations of fabricated MoS2 FETs yielded current densities exceeding 200 μA/μm and maximum transconductance of 38 μS/μm. A contact resistance corrected low-field mobility of 55 cm(2)/(V s) was achieved. Radio frequency FETs were fabricated in the ground-signal-ground (GSG) layout, and standard de-embedding techniques were applied. Operating at the peak transconductance, we obtain short-circuit current-gain intrinsic cutoff frequency, fT, of 6.7 GHz and maximum intrinsic oscillation frequency, fmax, of 5.3 GHz for a device with a gate length of 250 nm. The MoS2 device afforded an extrinsic voltage gain Av of 6 dB at 100 MHz with voltage amplification until 3 GHz. With the as-measured frequency performance of CVD MoS2, we provide the first demonstration of a common-source (CS) amplifier with voltage gain of 14 dB and an active frequency mixer with conversion gain of -15 dB. Our results of gigahertz frequency performance as well as analog circuit operation show that large area CVD MoS2 may be suitable for industrial-scale electronic applications.
Structurally controlled deposition of silicon onto nanowires
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wang, Weijie; Liu, Zuqin; Han, Song
Provided herein are nanostructures for lithium ion battery electrodes and methods of fabrication. In some embodiments, a nanostructure template coated with a silicon coating is provided. The silicon coating may include a non-conformal, more porous layer and a conformal, denser layer on the non-conformal, more porous layer. In some embodiments, two different deposition processes, e.g., a PECVD layer to deposit the non-conformal layer and a thermal CVD process to deposit the conformal layer, are used. Anodes including the nanostructures have longer cycle lifetimes than anodes made using either a PECVD or thermal CVD method alone.
Disturbed tryptophan metabolism in cardiovascular disease.
Mangge, H; Stelzer, I; Reininghaus, E Z; Weghuber, D; Postolache, T T; Fuchs, D
2014-06-01
Atherosclerosis (AS), a major pathologic consequence of obesity, is the main etiological factor of cardiovascular disease (CVD), which is the most common cause of death in the western world. A systemic chronic low grade immune- mediated inflammation (scLGI) is substantially implicated in AS and its consequences. In particular, proinflammatory cytokines play a major role, with Th1-type cytokine interferon-γ (IFN-γ) being a key mediator. Among various other molecular and cellular effects, IFN-γ activates the enzyme indoleamine 2,3-dioxygenase (IDO) in monocyte-derived macrophages, dendritic, and other cells, which, in turn, decreases serum levels of the essential amino acid tryptophan (TRP). Thus, people with CVD often have increased serum kynurenine to tryptophan ratios (KYN/TRP), a result of an increased TRP breakdown. Importantly, increased KYN/TRP is associated with a higher likelihood of fatal cardiovascular events. A scLGI with increased production of the proinflammatory adipokine leptin, in combination with IFN-γ and interleukin-6 (IL-6), represents another central link between obesity, AS, and CVD. Leptin has also been shown to contribute to Th1-type immunity shifting, with abdominal fat being thus a direct contributor to KYN/TRP ratio. However, TRP is not only an important source for protein production but also for the generation of one of the most important neurotransmitters, 5-hydroxytryptamine (serotonin), by the tetrahydrobiopterin-dependent TRP 5-hydroxylase. In prolonged states of scLGI, availability of free serum TRP is strongly diminished, affecting serotonin synthesis, particularly in the brain. Additionally, accumulation of neurotoxic KYN metabolites such as quinolinic acid produced by microglia, can contribute to the development of depression via NMDA glutamatergic stimulation. Depression had been reported to be associated with CVD endpoints, but it most likely represents only a secondary loop connecting excess adipose tissue, scLGI and cardiovascular morbidity and mortality. Accelerated catabolism of TRP is further involved in the pathogenesis of the anemia of scLGI. The pro-inflammatory cytokine IFN-γ suppresses growth and differentiation of erythroid progenitor cells, and the depletion of TRP limits protein synthesis and thus hemoglobin production, and, through reduction in oxygen supply, may contribute to ischemic vascular disease. In this review we discuss the impact of TRP breakdown and the related complex mechanisms on the prognosis and individual course of CVD. Measurement of TRP, KYN concentrations, and calculation of the KYN/TRYP ratio will contribute to a better understanding of the interplay between inflammation, metabolic syndrome, mood disturbance, and anemia, all previously described as significant predictors of an unfavorable outcome in patients with CVD. The review leads to a novel framework for successful therapeutic modification of several cardinal pathophysiological processes leading to adverse cardiovascular outcome.
Siri-Tarino, Patty W.; Chiu, Sally; Bergeron, Nathalie; Krauss, Ronald M.
2016-01-01
The effects of saturated fatty acids (SFAs) on cardiovascular disease (CVD) risk are modulated by the nutrients that replace them and their food matrices. Replacement of SFAs with polyunsaturated fatty acids has been associated with reduced CVD risk, although there is heterogeneity in both fatty acid categories. In contrast, replacement of SFAs with carbohydrates, particularly sugar, has been associated with no improvement or even a worsening of CVD risk, at least in part through effects on atherogenic dyslipidemia, a cluster of traits including small, dense low-density lipoprotein particles. The effects of dietary SFAs on insulin sensitivity, inflammation, vascular function, and thrombosis are less clear. There is growing evidence that SFAs in the context of dairy foods, particularly fermented dairy products, have neutral or inverse associations with CVD. Overall dietary patterns emphasizing vegetables, fish, nuts, and whole versus processed grains form the basis of heart-healthy eating and should supersede a focus on macronutrient composition. PMID:26185980
Siri-Tarino, Patty W; Chiu, Sally; Bergeron, Nathalie; Krauss, Ronald M
2015-01-01
The effects of saturated fatty acids (SFAs) on cardiovascular disease (CVD) risk are modulated by the nutrients that replace them and their food matrices. Replacement of SFAs with polyunsaturated fatty acids has been associated with reduced CVD risk, although there is heterogeneity in both fatty acid categories. In contrast, replacement of SFAs with carbohydrates, particularly sugar, has been associated with no improvement or even a worsening of CVD risk, at least in part through effects on atherogenic dyslipidemia, a cluster of traits including small, dense low-density lipoprotein particles. The effects of dietary SFAs on insulin sensitivity, inflammation, vascular function, and thrombosis are less clear. There is growing evidence that SFAs in the context of dairy foods, particularly fermented dairy products, have neutral or inverse associations with CVD. Overall dietary patterns emphasizing vegetables, fish, nuts, and whole versus processed grains form the basis of heart-healthy eating and should supersede a focus on macronutrient composition.
Gender Differences in Cardiovascular Disease: Hormonal and Biochemical Influences
Pérez-López, Faustino R.; Larrad-Mur, Luis; Kallen, Amanda; Chedraui, Peter; Taylor, Hugh S.
2011-01-01
Objective Atherosclerosis is a complex process characterized by an increase in vascular wall thickness owing to the accumulation of cells and extracellular matrix between the endothelium and the smooth muscle cell wall. There is evidence that females are at lower risk of developing cardiovascular disease (CVD) as compared to males. This has led to an interest in examining the contribution of genetic background and sex hormones to the development of CVD. The objective of this review is to provide an overview of factors, including those related to gender, that influence CVD. Methods Evidence analysis from PubMed and individual searches concerning biochemical and endocrine influences and gender differences, which affect the origin and development of CVD. Results Although still controversial, evidence suggests that hormones including estradiol and androgens are responsible for subtle cardiovascular changes long before the development of overt atherosclerosis. Conclusion Exposure to sex hormones throughout an individual's lifespan modulates many endocrine factors involved in atherosclerosis. PMID:20460551
Formation of Aluminide Coatings on Fe-Based Alloys by Chemical Vapor Deposition
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhang, Ying; Pint, Bruce A; Cooley, Kevin M
2008-01-01
Aluminide and Al-containing coatings were synthesized on commercial ferritic (P91) and austenitic (304L) alloys via a laboratory chemical vapor deposition (CVD) procedure for rigorous control over coating composition, purity and microstructure. The effect of the CVD aluminizing parameters such as temperature, Al activity, and post-aluminizing anneal on coating growth was investigated. Two procedures involving different Al activities were employed with and without including Cr-Al pellets in the CVD reactor to produce coatings with suitable thickness and composition for coating performance evaluation. The phase constitution of the as-synthesized coatings was assessed with the aid of a combination of X-ray diffraction, electronmore » probe microanalysis, and existing phase diagrams. The mechanisms of formation of these CVD coatings on the Fe-based alloys are discussed, and compared with nickel aluminide coatings on Ni-base superalloys. In addition, Cr-Al pellets were replaced with Fe-Al metals in some aluminizing process runs and similar coatings were achieved.« less
Chemical reactivity of CVC and CVD SiC with UO 2 at high temperatures
Silva, Chinthaka M.; Katoh, Yutai; Voit, Stewart L.; ...
2015-02-11
Two types of silicon carbide (SiC) synthesized using two different vapor deposition processes were embedded in UO 2 pellets and evaluated for their potential chemical reaction with UO 2. While minor reactivity between chemical-vapor-composited (CVC) SiC and UO 2 was observed at comparatively low temperatures of 1100 and 1300 C, chemical-vapor-deposited (CVD) SiC did not show any such reactivity, according to microstructural investigations. But, both CVD and CVC SiCs showed some reaction with UO 2 at a higher temperature (1500 C). Elemental maps supported by phase maps obtained using electron backscatter diffraction indicated that CVC SiC was more reactive thanmore » CVD SiC at 1500 C. Moreover, this investigation indicated the formation of uranium carbides and uranium silicide chemical phases such as UC, USi 2, and U 3Si 2 as a result of SiC reaction with UO 2.« less
Dalmeijer, G W; Olthof, M R; Verhoef, P; Bots, M L; van der Schouw, Y T
2008-03-01
To investigate the association between dietary intakes of folate, betaine and choline and the risk of cardiovascular disease (CVD). Prospective cohort study. A total of 16 165 women aged 49-70 years without prior CVD. SUBJECTS were breast cancer screening participants in the PROSPECT-EPIC cohort, which is 1 of the 2 Dutch contributions to the European Prospective Investigation into Cancer and Nutrition (EPIC). Each participant completed a validated food frequency questionnaire. Folate intake was calculated with the Dutch National Food Database. Betaine and choline intakes were calculated with the USDA database containing choline and betaine contents of common US foods. Data on coronary heart disease (CHD) events and cerebrovascular accident (CVA) events morbidity data were obtained from the Dutch Centre for Health Care Information. During a median follow-up period of 97 months, 717 women were diagnosed with CVD. After adjustment, neither folate, nor betaine, nor choline intakes were associated with CVD (hazard ratios for highest versus lowest quartile were 1.23 (95% confidence interval 0.75; 2.01), 0.90 (0.69; 1.17), 1.04 (0.71; 1.53), respectively). In a subsample of the population, high folate and choline intakes were statistically significantly associated with lower homocysteine levels. High betaine intake was associated with slightly lower high-density lipoprotein (HDL)-cholesterol concentrations. Regular dietary intakes of folate, betaine and choline were not associated with CVD risk in post-menopausal Dutch women. However, the effect of doses of betaine and choline beyond regular dietary intake--for example, via supplementation or fortification--remains unknown.
Zimmet, Paul
2005-04-01
Type 2 diabetes mellitus and obesity have reached epidemic proportions in many developing and developed nations, leading to talk of the "twin epidemics." The latest projections from the International Diabetes Federation suggest that 190 million people worldwide currently have type 2 diabetes. In addition, > or = 300 million people worldwide have impaired glucose tolerance (IGT). These statistics represent an epidemic of major proportions--possibly the largest epidemic in human history--in terms of glucose intolerance and cardiovascular disease (CVD) risk because individuals with IGT are at substantially higher risk for diabetes and CVD than are members of the general population. Along with IGT, the metabolic syndrome comprises other major CVD risk factors, including insulin resistance, central obesity, and dyslipidemia; insulin resistance has been implicated as the single most common cause of the syndrome. Although the exact prevalence of the metabolic syndrome is unknown, the syndrome is widespread among adults in developed nations, becoming more prevalent with age. Epidemiologic data suggest that in patients with schizophrenia or affective disorders, both diabetes and obesity are 1.5 to 2.0 times more prevalent than in the general population. Furthermore, because adverse effects of certain therapies for human immunodeficiency virus (HIV) infection and psychiatric disorders increase the risk for developing diabetes, obesity, and the metabolic syndrome, such therapies should be carefully chosen, particularly considering CVD risk. Appropriate therapy may be determined via screening of patients for levels of fasting blood glucose and lipids, as well as other CVD risk factors, before initiating use of second-generation antipsychotic agents or highly active antiretroviral therapy.
Relationship between biochemical factors and skin symptoms in chronic venous disease.
Takai, Yasushi; Hiramoto, Keiichi; Nishimura, Yoshiyuki; Ooi, Kazuya
2017-05-01
Chronic venous disease (CVD) is a common venous disease of the lower extremities and patients often develop symptoms of itching and skin roughness. An easy to use and objective skin examination was recently developed that allows measurement of the level of stratum corneum content and transepidermal water loss (TEWL), which can indicate the status of the barrier function of the stratum corneum. Previous studies demonstrated that histamine production from mast cells, and tryptase and matrix metalloprotease-9 levels were associated with skin inflammation. This study aimed to clarify the relationship between dry skin and inflammatory mediators that mediate the skin symptoms of CVD subjects. The study enrolled 27 subjects with CVD and a control group consisting of 9 volunteers. The itching onset frequency was higher in women (70.4%) compared with men (50.0%). To analyze the mechanisms involved in itching we measured blood inflammatory mediators pre- and post-sclerotherapy. There was a significant decrease in Substance P, histamine, IgE, and tryptase levels post-sclerotherapy compared with those at pre-sclerotherapy. These levels were associated with the severity of itching. In addition, compared with the control subjects, there was a significant increase in the stratum corneum water content and a decrease in the TEWL in the 27 patients with CVD. This was associated with a decrease in the itching symptoms. Our findings indicate that sclerotherapy decreased levels of inflammatory mediators, increased stratum corneum water content and decreased TEWL, which coincided with reduced itching in CVD patients, indicating they might be therapeutic targets.
Kingery, Justin R; Alfred, Yona; Smart, Luke R; Nash, Emily; Todd, Jim; Naguib, Mostafa R; Downs, Jennifer A; Kalluvya, Samuel; Kataraihya, Johannes B; Peck, Robert N
2016-01-01
Objective To compare short and long term cardiovascular disease (CVD) risk scores and prevalence of metabolic syndrome in HIV-infected adults receiving and not receiving antiretroviral therapy (ART) to HIV-negative controls. Methods A cross-sectional study including: 151 HIV-infected, ART-naive, 150 HIV-infected on ART and 153 HIV-negative adults. Traditional cardiovascular risk factors were determined by standard investigations. The primary outcome was ACC/AHA ASCVD Risk Estimator lifetime CVD risk score. Secondary outcomes were ASCVD 10-year risk, Framingham risk scores, statin indication and metabolic syndrome. Results Compared to HIV-negative controls, more HIV-infected adults on ART were classified as high lifetime CVD risk (34.7% vs 17.0%, p<0.001) although 10-year risk scores were similar, a trend which was similar across multiple CVD risk models. In addition, HIV-infected adults on ART had a higher prevalence of metabolic syndrome vs HIV-negative controls (21.3% vs 7.8%, p=0.008), with 2 common clusters of risk factors. More than one-quarter (28.7%) of HIV-infected Tanzanian adults on ART meet criteria for statin initiation. Conclusions HIV-infected ART-treated individuals have high lifetime cardiovascular risk, and this risk seems to develop rapidly in the first 3–4 years of ART as does the development of clusters of metabolic syndrome criteria. These data identify a new subgroup of low short-term/high lifetime risk HIV-infected individuals on ART who do not currently meet criteria for CVD risk factor modification but require further study. PMID:27105648
Cardiovascular disease in children in Djibouti: a single-centre study
Massoure, Pierre-Laurent; Roche, Nicolas-Charles; Lamblin, Gatien; Dehan, Celine; Kaiser, Eric; Fourcade, Laurent
2013-01-01
Introduction Few data are available about pediatric cardiovascular disease (CVD) in the Horn of Africa. The objective of this study was to describe the spectrum of CVD in children in Djibouti. Methods Clinical features and management of Djiboutian children between 1 month-old and 15 year-old with CVD were prospectively recorded over a two-year period in Bouffard Military Hospital in Djibouti (January 2009- December 2010). Results Clinical examination and echocardiography were performed on 156 patients: 32 of them (20%) had CVD. Three (10%) of them had Down's syndrome. The median age was 5 years (male 53%). Congenital heart disease was observed in 27 (84%) patients and dilated cardiomyopathy (DCM) in 5 (16%) patients including 2 patients with rheumatic valvular disease. Ventricular septal defect was frequent (28%). Other abnormalities were atrial septal defect (13%), Tetralogy of Fallot (9%), pulmonary stenosis (6%) and 3 other patients had multiple congenital anomalies condition. Surgical management was required in 22 (69%) patients and was performed on 15 (47%) cases. During follow up (mean 11.3 ± 6.8 months), 5 (16%) patients died. Absence of surgery was associated with significant mortality (p > 0.05) but age, sex and mean follow up were not. Conclusion Pediatric CVD is at least as common in this Djiboutian community as in other African cohorts. The absence of surgery was a major mortality risk factor. DCM was frequent in this study. Much work remains to be done to discover the size and nature of genetic and environmental contributions to these various forms of heart diseases in the Horn of Africa. PMID:23785546
Cardiovascular disease in children in Djibouti: a single-centre study.
Massoure, Pierre-Laurent; Roche, Nicolas-Charles; Lamblin, Gatien; Dehan, Celine; Kaiser, Eric; Fourcade, Laurent
2013-01-01
Few data are available about pediatric cardiovascular disease (CVD) in the Horn of Africa. The objective of this study was to describe the spectrum of CVD in children in Djibouti. Clinical features and management of Djiboutian children between 1 month-old and 15 year-old with CVD were prospectively recorded over a two-year period in Bouffard Military Hospital in Djibouti (January 2009- December 2010). Clinical examination and echocardiography were performed on 156 patients: 32 of them (20%) had CVD. Three (10%) of them had Down's syndrome. The median age was 5 years (male 53%). Congenital heart disease was observed in 27 (84%) patients and dilated cardiomyopathy (DCM) in 5 (16%) patients including 2 patients with rheumatic valvular disease. Ventricular septal defect was frequent (28%). Other abnormalities were atrial septal defect (13%), Tetralogy of Fallot (9%), pulmonary stenosis (6%) and 3 other patients had multiple congenital anomalies condition. Surgical management was required in 22 (69%) patients and was performed on 15 (47%) cases. During follow up (mean 11.3 ± 6.8 months), 5 (16%) patients died. Absence of surgery was associated with significant mortality (p > 0.05) but age, sex and mean follow up were not. Pediatric CVD is at least as common in this Djiboutian community as in other African cohorts. The absence of surgery was a major mortality risk factor. DCM was frequent in this study. Much work remains to be done to discover the size and nature of genetic and environmental contributions to these various forms of heart diseases in the Horn of Africa.
Large scale integration of CVD-graphene based NEMS with narrow distribution of resonance parameters
NASA Astrophysics Data System (ADS)
Arjmandi-Tash, Hadi; Allain, Adrien; (Vitto Han, Zheng; Bouchiat, Vincent
2017-06-01
We present a novel method for the fabrication of the arrays of suspended micron-sized membranes, based on monolayer pulsed-CVD graphene. Such devices are the source of an efficient integration of graphene nano-electro-mechanical resonators, compatible with production at the wafer scale using standard photolithography and processing tools. As the graphene surface is continuously protected by the same polymer layer during the whole process, suspended graphene membranes are clean and free of imperfections such as deposits, wrinkles and tears. Batch fabrication of 100 μm-long multi-connected suspended ribbons is presented. At room temperature, mechanical resonance of electrostatically-actuated devices show narrow distribution of their characteristic parameters with high quality factor and low effective mass and resonance frequencies, as expected for low stress and adsorbate-free membranes. Upon cooling, a sharp increase of both resonant frequency and quality factor is observed, enabling to extract the thermal expansion coefficient of CVD graphene. Comparison with state-of-the-art graphene NEMS is presented.
Investigation of chemical vapor deposition of garnet films for bubble domain memories
NASA Technical Reports Server (NTRS)
Besser, P. J.; Hamilton, T. N.
1973-01-01
The important process parameters and control required to grow reproducible device quality ferrimagnetic films by chemical vapor deposition (CVD) were studied. The investigation of the critical parameters in the CVD growth process led to the conclusion that the required reproducibility of film properties cannot be achieved with individually controlled separate metal halide sources. Therefore, the CVD growth effort was directed toward replacement of the halide sources with metallic sources with the ultimate goal being the reproducible growth of complex garnet compositions utilizing a single metal alloy source. The characterization of the YGdGaIG films showed that certain characteristics of this material, primarily the low domain wall energy and the large temperature sensitivity, severely limited its potential as a useful material for bubble domain devices. Consequently, at the time of the change from halide to metallic sources, the target film compositions were shifted to more useful materials such as YGdTmGaIG, YEuGaIG and YSmGaIG.
Vascular Effects of Estrogenic Menopausal Hormone Therapy
Reslan, Ossama M.; Khalil, Raouf A.
2011-01-01
Cardiovascular disease (CVD) is more common in men and postmenopausal women (Post-MW) than premenopausal women (Pre-MW). Despite recent advances in preventive measures, the incidence of CVD in women has shown a rise that matched the increase in the Post-MW population. The increased incidence of CVD in Post-MW has been related to the decline in estrogen levels, and hence suggested vascular benefits of endogenous estrogen. Experimental studies have identified estrogen receptor ERα, ERβ and a novel estrogen binding membrane protein GPR30 (GPER) in blood vessels of humans and experimental animals. The interaction of estrogen with vascular ERs mediates both genomic and non-genomic effects. Estrogen promotes endothelium-dependent relaxation by increasing nitric oxide, prostacyclin, and hyperpolarizing factor. Estrogen also inhibits the mechanisms of vascular smooth muscle (VSM) contraction including [Ca2+]i, protein kinase C and Rho-kinase. Additional effects of estrogen on the vascular cytoskeleton, extracellular matrix, lipid profile and the vascular inflammatory response have been reported. In addition to the experimental evidence in animal models and vascular cells, initial observational studies in women using menopausal hormonal therapy (MHT) have suggested that estrogen may protect against CVD. However, randomized clinical trials (RCTs) such as the Heart and Estrogen/progestin Replacement Study (HERS) and the Women’s Health Initiative (WHI), which examined the effects of conjugated equine estrogens (CEE) in older women with established CVD (HERS) or without overt CVD (WHI), failed to demonstrate protective vascular effects of estrogen treatment. Despite the initial set-back from the results of MHT RCTs, growing evidence now supports the ‘timing hypothesis’, which suggests that MHT could increase the risk of CVD if started late after menopause, but may produce beneficial cardiovascular effects in younger women during the perimenopausal period. The choice of an appropriate MHT dose, route of administration, and estrogen/progestin combination could maximize the vascular benefits of MHT and minimize other adverse effects, especially if given within a reasonably short time after menopause to women that seek MHT for the relief of menopausal symptoms. PMID:21864249
Stramba-Badiale, Marco; Fox, Kim M; Priori, Silvia G; Collins, Peter; Daly, Caroline; Graham, Ian; Jonsson, Benct; Schenck-Gustafsson, Karin; Tendera, Michal
2006-04-01
Cardiovascular diseases (CVD) are the leading cause of mortality both in men and women. In Europe, about 55% of all females' deaths are caused by CVD, especially coronary heart disease and stroke. Unfortunately, however, the risk of heart disease in women is underestimated because of the perception that women are 'protected' against ischaemic heart disease. What is not fully understood is that women during the fertile age have a lower risk of cardiac events, but this protection fades after menopause thus leaving women with untreated risk factors vulnerable to develop myocardial infarction, heart failure, and sudden cardiac death. Furthermore, clinical manifestations of ischaemic heart disease in women may be different from those commonly observed in males and this factor may account for under-recognition of the disease. The European Society of Cardiology has recently initiated an extensive 'Women at heart' program to coordinate research and educational initiatives on CVD in women. A Policy Conference on CVD in Women was one of the first steps in the development of this program. The objective of the conference was to collect the opinion of experts in the field coming from the European Society of Cardiology member countries to: (1) summarize the state-of-the-art from an European perspective; (2) to identify the scientific gaps on CVD in women; and (3) to delineate the strategies for changing the misperception of CVD in women, improving risk stratification, diagnosis, and therapy from a gender perspective and increasing women representation in clinical trials. The Policy Conference has provided the opportunity to review and comment on the current status of knowledge on CVD in women and to prioritize the actions needed to advance this area of knowledge in cardiology. In the preparation of this document we intend to provide the medical community and the stakeholders of this field with an overview of the more critical aspects that have emerged during the discussion. We also propose some immediate actions that should be undertaken with the hope that synergic activities will be implemented at European level with the support of national health care authorities.
Guo, Shuyu; Lucas, Robyn M.; Joshy, Grace; Banks, Emily
2015-01-01
Risk factors for cardiovascular disease (CVD), such as obesity, diabetes, hypertension and physical inactivity, are common in Australia, but the prevalence varies according to cultural background. We examined the relationship between region of birth, measures of acculturation, and CVD risk profiles in immigrant, compared to Australian-born, older Australians. Cross-sectional data from 263,356 participants aged 45 and over joining the population-based 45 and Up Study cohort from 2006–2008 were used. Prevalence ratios for CVD risk factors in Australian- versus overseas-born participants were calculated using modified Poisson regression, adjusting for age, sex and socioeconomic factors and focusing on Asian migrants. The association between time resident in Australia and age at migration and CVD risk factors in Asian migrants was also examined. Migrants from Northeast (n = 3,213) and Southeast Asia (n = 3,942) had lower levels of overweight/obesity, physical activity and female smoking than Australian-born participants (n = 199,356), although differences in prevalence of overweight/obesity were sensitive to body-mass-index cut-offs used. Compared to Australian-born participants, migrants from Northeast Asia were 20–30% less likely, and from Southeast Asia 10–20% more likely, to report being treated for hypertension and/or hypercholesterolaemia; Southeast Asian migrants were 40–60% more likely to report diabetes. Northeast Asian-born individuals were less likely than Australian-born to have 3 or more CVD risk factors. Diabetes, treated hypertension and hypercholesterolaemia occurred at relatively low average body-mass-index in Southeast Asian migrants. The CVD risk factor profiles of migrants tended to approximate those of Australian-born with increasing acculturation, in both favourable (e.g., increased physical activity) and unfavourable directions (e.g., increased female smoking). Minimizing CVD risk in migrant populations may be achieved through efforts to retain the healthy facets of the traditional lifestyle, such as a normal body mass index and low prevalence of smoking in women, in addition to adopting healthy aspects of the host country lifestyle, such as increased physical activity. PMID:25695771
Asztalos, Bela F.; Collins, Dorothea; Horvath, Katalin V.; Bloomfield, Hanna E.; Robins, Sander J.; Schaefer, Ernst J.
2007-01-01
Objective The significant cardiovascular disease (CVD) event reduction in VA-HIT could not be fully explained by the 6% increase in HDL-C with the fibrate, gemfibrozil. We examined whether measurement of HDL subpopulations provided additional information relative to CVD-risk reduction. Methods and Results HDL subpopulations were characterized by 2-dimensional gel-electrophoresis in subjects who were treated with gemfibrozil (n=754) or placebo (n=741). In this study, samples obtained at the 3-month visit were used and data were analyzed prospectively using CVD events (CHD death, MI, or stroke) during the 5.1 years follow up. Analyses in the gemfibrozil arm showed that subjects with recurrent CVD events had significantly higher preβ-1 and had significantly lower α-1 and α-2 HDL levels than those without such events. Preβ-1 level was a significant positive predictor; α-1 and α-2 levels were significant negative risk factors for future CVD events. α-2 level was superior to HDL-C level in CVD-risk assessment after adjustment for established risk factors. Gemfibrozil treatment was associated with 3%-6% decreases in the small, lipid-poor preβ-1 HDL and in the large, lipid-rich α-1 and α-2 HDL and with increases in the small α-3 (3%) and preα-3 (16%) HDLs. Conclusions While the use of gemfibrozil has been associated with reduction in CVD events in VA-HIT, HDL subpopulation analysis indicates that gemfibrozil-mediated improvement in CVD risk might not be the result of its effects on HDL. It is quite possible that much of the cardiovascular benefits of gemfibrozil are due to a much wider spectrum of effects on metabolic processes that is not reflected by changes in blood lipids and HDL subpopulations. PMID:18078862
Economic assessment of single-walled carbon nanotube processes
NASA Astrophysics Data System (ADS)
Isaacs, J. A.; Tanwani, A.; Healy, M. L.; Dahlben, L. J.
2010-02-01
The carbon nanotube market is steadily growing and projected to reach 1.9 billion by 2010. This study examines the economics of manufacturing single-walled carbon nanotubes (SWNT) using process-based cost models developed for arc, CVD, and HiPco processes. Using assumed input parameters, manufacturing costs are calculated for 1 g SWNT for arc, CVD, and HiPco, totaling 1,906, 1,706, and 485, respectively. For each SWNT process, the synthesis and filtration steps showed the highest costs, with direct labor as a primary cost driver. Reductions in production costs are calculated for increased working hours per day and for increased synthesis reaction yield (SRY) in each process. The process-based cost models offer a means for exploring opportunities for cost reductions, and provide a structured system for comparisons among alternative SWNT manufacturing processes. Further, the models can be used to comprehensively evaluate additional scenarios on the economics of environmental, health, and safety best manufacturing practices.
The growth and in situ characterization of chemical vapor deposited SiO2
NASA Technical Reports Server (NTRS)
Iyer, R.; Chang, R. R.; Lile, D. L.
1987-01-01
This paper reports the results of studies of the kinetics of remote (indirect) plasma enhanced low pressure CVD growth of SiO2 on Si and InP and of the in situ characterization of the electrical surface properties of InP during CVD processing. In the latter case photoluminescence was employed as a convenient and sensitive noninvasive method for characterizing surface trap densities. It was determined that, provided certain precautions are taken, the growth of SiO2 occurs in a reproducible and systematic fashion that can be expressed in an analytic form useful for growth rate prediction. Moreover, the in situ photoluminescence studies have yielded information on sample degradation resulting from heating and chemical exposure during the CVD growth.
Reading, Jeffrey
2015-09-01
Although the prevalence of cardiovascular disease (CVD) has been decreasing worldwide, Aboriginal populations of Canada (including First Nations, Métis, and Inuit Peoples) continue to experience a rapidly growing burden of CVD morbidity and mortality. This article provides a succinct summary of the current crisis of CVD among Canadian Aboriginal peoples, including how and why it originated, elucidates the underlying population health risks driving higher rates of aboriginal CVD, and articulates the urgent need for community-engagement solutions and innovations in the areas of prevention, treatment and care, rehabilitation services, aboriginal-specific CVD surveillance, and advanced knowledge. In the past, particularly in rural and remote communities, Aboriginal Peoples' survival depended (and often still does) on hunting, fishing, and other forms of traditional food-gathering. However, the traditional life is being changed for many Aboriginal communities, resulting in significantly impaired dietary options and the undermining of a long-established way of life that was healthy and physically active. Reclaiming CVD health and well-being requires replacement of the calorie-dense and nutritionally inadequate diets of highly processed store-bought foods with fresh and nutritionally balanced diets and addressing the physically inactive lifestyles that together have contributed to an increase in CVD prevalence. Furthermore, disparities exist for hospital-based treatment experiences for patients from areas with high proportions of Aboriginal Peoples vs those with low proportions of Aboriginal Peoples. It is crucial to investigate and develop concrete plans to reduce the burden of CVDs among Aboriginal Peoples by improved prevention and treatment in a community-centred way. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Konfino, Jonatan; Mekonnen, Tekeshe A.; Coxson, Pamela G.; Ferrante, Daniel; Bibbins-Domingo, Kirsten
2013-01-01
Background Cardiovascular disease (CVD) is the leading cause of death in adults in Argentina. Sodium reduction policies targeting processed foods were implemented in 2011 in Argentina, but the impact has not been evaluated. The aims of this study are to use Argentina-specific data on sodium excretion and project the impact of Argentina’s sodium reduction policies under two scenarios - the 2-year intervention currently being undertaken or a more persistent 10 year sodium reduction strategy. Methods We used Argentina-specific data on sodium excretion by sex and projected the impact of the current strategy on sodium consumption and blood pressure decrease. We assessed the projected impact of sodium reduction policies on CVD using the Cardiovascular Disease (CVD) Policy Model, adapted to Argentina, modeling two alternative policy scenarios over the next decade. Results Our study finds that the initiative to reduce sodium consumption currently in place in Argentina will have substantial impact on CVD over the next 10 years. Under the current proposed policy of 2-year sodium reduction, the mean sodium consumption is projected to decrease by 319–387 mg/day. This decrease is expected to translate into an absolute reduction of systolic blood pressure from 0.93 mmHg to 1.81 mmHg. This would avert about 19,000 all-cause mortality, 13,000 total myocardial infarctions, and 10,000 total strokes over the next decade. A more persistent sodium reduction strategy would yield even greater CVD benefits. Conclusion The impact of the Argentinean initiative would be effective in substantially reducing mortality and morbidity from CVD. This paper provides evidence-based support to continue implementing strategies to reduce sodium consumption at a population level. PMID:24040085
Kim, Chun-Ja; Kim, Dae-Jung; Park, Hyung-Ran
2011-01-01
Type 2 diabetes mellitus (DM) and metabolic syndrome are associated with high risk of cardiovascular disease (CVD) and depression. Although lifestyle modifications including regular exercise and weight control are recommended as a primary approach to glycemic control and CVD risk reduction for people with DM and/or metabolic syndrome, little is known concerning the effects of CVD risk reduction interventions using psychobehavioral strategies in this population. This pilot study investigated the effects of a 16-week CVD risk reduction intervention in Korean adults with type 2 DM and metabolic syndrome. A prospective, pretest and posttest, controlled, quasi-experimental design enrolled a convenience sample of 43 Korean adults with type 2 DM and metabolic syndrome at a university hospital. The adults in the intervention group participated in a 16-week CVD risk reduction intervention consisting of 150 minutes of regular exercise per week; 200- to 300-kcal reduced daily diet for weight control; one-on-one psychobehavioral counseling based on constructs from the Transtheoretical Model such as processes of change, self-efficacy, and decisional balance; and telephone coaching for behavioral modification. Participants in the control group received a booklet with basic diabetic education as part of their routine care. Repeated-measures analysis of variance was used for analyzing the effects of the CVD risk reduction intervention on cardiometabolic risk factors including the UK Prospective Diabetes Study score for 10-year CVD risk, glycated hemoglobin (HbA1c), and depression. The intervention group showed significant reductions (P < .05) at 16 weeks, compared with the control group on the UK Prospective Diabetes Study fatal risk scale (-1.73% vs -0.04%), triglycerides (-38.5 vs -15.1 mg/dL), fasting plasma glucose (-29.24 vs +1.77 mg/dL), HbA1c (-0.37% vs +0.17%), and depression (score, -3.24 vs 1.40) measurements. This pilot study yielded evidence for the beneficial impact of the CVD risk reduction intervention for Korean adults with type 2 DM and metabolic syndrome on improved glycemic control, reduced CVD risk, and depression.
Skin Autofluorescence and Mortality in Patients on Peritoneal Dialysis
Mácsai, Emília; Benke, Attila; Kiss, István
2015-01-01
Abstract Skin autofluorescence (SAF) is a proven prognostic factor of mortality in hemodialysis patients. Traditional and nontraditional risk factors are almost equivalent in peritoneal dialysis (PD), and cardiovascular disease (CVD) is the leading cause of death. Moreover, peritoneal glucose absorption accelerates the degenerative processes of connective tissues as in diabetes. In our study, we examined the predictive value of SAF for total mortality in the PD population. Data were collected from 198 prevalently adult Caucasian PD patients. One hundred twenty-six patients (mean age 66.2 y, men [n = 73], diabetes ratio 75/126) had anamnestic CVD (coronary heart disease, cerebrovascular disease, peripheral arterial disease). Initially, we evaluated factors affecting SAF and CVD by multivariate linear regression. Survival rates were estimated by recording clinical and demographic data associated with mortality during a 36-month follow-up using the Kaplan–Meier method. Analyses were further stratified based on the presence or absence of CVD and SAF levels above or below the upper tercile 3.61 arbitrary units. Skin autofluorescence was influenced by CVD (P < 0.01, 95% confidence interval [CI] 0.1–0.5) and white blood cell counts (P < 0.001, 95% CI 0.031–0.117). According to the Spearman correlation, SAF correlated with peritoneal cumulative glucose exposure (P = 0.02) and elapsed time in PD (P = 0.008). CVD correlated with age (P < 0.001, 95% CI 1.24–1.65) and diabetes (P < 0.001, 95% CI 2.58–10.66). More deaths were observed in the high SAF group than in the low SAF group (34/68 vs 44/130; P = 0.04). Comparing the CVD(−) low SAF group survival (mean 33.9 mos, standard error [SE] 1.39) to CVD(+) low SAF (mean 30.5 mos, SE 1.37, P = 0.03) and to CVD(+) high SAF group (mean 27.1 mos, SE 1.83, P = 0.001), the difference was significant. In conclusion, among PD patients, SAF values over 3.61 arbitrary units seem to be a predictor of mortality. The relationship among peritoneal glucose exposure, CVD, and diabetes suggests its suitability to characterize systemic cumulative glucose load in this patient population. PMID:26559261
Denman, Catalina A.; Montano, Carlos Mendoza; Gaziano, Thomas A.; Levitt, Naomi; Rivera-Andrade, Alvaro; Carrasco, Diana Munguía; Zulu, Jabu; Khanam, Masuma Akter; Puoane, Thandi
2015-01-01
Background Cardiovascular disease (CVD) is on the rise in low- and middle-income countries (LMIC) and is proving difficult to combat due to the emphasis on improving outcomes in maternal and child health and infectious diseases, against a backdrop of severe human resource and infrastructure constraints. Effective task-sharing from physicians or nurses to community health workers (CHWs) to conduct population-based screening for persons at risk, has the potential to mitigate the impact of CVD on vulnerable populations. CHWs in Bangladesh, Guatemala, Mexico, and South Africa were trained to conduct non-invasive population-based screening for persons at high risk for CVD. Objective (s) The objectives of this study were to quantitatively assess the performance of CHWs during training and to qualitatively capture their training and fieldwork experiences while conducting non-invasive screening for cardiovascular disease (CVD) risk in their communities. Methods Written tests were used to assess CHWs’ acquisition of content knowledge during training, and focus group discussions conducted to capture their training and fieldwork experiences. Results Training was effective at increasing the CHWs’ content knowledge of cardiovascular disease (CVD) and this knowledge was largely retained up to six months after the completion of field work. Common themes which need to be addressed when designing task sharing with CHWs in chronic diseases are identified, including language, respect, and compensation. The importance of having intimate knowledge of the community receiving services from design to implementation is underscored. Conclusions Effective training for screening for CVD in community settings should have a strong didactic core that is supplemented with culture-specific adaptations in the delivery of instruction. The incorporation of expert and intimate knowledge of the communities themselves is critical, from the design to implementation phases of training. Challenges such as role definition, defining career paths, and providing adequate remuneration, must be addressed. PMID:25754566
Morales, Daniel R; Lipworth, Brian J; Donnan, Peter T; Jackson, Cathy; Guthrie, Bruce
2017-01-27
Cardiovascular disease (CVD) is a common comorbidity in people with asthma. However, safety concerns have caused heterogeneity in clinical guideline recommendations over the use of cardioselective beta-blockers in people with asthma and CVD, partly because risk in the general population has been poorly quantified. The aim of this study was to measure the risk of asthma exacerbations with beta-blockers prescribed to a general population with asthma and CVD. Linked data from the UK Clinical Practice Research Datalink was used to perform nested case-control studies among people with asthma and CVD matched on age, sex and calendar time. Adjusted incidence rate ratios (IRR) were calculated for the association between oral beta-blocker use and moderate asthma exacerbations (rescue oral steroids) or severe asthma exacerbations (hospitalisation or death) using conditional logistic regression. The cohort consisted of 35,502 people identified with active asthma and CVD, of which 14.1% and 1.2% were prescribed cardioselective and non-selective beta-blockers, respectively, during follow-up. Cardioselective beta-blocker use was not associated with a significantly increased risk of moderate or severe asthma exacerbations. Consistent results were obtained following sensitivity analyses and a self-controlled case series approach. In contrast, non-selective beta-blockers were associated with a significantly increased risk of moderate asthma exacerbations when initiated at low to moderate doses (IRR 5.16, 95% CI 1.83-14.54, P = 0.002), and both moderate and severe exacerbations when prescribed chronically at high dose (IRR 2.68, 95% CI 1.08-6.64, P = 0.033 and IRR 12.11, 95% CI 1.02-144.11, P = 0.048, respectively). Cardioselective beta-blockers prescribed to people with asthma and CVD were not associated with a significantly increased risk of moderate or severe asthma exacerbations and potentially could be used more widely when strongly indicated.
Obese adolescents with polycystic ovarian syndrome have elevated cardiovascular disease risk markers
Patel, Sonali S; Truong, Uyen; King, Martina; Ferland, Annie; Moreau, Kerrie L; Dorosz, Jennifer; Hokanson, John E; Wang, Hong; Kinney, Gregory L; Maahs, David M; Eckel, Robert H; Nadeau, Kristen J; Cree-Green, Melanie
2018-01-01
Women with polycystic ovarian syndrome (PCOS) have evidence of subclinical cardiovascular disease (CVD). However, insulin resistance, an important factor in the development of CVD in adults, is common in adolescents with PCOS, yet data in adolescents are limited. Therefore, we sought to measure insulin resistance and CVD markers in obese youth with and without PCOS. Thirty-six PCOS and 17 non-PCOS adolescent girls who were obese, sedentary, and non-hypertensive were recruited from clinics located within the Children's Hospital Colorado. Following 3 days of controlled diet and restricted exercise, fasting plasma samples were obtained prior to a hyperinsulinemic euglycemic clamp. PCOS girls were more insulin resistant than controls (glucose infusion rate 5.24±1.86 mg/kg/min vs 9.10±2.69; p<0.001). Girls with PCOS had blood pressure in the normal range, but had greater carotid intima–media thickness (cIMT) (0.49±0.07 mm vs 0.44±0.06; p=0.038), beta stiffness index (5.1±1.3 U vs 4.4±0.9; p=0.037), and reduced arterial compliance (1.95±0.47 mm2/mmHg × 10−1 vs 2.13±0.43; p=0.047). PCOS girls had a normal mean lipid profile, yet had a more atherogenic lipoprotein cholesterol distribution and had persistent elevations of free fatty acids despite hyperinsulinemia (68±28 μmol/mL vs 41±10; p=0.001), both potential contributors to CVD. Free fatty acid concentrations correlated best with all CVD markers. In summary, adolescent girls with PCOS have greater cIMT and stiffer arteries than girls without PCOS, perhaps related to altered lipid metabolism, even when clinical measures of blood pressure and cholesterol profiles are ‘normal’. Therefore, management of adolescent PCOS should include assessment of CVD risk factor development. PMID:28095749
Patel, Sonali S; Truong, Uyen; King, Martina; Ferland, Annie; Moreau, Kerrie L; Dorosz, Jennifer; Hokanson, John E; Wang, Hong; Kinney, Gregory L; Maahs, David M; Eckel, Robert H; Nadeau, Kristen J; Cree-Green, Melanie
2017-04-01
Women with polycystic ovarian syndrome (PCOS) have evidence of subclinical cardiovascular disease (CVD). However, insulin resistance, an important factor in the development of CVD in adults, is common in adolescents with PCOS, yet data in adolescents are limited. Therefore, we sought to measure insulin resistance and CVD markers in obese youth with and without PCOS. Thirty-six PCOS and 17 non-PCOS adolescent girls who were obese, sedentary, and non-hypertensive were recruited from clinics located within the Children's Hospital Colorado. Following 3 days of controlled diet and restricted exercise, fasting plasma samples were obtained prior to a hyperinsulinemic euglycemic clamp. PCOS girls were more insulin resistant than controls (glucose infusion rate 5.24±1.86 mg/kg/min vs 9.10±2.69; p<0.001). Girls with PCOS had blood pressure in the normal range, but had greater carotid intima-media thickness (cIMT) (0.49±0.07 mm vs 0.44±0.06; p=0.038), beta stiffness index (5.1±1.3 U vs 4.4±0.9; p=0.037), and reduced arterial compliance (1.95±0.47 mm 2 /mmHg × 10 -1 vs 2.13±0.43; p=0.047). PCOS girls had a normal mean lipid profile, yet had a more atherogenic lipoprotein cholesterol distribution and had persistent elevations of free fatty acids despite hyperinsulinemia (68±28 μmol/mL vs 41±10; p=0.001), both potential contributors to CVD. Free fatty acid concentrations correlated best with all CVD markers. In summary, adolescent girls with PCOS have greater cIMT and stiffer arteries than girls without PCOS, perhaps related to altered lipid metabolism, even when clinical measures of blood pressure and cholesterol profiles are 'normal'. Therefore, management of adolescent PCOS should include assessment of CVD risk factor development.
The Chemical Vapor Deposition of Thin Metal Oxide Films
NASA Astrophysics Data System (ADS)
Laurie, Angus Buchanan
1990-01-01
Chemical vapor deposition (CVD) is an important method of preparing thin films of materials. Copper (II) oxide is an important p-type semiconductor and a major component of high T_{rm c} superconducting oxides. By using a volatile copper (II) chelate precursor, copper (II) bishexafluoroacetylacetonate, it has been possible to prepare thin films of copper (II) oxide by low temperature normal pressure metalorganic chemical vapor deposition. In the metalorganic CVD (MOCVD) production of oxide thin films, oxygen gas saturated with water vapor has been used mainly to reduce residual carbon and fluorine content. This research has investigated the influence of water-saturated oxygen on the morphology of thin films of CuO produced by low temperature chemical vapor deposition onto quartz, magnesium oxide and cubic zirconia substrates. ZnO is a useful n-type semiconductor material and is commonly prepared by the MOCVD method using organometallic precursors such as dimethyl or diethylzinc. These compounds are difficult to handle under atmospheric conditions. In this research, thin polycrystalline films of zinc oxide were grown on a variety of substrates by normal pressure CVD using a zinc chelate complex with zinc(II) bishexafluoroacetylacetonate dihydrate (Zn(hfa)_2.2H _2O) as the zinc source. Zn(hfa) _2.2H_2O is not moisture - or air-sensitive and is thus more easily handled. By operating under reduced-pressure conditions (20-500 torr) it is possible to substantially reduce deposition times and improve film quality. This research has investigated the reduced-pressure CVD of thin films of CuO and ZnO. Sub-micron films of tin(IV) oxide (SnO _2) have been grown by normal pressure CVD on quartz substrates by using tetraphenyltin (TPT) as the source of tin. All CVD films were characterized by X-ray powder diffraction (XRPD), scanning electron microscopy (SEM) and electron probe microanalysis (EPMA).
Impact of Cardiovascular Counseling and Screening in Hodgkin Lymphoma Survivors
DOE Office of Scientific and Technical Information (OSTI.GOV)
Daniëls, Laurien A., E-mail: l.a.daniels@lumc.nl; Krol, Stijn D.G.; Graaf, Michiel A. de
Purpose: Cardiovascular disease (CVD) is the most common nonmalignant cause of death in Hodgkin lymphoma (HL) survivors, especially after mediastinal irradiation. The role of screening for CVD in HL survivors is unclear, but confrontation with risks of CVD may have a negative influence on health-related quality of life (HRQL). As part of a phase 2 screening study using computed tomography angiography (CTA) among HL survivors, an HRQL analysis was done to evaluate the emotional and practical burden and perceived benefits of screening and the effect of CVD-specific counseling on patient satisfaction. Methods and Materials: Patients who participated in the screeningmore » study also took part in the HRQL study. The impact of undergoing screening was evaluated with a 9-item questionnaire, and impact on HRQL with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire C30, version 3.0. The effect of counseling of CVD on perceived provision of information was evaluated with EORTC INFO-25. All questionnaires were completed at baseline and after screening. Results: Baseline questionnaires were received from 48 participants, and 43 completed questionnaires after screening. Mean age was 47 years, and mean time since diagnosis was 21 years. Of the total, 93% of subjects were content with participating, and 80% did not find the emphasis placed on late effects burdensome, although screening did have a small impact on social functioning and global quality of life. Perceived information on disease, medical tests, and treatment increased significantly after screening (P<.01). Differences were clinically relevant. There were no differences in perceived information between patients with and without screen-detected CVD. Conclusions: Screening was evaluated favorably, whether CTA showed abnormalities or not. Extensive counseling resulted in substantially increased provision of information and improved information satisfaction. Screening by means of CTA and subsequent cardiac intervention was highly valued, and the benefits were felt to outweigh the emotional and practical burden.« less
Impact of cardiovascular counseling and screening in Hodgkin lymphoma survivors.
Daniëls, Laurien A; Krol, Stijn D G; de Graaf, Michiel A; Scholte, Arthur J H A; van 't Veer, Mars B; Putter, Hein; de Roos, Albert; Schalij, Martin J; van de Poll-Franse, Lonneke V; Creutzberg, Carien L
2014-09-01
Cardiovascular disease (CVD) is the most common nonmalignant cause of death in Hodgkin lymphoma (HL) survivors, especially after mediastinal irradiation. The role of screening for CVD in HL survivors is unclear, but confrontation with risks of CVD may have a negative influence on health-related quality of life (HRQL). As part of a phase 2 screening study using computed tomography angiography (CTA) among HL survivors, an HRQL analysis was done to evaluate the emotional and practical burden and perceived benefits of screening and the effect of CVD-specific counseling on patient satisfaction. Patients who participated in the screening study also took part in the HRQL study. The impact of undergoing screening was evaluated with a 9-item questionnaire, and impact on HRQL with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire C30, version 3.0. The effect of counseling of CVD on perceived provision of information was evaluated with EORTC INFO-25. All questionnaires were completed at baseline and after screening. Baseline questionnaires were received from 48 participants, and 43 completed questionnaires after screening. Mean age was 47 years, and mean time since diagnosis was 21 years. Of the total, 93% of subjects were content with participating, and 80% did not find the emphasis placed on late effects burdensome, although screening did have a small impact on social functioning and global quality of life. Perceived information on disease, medical tests, and treatment increased significantly after screening (P<.01). Differences were clinically relevant. There were no differences in perceived information between patients with and without screen-detected CVD. Screening was evaluated favorably, whether CTA showed abnormalities or not. Extensive counseling resulted in substantially increased provision of information and improved information satisfaction. Screening by means of CTA and subsequent cardiac intervention was highly valued, and the benefits were felt to outweigh the emotional and practical burden. Copyright © 2014 Elsevier Inc. All rights reserved.
Yang, Hua; Tian, Tiantian; Wu, Dianhui; Guo, Dejun; Lu, Jian
2018-01-30
Cardiovascular disease (CVD), cancer and diabetes are serious threat to human health and more and more aroused people's attention. It is important to find the safe and effective prevention and treatment methods for the three deadly diseases. At present, a generally attention in the possible positive effects of edible berries for the three deadly diseases has been noted. Berry phytochemical compounds regulate different signaling pathways about cell survival, growth and differentiation. They contribute to the prevention and treatment of CVD, cancer and diabetes. This article reviews previous experimental evidence, several common berry phytochemical compounds and their possible mechanisms involved in three deadly diseases were summarized.
Surface functionalization of 3D-printed plastics via initiated chemical vapor deposition
Cheng, Christine
2017-01-01
3D printing is a useful fabrication technique because it offers design flexibility and rapid prototyping. The ability to functionalize the surfaces of 3D-printed objects allows the bulk properties, such as material strength or printability, to be chosen separately from surface properties, which is critical to expanding the breadth of 3D printing applications. In this work, we studied the ability of the initiated chemical vapor deposition (iCVD) process to coat 3D-printed shapes composed of poly(lactic acid) and acrylonitrile butadiene styrene. The thermally insulating properties of 3D-printed plastics pose a challenge to the iCVD process due to large thermal gradients along the structures during processing. In this study, processing parameters such as the substrate temperature and the filament temperature were systematically varied to understand how these parameters affect the uniformity of the coatings along the 3D-printed objects. The 3D-printed objects were coated with both hydrophobic and hydrophilic polymers. Contact angle goniometry and X-ray photoelectron spectroscopy were used to characterize the functionalized surfaces. Our results can enable the use of iCVD to functionalize 3D-printed materials for a range of applications such as tissue scaffolds and microfluidics. PMID:28875099
Hayek, Adina; Joshi, Rohina; Usherwood, Tim; Webster, Ruth; Kaur, Baldeep; Saini, Bandana; Armour, Carol; Krass, Ines; Laba, Tracey-Lea; Reid, Christopher; Shiel, Louise; Hespe, Charlotte; Hersch, Fred; Jan, Stephen; Lo, Serigne; Peiris, David; Rodgers, Anthony; Patel, Anushka
2016-09-23
Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; and access to a pharmacy-based program to support long-term medication adherence and lifestyle modification. Following a systematic development process, the intervention will be evaluated in a pragmatic cluster randomized controlled trial including 70 general practices for a median period of 18 months. The 35 general practices in the intervention group will work with a nominated partner pharmacy, whereas those in the control group will provide usual care without access to the intervention tools. The primary outcome is the proportion of patients at high CVD risk who were inadequately treated at baseline who achieve target blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels at the study end. The outcomes will be analyzed using data from electronic medical records, utilizing a validated extraction tool. Detailed process and economic evaluations will also be performed. The study intends to establish evidence about an intervention that combines technological innovation with team collaboration between patients, pharmacists, and general practitioners (GPs) for CVD prevention. Australian New Zealand Clinical Trials Registry ACTRN12616000233426.
Koonrungsesomboon, Nut; Karbwang, Juntra
2016-10-15
Cardiovascular disease (CVD) in the ageing is a major public health problem worldwide. The nature of most CVD is subclinical with pathological processes that can span over years. Use of preventive measures could be an appropriate approach to prevailing over CVD in the ageing, and herbal medicine is one of the promising preventive approaches and is currently of interest among medical societies. In the evidence-based era, herbal medicine is, however, often underestimated and approached with skepticism, mainly due to the paucity of scientific evidence. Properly designed clinical trials on herbal medicine for prevention of CVD in a geriatric population are thus of importance and of clinical value. To review ethical issues and discuss considerations when such research is proposed. Four ethical issues, including the scientific validity of research, risk-benefit assessments, subject selection and vulnerability, and informed consent, are structured and extensively discussed in this article. Ethical core considerations of prevention research of CVD on herbal medicine involve particular attention on the scientific validity of research, risk-benefit assessments, subject selection and vulnerability, and informed consent. These issues and considerations are keys, although they must be adapted to an individual research setting in which a clinical study is proposed. Copyright © 2015 Elsevier GmbH. All rights reserved.
HDL and microRNA Therapeutics in Cardiovascular Disease
Michell, Danielle L.; Vickers, Kasey C.
2016-01-01
microRNAs (miRNA) are small non-coding RNAs (sRNA) that post-transcriptionally regulate gene (mRNA) expression and are implicated in many biological processes and diseases. Many miRNAs have been reported to be altered in cardiovascular disease (CVD); both cellular and extracellular miRNA levels are affected by hypercholesterolemia and atherosclerosis. We and other groups have reported that lipoproteins transport miRNAs in circulation and these lipoprotein signatures are significantly altered in hypercholesterolemia and coronary artery disease (CAD). Extracellular miRNAs are a new class of potential biomarkers for CVD; however, they may also be new drug targets as high-density lipoproteins (HDL) transfer functional miRNAs to recipient cells in an endocrine-like form of intercellular communication that likely suppresses vascular inflammation. Recently, RNA-based drugs have emerged as the next frontier in drug therapy, and there are many miRNA inhibitors and mimics in clinical development. Here, we discuss specific miRNA drug targets and how their manipulation may impact CVD. We also address the potential for manipulating HDL-miRNA levels to treat CVD and the use of HDL as a delivery vehicle for RNA and chemical drugs. Finally, we outline the current and future challenges for HDL and miRNA-based therapeutics for the prevention and treatment of CVD. PMID:27595929
Gadkar, Kapil; Lu, James; Sahasranaman, Srikumar; Davis, John; Mazer, Norman A.; Ramanujan, Saroja
2016-01-01
The recent failures of cholesteryl ester transport protein inhibitor drugs to decrease CVD risk, despite raising HDL cholesterol (HDL-C) levels, suggest that pharmacologic increases in HDL-C may not always reflect elevations in reverse cholesterol transport (RCT), the process by which HDL is believed to exert its beneficial effects. HDL-modulating therapies can affect HDL properties beyond total HDL-C, including particle numbers, size, and composition, and may contribute differently to RCT and CVD risk. The lack of validated easily measurable pharmacodynamic markers to link drug effects to RCT, and ultimately to CVD risk, complicates target and compound selection and evaluation. In this work, we use a systems pharmacology model to contextualize the roles of different HDL targets in cholesterol metabolism and provide quantitative links between HDL-related measurements and the associated changes in RCT rate to support target and compound evaluation in drug development. By quantifying the amount of cholesterol removed from the periphery over the short-term, our simulations show the potential for infused HDL to treat acute CVD. For the primary prevention of CVD, our analysis suggests that the induction of ApoA-I synthesis may be a more viable approach, due to the long-term increase in RCT rate. PMID:26522778
Gadkar, Kapil; Lu, James; Sahasranaman, Srikumar; Davis, John; Mazer, Norman A; Ramanujan, Saroja
2016-01-01
The recent failures of cholesteryl ester transport protein inhibitor drugs to decrease CVD risk, despite raising HDL cholesterol (HDL-C) levels, suggest that pharmacologic increases in HDL-C may not always reflect elevations in reverse cholesterol transport (RCT), the process by which HDL is believed to exert its beneficial effects. HDL-modulating therapies can affect HDL properties beyond total HDL-C, including particle numbers, size, and composition, and may contribute differently to RCT and CVD risk. The lack of validated easily measurable pharmacodynamic markers to link drug effects to RCT, and ultimately to CVD risk, complicates target and compound selection and evaluation. In this work, we use a systems pharmacology model to contextualize the roles of different HDL targets in cholesterol metabolism and provide quantitative links between HDL-related measurements and the associated changes in RCT rate to support target and compound evaluation in drug development. By quantifying the amount of cholesterol removed from the periphery over the short-term, our simulations show the potential for infused HDL to treat acute CVD. For the primary prevention of CVD, our analysis suggests that the induction of ApoA-I synthesis may be a more viable approach, due to the long-term increase in RCT rate. Copyright © 2016 by the American Society for Biochemistry and Molecular Biology, Inc.
NASA Astrophysics Data System (ADS)
Laude, Lucien D.; Rauscher, Gerhard
The use of lasers in industrial material processing is discussed in reviews and reports. Sections are devoted to high-precision laser machining, deposition methods, ablation and polymers, and synthesis and oxidation. Particular attention is given to laser cutting of steel sheets, laser micromachining of material surfaces, process control in laser soldering, laser-induced CVD of doped Si stripes on SOS and their characterization by piezoresistivity measurements, laser CVD of Pt spots on glass, laser deposition of GaAs, UV-laser photoablation of polymers, ArF excimer-laser ablation of HgCdTe semiconductor, pulsed laser synthesis of Ti silicides and nitrides, the kinetics of laser-assisted oxidation of metallic films, and excimer-laser-assisted etching of solids for microelectronics.
NASA Astrophysics Data System (ADS)
Nakamura, Daisuke; Kimura, Taishi; Narita, Tetsuo; Suzumura, Akitoshi; Kimoto, Tsunenobu; Nakashima, Kenji
2017-11-01
A novel sintered tantalum carbide coating (SinTaC) prepared via a wet ceramic process is proposed as an approach to reducing the production cost and improving the crystal quality of bulk-grown crystals and epitaxially grown films of wide-bandgap semiconductors. Here, we verify the applicability of the SinTaC components as susceptors for chemical vapor deposition (CVD)-SiC and metal-organic chemical vapor deposition (MOCVD)-GaN epitaxial growth in terms of impurity incorporation from the SinTaC layers and also clarify the surface-roughness controllability of SinTaC layers and its advantage in CVD applications. The residual impurity elements in the SinTaC layers were confirmed to not severely incorporate into the CVD-SiC and MOCVD-GaN epilayers grown using the SinTaC susceptors. The quality of the epilayers was also confirmed to be equivalent to that of epilayers grown using conventional susceptors. Furthermore, the surface roughness of the SinTaC components was controllable over a wide range of average roughness (0.4 ≤ Ra ≤ 5 μm) and maximum height roughness (3 ≤ Rz ≤ 36 μm) through simple additional surface treatment procedures, and the surface-roughened SinTaC susceptor fabricated using these procedures was predicted to effectively reduce thermal stress on epi-wafers. These results confirm that SinTaC susceptors are applicable to epitaxial growth processes and are advantageous over conventional susceptor materials for reducing the epi-cost and improving the quality of epi-wafers.
Giving Bigger Satellites a Boost
NASA Technical Reports Server (NTRS)
2000-01-01
Ultramet, Inc. has spurred a new process for producing rocket engine thrust chambers, through SBIR funding and the Glenn Research Center. High-temperature oxidation-resistant thruster materials are being produced in order to achieve high-temperature capability without sacrificing reliability. These thruster materials lead to an estimated three-percent improvement in propulsion system performance. To develop this material, Ultramet used a process called chemical vapor deposition (CVD). CVD involves heating precursors for metals, like iridium and rhenium, to temperatures at which they become gaseous. They are then deposited onto a mandrel, or spindle, layer-by-layer to produce high-density, highly resistant materials from the inside out.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kozlovski, V. V.; Lebedev, A. A.; Bogdanova, E. V.
The model of conductivity compensation in SiC under irradiation with high-energy electrons is presented. The following processes are considered to cause a decrease in the free carrier concentration: (i) formation of deep traps by intrinsic point defects, Frenkel pairs produced by irradiation; (ii) 'deactivation' of the dopant via formation of neutral complexes including a dopant atom and a radiation-induced point defect; and (iii) formation of deep compensating traps via generation of charged complexes constituted by a dopant atom and a radiation-induced point defect. To determine the compensation mechanism, dose dependences of the deep compensation of moderately doped SiC (CVD) undermore » electron irradiation have been experimentally studied. It is demonstrated that, in contrast to n-FZ-Si, moderately doped SiC (CVD) exhibits linear dependences (with a strongly nonlinear dependence observed for Si). Therefore, the conductivity compensation in silicon carbide under electron irradiation occurs due to deep traps formed by primary radiation defects (vacancies and interstitial atoms) in the silicon and carbon sublattices. It is known that the compensation in silicon is due to the formation of secondary radiation defects that include a dopant atom. It is shown that, in contrast to n-SiC (CVD), primary defects in only the carbon sublattice of moderately doped p-SiC (CVD) cannot account for the compensation process. In p-SiC, either primary defects in the silicon sublattice or defects in both sublattices are responsible for the conductivity compensation.« less
High blood pressure (hypertension), the most common of all cardiovascular (CVD) diseases, is a major cause of morbidity and mortality in the United States, and a large percentage of the population manifests a genetic predisposition. Hypertension is polygenetically inherited, envi...
Mårtensson, Jan; Fridlund, Bengt; Jaarsma, Tiny
2014-12-02
Decreased sexual activity among cardiac patients is frequently reported. Rates of erectile dysfunction among men with cardiovascular disease (CVD) are twice as high as those in the general population with similar rates of sexual dysfunction in females with CVD. Returning to sexual activity is a common concern, and patients frequently request information on how to resume sexual activity. Partners also have considerable concerns, often more so than patients; why sexual counseling is important for both cardiac patients and their partners. In general, healthcare professionals, in caring for patients recognize the importance of discussing sexual function and activity and also express their responsibility to do so, although many healthcare professionals do not know what specific advice to give. Therefore, the intent of a consensus statement made by the American and European heart associations is to summarize current evidence related to sexual counseling in cardiovascular disease, and to provide direction to physicians, nurses, and other healthcare professionals in the practice of sexual counseling.
Evaluation of community health screening participants' knowledge of cardiovascular risk factors.
Mooney, Leslie A; Franks, Amy M
2009-01-01
To assess knowledge of cardiovascular disease (CVD) risk factors among a group of health screening participants and to compare knowledge between participants with high and low CVD risk. Cross-sectional pilot study. Jonesboro, AR, during June 2007. 121 adult volunteers participating in a community health screening. 34-item self-administered written questionnaire. Ability to identify CVD risk factors and healthy values for CVD risk factors and the differences in these abilities between participants with high and low CVD risk. Participants demonstrated good knowledge of traditional CVD risk factors such as high blood pressure, high cholesterol, lack of exercise, and overweight or obese status. Knowledge of other CVD risk factors and healthy values for major CVD risk factors was limited. Participants with high CVD risk were significantly more likely to correctly identify high triglycerides as a CVD risk factor and to identify healthy values for fasting blood glucose and total cholesterol compared with participants with low CVD risk. Overall, participants lacked knowledge of the risk factor status and healthy values for many CVD risk factors. Participants with high CVD risk may have better knowledge of some CVD risk factors than participants with low CVD risk. These findings highlight the need for more education to improve knowledge in both risk groups.
Is cardiovascular risk in women with PCOS a real risk? Current insights.
Papadakis, Georgios; Kandaraki, Eleni; Papalou, Olga; Vryonidou, Andromachi; Diamanti-Kandarakis, Evanthia
2017-12-01
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive aged women. PCOS incorporates not only symptoms related to the reproductive system but also a clustering of systemic metabolic abnormalities that are linked with increased risk for cardiovascular disease (CVD). More specifically, metabolic aberrations such as impaired glucose and lipid metabolism, accompanied by increased low-grade inflammation as well as elevated coagulation factors appear to contribute to the increased cardiovascular risk. Even though many studies have indicated a rise in surrogate biomarkers of CVD in women with PCOS, it is still doubtful to what extent and magnitude this elevation can be translated to real cardiovascular events. Furthermore, the cardiovascular risk factors appear to vary significantly in the different phenotypes of the syndrome. Women with PCOS have the potential for early atherosclerosis, myocardial and endothelial dysfunction. Whether PCOS women are at real cardiovascular risk compared to controls remains between the verge of theoretical and real threat for the PCOS women at any age but particularly in the post-menopausal state. Interestingly, although the presence of the CVD risk factors is well documented in PCOS women, their combination on different phenotypes may play a role, which eventually results in a spectrum of clinical manifestations of CVD with variable degree of severity. The present manuscript aims to review the interaction between PCOS and the combination of several cardiovascular risk factors.
2014-01-01
Objectives The objectives are to assess the prevalence and determinants of cardiovascular disease (CVD) risk factors among the residents of Community Housing Projects in metropolitan Kuala Lumpur, Malaysia. Method By using simple random sampling, we selected and surveyed 833 households which comprised of 3,722 individuals. Out of the 2,360 adults, 50.5% participated in blood sampling and anthropometric measurement sessions. Uni and bivariate data analysis and multivariate binary logistic regression were applied to identify demographic and socioeconomic determinants of the existence of having at least one CVD risk factor. Results As a Result, while obesity (54.8%), hypercholesterolemia (51.5%), and hypertension (39.3%) were the most common CVD risk factors among the low-income respondents, smoking (16.3%), diabetes mellitus (7.8%) and alcohol consumption (1.4%) were the least prevalent. Finally, the results from the multivariate binary logistic model illustrated that compared to the Malays, the Indians were 41% less likely to have at least one of the CVD risk factors (OR = 0.59; 95% CI: 0.37 - 0.93). Conclusion In Conclusion, the low-income individuals were at higher risk of developing CVDs. Prospective policies addressing preventive actions and increased awareness focusing on low-income communities are highly recommended and to consider age, gender, ethnic backgrounds, and occupation classes. PMID:25436515
Thayer, Julian F; Yamamoto, Shelby S; Brosschot, Jos F
2010-05-28
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. The understanding of the risk factors for CVD may yield important insights into the prevention, etiology, course, and treatment of this major public health concern. Autonomic imbalance, characterized by a hyperactive sympathetic system and a hypoactive parasympathetic system, is associated with various pathological conditions. Over time, excessive energy demands on the system can lead to premature aging and diseases. Therefore, autonomic imbalance may be a final common pathway to increased morbidity and mortality from a host of conditions and diseases, including cardiovascular disease. Heart rate variability (HRV) may be used to assess autonomic imbalances, diseases and mortality. Parasympathetic activity and HRV have been associated with a wide range of conditions including CVD. Here we review the evidence linking HRV to established and emerging modifiable and non-modifiable CVD risk factors such as hypertension, obesity, family history and work stress. Substantial evidence exists to support the notion that decreased HRV precedes the development of a number of risk factors and that lowering risk profiles is associated with increased HRV. We close with a suggestion that a model of autonomic imbalance may provide a unifying framework within which to investigate the impact of risk factors, including psychosocial factors and work stress, on cardiovascular disease. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
Initiated chemical vapor deposition polymers for high peak-power laser targets
DOE Office of Scientific and Technical Information (OSTI.GOV)
Baxamusa, Salmaan H.; Lepro, Xavier; Lee, Tom
2016-12-05
Here, we report two examples of initiated chemical vapor deposition (iCVD) polymers being developed for use in laser targets for high peak-power laser systems. First, we show that iCVD poly(divinylbenzene) is more photo-oxidatively stable than the plasma polymers currently used in laser targets. Thick layers (10–12 μm) of this highly crosslinked polymer can be deposited with near-zero intrinsic film stress. Second, we show that iCVD epoxy polymers can be crosslinked after deposition to form thin adhesive layers for assembling precision laser targets. The bondlines can be made as thin as ~ 1 μm, approximately a factor of 2 thinner thanmore » achievable using viscous resin-based adhesives. These bonds can withstand downstream coining and stamping processes.« less
Ultrahigh-mobility graphene devices from chemical vapor deposition on reusable copper
Banszerus, Luca; Schmitz, Michael; Engels, Stephan; Dauber, Jan; Oellers, Martin; Haupt, Federica; Watanabe, Kenji; Taniguchi, Takashi; Beschoten, Bernd; Stampfer, Christoph
2015-01-01
Graphene research has prospered impressively in the past few years, and promising applications such as high-frequency transistors, magnetic field sensors, and flexible optoelectronics are just waiting for a scalable and cost-efficient fabrication technology to produce high-mobility graphene. Although significant progress has been made in chemical vapor deposition (CVD) and epitaxial growth of graphene, the carrier mobility obtained with these techniques is still significantly lower than what is achieved using exfoliated graphene. We show that the quality of CVD-grown graphene depends critically on the used transfer process, and we report on an advanced transfer technique that allows both reusing the copper substrate of the CVD growth and making devices with mobilities as high as 350,000 cm2 V–1 s–1, thus rivaling exfoliated graphene. PMID:26601221
Katakami, Naoto; Mita, Tomoya; Yoshii, Hidenori; Shiraiwa, Toshihiko; Yasuda, Tetsuyuki; Okada, Yosuke; Umayahara, Yutaka; Kaneto, Hideaki; Osonoi, Takeshi; Yamamoto, Tsunehiko; Kuribayashi, Nobuichi; Maeda, Kazuhisa; Yokoyama, Hiroki; Kosugi, Keisuke; Ohtoshi, Kentaro; Hayashi, Isao; Sumitani, Satoru; Tsugawa, Mamiko; Ohashi, Makoto; Taki, Hideki; Nakamura, Tadashi; Kawashima, Satoshi; Sato, Yasunori; Watada, Hirotaka; Shimomura, Iichiro
2017-10-01
Sodium-glucose co-transporter-2 (SGLT2) inhibitors are anti-diabetic agents that improve glycemic control with a low risk of hypoglycemia and ameliorate a variety of cardiovascular risk factors. The aim of the ongoing study described herein is to investigate the preventive effects of tofogliflozin, a potent and selective SGLT2 inhibitor, on the progression of atherosclerosis in subjects with type 2 diabetes (T2DM) using carotid intima-media thickness (IMT), an established marker of cardiovascular disease (CVD), as a marker. The Study of Using Tofogliflozin for Possible better Intervention against Atherosclerosis for type 2 diabetes patients (UTOPIA) trial is a prospective, randomized, open-label, blinded-endpoint, multicenter, and parallel-group comparative study. The aim was to recruit a total of 340 subjects with T2DM but no history of apparent CVD at 24 clinical sites and randomly allocate these to a tofogliflozin treatment group or a conventional treatment group using drugs other than SGLT2 inhibitors. As primary outcomes, changes in mean and maximum IMT of the common carotid artery during a 104-week treatment period will be measured by carotid echography. Secondary outcomes include changes in glycemic control, parameters related to β-cell function and diabetic nephropathy, the occurrence of CVD and adverse events, and biochemical measurements reflecting vascular function. This is the first study to address the effects of SGLT2 inhibitors on the progression of carotid IMT in subjects with T2DM without a history of CVD. The results will be available in the very near future, and these findings are expected to provide clinical data that will be helpful in the prevention of diabetic atherosclerosis and subsequent CVD. Kowa Co., Ltd. UMIN000017607.
Cardiovascular, diabetes, and cancer strips: evidences, mechanisms, and classifications
Wu, Qing-Hua; Hu, Da-Yi
2014-01-01
Objectives To report and name firstly that there are cardiovascular disease (CVD), diabetes mellitus (DM) and cancers (CDC) strips; and disclose their mechanisms, classifications, and clinical significances. Study design Narrative and systematic review study and interpretive analysis. Methods Data sources and study selection: to collect and present related evidences on CDC strips from evidence-based, open-access, both Chinese- and English-language literatures in recent 10 years on clinical trials from PubMed according to keywords “CVD, DM and cancers” as well as authors’ extensive clinical experience with the treatment of more than fifty thousands of patients with CVD, diabetes and cancers over the past decades, and analyze their related mechanisms and categories which based on authors’ previous works. Data extraction: data were mainly extracted from 48 articles which are listed in the reference section of this review. Qualitative, quantitative and mixed data were included, narratively and systematically reviewed. Results With several conceptual and technical breakthrough, authors present related evidences on CDC strips, these are, CVD and DM, DM and cancers, cancers and CVD linked, respectively; And “Bad SEED” +/– “bad soil” theory or doctrine may explain this phenomenon due to “internal environmental injure, abnormal or unbalance” in human body resulting from the role of risk factors (RFs) related multi-pathways and multi-targets, which including organ & tissue (e.g., vascular-specific), cell and gene-based mechanisms. Their classifications include main strips/type B, and Branches/type A as showed by tables and figures in this article. Conclusions There are CDC strips and related mechanisms and classifications. CDC strips may help us to understand, prevent, and control related common non-communicable diseases (NCDs) as well as these high risk strips. PMID:25276377
Hill, Nathan R; Lasserson, Daniel; Thompson, Ben; Perera-Salazar, Rafael; Wolstenholme, Jane; Bower, Peter; Blakeman, Thomas; Fitzmaurice, David; Little, Paul; Feder, Gene; Qureshi, Nadeem; Taal, Maarten; Townend, Jonathan; Ferro, Charles; McManus, Richard; Hobbs, Fd Richard
2014-05-08
Chronic kidney disease (CKD) is common and increasing in prevalence. Cardiovascular disease (CVD) is a major cause of morbidity and death in CKD, though of a different phenotype to the general CVD population. Few therapies have proved effective in modifying the increased CVD risk or rate of renal decline in CKD. There are accumulating data that aldosterone receptor antagonists (ARA) may offer cardio-protection and delay renal impairment in patients with the CV phenotype in CKD. The use of ARA in CKD has therefore been increasingly advocated. However, no large study of ARA with renal or CVD outcomes is underway. The study is a prospective randomised open blinded endpoint (PROBE) trial set in primary care where patients will mainly be identified by their GPs or from existing CKD lists. They will be invited if they have been formally diagnosed with CKD stage 3b or there is evidence of stage 3b CKD from blood results (eGFR 30-44 mL/min/1.73 m2) and fulfil the other inclusion/exclusion criteria. Patients will be randomised to either spironolactone 25 mg once daily in addition to routine care or routine care alone and followed-up for 36 months. BARACK D is a PROBE trial to determine the effect of ARA on mortality and cardiovascular outcomes (onset or progression of CVD) in patients with stage 3b CKD. EudraCT: 2012-002672-13ISRTN: ISRCTN44522369.
Stokic, Edita; Romani, Andrea; Ilincic, Branislava; Kupusinac, Aleksandar; Stosic, Zoran; Isenovic, Esma R
2017-08-21
Obesity and micronutrient deficiencies contribute to the risk of cardiometabolic diseases such are type 2 diabetes mellitus and cardiovascular disease (CVD). We examined the frequency of concomitant deficit of magnesium (Mg) and vitamin D in obese patients and evaluated the connection of these combined deficiencies with indicators of cardiometabolic risk in non-diabetic subjects. Non-diabetic middle aged adults (n = 80; mean age 36 ± 4 years, 52% women) were recruited based on weight/adiposity parameters [i.e. body mass index (BMI) and body fat percentage (FAT%)]. Cardiometabolic risk indicators [insulin resistance (Homeostatic Model Assessment for insulin resistance (HOMA-IR)) and CVD risk (Framingham risk score for predicting 10-year CVD)], Mg status [i.e. total serum Mg concentration (TMg), chronic latent Mg deficiency (CLMD) - 0.75-0.85 mmol/L], vitamin D status [i.e. serum concentration of 25-hydroxyvitamin D (25(OH)D), vitamin D deficiency <50 nmol/l] were assessed. Among obese subjects 36% presented a combination of vitamin D deficiency and CLMD. In all studied patients, 25(OH)D and TMg levels both, individually and combined, showed a negative linear correlation with HOMA-IR and CVD risk. In subjects with CLMD (TMg ˂0.85 mmol/L), a negative linear coefficient was found between 25(OH)D and, HOMA-IR and CVD risk, compared with subjects with normal TMg status (TMg ≥0.85 mmol/L). CLMD and vitamin D deficiency may commonly be present in obese non-diabetic subjects. Individually and combined, both deficiencies predispose non-diabetic patients to increased risk of cardiometabolic diseases. Maintaining normal Mg status may improve the beneficial effects of vitamin D on cardiometabolic risk indicators. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
Mousavi, Seyedeh Neda; Faghihi, Amirhosein; Motaghinejad, Majid; Shiasi, Maryam; Imanparast, Fatemeh; Amiri, Hamid Lorvand; Shidfar, Farzad
2018-02-01
Studies have shown that non-alcoholic fatty liver disease (NAFLD) patients are more prone to cardiovascular disease (CVD). Zinc and selenium deficiency are common in NAFLD. But the effects of zinc and selenium co-supplementation before and/or after disease progression on CVD markers are not clear in NAFLD patients. This study aimed to compare the effects of zinc and selenium co-supplementation before and/or after disease progression on some of the CVD markers in an experimental model of NAFLD. Forty male Sprague Dawley rats (197 ± 4 g) were randomly assigned into four dietary groups: control group (C; received 9% of calorie as fat), model group (M; received 82% of calorie as fat), and supplementation before (BS) or after (AS) disease progression. Animals were fed diets for 20 weeks in all groups. Fasting plasma glucose (FPG), insulin, HOMA-IR, ALT, AST, lipid profile, malondialdehyde (MDA) and vascular endothelial growth factor (VEGF) levels were measured as CVD indices. Serum ALT, AST, FPG, insulin, MDA, VEGF and HOMA-IR were significantly higher in the M than C group. Co-supplementation reduced serum ALT and AST levels in the BS and AS groups compared with the M group. FPG, insulin, HOMA-IR, VEGF, MDA, LDL/HDL-c and TC/HDL-c ratio were significantly reduced in the AS compared with the M group. TG/HDL-c ratio was significantly reduced in the BS and AS compared with the M group. Serum MDA, VEGF, Insulin and HOMA-IR were significantly lowered in the AS than BS group (p < 0.05). Zinc and selenium co-supplementation after NAFLD progression reduced CVD risk indices in an experimental model.
Fujishiro, Kaori; Diez Roux, Ana V; Landsbergis, Paul; Kaufman, Joel D; Korcarz, Claudia E; Stein, James H
2015-01-01
Objectives The role of occupation in the development of cardiovascular disease (CVD) remains a topic of research because few studies have examined longitudinal associations, and because occupation can be an indicator of socioeconomic position (SEP) and a proxy for hazard exposure. This study examines associations of occupational category as an SEP marker and selected occupational exposures with progression of the subclinical carotid artery disease. Methods A community-based, multiethnic sample (n=3109, mean age=60.2) provided subclinical CVD measures at least twice at three data collection points (mean follow-up=9.4 years). After accounting for demographic characteristics, SEP, and traditional CVD risk factors, we modelled common carotid intima-media thickness, carotid plaque scores, and carotid plaque shadowing as a function of occupational category, physical hazard exposure, physical activity on the job, interpersonal stress, job control and job demands. These job characteristics were derived from the Occupational Resource Network (O*NET). Random coefficient models were used to account for repeated measures and time-varying covariates. Results There were a few statistically significant associations at baseline. After all covariates were included in the model, men in management, office/sales, service and blue-collar jobs had 28–44% higher plaque scores than professionals at baseline (p=0.001). Physically hazardous jobs were positively associated with plaque scores among women (p=0.014). However, there were no significant longitudinal associations between any of the occupational characteristics and any of the subclinical CVD measures. Conclusions There was little evidence that the occupational characteristics examined in this study accelerated the progression of subclinical CVD. PMID:25217203
Cowan, Logan T; Alonso, Alvaro; Pankow, James S; Folsom, Aaron R; Rosamond, Wayne D; Gottesman, Rebecca F; Lakshminarayan, Kamakshi
2016-06-01
Acute triggers for ischemic stroke, which may include infection, are understudied, as is whether background cardiovascular disease (CVD) risk modifies such triggering. We hypothesized that infection increases acute stroke risk, especially among those with low CVD risk. Hospitalized strokes and infections were identified in the Atherosclerosis Risk in Communities (ARIC) cohort. A case-crossover design and conditional logistic regression were used to compare hospitalized infections among patients with stroke (14, 30, 42, and 90 days before stroke) with corresponding control periods 1 year and 2 years before stroke. Background CVD risk was assessed at both visit 1 and the visit most proximal to stroke, with risk dichotomized at the median. A total of 1008 adjudicated incident ischemic strokes were included. Compared with control periods, hospitalized infection was more common within 2 weeks before stroke (14-day odds ratio [OR], 7.7; 95% CI, 2.1-27.3); the strength of association declined with increasing time in the exposure window before stroke (30-day OR, 5.7 [95% CI, 2.3-14.3]; 42-day OR, 4.5 [95% CI, 2.0-10.2]; and 90-day OR, 3.6 [95% CI, 2.1-6.5]). Stroke risk was higher among those with low compared with high CVD risk, with this interaction reaching statistical significance for some exposure periods. These results support the hypothesis that hospitalized infection is a trigger of ischemic stroke and may explain some cryptogenic strokes. Infection control efforts may prevent strokes. CVD preventive therapies may prevent strokes if used in the peri-infection period, but clinical trials are needed. © 2016 American Heart Association, Inc.
Acidemia and blood free fatty acids: analysis of cardiovascular risk factors in a new context.
Reis, António Heitor
2017-03-01
Following a hypothesis developed in an earlier paper, here it is discussed how deviations of blood pH from the normal range (namely states of acidemia) together with high blood levels of free fatty acids (FFA) may offer a rationale for many important risk factors for cardiovascular diseases (CVD) by shaping a context for formation of fatty acid micelles and vesicles with an acidic core, which fuse with the endothelia, disrupt vital cell processes, and thereby may initiate atherosclerotic plaque formation. Acidemia may arise primarily from dysregulation of the systemic buffers that control blood pH, chronic diseases of kidneys and lungs, inappropriate diet, or may be induced by some common drugs. The level of free fatty acids may be increased and maintained high by chronic stress, and adrenergic shocks. Elevated concentrations of blood FFA in a context of acidemia allow to understand important cardiovascular aspects: the increased risk of menopausal women, the protective effects of physical exercise, the changes in vascular behavior characteristic of metabolic acidosis/acidemia, the role of diet in the pH balance, on how some known medicines like metformin, steroids, NSAIDS, proton pump inhibitors, and calcium supplements may influence CVD risk, and an explanation is offered for the role of statins.
Lundmark, Anna; Davanian, Haleh; Båge, Tove; Johannsen, Gunnar; Koro, Catalin; Lundeberg, Joakim; Yucel-Lindberg, Tülay
2015-01-01
The multifactorial chronic inflammatory disease periodontitis, which is characterized by destruction of tooth-supporting tissues, has also been implicated as a risk factor for various systemic diseases. Although periodontitis has been studied extensively, neither disease-specific biomarkers nor therapeutic targets have been identified, nor its link with systemic diseases. Here, we analyzed the global transcriptome of periodontitis and compared its gene expression profile with those of other inflammatory conditions, including cardiovascular disease (CVD), rheumatoid arthritis (RA), and ulcerative colitis (UC). Gingival biopsies from 62 patients with periodontitis and 62 healthy subjects were subjected to RNA sequencing. The up-regulated genes in periodontitis were related to inflammation, wounding and defense response, and apoptosis, whereas down-regulated genes were related to extracellular matrix organization and structural support. The most highly up-regulated gene was mucin 4 (MUC4), and its protein product was confirmed to be over-expressed in periodontitis. When comparing the expression profile of periodontitis with other inflammatory diseases, several gene ontology categories, including inflammatory response, cell death, cell motion, and homeostatic processes, were identified as common to all diseases. Only one gene, pleckstrin (PLEK), was significantly overexpressed in periodontitis, CVD, RA, and UC, implicating this gene as an important networking link between these chronic inflammatory diseases. PMID:26686060
Allport, Shannon Anjelica; Kikah, Ngum; Abu Saif, Nessim; Ekokobe, Fonkem; Atem, Folefac D
2016-01-01
The risk for cardiovascular disease (CVD) is higher for individuals with a first-degree relative who developed premature CVD (with a threshold at age 55 years for a male or 65 years for a female). However, little is known about the effect that each unit increase or decrease of maternal or paternal age of onset of CVD has on offspring age of onset of CVD. We hypothesized that there is an association between maternal and paternal age of onset of CVD and offspring age of onset of CVD. We used the Framingham Heart Study database and performed conditional imputation for CVD-censored parental age (i.e. parents that didn't experience onset of CVD) and Cox proportional regression analysis, with offspring's age of onset of CVD as the dependent variable and parental age of onset of CVD as the primary predictor. Modifiable risk factors in offspring, such as cigarette smoking, body mass index (BMI), diabetes mellitus, systolic blood pressure (SBP), high-density lipoprotein (HDL) level, and low-density lipoprotein (LDL) level, were controlled for. Separate analyses were performed for the association between maternal age of onset of CVD and offspring age of onset of CVD and the association between paternal age of onset of CVD and offspring age of onset of CVD. Parental age of onset of CVD was predictive of offspring age of onset of CVD for maternal age of onset of CVD (P < .0001; N = 1401) and for paternal age of onset of CVD (P = 0.0134; N = 1221). A negative estimate of the coefficient of interest signifies that late onset of cardiovascular events in parents is protective of onset of CVD in offspring. Cigarette smoking and HDL level were important associated confounders. Offspring age of onset of cardiovascular disease is significantly associated with both maternal and paternal age of onset CVD. The incorporation of the parameters, maternal or paternal age of onset of CVD, into risk estimate calculators may improve accuracy of identification of high-risk patients in clinical settings.
Rare variants and cardiovascular disease.
Wain, Louise V
2014-09-01
Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in the Western world. Large genome-wide association studies (GWASs) of coronary artery disease, myocardial infarction, stroke and dilated cardiomyopathy have identified a number of common genetic variants with modest effects on disease risk. Similarly, studies of important modifiable risk factors of CVD have identified a large number of predominantly common variant associations, for example, with blood pressure and blood lipid levels. In each case, despite the often large numbers of loci identified, only a small proportion of the phenotypic variance is explained. It has been hypothesised that rare variants with large effects may account for some of the missing variance but large-scale studies of rare variation are in their infancy for cardiovascular traits and have yet to produce fruitful results. Studies of monogenic CVDs, inherited disorders believed to be entirely driven by individual rare mutations, have highlighted genes that play a key role in disease aetiology. In this review, we discuss how findings from studies of rare variants in monogenic disease and GWAS of predominantly common variants are converging to provide further insight into biological disease mechanisms. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
NASA Astrophysics Data System (ADS)
Stepińska, Izabela; Czerwosz, ElŻbieta; Diduszko, Ryszard; Kozłowski, Mirosław; Wronka, Halina
2017-08-01
In this work molecular and crystalline structure of new type of nanocomposite films were investigated. These films compose of CNT decorated with palladium nanograins. They were prepared on a base of C-Ni films modified in CVD process. C-Ni nanocomposite films were obtained by PVD process and their modification by CVD leads to a growth of CNT film. CNTs-Ni or C-Ni films were treated with additional PVD process with palladium. Nickel and palladium acetate and fulleren C60 are precursors of films in PVD process. FTIR spectroscopy was used to studied the molecular structure of film in every stage of preparation . The crystalline structure of these films was studied by X-ray diffraction. SEM (scanning electron microscopy) was applied to investigate film's surface topography.
Beneficial impact of exercise and obesity interventions on erectile function and its risk factors.
Hannan, Johanna L; Maio, M Tina; Komolova, Marina; Adams, Michael A
2009-03-01
Erectile dysfunction (ED) is a multifaceted disease involving cardiovascular, metabolic, and hormonal factors and affects over 100 million men worldwide. ED has been shown to be a harbinger of underlying cardiovascular diseases (CVD), as there are common risk factors (aging, hypertension, obesity) and mechanistic basis. To provide an update on clinical and experimental evidence regarding the impact of lifestyle modifications, such as exercise and diet, with respect to changes in erectile function. Published evidence regarding the impact of aging, hypertension, and obesity on ED and CVD, as well as new experimental data linking obesity and diminished erectile responses. We reviewed the literature regarding common risk factors of ED and CVD, particularly involving obesity, as well as performed new analysis on the findings of other experimental studies involving diet and exercise interventions. Physical inactivity negatively impacts on erectile function, and experimental and clinical exercise interventions have been shown to improve sexual responses and overall cardiovascular health. Mediterranean-style diets and a reduction in caloric intake have been found to improve erectile function in men with the aspects of the metabolic syndrome. In addition, both clinical and experimental studies have confirmed that combining the two interventions provides additional benefit to erectile function, likely via reduced metabolic disturbances (e.g., inflammatory markers, insulin resistance), decreased visceral adipose tissue, and improvement in vascular function (e.g., increased endothelial function). Lifestyle modifications provide significant benefits to vascular health and erectile function in a population that is increasingly aged and more obese.
Sublimation-assisted graphene transfer technique based on small polyaromatic hydrocarbons
NASA Astrophysics Data System (ADS)
Chen, Mingguang; Stekovic, Dejan; Li, Wangxiang; Arkook, Bassim; Haddon, Robert C.; Bekyarova, Elena
2017-06-01
Advances in the chemical vapor deposition (CVD) growth of graphene have made this material a very attractive candidate for a number of applications including transparent conductors, electronics, optoeletronics, biomedical devices and energy storage. The CVD method requires transfer of graphene on a desired substrate and this is most commonly accomplished with polymers. The removal of polymer carriers is achieved with organic solvents or thermal treatment which makes this approach inappropriate for application to plastic thin films such as polyethylene terephthalate substrates. An ultraclean graphene transfer method under mild conditions is highly desired. In this article, we report a naphthalene-assisted graphene transfer technique which provides a reliable route to residue-free transfer of graphene to both hard and flexible substrates. The quality of the transferred graphene was characterized with atomic force microscopy, scanning electron microscopy, and Raman spectroscopy. Field effect transistors, based on the naphthalene-transfered graphene, were fabricated and characterized. This work has the potential to broaden the applications of CVD graphene in fields where ultraclean graphene and mild graphene transfer conditions are required.
Role of Ambulatory and Home Blood Pressure Monitoring in Clinical Practice: A Narrative Review
Shimbo, Daichi; Abdalla, Marwah; Falzon, Louise; Townsend, Raymond R.; Muntner, Paul
2015-01-01
Hypertension, a common cardiovascular disease (CVD) risk factor, is usually diagnosed and treated based on blood pressure readings obtained in the clinic setting. Blood pressure may differ considerably when measured in the clinic versus outside of the clinic setting. Over the past several decades, evidence has accumulated on two approaches for measuring out-of-clinic blood pressure: ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM). Blood pressure measures on ABPM and HBPM each have a stronger association with CVD outcomes than clinic blood pressure. Controversy exists whether ABPM or HBPM is superior for estimating CVD risk, and under what circumstances these methods should be used in clinical practice for assessing out-of-clinic blood pressure. This review describes ABPM and HBPM procedures, the blood pressure phenotypic measures that can be ascertained, and the evidence that supports the use of each approach to measure out-of-clinic blood pressure. This review also describes barriers to the successful implementation of ABPM and HBPM in clinical practice, proposes core competencies for the conduct of these procedures, and highlights important areas for future research. PMID:26457954
Depression and Cardiac Disease: Epidemiology, Mechanisms, and Diagnosis
Huffman, Jeff C.; Celano, Christopher M.; Beach, Scott R.; Motiwala, Shweta R.; Januzzi, James L.
2013-01-01
In patients with cardiovascular disease (CVD), depression is common, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. Both physiological and behavioral factors—including endothelial dysfunction, platelet abnormalities, inflammation, autonomic nervous system dysfunction, and reduced engagement in health-promoting activities—may link depression with adverse cardiac outcomes. Because of the potential impact of depression on quality of life and cardiac outcomes, the American Heart Association has recommended routine depression screening of all cardiac patients with the 2- and 9-item Patient Health Questionnaires. However, despite the availability of these easy-to-use screening tools and effective treatments, depression is underrecognized and undertreated in patients with CVD. In this paper, we review the literature on epidemiology, phenomenology, comorbid conditions, and risk factors for depression in cardiac disease. We outline the associations between depression and cardiac outcomes, as well as the mechanisms that may mediate these links. Finally, we discuss the evidence for and against routine depression screening in patients with CVD and make specific recommendations for when and how to assess for depression in this high-risk population. PMID:23653854
USDA-ARS?s Scientific Manuscript database
Twenty publications from twelve prospective cohorts have evaluated associations between flavonoid intakes and incidence or mortality from cardiovascular disease (CVD) among adults in Europe and the United States. The most common outcome was coronary heart disease mortality, and four of eight cohort ...
Kim, Eunjoo; Lee, Taehee; Kim, Hyungmin; Jung, Won-Jin; Han, Doug-Young; Baik, Hionsuck; Choi, Nakwon; Choi, Jungkyu
2014-12-16
Chabazite (CHA) zeolites with a pore size of 0.37 × 0.42 nm(2) are expected to separate CO2 (0.33 nm) from larger N2 (0.364 nm) in postcombustion flue gases by recognizing their minute size differences. Furthermore, the hydrophobic siliceous constituent in CHA membranes can allow for maintaining the CO2/N2 separation performance in the presence of H2O in contrast with the CO2 affinity-based membranes. In an attempt to increase the molecular sieving ability, the pore mouth size of all silica CHA (Si-CHA) particles was reduced via the chemical vapor deposition (CVD) of a silica precursor (tetraethyl orthosilicate). Accordingly, an increase of the CVD treatment duration decreased the penetration rate of CO2 into the CVD-treated Si-CHA particles. Furthermore, the CVD process was applied to siliceous CHA membranes in order to improve their CO2/N2 separation performance. Compared to the intact CHA membranes, the CO2/N2 maximum separation factor (max SF) for CVD-treated CHA membranes was increased by ∼ 2 fold under dry conditions. More desirably, the CO2/N2 max SF was increased by ∼ 3 fold under wet conditions at ∼ 50 °C, a representative temperature of the flue gas stream. In fact, the presence of H2O in the feed disfavored the permeation of N2 more than that of CO2 through CVD-modified CHA membranes and thus, contributed to the increased CO2/N2 separation factor.
Trauma exposure and endothelial function among midlife women.
Thurston, Rebecca C; Barinas-Mitchell, Emma; von Känel, Roland; Chang, Yuefang; Koenen, Karestan C; Matthews, Karen A
2018-04-01
Trauma is a potent exposure that can have implications for health. However, little research has considered whether trauma exposure is related to endothelial function, a key process in the pathophysiology of cardiovascular disease (CVD). We tested whether exposure to traumatic experiences was related to poorer endothelial function among midlife women, independent of CVD risk factors, demographic factors, psychosocial factors, or a history of childhood abuse. In all, 272 nonsmoking perimenopausal and postmenopausal women aged 40 to 60 years without clinical CVD completed the Brief Trauma Questionnaire, the Child Trauma Questionnaire, physical measures, a blood draw, and a brachial ultrasound for assessment of brachial artery flow-mediated dilation (FMD). Relations between trauma and FMD were tested in linear regression models controlling for baseline vessel diameter, demographics, depression/anxiety, CVD risk factors, health behaviors, and, additionally, a history of childhood abuse. Over 60% of the sample had at least one traumatic exposure, and 18% had three or more exposures. A greater number of traumatic exposures was associated with lower FMD, indicating poorer endothelial function in multivariable models (beta, β [standard error, SE] -1.05 [0.40], P = 0.01). Relations between trauma exposure and FMD were particularly pronounced for three or more trauma exposures (b [SE] -1.90 [0.71], P = 0.008, relative to no exposures, multivariable). A greater number of traumatic exposures were associated with poorer endothelial function. Relations were not explained by demographics, CVD risk factors, mood/anxiety, or a by history of childhood abuse. Women with greater exposure to trauma over life maybe at elevated CVD risk.
NASA Technical Reports Server (NTRS)
Duffy, M. T.; Berkman, S.; Moss, H. S.; Cullen, G. W.
1978-01-01
The results of emission spectroscopic analysis indicate that molten silicon can remain in contact with hot-pressed Si3N4 (99.2 percent theoretical density) for prolonged periods without attaining the impurity content level of the nitride. Although MgO was used as binder, Mg was not found present in the silicon sessile drop in quantities much above the level initially present in the silicon source material. Preliminary experiments with EFG-type dies coated with CVD Si3N4 or CVD SiOxNy indicate that capillary rise does not occur readily in these dies. The same was found to be true of hot-pressed and reaction-sintered Si3N4 obtained commercially. However, when dies were formed by depositing CVD layers on shaped silicon slabs, a column of molten silicon was maintained in each CVD die while being heated in contact with a crucible of molten silicon. Preliminary wetting of dies appears necessary for EFG growth. Several ribbon growth experiments were performed from V-shaped dies.
Mixed Convection Flow in Horizontal CVD Reactors
NASA Astrophysics Data System (ADS)
Chiu, Wilson K. S.; Richards, Cristy J.; Jaluria, Yogesh
1998-11-01
Increasing demands for high quality films and production rates are challenging current Chemical Vapor Deposition (CVD) technology. Since film quality and deposition rates are strongly dependent on gas flow and heat transfer (W.K.S. Chiu and Y. Jaluria, ASME HTD-Vol. 347, pp. 293-311, 1997.), process improvement is obtained through the study of mixed convection flow and temperature distribution in a CVD reactor. Experimental results are presented for a CVD chamber with a horizontal or inclined resistance heated susceptor. Vaporized glycol solution illuminated by a light sheet is used for flow visualization. Temperature measurements are obtained by inserting thermocouple probes into the gas stream or embedding probes into the reactor walls. Flow visualization and temperature measurements show predominantly two dimensional flow and temperature distributions along the streamwise direction under forced convection conditions. Natural convection dominates under large heating rates and low flow rates. Over the range of parameters studied, several distinct flow regimes, characterized by instability, separation, and turbulence, are evident. Different flow regimes alter the flow pattern and temperature distribution, and in consequence, significantly modify deposition rates and uniformity.
NASA Astrophysics Data System (ADS)
Liu, Chaojun; Liang, Xiaoyi; Liu, Xiaojun; Wang, Qin; Zhan, Liang; Zhang, Rui; Qiao, Wenming; Ling, Licheng
2008-08-01
Surface chemistry of pitch-based spherical activated carbon (PSAC) was modified by chemical vapor deposition of NH 3 (NH 3-CVD) to improve the adsorption properties of uric acid. The texture and surface chemistry of PSAC were studied by N 2 adsorption, pH PZC (point of zero charge), acid-base titration and X-ray photoelectron spectroscopy (XPS). NH 3-CVD has a limited effect on carbon textural characteristics but it significantly changed the surface chemical properties, resulting in positive effects on uric acid adsorption. After modification by NH 3-CVD, large numbers of nitrogen-containing groups (especially valley-N and center-N) are introduced on the surface of PSAC, which is responsible for the increase of pH PZC, surface basicity and uric acid adsorption capacity. Pseudo-second-order kinetic model can be used to describe the dynamic adsorption of uric acid on PSAC, and the thermodynamic parameters show that the adsorption of uric acid on PSAC is spontaneous, endothermic and irreversible process in nature.
Spray CVD for Making Solar-Cell Absorber Layers
NASA Technical Reports Server (NTRS)
Banger, Kulbinder K.; Harris, Jerry; Jin, Michael H.; Hepp, Aloysius
2007-01-01
Spray chemical vapor deposition (spray CVD) processes of a special type have been investigated for use in making CuInS2 absorber layers of thin-film solar photovoltaic cells from either of two subclasses of precursor compounds: [(PBu3) 2Cu(SEt)2In(SEt)2] or [(PPh3)2Cu(SEt)2 In(SEt)2]. The CuInS2 films produced in the experiments have been characterized by x-ray diffraction, scanning electron microscopy, energy-dispersive spectroscopy, and four-point-probe electrical tests.
Ultratough CVD single crystal diamond and three dimensional growth thereof
Hemley, Russell J [Washington, DC; Mao, Ho-kwang [Washington, DC; Yan, Chih-shiue [Washington, DC
2009-09-29
The invention relates to a single-crystal diamond grown by microwave plasma chemical vapor deposition that has a toughness of at least about 30 MPa m.sup.1/2. The invention also relates to a method of producing a single-crystal diamond with a toughness of at least about 30 MPa m.sup.1/2. The invention further relates to a process for producing a single crystal CVD diamond in three dimensions on a single crystal diamond substrate.
Vascular Ageing and Exercise: Focus on Cellular Reparative Processes.
Ross, Mark D; Malone, Eva; Florida-James, Geraint
2016-01-01
Ageing is associated with an increased risk of developing noncommunicable diseases (NCDs), such as diabetes and cardiovascular disease (CVD). The increased risk can be attributable to increased prolonged exposure to oxidative stress. Often, CVD is preceded by endothelial dysfunction, which carries with it a proatherothrombotic phenotype. Endothelial senescence and reduced production and release of nitric oxide (NO) are associated with "vascular ageing" and are often accompanied by a reduced ability for the body to repair vascular damage, termed "reendothelialization." Exercise has been repeatedly shown to confer protection against CVD and diabetes risk and incidence. Regular exercise promotes endothelial function and can prevent endothelial senescence, often through a reduction in oxidative stress. Recently, endothelial precursors, endothelial progenitor cells (EPC), have been shown to repair damaged endothelium, and reduced circulating number and/or function of these cells is associated with ageing. Exercise can modulate both number and function of these cells to promote endothelial homeostasis. In this review we look at the effects of advancing age on the endothelium and these endothelial precursors and how exercise appears to offset this "vascular ageing" process.
MOCVD of aluminium oxide films using aluminium β-diketonates as precursors
NASA Astrophysics Data System (ADS)
Devi, A.; Shivashankar, S. A.; Samuelson, A. G.
2002-06-01
Deposition of Al203 coatings by CVD is of importance because they are often used as abrading material in cemented carbide cutting tools. The conventionally used CVD process for Al203 involves the corrosive reactant AICl3. In this paper, we report on the thermal characterisation of the metalorganic precursors namely aluminium tris-tetramethyl-heptanedionate [ Al(thd)3] and aluminium tris-acetylacetonate [ Al(acac)3] and their application to the CVD of Al203 films. Crystalline A1203 films were deposited by MOCVD at low temperatures by the pyrolysis of Al(thd)3 and AI(acac)3. The films were deposited on a TiN-coated tungsten carbide (TiN/WC) and Si(100) substrates in the temperature range 500-1100 °C. The as-deposited films were characterised by x-ray diffraction, optical microscopy, scanning and transmission electron microscopy, Auger electron spectroscopy. The observed crystallinity of films grown at low temperatures, their microstructure, and composition may be interpreted in terms of a growth process that involves the melting of the metalorganic precursor on the hot growth surface.
Alternate electrode materials for the SP100 reactor
NASA Astrophysics Data System (ADS)
Randich, E.
1992-05-01
This work was performed in response to a request by the Astro-Space Division of the General Electric Co. to develop alternate electrodes materials for the electrodes of the PD2 modules to be used in the SP100 thermoelectric power conversion system. Initially, the project consisted of four tasks: (1) development of a ZrB2 (C) CVD coating on SiMo substrates; (2) development of a ZrB2 (C) CVD coating on SiGe substrates; (3) development of CVI W for porous graphite electrodes; and (4) technology transfer of pertinent developed processes. The project evolved initially into developing only ZrB2 coatings on SiGe and graphite substrates, and later into developing ZrB2 coatings only on graphite substrates. Several sizes of graphite and pyrolytic carbon-coated graphite substrates were coated with ZrB2 during the project. For budgetary reasons, the project was terminated after half the allotted time had passed. Apart from the production of coated specimens for evaluation, the major accomplishment of the project was the development of the CVD processing to produce the desired coatings.
LARGE—A Plasma Torch for Surface Chemistry Applications and CVD Processes—A Status Report
NASA Astrophysics Data System (ADS)
Zimmermann, Stephan; Theophile, Eckart; Landes, Klaus; Schein, Jochen
2008-12-01
The LARGE ( LONG ARG GENERATOR) is a new generation DC-plasma torch featuring an extended arc which is operated with a perpendicular gas flow to create a wide (up to 45 cm) plasma jet well suited for large area plasma processing. Using plasma diagnostic systems like high speed imaging, enthalpy probe, emission spectroscopy, and tomography, the LARGE produced plasma jet characteristics have been measured and sources of instability have been identified. With a simple model/simulation of the system LARGE III-150 and numerous experimental results, a new nozzle configuration and geometry (LARGE IV-150) has been designed, which produces a more homogenous plasma jet. These improvements enable the standard applications of the LARGE plasma torch (CVD coating process and surface activation process) to operate with higher efficiency.
Cardiovascular Disease Prevalence and Risk Factors of Persons with Mental Retardation
ERIC Educational Resources Information Center
Draheim, Christopher C.
2006-01-01
This paper reviews the recent literature on cardiovascular disease (CVD) prevalence, CVD-related mortality, physiological CVD risk factors, and behavioral CVD risk factors in adults with mental retardation (MR). The literature on the potential influences of modifiable behavioral CVD risk factors and the physiological CVD risk factors are also…
Circulating cell-derived microparticles as biomarkers in cardiovascular disease.
Thulin, Åsa; Christersson, Christina; Alfredsson, Jenny; Siegbahn, Agneta
2016-09-01
Cardiovascular diseases (CVDs) are a common cause of death, and a search for biomarkers for risk stratification is warranted. Elevated levels of cell-derived microparticles (MPs) are found in patients with CVD and in groups with risk factors for CVD. Subpopulations of MPs are promising biomarkers for improving risk prediction, as well as monitoring treatment. However, the field has been hampered by technical difficulties, and the ongoing development of sensitive standardized techniques is crucial for implementing MP analyses in the clinic. Large prospective studies are required to establish which MPs are of prognostic value in different patient groups. In this review, we discuss methodological challenges and progress in the field, as well as MP populations that are of interest for further clinical evaluation.
Vasomotor symptoms and cardiovascular events in postmenopausal women
Szmuilowicz, Emily D.; Manson, JoAnn E.; Rossouw, Jacques E.; Howard, Barbara V.; Margolis, Karen L.; Greep, Nancy C.; Brzyski, Robert G.; Stefanick, Marcia L.; O'Sullivan, Mary Jo; Wu, Chunyuan; Allison, Matthew; Grobbee, Diederick E.; Johnson, Karen C.; Ockene, Judith K.; Rodriguez, Beatriz L.; Sarto, Gloria E.; Vitolins, Mara Z.; Seely, Ellen W.
2010-01-01
Objective Emerging evidence suggests that women with menopausal vasomotor symptoms (VMS) have increased cardiovascular disease (CVD) risk as measured by surrogate markers. We investigated the relationships between VMS and clinical CVD events and all-cause mortality in the Women's Health Initiative Observational Study (WHI-OS). Methods We compared the risk of incident CVD events and all-cause mortality between four groups of women (total N=60,027): (1) No VMS at menopause onset and no VMS at WHI-OS enrollment (no VMS [referent group]); (2) VMS at menopause onset, but not at WHI-OS enrollment (early VMS); (3) VMS at both menopause onset and WHI-OS enrollment (persistent VMS [early and late]); and (4) VMS at WHI-OS enrollment, but not at menopause onset (late VMS). Results For women with early VMS (N=24,753), compared to no VMS (N=18,799), hazard ratios (HRs) and 95% confidence intervals (CIs) in fully-adjusted models were: major CHD, 0.94 (0.84, 1.06); stroke, 0.83 (0.72, 0.96); total CVD, 0.89 (0.81, 0.97); and all-cause mortality, 0.92 (0.85, 0.99). For women with persistent VMS (N=15,084), there was no significant association with clinical events. For women with late VMS (N=1,391) compared to no VMS, HRs and 95% CIs were: major CHD, 1.32 (1.01, 1.71); stroke, 1.14 (0.82, 1.59); total CVD, 1.23 (1.00, 1.52); and all-cause mortality, 1.29 (1.08, 1.54). Conclusions Early VMS were not associated with increased CVD risk. Rather, early VMS were associated with decreased risk of stroke, total CVD events, and all-cause mortality. Late VMS were associated with increased CHD risk and all-cause mortality. The predictive value of VMS for clinical CVD events may vary with onset of VMS at different stages of menopause. Further research examining the mechanisms underlying these associations is needed. Future studies will also be necessary to investigate whether VMS that develop for the first time in the later postmenopausal years represent a pathophysiologic process distinct from classical perimenopausal VMS. PMID:21358352
Silicon carbide, a semiconductor for space power electronics
NASA Technical Reports Server (NTRS)
Powell, J. Anthony; Matus, Lawrence G.
1991-01-01
After many years of promise as a high temperature semiconductor, silicon carbide (SiC) is finally emerging as a useful electronic material. Recent significant progress that has led to this emergence has been in the areas of crystal growth and device fabrication technology. High quality single-crystal SiC wafers, up to 25 mm in diameter, can now be produced routinely from boules grown by a high temperature (2700 K) sublimation process. Device fabrication processes, including chemical vapor deposition (CVD), in situ doping during CVD, reactive ion etching, oxidation, metallization, etc. have been used to fabricate p-n junction diodes and MOSFETs. The diode was operated to 870 K and the MOSFET to 770 K.
Effects of etchants in the transfer of chemical vapor deposited graphene
NASA Astrophysics Data System (ADS)
Wang, M.; Yang, E. H.; Vajtai, R.; Kono, J.; Ajayan, P. M.
2018-05-01
The quality of graphene can be strongly modified during the transfer process following chemical vapor deposition (CVD) growth. Here, we transferred CVD-grown graphene from a copper foil to a SiO2/Si substrate using wet etching with four different etchants: HNO3, FeCl3, (NH4)2S2O8, and a commercial copper etchant. We then compared the quality of graphene after the transfer process in terms of surface modifications, pollutions (residues and contaminations), and electrical properties (mobility and density). Our tests and analyses showed that the commercial copper etchant provides the best structural integrity, the least amount of residues, and the smallest doping carrier concentration.
75 FR 74773 - Mandatory Reporting of Greenhouse Gases: Additional Sources of Fluorinated GHGs
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-01
..., Methods for Estimating Air Emissions from Chemical Manufacturing Facilities; Protocol for Equipment Leak... chemical vapor deposition process (CVD) or other manufacturing processes use N 2 O. Production processes.... N 2 O emissions from chemical vapor deposition and other electronics manufacturing processes...
Oliver, C. Ryan; Westrick, William; Koehler, Jeremy; Brieland-Shoultz, Anna; Anagnostopoulos-Politis, Ilias; Cruz-Gonzalez, Tizoc; Hart, A. John
2013-01-01
Laboratory research and development on new materials, such as nanostructured thin films, often utilizes manual equipment such as tube furnaces due to its relatively low cost and ease of setup. However, these systems can be prone to inconsistent outcomes due to variations in standard operating procedures and limitations in performance such as heating and cooling rates restrict the parameter space that can be explored. Perhaps more importantly, maximization of research throughput and the successful and efficient translation of materials processing knowledge to production-scale systems, relies on the attainment of consistent outcomes. In response to this need, we present a semi-automated lab-scale chemical vapor deposition (CVD) furnace system, called “Robofurnace.” Robofurnace is an automated CVD system built around a standard tube furnace, which automates sample insertion and removal and uses motion of the furnace to achieve rapid heating and cooling. The system has a 10-sample magazine and motorized transfer arm, which isolates the samples from the lab atmosphere and enables highly repeatable placement of the sample within the tube. The system is designed to enable continuous operation of the CVD reactor, with asynchronous loading/unloading of samples. To demonstrate its performance, Robofurnace is used to develop a rapid CVD recipe for carbon nanotube (CNT) forest growth, achieving a 10-fold improvement in CNT forest mass density compared to a benchmark recipe using a manual tube furnace. In the long run, multiple systems like Robofurnace may be linked to share data among laboratories by methods such as Twitter. Our hope is Robofurnace and like automation will enable machine learning to optimize and discover relationships in complex material synthesis processes. PMID:24289435
Kozan, Ömer; Zoghi, Mehdi; Ergene, Oktay; Arıcı, Mustafa; Derici, Ülver; Bakaç, Göksel; Güllü, Sevim; Sain Güven, Gülay
2013-06-01
Cardiovascular disease (CVD) is the leading cause of death throughout the world. Despite its high prevalence, the atherosclerotic process can be slowed and its consequences markedly reduced by preventive measures. The lack of risk factor awareness is a major barrier. We aimed to assess total CV risk, determine the knowledge and awareness regarding CVD, and evaluate the effectiveness of education program in urban population of Turkey. A 24-item questionnaire was used to detect CV risk factors and the awareness of participants about CVD. The feedback data for the education program were collected by either questionnaires or individual interviews with participants. For comparison of total CVD risk in men and women in different age groups, a sample t test was used. The level of statistical significance was set at p < 0.05. The prevalence of hyperlipidemia was established to be 41.3%. Nearly one-quarter of the women and one-third of the men were smokers (p < 0.001). One-quarter of the responders had a history of hypertension (men: 21.5%, women: 18.6%), and one-tenth were diabetic. The high CV risk rate was more pronounced among men (p < 0.01) and those with low socioeconomic level (p < 0.01). Awareness regarding CV risk factors following the educational program increased from 6.6% to 12.7% for high blood pressure, from 3.9% to 9.2% for diabetes mellitus, and from 10.2% to 15.1% for elevated cholesterol levels. All the increases were statistically significant. The educational program significantly increased the awareness of CVD and risk factors. The prevalence of CV risk factors was higher in low socioeconomic level groups. The knowledge and awareness of the risk factors for CVD before the education program was very low in our study group. The awareness of CVD and risk factors significantly increased following our education programs. Copyright © 2013 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.
NASA Astrophysics Data System (ADS)
Vinten, Phillip
This thesis analyzes the chemical vapour deposition (CVD) growth of vertically aligned carbon nanotube (CNT) forests in order to understand how CNT forests grow, why they stop growing, and how to control the properties of the synthesized CNTs. in situ kinetics data of the growth of CNT forests are gathered by in situ optical microscopy. The overall morphology of the forests and the characteristics of the individual CNTs in the forests are investigated using scanning electron microscopy and Raman spectroscopy. The in situ data show that forest growth and termination are activated processes (with activation energies on the order of 1 eV), suggesting a possible chemical origin. The activation energy changes at a critical temperature for ethanol CVD (approximately 870°C). These activation energies and critical temperature are also seen in the temperature dependence of several important characteristics of the CNTs, including the defect density as determined by Raman spectroscopy. This observation is seen across several CVD processes and suggests a mechanism of defect healing. The CNT diameter also depends on the growth temperature. In this thesis, a thermodynamic model is proposed. This model predicts a temperature and pressure dependence of the CNT diameter from the thermodynamics of the synthesis reaction and the effect of strain on the enthalpy of formation of CNTs. The forest morphology suggests significant interaction between the constituent CNTs. These interactions may play a role in termination. The morphology, in particular a microscale rippling feature that is capable of diffracting light, suggest a non-uniform growth rate across the forest. A gas phase diffusion model predicts a non-uniform distribution of the source gas. This gas phase diffusion is suggested as a possible explanation for the non-uniform growth rate. The gas phase diffusion is important because growth by acetylene CVD is found to be very efficient (approximately 30% of the acetylene is converted to CNTs). It is seen that multiple mechanisms are active during CNT growth. The results of this thesis provide insight into both the basic understanding of the microscopic processes involved in CVD growth and how to control the properties of the synthesized CNTs.
Lee, Juyeon; Bahk, Jinwook; Kim, Ikhan; Kim, Yeon-Yong; Yun, Sung-Cheol; Kang, Hee-Yeon; Lee, Jeehye; Park, Jong Heon; Shin, Soon-Ae; Khang, Young-Ho
2018-03-01
Little is known about within-country variation in morbidity and mortality of cerebrovascular diseases (CVDs). Geographic differences in CVD morbidity and mortality have yet to be properly examined. This study examined geographic variation in morbidity and mortality of CVD, neighborhood factors for CVD morbidity and mortality, and the association between CVD morbidity and mortality across the 245 local districts in Korea during 2011-2015. District-level health care utilization and mortality data were obtained to estimate age-standardized CVD morbidity and mortality. The bivariate Pearson correlation was used to examine the linear relationship between district-level CVD morbidity and mortality Z-scores. Simple linear regression and multivariate analyses were conducted to investigate the associations of area characteristics with CVD morbidity, mortality, and discrepancies between morbidity and mortality. Substantial variation was found in CVD morbidity and mortality across the country, with 1074.9 excess CVD inpatients and 73.8 excess CVD deaths per 100,000 between the districts with the lowest and highest CVD morbidity and mortality, respectively. Higher rates of CVD admissions and deaths were clustered in the noncapital regions. A moderate geographic correlation between CVD morbidity and mortality was found (Pearson correlation coefficient = .62 for both genders). Neighborhood level indicators for socioeconomic disadvantages, undersupply of health care resources, and unhealthy behaviors were positively associated with CVD morbidity and mortality and the relative standing of CVD mortality vis-à-vis morbidity. Policy actions targeting life-course socioeconomic conditions, equitable distribution of health care resources, and behavioral risk factors may help reduce geographic differences in CVD morbidity and mortality in Korea. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Romero, Daniela C; Sauris, Aileen; Rodriguez, Fátima; Delgado, Daniela; Reddy, Ankita; Foody, JoAnne M
2016-03-01
Hispanic women suffer from high rates of cardiometabolic risk factors and an increasingly disproportionate burden of cardiovascular disease (CVD). Particularly, Hispanic women with limited English proficiency suffer from low levels of CVD knowledge associated with adverse CVD health outcomes. Thirty-two predominantly Spanish-speaking Hispanic women completed, Vivir Con un Corazón Saludable (VCUCS), a culturally tailored Spanish language-based 6-week intensive community program targeting CVD health knowledge through weekly interactive health sessions. A 30-question CVD knowledge questionnaire was used to assess mean changes in CVD knowledge at baseline and postintervention across five major knowledge domains including CVD epidemiology, dietary knowledge, medical information, risk factors, and heart attack symptoms. Completion of the program was associated with a statistically significant (p < 0.001) increase in total mean CVD knowledge scores from 39 % (mean 11.7/30.0) to 66 % (mean 19.8/30.0) postintervention consistent with a 68 % increase in overall mean CVD scores. There was a statistically significant (p < 0.001) increase in mean knowledge scores across all five CVD domains. A culturally tailored Spanish language-based health program is effective in increasing CVD awareness among high CVD risk Hispanic women with low English proficiency and low baseline CVD knowledge.
Sims, Regina; Madhere, Serge; Callender, Clive; Campbell, Alfonso
2013-01-01
Objective The association between cardiovascular disease (CVD) risk and neurocognitive function has gathered a good deal of attention in the health and social science literature; however, the relationship among several CVD risk factors and neurocognitive function has not been fully explored in an African American sample. The purpose of this study was to examine the pattern of relationships among four CVD risk factors and five measures of higher cortical functions. Methods Data were collected from a sample of 106 African American community-dwelling adults in the metropolitan Washington, DC, area. A nurse collected blood pressure, waist circumference, and a blood sample (to assess triglycerides and high-density lipoprotein (HDL) cholesterol) from study participants. Participants completed the Symbol Digit Modalities Test, Trailmaking B, Stroop Colorword Task, California Verbal Learning Test-II, and Wisconsin Card Sorting Test as assessments of neurocognitive function. Canonical analysis and multiple regression analysis were the major statistical methods utilized to assess relationships between CVD risk factors and neurocognitive function. Results The results suggest that 1) attentional processes are associated with diastolic blood pressure levels, 2) verbal learning processes are associated with diastolic blood pressure and triglyceride levels, and 3) the ability to shift cognitive set is associated with HDL cholesterol levels. Conclusion As cardiovascular health worsens in our society, particularly among ethnic minorities, the neurocognitive consequences must be clearly understood. Future studies should focus on identifying and building awareness of cardiovascular and neurocognitive links through longitudinal research designs and brain imaging technology. PMID:19157252
Cain, Jeffrey D; Shi, Fengyuan; Wu, Jinsong; Dravid, Vinayak P
2016-05-24
Due to their unique optoelectronic properties and potential for next generation devices, monolayer transition metal dichalcogenides (TMDs) have attracted a great deal of interest since the first observation of monolayer MoS2 a few years ago. While initially isolated in monolayer form by mechanical exfoliation, the field has evolved to more sophisticated methods capable of direct growth of large-area monolayer TMDs. Chemical vapor deposition (CVD) is the technique used most prominently throughout the literature and is based on the sulfurization of transition metal oxide precursors. CVD-grown monolayers exhibit excellent quality, and this process is widely used in studies ranging from the fundamental to the applied. However, little is known about the specifics of the nucleation and growth mechanisms occurring during the CVD process. In this study, we have investigated the nucleation centers or "seeds" from which monolayer TMDs typically grow. This was accomplished using aberration-corrected scanning transmission electron microscopy to analyze the structure and composition of the nuclei present in CVD-grown MoS2-MoSe2 alloys. We find that monolayer growth proceeds from nominally oxi-chalcogenide nanoparticles which act as heterogeneous nucleation sites for monolayer growth. The oxi-chalcogenide nanoparticles are typically encased in a fullerene-like shell made of the TMD. Using this information, we propose a step-by-step nucleation and growth mechanism for monolayer TMDs. Understanding this mechanism may pave the way for precise control over the synthesis of 2D materials, heterostructures, and related complexes.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tadanaga, Kiyoharu, E-mail: tadanaga@chem.osakafu-u.ac.jp; Yamaguchi, Akihiro; Sakuda, Atsushi
2014-05-01
Highlights: • LiMn{sub 2}O{sub 4} thin films were prepared by using the mist CVD process. • An aqueous solution of lithium and manganese acetates is used for the precursor solution. • The cell with the LiMn{sub 2}O{sub 4} thin films exhibited a capacity of about 80 mAh/g. • The cell showed good cycling performance during 10 cycles. - Abstract: LiMn{sub 2}O{sub 4} cathode thin films for thin film lithium secondary batteries were prepared by using so-called the “mist CVD process”, employing an aqueous solution of lithium acetate and manganese acetate, as the source of Li and Mn, respectively. The aqueousmore » solution of starting materials was ultrasonically atomized to form mist particles, and mists were transferred by nitrogen gas to silica glass substrate to form thin films. FE-SEM observation revealed that thin films obtained by this process were dense and smooth, and thin films with a thickness of about 750 nm were obtained. The electrochemical cell with the thin films obtained by sintering at 700 °C exhibited a capacity of about 80 mAh/g, and the cell showed good cycling performance during 10 cycles.« less
Growth of hybrid carbon nanostructures on iron-decorated ZnO nanorods
NASA Astrophysics Data System (ADS)
Mbuyisa, Puleng N.; Rigoni, Federica; Sangaletti, Luigi; Ponzoni, Stefano; Pagliara, Stefania; Goldoni, Andrea; Ndwandwe, Muzi; Cepek, Cinzia
2016-04-01
A novel carbon-based nanostructured material, which includes carbon nanotubes (CNTs), porous carbon, nanostructured ZnO and Fe nanoparticles, has been synthetized using catalytic chemical vapour deposition (CVD) of acetylene on vertically aligned ZnO nanorods (NRs). The deposition of Fe before the CVD process induces the presence of dense CNTs in addition to the variety of nanostructures already observed on the process done on the bare NRs, which range from amorphous graphitic carbon up to nanostructured dendritic carbon films, where the NRs are partially or completely etched. The combination of scanning electron microscopy and in situ photoemission spectroscopy indicate that Fe enhances the ZnO etching, and that the CNT synthesis is favoured by the reduced Fe mobility due to the strong interaction between Fe and the NRs, and to the presence of many defects, formed during the CVD process. Our results demonstrate that the resulting new hybrid shows a higher sensitivity to ammonia gas at ambient conditions (∼60 ppb) than the carbon nanostructures obtained without the aid of Fe, the bare ZnO NRs, or other one-dimensional carbon nanostructures, making this system of potential interest for environmental ammonia monitoring. Finally, in view of the possible application in nanoscale optoelectronics, the photoexcited carrier behaviour in these hybrid systems has been characterized by time-resolved reflectivity measurements.
NASA Astrophysics Data System (ADS)
Xu, Ziwei; Yan, Tianying; Liu, Guiwu; Qiao, Guanjun; Ding, Feng
2015-12-01
To explore the mechanism of graphene chemical vapor deposition (CVD) growth on a catalyst surface, a molecular dynamics (MD) simulation of carbon atom self-assembly on a Ni(111) surface based on a well-designed empirical reactive bond order potential was performed. We simulated single layer graphene with recorded size (up to 300 atoms per super-cell) and reasonably good quality by MD trajectories up to 15 ns. Detailed processes of graphene CVD growth, such as carbon atom dissolution and precipitation, formation of carbon chains of various lengths, polygons and small graphene domains were observed during the initial process of the MD simulation. The atomistic processes of typical defect healing, such as the transformation from a pentagon into a hexagon and from a pentagon-heptagon pair (5|7) to two adjacent hexagons (6|6), were revealed as well. The study also showed that higher temperature and longer annealing time are essential to form high quality graphene layers, which is in agreement with experimental reports and previous theoretical results.To explore the mechanism of graphene chemical vapor deposition (CVD) growth on a catalyst surface, a molecular dynamics (MD) simulation of carbon atom self-assembly on a Ni(111) surface based on a well-designed empirical reactive bond order potential was performed. We simulated single layer graphene with recorded size (up to 300 atoms per super-cell) and reasonably good quality by MD trajectories up to 15 ns. Detailed processes of graphene CVD growth, such as carbon atom dissolution and precipitation, formation of carbon chains of various lengths, polygons and small graphene domains were observed during the initial process of the MD simulation. The atomistic processes of typical defect healing, such as the transformation from a pentagon into a hexagon and from a pentagon-heptagon pair (5|7) to two adjacent hexagons (6|6), were revealed as well. The study also showed that higher temperature and longer annealing time are essential to form high quality graphene layers, which is in agreement with experimental reports and previous theoretical results. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr06016h
NASA Astrophysics Data System (ADS)
Smolin, Yuriy Y.
Dye sensitized solar cells (DSSCs) and carbon-based supercapacitors are promising energy conversion and storage systems, respectively, because they can be made inexpensively, have good performance, and can be integrated into portable and flexible electronics. Both systems utilize nanostructured porous electrodes, leading to fewer diffusion limitations and higher active surface areas for interfacial processes compared to planar electrodes. A major drawback of the DSSC design is the use of a liquid electrolyte, since it is prone to leakage and evaporation--hindering DSSC applications, durability, and thermal stability. A polymer electrolyte (PE) can overcome these shortcomings; however, the integration of a PE within the mesoporous TiO2 photoanode of DSSCs with pore openings of 10-20 nm and photoanode thicknesses of 10 microm is very challenging. Solution-based deposition methods such as spin coating and drop casting to deposit PEs has led to incomplete pore filling inside the mesoporous photoanode, resulting in lower than optimal efficiencies. To overcome these challenges, a solvent-free method called initiated chemical vapor deposition (iCVD) was adopted to deposit PEs within the porous TiO2 electrode. In iCVD, the monomer and initiator are vapors which easily penetrate into the porous electrode. By carefully controlling the iCVD processing parameters, complete pore filling of PEs into the TiO2 photoanode was achieved, leading to 50% improvement in conversion efficiency. Polymers with ether, ester, pyridine, pyrrolidone, imidazole and epoxy functionality were synthesized and integrated. The findings indicated that DSSC characteristics, including open circuit voltage, short circuit current density and fill factor, can be tuned by polymer chemistry. A promising approach to improve the energy density of supercapacitor electrodes is to integrate inexpensive conducting polymers (CPs), such as polyaniline (PANI). Unfortunately, most CPs are insoluble, and integrating CPs into tortuous electrode pores with aspect ratios of >10,000 while preserving the intrinsic pore structures, to retain the double layer capacitance, is very challenging. Therefore, similarly to the iCVD process, oxidative CVD (oCVD) was chosen to bypass the limited solubility of CPs to deposit thin conformal CP films onto porous electrodes. By controlling the oCVD deposition parameters, PANI films on the order of a few nm were integrated into carbide-derived-carbon (CDC) electrodes, leading to a doubling of the capacitance. This yielded a PANI-only capacitance of 690 F/g, close to the theoretical value of 750 F/g. This work also combined experiments with first-principles modeling to develop a model-guided design and optimization framework, allowing for optimal device design and the intelligent selection of polymer chemistries with minimal experimental investigations. For example, to determine the effects of PE chemistry on DSSC processes, parameter estimation and parametric sensitivity studies were conducted which indicated that a shift in the conduction band of TiO2 and a suppression of the back electron transfer at the dye-TiO2-PE interface was induced by the side group PE chemistry. Furthermore, optimal design specifications for a PE DSSC were calculated using the model, and optimally performing DSSCs were subsequently fabricated and tested, validating the model.
A Computational Chemistry Database for Semiconductor Processing
NASA Technical Reports Server (NTRS)
Jaffe, R.; Meyyappan, M.; Arnold, J. O. (Technical Monitor)
1998-01-01
The concept of 'virtual reactor' or 'virtual prototyping' has received much attention recently in the semiconductor industry. Commercial codes to simulate thermal CVD and plasma processes have become available to aid in equipment and process design efforts, The virtual prototyping effort would go nowhere if codes do not come with a reliable database of chemical and physical properties of gases involved in semiconductor processing. Commercial code vendors have no capabilities to generate such a database, rather leave the task to the user of finding whatever is needed. While individual investigations of interesting chemical systems continue at Universities, there has not been any large scale effort to create a database. In this presentation, we outline our efforts in this area. Our effort focuses on the following five areas: 1. Thermal CVD reaction mechanism and rate constants. 2. Thermochemical properties. 3. Transport properties.4. Electron-molecule collision cross sections. and 5. Gas-surface interactions.
Ramey, Sandra L
2003-05-01
The relationship among cardiovascular disease (CVD) morbidity, risk factors (including stress), and the perception of health among male law enforcement officers (LEOs) compared to men in the general population were examined in this study. Self reported prevalence of CVD and CVD risk factors among currently employed male LEOs from nine states (n = 2,818) were compared to those of other men in the same states (n = 9,650 for CVD risk factors, n = 3,147 for CVD prevalence). Perceived stress in LEOs was assessed to determine if it affected the relationship between CVD prevalence and CVD risk factors. Cross tabulated simple percentages showed CVD was less prevalent in the LEO group than among the general population. The best predictor variables for CVD were perceived stress, time in the profession, and hypertension. The LEO group had greater prevalence of hypercholesterolemia, overweight, and tobacco use than the general population. However, a greater percentage of LEOs perceived their health as "good to excellent" compared to men in the general population. Using multivariate analysis of variance (MANOVA) it was determined that perceived stress was associated with CVD in the LEO group and three CVD risk factors (i.e., cholesterol, hypertension, physical activity) were significantly affected by perceived stress. Among susceptible officers, stress may contribute to CVD development as well as potentiate several CVD risk factors. However, an apparent lack of association exists between perception of general health and CVD risk in LEOs.
Kapwata, Thandi; Manda, Samuel
2018-03-22
Noncommunicable diseases (NCDs) including cardiovascular diseases (CVDs), diabetes, cancer and chronic lung disease are increasingly emerging as major contributors to morbidity and mortality in developing countries. For example, in South Africa, 195 people died per day between 1997 and 2004 from CVDs related causes. Access to efficient and effective health facility and care is an important contributing factor to overall population health and addressing prognosis, care and management CVD disease burden. This study aimed to spatially evaluate geographic health care access of people diagnosed with CVD to health facilities and to evaluate the density of the existing health facility network in South Africa. Data was obtained from the National Income Dynamics Study (NIDS) conducted in 4 waves (phases) between 2008 and 2014. The participants who responded as having heart problems that were diagnosed by a health practitioner were extracted for use in this study. Network analyst in ArcGIS ® was used to generate a least-cost path, which refers to the best path that one can travel. The residential locations of participants diagnosed with heart problems were put into the network analysis model as origins and the location of health facilities were destinations. District averages were used to protect the identity of studied participants. There were a total of 51, 42, 43, 43 health districts out the 52 that had recorded subjects with a heart condition in the 2008, 2010-2011, 2012 and 2014-2015 waves, respectively. The mean distance from a case household to a health facility per wave was 2, 2.3, 2.1 and 2.1 km in 2008, 2010-2011 and 2014-2015 respectively. The maximum individual distances travelled per wave were 41.4 km, 40,5 km, 44,2 km and 39.6 km for the 2008, 2010-2011, 2012 and 2014-2015 waves respectively. For district level analysis, participants with CVD residing in the districts found to be among the poorest in the country travelled the longest distances. These were located in the provinces of Limpopo and KwaZulu Natal. It was also found that districts with large proportions of their population living in rural settings had among the lowest densities of health facilities. Significant percentages of study participants were exposed to numerous CVD risk factors, the commonly reported one being high blood pressure. A lack of regular exercise was also commonly reported in each of the waves. A lack of accessible healthcare in already impoverished municipalities could result in an increase lack of timely diagnosis, CVD case management. This could result in increased CVD-related morbidity and mortality. GIS methods have the potential to assist national health programs to develop policies that target issues such as areas or populations being underserved by health facilities and populations that must travel long distances to receive healthcare. These policies will be key in preventing and controlling the emerging CVD burden through an accessible primary healthcare system for early detection and case management.
Computational Modeling in Structural Materials Processing
NASA Technical Reports Server (NTRS)
Meyyappan, Meyya; Arnold, James O. (Technical Monitor)
1997-01-01
High temperature materials such as silicon carbide, a variety of nitrides, and ceramic matrix composites find use in aerospace, automotive, machine tool industries and in high speed civil transport applications. Chemical vapor deposition (CVD) is widely used in processing such structural materials. Variations of CVD include deposition on substrates, coating of fibers, inside cavities and on complex objects, and infiltration within preforms called chemical vapor infiltration (CVI). Our current knowledge of the process mechanisms, ability to optimize processes, and scale-up for large scale manufacturing is limited. In this regard, computational modeling of the processes is valuable since a validated model can be used as a design tool. The effort is similar to traditional chemically reacting flow modeling with emphasis on multicomponent diffusion, thermal diffusion, large sets of homogeneous reactions, and surface chemistry. In the case of CVI, models for pore infiltration are needed. In the present talk, examples of SiC nitride, and Boron deposition from the author's past work will be used to illustrate the utility of computational process modeling.
Evidence of Dietary Improvement and Preventable Costs of Cardiovascular Disease.
Zhang, Donglan; Cogswell, Mary E; Wang, Guijing; Bowman, Barbara A
2017-11-01
We conducted a review to summarize preventable medical costs of cardiovascular disease (CVD) associated with improved diet, as defined by the 2020 Strategic Impact Goal of the American Heart Association. We searched databases of PubMed, Embase, CINAHL and ABI/INFORM to identify population-based studies published from January 1995 to December 2015 on CVD medical costs related to excess intake of salt/sodium or sugar-sweetened beverages, and inadequate intake of fruits and vegetables, fish/fish oils/omega-3 fatty acids, or whole grains/fiber/dietary fiber. Based on the American Heart Association's secondary dietary metrics, we also searched the literature on inadequate intake of nuts and excess intake of processed meat and saturated fat. For each component, we evaluated the CVD cost savings if consumption levels were changed. The cost savings were adjusted into 2013 US dollars. Among 330 studies focusing on diet and economic consequences, 16 studies evaluated CVD costs associated with 1 or more dietary components: salt/sodium (n = 13), fruits and vegetables (n = 1), meat (n = 1), and saturated fat (n = 3). In the United States, reducing individual sodium intake to 2,300 mg/day from the current level could potentially save $1,990.9/person per year for hypertension treatment, based on a simulation study. Increasing consumption of fruits and vegetables from <0.5 cup/day to >1.5 cups/day could save $1,568.0/person per year in treatment costs for CVD, based on a cohort study. Potential CVD cost savings associated with diet improvement are substantial. Interventions for reducing sodium intake and increasing fruit and vegetable consumption could be viable means to alleviate the increasing national medical expenditures. Published by Elsevier Inc.
Smith, Ann; Patterson, Chris; Yarnell, John; Rumley, Ann; Ben-Shlomo, Yoav; Lowe, Gordon
2005-11-15
Few studies have examined whether hemostatic markers contribute to risk of coronary disease and ischemic stroke independently of conventional risk factors. This study examines 11 hemostatic markers that reflect different aspects of the coagulation process to determine which have prognostic value after accounting for conventional risk factors. A total of 2398 men aged 49 to 65 years were examined in 1984 to 1988, and the majority gave a fasting blood sample for assay of lipids and hemostatic markers. Men were followed up for a median of 13 years, and cardiovascular disease (CVD) events were recorded. There were 486 CVD events in total, 353 with prospective coronary disease and 133 with prospective ischemic stroke. On univariable analysis, fibrinogen, low activated protein C ratio, D-dimer, tissue plasminogen activator (tPA), and plasminogen activator inhibitor-1 (PAI-1) were associated significantly with risk of CVD. On multivariable analyses with conventional risk factors forced into the proportional hazards model, fibrinogen, D-dimer, and PAI-1 were significantly associated with risk of CVD, whereas factor VIIc showed an inverse association (P=0.001). In a model that contained the conventional risk factors, the hazard ratio for subsequent CVD in the top third of the distribution of predicted risk relative to the bottom third was 2.7 for subjects without preexisting CVD. This ratio increased to 3.7 for the model that also contained the 4 hemostatic factors. Fibrinogen, D-dimer, PAI-1 activity, and factor VIIc each has potential to increase the prediction of coronary disease/ischemic stroke in middle-aged men, in addition to conventional risk factors.
The obesity paradox and incident cardiovascular disease: A population-based study.
Chang, Virginia W; Langa, Kenneth M; Weir, David; Iwashyna, Theodore J
2017-01-01
Prior work suggests that obesity may confer a survival advantage among persons with cardiovascular disease (CVD). This obesity "paradox" is frequently studied in the context of prevalent disease, a stage in the disease process when confounding from illness-related weight loss and selective survival are especially problematic. Our objective was to examine the association of obesity with mortality among persons with incident CVD, where biases are potentially reduced, and to compare these findings with those based on prevalent disease. We used data from the Health and Retirement Study, an ongoing, nationally representative longitudinal survey of U.S. adults age 50 years and older initiated in 1992 and linked to Medicare claims. Cox proportional hazard models were used to estimate the association between weight status and mortality among persons with specific CVD diagnoses. CVD diagnoses were established by self-reported survey data as well as Medicare claims. Prevalent disease models used concurrent weight status, and incident disease models used pre-diagnosis weight status. We examined myocardial infarction, congestive heart failure, stroke, and ischemic heart disease. A strong and significant obesity paradox was consistently observed in prevalent disease models (hazard of death 18-36% lower for obese class I relative to normal weight), replicating prior findings. However, in incident disease models of the same conditions in the same dataset, there was no evidence of this survival benefit. Findings from models using survey- vs. claims-based diagnoses were largely consistent. We observed an obesity paradox in prevalent CVD, replicating prior findings in a population-based sample with longer-term follow-up. In incident CVD, however, we did not find evidence of a survival advantage for obesity. Our findings do not offer support for reevaluating clinical and public health guidelines in pursuit of a potential obesity paradox.
Cortés-Puch, I; Wiley, B M; Sun, J; Klein, H G; Welsh, J; Danner, R L; Eichacker, P Q; Natanson, C
2018-04-19
To evaluate the risks of restrictive red blood cell transfusion strategies (haemoglobin 7-8 g dL -1 ) in patients with and without known cardiovascular disease (CVD). Recent guidelines recommend restrictive strategies for CVD patients hospitalised for non-CVD indications, patients without known CVD and patients hospitalised for CVD corrective procedures. Database searches were conducted through December 2017 for randomised clinical trials that enrolled patients with and without known CVD, hospitalised either for CVD-corrective procedures or non-cardiac indications, comparing effects of liberal with restrictive strategies on major adverse coronary events (MACE) and death. In CVD patients not undergoing cardiac interventions, a liberal strategy decreased (P = 0·01) the relative risk (95% CI) (RR) of MACE [0·50 (0·29-0·86)] (I 2 = 0%). Among patients without known CVD, the incidence of MACE was lower (1·7 vs 3·9%), and the effect of a liberal strategy on MACE [0·79, (0·39-1·58)] was smaller and non-significant but not different from CVD patients (P = 0·30). Combining all CVD and non-CVD patients, a liberal strategy decreased MACE [0·59, (0·39-0·91); P = 0·02]. Conversely, among studies reporting mortality, a liberal strategy decreased mortality in CVD patients (11·7% vs·13·3%) but increased mortality (19·2% vs 18·0%) in patients without known CVD [interaction P = 0·05; ratio of RR 0·73, (0·53-1·00)]. A liberal strategy also did not benefit patients undergoing cardiac surgery; data were insufficient for percutaneous cardiac procedures. In patients hospitalised for non-cardiac indications, liberal transfusion strategies are associated with a decreased risk of MACE in both those with and without known CVD. However, this only provides a survival benefit to CVD patients not admitted for CVD-corrective procedures. © 2018 British Blood Transfusion Society.
Chronic Kidney Disease as a Predictor of Cardiovascular Disease (From the Framingham Heart Study)
Parikh, Nisha I.; Hwang, Shih-Jen; Larson, Martin G.; Levy, Daniel; Fox, Caroline S.
2008-01-01
Chronic kidney disease (CKD) is a risk factor for cardiovascular disease (CVD), although shared risk factors may mediate much of the association. We related CKD and CVD in the setting of specific CVD risk factors and determined whether more advanced CKD was a CVD risk equivalent. The Framingham Heart Study original cohort (n=2471, mean age 68 years, 58.9% women) was studied. Glomerular filtration rate (eGFR) was estimated using the simplified Modification of Diet in Renal Disease Study equation. CKD was defined as eGFR < 59 mL/min per 1.73 m2 (women) and < 64 (men) and Stage 3b CKD defined as eGFR 30-44 (women) and 30-50 (men). Cox Proportional Hazard models adjusting for CVD risk factors were used to relate CKD to CVD. We tested for effect modification by CVD risk factors. Overall, 23.2% of the study sample had CKD (n=574; mean eGFR 50 mL/min per 1.73 m2) and 5.3% had Stage 3b CKD (n=131; mean eGFR 42 mL/min per 1.73 m2). In multivariable models (mean follow-up time 16 years), Stage 3 CKD was marginally associated with CVD (HR=1.17, 95% CI 0.99-1.38, p=0.06), whereas Stage 3b CKD was associated with CVD [HR=1.41, 95% CI 1.05-1.91, p=0.02]. Upon testing CVD risk equivalency, the risk of CVD for Stage 3b CKD among participants with prior CVD was significantly lower as compared to participants with prior CVD and no Stage 3b CKD (age- and sex-adjusted HR for CVD = 0.66 [95% CI 0.47 to 0.91], p=0.01). Low HDL modified the association between CKD and CVD (p-value=0.004 for interaction). Stage 3b CKD is associated with CVD but is not a CVD risk equivalent. In conclusion, CVD risk in the setting of CKD is higher in the setting of low HDL cholesterol. PMID:18572034
Increased cardiovascular risk in South African patients with Addison's disease.
Ross, I L; Bergthorsdottir, R; Levitt, N S; Schatz, D A; Johannsson, G; Marais, A D
2013-11-01
Patients with Addison's disease (AD) are believed to be at risk for cardiovascular disease (CVD). South Africa, like the rest of the developing world is experiencing an increase in CVD and patients with AD may be at double the risk of their peers. We wished to explore AD patients' CVD risk factors. A cross-sectional nationwide study in South Africa of patients with AD was conducted. A cohort of 147 patients with AD and 147 healthy control subjects were matched by age, gender, ethnicity, and BMI as far as was possible. Lipoproteins and highly-sensitive C-reactive-protein (hs-CRP) were the main outcome measures. AD patients had significantly higher triglycerides; (p=0.001), lower HDLC (p<0.001), higher hs-CRP (p<0.001), and more small dense LDL; (p=0.002) than controls. Nonesterified fatty acids were lower in patients (p<0.001). Approximately 65% [95% confidence interval (CI 55.6-72.4%)] had hypercholesterolaemia, 75% (CI 64.8-81.2%) had low HDLC, and 75% (CI 68.0-84.1%) had a higher LDLC. Thirteen percent of AD patients had diabetes mellitus, but none of the risk factors differed from the nondiabetics. Only HDLC correlated positively with daily hydrocortisone dose (r=0.32; p=0.005). In conclusion dyslipidaemia is common in South African AD patients; CVD risk assessment and intervention are probably warranted in the management of these patients. © Georg Thieme Verlag KG Stuttgart · New York.
Schryver, Tamara; Smith, Chery
2006-10-01
To determine if participants would be interested in consuming soy foods to lower cholesterol in primary and secondary prevention of heart disease, and to identify the role physicians and registered dietitians have in providing dietary advice, about soy foods or other foods, for participants with elevated cholesterol. Qualitative data from 12 focus groups were gathered from a convenience sample of 74 adults, aged 18-91 years, with and without high cholesterol (total cholesterol >200 mg dl(-1)). Participants were recruited from Minneapolis/St. Paul mainstream and natural foods grocery stores. Focus group interviews were taped and transcribed verbatim. Common themes were identified, coded and compared using NVivo computer software. Participants believed diet, lifestyle and genetics were the cause of high cholesterol and cardiovascular disease (CVD). Few participants were aware of the Food and Drug Administration health claim for soy protein, yet many were willing to consume soy as part of lifestyle modification to prevent CVD. They reported preferring food and exercise over medication to treat high cholesterol. Few participants had ever received dietary advice from physicians on treating high cholesterol or CVD, and most doubted the accuracy of such advice. They believed registered dietitians were the most credible source of nutrition counselling and expressed an interest in physician referrals to dietitians. A collaboration and referral system between physicians and registered dietitians could increase CVD patients' consumption of soy foods as a means potentially leading to a reduced risk of heart disease in participants.
Demystifying the management of hypertriglyceridaemia.
Watts, Gerald F; Ooi, Esther M M; Chan, Dick C
2013-11-01
Hypertriglyceridaemia (typical triglyceride level 1.7-5.0 mmol/l) is caused by interactions between many genetic and nongenetic factors, and is a common risk factor for atherosclerotic cardiovascular disease (CVD). Patients with hypertriglyceridaemia usually present with obesity, insulin resistance, hepatic steatosis, ectopic fat deposition, and diabetes mellitus. Hypertriglyceridaemia reflects the accumulation in plasma of proatherogenic lipoproteins, triglyceride-rich lipoprotein (TRL) remnants, and small, dense LDL particles. Mendelian randomization studies and research on inherited dyslipidaemias, such as type III dysbetalipoproteinaemia, testify that TRLs are causally related to atherosclerotic CVD. Extreme hypertriglyceridaemia (a triglyceride level >20 mmol/l) is rare, often monogenic in aetiology, and frequently causes pancreatitis. Treatment of hypertriglyceridaemia relies on correcting secondary factors and unhealthy lifestyle habits, particularly poor diet and lack of exercise. Pharmacotherapy is indicated for patients with established CVD or individuals at moderate-to-high risk of CVD, primarily those with metabolic syndrome or diabetes. Statins are the cornerstone of treatment, followed by fibrates and n-3 fatty acids, to achieve recommended therapeutic levels of plasma LDL cholesterol, non-HDL cholesterol, and apolipoprotein (apo) B-100. The case for using niacin has been weakened by the results of clinical trials, but needs further investigation. Extreme hypertriglyceridaemia requires strict dietary measures, and patients with a diagnosis of genetic lipoprotein lipase deficiency might benefit from LPL gene replacement therapy. Several therapies for regulating TRL metabolism, including inhibitors of diacylglycerol O-acyltransferase and microsomal triglyceride transfer protein, and apoC-III antisense oligonucleotides, merit further investigation in patients with hypertriglyceridaemia.
Leritz, Elizabeth C; McGlinchey, Regina E; Salat, David H; Milberg, William P
2016-04-01
We examined how serum cholesterol, an established risk factor for cerebrovascular disease (CVD), relates to cognitive function in healthy middle-older aged individuals with no neurologic or CVD history. A complete lipid panel was obtained from a cohort of one hundred twenty individuals, ages 43-85, who also underwent a comprehensive neuropsychological examination. In order to reduce the number of variables and empirically identify broad cognitive domains, scores from neuropsychological tests were submitted into a factor analysis. This analysis revealed three explainable factors: Memory, Executive Function and Memory/Language. Three separate hierarchical multiple regression analyses were conducted using individual cholesterol metrics (total cholesterol, low density lipoprotein; LDL, high density lipoprotein; HDL, and triglycerides), as well as age, education, medication status (lipid lowering agents), ApoE status, and additional risk factors for CVD to predict neuropsychological function. The Memory Factor was predicted by a combination of age, LDL, and triglyceride levels; both age and triglycerides were negatively associated with factor score, while LDL levels revealed a positive relationship. Both the Executive and Memory/Language factor were only explained by education, whereby more years were associated with better performance. These results provide evidence that individual cholesterol lipoproteins and triglycerides may differentially impact cognitive function, over and above other common CVD risk factors and ApoE status. Our findings demonstrate the importance of consideration of vascular risk factors, such as cholesterol, in studies of cognitive aging.
Life satisfaction and cardiovascular disease risk in Poland
Szklarska, Alicja; Lipowicz, Anna; Jankowska, Ewa Anita; Kozieł, Sławomir
2013-01-01
Introduction Cardiovascular disease is the most common cause of death. Life satisfaction is a predictor of morbidity and mortality, irrespectively of objective measures of health status. The aim of the study was to evaluate the relationship between life satisfaction (LS) and cardiovascular disease risk (CVD) assessed with the Framingham Risk Score (FRS) in Polish adults. Material and methods Past, present and projected LS were estimated. The FRS reflecting 10-year CVD risk was calculated from health indices and lifestyle parameters. Relationships between LS and FRS were tested by two-way analysis of variance in 489 men and 591 women, 40–50 years of age. Results Subjects with a reduction in LS over time had a higher FRS compared to peers with an improvement in LS. The relationship between current LS and FRS had a J-shape in men; FRS was lowest in men with an LS of 5–7 (average LS), slightly higher in men with an LS of 8–10 (highest LS), and highest in men with an LS of 1–4 (lowest LS). Among women, there was an inverse linear relationship between LS and FRS: the higher the LS, the lower FRS. There was a strong linear relationship between predicted LS and CVD risk. Highest risk was evident in subjects with low LS in whom low LS was predicted over the next five years. Conclusions Low LS (dissatisfaction) thus has a long-term negative effect on CVD risk in Polish adults of both sexes. PMID:24049521
Anthocyanins in Cardiovascular Disease1
Wallace, Taylor C.
2011-01-01
Anthocyanins are a group of abundant and widely consumed flavonoid constituents that occur ubiquitously in the plant kingdom, providing the bright red-orange to blue-violet colors present in many fruit- and vegetable-based food products. Their intake has been estimated to be up to 9-fold higher than that of other dietary flavonoids. Anthocyanins have become increasingly important to the food industry as their use as natural alternatives to artificial colors has become widespread and knowledge of their health-promoting properties has become more evident. Epidemiological studies suggest that increased consumption of anthocyanins lowers the risk of cardiovascular disease (CVD), the most common cause of mortality among men and women. Anthocyanins frequently interact with other phytochemicals, exhibiting synergistic biological effects but making contributions from individual components difficult to decipher. Over the past 2 decades, many peer-reviewed publications have demonstrated that in addition to their noted in vitro antioxidant activity, anthocyanins may regulate different signaling pathways involved in the development of CVD. This review summarizes the latest developments on the bioavailability/bioactivity and CVD preventative activities of anthocyanins, including results from in vitro cell culture and in vivo animal model systems as related to their multiple proposed mechanisms of action. Limited yet promising data from epidemiological studies and human clinical trials are also presented. Future studies aimed at enhancing the absorption of anthocyanins and characterizing their metabolic and/or breakdown products are necessary to ultimately evaluate their use for protection/prevention against the development of CVD. PMID:22211184
Ravn-Haren, Gitte; Dragsted, Lars O; Buch-Andersen, Tine; Jensen, Eva N; Jensen, Runa I; Németh-Balogh, Mária; Paulovicsová, Brigita; Bergström, Anders; Wilcks, Andrea; Licht, Tine R; Markowski, Jarosław; Bügel, Susanne
2013-12-01
Fruit consumption is associated with a decreased risk of CVD in cohort studies and is therefore endorsed by health authorities as part of the '5 or more a day' campaigns. A glass of fruit juice is generally counted as one serving. Fruit may cause protection by affecting common risk factors of CVD. Apples are among the most commonly consumed fruits and were chosen for a comprehensive 5 × 4 weeks dietary crossover study to assess the effects of whole apples (550 g/day), apple pomace (22 g/day), clear and cloudy apple juices (500 ml/day), or no supplement on lipoproteins and blood pressure in a group of 23 healthy volunteers. The intervention significantly affected serum total and LDL-cholesterol. Trends towards a lower serum LDL-concentration were observed after whole apple (6.7%), pomace (7.9%) and cloudy juice (2.2%) intake. On the other hand, LDL-cholesterol concentrations increased by 6.9% with clear juice compared to whole apples and pomace. There was no effect on HDL-cholesterol, TAG, weight, waist-to-hip ratio, blood pressure, inflammation (hs-CRP), composition of the gut microbiota or markers of glucose metabolism (insulin, IGF1 and IGFBP3). Apples are rich in polyphenols and pectin, two potentially bioactive constituents; however, these constituents segregate differently during processing into juice products and clear juice is free of pectin and other cell wall components. We conclude that the fibre component is necessary for the cholesterol-lowering effect of apples in healthy humans and that clear apple juice may not be a suitable surrogate for the whole fruit in nutritional recommendations.
Ryodi, Essi; Metso, Saara; Huhtala, Heini; Välimäki, Matti; Auvinen, Anssi; Jaatinen, Pia
2018-06-08
BACKGROUND Hyperthyroid patients remain at an increased risk of cardiovascular diseases (CVDs) after restoring euthyroidism. The impact of the different treatment modalities of hyperthyroidism on future CVD risk remains unclear. The aim of this paper is to assess cardiovascular morbidity and mortality in hyperthyroidism before and after the treatment, and to compare the effects of two different treatment modalities, radioactive iodine (RAI) and thyroid surgery. METHODS A comparative cohort study was conducted among 6,148 hyperthyroid patients treated either with RAI or thyroidectomy, and 18,432 age- and gender-matched controls. Firstly, hospitalizations due to CVDs prior to the treatment were analyzed. Secondly, the hazard ratios (HR) for any new hospitalization and mortality due to CVDs after the treatment were estimated among all the hyperthyroid patients compared to the age- and gender-matched controls and also in the RAI-treated patients compared to the thyroidectomy-treated patients. The results were adjusted for prevalent CVDs at the time of treatment. RESULTS Before the treatment of hyperthyroidism, hospitalizations due to all CVDs were more common in the hyperthyroid patients compared to the controls (OR 1.61, 95% CI 1.49-1.73). During the post-treatment follow-up, hospitalizations due to CVDs remained more frequent among the patients (HR 1.15, 95% CI 1.09-1.21), but there was no difference in CVD mortality (HR 0.93, 95% CI 0.84-1.03). Compared to the patients treated with thyroidectomy, the RAI-treated patients had a higher risk of hospitalization due to all CVDs (HR 1.17), and atrial fibrillation (HR 1.28), as well as a higher CVD mortality (HR 2.56). Yet, treatment with RAI resulting in hypothyroidism was not associated with increased CVD morbidity compared with thyroidectomy. CONCLUSIONS Hyperthyroidism increases the risk of CVD-related hospitalization, and the risk is sustained for up to two decades after treatment with RAI or surgery. Hyperthyroid patients treated with RAI remain at a higher CVD risk compared to patients treated with thyroidectomy. Hypothyroidism during the follow-up, however, predicts better cardiovascular outcome.
Cai, Yutong; Hodgson, Susan; Blangiardo, Marta; Gulliver, John; Morley, David; Fecht, Daniela; Vienneau, Danielle; de Hoogh, Kees; Key, Tim; Hveem, Kristian; Elliott, Paul; Hansell, Anna L
2018-05-01
This study aimed to investigate the effects of long-term exposure to road traffic noise and air pollution on incident cardiovascular disease (CVD) in three large cohorts: HUNT, EPIC-Oxford and UK Biobank. In pooled complete-case sample of the three cohorts from Norway and the United Kingdom (N = 355,732), 21,081 incident all CVD cases including 5259 ischemic heart disease (IHD) and 2871 cerebrovascular cases were ascertained between baseline (1993-2010) and end of follow-up (2008-2013) through medical record linkage. Annual mean 24-hour weighted road traffic noise (Lden) and air pollution (particulate matter with aerodynamic diameter ≤ 10 μm [PM10], ≤2.5 μm [PM2.5] and nitrogen dioxide [NO2]) exposure at baseline address was modelled using a simplified version of the Common Noise Assessment Methods in Europe (CNOSSOS-EU) and European-wide Land Use Regression models. Individual-level covariate data were harmonised and physically pooled across the three cohorts. Analysis was via Cox proportional hazard model with mutual adjustments for both noise and air pollution and potential confounders. No significant associations were found between annual mean Lden and incident CVD, IHD or cerebrovascular disease in the overall population except that the association with incident IHD was significant among current-smokers. In the fully adjusted models including adjustment for Lden, an interquartile range (IQR) higher PM10 (4.1 μg/m3) or PM2.5 (1.4 μg/m3) was associated with a 5.8% (95%CI: 2.5%-9.3%) and 3.7% (95%CI: 0.2%-7.4%) higher risk for all incident CVD respectively. No significant associations were found between NO2 and any of the CVD outcomes. We found suggestive evidence of a possible association between road traffic noise and incident IHD, consistent with current literature. Long-term particulate air pollution exposure, even at concentrations below current European air quality standards, was significantly associated with incident CVD. Copyright © 2018 Elsevier Ltd. All rights reserved.
Factors associated with blue-collar workers' risk perception of cardiovascular disease.
Hwang, Won Ju; Hong, Oisaeng; Kim, Mi Ja
2012-12-01
The purpose of this study was to investigate the contribution of actual cardiovascular disease (CVD) risk, as well as, individual, psychosocial, and work-related factors as predictors of CVD risk perception among Korean blue-collar workers. The participants were 238 Korean blue-collar workers who worked in small companies. Data were collected through a survey; anthropometric and blood pressure measures; and blood sampling for lipid levels. Blue-collar workers had high actual CVD risk and low CVD risk perception. The significant predictors of risk perception included perceived health status, alcohol consumption, knowledge of CVD risk, actual CVD risk, decision latitude, and shift work. The model explained 26% of the variance in CVD risk perception. The result suggests when occupational health nurses are giving routine health examination in small companies, they can enhance CVD risk perception in blue-collar workers by providing essential information about CVD risk factors and personal counseling on the individual worker's CVD risk status.
Tsuo, S.; Langford, A.A.
1989-03-28
Unwanted build-up of the film deposited on the transparent light-transmitting window of a photochemical vacuum deposition (photo-CVD) chamber is eliminated by flowing an etchant into the part of the photolysis region in the chamber immediately adjacent the window and remote from the substrate and from the process gas inlet. The respective flows of the etchant and the process gas are balanced to confine the etchant reaction to the part of the photolysis region proximate to the window and remote from the substrate. The etchant is preferably one that etches film deposit on the window, does not etch or affect the window itself, and does not produce reaction by-products that are deleterious to either the desired film deposited on the substrate or to the photolysis reaction adjacent the substrate. 3 figs.
Tsuo, Simon; Langford, Alison A.
1989-01-01
Unwanted build-up of the film deposited on the transparent light-transmitting window of a photochemical vacuum deposition (photo-CVD) chamber is eliminated by flowing an etchant into the part of the photolysis region in the chamber immediately adjacent the window and remote from the substrate and from the process gas inlet. The respective flows of the etchant and the process gas are balanced to confine the etchant reaction to the part of the photolysis region proximate to the window and remote from the substrate. The etchant is preferably one that etches film deposit on the window, does not etch or affect the window itself, and does not produce reaction by-products that are deleterious to either the desired film deposited on the substrate or to the photolysis reaction adjacent the substrate.
An overview on tritium permeation barrier development for WCLL blanket concept
NASA Astrophysics Data System (ADS)
Aiello, A.; Ciampichetti, A.; Benamati, G.
2004-08-01
The reduction of tritium permeation through blanket structural materials and cooling tubes has to be carefully evaluated to minimise radiological hazards. A strong effort has been made in the past to select the best technological solution for the realisation of tritium permeation barriers (TPB) on complex structures not directly accessible after the completion of the manufacturing process. The best solution was identified in aluminium rich coatings, which form Al 2O 3 at their surface. Two technologies were selected as reference for the realisation of coating in the WCLL blanket concept: the chemical vapour deposition (CVD) process developed on laboratory scale by CEA, and the hot dipping (HD) process developed by FZK. The results obtained during three years of tests on CVD and HD coated specimens in gas and liquid metal phase are summarised and discussed.
Room temperature chemical vapor deposition of c-axis ZnO
NASA Astrophysics Data System (ADS)
Barnes, Teresa M.; Leaf, Jacquelyn; Fry, Cassandra; Wolden, Colin A.
2005-02-01
Highly (0 0 2) oriented ZnO films have been deposited at temperatures between 25 and 230 °C by high-vacuum plasma-assisted chemical vapor deposition (HVP-CVD) on glass and silicon substrates. The HVP-CVD process was found to be weakly activated with an apparent activation energy of ∼0.1 eV, allowing room temperature synthesis. Films deposited on both substrates displayed a preferential c-axis texture over the entire temperature range. Films grown on glass demonstrated high optical transparency throughout the visible and near infrared.
Ochoa-Avilés, Angélica; Verstraeten, Roosmarijn; Lachat, Carl; Andrade, Susana; Van Camp, John; Donoso, Silvana; Kolsteren, Patrick
2014-09-09
Cardiovascular diseases (CVD) are amongst the leading causes of death worldwide. Risk factors of CVD develop during childhood and adolescence, and dietary quality has been linked to the development of CVD itself. This study examines the association between dietary patterns and cardiovascular risk in a group of urban and rural Ecuadorian adolescents from different socioeconomic backgrounds. A cross-sectional study was conducted from January 2008 to April 2009 among 606 adolescents from the 8th, 9th and 10th grade in an urban area (Cuenca), and 173 adolescents from a rural area (Nabón) in Ecuador. Data collection involved measuring anthropometric data (weight, height and waist circumference), blood pressure, dietary intake (2-day 24 h recall) and socio-demographic characteristics. Fasting blood lipids and glucose were measured in a subsample of 334 adolescents. Factor analysis was used to identify dietary patterns and linear regression models were used to (i) identify differences in food intake practices according to socioeconomic status and place of residence and (ii) establish relationships between dietary patterns and cardiovascular risk factors. Median energy intake was 1851 kcal/day. Overall, fiber, fish and fruit and vegetables were scarcely consumed, while added sugar, refined cereals and processed food were important constituents of the diet. Two dietary patterns emerged, one labelled as "rice-rich non-animal fat pattern" and the other one as "wheat-dense animal-fat pattern". The first pattern was correlated with a moderate increase in glucose in urban participants, while the second pattern was associated with higher LDL and cholesterol blood levels in rural participants. This group of adolescents presented various dietary practices conducive to CVD development. Effective strategies are needed to prevent CVD in the Ecuadorian population by encouraging a balanced diet, which contains less refined cereals, added sugar, and processed food, but has more fruits, vegetables and whole grain cereals.
Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease
Wang, Zeneng; Klipfell, Elizabeth; Bennett, Brian J.; Koeth, Robert; Levison, Bruce S.; DuGar, Brandon; Feldstein, Ariel E.; Britt, Earl B.; Fu, Xiaoming; Chung, Yoon-Mi; Wu, Yuping; Schauer, Phil; Smith, Jonathan D.; Allayee, Hooman; Tang, W. H. Wilson; DiDonato, Joseph A.; Lusis, Aldons J.; Hazen, Stanley L.
2011-01-01
Metabolomics studies hold promise for discovery of pathways linked to disease processes. Cardiovascular disease (CVD) represents the leading cause of death and morbidity worldwide. A metabolomics approach was used to generate unbiased small molecule metabolic profiles in plasma that predict risk for CVD. Three metabolites of the dietary lipid phosphatidylcholine, namely choline, trimethylamine N-oxide (TMAO), and betaine, were identified and then shown to predict risk for CVD in an independent large clinical cohort. Dietary supplementation of mice with choline, TMAO or betaine promoted up-regulation of multiple macrophage scavenger receptors linked to atherosclerosis, and supplementation with choline or TMAO promoted atherosclerosis. Studies using germ-free mice confirmed a critical role for dietary choline and gut flora in TMAO production, augmented macrophage cholesterol accumulation and foam cell formation. Suppression of intestinal microflora in atherosclerosis-prone mice inhibited dietary choline-enhanced atherosclerosis. Genetic variations controlling expression of flavin monooxygenases (FMOs), an enzymatic source of TMAO, segregated with atherosclerosis in hyperlipidemic mice. Discovery of a relationship between gut flora-dependent metabolism of dietary phosphatidylcholine and CVD pathogenesis provides opportunities for development of both novel diagnostic tests and therapeutic approaches for atherosclerotic heart disease. PMID:21475195
A Community Health Advisor Program to reduce cardiovascular risk among rural African-American women
Cornell, C. E.; Littleton, M. A.; Greene, P. G.; Pulley, L.; Brownstein, J. N.; Sanderson, B. K.; Stalker, V. G.; Matson-Koffman, D.; Struempler, B.; Raczynski, J. M.
2009-01-01
The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and training, community intervention and maintenance. Formative data collected to develop the training, intervention and evaluation methods and materials indicated the need for programs to increase knowledge, skills and resources for changing behaviors that increase the risk of CVD. CHAs worked in partnership with staff to develop, implement, evaluate and maintain strategies to reduce risk for CVD in women and to influence city officials, business owners and community coalitions to facilitate project activities. Process data documented sustained increases in social capital and community capacity to address health-related issues, as well as improvements in the community’s physical infrastructure. This project is unique in that it documents that a comprehensive CHA-based intervention for CVD can facilitate wide-reaching changes in capacity to address health issues in a rural community that include improvements in community infrastructure and are sustained beyond the scope of the originally funded intervention. PMID:19047648
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kozlovski, V. V.; Lebedev, A. A., E-mail: shura.lebe@mail.ioffe.ru; Bogdanova, E. V.
The compensation of moderately doped p-4H-SiC samples grown by the chemical vapor deposition (CVD) method under irradiation with 0.9-MeV electrons and 15-MeV protons is studied. The experimentally measured carrier removal rates are 1.2–1.6 cm{sup –1} for electrons and 240–260 cm{sup –1} for protons. The dependence of the concentration of uncompensated acceptors and donors, measured in the study, demonstrates a linear decrease with increasing irradiation dose to the point of complete compensation. This run of the dependence shows that compensation of the samples is due to the transition of carriers to deep centers formed by primary radiation-induced defects. It is demonstratedmore » that, in contrast to n-SiC (CVD), primary defects in the carbon sublattice of moderately doped p-SiC (CVD) only cannot account for the compensation process. In p-SiC, either primary defects in the silicon sublattice, or defects in both sublattices are responsible for conductivity compensation. Also, photoluminescence spectra are examined in relation to the irradiation dose.« less
Bagheri, Nasser; Gilmour, Bridget; McRae, Ian; Konings, Paul; Dawda, Paresh; Del Fante, Peter; van Weel, Chris
2015-02-26
Cardiovascular disease (CVD) continues to be a leading cause of illness and death among adults worldwide. The objective of this study was to calculate a CVD risk score from general practice (GP) clinical records and assess spatial variations of CVD risk in communities. We used GP clinical data for 4,740 men and women aged 30 to 74 years with no history of CVD. A 10-year absolute CVD risk score was calculated based on the Framingham risk equation. The individual risk scores were aggregated within each Statistical Area Level One (SA1) to predict the level of CVD risk in that area. Finally, the pattern of CVD risk was visualized to highlight communities with high and low risk of CVD. The overall 10-year risk of CVD in our sample population was 14.6% (95% confidence interval [CI], 14.3%-14.9%). Of the 4,740 patients in our study, 26.7% were at high risk, 29.8% were at moderate risk, and 43.5% were at low risk for CVD over 10 years. The proportion of patients at high risk for CVD was significantly higher in the communities of low socioeconomic status. This study illustrates methods to further explore prevalence, location, and correlates of CVD to identify communities of high levels of unmet need for cardiovascular care and to enable geographic targeting of effective interventions for enhancing early and timely detection and management of CVD in those communities.
Hansen, Peter Riis
2018-01-01
Inflammation plays a significant role in atherosclerosis and cardiovascular disease (CVD). Patients with chronic inflammatory diseases are at increased risk of CVD, but it is debated whether this association is causal or dependent on shared risk factors, other exposures, genes, and/or inflammatory pathways. The current review summarizes epidemiological, clinical, and experimental data supporting the role of shared inflammatory mechanisms between atherosclerotic CVD and rheumatoid arthritis, psoriasis, inflammatory bowel disease, and periodontitis, respectively, and provides insights to future prospects in this area of research. Awareness of the role of inflammation in CVD in patients with chronic inflammatory diseases and the potential for anti-inflammatory therapy, e.g., with tumor necrosis factor-α inhibitors, to also reduce atherosclerotic CVD has evolved into guideline- based recommendations. These include regular CVD risk assessment, aggressive treatment of traditional CVD risk factors, and recognition of reduced CVD as an added benefit of strict inflammatory disease control. At present, chronic inflammatory diseases would appear to qualify as partners in crime and not merely innocent bystanders to CVD. However, definite incremental contributions of inflammation versus effects of the complex interplay with other CVD risk factors may never be fully elucidated and for the foreseeable future, inflammation is posed to maintain its current position as both a marker and a maker of CVD, with clinical utility both for identification of patient at risk of CVD and as target for therapy to reduce CVD. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
Scholte op Reimer, Wilma J M; Moons, Philip; De Geest, Sabina; Fridlund, Bengt; Heikkilä, Johanna; Jaarsma, Tiny; Lenzen, Mattie; Martensson, Jan; Norekvål, Tone M; Smith, Karen; Stewart, Simon; Strömberg, Anna; Thompson, David R
2006-12-01
Nurses play a key role in the prevention of cardiovascular disease (CVD) and one would, therefore, expect them to have a heightened awareness of the need for systematic screening and their own CVD risk profile. The aim of this study was to examine personal awareness of CVD risk among a cohort of cardiovascular nurses attending a European conference. Of the 340 delegates attending the 5th annual Spring Meeting on Cardiovascular Nursing (Basel, Switzerland, 2005), 287 (83%) completed a self-report questionnaire to assess their own risk factors for CVD. Delegates were also asked to give an estimation of their absolute total risk of experiencing a fatal CVD event in the next 10 years. Level of agreement between self-reported CVD risk estimation and their actual risk according to the SCORE risk assessment system was compared by calculating weighted Kappa (kappa(w)). Overall, 109 responders (38%) self-reported having either pre-existing CVD (only 2%), one or more markedly raised CVD risk factors, a high total risk of fatal CVD (> or =5% in 10 years) or a strong family history of CVD. About half of this cohort (53%) did not know their own total cholesterol level. Less than half (45%) reported having a 10-year risk of fatal CVD of <1%, while 13% reported having a risk > or =5%. Based on the SCORE risk function, the estimated 10-year risk of a fatal CVD event was <1% for 96% of responders: only 2% had a > or =5% risk of such an event. Overall, less than half (46%) of this cohort's self-reported CVD risk corresponded with that calculated using the SCORE risk function (kappa(w)=0.27). Most cardiovascular nurses attending a European conference in 2005 poorly understood their own CVD risk profile, and the agreement between their self-reported 10-year risk of a fatal CVD and their CVD risk using SCORE was only fair. Given the specialist nature of this conference, our findings clearly demonstrate a need to improve overall nursing awareness of the role and importance of systematic CVD risk assessment.
Aljimaee, Yazeed HM; El-Helw, Abdel-Rahim M; Ahmed, Osama AA; El-Say, Khalid M
2015-01-01
Background Carvedilol (CVD) is used for the treatment of essential hypertension, heart failure, and systolic dysfunction after myocardial infarction. Due to its lower aqueous solubility and extensive first-pass metabolism, the absolute bioavailability of CVD does not exceed 30%. To overcome these drawbacks, the objective of this work was to improve the solubility and onset of action of CVD through complexation with hydroxypropyl-β-cyclodextrin and formulation of the prepared complex as orodispersible tablets (ODTs). Methods Compatibility among CVD and all tablet excipients using differential scanning calorimetry and Fourier transform infrared spectroscopy, complexation of CVD with different polymers, and determination of the solubility of CVD in the prepared complexes were first determined. A Box-Behnken design (BBD) was used to study the effect of tablet formulation variables on the characteristics of the prepared tablets and to optimize preparation conditions. According to BBD design, 15 formulations of CVD-ODTs were prepared by direct compression and then evaluated for their quality attributes. The relative pharmacokinetic parameters of the optimized CVD-ODTs were compared with those of the marketed CVD tablet. A single dose, equivalent to 2.5 mg/kg CVD, was administered orally to New Zealand white rabbits using a double-blind, randomized, crossover design. Results The solubility of CVD was improved from 7.32 to 22.92 mg/mL after complexation with hydroxypropyl-β-cyclodextrin at a molar ratio of 1:2 (CVD to cyclodextrin). The formulated CVD-ODTs showed satisfactory results concerning tablet hardness (5.35 kg/cm2), disintegration time (18 seconds), and maximum amount of CVD released (99.72%). The pharmacokinetic data for the optimized CVD-ODT showed a significant (P<0.05) increase in maximum plasma concentration from 363.667 to 496.4 ng/mL, and a shortening of the time taken to reach maximum plasma concentration to 2 hours in comparison with the marketed tablet. Conclusion The optimized CVD-ODTs showed improved oral absorption of CVD and a subsequent acceleration of clinical effect, which is favored for hypertensive and cardiac patients. PMID:25834396
NASA Astrophysics Data System (ADS)
Gu, Yanchao; Fan, Dongming; You, Wei
2017-07-01
Eleven GPS crustal vertical displacement (CVD) solutions for 110 IGS08/IGS14 core stations provided by the International Global Navigation Satellite Systems Service Analysis Centers are compared with seven Gravity Recovery and Climate Experiment (GRACE)-modeled CVD solutions. The results of the internal comparison of the GPS solutions from multiple institutions imply large uncertainty in the GPS postprocessing. There is also evidence that GRACE solutions from both different institutions and different processing approaches (mascon and traditional spherical harmonic coefficients) show similar results, suggesting that GRACE can provide CVD results of good internal consistency. When the uncertainty of the GPS data is accounted for, the GRACE data can explain as much as 50% of the actual signals and more than 80% of the GPS annual signals. Our study strongly indicates that GRACE data have great potential to correct the nontidal loading in GPS time series.
CVD-Enabled Graphene Manufacture and Technology
2015-01-01
Integrated manufacturing is arguably the most challenging task in the development of technology based on graphene and other 2D materials, particularly with regard to the industrial demand for “electronic-grade” large-area films. In order to control the structure and properties of these materials at the monolayer level, their nucleation, growth and interfacing needs to be understood to a level of unprecedented detail compared to existing thin film or bulk materials. Chemical vapor deposition (CVD) has emerged as the most versatile and promising technique to develop graphene and 2D material films into industrial device materials and this Perspective outlines recent progress, trends, and emerging CVD processing pathways. A key focus is the emerging understanding of the underlying growth mechanisms, in particular on the role of the required catalytic growth substrate, which brings together the latest progress in the fields of heterogeneous catalysis and classic crystal/thin-film growth. PMID:26240694
Reducing flicker noise in chemical vapor deposition graphene field-effect transistors
NASA Astrophysics Data System (ADS)
Arnold, Heather N.; Sangwan, Vinod K.; Schmucker, Scott W.; Cress, Cory D.; Luck, Kyle A.; Friedman, Adam L.; Robinson, Jeremy T.; Marks, Tobin J.; Hersam, Mark C.
2016-02-01
Single-layer graphene derived from chemical vapor deposition (CVD) holds promise for scalable radio frequency (RF) electronic applications. However, prevalent low-frequency flicker noise (1/f noise) in CVD graphene field-effect transistors is often up-converted to higher frequencies, thus limiting RF device performance. Here, we achieve an order of magnitude reduction in 1/f noise in field-effect transistors based on CVD graphene transferred onto silicon oxide substrates by utilizing a processing protocol that avoids aqueous chemistry after graphene transfer. Correspondingly, the normalized noise spectral density (10-7-10-8 μm2 Hz-1) and noise amplitude (4 × 10-8-10-7) in these devices are comparable to those of exfoliated and suspended graphene. We attribute the reduction in 1/f noise to a decrease in the contribution of fluctuations in the scattering cross-sections of carriers arising from dynamic redistribution of interfacial disorder.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schulberg, M.T.; Allendorf, M.D.; Outka, D.A.
NH{sub 3} is an important component of many chemical vapor deposition (CVD) processes for TiN films, which are used for diffusion barriers and other applications in microelectronic circuits. In this study, the interaction of NH{sub 3} with TiN surfaces is examined with temperature programmed desorption (TPD) and Auger electron spectroscopy. NH{sub 3} has two adsorption states on TiN: a chemisorbed state and a multilayer state. A new method for analyzing TPD spectra in systems with slow pumping speeds yields activation energies for desorption for the two states of 24 kcal/mol and 7.3 kcal/mol, respectively. The sticking probability into the chemisorptionmore » state is {approximately}0.06. These results are discussed in the context of TiN CVD. In addition, the high temperature stability of TiN is investigated. TiN decomposes to its elements only after heating to 1300 K, showing that decomposition is unlikely to occur under CVD conditions.« less
Graphene growth with ‘no’ feedstock
NASA Astrophysics Data System (ADS)
Qing, Fangzhu; Jia, Ruitao; Li, Bao-Wen; Liu, Chunlin; Li, Congzhou; Peng, Bo; Deng, Longjiang; Zhang, Wanli; Li, Yanrong; Ruoff, Rodney S.; Li, Xuesong
2017-06-01
Synthesis of graphene by chemical vapor deposition (CVD) from hydrocarbons on Cu foil substrates can yield high quality and large area graphene films. In a typical CVD process, a hydrocarbon in the gas phase is introduced for graphene growth and hydrogen is usually required to achieve high quality graphene. We have found that in a low pressure CVD system equipped with an oil mechanical vacuum pump located downstream, graphene can be grown without deliberate introduction of a carbon feedstock but with only trace amounts of C present in the system, the origin of which we attribute to the vapor of the pump oil. This finding may help to rationalize the differences in graphene growth reported by different research groups. It should also help to gain an in-depth understanding of graphene growth mechanisms with the aim to improve the reproducibility and structure control in graphene synthesis, e.g. the formation of large area single crystal graphene and uniform bilayer graphene.
NASA Astrophysics Data System (ADS)
Kasikov, Aarne; Kahro, Tauno; Matisen, Leonard; Kodu, Margus; Tarre, Aivar; Seemen, Helina; Alles, Harry
2018-04-01
Graphene layers grown by chemical vapour deposition (CVD) method and transferred from Cu-foils to the oxidized Si-substrates were investigated by spectroscopic ellipsometry (SE), Raman and X-Ray Photoelectron Spectroscopy (XPS) methods. The optical properties of transferred CVD graphene layers do not always correspond to the ones of the exfoliated graphene due to the contamination from the chemicals used in the transfer process. However, the real thickness and the mean properties of the transferred CVD graphene layers can be found using ellipsometry if a real thickness of the SiO2 layer is taken into account. The pulsed laser deposition (PLD) and atomic layer deposition (ALD) methods were used to grow dielectric layers on the transferred graphene and the obtained structures were characterized using optical methods. The approach demonstrated in this work could be useful for the characterization of various materials grown on graphene.
Wong, Wai-Man R; Stephens, Jeffrey W; Acharya, Jayshree; Hurel, Steven J; Humphries, Steve E; Talmud, Philippa J
2004-08-01
Apolipoprotein A-IV (apoA-IV) has been postulated to be antiatherogenic. Transgenic APOA4/Apoe-/- mice are protected against atherosclerosis, with plasma apoA-IV displaying antioxidant activity in vitro. In humans, there is an inverse relationship between apoA-IV levels and risk of coronary heart disease (CHD). Furthermore, the APOA4 T347S rare allele has been associated with increased risk of CHD and reduced apoA-IV levels. Reduced total antioxidant status (TAOS) due to increased oxidative stress is implicated in the process of atherogenesis. Thus, this study aimed to examine the association between the APOA4 T347S variant and TAOS in diabetic patients with (n = 196) or without (n = 509) cardiovascular disease (CVD). A higher percentage of CVD patients were present in the lowest quartile of TAOS, compared with the rest (P = 0.04). Overall, there was no association between genotype and TAOS. However, in patients with CVD, homozygotes for the S347 allele had significantly lower TAOS compared with TT and TS subjects (31.2 +/- 9.89% and 42.5 +/- 13.04% TAOS, respectively; P = 0.0024), an effect that was not seen in the patients without CVD. This study offers direct support for an antioxidant capacity of apoA-IV, thus providing some explanation for the antiatherogenic role of apoA-IV and the higher CVD risk in S347 homozygotes. Copyright 2004 American Society for Biochemistry and Molecular Biology, Inc.
Keegan, Theresa H M; Kushi, Lawrence H; Li, Qian; Brunson, Ann; Chawla, X; Chew, Helen K; Malogolowkin, Marcio; Wun, Ted
2018-06-01
Few population-based studies have focused on cardiovascular disease (CVD) risk in adolescent and young adult (AYA; 15-39 years) cancer survivors and none have considered whether CVD risk differs by sociodemographic factors. Analyses focused on 79,176 AYA patients diagnosed with 14 first primary cancers in 1996-2012 and surviving > 2 years after diagnosis with follow-up through 2014. Data were obtained from the California Cancer Registry and State hospital discharge data. CVD included coronary artery disease, heart failure, and stroke. The cumulative incidence of developing CVD accounted for the competing risk of death. Multivariable Cox proportional hazards regression evaluated factors associated with CVD and the impact of CVD on mortality. Overall, 2249 (2.8%) patients developed CVD. Survivors of central nervous system cancer (7.3%), acute lymphoid leukemia (6.9%), acute myeloid leukemia (6.8%), and non-Hodgkin lymphoma (4.1%) had the highest 10-year CVD incidence. In multivariable models, African-Americans (hazard ratio (HR) = 1.55, 95% confidence interval (CI) = 1.33-1.81; versus non-Hispanic Whites), those with public/no health insurance (HR = 1.78, 95% CI = 1.61-1.96; versus private) and those who resided in lower socioeconomic status neighborhoods had a higher CVD risk. These sociodemographic differences in CVD incidence were apparent across most cancer sites. The risk of death was increased by eightfold or higher among AYAs who developed CVD. While cancer therapies are known to increase the risk of CVD, this study additionally shows that CVD risk varies by sociodemographic factors. The identification and mitigation of CVD risk factors in these subgroups may improve long-term patient outcomes.
Systematic Review of Anthocyanins and Markers of Cardiovascular Disease.
Wallace, Taylor C; Slavin, Margaret; Frankenfeld, Cara L
2016-01-09
Anthocyanins are dietary flavonoids commonly consumed in the diet, which have been suggested to have a preventative effect on cardiovascular disease (CVD) development among epidemiological studies. We systematically reviewed randomized controlled trials (RCTs) testing the effects of purified anthocyanins and anthocyanin-rich extracts on markers of CVD (triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and blood pressure) in both healthy and diseased populations. Eligible studies included RCTs of adults published in English. We searched PubMed, Web of Science Core Collection, and BIOSIS Previews for relevant articles from inception until 1 July 2014. Twelve RCTs representing 10 studies were included in this review. Supplementation with anthocyanins significantly improved LDL cholesterol among diseased individuals or those with elevated biomarkers. Supplementation did not significantly affect other markers of CVD in either healthy individuals or those with elevated markers. No adverse effects of anthocyanins were reported across studies at levels up to 640 mg/day. Limitations of trials in the qualitative analyses include short trial duration and large variability in the dose administered within the trials. Longer-duration trials assessing dose response are needed to adequately determine whether an effect of supplementation exists.
Meyer, Katie A.; Shea, Jonathan W.
2017-01-01
Studies implicate choline and betaine metabolite trimethylamine N-oxide (TMAO) in cardiovascular disease (CVD). We conducted a systematic review and random-effects meta-analysis to quantify a summary estimated effect of dietary choline and betaine on hard CVD outcomes (incidence and mortality). Eligible studies were prospective studies in adults with comprehensive diet assessment and follow-up for hard CVD endpoints. We identified six studies that met our criteria, comprising 18,076 incident CVD events, 5343 CVD deaths, and 184,010 total participants. In random effects meta-analysis, incident CVD was not associated with choline (relative risk (RR): 1.00; 95% CI: 0.98, 1.02) or betaine (RR: 0.99; 95% CI: 0.98, 1.01) intake. Results did not vary by study outcome (incident coronary heart disease, stroke, total CVD) and there was no evidence for heterogeneity among studies. Only two studies provided data on phosphatidylcholine and CVD mortality. Random effects meta-analysis did not support an association between choline and CVD mortality (RR: 1.09, 95% CI: 0.89, 1.35), but one study supported a positive association and there was significant heterogeneity (I2 = 84%, p-value < 0.001). Our findings do not support an association between dietary choline/betaine with incident CVD, but call for further research into choline and CVD mortality. PMID:28686188
Meyer, Katie A; Shea, Jonathan W
2017-07-07
Studies implicate choline and betaine metabolite trimethylamine N-oxide (TMAO) in cardiovascular disease (CVD). We conducted a systematic review and random-effects meta-analysis to quantify a summary estimated effect of dietary choline and betaine on hard CVD outcomes (incidence and mortality). Eligible studies were prospective studies in adults with comprehensive diet assessment and follow-up for hard CVD endpoints. We identified six studies that met our criteria, comprising 18,076 incident CVD events, 5343 CVD deaths, and 184,010 total participants. In random effects meta-analysis, incident CVD was not associated with choline (relative risk (RR): 1.00; 95% CI: 0.98, 1.02) or betaine (RR: 0.99; 95% CI: 0.98, 1.01) intake. Results did not vary by study outcome (incident coronary heart disease, stroke, total CVD) and there was no evidence for heterogeneity among studies. Only two studies provided data on phosphatidylcholine and CVD mortality. Random effects meta-analysis did not support an association between choline and CVD mortality (RR: 1.09, 95% CI: 0.89, 1.35), but one study supported a positive association and there was significant heterogeneity ( I ² = 84%, p -value < 0.001). Our findings do not support an association between dietary choline/betaine with incident CVD, but call for further research into choline and CVD mortality.
Cartier, Jacqueline L; Kukreja, Subhash C; Barengolts, Elena
2017-03-01
The study examined whether vitamin D insufficiency is a predictor of prevalent and/or incident common chronic conditions in African American men (AAM) and Caucasian American men (CAM). A total of 1,017 men were recruited at an urban VA medical center and followed prospectively for a mean of 5.4 years. Prevalent and incident chronic conditions evaluated were: obesity, type 2 diabetes, cancer, depression, dementia, and cardiovascular disease (CVD, including coronary artery disease [CAD], cerebrovascular accident [CVA], and congestive heart failure [CHF]). Univariate and multivariate regressions were performed to examine the association between 25-hydroxyvitamin D (25[OH]D) and these chronic illnesses. This analysis was limited to 955 men (65.5% AAM, 27.2% CAM, 6.4% Hispanic) who had at least 1 year of follow-up (range, 1.0 to 7.1 years). Univariate analysis of the entire group showed that 25(OH)D correlated negatively with body mass index (BMI). There was no correlation between 25(OH)D and prevalent CVD (including separate analyses for CAD, CVA, and CHF), cancer, depression, dementia, all-cause mortality, or incident cancer, CAD, or CVA. Independent predictors of prevalent common conditions included increasing age, BMI, smoking, alcohol and polysubstance use, but not 25(OH)D levels. The study does not support previously suggested associations of low vitamin D levels with prevalent common chronic conditions or increased risk for cancer, CAD, and CVA in a population of men with high burden of chronic disease. The finding that smoking and alcohol and polysubstance use are predictors of chronic conditions is an important reminder for addressing these risks during patient encounters. AAM = African American men BMI = body mass index CAD = coronary artery disease CAM = Caucasian American men CHF = congestive heart failure CI = confidence interval CVA = cerebrovascular accident CVD = cardiovascular disease HTN = hypertension OR = odds ratio T2DM = type 2 diabetes mellitus VAMC = Veteran Administration Medical Center 25(OH)D = 25-hydroxyvitamin D.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Amani, Matin; Chin, Matthew L.; Mazzoni, Alexander L.
2014-05-19
We report on the electronic transport properties of single-layer thick chemical vapor deposition (CVD) grown molybdenum disulfide (MoS{sub 2}) field-effect transistors (FETs) on Si/SiO{sub 2} substrates. MoS{sub 2} has been extensively investigated for the past two years as a potential semiconductor analogue to graphene. To date, MoS{sub 2} samples prepared via mechanical exfoliation have demonstrated field-effect mobility values which are significantly higher than that of CVD-grown MoS{sub 2}. In this study, we will show that the intrinsic electronic performance of CVD-grown MoS{sub 2} is equal or superior to that of exfoliated material and has been possibly masked by a combinationmore » of interfacial contamination on the growth substrate and residual tensile strain resulting from the high-temperature growth process. We are able to quantify this strain in the as-grown material using pre- and post-transfer metrology and microscopy of the same crystals. Moreover, temperature-dependent electrical measurements made on as-grown and transferred MoS{sub 2} devices following an identical fabrication process demonstrate the improvement in field-effect mobility.« less
Lysenkov, Dmitry; Engstler, Jörg; Dangwal, Arti; Popp, Alexander; Müller, Günter; Schneider, Jörg J; Janardhanan, Vinod M; Deutschmann, Olaf; Strauch, Peter; Ebert, Volker; Wolfrum, Jürgen
2007-06-01
We have developed a chemical vapor deposition (CVD) process for the catalytic growth of carbon nanotubes (CNTs), anchored in a comose-type structure on top of porous alumina substrates. The mass-flow conditions of precursor and carrier gases and temperature distributions in the CVD reactor were studied by transient computational fluid dynamic simulation. Molecular-beam quadrupole mass spectroscopy (MB-QMS) has been used to analyze the gas phase during ferrocene CVD under reaction conditions (1073 K) in the boundary layer near the substrate. Field-emission (FE) properties of the nonaligned CNTs were measured for various coverages and pore diameters of the alumina. Samples with more dense CNT populations provided emitter-number densities up to 48,000 cm(-2) at an electric field of 6 V microm(-1). Samples with fewer but well-anchored CNTs in 22-nm pores yielded the highest current densities. Up to 83 mA cm(-2) at 7 V microm(-1) in dc mode and more than 200 mA cm(-2) at 11 V microm(-1) in pulsed diode operation have been achieved from a cathode size of 24 mm2.
Support for self-management of cardiovascular disease by people with learning disabilities.
Young, Anita F; Naji, Simon; Kroll, Thilo
2012-08-01
Cardiovascular disease (CVD) is the second most common cause of death among people with learning disabilities (LD), and lifestyle has been linked to risk factors. With a shift towards illness prevention and self-management support, it is important to know how people with LD can be involved in this process. To elicit the perceptions of people with LD, carers and health professionals regarding supported self-management of CVD. A qualitative approach used in-depth semi-structured interviews based on vignettes with accompanying pictures. Fourteen people with LD, 11 carers/care staff and 11 health professionals were recruited and interviewed. Thematic framework analysis was used to analyse interview data. In total, 11 men and 25 women were interviewed. All respondents contributed views of self-management with a wide range of opinions expressed within each participant group. Four key themes encompassed: strategies for self-management; understanding the prerequisites for self-management support; preferred supporters and challenges for self-management implementation. Facilitated service user involvement in self-management decision making was highly valued in all groups. Service users wished for co-ordinated incremental support from across agencies and individuals. People with LD can be effectively consulted regarding health management and their views can inform service development. Promoting joined-up support across health and social care and families will require investment in resources, education and dismantling of professional barriers.
Tso, David K; Moe, Gordon
2002-08-01
Cardiovascular diseases (CVD) are the leading cause of death in Canada. Non-European ethnic groups such as the Chinese constitute an increasingly significant sector of the Canadian population. To compare the frequency and risk factors of CVD in Chinese and white Canadians in a cardiology referral clinic that saw a high number of ethnic Chinese patients and provided equal access to advanced diagnostic facilities. Clinic charts of patients referred between 1994 and 1999 were reviewed. Patients of Chinese descent were identified by their names. Primary cardiovascular and secondary cardiovascular diagnoses, as well as risk factors for coronary artery disease (CAD), were established. The frequency of disease and risk factors were age-standardized. The sample of patients with CVD consisted of 404 Chinese and 1129 white subjects. Chinese patients were older (median age 65 versus 62 years, P=0.006). CAD, heart failure and peripheral vascular disease were less frequent in Chinese than in white patients. On the other hand, valvular heart disease was more frequent in Chinese patients. Diabetes, smoking and family history of heart disease were less frequent in Chinese subjects, whereas the frequencies of hypertension and hypercholerolemia were similar to those of white patients. In patients who had undergone coronary angiography, the frequency of multivessel CAD was less in Chinese patients (40% versus 56%, P=0.0016). Angina pectoris was a more common manifestation of CAD in Chinese patients, whereas myocardial infarction was more common in people who were white. In patients with heart failure, the median left ventricular ejection fraction was higher in Chinese than in white patients (34% versus 28%, P=0.031). In patients referred to a cardiology clinic, the diagnosis of CAD and the majority of other CVDs was less frequent in Chinese Canadians than in white Canadians. However, selected modifiable risk factors for CAD, such as hypertension and hypercholesterolemia, were equally frequent. Further research at the population level is warranted to define the characteristics of CVD in Chinese Canadians, and may be useful to the future design of disease management and prevention programs tailored to the needs of this growing ethnic population.
Gene-centric Association Signals for Lipids and Apolipoproteins Identified via the HumanCVD BeadChip
Talmud, Philippa J.; Drenos, Fotios; Shah, Sonia; Shah, Tina; Palmen, Jutta; Verzilli, Claudio; Gaunt, Tom R.; Pallas, Jacky; Lovering, Ruth; Li, Kawah; Casas, Juan Pablo; Sofat, Reecha; Kumari, Meena; Rodriguez, Santiago; Johnson, Toby; Newhouse, Stephen J.; Dominiczak, Anna; Samani, Nilesh J.; Caulfield, Mark; Sever, Peter; Stanton, Alice; Shields, Denis C.; Padmanabhan, Sandosh; Melander, Olle; Hastie, Claire; Delles, Christian; Ebrahim, Shah; Marmot, Michael G.; Smith, George Davey; Lawlor, Debbie A.; Munroe, Patricia B.; Day, Ian N.; Kivimaki, Mika; Whittaker, John; Humphries, Steve E.; Hingorani, Aroon D.
2009-01-01
Blood lipids are important cardiovascular disease (CVD) risk factors with both genetic and environmental determinants. The Whitehall II study (n = 5592) was genotyped with the gene-centric HumanCVD BeadChip (Illumina). We identified 195 SNPs in 16 genes/regions associated with 3 major lipid fractions and 2 apolipoprotein components at p < 10−5, with the associations being broadly concordant with prior genome-wide analysis. SNPs associated with LDL cholesterol and apolipoprotein B were located in LDLR, PCSK9, APOB, CELSR2, HMGCR, CETP, the TOMM40-APOE-C1-C2-C4 cluster, and the APOA5-A4-C3-A1 cluster; SNPs associated with HDL cholesterol and apolipoprotein AI were in CETP, LPL, LIPC, APOA5-A4-C3-A1, and ABCA1; and SNPs associated with triglycerides in GCKR, BAZ1B, MLXIPL, LPL, and APOA5-A4-C3-A1. For 48 SNPs in previously unreported loci that were significant at p < 10−4 in Whitehall II, in silico analysis including the British Women's Heart and Health Study, BRIGHT, ASCOT, and NORDIL studies (total n > 12,500) revealed previously unreported associations of SH2B3 (p < 2.2 × 10−6), BMPR2 (p < 2.3 × 10−7), BCL3/PVRL2 (flanking APOE; p < 4.4 × 10−8), and SMARCA4 (flanking LDLR; p < 2.5 × 10−7) with LDL cholesterol. Common alleles in these genes explained 6.1%–14.7% of the variance in the five lipid-related traits, and individuals at opposite tails of the additive allele score exhibited substantial differences in trait levels (e.g., >1 mmol/L in LDL cholesterol [∼1 SD of the trait distribution]). These data suggest that multiple common alleles of small effect can make important contributions to individual differences in blood lipids potentially relevant to the assessment of CVD risk. These genes provide further insights into lipid metabolism and the likely effects of modifying the encoded targets therapeutically. PMID:19913121
Prevention of cardiovascular disease in rheumatoid arthritis.
Hollan, I; Dessein, P H; Ronda, N; Wasko, M C; Svenungsson, E; Agewall, S; Cohen-Tervaert, J W; Maki-Petaja, K; Grundtvig, M; Karpouzas, G A; Meroni, P L
2015-10-01
The increased risk of cardiovascular disease (CVD) in rheumatoid arthritis (RA) has been recognized for many years. However, although the characteristics of CVD and its burden resemble those in diabetes, the focus on cardiovascular (CV) prevention in RA has lagged behind, both in the clinical and research settings. Similar to diabetes, the clinical picture of CVD in RA may be atypical, even asymptomatic. Therefore, a proactive screening for subclinical CVD in RA is warranted. Because of the lack of clinical trials, the ideal CVD prevention (CVP) in RA has not yet been defined. In this article, we focus on challenges and controversies in the CVP in RA (such as thresholds for statin therapy), and propose recommendations based on the current evidence. Due to the significant contribution of non-traditional, RA-related CV risk factors, the CV risk calculators developed for the general population underestimate the true risk in RA. Thus, there is an enormous need to develop adequate CV risk stratification tools and to identify the optimal CVP strategies in RA. While awaiting results from randomized controlled trials in RA, clinicians are largely dependent on the use of common sense, and extrapolation of data from studies on other patient populations. The CVP in RA should be based on an individualized evaluation of a broad spectrum of risk factors, and include: 1) reduction of inflammation, preferably with drugs decreasing CV risk, 2) management of factors associated with increased CV risk (e.g., smoking, hypertension, hyperglycemia, dyslipidemia, kidney disease, depression, periodontitis, hypothyroidism, vitamin D deficiency and sleep apnea), and promotion of healthy life style (smoking cessation, healthy diet, adjusted physical activity, stress management, weight control), 3) aspirin and influenza and pneumococcus vaccines according to current guidelines, and 4) limiting use of drugs that increase CV risk. Rheumatologists should take responsibility for the education of health care providers and RA patients regarding CVP in RA. It is immensely important to incorporate CV outcomes in testing of anti-rheumatic drugs. Copyright © 2015 Elsevier B.V. All rights reserved.
Depressive symptoms and smoking cessation after hospitalization for cardiovascular disease.
Thorndike, Anne N; Regan, Susan; McKool, Kathleen; Pasternak, Richard C; Swartz, Susan; Torres-Finnerty, Nancy; Rigotti, Nancy A
2008-01-28
Although smoking cessation is essential for prevention of secondary cardiovascular disease (CVD), many smokers do not stop smoking after hospitalization. Mild depressive symptoms are common during hospitalization for CVD. We hypothesized that depressive symptoms measured during hospitalization for acute CVD would predict return to smoking after discharge from the hospital. This was a planned secondary analysis of data from a placebo-controlled, double-blind, randomized trial of bupropion hydrochloride therapy in 245 smokers hospitalized for acute CVD. All subjects received smoking counseling in the hospital and for 12 weeks after discharge. Depressive symptoms were measured during hospitalization with the Beck Depression Inventory (BDI), and smoking cessation was biochemically validated at 2-week, 12-week, and 1-year follow-up. The effect of depressive symptoms on smoking cessation was assessed using multiple logistic regression and survival analyses. Twenty-two percent of smokers had moderate to severe depressive symptoms (BDI >or= 16) during hospitalization. These smokers were more likely to resume smoking by 4 weeks after discharge (P= .007; incidence rate ratio, 2.40; 95% confidence interval, 1.48-3.78) than were smokers with lower BDI scores. Smokers with low BDI scores were more likely to remain abstinent than were those with high BDI scores at 3-month follow-up (37% vs 15%; adjusted odds ratio, 3.02; 95% confidence interval, 1.28-7.09) and 1-year follow-up (27% vs 10%; adjusted odds ratio, 3.77; 95% confidence interval, 1.31-10.82). We estimate that 27% of the effect of the BDI score on smoking cessation was mediated by nicotine withdrawal symptoms. Moderate to severe depressive symptoms during hospitalization for acute CVD are independently associated with rapid relapse to smoking after discharge and lower rates of smoking cessation at long-term follow-up. The relationship was mediated in part by the stronger nicotine withdrawal symptoms experienced by smokers with higher depressive symptoms.
Muthukumar, Sankaran; Sadacharan, Dhalapathy; Ravikumar, Krishnan; Mohanapriya, Gajarajan; Hussain, Zahir; Suresh, R V
2016-03-01
Cardiovascular dysfunction (CVD) is a major cause of mortality and morbidity in hyperthyroidism. CVD and its reversibility after total thyroidectomy (TT) are not adequately addressed. This prospective case-control study evaluates the effect of hyperthyroidism on myocardium and its reversibility after TT. Surgical candidates of new onset hyperthyroidism, Group A (n = 41, age < 60 years) was evaluated with 2D Echocardiography, serum n-terminal probrain natriuretic peptide (NT-proBNP) at the time of diagnosis (Point A), after achieving euthyroidism (Point B) with antithyroid drugs, and 3 months after TT (Point C). 20 patients with nontoxic benign thyroid nodules undergoing TT served as controls (Group B). Both groups were age and sex matched. Group A (n = 41) comprises Graves disease (n = 22) and Toxic Multinodular goiter (n = 19). At point A, CVD was evident in 26/41(63.4%), pulmonary hypertension (PHT) in 24/41(58.5%)--mild in 17/41(41.4%) and moderate in 7/41(17%)--dilated cardiomyopathy (DCM) in 8/41(19.5%), heart failure in 4/41(9.7%), and NT-proBNP elevated in 28/41(68.3%). At point B, recovery was observed in PHT 19/26(73.1%), DCM 4/8(50%), heart failure 4/4(100%), NT-proBNP in 3/28(10.7%). At Point C, further improvement occurred in PHT 23/24(95.8%), DCM 7/8(87.5%), heart failure 4/4(100%), and NT-proBNP in 24/28(85.7%). Pulmonary hypertension is completely reversible at 3 months after TT and is the most common cardiac event in Hyperthyroidism. Various parameters of CVD improved consistently after surgical cure. NT-proBNP levels correlated well with the severity and duration of CVD and hence can be an objective tool in monitoring of hyperthyroid cardiac dysfunction.
Kaess, Bernhard M; Preis, Sarah R; Lieb, Wolfgang; Beiser, Alexa S; Yang, Qiong; Chen, Tai C; Hengstenberg, Christian; Erdmann, Jeanette; Schunkert, Heribert; Seshadri, Sudha; Vasan, Ramachandran S; Assimes, Themistocles L; Deloukas, Panos; Holm, Hilma; Kathiresan, Sekar; König, Inke R; McPherson, Ruth; Reilly, Muredach P; Roberts, Robert; Samani, Nilesh J; Stewart, Alexandre F R
2015-03-11
Brain-derived neurotrophic factor (BDNF) is a pleiotropic peptide involved in maintaining endothelial integrity. It is unknown if circulating BDNF levels are associated with risk of cardiovascular disease (CVD). We prospectively investigated the association of circulating BDNF levels with cardiovascular events and mortality in 3687 participants (mean age 65 years, 2068 women) from the Framingham Heart Study (FHS). Using a common nonsynonomous single nucleotide polymorphism (SNP) in the BDNF gene (rs6265), we then performed a Mendelian randomization experiment in the CARDIoGRAM (Coronary ARtery DIsease Genome-Wide Replication And Meta-Analysis) consortium (>22,000 coronary artery disease [CAD] cases, >60,000 controls) to investigate whether SNP rs6265 was associated with CAD in CARDIoGRAM and, if so, whether the effect estimate differed from that predicted based on FHS data. On follow-up (median 8.9 years), 467 individuals (261 women) in FHS experienced a CVD event, and 835 (430 women) died. In multivariable-adjusted Cox regression, serum BDNF was associated inversely with CVD risk (hazard ratio [HR] per 1-SD increase 0.88, 95% CI 0.80 to 0.97, P=0.01) and with mortality (HR 0.87, 95% CI 0.80 to 0.93, P=0.0002). SNP rs6265 was associated with BDNF concentrations (0.772 ng/mL increase per minor allele copy) in FHS. In CARDIoGRAM, SNP rs6265 was associated with CAD (odds ratio 0.957, 95% CI 0.923 to 0.992), a magnitude consistent with the predicted effect (HR per minor allele copy 0.99, 95% CI 0.98 to 1.0; P=0.06 for difference between predicted and observed effect). Higher serum BDNF is associated with a decreased risk of CVD and mortality. Mendelian randomization suggests a causal protective role of BDNF in the pathogenesis of CVD. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Parsons, Janet A; Yu, Catherine H Y; Baker, Natalie A; Mamdani, Muhammad M; Bhattacharyya, Onil; Zwarenstein, Merrick; Shah, Baiju R
2016-01-01
Diabetes is a chronic disease commonly managed by family physicians, with the most prevalent complication being cardiovascular disease (CVD). Clinical practice guidelines have been developed to support clinicians in the care of diabetic patients. We conducted a pragmatic cluster randomized controlled trial (RCT) of a printed educational toolkit aimed at improving CVD management in diabetes in primary care, and found no effect, and indeed, the possibility of some harm. We conducted a qualitative evaluation to study the strategy for guideline implementation employed in this trial, and to understand its effects. This paper focuses solely on the qualitative findings, as the RCT's quantitative results have already been reported elsewhere. All family practices in the province of Ontario had been randomized to receive the educational toolkit by mail, in either the summer of 2009 (intervention arm) or the spring of 2010 (control arm).A subset of 80 family physicians (representing approximately 10% of the practices randomized and approached, with records on 1,592 randomly selected patients with diabetes at high risk for CVD) then took part in a chart audit and reflective feedback exercise related to their own practice in comparison to the guideline recommendations. They were asked to complete two forms (one pre- and one post-audit) in order to understand their awareness of the guidelines pre-trial, their expectations regarding their individual performance pre-audit, and their reflections on their audit results. In addition, individual interviews with thirteen other family physicians were conducted. Textual data from interview transcripts and written commentary from the pre- and post-audit forms underwent qualitative descriptive analysis to identify common themes and patterns. Analysis revealed four main themes: impressions of the toolkit, awareness was not the issue, 'it's not me it's my patients', and chart audit as a more effective intervention than the toolkit. Participants saw neither the toolkit content nor its dissemination strategy to be effective, indicating they perceived themselves to be aware of the guidelines pre-trial. However, their accounts also indicated that they may be struggling to prioritize CVD management in the midst of competing demands for their attention. Upon receiving their chart audit results, many participants expressed surprise that they had not performed better. They reported that the audit results would be an important motivator for behaviour change. The qualitative findings outlined in this paper offer important insights into why the intervention was not effective. They also demonstrate that physicians have unperceived needs relative to CVD management and that the chart audit served to identify shortcomings in their practice of which they had been hitherto unaware. The findings also indicate that new methods of intervention development and implementation should be explored. This is important given the high prevalence of diabetes worldwide; appropriate CVD management is critical to addressing the morbidity and mortality associated with the disease.
Ikdahl, Eirik; Rollefstad, Silvia; Olsen, Inge C; Kvien, Tore K; Hansen, Inger Johanne Widding; Soldal, Dag Magnar; Haugeberg, Glenn; Semb, Anne Grete
2015-01-01
EULAR recommendations for cardiovascular disease (CVD) risk management include annual CVD risk assessments for patients with rheumatoid arthritis (RA). We evaluated the recording of CVD risk factors (CVD-RF) in a rheumatology outpatient clinic, where EULAR recommendations had been implemented. Further, we compared CVD-RF recordings between a regular rheumatology outpatient clinic (RegROC) and a structured arthritis clinic (AC). In 2012, 1142 RA patients visited the rheumatology outpatient clinic: 612 attended RegROC and 530 attended AC. We conducted a search in the patient journals to ascertain the rate of CVD-RF recording. The overall CVD-RF recording rate was 40.1% in the rheumatology outpatient clinic, reflecting a recording rate of 59.1% in the AC and 23.6% in the RegROC. The odds ratios for having CVD-RFs recorded for patients attending AC compared to RegROC were as follows: blood pressure: 12.4, lipids: 5.0-6.0, glucose: 9.1, HbA1c: 6.1, smoking: 1.4, and for having all the CVD-RFs needed to calculate the CVD risk by the systematic coronary risk evaluation (SCORE): 21.0. The CVD-RF recording rate was low in a rheumatology outpatient clinic. However, a systematic team-based model was superior compared to a RegROC. Further measures are warranted to improve CVD-RF recording in RA patients.
Suicide in males and females with cardiovascular disease and comorbid depression.
Hawkins, Michael; Schaffer, Ayal; Reis, Catherine; Sinyor, Mark; Herrmann, Nathan; Lanctôt, Krista L
2016-06-01
Myocardial infarction (MI) has been associated with an increased risk of suicide, further increased among individuals with a comorbid psychiatric illness. A paucity of studies have examined details of suicide among individuals with cardiovascular disease (CVD) and comorbid depression. We aimed to compare demographic, clinical and suicide-specific characteristics between suicide victims with CVD with depression (CVD+D) and without comorbid depression (CVD-D). Coroner data on suicide decedents with CVD (n=413) occurring in Toronto, Canada from 1998 to 2012 were collected. Characteristics were compared between the CVD+D and CVD-D groups. Regression analysis examined for gender differences in these groups. CVD+D subjects compared to CVD-D were more likely to have had a past suicide attempt (p=0.008), and to have experienced a bereavement (p=0.008) or financial stressor (p=0.005) in the past year. Each of these variables remained significantly associated with the presence of depression after the regression analysis. Within the CVD+D group, females were more likely to die from suicide by self-poisoning (p<0.0001) and males by shooting (p=0.001). Psychological autopsies were not available. The definition of CVD was broad and the accuracy of its diagnosis could not be confirmed. Individuals with CVD+D who died from suicide had significant differences in clinical characteristics and specific stressors compared to those without depression. These data may help to better characterize suicide risk and prevention in this vulnerable population. Copyright © 2016 Elsevier B.V. All rights reserved.
Electrical property of macroscopic graphene composite fibers prepared by chemical vapor deposition
NASA Astrophysics Data System (ADS)
Sun, Haibin; Fu, Can; Gao, Yanli; Guo, Pengfei; Wang, Chunlei; Yang, Wenchao; Wang, Qishang; Zhang, Chongwu; Wang, Junya; Xu, Junqi
2018-07-01
Graphene fibers are promising candidates in portable and wearable electronics due to their tiny volume, flexibility and wearability. Here, we successfully synthesized macroscopic graphene composite fibers via a two-step process, i.e. first electrospinning and then chemical vapor deposition (CVD). Briefly, the well-dispersed PAN nanofibers were sprayed onto the copper surface in an electrified thin liquid jet by electrospinning. Subsequently, CVD growth process induced the formation of graphene films using a PAN-solid source of carbon and a copper catalyst. Finally, crumpled and macroscopic graphene composite fibers were obtained from carbon nanofiber/graphene composite webs by self-assembly process in the deionized water. Temperature-dependent conduct behavior reveals that electron transport of the graphene composite fibers belongs to hopping mechanism and the typical electrical conductivity reaches 4.59 × 103 S m‑1. These results demonstrated that the graphene composite fibers are promising for the next-generation flexible and wearable electronics.
Epidemiology of ischemic heart disease in HIV.
Triant, Virginia A; Grinspoon, Steven K
2017-11-01
The purpose of this review is to summarize and synthesize recent data on the risk of ischemic heart disease (IHD) in HIV-infected individuals. Recent studies in the field demonstrate an increasing impact of cardiovascular disease (CVD) on morbidity and mortality in HIV relative to AIDS-related diagnoses. Studies continue to support an approximately 1.5 to two-fold increased risk of IHD conferred by HIV, with specific risk varying by sex and virologic/immunologic status. Risk factors include both traditional CVD risk factors and novel, HIV-specific factors including inflammation and immune activation. Specific antiretroviral therapy (ART) drugs may increase CVD risk, yet the net effect of ART with viral suppression is beneficial with regard to CVD risk. Management of cardiovascular risk and prevention of CVD is complex, because current general population strategies target traditional CVD risk factors only. Extensive investigation is being directed at developing tailored CVD risk prediction algorithms and interventions to reduce CVD risk in HIV. Increased IHD risk is a significant clinical and public health challenge in HIV. The development and application of HIV-specific interventions to manage CVD risk factors and reduce CVD risk will improve the long-term health of this ageing population.
All-Cause and CVD Mortality in Native Hawaiians
Aluli, N. Emmett; Reyes, Phillip W.; Brady, S. Kalani; Tsark, JoAnn U.; Jones, Kristina L.; Mau, Marjorie; Howard, Wm. J.; Howard, Barbara V.
2010-01-01
Aims Cardiovascular disease (CVD) is the leading cause of death among Native Hawaiians. In this article, all-cause and cardiovascular mortality rates among Native Hawaiians are examined, along with associated CVD risk factors. Methods A total of 855 Native Hawaiians (343 men and 512 women, ages 19–88) were examined as participants of the Cardiovascular Risk Clinics program (1992–1998) and underwent surveillance through September 2007. Cause of each death was determined by review of medical records, death certificates, newspapers, and through queries to community members. Results CVD accounted for 55% of deaths. Coronary heart disease (CHD) accounted for the majority of CVD deaths. CVD increased with age and was higher in those with diabetes, hypertension, or high low-density lipoprotein cholesterol (LDL-C). CVD rates were higher in men than in women and 4-fold higher in those with diabetes. In addition to age, diabetes, hypertension, and elevated LDL-C were major risk factors. Conclusions Diabetes is a major determinant of CVD in this population and most of the CVD is occurring in those with diabetes. Strategies to prevent diabetes and manage blood pressure and lipids should reduce CVD rates in Native Hawaiians. PMID:20392507
Arts, E E A; Popa, C D; Den Broeder, A A; Donders, R; Sandoo, A; Toms, T; Rollefstad, S; Ikdahl, E; Semb, A G; Kitas, G D; Van Riel, P L C M; Fransen, J
2016-04-01
Predictive performance of cardiovascular disease (CVD) risk calculators appears suboptimal in rheumatoid arthritis (RA). A disease-specific CVD risk algorithm may improve CVD risk prediction in RA. The objectives of this study are to adapt the Systematic COronary Risk Evaluation (SCORE) algorithm with determinants of CVD risk in RA and to assess the accuracy of CVD risk prediction calculated with the adapted SCORE algorithm. Data from the Nijmegen early RA inception cohort were used. The primary outcome was first CVD events. The SCORE algorithm was recalibrated by reweighing included traditional CVD risk factors and adapted by adding other potential predictors of CVD. Predictive performance of the recalibrated and adapted SCORE algorithms was assessed and the adapted SCORE was externally validated. Of the 1016 included patients with RA, 103 patients experienced a CVD event. Discriminatory ability was comparable across the original, recalibrated and adapted SCORE algorithms. The Hosmer-Lemeshow test results indicated that all three algorithms provided poor model fit (p<0.05) for the Nijmegen and external validation cohort. The adapted SCORE algorithm mainly improves CVD risk estimation in non-event cases and does not show a clear advantage in reclassifying patients with RA who develop CVD (event cases) into more appropriate risk groups. This study demonstrates for the first time that adaptations of the SCORE algorithm do not provide sufficient improvement in risk prediction of future CVD in RA to serve as an appropriate alternative to the original SCORE. Risk assessment using the original SCORE algorithm may underestimate CVD risk in patients with RA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Hirata, Takumi; Arai, Yasumichi; Takayama, Michiyo; Abe, Yukiko; Ohkuma, Kiyoshi; Takebayashi, Toru
2018-01-01
Accumulating evidence suggests that predictability of traditional cardiovascular risk factors declines with advancing age. We investigated whether carotid plaque scores (CPSs) were associated with cardiovascular disease (CVD) death in the oldest old, and whether asymmetrical dimethylarginine (ADMA), a marker of endothelial dysfunction, moderated the association between the CPS and CVD death. We conducted a prospective cohort study of Japanese subjects aged ≥85 years without CVD at baseline. We followed this cohort for 6 years to investigate the association of CPS with CVD death via multivariable Cox proportional hazard analysis. We divided participants into three groups according to CPS (no, 0 points; low, 1.2-4.9 points; high, ≥5.0 points). The predictive value of CPS for estimating CVD death risk over CVD risk factors, including ADMA, was examined using C-statistics. We analyzed 347 participants (151 men, 196 women; mean age, 87.6 years), of which 135 (38.9%) had no carotid plaque at baseline, and 48 (13.8%) had high CPS. Of the total, 29 (8.4%) participants experienced CVD-related death during the study period. Multivariable analysis revealed a significant association of high CPS with CVD-related mortality relative to no CPS (hazard ratio, 3.90; 95% confidence interval: 1.47-10.39). ADMA was not associated with CVD death, but the significant association between CPS and CVD death was observed only in lower ADMA level. The addition of CPS to other risk factors improved the predictability of CVD death (p=0.032). High CPS correlated significantly with a higher CVD death risk in the oldest old with low cardiovascular risk. Ultrasound carotid plaque evaluation might facilitate risk evaluations of CVD death in the very old.
Cho, Soo-Kyung; Kim, Dam; Won, Soyoung; Lee, Jiyoung; Park, ByeongJu; Jang, Eun Jin; Bae, Sang-Cheol; Sung, Yoon-Kyoung
2018-02-01
To estimate the incidence of cardiovascular disease (CVD) in Asian patients with rheumatoid arthritis (RA) and to evaluate the impact of anti-rheumatic treatment on the development of CVD. A retrospective cohort of Asian patients with RA was established to identify the incidence rate (IR) of CVD in RA patients. The cohort was generated using the Korean National Healthcare claims database, which contained claims from Jan 2009 to Dec 2013. A total of 137,512 RA patients were identified; individuals with a history of CVD for 6 months or more before the index date were excluded. Nested case-control samples were drawn from the full study population with a case:control ratio of 1:4 (n = 7102 cases; n = 27,018 controls without CVD). A conditional multivariate regression model was used to evaluate the impact of anti-rheumatic treatment on the development of CVD in RA patients after matching for age, sex, RA index date, comorbidities, and drug use (e.g., antiplatelet agents and cholesterol-lowering agents). The IR for development of overall CVD in RA patients was 182.1 (95% CI: 178.4-185.9) per 10,000 person-years. In models adjusted for other CVD risk factors, disease-modifying anti-rheumatic drugs (DMARDs) (OR = 0.79) were protective against CVD, and biologic DMARDs were not significantly associated with CVD risk (OR = 0.85). Corticosteroids (OR = 1.26) and NSAIDs (nonselective NSAIDs: OR = 1.32, Cox-2 inhibitors: OR = 1.31) were risk factors for CVD in RA patients. The use of DMARDs is protective against CVD, while corticosteroids and NSAIDs increased the risk of CVD in RA patients. Copyright © 2018 Elsevier Inc. All rights reserved.
McLean, Gary; Martin, Julie Langan; Martin, Daniel J; Guthrie, Bruce; Mercer, Stewart W; Smith, Daniel J
2014-10-01
Schizophrenia is associated with increased cardiovascular mortality. Although cardiovascular disease (CVD) risk prediction algorithms are widely in the general population, their utility for patients with schizophrenia is unknown. A primary care dataset was used to compare CVD risk scores (Joint British Societies (JBS) score), cardiovascular risk factors, rates of pre-existing CVD and age of first diagnosis of CVD for schizophrenia (n=1997) relative to population controls (n=215,165). Pre-existing rates of CVD and the recording of risk factors for those without CVD were higher in the schizophrenia cohort in the younger age groups, for both genders. Those with schizophrenia were more likely to have a first diagnosis of CVD at a younger age, with nearly half of men with schizophrenia plus CVD diagnosed under the age of 55 (schizophrenia men 46.1% vs. control men 34.8%, p<0.001; schizophrenia women 28.9% vs. control women 23.8%, p<0.001). However, despite high rates of CVD risk factors within the schizophrenia group, only a very small percentage (3.2% of men and 7.5% of women) of those with schizophrenia under age 55 were correctly identified as high risk for CVD according to the JBS risk algorithm. The JBS2 risk score identified only a small proportion of individuals with schizophrenia under the age of 55 as being at high risk of CVD, despite high rates of risk factors and high rates of first diagnosis of CVD within this age group. The validity of CVD risk prediction algorithms for schizophrenia needs further research. Copyright © 2014 Elsevier B.V. All rights reserved.
Fabrication of nanostructured electrodes and interfaces using combustion CVD
NASA Astrophysics Data System (ADS)
Liu, Ying
Reducing fabrication and operation costs while maintaining high performance is a major consideration for the design of a new generation of solid-state ionic devices such as fuel cells, batteries, and sensors. The objective of this research is to fabricate nanostructured materials for energy storage and conversion, particularly porous electrodes with nanostructured features for solid oxide fuel cells (SOFCs) and high surface area films for gas sensing using a combustion CVD process. This research started with the evaluation of the most important deposition parameters: deposition temperature, deposition time, precursor concentration, and substrate. With the optimum deposition parameters, highly porous and nanostructured electrodes for low-temperature SOFCs have been then fabricated. Further, nanostructured and functionally graded La0.8Sr0.2MnO2-La 0.8SrCoO3-Gd0.1Ce0.9O2 composite cathodes were fabricated on YSZ electrolyte supports. Extremely low interfacial polarization resistances (i.e. 0.43 Ocm2 at 700°C) and high power densities (i.e. 481 mW/cm2 at 800°C) were generated at operating temperature range of 600°C--850°C. The original combustion CVD process is modified to directly employ solid ceramic powder instead of clear solution for fabrication of porous electrodes for solid oxide fuel cells. Solid particles of SOFC electrode materials suspended in an organic solvent were burned in a combustion flame, depositing a porous cathode on an anode supported electrolyte. Combustion CVD was also employed to fabricate highly porous and nanostructured SnO2 thin film gas sensors with Pt interdigitated electrodes. The as-prepared SnO2 gas sensors were tested for ethanol vapor sensing behavior in the temperature range of 200--500°C and showed excellent sensitivity, selectivity, and speed of response. Moreover, several novel nanostructures were synthesized using a combustion CVD process, including SnO2 nanotubes with square-shaped or rectangular cross sections, well-aligned ZnO nanorods, and two-dimensional ZnO flakes. Solid-state gas sensors based on single piece of these nanostructures demonstrated superior gas sensing performances. These size-tunable nanostructures could be the building blocks of or a template for fabrication of functional devices. In summary, this research has developed new ways for fabrication of high-performance solid-state ionic devices and has helped generating fundamental understanding of the correlation between processing conditions, microstructure, and properties of the synthesized structures.
Kotze, Maritha J; van Rensburg, Susan J
2012-09-01
Chronic, multi-factorial conditions caused by a complex interaction between genetic and environmental risk factors frequently share common disease mechanisms, as evidenced by an overlap between genetic risk factors for cardiovascular disease (CVD) and Alzheimer's disease (AD). Single nucleotide polymorphisms (SNPs) in several genes including ApoE, MTHFR, HFE and FTO are known to increase the risk of both conditions. The E4 allele of the ApoE polymorphism is the most extensively studied risk factor for AD and increases the risk of coronary heart disease by approximately 40%. It furthermore displays differential therapeutic responses with use of cholesterol-lowering statins and acetylcholinesterase inhibitors, which may also be due to variation in the CYP2D6 gene in some patients. Disease expression may be triggered by gene-environment interaction causing conversion of minor metabolic abnormalities into major brain disease due to cumulative risk. A growing body of evidence supports the assessment and treatment of CVD risk factors in midlife as a preventable cause of cognitive decline, morbidity and mortality in old age. In this review, the concept of pathology supported genetic testing (PSGT) for CVD is described in this context. PSGT combines DNA testing with biochemical measurements to determine gene expression and to monitor response to treatment. The aim is to diagnose treatable disease subtypes of complex disorders, facilitate prevention of cumulative risk and formulate intervention strategies guided from the genetic background. CVD provides a model to address the lifestyle link in most chronic diseases with a genetic component. Similar preventative measures would apply for optimisation of heart and brain health.
Bisphenol A and Peripheral Arterial Disease: Results from the NHANES
Teppala, Srinivas; Sabanayagam, Charumathi
2012-01-01
Background: Bisphenol A (BPA) is a common chemical used in the manufacture of polycarbonate plastics and epoxy resins, and > 93% of U.S. adults have detectable levels of urinary BPA. Recent animal studies have suggested that BPA exposure may have a role in several mechanisms involved in the development of cardiovascular disease (CVD), including weight gain, insulin resistance, thyroid dysfunction, endothelial dysfunction, and oxidative stress. However, few human studies have examined the association between markers of BPA exposure and CVD. Peripheral arterial disease (PAD) is a subclinical measure of atherosclerotic vascular disease and a strong independent risk factor for CVD and mortality. Objective: We examined the association between urinary BPA levels and PAD in a nationally representative sample of U.S. adults. Methods: We analyzed data from 745 participants in the National Health and Nutritional Examination Survey 2003–2004. We estimated associations between urinary BPA levels (in tertiles) and PAD (ankle–brachial index < 0.9, n = 63) using logistic regression models adjusted for potential confounders (age, sex, race/ethnicity, education, smoking, body mass index, diabetes mellitus, hypertension, urinary creatinine, estimated glomerular filtration rate, and serum cholesterol levels). Results: We observed a significant, positive association between increasing levels of urinary BPA and PAD before and after adjusting for confounders. The multivariable-adjusted odds ratio for PAD associated with the highest versus lowest tertile of urinary BPA was 2.69 (95% confidence interval: 1.02, 7.09; p-trend = 0.01). Conclusions: Urinary BPA levels were significantly associated with PAD, independent of traditional CVD risk factors. PMID:22645278
Abbs, Elizabeth S; Viñoles, José; Alarcón, Jorge O; Johnson, Heather M; Zunt, Joseph R
2017-05-22
Adults of the peri-urban Peruvian shantytown of Lomas de Zapallal have a high prevalence of risk factors for developing cardiovascular disease (CVD)-likely due to behavioral choices established during childhood and adolescence. To guide the development of community-based risk reduction programs, we assessed the prevalence of risk factors for developing CVD among adolescents. We collected cross sectional data from adolescents of Peruvian peri-urban shantytown to evaluate four domains of CVD risk factors: (1) clinical (blood pressure, fasting blood glucose, and blood lipids), (2) anthropometric (height, weight, and waist circumference), (3) behavioral (physical activity, diet, and substance abuse), and (4) psychosocial (mental health and violence). We enrolled 275 adolescents (56.4% female, mean age 14 years). Prevalence of overweight or obese status was 27.8%. High blood pressure was more common in males (37.4%) than females (20.5%) (p = 0.002). Total cholesterol was elevated (>170 mg/dL) in nearly half (45.5%) of the adolescents, and 71% had impaired fasting blood glucose (>100 mg/dL). Females were less likely to exercise daily (95.4%) than males (84.2%) (p = 0.002) but reported higher rates of depression (66.4%), anhedonia (67.6%), and self-harm behavior (37.9%) (all p < 0.01). Adolescents living in the peri-urban population of Puente Piedra had high prevalence of risk factors for future development of CVD; preventative efforts focused on improving nutrition, increasing physical inactivity, and addressing mental health conditions could reduce such risk factors.
l-Carnitine and heart disease.
Wang, Zhong-Yu; Liu, Ying-Yi; Liu, Guo-Hui; Lu, Hai-Bin; Mao, Cui-Ying
2018-02-01
Cardiovascular disease (CVD) is a key cause of deaths worldwide, comprising 15-17% of healthcare expenditure in developed countries. Current records estimate an annual global average of 30 million cardiac dysfunction cases, with a predicted escalation by two-three folds for the next 20-30years. Although β-blockers and angiotensin-converting-enzymes are commonly prescribed to control CVD risk, hepatotoxicity and hematological changes are frequent adverse events associated with these drugs. Search for alternatives identified endogenous cofactor l-carnitine, which is capable of promoting mitochondrial β-oxidation towards a balanced cardiac energy metabolism. l-Carnitine facilitates transport of long-chain fatty acids into the mitochondrial matrix, triggering cardioprotective effects through reduced oxidative stress, inflammation and necrosis of cardiac myocytes. Additionally, l-carnitine regulates calcium influx, endothelial integrity, intracellular enzyme release and membrane phospholipid content for sustained cellular homeostasis. Carnitine depletion, characterized by reduced expression of "organic cation transporter-2" gene, is a metabolic and autosomal recessive disorder that also frequently associates with CVD. Hence, exogenous carnitine administration through dietary and intravenous routes serves as a suitable protective strategy against ventricular dysfunction, ischemia-reperfusion injury, cardiac arrhythmia and toxic myocardial injury that prominently mark CVD. Additionally, carnitine reduces hypertension, hyperlipidemia, diabetic ketoacidosis, hyperglycemia, insulin-dependent diabetes mellitus, insulin resistance, obesity, etc. that enhance cardiovascular pathology. These favorable effects of l-carnitine have been evident in infants, juvenile, young, adult and aged patients of sudden and chronic heart failure as well. This review describes the mechanism of action, metabolism and pharmacokinetics of l-carnitine. It specifically emphasizes upon the beneficial role of l-carnitine in cardiomyopathy. Copyright © 2017 Elsevier Inc. All rights reserved.
In-situ sensing using mass spectrometry and its use for run-to-run control on a W-CVD cluster tool
NASA Astrophysics Data System (ADS)
Gougousi, T.; Sreenivasan, R.; Xu, Y.; Henn-Lecordier, L.; Rubloff, G. W.; Kidder, , J. N.; Zafiriou, E.
2001-01-01
A 300 amu closed-ion-source RGA (Leybold-Inficon Transpector 2) sampling gases directly from the reactor of an ULVAC ERA-1000 cluster tool has been used for real time process monitoring of a W CVD process. The process involves H2 reduction of WF6 at a total pressure of 67 Pa (0.5 torr) to produce W films on Si wafers heated at temperatures around 350 °C. The normalized RGA signals for the H2 reagent depletion and the HF product generation were correlated with the W film weight as measured post-process with an electronic microbalance for the establishment of thin-film weight (thickness) metrology. The metrology uncertainty (about 7% for the HF product) was limited primarily by the very low conversion efficiency of the W CVD process (around 2-3%). The HF metrology was then used to drive a robust run-to-run control algorithm, with the deposition time selected as the manipulated (or controlled) variable. For that purpose, during a 10 wafer run, a systematic process drift was introduced as a -5 °C processing temperature change for each successive wafer, in an otherwise unchanged process recipe. Without adjustment of the deposition time the W film weight (thickness) would have declined by about 50% by the 10th wafer. With the aid of the process control algorithm, an adjusted deposition time was computed so as to maintain constant HF sensing signal, resulting in weight (thickness) control comparable to the accuracy of the thickness metrology. These results suggest that in-situ chemical sensing, and particularly mass spectrometry, provide the basis for wafer state metrology as needed to achieve run-to-run control. Furthermore, since the control accuracy was consistent with the metrology accuracy, we anticipate significant improvements for processes as used in manufacturing, where conversion rates are much higher (40-50%) and corresponding signals for metrology will be much larger.
Hayden, Elizabeth P.; Olino, Thomas M.; Mackrell, Sarah V.M.; Jordan, Patricia L.; Desjardins, Jasmine; Katsiroumbas, Patrice
2014-01-01
Theories of cognitive vulnerability to depression (CVD) imply that CVD is early-emerging and trait-like; however, little longitudinal work has tested this premise in middle childhood, or examined theoretically relevant predictors of child CVD. We examined test–retest correlations of self-referent encoding task performance and self-reported attributional styles and their associations with parental characteristics in 205 seven-year-olds. At baseline, child CVD was assessed, structured clinical interviews were conducted with parents, and ratings of observed maternal affective styles were made. Children’s CVD was re-assessed approximately one and two years later. Both measures of children’s CVD were prospectively and concurrently associated with children’s depressive symptoms and showed modest stability. Multilevel modeling indicated that maternal criticism and paternal depression were related to children’s CVD. Findings indicate that even early-emerging CVD is a valid marker of children’s depression risk. PMID:25392596
Czarzasta, Katarzyna; Cudnoch-Jedrzejewska, Agnieszka
2014-01-01
Research studies indicate a role of the apelinergic and vasopressinergic systems both in the regulation of the cardiovascular system and the pathogenesis of CVD, including in such settings as obesity and stress. Based on these data, it may be suggested that interactions between these systems underlie numerous physiological and pathophysiological processes, some of them related to the cardiovascular system. Better understanding of the role of these systems and their interactions, both physiological and related to the pathogenesis of CVD, will allow further advances in prevention and drug therapy.
Dietary antioxidant capacity of the patients with cardiovascular disease in a cross-sectional study.
Zujko, Małgorzata E; Witkowska, Anna M; Waśkiewicz, Anna; Piotrowski, Walerian; Terlikowska, Katarzyna M
2015-03-15
The purpose of this study was to establish sources and patterns of antioxidant, polyphenol and flavonoid intakes in men and women with cardiovascular disease (CVD). The subjects with CVD and healthy controls (HC) were participants of the Polish National Multicenter Health Survey (WOBASZ). Food intakes were measured with the 1-day 24-hour recall method. A self-developed database was used to calculate dietary total antioxidant capacity (DTAC), dietary total polyphenol content (DTPC) and dietary total flavonoid content (DTFC). DTAC did not differ between the men with CVD and HC men (6442 vs. 6066 μmol trolox equivalents - TE), but in the women with CVD it was significantly higher than in the HC women (6182 vs. 5500 μmol TE). The main sources of antioxidants in the males with CVD were: tea, coffee, apples, and nuts and seeds, and tea, coffee and apples in HC. In the females they were: tea, coffee, apples and strawberries, both in the women with CVD and HC. DTPC in the men with CVD did not differ from HC (1198 vs. 1114 mg gallic acid equivalents, GAE). In the females, DTPC was significantly higher in the subjects with CVD as compared to HC (1075 vs. 981 mg GAE). Predominant sources of polyphenols were: tea, coffee, cabbage, potatoes, apples and white bread in the men with CVD, and tea, coffee, potatoes, white bread and apples in HC, while in the women (both with CVD and HC): tea, coffee, apples, potatoes and cabbage. No differences in DTFC have been found between the males with CVD and HC (212 vs. 202 mg quercetine equivalents, QE). In the women with CVD, DTFC was significantly higher than in HC (200 vs. 177 mg QE). Main sources of flavonoids in all participants (men and women, CVD and HC) were tea, apples, cabbage and coffee. Polish men and women faced with CVD beneficially modify their dietary practices by enhancing intakes of foods that are sources of antioxidants, polyphenols and flavonoids. Different sources and patterns of antioxidant, polyphenol and flavonoid intakes, however, between male and female patients with CVD were observed.
NASA Astrophysics Data System (ADS)
Chandrashekar, Anand; Chen, Feng; Lin, Jasmine; Humayun, Raashina; Wongsenakhum, Panya; Chang, Sean; Danek, Michal; Itou, Takamasa; Nakayama, Tomoo; Kariya, Atsushi; Kawaguchi, Masazumi; Hizume, Shunichi
2010-09-01
This paper describes electrical testing results of new tungsten chemical vapor deposition (CVD-W) process concepts that were developed to address the W contact and bitline scaling issues on 55 nm node devices. Contact resistance (Rc) measurements in complementary metal oxide semiconductor (CMOS) devices indicate that the new CVD-W process for sub-32 nm and beyond - consisting of an advanced pulsed nucleation layer (PNL) combined with low resistivity tungsten (LRW) initiation - produces a 20-30% drop in Rc for diffused NiSi contacts. From cross-sectional bright field and dark field transmission electron microscopy (TEM) analysis, such Rc improvement can be attributed to improved plugfill and larger in-feature W grain size with the advanced PNL+LRW process. More experiments that measured contact resistance for different feature sizes point to favorable Rc scaling with the advanced PNL+LRW process. Finally, 40% improvement in line resistance was observed with this process as tested on 55 nm embedded dynamic random access memory (DRAM) devices, confirming that the advanced PNL+LRW process can be an effective metallization solution for sub-32 nm devices.
NASA Astrophysics Data System (ADS)
Pyo, Youngjun; Choi, Dahyun; Son, Yeon-Ho; Kang, Suhee; Yoon, Eric H.; Jung, Seung-Boo; Kim, Yongil; Sunyong Lee, Caroline
2016-05-01
A novel method of carbonaceous coating on the surface of copper particles was developed through a chemical vapor deposition (CVD) process to prevent the oxidation of copper nanoparticles (CNPs). The types of poly(vinyl pyrrolidone) (PVP) used were K-12 (M W 3,500) and K-30 (M W 45,000). The amounts of PVP used ranged from 10 to 50 wt %. Additionally, processing temperatures of 900 and 875 °C were tested and compared. The optimum CVD process conditions for the carbonaceous coating were as follows: 875 °C processing temperature, 50 wt % K12 PVP solution, and gas conditions of \\text{Ar}:\\text{H}2 = 1:1. The resistivity change in the fabricated copper pattern was confirmed that the initial resistivity value of the ink with a mixing ratio of carbonaceous-coated CNPs to 1-octanethiol-coated CNPs of 4:6 (w/w) maintained its initial resistivity value of 2.93 × 10-7 Ω·m for more than 210 days.
Development Status of a CVD System to Deposit Tungsten onto UO2 Powder via the WCI6 Process
NASA Technical Reports Server (NTRS)
Mireles, O. R.; Kimberlin, A.; Broadway, J.; Hickman, R.
2014-01-01
Nuclear Thermal Propulsion (NTP) is under development for deep space exploration. NTP's high specific impulse (> 850 second) enables a large range of destinations, shorter trip durations, and improved reliability. W-60vol%UO2 CERMET fuel development efforts emphasize fabrication, performance testing and process optimization to meet service life requirements. Fuel elements must be able to survive operation in excess of 2850 K, exposure to flowing hydrogen (H2), vibration, acoustic, and radiation conditions. CTE mismatch between W and UO2 result in high thermal stresses and lead to mechanical failure as a result UO2 reduction by hot hydrogen (H2) [1]. Improved powder metallurgy fabrication process control and mitigated fuel loss can be attained by coating UO2 starting powders within a layer of high density tungsten [2]. This paper discusses the advances of a fluidized bed chemical vapor deposition (CVD) system that utilizes the H2-WCl6 reduction process.
Graphene growth on Ge(100)/Si(100) substrates by CVD method.
Pasternak, Iwona; Wesolowski, Marek; Jozwik, Iwona; Lukosius, Mindaugas; Lupina, Grzegorz; Dabrowski, Pawel; Baranowski, Jacek M; Strupinski, Wlodek
2016-02-22
The successful integration of graphene into microelectronic devices is strongly dependent on the availability of direct deposition processes, which can provide uniform, large area and high quality graphene on nonmetallic substrates. As of today the dominant technology is based on Si and obtaining graphene with Si is treated as the most advantageous solution. However, the formation of carbide during the growth process makes manufacturing graphene on Si wafers extremely challenging. To overcome these difficulties and reach the set goals, we proposed growth of high quality graphene layers by the CVD method on Ge(100)/Si(100) wafers. In addition, a stochastic model was applied in order to describe the graphene growth process on the Ge(100)/Si(100) substrate and to determine the direction of further processes. As a result, high quality graphene was grown, which was proved by Raman spectroscopy results, showing uniform monolayer films with FWHM of the 2D band of 32 cm(-1).
Mugure, Gladys; Karama, Mohamed; Kyobutungi, Catherine; Karanja, Simon
2014-01-01
Introduction Cardiovascular diseases (CVD) are the leading cause of death in the world. Over 80% of CVD related deaths occur in low- and middle-income countries (LMICs). Diabetes and hypertension, whose prevalence in Kenya is on the rise, are major risk factors for CVD. Despite this, studies indicate that awareness on the management of risk factors for CVD among diabetic/hypertensive patients in African populations is generally low. The aim of the study was to determine the risk factors for CVD among diabetic and/or hypertensive patients attending diabetes and hypertension management clinics in Korogocho and Viwandani slums of Nairobi. Methods Data were collected using questionnaires administered to 206 diabetic/hypertensive patients attending the clinics between July 2010 and February 2011. A review of these patients’ medical records was done to determine the history of CVD outcomes such as hypertensive heart diseases, stroke and peripheral arterial diseases. Results Majority (66.5%) of the study participants were females mainly in the 51-65 age category. The study findings revealed that 73 (33.4%) respondents had CVD outcomes. In addition, 41.8% of the respondents were not aware of the causes of diabetes/hypertension. Age category 51-65 years had the highest (43.8%) number of respondents with CVD. Sex of the respondents and awareness of the link between hypertension and CVD were significantly associated with CVD outcomes (p<0.05) among the respondents. Conclusion Measures to improve awareness levels among patients at high risk of CVD outcomes are needed to complement other measures to reduce CVD risk among such patients. PMID:25852804
Polycystic ovarian syndrome (PCOS): Long-term metabolic consequences.
Anagnostis, Panagiotis; Tarlatzis, Basil C; Kauffman, Robert P
2017-10-10
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during their reproductive ages, associated with a plethora of cardiometabolic consequences, with obesity, insulin resistance and hyperandrogenemia playing a major role in the degree of such manifestations. These consequences include increased risk of glucose intolerance and diabetes mellitus (both type 2 and gestational), atherogenic dyslipidemia, systemic inflammation, non-alcoholic fatty liver disease, hypertension and coagulation disorders. Whether this cluster of metabolic abnormalities is also translated in increased cardiovascular disease (CVD) morbidity and mortality in later life, remains to be established. Data so far based on markers of subclinical atherosclerosis as well as retrospective and prospective cohort studies indicate a possible increased CVD risk, mainly for coronary heart disease. Future studies are needed to further elucidate this issue. Copyright © 2017 Elsevier Inc. All rights reserved.
Mansilha, Armando; Sousa, Joel
2018-06-05
Chronic venous disease (CVD) is a common pathology, with significant physical and psychological impacts for patients and high economic costs for national healthcare systems. Throughout the last decades, several risk factors for this condition have been identified, but only recently, have the roles of inflammation and endothelial dysfunction been properly assessed. Although still incompletely understood, current knowledge of the pathophysiological mechanisms of CVD reveals several potential targets and strategies for therapeutic intervention, some of which are addressable by currently available venoactive drugs. The roles of these drugs in the clinical improvement of venous tone and contractility, reduction of edema and inflammation, as well as in improved microcirculation and venous ulcer healing have been studied extensively, with favorable results reported in the literature. Here, we aim to review these pathophysiological mechanisms and their implications regarding currently available venoactive drug therapies.
Barber, Claire E. H.; Marshall, Deborah A; Alvarez, Nanette; John Mancini, G. B.; Lacaille, Diane; Keeling, Stephanie; Aviña-Zubieta, J. Antonio; Khodyakov, Dmitry; Barnabe, Cheryl; Faris, Peter; Smith, Alexa; Noormohamed, Raheem; Hazlewood, Glen; Martin, Liam O.; Esdaile, John M.
2016-01-01
Objective Patients with rheumatoid arthritis (RA) have a high risk of premature cardiovascular disease (CVD). We developed CVD quality indicators (QIs) for screening and use in Rheumatology clinics. Methods A systematic review of the literature on CVD risk reduction in RA and the general population was conducted. Based on the best practices identified from this review, a draft set of 12 candidate QIs were presented to a Canadian panel of rheumatologists and cardiologists (n=6) from three academic centers to achieve consensus on the QI specifications. The resulting 11 QIs were then evaluated by an online modified-Delphi panel of multidisciplinary health professionals and patients (n = 43) to determine their relevance, validity and feasibility in three rounds of online voting and threaded discussion using a modified RAND/UCLA Appropriateness Methodology. Results Response rates for the online panel were 86%. All 11 QIs were rated as highly relevant, valid and feasible (median rating ≥7 on a 1–9 scale) with no significant disagreement. The final QI set addresses the following themes: communication to primary care about increased CV risk in RA, CV risk assessment, defining smoking status and providing cessation counseling, screening and addressing hypertension, dyslipidemia and diabetes, exercise recommendations, body mass index screening and lifestyle counseling, minimizing corticosteroid use and communicating to patients at high risk of CVD about the risks/benefits of non-steroidal anti-inflammatory drugs. Conclusion Eleven QIs for CVD care in RA patients have been developed and are rated as highly relevant, valid and feasible by an international multidisciplinary panel. PMID:26178275
Photochemical CVD of Ru on functionalized self-assembled monolayers from organometallic precursors
NASA Astrophysics Data System (ADS)
Johnson, Kelsea R.; Arevalo Rodriguez, Paul; Brewer, Christopher R.; Brannaka, Joseph A.; Shi, Zhiwei; Yang, Jing; Salazar, Bryan; McElwee-White, Lisa; Walker, Amy V.
2017-02-01
Chemical vapor deposition (CVD) is an attractive technique for the metallization of organic thin films because it is selective and the thickness of the deposited film can easily be controlled. However, thermal CVD processes often require high temperatures which are generally incompatible with organic films. In this paper, we perform proof-of-concept studies of photochemical CVD to metallize organic thin films. In this method, a precursor undergoes photolytic decomposition to generate thermally labile intermediates prior to adsorption on the sample. Three readily available Ru precursors, CpRu(CO)2Me, (η3-allyl)Ru(CO)3Br, and (COT)Ru(CO)3, were employed to investigate the role of precursor quantum yield, ligand chemistry, and the Ru oxidation state on the deposition. To investigate the role of the substrate chemistry on deposition, carboxylic acid-, hydroxyl-, and methyl-terminated self-assembled monolayers were used. The data indicate that moderate quantum yields for ligand loss (φ ≥ 0.4) are required for ruthenium deposition, and the deposition is wavelength dependent. Second, anionic polyhapto ligands such as cyclopentadienyl and allyl are more difficult to remove than carbonyls, halides, and alkyls. Third, in contrast to the atomic layer deposition, acid-base reactions between the precursor and the substrate are more effective for deposition than nucleophilic reactions. Finally, the data suggest that selective deposition can be achieved on organic thin films by judicious choice of precursor and functional groups present on the substrate. These studies thus provide guidelines for the rational design of new precursors specifically for selective photochemical CVD on organic substrates.
Strain transfer across grain boundaries in MoS2 monolayers grown by chemical vapor deposition
NASA Astrophysics Data System (ADS)
Niehues, Iris; Blob, Anna; Stiehm, Torsten; Schmidt, Robert; Jadriško, Valentino; Radatović, Borna; Čapeta, Davor; Kralj, Marko; Michaelis de Vasconcellos, Steffen; Bratschitsch, Rudolf
2018-07-01
Monolayers of transition metal dichalcogenides (TMDC) mechanically exfoliated from bulk crystals have exceptional mechanical and optical properties. They are extremely flexible, sustaining mechanical strain of about 10% without breaking. Their optical properties dramatically change with applied strain. However, the fabrication of a large number of mechanical devices is tedious due to the micromechanical exfoliation process. Alternatively, monolayers can be grown by chemical vapor deposition (CVD) on the wafer scale, with the drawback of cracks and grain boundaries in the material. Therefore, it is important to investigate the mechanical properties of CVD-grown material and its potential as a material for mass production of nanomechanical devices. Here, we measure the optical absorption of CVD-grown MoS2 monolayers with applied uniaxial tensile strain. We derive a strain-dependent shift for the A exciton of ‑42 meV/%. This value is identical to MoS2 monolayers, which are mechanically exfoliated from natural molybdenite crystals. Using angle-resolved second-harmonic generation spectroscopy, we find that the applied uniaxial tensile strain is fully transferred across grain boundaries of the CVD-grown monolayer. Our work demonstrates that large-area artificially grown MoS2 monolayers are promising for mass-produced nanomechanical devices.
Nutritional approach for designing meat-based functional food products with nuts.
Olmedilla-Alonso, B; Granado-Lorencio, F; Herrero-Barbudo, C; Blanco-Navarro, I
2006-01-01
Meat and meat products are essential components of diets in developed countries and despite the convincing evidence that relate them to an increased risk for CVD, a growing consumption of meat products is foreseen. Epidemiological studies show that regular consumption of nuts, in general, and walnuts in particular, correlates inversely with myocardial infarction and ischaemic vascular disease. We assess the nutritional basis for and technological approach to the development of functional meat-based products potentially relevant in cardiovascular disease (CVD) risk reduction. Using the available strategies in the meat industry (reformulation processes) and a food-based approach, we address the design and development of restructured beef steak with added walnuts, potentially functional for CVD risk reduction. Its adequacy as a vehicle for active nutrients is confirmed by a pharmacokinetic pilot study in humans using gamma-tocopherol as an exposure biomarker in chylomicrons during the post-prandial state. Effect and potential "functionality" is being assessed by a dietary intervention study in subjects at risk and markers and indicators related to CVD are being evaluated. Within the conceptual framework of evidence-based medicine, development of meat-based functional products may become a useful approach for specific applications, with a potential market and health benefits of great importance at a population level.
NASA Astrophysics Data System (ADS)
Xu, Shicai; Jiang, Shouzhen; Zhang, Chao; Yue, Weiwei; Zou, Yan; Wang, Guiying; Liu, Huilan; Zhang, Xiumei; Li, Mingzhen; Zhu, Zhanshou; Wang, Jihua
2018-01-01
Graphene has attracted much attention in biosensing applications for its unique properties. Because of one-atom layer structure, every atom of graphene is exposed to the environment, making the electronic properties of graphene are very sensitive to charged analytes. Therefore, graphene is an ideal material for transistors in high-performance sensors. Chemical vapor deposition (CVD) method has been demonstrated the most successful method for fabricating large area graphene. However, the conventional CVD methods can only grow graphene on metallic substrate and the graphene has to be transferred to the insulating substrate for further device fabrication. The transfer process creates wrinkles, cracks, or tears on the graphene, which severely degrade electrical properties of graphene. These factors severely degrade the sensing performance of graphene. Here, we directly fabricated graphene on sapphire substrate by high temperature CVD without the use of metal catalysts. The sapphire-based graphene was patterned and make into a DNA biosensor in the configuration of field-effect transistor. The sensors show high performance and achieve the DNA detection sensitivity as low as 100 fM (10-13 M), which is at least 10 times lower than prior transferred CVD G-FET DNA sensors. The use of the sapphire-based G-FETs suggests a promising future for biosensing applications.
Yunus, Rozan Mohamad; Endo, Hiroko; Tsuji, Masaharu; Ago, Hiroki
2015-10-14
Heterostructures of two-dimensional (2D) layered materials have attracted growing interest due to their unique properties and possible applications in electronics, photonics, and energy. Reduction of the dimensionality from 2D to one-dimensional (1D), such as graphene nanoribbons (GNRs), is also interesting due to the electron confinement effect and unique edge effects. Here, we demonstrate a bottom-up approach to grow vertical heterostructures of MoS2 and GNRs by a two-step chemical vapor deposition (CVD) method. Single-layer GNRs were first grown by ambient pressure CVD on an epitaxial Cu(100) film, followed by the second CVD process to grow MoS2 over the GNRs. The MoS2 layer was found to grow preferentially on the GNR surface, while the coverage could be further tuned by adjusting the growth conditions. The MoS2/GNR nanostructures show clear photosensitivity to visible light with an optical response much higher than that of a 2D MoS2/graphene heterostructure. The ability to grow a novel 1D heterostructure of layered materials by a bottom-up CVD approach will open up a new avenue to expand the dimensionality of the material synthesis and applications.
Kryzwanski, David M.; Moellering, Douglas; Fetterman, Jessica L.; Dunham-Snary, Kimberly J.; Sammy, Melissa J.; Ballinger, Scott W.
2013-01-01
While there is general agreement that cardiovascular disease (CVD) development is influenced by a combination of genetic, environmental, and behavioral contributors, the actual mechanistic basis of how these factors initiate or promote CVD development in some individuals while others with identical risk profiles do not, is not clearly understood. This review considers the potential role for mitochondrial genetics and function in determining CVD susceptibility from the standpoint that the original features that molded cellular function were based upon mitochondrial-nuclear relationships established millions of years ago and were likely refined during prehistoric environmental selection events that today, are largely absent. Consequently, contemporary risk factors that influence our susceptibility to a variety of age-related diseases, including CVD were probably not part of the dynamics that defined the processes of mitochondrial – nuclear interaction, and thus, cell function. In this regard, the selective conditions that contributed to cellular functionality and evolution should be given more consideration when interpreting and designing experimental data and strategies. Finally, future studies that probe beyond epidemiologic associations are required. These studies will serve as the initial steps for addressing the provocative concept that contemporary human disease susceptibility is the result of selection events for mitochondrial function that increased chances for prehistoric human survival and reproductive success. PMID:21647091
Awareness Status of Chronic Disabling Neurological Diseases among Elderly Veterans.
Tan, Ji-Ping; Zhu, Lin-Qi; Zhang, Jun; Zhang, Shi-Min; Lan, Xiao-Yang; Cui, Bo; Deng, Yu-Cheng; Li, Ying-Hao; Ye, Guang-Hua; Wang, Lu-Ning
2015-05-20
The awareness, treatment and prevention of chronic diseases are generally poor among the elderly population of China, whereas the prevention and control of chronic diseases in elderly veteran communities have been ongoing for more than 30 years. Therefore, investigating the awareness status of chronic disabling neurological diseases (CDND) and common chronic diseases (CCD) among elderly veterans may provide references for related programs among the elderly in the general population. A cross-sectional survey was conducted among veterans ≥60 years old in veteran communities in Beijing. The awareness of preventive strategies against dementia, Alzheimer's disease (AD), Parkinson's disease (PD), sleep disorders, cerebrovascular disease (CVD) and CCD such as hypertension, and the approaches used to access this information, including media, word of mouth (verbal communication among the elderly) and health care professionals, were investigated via face-to-face interviews. The awareness rates for CCD and CVD were approximately 100%, but that for AD was the lowest at <10%. The awareness rates for sleep disorders, PD and dementia, were 51.0-89.4%. Media was the most commonly selected mode of communication by which veterans acquired knowledge about CCD and CVD. Media was used by approximately 80% of veterans. Both health care professionals and word of mouth were used by approximately 50% of veterans. With respect to the source of information about CDND excluding AD, the rates of the use of health care professionals, word of mouth and media were 10.6-28.2%, 56.5-76.5%, and approximately 50%, respectively. The awareness of CDND among elderly veterans was significantly lower than that of CCD. More information about CDND should be disseminated by health care professionals. Appropriate guidance will promote the rapid and extensive dissemination of information about the prevention of CDND by media and word-of-mouth peer education.
Scragg, Robert
2011-09-01
There is increasing interest in vitamin D and its possible health effects. The aims of the present overview are to summarise the research on common diseases for which there is substantial evidence on vitamin D, identify diseases where vitamin D may be beneficial and discuss the public health implications of these findings. Literature search of PubMed for the years 2000 to 2010 to identify cohort studies with baseline measures of 25-hydroxyvitamin D (25(OH)D) and randomised controlled trials (RCT) of vitamin D supplementation in relation to fractures, colorectal cancer, CVD and all-cause mortality. Risk ratios of disease from comparisons between 25(OH)D quantiles in these studies were summarised using RevMan software version 5·1 (The Nordic Cochrane Centre, Copenhagen). Community-based samples recruited into cohort studies from many countries. Older men and women, mostly above 50 years of age. When comparing the lowest 25(OH)D category with the highest (or reference), the pooled risk ratio (95 % CI) was: 1·34 (1·13, 1·59) for fractures from nine studies; 1·59 (1·30, 1·95) for colorectal cancer from nine studies; 1·35 (1·17, 1·56) for CVD from twelve studies; and 1·42 (1·23, 1·63) for all-cause mortality from twelve studies. Cohort studies show that baseline 25(OH)D levels predict increased risk of fractures, colorectal cancer, CVD and all-cause mortality. These associations are weak and could be explained by confounding variables such as obesity and physical activity. Because of their potential public health significance, RCT using vitamin D doses ≥50 μg/d are required to determine whether vitamin D protects against these diseases.
Zimmerman, Matthew C; Clemens, Dahn L; Duryee, Michael J; Sarmiento, Cleofes; Chiou, Andrew; Hunter, Carlos D; Tian, Jun; Klassen, Lynell W; O'Dell, James R; Thiele, Geoffrey M; Mikuls, Ted R; Anderson, Daniel R
2017-10-01
Methotrexate (MTX) is an immunosuppressant commonly used for the treatment of autoimmune diseases. Recent observations have shown that patients treated with MTX also exhibit a reduced risk for the development of cardiovascular disease (CVD). Although MTX reduces systemic inflammation and tissue damage, the mechanisms by which MTX exerts these beneficial effects are not entirely known. We have previously demonstrated that protein adducts formed by the interaction of malondialdehyde (MDA) and acetaldehyde (AA), known as MAA-protein adducts, are present in diseased tissues of individuals with rheumatoid arthritis (RA) or CVD. In previously reported studies, MAA-adducts were shown to be highly immunogenic, supporting the concept that MAA-adducts not only serve as markers of oxidative stress but may have a direct role in the pathogenesis of inflammatory diseases. Because MAA-adducts are commonly detected in diseased tissues and are proposed to mitigate disease progression in both RA and CVD, we tested the hypothesis that MTX inhibits the generation of MAA-protein adducts by scavenging reactive oxygen species. Using a cell free system, we found that MTX reduces MAA-adduct formation by approximately 6-fold, and scavenges free radicals produced during MAA-adduct formation. Further investigation revealed that MTX directly scavenges superoxide, but not hydrogen peroxide. Additionally, using the Nrf2/ARE luciferase reporter cell line, which responds to intracellular redox changes, we observed that MTX inhibits the activation of Nrf2 in cells treated with MDA and AA. These studies define previously unrecognized mechanisms by which MTX can reduce inflammation and subsequent tissue damage, namely, scavenging free radicals, reducing oxidative stress, and inhibiting MAA-adduct formation. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
The obesity paradox and incident cardiovascular disease: A population-based study
Langa, Kenneth M.; Weir, David; Iwashyna, Theodore J.
2017-01-01
Background Prior work suggests that obesity may confer a survival advantage among persons with cardiovascular disease (CVD). This obesity “paradox” is frequently studied in the context of prevalent disease, a stage in the disease process when confounding from illness-related weight loss and selective survival are especially problematic. Our objective was to examine the association of obesity with mortality among persons with incident CVD, where biases are potentially reduced, and to compare these findings with those based on prevalent disease. Methods We used data from the Health and Retirement Study, an ongoing, nationally representative longitudinal survey of U.S. adults age 50 years and older initiated in 1992 and linked to Medicare claims. Cox proportional hazard models were used to estimate the association between weight status and mortality among persons with specific CVD diagnoses. CVD diagnoses were established by self-reported survey data as well as Medicare claims. Prevalent disease models used concurrent weight status, and incident disease models used pre-diagnosis weight status. Results We examined myocardial infarction, congestive heart failure, stroke, and ischemic heart disease. A strong and significant obesity paradox was consistently observed in prevalent disease models (hazard of death 18–36% lower for obese class I relative to normal weight), replicating prior findings. However, in incident disease models of the same conditions in the same dataset, there was no evidence of this survival benefit. Findings from models using survey- vs. claims-based diagnoses were largely consistent. Conclusion We observed an obesity paradox in prevalent CVD, replicating prior findings in a population-based sample with longer-term follow-up. In incident CVD, however, we did not find evidence of a survival advantage for obesity. Our findings do not offer support for reevaluating clinical and public health guidelines in pursuit of a potential obesity paradox. PMID:29216243
NASA Technical Reports Server (NTRS)
Miyoshi, Kazuhisa; Wu, Richard L. C.; Lanter, William C.
1996-01-01
Friction and wear behavior of ion-beam-deposited diamondlike carbon (DLC) films coated on chemical-vapor-deposited (CVD), fine-grain diamond coatings were examined in ultrahigh vacuum, dry nitrogen, and humid air environments. The DLC films were produced by the direct impact of an ion beam (composed of a 3:17 mixture of Ar and CH4) at ion energies of 1500 and 700 eV and an RF power of 99 W. Sliding friction experiments were conducted with hemispherical CVD diamond pins sliding on four different carbon-base coating systems: DLC films on CVD diamond; DLC films on silicon; as-deposited, fine-grain CVD diamond; and carbon-ion-implanted, fine-grain CVD diamond on silicon. Results indicate that in ultrahigh vacuum the ion-beam-deposited DLC films on fine-grain CVD diamond (similar to the ion-implanted CVD diamond) greatly decrease both the friction and wear of fine-grain CVD diamond films and provide solid lubrication. In dry nitrogen and in humid air, ion-beam-deposited DLC films on fine-grain CVD diamond films also had a low steady-state coefficient of friction and a low wear rate. These tribological performance benefits, coupled with a wider range of coating thicknesses, led to longer endurance life and improved wear resistance for the DLC deposited on fine-grain CVD diamond in comparison to the ion-implanted diamond films. Thus, DLC deposited on fine-grain CVD diamond films can be an effective wear-resistant, lubricating coating regardless of environment.
Disveld, Iris J M; Fransen, Jaap; Rongen, Gerard A; Kienhorst, Laura B E; Zoakman, Sahel; Janssens, Hein J E M; Janssen, Matthijs
2018-04-15
Our aim was to examine the prevalence of cardiovascular disease (CVD) in patients with crystal-proven gout compared to arthritis controls. Further, we analyzed the association between characteristic gout severity factors and CVD to provide further support for a pathogenetic relationship between gout and CVD. Patients with arthritis referred for diagnosis were consecutively included in the Gout Arnhem-Liemers cohort. Joint fluid analysis was performed in all referred patients; controls were negative for crystals. Patients' characteristics and different manifestations of CVD and gout severity factors (disease duration, attack frequency, tophi, affected joints, high serum urate acid level, joint damage) were collected. Gout patients were compared with controls for the prevalence of CVD. In addition, the association between characteristic gout severity factors and presence of CVD was analyzed. Data from 700 gout patients and 276 controls were collected. CVD was present in 47% (95% CI 44%-51%) and 24% (95% CI 19%-29%) of gout patients and controls, respectively. Corrected for confounders, gout was still strongly associated with an increased prevalence of CVD compared to controls (OR 3.39, 95% CI 2.37-4.84). In patients with gout, disease duration ≥ 2 years, oligo- or polyarthritis, serum urate acid > 0.55 mmol/l at presentation, and joint damage were independently (p < 0.05) associated with prevalent CVD. Crystal-proven gout was strongly associated with an increased prevalence of CVD. In patients with gout, characteristic gout severity factors were associated with CVD.
Thomas, Isac C; McClelland, Robyn L; Michos, Erin D; Allison, Matthew A; Forbang, Nketi I; Longstreth, W T; Post, Wendy S; Wong, Nathan D; Budoff, Matthew J; Criqui, Michael H
2017-10-01
The volume and density of coronary artery calcium (CAC) both independently predict cardiovascular disease (CVD) beyond standard risk factors, with CAC density inversely associated with incident CVD after accounting for CAC volume. We tested the hypothesis that ascending thoracic aorta calcium (ATAC) volume and density predict incident CVD events independently of CAC. The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study of participants without clinical CVD at baseline. ATAC and CAC were measured from baseline cardiac computed tomography (CT). Cox regression models were used to estimate the associations of ATAC volume and density with incident coronary heart disease (CHD) events and CVD events, after adjustment for standard CVD risk factors and CAC volume and density. Among 6811 participants, 234 (3.4%) had prevalent ATAC and 3395 (49.8%) had prevalent CAC. Over 10.3 years, 355 CHD and 562 CVD events occurred. One-standard deviation higher ATAC density was associated with a lower risk of CHD (HR 0.48 [95% CI 0.29-0.79], p<0.01) and CVD (HR 0.56 [0.37-0.84], p<0.01) after full adjustment. ATAC volume was not associated with outcomes after full adjustment. ATAC was uncommon in a cohort free of clinical CVD at baseline. However, ATAC density was inversely associated with incident CHD and CVD after adjustment for CVD risk factors and CAC volume and density. Copyright © 2017 Elsevier B.V. All rights reserved.
Mortality from cardiovascular diseases in Bavi District, Vietnam.
Minh, Hoang Van; Byass, Peter; Wall, Stig
2003-01-01
Like other developing countries, Vietnam is undergoing epidemiological transition, which is characterized by many changes in terms of morbidity and mortality patterns. The fact that cardiovascular diseases (CVD) are leading causes of death in hospitals in the whole country was ascertained from annual statistics. However, the magnitude of the burden of mortality from CVD at the community level remained unknown. The aims of the study were to outline CVD mortality during health transition in a rural community in the north of Vietnam and to examine associations between CVD mortality and the socioeconomic status of the population. Within an established demographic surveillance system (DSS), verbal autopsy (VA) was used to identify the burden of mortality from CVD. Cohort analysis was used in this study to measure associations between CVD mortality and socioeconomic determinants. CVD emerged as a leading cause of death in the study area, accounting for more than infectious and parasitic diseases combined. CVD killed many people among the most economically productive age group, both men and women, in all socioeconomic groups. Occupational status was shown to be significantly associated with CVD mortality. Already at this point in the epidemiological transition, there is evidence of a substantial burden of CVD in rural Vietnam. Although this study was not able to show trends, the current situation is a cause for concern in health policy and planning. Verbal autopsy methods and CVD risk factor evaluations will form important parts of future research agendas.
Briggs, Michelle A.; Petersen, Kristina S.; Kris-Etherton, Penny M.
2017-01-01
Dietary recommendations to decrease the risk of cardiovascular disease (CVD) have focused on reducing intake of saturated fatty acids (SFA) for more than 50 years. While the 2015–2020 Dietary Guidelines for Americans advise substituting both monounsaturated and polyunsaturated fatty acids for SFA, evidence supports other nutrient substitutions that will also reduce CVD risk. For example, replacing SFA with whole grains, but not refined carbohydrates, reduces CVD risk. Replacing SFA with protein, especially plant protein, may also reduce CVD risk. While dairy fat (milk, cheese) is associated with a slightly lower CVD risk compared to meat, dairy fat results in a significantly greater CVD risk relative to unsaturated fatty acids. As research continues, we will refine our understanding of dietary patterns associated with lower CVD risk. PMID:28635680
Harmon, Molly E.; Campen, Matthew J.; Miller, Curtis; Shuey, Chris; Cajero, Miranda; Lucas, Selita; Pacheco, Bernadette; Erdei, Esther; Ramone, Sandy; Nez, Teddy; Lewis, Johnnye
2016-01-01
The prevalences of cardiovascular disease (CVD) and type 2 diabetes (T2D) have increased among the Navajo Native American community in recent decades. Oxidized low-density lipoprotein (oxLDL) is a novel CVD biomarker that has never been assessed in the Navajo population. We examined the relationship of oxLDL to conventional CVD and T2D risk factors and biomarkers in a cross-sectional population of Navajo participants. This cross-sectional study included 252 participants from 20 Navajo communities from the Diné Network for Environmental Health Project. Plasma samples were tested for oxLDL levels by a sandwich enzyme-linked immunosorbent assay. Univariate and multivariate analyses were used to determine the relationship of oxLDL and oxidized- to non-oxidized lipoprotein ratios to glycated hemoglobin (HbA1c), C-reactive protein (CRP), interleukin 6 (IL6) and demographic and health variables. Type 2 diabetes, hypertension and obesity are very prevalent in this Navajo population. HbA1c, CRP, body mass index (BMI), high-density lipoprotein, and triglycerides were at levels that may increase risk for CVD and T2D. Median oxLDL level was 47 (36.8–57) U/L. Correlational analysis showed that although oxLDL alone was not associated with HbA1c, oxLDL/HDL, oxLDL/LDL and CRP were significantly associated with HbA1c and glucose. OxLDL, oxLDL/HDL and oxLDL/LDL were significantly associated with CRP. Multivariate analysis showed that triglycerides were a common and strong predictor of oxLDL, oxLDL/HDL and oxLDL/LDL. OxLDL was trended with HbA1c and glucose but did not reach significance, however, HbA1c was an independent predictor of OxLDL/HDL. CRP trended with oxLDL/HDL and was a weak predictor of oxLDL/LDL. This Navajo subset appears to have oxLDL levels comparable to subjects without evidence of CVD reported in other studies. The high prevalence of T2D, hypertension and obesity along with abnormal levels of other biomarkers including HbA1c indicate that the Navajo population has a worsening CVD risk profile. PMID:26938991
NASA Technical Reports Server (NTRS)
1982-01-01
Liquid diffusion masks and liquid applied dopants to replace the CVD Silox masking and gaseous diffusion operations specified for forming junctions in the Westinghouse baseline process sequence for producing solar cells from dendritic web silicon were investigated.
Scalzi, Lisabeth V; Hollenbeak, Christopher S; Wang, Li
2010-09-01
To determine whether racial disparities exist with regard to the age at which patients with systemic lupus erythematosus (SLE) experience cardiovascular disease (CVD) and CVD-associated death. Using the 2003-2006 Nationwide Inpatient Sample, we calculated the age difference between patients with SLE and their race- and sex-matched controls at the time of hospitalization for a cardiovascular event and for CVD-associated death. In addition, we calculated the age difference between white patients with SLE and sex-matched controls for each minority group for the same outcomes. The mean age difference between women with and those without SLE at the time of admission for a CVD event was 10.5 years. All age differences between women with SLE (n = 3,627) and women without SLE admitted for CVD were significant (P < 0.0001). Among different racial groups with SLE, black women were the youngest to be admitted with CVD (53.9 years) and to have a CVD-associated in-hospital death (52.8 years; n = 218). Black women with SLE were 19.8 years younger than race- and sex-matched controls at the time of CVD-associated death. Admission trends for CVD were reversed for black women, such that the highest proportions of these patients were admitted before age 55 years, and then the proportions steadily decreased across age categories. Among the 805 men with SLE who were admitted with a CVD event, those who were black or Hispanic were youngest. There are significant racial disparities with regard to age at the time of hospital admission for CVD events and CVD-related hospitalization resulting in death in patients with SLE.
Boo, Sunjoo; Froelicher, Erika S; Yun, Ju-Hui; Kim, Ye-Won; Jung, Ju-Yang; Suh, Chang-Hee
2016-10-01
The purposes of this study were to compare the perceived and actual 10-year risk for cardiovascular disease (CVD) and to evaluate the influence of cardiovascular risk factors on perceived CVD risk in patients with rheumatoid arthritis (RA) in Korea. Additionally, the attainment of CVD prevention guideline goals by 3 levels of CVD risk (low, moderate, and high) was presented.For this cross-sectional study, data were collected from 208 patients with RA. Actual CVD risk was estimated with the Systematic Coronary Risk Evaluation (SCORE), and goal attainment was assessed based on the European League Against Rheumatism guidelines. Actual CVD risk and perceived risk were compared with cross-tabulation. Chi-square tests were used to evaluate differences in cardiovascular risk factors by perceived risk. Levels of goal attainment were presented in percentages.Among patients with RA, 13.9% were identified as being at high risk for CVD, whereas 39.9% were at moderate risk, and 46.2% were at low risk. The majority of those at high risk (96.6%) underestimated their risk for CVD. The use of antihypertensive or lipid-lowering medications and having a parental history of CVD significantly increased the likelihood that subjects with RA would perceive themselves as being at high risk for CVD. Diabetes, smoking, physical inactivity, and obesity did not affect perceived risk. A substantial proportion of the subjects with RA did not meet the prevention guideline goals.Patients with RA who are at increased risk of developing CVD must be managed as soon as possible to attain the guideline goals and, accordingly, lower their risk of future CVD.
Haidinger, Teresa; Zweimüller, Martin; Stütz, Lena; Demir, Dondue; Kaider, Alexandra; Strametz-Juranek, Jeanette
2012-04-01
The incidence of cardiovascular disease (CVD) is increasing in industrialized countries. Preventive action is an important factor in minimizing CVD-associated morbidity and mortality. However, it is not known whether gender differences affect CVD or risk factor awareness influencing self-assessment of personal risk and preventive action. This study was performed to assess individual CVD and risk factor awareness, preventive action taken, and barriers to cardiovascular health. The study included 573 women and 336 men, randomly chosen to complete an anonymous questionnaire to assess individual CVD and risk factor awareness, preventive action taken, and barriers to cardiovascular health. The data were analyzed using SAS software. Cardiovascular disease was identified in 75% of patients, in both sexes, as the leading cause of death; however, both groups showed significant lack of knowledge about CVD risk factors. Type 2 diabetes was identified correctly in only 27.5%. Preventive action was linked more often to family members in 66.5% of women and 62.8% of men. The primary barrier to cardiovascular health in adults was incorrect assessment of personal CVD risk. More than half of female respondents (56.4%) and male respondents (52.7%) underestimated their risk of CVD. Knowledge about risk factors for CVD needs to be improved in members of both sexes. Because women, in particular, have difficulty in correctly assessing their personal CVD risk, future education programs are warranted to inform both women and men about CVD and its risk factors, thereby helping them to correctly assess their individual risk. However, greater effort is needed to inform men, compared with women, about the various ways in which to prevent CVD and to motivate them to take preventive action. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.
Mackey, Rachel H.; Kuller, Lewis H.; Deane, Kevin D.; Walitt, Brian T.; Chang, Yuefang F.; Holers, V. Michael; Robinson, William H.; Tracy, Russell P.; Hlatky, Mark A.; Eaton, Charles; Liu, Simin; Freiberg, Matthew S.; Talabi, Mehret Birru; Schelbert, Erik B.; Moreland, Larry W.
2015-01-01
Objective This report evaluates incidence of cardiovascular disease (CVD) morbidity and mortality over 10 years among the >160,000 postmenopausal women in the Women’s Health Initiative (WHI) in relation to self-reported RA, disease modifying anti-rheumatic drugs (DMARD) use, anti-CCP+, RF+, CVD risk factors, joint pain, and inflammation (white blood cell (WBC) count and IL-6.) Methods Anti-CCP and RF were measured on a sample (n=9,988) of WHI participants with self-reported RA. RA was classified as self-reported RA plus anti-CCP+ positivity and/or use of DMARDs. Self-reported RA that was both anti-CCP− and DMARD− was classified as “unverified RA.” Results Age-adjusted rates of coronary heart disease (CHD), stroke, CVD, fatal CVD and total mortality were higher for women with RA vs. no RA, with multivariable-adjusted HR(95%CI) of 1.46(1.17, 1.83) for CHD, and 2.55(1.86, 3.51) for fatal CVD. Within RA, anti-CCP+ and RF+ were not significantly associated with higher risk of any outcomes, despite slightly higher risk of fatal CVD and death for anti-CCP+ vs. anti-CCP− RA. Joint pain severity and CVD risk factors were strongly associated with CVD risk, even for women with no RA. CVD incidence was increased for RA vs. no RA at almost all risk factor levels, except low levels of joint pain or inflammation. Within RA, inflammation was more strongly associated with fatal CVD and total mortality than CHD or CVD. Conclusion Among postmenopausal women, RA was associated with 1.5-2.5 higher CVD risk, strongly associated with CV risk factors, joint pain severity, and inflammation, but similar for anti-CCP+ and RF+. Clinical Trial Registration clinicaltrials.gov identifier: NCT00000611 PMID:25988241
Puspitasari, Hanni Prihhastuti; Aslani, Parisa; Krass, Ines
2013-12-01
Pharmacists are well placed to identify, prevent and resolve medicine related problems as well as monitor the effectiveness of treatments in cardiovascular disease (CVD). Pharmacists' interventions in CVD secondary prevention have been shown to improve outcomes for clients with established CVD. To explore the scope of pharmacists' activities in supporting CVD secondary prevention. Community pharmacies in New South Wales, Australia. Twenty-one in-depth, semi-structured interviews with a range of community pharmacists were conducted. All interviews were audio-recorded and transcribed ad verbatim. Data were analyzed using a 'grounded-theory' approach by applying methods of constant comparison. Community pharmacists' awareness and current practice in supporting secondary prevention of CVD. Four key themes identified included 'awareness', 'patient counselling', 'patient monitoring', and 'perceptions of the role of pharmacists in CVD secondary prevention'. The pharmacists demonstrated a moderate understanding of CVD secondary prevention. There was considerable variability in the scope of practice among the participants, ranging from counselling only about medicines to providing continuity of care. A minority of pharmacists who had negative beliefs about their roles in CVD secondary prevention offered limited support to their clients. The majority of pharmacists, however, believed that they have an important role to play in supporting clients with established CVD. Community pharmacists in Australia make a contribution to the care of clients with established CVD despite the gap in their knowledge and understanding of CVD secondary prevention. The scope of practice in CVD secondary prevention ranged from only counselling about medicines to offering continuity of care. The extent of pharmacists' involvement in offering disease management appears to be influenced by their beliefs regarding what is required within their scope of practice.
Del Bas, Josep Maria; Crescenti, Anna; Arola-Arnal, Anna; Oms-Oliu, Gemma; Arola, Lluís; Caimari, Antoni
2015-12-01
Cardiovascular disease (CVD) is one of the most prevalent noncommunicable diseases in humans. Different studies have identified dietary procyanidins as bioactive compounds with beneficial properties against CVD by improving lipid homeostasis, among other mechanisms. The aim of this work was to assess whether grape seed procyanidin consumption at a physiological dose during the perinatal period could influence the CVD risk of the offspring. Wistar rat dams were treated with a grape seed procyanidin extract (GSPE; 25mg/kg of body weight per day) or vehicle during gestation and lactation. The adult male offspring of GSPE-treated dams presented decreased high-density lipoprotein cholesterol (HDL-C) levels, increased total cholesterol-to-HDL-C ratios and an exacerbated fasting triglyceride-to-HDL-C ratios (atherogenic index of plasma) compared to the control group. Impaired reverse cholesterol transport (RCT) was evidenced by the accumulation of cholesterol in skeletal muscle and by decreased fecal excretion of cholesterol and bile acids, which was consistent with the observed mRNA down-regulation of the rate-limiting enzyme in the hepatic bile acid synthesis pathway Cyp7A1. Conversely, GSPE programming also resulted in up-regulated gene expression of different key components of the RCT process, such as hepatic Npc1, Abcg1, Abca1, Lxra, Srebp2, Lcat, Scarb1 and Pltp, and the repression of microRNA miR-33a expression, a key negative controller of hepatic RCT at the gene expression level. Our results show that maternal intake of grape procyanidins during the perinatal period impacts different components of the RCT process, resulting in increased CVD risk in the adult offspring. Copyright © 2015 Elsevier Inc. All rights reserved.
Maloyan, Alina; Muralimanoharan, Sribalasubashini; Huffman, Steven; Cox, Laura A; Nathanielsz, Peter W; Myatt, Leslie; Nijland, Mark J
2013-10-01
Human and animal studies show that suboptimal intrauterine environments lead to fetal programming, predisposing offspring to disease in later life. Maternal obesity has been shown to program offspring for cardiovascular disease (CVD), diabetes, and obesity. MicroRNAs (miRNAs) are small, noncoding RNA molecules that act as key regulators of numerous cellular processes. Compelling evidence links miRNAs to the control of cardiac development and etiology of cardiac pathology; however, little is known about their role in the fetal cardiac response to maternal obesity. Our aim was to sequence and profile the cardiac miRNAs that are dysregulated in the hearts of baboon fetuses born to high fat/high fructose-diet (HFD) fed mothers for comparison with fetal hearts from mothers eating a regular diet. Eighty miRNAs were differentially expressed. Of those, 55 miRNAs were upregulated and 25 downregulated with HFD. Twenty-two miRNAs were mapped to human; 14 of these miRNAs were previously reported to be dysregulated in experimental or human CVD. We used an Ingenuity Pathway Analysis to integrate miRNA profiling and bioinformatics predictions to determine miRNA-regulated processes and genes potentially involved in fetal programming. We found a correlation between miRNA expression and putative gene targets involved in developmental disorders and CVD. Cellular death, growth, and proliferation were the most affected cellular functions in response to maternal obesity. Thus, the current study reveals significant alterations in cardiac miRNA expression in the fetus of obese baboons. The epigenetic modifications caused by adverse prenatal environment may represent one of the mechanisms underlying fetal programming of CVD.
Mirjafari, Hoda; Welsh, Paul; Verstappen, Suzanne M M; Wilson, Paddy; Marshall, Tarnya; Edlin, Helena; Bunn, Diane; Chipping, Jacqueline; Lunt, Mark; Symmons, Deborah P M; Sattar, Naveed; Bruce, Ian N
2014-01-01
Background We measured N-terminal pro-brain natriuretic peptide (NT-pro-BNP), a marker of cardiac dysfunction, in an inception cohort with early inflammatory polyarthritis (IP) and assessed its association with disease phenotype, cardiovascular disease (CVD), all-cause and CVD related mortality. Methods Subjects with early IP were recruited to the Norfolk Arthritis Register from January 2000 to December 2008 and followed up to death or until March 2010 including any data from the national death register. The associations of baseline NT-pro-BNP with IP related factors and CVD were assessed by linear regression. Cox proportional hazards models examined the independent association of baseline NT-pro-BNP with all-cause and CVD mortality. Results We studied 960 early IP subjects; 163 (17%) had prior CVD. 373 (39%) patients had a baseline NT-pro-BNP levels ≥100 pg/ml. NT-pro-BNP was associated with age, female gender, HAQ score, CRP, current smoking, history of hypertension, prior CVD and the presence of carotid plaque. 92 (10%) IP subjects died including 31 (3%) from CVD. In an age and gender adjusted analysis, having a raised NT-pro-BNP level (≥100 pg/ml) was associated with both all-cause and CVD mortality (adjusted HR (95% CI) 2.36 (1.42 to 3.94) and 3.40 (1.28 to 9.03), respectively). These findings were robust to adjustment for conventional CVD risk factors and prevalent CVD. Conclusions In early IP patients, elevated NT-pro-BNP is related to HAQ and CRP and predicts all-cause and CVD mortality independently of conventional CVD risk factors. Further study is required to identify whether NT-pro-BNP may be clinically useful in targeting intensive interventions to IP patients at greatest risk of CVD. PMID:23511225
Spies, Petra E; Verbeek, Marcel M; Sjogren, Magnus J C; de Leeuw, Frank-Erik; Claassen, Jurgen A H R
2014-01-01
Preclinical and post-mortem studies suggest that Alzheimer disease (AD) causes cerebrovascular dysfunction, and therefore may enhance susceptibility to cerebrovascular disease (CVD). The objective of this study was to investigate this association in a memory clinic population. The AD biomarkers CSF amyloid β42, amyloid β40 and APOE-ε4 status have all been linked to increased CVD risk in AD, and therefore the first aim of this study was to analyze the association between these biomarkers and CVD. In 92 memory clinic patients the cross-sectional association between AD biomarkersand the severity of CVD was investigated with linear regression analysis. Additionally, we studied whether AD biomarkers modified the relation between vascular risk factors and CVD. CVD was assessed on MRI through a visual rating scale.Analyses were adjusted for age. The second aim of this study was to investigate the association between clinical AD and CVD, where 'clinical AD' was defined as follows: impairment in episodic memory, hippocampal atrophy and an aberrant concentration of cerebrospinal fluid (CSF) biomarkers. 47 of the 92 patients had AD. No association between CSF amyloid β42, amyloid β40 or APOE-ε4 status and CVD severity was found, nor did these AD biomarkers modify the relation between vascular risk factors and CVD. Clinical AD was not associated with CVD severity (p=0.83). Patients with more vascular risk factors had more CVD, but this relationship was not convincingly modified by AD (p=0.06). In this memory clinic population, CVD in patients with AD was related to vascular risk factors and age, comparable to patients without AD. Therefore, in our study, the preclinical and post-mortem evidence that AD would predispose to CVD could not be translated clinically. Further work, including replication of this work in a different and larger sample, is warranted.
van Kempen, Bob J H; Ferket, Bart S; Hofman, Albert; Steyerberg, Ewout W; Colkesen, Ersen B; Boekholdt, S Matthijs; Wareham, Nicholas J; Khaw, Kay-Tee; Hunink, M G Myriam
2012-12-06
We developed a Monte Carlo Markov model designed to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD. Internal, predictive, and external validity of the model have not yet been established. The Rotterdam Ischemic Heart Disease and Stroke Computer Simulation (RISC) model was developed using data covering 5 years of follow-up from the Rotterdam Study. To prove 1) internal and 2) predictive validity, the incidences of coronary heart disease (CHD), stroke, CVD death, and non-CVD death simulated by the model over a 13-year period were compared with those recorded for 3,478 participants in the Rotterdam Study with at least 13 years of follow-up. 3) External validity was verified using 10 years of follow-up data from the European Prospective Investigation of Cancer (EPIC)-Norfolk study of 25,492 participants, for whom CVD and non-CVD mortality was compared. At year 5, the observed incidences (with simulated incidences in brackets) of CHD, stroke, and CVD and non-CVD mortality for the 3,478 Rotterdam Study participants were 5.30% (4.68%), 3.60% (3.23%), 4.70% (4.80%), and 7.50% (7.96%), respectively. At year 13, these percentages were 10.60% (10.91%), 9.90% (9.13%), 14.20% (15.12%), and 24.30% (23.42%). After recalibrating the model for the EPIC-Norfolk population, the 10-year observed (simulated) incidences of CVD and non-CVD mortality were 3.70% (4.95%) and 6.50% (6.29%). All observed incidences fell well within the 95% credibility intervals of the simulated incidences. We have confirmed the internal, predictive, and external validity of the RISC model. These findings provide a basis for analyzing the effects of modifying cardiovascular disease risk factors on the burden of CVD with the RISC model.
Fang, Jing; Wylie-Rosett, Judith; Alderman, Michael H
2005-06-01
A favorable effect of exercise on cardiovascular longevity has been repeatedly demonstrated in the general population. The association of exercise and cardiovascular disease (CVD) outcome among persons with different blood pressure (BP) status is less well known. We examined the epidemiologic follow-up of the First National Health and Nutrition Examination Survey (NHANES I) (1971-1992). Of 14,407 participants, 9791 subjects aged 25 to 74 years met inclusion criteria. All cause, CVD, and non-CVD mortality rates, as well as CVD incidence rates were determined. The associations of levels of exercise and outcomes by BP status were examined. Age- and gender-adjusted rates, as well as Cox proportional hazard models were determined. During 17 years of follow-up, there were 3069 deaths, 1465 of which were CVD. In addition, 2808 subjects had incident CVD events. Overall, CVD incidence and mortality rates increased as BP rose. The association of exercise with CVD events differed by BP status (normal, prehypertension, and hypertension). Age- and gender-adjusted CVD mortality rate per 1000 person-years for least, moderate, and most exercise were 5.0, 3.6, and 2.4 among normotensive subjects (P > .05), 6.3, 4.7, and 5.2 among prehypertensive subjects (P > .05), and 11.8, 9.8, and 8.7 among hypertensive subjects (P < .01), respectively. In fact, exercise was a significant independent predictor of reduced CVD event only among hypertensive subjects, after adjusting for other CVD risk factors. Among prehypertensive and normotensive subjects, where events were fewer, those who exercise more vigorously also had lower mortality, but these differences did not reach statistical significance. This study, consistent with previous observational data, demonstrates that increased exercise is associated with decreased CVD event. Interestingly, this effect is most robust among hypertensive subjects, whereas for prehypertensive and normotensive subjects, a significant benefit of exercise on CVD outcome, perhaps because of lack of power, was not found.
Peters, Sanne Ae; Woodward, Mark; Rumley, Ann; Tunstall-Pedoe, Hugh D; Lowe, Gordon DO
2017-01-01
Background There is increasing evidence that blood viscosity and its major determinants (haematocrit and plasma viscosity) are associated with increased risks of cardiovascular disease (CVD) and premature mortality; however, their predictive value for CVD and mortality is not clear. Methods We prospectively assessed the added predictive value of plasma viscosity and whole blood viscosity and haematocrit in 3386 men and women aged 30-74 years participating in the Scottish Heart Health Extended Cohort study. Results Over a median follow-up of 17 years, 819 CVD events and 778 deaths were recorded. Hazard ratios (95% confidence intervals) for a 1 SD increase in plasma viscosity, adjusted for major CVD risk factors, were 1.12 (1.04-1.20) for CVD and 1.20 (1.12-1.29) for mortality. These remained significant after further adjustment for plasma fibrinogen: 1.09 (1.01-1.18) and 1.13 (1.04-1.22). The corresponding results for blood viscosity were 0.99 (0.90, 1.09) for CVD, and 1.11 (1.01, 1.22) for total mortality after adjustment for major CVD risk factors; and 0.97 (0.88, 1.08) and 1.06 (0.96, 1.18) after further adjustment for fibrinogen. Haematocrit showed similar associations to blood viscosity. When added to classical CVD risk factors, plasma viscosity improved the discrimination of CVD and mortality by 2.4% (0.7-4.4%) and 4.1% (2.0-6.5%). Conclusions Although plasma and blood viscosity may have a role in the pathogenesis of CVD and mortality, much of their association with CVD and mortality is due to the mutual effects of major CVD risk factors. However, plasma viscosity adds to the discrimination of CVD and mortality and might be considered for inclusion in multivariable risk scores.
Risk scoring for the primary prevention of cardiovascular disease.
Karmali, Kunal N; Persell, Stephen D; Perel, Pablo; Lloyd-Jones, Donald M; Berendsen, Mark A; Huffman, Mark D
2017-03-14
The current paradigm for cardiovascular disease (CVD) emphasises absolute risk assessment to guide treatment decisions in primary prevention. Although the derivation and validation of multivariable risk assessment tools, or CVD risk scores, have attracted considerable attention, their effect on clinical outcomes is uncertain. To assess the effects of evaluating and providing CVD risk scores in adults without prevalent CVD on cardiovascular outcomes, risk factor levels, preventive medication prescribing, and health behaviours. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (2016, Issue 2), MEDLINE Ovid (1946 to March week 1 2016), Embase (embase.com) (1974 to 15 March 2016), and Conference Proceedings Citation Index-Science (CPCI-S) (1990 to 15 March 2016). We imposed no language restrictions. We searched clinical trial registers in March 2016 and handsearched reference lists of primary studies to identify additional reports. We included randomised and quasi-randomised trials comparing the systematic provision of CVD risk scores by a clinician, healthcare professional, or healthcare system compared with usual care (i.e. no systematic provision of CVD risk scores) in adults without CVD. Three review authors independently selected studies, extracted data, and evaluated study quality. We used the Cochrane 'Risk of bias' tool to assess study limitations. The primary outcomes were: CVD events, change in CVD risk factor levels (total cholesterol, systolic blood pressure, and multivariable CVD risk), and adverse events. Secondary outcomes included: lipid-lowering and antihypertensive medication prescribing in higher-risk people. We calculated risk ratios (RR) for dichotomous data and mean differences (MD) or standardised mean differences (SMD) for continuous data using 95% confidence intervals. We used a fixed-effects model when heterogeneity (I²) was at least 50% and a random-effects model for substantial heterogeneity (I² > 50%). We evaluated the quality of evidence using the GRADE framework. We identified 41 randomised controlled trials (RCTs) involving 194,035 participants from 6422 reports. We assessed studies as having high or unclear risk of bias across multiple domains. Low-quality evidence evidence suggests that providing CVD risk scores may have little or no effect on CVD events compared with usual care (5.4% versus 5.3%; RR 1.01, 95% confidence interval (CI) 0.95 to 1.08; I² = 25%; 3 trials, N = 99,070). Providing CVD risk scores may reduce CVD risk factor levels by a small amount compared with usual care. Providing CVD risk scores reduced total cholesterol (MD -0.10 mmol/L, 95% CI -0.20 to 0.00; I² = 94%; 12 trials, N = 20,437, low-quality evidence), systolic blood pressure (MD -2.77 mmHg, 95% CI -4.16 to -1.38; I² = 93%; 16 trials, N = 32,954, low-quality evidence), and multivariable CVD risk (SMD -0.21, 95% CI -0.39 to -0.02; I² = 94%; 9 trials, N = 9549, low-quality evidence). Providing CVD risk scores may reduce adverse events compared with usual care, but results were imprecise (1.9% versus 2.7%; RR 0.72, 95% CI 0.49 to 1.04; I² = 0%; 4 trials, N = 4630, low-quality evidence). Compared with usual care, providing CVD risk scores may increase new or intensified lipid-lowering medications (15.7% versus 10.7%; RR 1.47, 95% CI 1.15 to 1.87; I² = 40%; 11 trials, N = 14,175, low-quality evidence) and increase new or increased antihypertensive medications (17.2% versus 11.4%; RR 1.51, 95% CI 1.08 to 2.11; I² = 53%; 8 trials, N = 13,255, low-quality evidence). There is uncertainty whether current strategies for providing CVD risk scores affect CVD events. Providing CVD risk scores may slightly reduce CVD risk factor levels and may increase preventive medication prescribing in higher-risk people without evidence of harm. There were multiple study limitations in the identified studies and substantial heterogeneity in the interventions, outcomes, and analyses, so readers should interpret results with caution. New models for implementing and evaluating CVD risk scores in adequately powered studies are needed to define the role of applying CVD risk scores in primary CVD prevention.
Pieniak, Zuzanna; Verbeke, Wim; Perez-Cueto, Federico; Brunsø, Karen; De Henauw, Stefaan
2008-01-01
Background The purpose of this study was to explore the cross-cultural differences in the frequency of fish intake and in motivations for fish consumption between people from households with (CVD+) or without (CVD-) medical history of cardiovascular disease, using data obtained in five European countries. Methods A cross-sectional consumer survey was carried out in November-December 2004 with representative household samples from Belgium, the Netherlands, Denmark, Poland and Spain. The sample consisted of 4,786 respondents, aged 18–84 and who were responsible for food purchasing and cooking in the household. Results Individuals from households in the CVD+ group consumed fish more frequently in Belgium and in Denmark as compared to those in the CVD- group. The consumption of fatty fish, which is the main sources of omega-3 PUFA associated with prevention of cardiovascular diseases, was on the same level for the two CVD groups in the majority of the countries, except in Belgium where CVD+ subjects reported to eat fatty fish significantly more frequently than CVD- subjects. All respondents perceived fish as a very healthy and nutritious food product. Only Danish consumers reported a higher subjective and objective knowledge related to nutrition issues about fish. In the other countries, objective knowledge about fish was on a low level, similar for CVD+ as for CVD- subjects, despite a higher claimed use of medical information sources about fish among CVD+ subjects. Conclusion Although a number of differences between CVD- and CVD+ subjects with respect to their frequency of fish intake are uncovered, the findings suggest that fish consumption traditions and habits – rather than a medical history of CVD – account for large differences between the countries, particularly in fatty fish consumption. This study exemplifies the need for nutrition education and more effective communication about fish, not only to the people facing chronic diseases, but also to the broader public. European consumers are convinced that eating fish is healthy, but particular emphasis should be made on communicating benefits especially from fatty fish consumption. PMID:18783593
NASA Technical Reports Server (NTRS)
Duffy, M. T.; Berkman, S.; Moss, H. I.; Cullen, G. W.
1978-01-01
Several ribbon growth experiments were performed from V-shaped dies coated with CVD Si3N4. The most significant result was the ability to perform five consecutive growth runs from the same die without mechanical degradation of the die through temperature cycling. The die was made from vitreous carbon coated with CVD Si3N4. Silicon oxynitride, Si2N2O, was examined with respect to thermal stability in contact with molten silicon. The results of X-ray analysis indicate that this material is converted to both alpha - and beta-Si3N4 in the presence of molten silicon. Experiments on the stability of CVD SiOxNy shoe that this material can be maintained in contact with molten silicon (sessile drop test) for greater than 30 h at 1450 C without total decompositon. These layers are converted mainly to beta-Si3N4.
NASA Astrophysics Data System (ADS)
Majee, Subimal; Fátima Cerqueira, Maria; Tondelier, Denis; Geffroy, Bernard; Bonnassieux, Yvan; Alpuim, Pedro; Bourée, Jean Eric
2014-01-01
The reliability and stability are key issues for the commercial utilization of organic photovoltaic devices based on flexible polymer substrates. To increase the shelf-lifetime of these devices, transparent moisture barriers of silicon nitride (SiNx) films are deposited at low temperature by hot wire CVD (HW-CVD) process. Instead of the conventional route based on organic/inorganic hybrid structures, this work defines a new route consisting in depositing multilayer stacks of SiNx thin films, each single layer being treated by argon plasma. The plasma treatment allows creating smoother surface and surface atom rearrangement. We define a critical thickness of the single layer film and focus our attention on the effect of increasing the number of SiNx single-layers on the barrier properties. A water vapor transmission rate (WVTR) of 2 × 10-4 g/(m2·day) is reported for SiNx multilayer stack and a physical interpretation of the plasma treatment effect is given.
Globalization, Work, and Cardiovascular Disease.
Schnall, Peter L; Dobson, Marnie; Landsbergis, Paul
2016-10-01
Cardiovascular disease (CVD), a global epidemic, is responsible for about 30% of all deaths worldwide. While mortality rates from CVD have been mostly declining in the advanced industrialized nations, CVD risk factors, including hypertension, obesity, and diabetes, have been on the increase everywhere. Researchers investigating the social causes of CVD have produced a robust body of evidence documenting the relationships between the work environment and CVD, including through the mechanisms of psychosocial work stressors. We review the empirical evidence linking work, psychosocial stressors, and CVD. These work stressors can produce chronic biologic arousal and promote unhealthy behaviors and thus, increased CVD risk. We offer a theoretical model that illustrates how economic globalization influences the labor market and work organization in high-income countries, which, in turn, exacerbates job characteristics, such as demands, low job control, effort-reward imbalance, job insecurity, and long work hours. There is also a growing interest in "upstream" factors among work stress researchers, including precarious employment, downsizing/restructuring, privatization, and lean production. We conclude with suggestions for future epidemiologic research on the role of work in the development of CVD, as well as policy recommendations for prevention of work-related CVD. © The Author(s) 2016.
Association Between Hospitalization for Pneumonia and Subsequent Risk of Cardiovascular Disease
Corrales-Medina, Vicente F.; Alvarez, Karina N.; Weissfeld, Lisa A.; Angus, Derek C.; Chirinos, Julio A.; Chang, Chung-Chou H.; Newman, Anne; Loehr, Laura; Folsom, Aaron R.; Elkind, Mitchell S.; Lyles, Mary F.; Kronmal, Richard A.; Yende, Sachin
2015-01-01
IMPORTANCE The risk of cardiovascular disease (CVD) after infection is poorly understood. OBJECTIVE To determine whether hospitalization for pneumonia is associated with an increased short-term and long-term risk of CVD. DESIGN, SETTINGS, AND PARTICIPANTS We examined 2 community-based cohorts: the Cardiovascular Health Study (CHS, n = 5888; enrollment age, ≥65 years; enrollment period, 1989–1994) and the Atherosclerosis Risk in Communities study (ARIC, n = 15 792; enrollment age, 45-64 years; enrollment period, 1987–1989). Participants were followed up through December 31, 2010. We matched each participant hospitalized with pneumonia to 2 controls. Pneumonia cases and controls were followed for occurrence of CVD over 10 years after matching. We estimated hazard ratios (HRs) for CVD at different time intervals, adjusting for demographics, CVD risk factors, subclinical CVD, comorbidities, and functional status. EXPOSURES Hospitalization for pneumonia. MAIN OUTCOMES AND MEASURES Incident CVD (myocardial infarction, stroke, and fatal coronary heart disease). RESULTS Of 591 pneumonia cases in CHS, 206 had CVD events over 10 years after pneumonia hospitalization. Compared with controls, CVD risk among pneumonia cases was highest during the first year after hospitalization and remained significantly higher than among controls through 10 years. In ARIC, of 680 pneumonia cases, 112 had CVD events over 10 years after hospitalization. After the second year, CVD risk among pneumonia cases was not significantly higher than among controls. Pneumonia Cases Controls HR (95% CI) CHS No. of participants 591 1182 CVD events 0-30 d 54 6 4.07 (2.86-5.27) 31-90 d 11 9 2.94 (2.18-3.70) 91 d-1 y 22 55 2.10 (1.59-2.60) 9-10 y 4 12 1.86 (1.18-2.55) ARIC No. of participants 680 1360 CVD events 0-30 d 4 3 2.38 (1.12-3.63) 31-90 d 4 0 2.40 (1.23-3.47) 91 d-1 y 11 8 2.19 (1.20-3.19) 1-2 y 8 7 1.88 (1.10-2.66) CONCLUSIONS AND RELEVANCE Hospitalization for pneumonia was associated with increased short-term and long-term risk of CVD, suggesting that pneumonia may be a risk factor for CVD. PMID:25602997
Lu, Yuan; Ezzati, Majid; Rimm, Eric B; Hajifathalian, Kaveh; Ueda, Peter; Danaei, Goodarz
2016-08-09
Cardiovascular disease (CVD) death rates are much higher in blacks than whites in the United States. It is unclear how CVD risk and events are distributed among blacks versus whites and how interventions reduce racial disparities. We developed risk models for fatal and for fatal and nonfatal CVD using 8 cohorts in the United States. We used 6154 adults who were 50 to 69 years of age in the National Health and Nutrition Examination Survey 1999 to 2012 to estimate the distributions of risk and events in blacks and whites. We estimated the total and disparity impacts of a range of population-wide, targeted, and risk-based interventions on 10-year CVD risks and event rates. Twenty-five percent (95% confidence interval [CI], 22-28) of black men and 12% (95% CI, 10-14) of black women were at ≥6.67% risk of fatal CVD (almost equivalent to 20% risk of fatal or nonfatal CVD) compared with 10% (95% CI, 8-12) of white men and 3% (95% CI, 2-4) of white women. These high-risk individuals accounted for 55% (95% CI, 49-59) of CVD deaths among black men and 42% (95% CI, 35-46) in black women compared with 30% (95% CI, 24-35) in white men and 18% (95% CI, 13-22) in white women. We estimated that an intervention that treated multiple risk factors in high-risk individuals could reduce black-white difference in CVD death rate from 1659 to 1244 per 100 000 in men and from 1320 to 897 in women. Rates of fatal and nonfatal CVD were generally similar between black and white men. In women, a larger proportion of women were at ≥7.5% risk of CVD (30% versus 19% in whites), and an intervention that targeted multiple risk factors among this group was estimated to reduce black-white differences in CVD rates from 1688 to 1197 per 100 000. A substantially larger proportion of blacks have a high risk of fatal CVD and bear a large share of CVD deaths. A risk-based intervention that reduces multiple risk factors could substantially reduce overall CVD rates and racial disparities in CVD death rates. © 2016 American Heart Association, Inc.
Martins, Amanda R; Salviano, Adriana B; Oliveira, Aline A S; Mambrini, Raquel V; Moura, Flávia C C
2017-03-01
In this work, mesoporous silica mobil composition of matter no. 41 (MCM-41) was synthesized by the sol-gel method. Two different surface modifications were made to transform this material into a very active adsorbent and catalyst support: (i) impregnation of iron nanoparticles and (ii) hydrophobization via chemical vapor deposition (CVD) with ethanol. The materials prepared with different iron contents, i.e., 2.5, 5, and 10 %, after hydrophobization, were characterized by several techniques. CHN analysis and Raman spectroscopy proved that approximately 15 % of carbon is deposited during CVD process mainly as organized carbonaceous structures. The specific surface area was determined by the BET method as up to 1080 m 2 g -1 , which explains the excellent results of the materials in the adsorption of model dyes methylene blue and indigo carmine. Mössbauer spectroscopy, thermogravimetric (TG)/DTG analysis, and transmission electron microscopy (TEM) images showed that the iron supported may be partially reduced during the CVD process to Fe 2+ species, which are stabilized by the carbon coating. This iron species plays an important role in the oxidation of different contaminants, such as quinoline and methylene blue. The results obtained in the catalytic tests showed to be very promising.
Complement Activation: An Emerging Player in the Pathogenesis of Cardiovascular Disease
Carter, Angela M.
2012-01-01
A wealth of evidence indicates a fundamental role for inflammation in the pathogenesis of cardiovascular disease (CVD), contributing to the development and progression of atherosclerotic lesion formation, plaque rupture, and thrombosis. An increasing body of evidence supports a functional role for complement activation in the pathogenesis of CVD through pleiotropic effects on endothelial and haematopoietic cell function and haemostasis. Prospective and case control studies have reported strong relationships between several complement components and cardiovascular outcomes, and in vitro studies and animal models support a functional effect. Complement activation, in particular, generation of C5a and C5b-9, influences many processes involved in the development and progression of atherosclerosis, including promotion of endothelial cell activation, leukocyte infiltration into the extracellular matrix, stimulation of cytokine release from vascular smooth muscle cells, and promotion of plaque rupture. Complement activation also influences thrombosis, involving components of the mannose-binding lectin pathway, and C5b-9 in particular, through activation of platelets, promotion of fibrin formation, and impairment of fibrinolysis. The participation of the complement system in inflammation and thrombosis is consistent with the physiological role of the complement system as a rapid effector system conferring protection following vessel injury. However, in the context of CVD, these same processes contribute to development of atherosclerosis, plaque rupture, and thrombosis. PMID:24278688
Thermal barrier coatings on gas turbine blades: Chemical vapor deposition (Review)
NASA Astrophysics Data System (ADS)
Igumenov, I. K.; Aksenov, A. N.
2017-12-01
Schemes are presented for experimental setups (reactors) developed at leading scientific centers connected with the development of technologies for the deposition of coatings using the CVD method: at the Technical University of Braunschweig (Germany), the French Aerospace Research Center, the Materials Research Institute (Tohoku University, Japan) and the National Laboratory Oak Ridge (USA). Conditions and modes for obtaining the coatings with high operational parameters are considered. It is established that the formed thermal barrier coatings do not fundamentally differ in their properties (columnar microstructure, thermocyclic resistance, thermal conductivity coefficient) from standard electron-beam condensates, but the highest growth rates and the perfection of the crystal structure are achieved in the case of plasma-chemical processes and in reactors with additional laser or induction heating of a workpiece. It is shown that CVD reactors can serve as a basis for the development of rational and more advanced technologies for coating gas turbine blades that are not inferior to standard electron-beam plants in terms of the quality of produced coatings and have a much simpler and cheaper structure. The possibility of developing a new technology based on CVD processes for the formation of thermal barrier coatings with high operational parameters is discussed, including a set of requirements for industrial reactors, high-performance sources of vapor precursors, and promising new materials.
An update on the safety of nutraceuticals and effects on lipid parameters.
Cicero, Arrigo F G; Colletti, Alessandro
2018-03-01
Cardiovascular diseases (CVDs) are the leading cause of mortality and disability in developed countries, whereas a large portion of patients in primary prevention have uncontrolled level of CVD risk factors. Dietary supplementation with bioactive natural compounds with demonstrated lipid-lowering effects is currently supported by the international guidelines for CVD prevention and some international expert panels. Areas covered: This review provides insights on issues concerning the tolerability and safety of the most commonly used nutraceuticals with demonstrated lipid-lowering effect in humans. They will be then divided into three main categories according to their mechanism of action (cholesterol synthesis inhibitors, intestinal cholesterol absorption inhibitors, and LDL-C excretion stimulants) and their pharmacological profile will be discussed. Expert opinion: A growing body of preclinical, epidemiological and clinical evidence has defined the tolerability and safety profile of the most commonly used lipid-lowering nutraceuticals. In the most part of cases, the side effects are mild and reversible. However, detailed knowledge of specific health risks and pharmacological interactions for each individual compound is needed for the management of frail patients, such as children, elderly, patients with liver or renal failure, and patients consuming numerous drugs.
Chen, Jui-Ming; Chang, Cheng-Wei; Lin, Ying-Chieh; Horng, Jorng-Tzong; Sheu, Wayne H.-H.
2014-01-01
Objective. To investigate the potential benefits of acarbose treatment on cardiovascular disease (CVD) in patients with type 2 diabetes by using nationwide insurance claim dataset. Research Design and Methods. Among 644,792 newly diagnosed type 2 diabetic patients without preexisting CVD in a nationwide cohort study, 109,139 (16.9%) who had received acarbose treatment were analyzed for CVD risk. Those with CVD followed by acarbose therapy were also subjected to analysis. Result. During 7 years of follow-up, 5,081 patients (4.7%) developed CVD. The crude hazard ratio (HR) and adjusted HR were 0.66 and 0.99, respectively. The adjusted HR of CVD was 1.19, 0.70, and 0.38 when the duration of acarbose use was <12 months, 12–24 months, and >24 months, respectively. Adjusted HR was 1.14, 0.64, and 0.41 with acarbose cumulative doses <54,750 mg, 54,751 to 109,500 mg, and >109,500 mg, respectively. Conclusion. In patients with type 2 diabetes without preexisting CVD, treatment with acarbose showed a transient increase in incidence of CVD in the initial 12 months followed by significant reductions of CVD in prolonged acarbose users. After the first CVD events, continuous use of acarbose revealed neutral effect within the first 12 months. The underlying mechanisms require further investigations. PMID:25197673
Chen, Jui-Ming; Chang, Cheng-Wei; Lin, Ying-Chieh; Horng, Jorng-Tzong; Sheu, Wayne H-H
2014-01-01
To investigate the potential benefits of acarbose treatment on cardiovascular disease (CVD) in patients with type 2 diabetes by using nationwide insurance claim dataset. Among 644,792 newly diagnosed type 2 diabetic patients without preexisting CVD in a nationwide cohort study, 109,139 (16.9%) who had received acarbose treatment were analyzed for CVD risk. Those with CVD followed by acarbose therapy were also subjected to analysis. During 7 years of follow-up, 5,081 patients (4.7%) developed CVD. The crude hazard ratio (HR) and adjusted HR were 0.66 and 0.99, respectively. The adjusted HR of CVD was 1.19, 0.70, and 0.38 when the duration of acarbose use was <12 months, 12-24 months, and >24 months, respectively. Adjusted HR was 1.14, 0.64, and 0.41 with acarbose cumulative doses <54,750 mg, 54,751 to 109,500 mg, and >109,500 mg, respectively. In patients with type 2 diabetes without preexisting CVD, treatment with acarbose showed a transient increase in incidence of CVD in the initial 12 months followed by significant reductions of CVD in prolonged acarbose users. After the first CVD events, continuous use of acarbose revealed neutral effect within the first 12 months. The underlying mechanisms require further investigations.
Reduced heart rate variability in schizophrenia and bipolar disorder compared to healthy controls.
Quintana, D S; Westlye, L T; Kaufmann, T; Rustan, Ø G; Brandt, C L; Haatveit, B; Steen, N E; Andreassen, O A
2016-01-01
Despite current diagnostic systems distinguishing schizophrenia (SZ) and bipolar disorder (BD) as separate diseases, emerging evidence suggests they share a number of clinical and epidemiological features, such as increased cardiovascular disease (CVD) risk. It is not well understood if poor cardiac autonomic nervous system regulation, which can be indexed non-invasively by the calculation of heart rate variability (HRV), contributes to these common CVD risk factors in both diseases. We calculated HRV in 47 patients with SZ, 33 patients with BD and 212 healthy controls. Measures of symptom severity were also collected from the patient groups. Heart rate variability was significantly reduced in both these disorders in comparison with the healthy participants; however, there were no HRV differences between disorders. Importantly, these reductions were independent of the medication, age or body mass index effects. There was also preliminary evidence that patients with reduced HRV had increased overall and negative psychosis symptom severity regardless of SZ or BD diagnosis. We suggest that HRV may provide a possible biomarker of CVD risk and symptom severity in severe mental illness. Thus, our results highlight the importance of cardiometabolic screening across SZ and bipolar spectrum disorders. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Wan, Zhaofei; Liu, Xiaojun; Wang, Xinhong; Liu, Fuqiang; Liu, Weimin; Wu, Yue; Pei, Leilei; Yuan, Zuyi
2014-04-01
Arterial elasticity has been shown to predict cardiovascular disease (CVD) in apparently healthy populations. The present study aimed to explore whether arterial elasticity could predict CVD events in Chinese patients with angiographic coronary artery disease (CAD). Arterial elasticity of 365 patients with angiographic CAD was measured. During follow-up (48 months; range 6-65), 140 CVD events occurred (including 34 deaths). Univariate Cox analysis demonstrated that both large arterial elasticity and small arterial elasticity were significant predictors of CVD events. Multivariate Cox analysis indicated that small arterial elasticity remained significant. Kaplan-Meier analysis showed that the probability of having a CVD event/CVD death increased with a decrease of small arterial elasticity (P < .001, respectively). Decreased small arterial elasticity independently predicts the risk of CVD events in Chinese patients with angiographic CAD.
Evolution of Cardiovascular Disease During the Transition to End-Stage Renal Disease.
Bansal, Nisha
2017-03-01
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The rate of death in incident dialysis patients remains high. This has led to interest in the study of the evolution of CVD during the critical transition period from CKD to ESRD. Understanding the natural history and risk factors of clinical and subclinical CVD during this transition may help guide the timing of appropriate CVD therapies to improve outcomes in patients with kidney disease. This review provides an overview of the epidemiology of subclinical and clinical CVD during the transition from CKD to ESRD and discusses clinical trials of CVD therapies to mitigate risk of CVD in CKD and ESRD patients. Copyright © 2017 Elsevier Inc. All rights reserved.
Growth and Characterization of Epitaxial Piezoelectric and Semiconductor Films.
1980-07-01
quality epitaxial films at low growth rates. This process is limited to films up to a few microns thickness. The aluminum chloride/ ammonia CVD process has... scrubber through a rotary Vacuum pump maintaining Reactions.-DEZ is an electron deficient compound a pressure of about 400 Torr inside the reaction chain
Billing, Beant Kaur; Dhar, Purbarun; Singh, Narinder; Agnihotri, Prabhat K
2018-01-03
A detailed experimental investigation was carried out to establish the relationship between CNT purification and functionalization routes and the average response of CNT/epoxy nanocomposites under static and dynamic loading. It was shown that the relative improvement in the mechanical properties of the epoxy matrix due to the addition of CNTs depends on the choice of purification and functionalization steps. A better dispersion of CNTs was recorded for the functionalized CNTs as compared to the oxidized and CVD grown CNTs. Moreover, tensile, 3-point bending and nanoDMA testing performed on nanocomposites processed with CVD-grown, oxidized and functionalized CNTs revealed that COOH functionalization after the oxidation of CNTs at 350 °C is the optimized processing route to harness the excellent properties of CNTs in CNT/epoxy nanocomposites.
Role of hydrogen in the chemical vapor deposition growth of MoS2 atomic layers
NASA Astrophysics Data System (ADS)
Li, Xiao; Li, Xinming; Zang, Xiaobei; Zhu, Miao; He, Yijia; Wang, Kunlin; Xie, Dan; Zhu, Hongwei
2015-04-01
Hydrogen plays a crucial role in the chemical vapor deposition (CVD) growth of graphene. Here, we have revealed the roles of hydrogen in the two-step CVD growth of MoS2. Our study demonstrates that hydrogen acts as the following: (i) an inhibitor of the thermal-induced etching effect in the continuous film growth process; and (ii) a promoter of the desulfurization reaction by decreasing the S/Mo atomic ratio and the oxidation reaction of the obtained MoSx (0 < x < 2) films. A high hydrogen content of more than 100% in argon forms nano-sized circle-like defects and damages the continuity and uniformity of the film. Continuous MoS2 films with a high crystallinity and a nearly perfect S/Mo atomic ratio were finally obtained after sulfurization annealing with a hydrogen content in the range of 20%-80%. This insightful understanding reveals the crucial roles of hydrogen in the CVD growth of MoS2 and paves the way for the controllable synthesis of two-dimensional materials.Hydrogen plays a crucial role in the chemical vapor deposition (CVD) growth of graphene. Here, we have revealed the roles of hydrogen in the two-step CVD growth of MoS2. Our study demonstrates that hydrogen acts as the following: (i) an inhibitor of the thermal-induced etching effect in the continuous film growth process; and (ii) a promoter of the desulfurization reaction by decreasing the S/Mo atomic ratio and the oxidation reaction of the obtained MoSx (0 < x < 2) films. A high hydrogen content of more than 100% in argon forms nano-sized circle-like defects and damages the continuity and uniformity of the film. Continuous MoS2 films with a high crystallinity and a nearly perfect S/Mo atomic ratio were finally obtained after sulfurization annealing with a hydrogen content in the range of 20%-80%. This insightful understanding reveals the crucial roles of hydrogen in the CVD growth of MoS2 and paves the way for the controllable synthesis of two-dimensional materials. Electronic supplementary information (ESI) available: Low-magnification optical images; Raman spectra of 0% and 5% H2 samples; AFM characterization; Schematic of the film before and after sulfurization annealing; Schematic illustrations of two typical Raman-active phonon modes (E12g, A1g); Raman (mapping) spectra for 40% and 80% H2 samples before and after sulfurization annealing; PL spectra. See DOI: 10.1039/c5nr00904a
Chemical vapor deposition of epitaxial silicon
Berkman, Samuel
1984-01-01
A single chamber continuous chemical vapor deposition (CVD) reactor is described for depositing continuously on flat substrates, for example, epitaxial layers of semiconductor materials. The single chamber reactor is formed into three separate zones by baffles or tubes carrying chemical source material and a carrier gas in one gas stream and hydrogen gas in the other stream without interaction while the wafers are heated to deposition temperature. Diffusion of the two gas streams on heated wafers effects the epitaxial deposition in the intermediate zone and the wafers are cooled in the final zone by coolant gases. A CVD reactor for batch processing is also described embodying the deposition principles of the continuous reactor.
Virgin coconut oil and its potential cardioprotective effects.
Babu, Abraham Samuel; Veluswamy, Sundar Kumar; Arena, Ross; Guazzi, Marco; Lavie, Carl J
2014-11-01
Emphasis on diet to improve the cardiovascular (CV) risk profile has been the focus of many studies. Recently, virgin coconut oil (VCO) has been growing in popularity due to its potential CV benefits. The chemical properties and the manufacturing process of VCO make this oil healthier than its copra-derived counterpart. This review highlights the mechanism through which saturated fatty acids contribute to CV disease (CVD), how oils and fats contribute to the risk of CVD, and the existing views on VCO and how its cardioprotective effects may make this a possible dietary intervention in isolation or in combination with exercise to help reduce the burden of CVDs.
Fujishiro, Kaori; Diez Roux, Ana V; Landsbergis, Paul; Baron, Sherry; Barr, R Graham; Kaufman, Joel D; Polak, Joseph F; Stukovsky, Karen Hinckley
2011-05-01
Occupation has been linked to cardiovascular disease (CVD) incidence and mortality, but few studies have investigated occupation in relation to early atherosclerotic disease. This study examined associations between various occupational characteristics and carotid artery intima-media thickness (IMT) in a multi-ethnic sample. The Multi-Ethnic Study of Atherosclerosis (MESA) recruited 6814 adults aged 45-84 years and free of clinical CVD (response rate 60%, 51% female). Questionnaire data were used to determine occupational group (managerial/professional, sales/office, service, blue-collar), psychosocial job characteristics (ie, job demands, job control) and other sociodemographic information. Common carotid artery (CCA)-IMT was greater for blue-collar jobs than for management/professional jobs (mean difference = 0.012 mm, p = 0.049) after adjustment for age, sex, race, place of birth (US or foreign born) and CVD risk factors. Compared to management/professional jobs, internal carotid artery (ICA)-IMT was greater for sales/office, service and blue-collar jobs (mean difference = 0.071 mm, p < 0.001; 0.057 mm, p = 0.009; and 0.110 mm, p < 0.001, respectively) after adjustment for age, sex, race and place of birth. The difference between blue-collar jobs and management/professional jobs remained significant after additional adjustment for CVD risk factors, income and education (mean difference = 0.048 mm, p = 0.045). Higher levels of control at work were associated with thinner CCA-IMT (mean difference = -0.009 mm, p = 0.016, adjusted for age, sex, race and place of birth) but not with ICA-IMT. Job demands had no significant association with IMT. Blue-collar jobs and low levels of job control were associated with the development of subclinical atherosclerosis.
Pearson-Stuttard, Jonathan; Guzman-Castillo, Maria; Penalvo, Jose L.; Rehm, Colin D.; Afshin, Ashkan; Danaei, Goodarz; Kypridemos, Chris; Gaziano, Tom; Mozaffarian, Dariush; Capewell, Simon; O’Flaherty, Martin
2016-01-01
Background Accurate forecasting of cardiovascular disease (CVD) mortality is crucial to guide policy and programming efforts. Prior forecasts have often not incorporated past trends in rates of reduction in CVD mortality. This creates uncertainties about future trends in CVD mortality and disparities. Methods and Results To forecast US CVD mortality and disparities to 2030, we developed a hierarchical Bayesian model to determine and incorporate prior age, period and cohort (APC) effects from 1979–2012, stratified by age, gender and race; which we combined with expected demographic shifts to 2030. Data sources included the National Vital Statistics System, SEER single year population estimates, and US Bureau of Statistics 2012 National Population projections. We projected coronary disease and stroke deaths to 2030, first based on constant APC effects at 2012 values, as most commonly done (conventional); and then using more rigorous projections incorporating expected trends in APC effects (trend-based). We primarily evaluated absolute mortality. The conventional model projected total coronary and stroke deaths by 2030 to increase by approximately 18% (67,000 additional coronary deaths/year) and 50% (64,000 additional stroke deaths/year). Conversely, the trend-based model projected that coronary mortality would fall by 2030 by approximately 27% (79,000 fewer deaths/year); and stroke mortality would remain unchanged (200 fewer deaths/year). Health disparities will be improved in stroke deaths, but not coronary deaths. Conclusions After accounting for prior mortality trends and expected demographic shifts, total US coronary deaths are expected to decline, while stroke mortality will remain relatively constant. Health disparities in stroke, but not coronary, deaths will be improved but not eliminated. These APC approaches offer more plausible predictions than conventional estimates. PMID:26846769
Inflammation-Related Morbidity and Mortality Among HIV-Positive Adults: How Extensive Is It?
Hart, Brian B; Nordell, Anna D; Okulicz, Jason F; Palfreeman, Adrian; Horban, Andrzej; Kedem, Eynat; Neuhaus, Jacqueline; Jacobs, David R; Duprez, Daniel A; Neaton, James D
2018-01-01
To determine the rate of grade 4, potentially life-threatening events not attributable to AIDS, cardiovascular disease (CVD), or non-AIDS cancer among participants on antiretroviral therapy and to describe associations of these events with interleukin-6 (IL-6) and D-dimer. Cohort study. HIV-infected participants on antiretroviral therapy (N = 3568) with an HIV-RNA level ≤ 500 copies/mL were followed for grade 4, AIDS, CVD, non-AIDS cancer, and all-cause mortality events. Grade 4 events were further classified masked to biomarker levels as reflecting chronic inflammation-related disease (ChrIRD) or not (non-ChrIRD). Associations of baseline IL-6 and D-dimer with events were studied using Cox models. Over a median follow-up of 4.3 years, 339 participants developed a grade 4 event (22.9 per 1000 person-years); 165 participants developed a ChrIRD grade 4 event (10.7 per 1000 person-years). Grade 4 events were more common than AIDS (54 participants), CVD (132), and non-AIDS cancer (80) events, any of which developed in 252 participants (17.1 per 1000 person-years). Grade 4 and AIDS events were associated with similar risks of death. Higher IL-6 [hazard ratio (HR) = 1.19 per doubling of biomarker; P = 0.003] and D-dimer (HR = 1.23; P < 0.001) levels were associated with an increased risk of grade 4 events. IL-6 associations were stronger for ChrIRD (HR = 1.38; P < 0.001) than non-ChrIRD grade 4 events (HR = 1.11; P = 0.21). Morbidity and mortality associated with activation of inflammatory and coagulation pathways include conditions other than AIDS, CVD, and non-AIDS cancer events. Effective inflammation-dampening interventions could greatly affect the health of people with HIV.
Accounting for Selection Bias in Studies of Acute Cardiac Events.
Banack, Hailey R; Harper, Sam; Kaufman, Jay S
2018-06-01
In cardiovascular research, pre-hospital mortality represents an important potential source of selection bias. Inverse probability of censoring weights are a method to account for this source of bias. The objective of this article is to examine and correct for the influence of selection bias due to pre-hospital mortality on the relationship between cardiovascular risk factors and all-cause mortality after an acute cardiac event. The relationship between the number of cardiovascular disease (CVD) risk factors (0-5; smoking status, diabetes, hypertension, dyslipidemia, and obesity) and all-cause mortality was examined using data from the Atherosclerosis Risk in Communities (ARIC) study. To illustrate the magnitude of selection bias, estimates from an unweighted generalized linear model with a log link and binomial distribution were compared with estimates from an inverse probability of censoring weighted model. In unweighted multivariable analyses the estimated risk ratio for mortality ranged from 1.09 (95% confidence interval [CI], 0.98-1.21) for 1 CVD risk factor to 1.95 (95% CI, 1.41-2.68) for 5 CVD risk factors. In the inverse probability of censoring weights weighted analyses, the risk ratios ranged from 1.14 (95% CI, 0.94-1.39) to 4.23 (95% CI, 2.69-6.66). Estimates from the inverse probability of censoring weighted model were substantially greater than unweighted, adjusted estimates across all risk factor categories. This shows the magnitude of selection bias due to pre-hospital mortality and effect on estimates of the effect of CVD risk factors on mortality. Moreover, the results highlight the utility of using this method to address a common form of bias in cardiovascular research. Copyright © 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Merchant, Anwar T; Virani, Salim S
2017-01-01
Periodontal disease is correlated with cardiovascular disease (CVD) in observational studies, but a causal connection has not been established. The empirical evidence linking periodontal disease and CVD consists of a large body of observational and mechanistic studies, but a limited number of clinical trials evaluating the effects of periodontal treatment on surrogate CVD endpoints. No randomized controlled trial has been conducted to evaluate the effect of periodontal treatment on CVD risk. In this review, we have summarized these data, described possible biological mechanisms linking periodontal disease and CVD, discussed barriers to conducting a randomized controlled trial to evaluate this hypothesis, and provided an alternative analytical approach using causal inference methods to answer the question. The public health implications of addressing this question can be significant because periodontal disease is under-treated, and highly prevalent among adults at risk of CVD. Even a small beneficial effect of periodontal treatment on CVD risk can be important.