Controlling the ripple density and heights: a new way to improve the electrical performance of CVD-grown graphene.

PubMed

Park, Won-Hwa; Jo, Insu; Hong, Byung Hee; Cheong, Hyeonsik

2016-05-14

We report a new way to enhance the electrical performances of large area CVD-grown graphene through controlling the ripple density and heights after transfer onto SiO2/Si substrates by employing different cooling rates during fabrication. We find that graphene films prepared with a high cooling rate have reduced ripple density and heights and improved electrical characteristics such as higher electron/hole mobilities as well as reduced sheet resistance. The corresponding Raman analysis also shows a significant decrease of the defects when a higher cooling rate is employed. We suggest a model that explains the improved morphology of the graphene film obtained with higher cooling rates. From these points of view, we can suggest a new pathway toward a relatively lower density and heights of ripples in order to reduce the flexural phonon-electron scattering effect, leading to higher lateral carrier mobilities.

Electrically insulating films deposited on V-4%Cr-4%Ti by reactive CVD

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, J.H.

1998-04-01

In the design of liquid-metal blankets for magnetic fusion reactors, corrosion resistance of structural materials and the magnetohydrodynamic forces and their influence on thermal hydraulics and corrosion are major concerns. Electrically insulating CaO films deposited on V-4%Cr-4%Ti exhibit high-ohmic insulator behavior even though a small amount of vanadium from the alloy become incorporated into the film. However, when vanadium concentration in the film is > 15 wt.%, the film becomes conductive. When the vanadium concentration is high in localized areas, a calcium vanadate phase that exhibits semiconductor behavior can form. The objective of this study is to evaluate electrically insulatingmore » films that were deposited on V-4%Cr-4%Ti by a reactive chemical vapor deposition (CVD) method. To this end, CaO and Ca-V-O coatings were produced on vanadium alloys by CVD and by a metallic-vapor process to investigate the electrical resistance of the coatings. The authors found that the Ca-V-O films exhibited insulator behavior when the ratio of calcium concentration to vanadium concentration R in the film > 0.9, and semiconductor or conductor behavior when R < 0.8. However, in some cases, semiconductor behavior was observed when CaO-coated samples with R > 0.98 were exposed in liquid lithium. Based on these studies, they conclude that semiconductor behavior occurs if a conductive calcium vanadate phase is present in localized regions in the CaO coating.« less

AuCl3 doping-induced conductive unstability for CVD-grown graphene on glass substrate

NASA Astrophysics Data System (ADS)

Wang, Jiaqing; Liu, Xianming; Cao, Xueying; Zhang, Peng; Lei, Xiaohua; Chen, Weimin

2017-09-01

Graphene is a candidate material for next-generation high performance transparent conducting film (TCF) to replace indium tin oxide (ITO) materials. However, the sheet resistance of large area graphene obtained by the chemical vapor deposition (CVD) method is higher than other kinds of TCFs. The main strategies for improving the electrical conductivity of graphene films have been based on various doping treatments. AuCl3 is one of the most effective dopants. In this paper, we investigate the influence of AuCl3 doping on the conductive stability of CVD-grown graphene. Large area graphene film synthesized by CVD and transferred to glass substrates is taken as experimental sample. AuCl3 in nitromethane is used to dope the graphene films to improve the electrical conductivity. Another sample without doping is prepared for comparison. The resistances of graphene under periodic visible light irradiation with and without AuCl3 doping are measured. Results show that the resistances for all samples increase exponentially under lighting, while decrease slowly in an exponential form as well after the light is switched off. The relative resistance changes for undoped and doped samples are compared under 445nm light irradiation with 40mW/cm2, 60mW/cm2, 80mW/cm2, 100mW/cm2 in atmosphere and vacuum. The change rate and degree for doped graphene are greater than that of undoped graphene. It is evident from the experimental data that AuCl3 doping may induce conductive unstability for CVD-grown graphene on glass substrate.

76 FR 64313 - Multilayered Wood Flooring From the People's Republic of China: Final Affirmative Countervailing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-18

... Countervailing Duty Operations, from Susan H. Kuhbach, Office Director AD/CVD Operations, Office 1... provision of electricity for less than adequate remuneration, and 2) the countervailable subsidy rates for... Other Programs Comment 4 Provision of Electricity for Less Than Adequate Remuneration Comment 5...

CVD-graphene for low equivalent series resistance in rGO/CVD-graphene/Ni-based supercapacitors.

PubMed

Kwon, Young Hwi; Kumar, Sunil; Bae, Joonho; Seo, Yongho

2018-05-11

Reduced equivalent series resistance (ESR) is necessary, particularly at a high current density, for high performance supercapacitors, and the interface resistance between the current collector and electrode material is one of the main components of ESR. In this report, we have optimized chemical vapor deposition-grown graphene (CVD-G) on a current collector (Ni-foil) using reduced graphene oxide as an active electrode material to fabricate an electric double layer capacitor with reduced ESR. The CVD-G was grown at different cooling rates-20 °C min -1 , 40 °C min -1 and 100 °C min -1 -to determine the optimum conditions. The lowest ESR, 0.38 Ω, was obtained for a cell with a 100 °C min -1 cooling rate, while the sample without a CVD-G interlayer exhibited 0.80 Ω. The CVD-G interlayer-based supercapacitors exhibited fast CD characteristics with high scan rates up to 10 Vs -1 due to low ESR. The specific capacitances deposited with CVD-G were in the range of 145.6 F g -1 -213.8 F g -1 at a voltage scan rate of 0.05 V s -1 . A quasi-rectangular behavior was observed in the cyclic voltammetry curves, even at very high scan rates of 50 and 100 V s -1 , for the cell with optimized CVD-G at higher cooling rates, i.e. 100 °C min -1 .

CVD-graphene for low equivalent series resistance in rGO/CVD-graphene/Ni-based supercapacitors

NASA Astrophysics Data System (ADS)

Kwon, Young Hwi; Kumar, Sunil; Bae, Joonho; Seo, Yongho

2018-05-01

Reduced equivalent series resistance (ESR) is necessary, particularly at a high current density, for high performance supercapacitors, and the interface resistance between the current collector and electrode material is one of the main components of ESR. In this report, we have optimized chemical vapor deposition-grown graphene (CVD-G) on a current collector (Ni-foil) using reduced graphene oxide as an active electrode material to fabricate an electric double layer capacitor with reduced ESR. The CVD-G was grown at different cooling rates—20 °C min‑1, 40 °C min‑1 and 100 °C min‑1—to determine the optimum conditions. The lowest ESR, 0.38 Ω, was obtained for a cell with a 100 °C min‑1 cooling rate, while the sample without a CVD-G interlayer exhibited 0.80 Ω. The CVD-G interlayer-based supercapacitors exhibited fast CD characteristics with high scan rates up to 10 Vs‑1 due to low ESR. The specific capacitances deposited with CVD-G were in the range of 145.6 F g‑1–213.8 F g‑1 at a voltage scan rate of 0.05 V s‑1. A quasi-rectangular behavior was observed in the cyclic voltammetry curves, even at very high scan rates of 50 and 100 V s‑1, for the cell with optimized CVD-G at higher cooling rates, i.e. 100 °C min‑1.

Cold cathode vacuum discharge tube

DOEpatents

Boettcher, Gordon E.

1998-01-01

A cold cathode vacuum discharge tube, and method for making same, with an interior surface of the trigger probe coated with carbon deposited by carbon vapor deposition (CVD) or diamond-like carbon (DLC) deposition. Preferably a solid graphite insert is employed in the probe-cathode structure in place of an aluminum bushing employed in the prior art. The CVD or DLC probe face is laser scribed to allow resistance trimming to match available trigger voltage signals and to reduce electrical aging.

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.

The significance of the psychosocial factors influence in pathogenesis of cardiovascular disease.

PubMed

Masic, Izet; Alajbegovic, Jasmin

2013-11-01

Cardiovascular diseases (CVD) are the leading cause of death in the world today. Risk factors are those factors that influence the development of CVD. Risk factors can be divided into materialistic (genetic predisposition, smoking, alcohol) and non-materialistic (psychosocial factors). Our goal is to note the role of the health system, to emphasize the importance of psychosocial factors in the pathogenesis of CVD, explain the relationship between psychosocial factors and other risk factors, stress the importance of prevention through the provision of management of the cardiovascular system (CVS) diseases. A DESCRIPTIVE ANALYSIS WAS PERFORMED ON SCIENTIFIC STUDIES IN SEVERAL PUBLISHED ARTICLES IN JOURNALS ON CVS: Public Health Reviews, CVD, European Heart Journal, Materia Socio Medica and other indexed journals that publish articles on CVS. THE IMPORTANCE AND ROLE OF THE HEALTH SYSTEM IN THE EARLY DETECTION, DIAGNOSIS, THERAPY AND CVS DISEASE PREVENTION IS PRESENTED THROUGH THREE THEMATIC AREAS: (a) The incidence and prevalence of CVS diseases; (b) treatment of CVS diseases and (c) promotion of health in patients with CVS disease and those the risk of their occurrence. Health promotion is the most important aspect of the health system monitoring. Health promotion is adequately implemented ifthe management ofCVD is proper. The main objectives of CVD management are: Preventing or delaying the occurrence of CVD, reducing the number and severity of worsening and complications of CVD. Management Includes: Individual and family, the health system and the community. Materialistic and non-materialistic risk factors together contribute to the development of CVD.

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.

Cold cathode vacuum discharge tube

DOEpatents

Boettcher, G.E.

1998-03-10

A cold cathode vacuum discharge tube, and method for making same, are disclosed with an interior surface of the trigger probe coated with carbon deposited by carbon vapor deposition (CVD) or diamond-like carbon (DLC) deposition. Preferably a solid graphite insert is employed in the probe-cathode structure in place of an aluminum bushing employed in the prior art. The CVD or DLC probe face is laser scribed to allow resistance trimming to match available trigger voltage signals and to reduce electrical aging. 15 figs.

Cold cathode vacuum discharge tube

DOEpatents

Boettcher, G.E.

1998-04-14

A cold cathode vacuum discharge tube, and method for making same, with an interior surface of the trigger probe coated with carbon deposited by chemical vapor deposition (CVD) or diamond-like carbon (DLC) deposition are disclosed. Preferably a solid graphite insert is employed in the probe-cathode structure in place of an aluminum bushing employed in the prior art. The CVD or DLC probe face is laser scribed to allow resistance trimming to match available trigger voltage signals and to reduce electrical aging. 14 figs.

Proceedings of the International Symposium on Diamond Materials Held in Washington, DC on 5-10 May 1991. Volume 91-8

DTIC Science & Technology

1991-05-01

J. S. Ma, H. Kawarada, T. Yonehara, & A. Hiraki DIAMOND ON SILICON: A HOT FILAMENT CVD STUDY OF 266 NUCLEATION P. Ascarelli, S. Fontana, E. Molinari...BORON-DOPED CVD DIAMONDS H. Ka warada, Y. Yokota, H. Matsuyama T. Sogi, & A. Hiraki SPATIALLY AND SPECTALLY RESOLVED 427 CATHODOLUMINESCENCE...Sheng Ma, *Hiroshi Kawarada, "Takao Yonehara, and Akio Hiraki Department of Electrical Engineering, Osaka University, Suita-shi, Osaka 565, Japan

Innovative Techniques for the Production of Low Cost 2D Laser Diode Arrays. Supplies or Services and Prices/Costs

DTIC Science & Technology

1991-12-31

continue on facet coatings, PL correlation to device performance, and CVD diamond. All global issues mentioned in Section 2.0 will be addresses and...The CVD diamond submounts will be hermetically sealed, electrically isolated and liquid cooled. (Deliverables: 5 5-bar arrays.) The following global ... issues not mentioned above will be investigated continuously throughout all four phases of this program: (1) design and development of a mask set to

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.

The Significance of the Psychosocial Factors Influence in Pathogenesis of Cardiovascular Disease

PubMed Central

Masic, Izet; Alajbegovic, Jasmin

2013-01-01

Background: Cardiovascular diseases (CVD) are the leading cause of death in the world today. Risk factors are those factors that influence the development of CVD. Risk factors can be divided into materialistic (genetic predisposition, smoking, alcohol) and non-materialistic (psychosocial factors). Our goal is to note the role of the health system, to emphasize the importance of psychosocial factors in the pathogenesis of CVD, explain the relationship between psychosocial factors and other risk factors, stress the importance of prevention through the provision of management of the cardiovascular system (CVS) diseases. Methods: A descriptive analysis was performed on scientific studies in several published articles in journals on CVS: Public Health Reviews, CVD, European Heart Journal, Materia Socio Medica and other indexed journals that publish articles on CVS. Results and Conclusions: The importance and role of the health system in the early detection, diagnosis, therapy and CVS disease prevention is presented through three thematic areas: (a) The incidence and prevalence of CVS diseases; (b) treatment of CVS diseases and (c) promotion of health in patients with CVS disease and those the risk of their occurrence. Health promotion is the most important aspect of the health system monitoring. Health promotion is adequately implemented ifthe management ofCVD is proper. The main objectives of CVD management are: Preventing or delaying the occurrence of CVD, reducing the number and severity of worsening and complications of CVD. Management Includes: Individual and family, the health system and the community. Materialistic and non-materialistic risk factors together contribute to the development of CVD. PMID:24404370

Ballistic Josephson junctions based on CVD graphene

NASA Astrophysics Data System (ADS)

Li, Tianyi; Gallop, John; Hao, Ling; Romans, Edward

2018-04-01

Josephson junctions with graphene as the weak link between superconductors have been intensely studied in recent years, with respect to both fundamental physics and potential applications. However, most of the previous work was based on mechanically exfoliated graphene, which is not compatible with wafer-scale production. To overcome this limitation, we have used graphene grown by chemical vapour deposition (CVD) as the weak link of Josephson junctions. We demonstrate that very short, wide CVD-graphene-based Josephson junctions with Nb electrodes can work without any undesirable hysteresis in their electrical characteristics from 1.5 K down to a base temperature of 320 mK, and their gate-tuneable critical current shows an ideal Fraunhofer-like interference pattern in a perpendicular magnetic field. Furthermore, for our shortest junctions (50 nm in length), we find that the normal state resistance oscillates with the gate voltage, consistent with the junctions being in the ballistic regime, a feature not previously observed in CVD-graphene-based Josephson junctions.

Role of Geographic Information System in Assessing Determinants of Cardiovascular Disease: An Experience From a Low- and Middle-Income Country.

PubMed

Valamparampil, Mathew Joseph; Mohan, Ananth; Jose, Chinu; Sadheesan, Deepthi Kottassery; Aby, Jemin Jose; Vasudevakaimal, Prasannakumar; Varghese, Sara; Surendrannair, Anish Tekkumkara; Ashokan, Achu Laila; Madhusoodhanan, Resmi Santhakumari; Ilyas, Insija Selene; Rajeevan, Amjith; Karthikeyan, Sreekanth Balakrishnan; Devadhas, Krishna Sulochana; Raghunath, Rajesh; Surendran, Sethulekshmi; Muraleedharanpillai, Harikrishnan; Nujum, Zinia Thajudeen

2018-04-01

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the world. The determinants of CVD in an urban population using conventional and geographic information system techniques were attempted as a community-based census-type cross-sectional study in Kerala, India, among 1649 individuals residing in 452 households. Sociodemographic details, risk factor exposures, and self-reported disease prevalence were determined. Location of houses, wells from which subjects drew drinking water, and distances of the house from the outer road (proxy for air pollution) were mapped using differential global positioning system and pH of water samples determined. Prevalence of CVD was 5.8%. Significant predictors of CVD were male gender, diabetes mellitus, hypertension, and hypothyroidism. Statistically significant spatial association was found between CVD and groundwater pH. Geographic information system technology is useful in identification of spatial clustering and disease hotspots for designing preventive strategies targeting CVD.

Coatings for Graphite Fibers

NASA Technical Reports Server (NTRS)

Galasso, F. S.; Scola, D. A.; Veltri, R. D.

1980-01-01

Several approaches for applying high resistance coatings continuously to graphite yarn were investigated. Two of the most promising approaches involved (1) chemically vapor depositing (CVD) SiC coatings on the surface of the fiber followed by oxidation, and (2) drawing the graphite yarn through an organo-silicone solution followed by heat treatments. In both methods, coated fibers were obtained which exhibited increased electrical resistances over untreated fibers and which were not degraded. This work was conducted in a previous program. In this program, the continuous CVD SiC coating process used on HTS fiber was extended to the coating of HMS, Celion 6000, Celion 12000 and T-300 graphite fiber. Electrical resistances three order of magnitude greater than the uncoated fiber were measured with no significant degradation of the fiber strength. Graphite fibers coated with CVD Si3N4 and BN had resistances greater than 10(exp 6) ohm/cm. Lower pyrolysis temperatures were used in preparing the silica-like coatings also resulting in resistances as high as three orders of magnitude higher than the uncoated fiber. The epoxy matrix composites prepared using these coated fibers had low shear strengths indicating that the coatings were weak.

Automatic graphene transfer system for improved material quality and efficiency

PubMed Central

Boscá, Alberto; Pedrós, Jorge; Martínez, Javier; Palacios, Tomás; Calle, Fernando

2016-01-01

In most applications based on chemical vapor deposition (CVD) graphene, the transfer from the growth to the target substrate is a critical step for the final device performance. Manual procedures are time consuming and depend on handling skills, whereas existing automatic roll-to-roll methods work well for flexible substrates but tend to induce mechanical damage in rigid ones. A new system that automatically transfers CVD graphene to an arbitrary target substrate has been developed. The process is based on the all-fluidic manipulation of the graphene to avoid mechanical damage, strain and contamination, and on the combination of capillary action and electrostatic repulsion between the graphene and its container to ensure a centered sample on top of the target substrate. The improved carrier mobility and yield of the automatically transferred graphene, as compared to that manually transferred, is demonstrated by the optical and electrical characterization of field-effect transistors fabricated on both materials. In particular, 70% higher mobility values, with a 30% decrease in the unintentional doping and a 10% strain reduction are achieved. The system has been developed for lab-scale transfer and proved to be scalable for industrial applications. PMID:26860260

Preliminary Results of Field Emission Cathode Tests

NASA Technical Reports Server (NTRS)

Sovey, James S.; Kovaleski, Scott D.

2001-01-01

Preliminary screening tests of field emission cathodes such as chemical vapor deposited (CVD) diamond, textured pyrolytic graphite, and textured copper were conducted at background pressures typical of electric thruster test facilities to assess cathode performance and stability. Very low power electric thrusters which provide tens to hundreds micronewtons of thrust may need field emission neutralizers that have a capability of tens to hundreds of microamperes. From current voltage characteristics, it was found that the CVD diamond and textured metals cathodes clearly satisfied the Fowler-Nordheim emission relation. The CVD diamond and a textured copper cathode had average current densities of 270 and 380 mA/sq cm, respectively, at the beginning-of-life. After a few hours of operation the cathode emission currents degraded by 40 to 75% at background pressures in the 10(exp -5) Pa to 10(exp -4) Pa range. The textured pyrolytic graphite had a modest current density at beginning-of-life of 84 mA/sq cm, but this cathode was the most stable of all. Extended testing of the most promising cathodes is warranted to determine if current degradation is a burn-in effect or whether it is a long-term degradation process. Preliminary experiments with ferroelectric emission cathodes, which are ceramics with spontaneous electric polarization, were conducted. Peak current densities of 30 to 120 mA/sq cm were obtained for pulse durations of about 500 ns in the 10(exp -4) Pa pressure range.

The electrical properties of low pressure chemical vapor deposition Ga doped ZnO thin films depending on chemical bonding configuration

NASA Astrophysics Data System (ADS)

Jung, Hanearl; Kim, Doyoung; Kim, Hyungjun

2014-04-01

The electrical and chemical properties of low pressure chemical vapor deposition (LP-CVD) Ga doped ZnO (ZnO:Ga) films were systematically investigated using Hall measurement and X-ray photoemission spectroscopy (XPS). Diethylzinc (DEZ) and O2 gas were used as precursor and reactant gas, respectively, and trimethyl gallium (TMGa) was used as a Ga doping source. Initially, the electrical properties of undoped LP-CVD ZnO films depending on the partial pressure of DEZ and O2 ratio were investigated using X-ray diffraction (XRD) by changing partial pressure of DEZ from 40 to 140 mTorr and that of O2 from 40 to 80 mTorr. The resistivity was reduced by Ga doping from 7.24 × 10-3 Ω cm for undoped ZnO to 2.05 × 10-3 Ω cm for Ga doped ZnO at the TMG pressure of 8 mTorr. The change of electric properties of Ga doped ZnO with varying the amount of Ga dopants was systematically discussed based on the structural crystallinity and chemical bonding configuration, analyzed by XRD and XPS, respectively.

CVD-grown monolayer MoS2 in bioabsorbable electronics and biosensors.

PubMed

Chen, Xiang; Park, Yong Ju; Kang, Minpyo; Kang, Seung-Kyun; Koo, Jahyun; Shinde, Sachin M; Shin, Jiho; Jeon, Seunghyun; Park, Gayoung; Yan, Ying; MacEwan, Matthew R; Ray, Wilson Z; Lee, Kyung-Mi; Rogers, John A; Ahn, Jong-Hyun

2018-04-27

Transient electronics represents an emerging technology whose defining feature is an ability to dissolve, disintegrate or otherwise physically disappear in a controlled manner. Envisioned applications include resorbable/degradable biomedical implants, hardware-secure memory devices, and zero-impact environmental sensors. 2D materials may have essential roles in these systems due to their unique mechanical, thermal, electrical, and optical properties. Here, we study the bioabsorption of CVD-grown monolayer MoS 2 , including long-term cytotoxicity and immunological biocompatibility evaluations in biofluids and tissues of live animal models. The results show that MoS 2 undergoes hydrolysis slowly in aqueous solutions without adverse biological effects. We also present a class of MoS 2 -based bioabsorbable and multi-functional sensor for intracranial monitoring of pressure, temperature, strain, and motion in animal models. Such technology offers specific, clinically relevant roles in diagnostic/therapeutic functions during recovery from traumatic brain injury. Our findings support the broader use of 2D materials in transient electronics and qualitatively expand the design options in other areas.

Chemical vapor deposition and characterization of polysilanes polymer based thin films and their applications in compound semiconductors and silicon devices

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.

Rheumatologist and Primary Care Management of Cardiovascular Disease Risk in Rheumatoid Arthritis: Patient and Provider Perspectives.

PubMed

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.

Diamond Nucleation Using Polyethene

NASA Technical Reports Server (NTRS)

Morell, Gerardo (Inventor); Makarov, Vladimir (Inventor); Varshney, Deepak (Inventor); Weiner, Brad (Inventor)

2013-01-01

The invention presents a simple, non-destructive and non-abrasive method of diamond nucleation using polyethene. It particularly describes the nucleation of diamond on an electrically viable substrate surface using polyethene via chemical vapor deposition (CVD) technique in a gaseous environment.

Diamond nucleation using polyethene

DOEpatents

Morell, Gerardo; Makarov, Vladimir; Varshney, Deepak; Weiner, Brad

2013-07-23

The invention presents a simple, non-destructive and non-abrasive method of diamond nucleation using polyethene. It particularly describes the nucleation of diamond on an electrically viable substrate surface using polyethene via chemical vapor deposition (CVD) technique in a gaseous environment.

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.

Cardiovascular Disease in Latin American Patients with Systemic Lupus Erythematosus: A Cross-Sectional Study and a Systematic Review

PubMed Central

Amaya-Amaya, Jenny; Caro-Moreno, Julián; Molano-González, Nicolás; Mantilla, Rubén D.; Rojas-Villarraga, Adriana; Anaya, Juan-Manuel

2013-01-01

Objective. This study was performed to determine the prevalence of and associated risk factors for cardiovascular disease (CVD) in Latin American (LA) patients with systemic lupus erythematosus (SLE). Methods. First, a cross-sectional analytical study was conducted in 310 Colombian patients with SLE in whom CVD was assessed. Associated factors were examined by multivariate regression analyses. Second, a systematic review of the literature on CVD in SLE in LA was performed. Results. There were 133 (36.5%) Colombian SLE patients with CVD. Dyslipidemia, smoking, coffee consumption, and pleural effusion were positively associated with CVD. An independent effect of coffee consumption and cigarette on CVD was found regardless of gender and duration of disease. In the systematic review, 60 articles fulfilling the eligibility criteria were included. A wide range of CVD prevalence was found (4%–79.5%). Several studies reported ancestry, genetic factors, and polyautoimmunity as novel risk factors for such a condition. Conclusions. A high rate of CVD is observed in LA patients with SLE. Awareness of the observed risk factors should encourage preventive population strategies for CVD in patients with SLE aimed at facilitating the suppression of cigarette smoking and coffee consumption as well as at the tight control of dyslipidemia and other modifiable risk factors. PMID:24294522

Drastically Enhanced High-Rate Performance of Carbon-Coated LiFePO4 Nanorods Using a Green Chemical Vapor Deposition (CVD) Method for Lithium Ion Battery: A Selective Carbon Coating Process.

PubMed

Tian, Ruiyuan; Liu, Haiqiang; Jiang, Yi; Chen, Jiankun; Tan, Xinghua; Liu, Guangyao; Zhang, Lina; Gu, Xiaohua; Guo, Yanjun; Wang, Hanfu; Sun, Lianfeng; Chu, Weiguo

2015-06-03

Application of LiFePO4 (LFP) to large current power supplies is greatly hindered by its poor electrical conductivity (10(-9) S cm(-1)) and sluggish Li+ transport. Carbon coating is considered to be necessary for improving its interparticle electronic conductivity and thus electrochemical performance. Here, we proposed a novel, green, low cost and controllable CVD approach using solid glucose as carbon source which can be extended to most cathode and anode materials in need of carbon coating. Hydrothermally synthesized LFP nanorods with optimized thickness of carbon coated by this recipe are shown to have superb high-rate performance, high energy, and power densities, as well as long high-rate cycle lifetime. For 200 C (18s) charge and discharge, the discharge capacity and voltage are 89.69 mAh g(-1) and 3.030 V, respectively, and the energy and power densities are 271.80 Wh kg(-1) and 54.36 kW kg(-1), respectively. The capacity retention of 93.0%, and the energy and power density retention of 93.6% after 500 cycles at 100 C were achieved. Compared to the conventional carbon coating through direct mixing with glucose (or other organic substances) followed by annealing (DMGA), the carbon phase coated using this CVD recipe is of higher quality and better uniformity. Undoubtedly, this approach enhances significantly the electrochemical performance of high power LFP and thus broadens greatly the prospect of its applications to large current power supplies such as electric and hybrid electric vehicles.

A Review of Carbon Nanomaterials' Synthesis via the Chemical Vapor Deposition (CVD) Method.

PubMed

Manawi, Yehia M; Samara, Ayman; Al-Ansari, Tareq; Atieh, Muataz A

2018-05-17

Carbon nanomaterials have been extensively used in many applications owing to their unique thermal, electrical and mechanical properties. One of the prime challenges is the production of these nanomaterials on a large scale. This review paper summarizes the synthesis of various carbon nanomaterials via the chemical vapor deposition (CVD) method. These carbon nanomaterials include fullerenes, carbon nanotubes (CNTs), carbon nanofibers (CNFs), graphene, carbide-derived carbon (CDC), carbon nano-onion (CNO) and MXenes. Furthermore, current challenges in the synthesis and application of these nanomaterials are highlighted with suggested areas for future research.

A Review of Carbon Nanomaterials’ Synthesis via the Chemical Vapor Deposition (CVD) Method

PubMed Central

Manawi, Yehia M.; Samara, Ayman; Al-Ansari, Tareq; Atieh, Muataz A.

2018-01-01

Carbon nanomaterials have been extensively used in many applications owing to their unique thermal, electrical and mechanical properties. One of the prime challenges is the production of these nanomaterials on a large scale. This review paper summarizes the synthesis of various carbon nanomaterials via the chemical vapor deposition (CVD) method. These carbon nanomaterials include fullerenes, carbon nanotubes (CNTs), carbon nanofibers (CNFs), graphene, carbide-derived carbon (CDC), carbon nano-onion (CNO) and MXenes. Furthermore, current challenges in the synthesis and application of these nanomaterials are highlighted with suggested areas for future research. PMID:29772760

The blockade of renin-angiotensin-aldosterone system in hemodialysis patients to control hypertension and prevent cardiovascular disease: optimal pharmacotherapy.

PubMed

Morishita, Yoshiyuki; Kusano, Eiji

2011-10-01

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in hemodialysis (HD) patients. Hypertension (HT) is a major risk factor for CVD. The renin-angiotensin-aldosterone system (RAAS) plays pivotal roles in the pathogenesis of HT in HD patients. Previous studies suggested that the blockade of RAAS may be effective to control blood pressure (BP) and to prevent CVD in HD patients. A certain level of preventive effects against CVD by RAAS blockade in HD patients has been reported independently from a BP lowering effect. This review focuses on the effect of blocking RAAS in HD patients for the control of HT and the prevention of CVD.

Predictors of CVD among breast cancer survivors in an integrated health system | Division of Cancer Prevention

Cancer.gov

PROJECT SUMMARY / ABSTRACT Breast cancer survivors are at high risk of developing and dying from cardiovascular disease (CVD) following breast cancer diagnosis, but subpopulations at increased risk and targets for intervention have not been well- characterized. A growing body of literature links CVD with specific cardiotoxic cancer treatments. CVD risk among breast cancer

Thickness-controlled direct growth of nanographene and nanographite film on non-catalytic substrates

NASA Astrophysics Data System (ADS)

Du, Lei; Yang, Liu; Hu, Zhiting; Zhang, Jiazhen; Huang, Chunlai; Sun, Liaoxin; Wang, Lin; Wei, Dacheng; Chen, Gang; Lu, Wei

2018-05-01

Metal-catalyzed chemical vapor deposition (CVD) has been broadly employed for large-scale production of high-quality graphene. However, a following transfer process to targeted substrates is needed, which is incompatible with current silicon technology. We here report a new CVD approach to form nanographene and nanographite films with accurate thickness control directly on non-catalytic substrates such as silicon dioxide and quartz at 800 °C. The growth time is as short as a few seconds. The approach includes using 9-bis(diethylamino)silylanthracene as the carbon source and an atomic layer deposition (ALD) controlling system. The structure of the formed nanographene and nanographite films were characterized using atomic force microscopy, high resolution transmission electron microscopy, Raman scattering, and x-ray photoemission spectroscopy. The nanographite film exhibits a transmittance higher than 80% at 550 nm and a sheet electrical resistance of 2000 ohms per square at room temperature. A negative temperature-dependence of the resistance of the nanographite film is also observed. Moreover, the thickness of the films can be precisely controlled via the deposition cycles using an ALD system, which promotes great application potential for optoelectronic and thermoelectronic-devices.

Thickness-controlled direct growth of nanographene and nanographite film on non-catalytic substrates.

PubMed

Du, Lei; Yang, Liu; Hu, Zhiting; Zhang, Jiazhen; Huang, Chunlai; Sun, Liaoxin; Wang, Lin; Wei, Dacheng; Chen, Gang; Lu, Wei

2018-05-25

Metal-catalyzed chemical vapor deposition (CVD) has been broadly employed for large-scale production of high-quality graphene. However, a following transfer process to targeted substrates is needed, which is incompatible with current silicon technology. We here report a new CVD approach to form nanographene and nanographite films with accurate thickness control directly on non-catalytic substrates such as silicon dioxide and quartz at 800 °C. The growth time is as short as a few seconds. The approach includes using 9-bis(diethylamino)silylanthracene as the carbon source and an atomic layer deposition (ALD) controlling system. The structure of the formed nanographene and nanographite films were characterized using atomic force microscopy, high resolution transmission electron microscopy, Raman scattering, and x-ray photoemission spectroscopy. The nanographite film exhibits a transmittance higher than 80% at 550 nm and a sheet electrical resistance of 2000 ohms per square at room temperature. A negative temperature-dependence of the resistance of the nanographite film is also observed. Moreover, the thickness of the films can be precisely controlled via the deposition cycles using an ALD system, which promotes great application potential for optoelectronic and thermoelectronic-devices.

Racial disparities in age at time of cardiovascular events and cardiovascular-related death in patients with systemic lupus erythematosus.

PubMed

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.

Microspheres and their methods of preparation

DOEpatents

Bose, Anima B; Yang, Junbing

2015-03-24

Carbon microspheres are doped with boron to enhance the electrical and physical properties of the microspheres. The boron-doped carbon microspheres are formed by a CVD process in which a catalyst, carbon source and boron source are evaporated, heated and deposited onto an inert substrate.

Arterial stiffness and cardiac functions in patients with chronic venous disease.

PubMed

Ozpelit, E; Ozpelit, M E; Albayrak, G; Karabay, O; Nesli Sahin, B; Gonencer, J Z; Badak, O

2015-12-01

Although the venous system is in direct continuity with the heart and the arterial system, it is not known whether chronic venous disease (CVD) has any impact on either of these. The aims of this study were to investigate the global functions of the left and right heart, and also arterial stiffness parameters in patients with CVD. Forty-eight patients with primary stage C4-C6 CVD were enrolled into the study. The control group consisted of 39 age/sex and Body Mass Index matched healthy volunteers. All of the patients underwent detailed echocardiographic examination with further focus on Doppler and tissue Doppler (TD) parameters of the left and right ventricle. Arterial stiffness was evaluated via applanation tonometry in each patient. The left atrial area (LAA) and interventricular septum thickness were slightly increased in patients with CVD. Regarding Doppler and tissue Doppler measurements of the LV, all of the parameters were similar among the groups, while RV tissue Doppler systolic velocity and TAPSE were higher in patients with CVD. Among the arterial stiffness parameters, central aortic pressure, augmentation index, and pulse wave velocity were slightly higher in patients with CVD. The results of this study indicated that CVD may be associated with a subclinical disease state in the arterial system and also in the heart. Further studies are needed to confirm this association and to describe the possible mechanisms.

Food Consumption and its impact on Cardiovascular Disease: Importance of Solutions focused on the globalized food system

PubMed Central

Anand, Sonia S.; Hawkes, Corinna; de Souza, Russell J.; Mente, Andrew; Dehghan, Mahshid; Nugent, Rachel; Zulyniak, Michael A.; Weis, Tony; Bernstein, Adam M.; Krauss, Ronald; Kromhout, Daan; Jenkins, David J.A.; Malik, Vasanti; Martinez-Gonzalez, Miguel A.; Mozafarrian, Dariush; Yusuf, Salim; Willett, Walter C.; Popkin, Barry M

2015-01-01

Major scholars in the field, based on a 3-day consensus, created an in-depth review of current knowledge on the role of diet in CVD, the changing global food system and global dietary patterns, and potential policy solutions. Evidence from different countries, age/race/ethnicity/socioeconomic groups suggest the health effects studies of foods, macronutrients, and dietary patterns on CVD appear to be far more consistent though regional knowledge gaps are highlighted. There are large gaps in knowledge about the association of macronutrients to CVD in low- and middle-income countries (LMIC), particularly linked with dietary patterns are reviewed. Our understanding of foods and macronutrients in relationship to CVD is broadly clear; however major gaps exist both in dietary pattern research and ways to change diets and food systems. Based on the current evidence, the traditional Mediterranean-type diet, including plant foods/emphasizing plant protein sources, provides a well-tested healthy dietary pattern to reduce CVD. PMID:26429085

Proton irradiation of CVD diamond detectors for high-luminosity experiments at the LHC

NASA Astrophysics Data System (ADS)

Meier, D.; Adam, W.; Bauer, C.; Berdermann, E.; Bergonzo, P.; Bogani, F.; Borchi, E.; Bruzzi, M.; Colledani, C.; Conway, J.; Dabrowski, W.; Delpierre, P.; Deneuville, A.; Dulinski, W.; van Eijk, B.; Fallou, A.; Foulon, F.; Friedl, M.; Jany, C.; Gan, K. K.; Gheeraert, E.; Grigoriev, E.; Hallewell, G.; Hall-Wilton, R.; Han, S.; Hartjes, F.; Hrubec, J.; Husson, D.; Kagan, H.; Kania, D.; Kaplon, J.; Kass, R.; Knöpfle, K. T.; Krammer, M.; Manfredi, P. F.; Marshall, R. D.; Mishina, M.; Le Normand, F.; Pan, L. S.; Palmieri, V. G.; Pernegger, H.; Pernicka, M.; Peitz, A.; Pirollo, S.; Pretzl, K.; Re, V.; Riester, J. L.; Roe, S.; Roff, D.; Rudge, A.; Schnetzer, S.; Sciortino, S.; Speziali, V.; Stelzer, H.; Stone, R.; Tapper, R. J.; Tesarek, R.; Thomson, G. B.; Trawick, M.; Trischuk, W.; Turchetta, R.; Walsh, A. M.; Wedenig, R.; Weilhammer, P.; Ziock, H.; Zoeller, M.; RD42 Collaboration

1999-04-01

CVD diamond shows promising properties for use as a position-sensitive detector for experiments in the highest radiation areas at the Large Hadron Collider. In order to study the radiation hardness of diamond we exposed CVD diamond detector samples to 24 Gev/ c and 500 Mev protons up to a fluence of 5×10 15 p/cm 2. We measured the charge collection distance, the average distance electron-hole pairs move apart in an external electric field, and leakage currents before, during, and after irradiation. The charge collection distance remains unchanged up to 1×10 15 p/cm 2 and decreases by ≈40% at 5×10 15 p/cm 2. Leakage currents of diamond samples were below 1 pA before and after irradiation. The particle-induced currents during irradiation correlate well with the proton flux. In contrast to diamond, a silicon diode, which was irradiated for comparison, shows the known large increase in leakage current. We conclude that CVD diamond detectors are radiation hard to 24 GeV/ c and 500 MeV protons up to at least 1×10 15p/cm 2 without signal loss.

The Veterans Affairs Cardiac Risk Score: Recalibrating the Atherosclerotic Cardiovascular Disease Score for Applied Use.

PubMed

Sussman, Jeremy B; Wiitala, Wyndy L; Zawistowski, Matthew; Hofer, Timothy P; Bentley, Douglas; Hayward, Rodney A

2017-09-01

Accurately estimating cardiovascular risk is fundamental to good decision-making in cardiovascular disease (CVD) prevention, but risk scores developed in one population often perform poorly in dissimilar populations. We sought to examine whether a large integrated health system can use their electronic health data to better predict individual patients' risk of developing CVD. We created a cohort using all patients ages 45-80 who used Department of Veterans Affairs (VA) ambulatory care services in 2006 with no history of CVD, heart failure, or loop diuretics. Our outcome variable was new-onset CVD in 2007-2011. We then developed a series of recalibrated scores, including a fully refit "VA Risk Score-CVD (VARS-CVD)." We tested the different scores using standard measures of prediction quality. For the 1,512,092 patients in the study, the Atherosclerotic cardiovascular disease risk score had similar discrimination as the VARS-CVD (c-statistic of 0.66 in men and 0.73 in women), but the Atherosclerotic cardiovascular disease model had poor calibration, predicting 63% more events than observed. Calibration was excellent in the fully recalibrated VARS-CVD tool, but simpler techniques tested proved less reliable. We found that local electronic health record data can be used to estimate CVD better than an established risk score based on research populations. Recalibration improved estimates dramatically, and the type of recalibration was important. Such tools can also easily be integrated into health system's electronic health record and can be more readily updated.

Chemical vapor deposition growth

NASA Technical Reports Server (NTRS)

Ruth, R. P.; Manasevit, H. M.; Johnson, R. E.; Kenty, J. L.; Moudy, L. A.; Simpson, W. I.; Yang, J. J.

1976-01-01

A laboratory type CVD reactor system with a vertical deposition chamber and sample pedestal heated by an external RF coil has been extensively modified by installation of mass flow controllers, automatic process sequence timers, and special bellows-sealed air-operated valves for overall improved performance. Various film characterization procedures, including classical metallography, SEM analyses, X ray diffraction analyses, surface profilometry, and electrical measurements (resistivity, carrier concentration, mobility, spreading resistance profiles, and minority-carrier lifetime by the C-V-t method) area used to correlate Si sheet properties with CVD parameters and substrate properties. Evaluation procedures and measurements are given. Experimental solar cell structures were made both in epitaxial Si sheet (on sapphire substrates) and in polycrystalline material on alumina substrates, the former to provide an indication of what might be an upper limit on performance of the latter. Preliminary results are given, as obtained in cell structures not specially designed to allow for the unique properties of the sheet material, and fabricated in material known to be far from optimum for photovoltaic performance. Low power conversion efficiencies have been obtained in the epitaxial as well as the polycrystalline Si sheet.

Electrical property of macroscopic graphene composite fibers prepared by chemical vapor deposition.

PubMed

Sun, Haibin; Fu, Can; Gao, Yanli; Guo, Pengfei; Wang, Chunlei; Yang, Wenchao; Wang, Qishang; Zhang, Chongwu; Wang, Junya; Xu, Junqi

2018-07-27

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 × 10 3 S m -1 . These results demonstrated that the graphene composite fibers are promising for the next-generation flexible and wearable electronics.

Chemical Degradation of the Cathodic Electrical Contact Between Carbon and Cast Iron in Aluminum Production Cells

NASA Astrophysics Data System (ADS)

Brassard, Martin; Désilets, Martin; Soucy, Gervais; Bilodeau, Jean-François; Forté, Martin

2017-06-01

The cathodic carbon to cast iron electrical contact degradation is one of the factors to consider in the cathode voltage drop (CVD) increase over the lifetime of aluminum production cells. Lab-scale experiments were carried out to study the cast iron to carbon interface chemical degradation and the impact of important cell parameters like temperature and bath chemistry. Laboratory degradation results were compared with industrial samples. A thermoelectric Ansys numerical model was then used to predict the effect of cast iron surface degradation over CVD. Results show that the aluminum formation on the cast iron surface and its subsequent diffusion creates an immiscible mixture of Fe-Al metal alloy and electrolytic bath. Disparities were also observed between industrial samples taken from two different technologies, suggesting that the degradation can be slowed down. Thermoelectric calculations finally revealed that the impact of the contact resistance augmentation is by far greater than the cast iron degradation.

Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

PubMed Central

Schwalm, Jon-David; McKee, Martin; Huffman, Mark D.; Yusuf, Salim

2016-01-01

Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality. PMID:26903017

Does sufficient evidence exist to support a causal association between vitamin D status and cardiovascular disease risk? An assessment using Hill's criteria for causality.

PubMed

Weyland, Patricia G; Grant, William B; Howie-Esquivel, Jill

2014-09-02

Serum 25-hydroxyvitamin D (25(OH)D) levels have been found to be inversely associated with both prevalent and incident cardiovascular disease (CVD) risk factors; dyslipidemia, hypertension and diabetes mellitus. This review looks for evidence of a causal association between low 25(OH)D levels and increased CVD risk. We evaluated journal articles in light of Hill's criteria for causality in a biological system. The results of our assessment are as follows. Strength of association: many randomized controlled trials (RCTs), prospective and cross-sectional studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Consistency of observed association: most studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors in various populations, locations and circumstances. Temporality of association: many RCTs and prospective studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Biological gradient (dose-response curve): most studies assessing 25(OH)D levels and CVD risk found an inverse association exhibiting a linear biological gradient. Plausibility of biology: several plausible cellular-level causative mechanisms and biological pathways may lead from a low 25(OH)D level to increased risk for CVD with mediators, such as dyslipidemia, hypertension and diabetes mellitus. Experimental evidence: some well-designed RCTs found increased CVD risk factors with decreasing 25(OH)D levels. Analogy: the association between serum 25(OH)D levels and CVD risk is analogous to that between 25(OH)D levels and the risk of overall cancer, periodontal disease, multiple sclerosis and breast cancer. all relevant Hill criteria for a causal association in a biological system are satisfied to indicate a low 25(OH)D level as a CVD risk factor.

Molecular engineered conjugated polymer with high thermal conductivity

PubMed Central

Song, Bai; Lee, Elizabeth M. Y.; Gleason, Karen K.

2018-01-01

Traditional polymers are both electrically and thermally insulating. The development of electrically conductive polymers has led to novel applications such as flexible displays, solar cells, and wearable biosensors. As in the case of electrically conductive polymers, the development of polymers with high thermal conductivity would open up a range of applications in next-generation electronic, optoelectronic, and energy devices. Current research has so far been limited to engineering polymers either by strong intramolecular interactions, which enable efficient phonon transport along the polymer chains, or by strong intermolecular interactions, which enable efficient phonon transport between the polymer chains. However, it has not been possible until now to engineer both interactions simultaneously. We report the first realization of high thermal conductivity in the thin film of a conjugated polymer, poly(3-hexylthiophene), via bottom-up oxidative chemical vapor deposition (oCVD), taking advantage of both strong C=C covalent bonding along the extended polymer chain and strong π-π stacking noncovalent interactions between chains. We confirm the presence of both types of interactions by systematic structural characterization, achieving a near–room temperature thermal conductivity of 2.2 W/m·K, which is 10 times higher than that of conventional polymers. With the solvent-free oCVD technique, it is now possible to grow polymer films conformally on a variety of substrates as lightweight, flexible heat conductors that are also electrically insulating and resistant to corrosion. PMID:29670943

Superhydrophobic Copper Surfaces with Anticorrosion Properties Fabricated by Solventless CVD Methods.

PubMed

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.

System for the growth of bulk SiC crystals by modified CVD techniques

NASA Technical Reports Server (NTRS)

Steckl, Andrew J.

1994-01-01

The goal of this program was the development of a SiC CVD growth of films thick enough to be useful as pseudo-substrates. The cold-walled CVD system was designed, assembled, and tested. Extrapolating from preliminary evaluation of SiC films grown in the system at relatively low temperatures indicates that the growth rate at the final temperatures will be high enough to make our approach practical. Modifications of the system to allow high temperature growth and cleaner growth conditions are in progress. This program was jointly funded by Wright Laboratory, Materials Directorate and NASA LeRC and monitored by NASA.

Interface properties of SiO2/GaN structures formed by chemical vapor deposition with remote oxygen plasma mixed with Ar or He

NASA Astrophysics Data System (ADS)

Truyen, Nguyen Xuan; Taoka, Noriyuki; Ohta, Akio; Makihara, Katsunori; Yamada, Hisashi; Takahashi, Tokio; Ikeda, Mitsuhisa; Shimizu, Mitsuaki; Miyazaki, Seiichi

2018-06-01

The impacts of noble gas species (Ar and He) on the formation of a SiO2/GaN structure formed by a remote oxygen plasma-enhanced chemical vapor deposition (ROPE-CVD) method were systematically investigated. Atomic force microscopy revealed that ROPE-CVD with He leads to a smooth SiO2 surface compared with the case of Ar. We found that no obvious oxidations of the GaN surfaces after the SiO2 depositions with the both Ar and He cases were observed. The capacitance–voltage (C–V) curves of the GaN MOS capacitors formed by ROPE-CVD with the Ar and He dilutions show good interface properties with no hysteresis and good agreement with the ideal C–V curves even after post deposition annealing at 800 °C. Besides, we found that the current density–oxide electric field characteristics shows a gate leakage current for the Ar case lower than the He case.

Prevention and Control of Cardiovascular Disease in the Rapidly Changing Economy of China.

PubMed

Wu, Yangfeng; Benjamin, Emelia J; MacMahon, Stephen

2016-06-14

With one-fifth of the world's total population, China's prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. Understanding China's current cardiovascular epidemic requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The latter have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the healthcare system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that 4 priorities should be taken: pursue multisectorial government and nongovernment strategies targeting the underlying causes of CVD (the whole-of-government and whole-of-society policy); give priority to prevention; reform the healthcare system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the 4 priorities, the pandemic of CVD and other major noncommunicable diseases in China will be reversed and the global sustainable development goal achieved. © 2016 American Heart Association, Inc.

Prevention and Control of Cardiovascular Disease in the Rapidly Changing Economy of China

PubMed Central

Wu, Yangfeng; Benjamin, Emelia J.; MacMahon, Stephen

2016-01-01

With one fifth of the world’s total population, China’s prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. To understand China’s current cardiovascular epidemic, requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The later have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the health care system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that four priorities should be taken: pursue multi-sectorial government and non-government strategies targeting the underlying causes of CVD (the “whole-of-government and whole-of-society” policy); give priority to prevention; reform the health care system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the four priorities, the pandemic of CVD and other major NCDs in China will be reversed and the global sustainable development goal achieved. PMID:27297347

Exploring the Crosstalk between Adipose Tissue and the Cardiovascular System.

PubMed

Akoumianakis, Ioannis; Akawi, Nadia; Antoniades, Charalambos

2017-09-01

Obesity is a clinical entity critically involved in the development and progression of cardiovascular disease (CVD), which is characterised by variable expansion of adipose tissue (AT) mass across the body as well as by phenotypic alterations in AT. AT is able to secrete a diverse spectrum of biologically active substances called adipocytokines, which reach the cardiovascular system via both endocrine and paracrine routes, potentially regulating a variety of physiological and pathophysiological responses in the vasculature and heart. Such responses include regulation of inflammation and oxidative stress as well as cell proliferation, migration and hypertrophy. Furthermore, clinical observations such as the "obesity paradox," namely the fact that moderately obese patients with CVD have favourable clinical outcome, strongly indicate that the biological "quality" of AT may be far more crucial than its overall mass in the regulation of CVD pathogenesis. In this work, we describe the anatomical and biological diversity of AT in health and metabolic disease; we next explore its association with CVD and, importantly, novel evidence for its dynamic crosstalk with the cardiovascular system, which could regulate CVD pathogenesis.

Exploring the Crosstalk between Adipose Tissue and the Cardiovascular System

PubMed Central

2017-01-01

Obesity is a clinical entity critically involved in the development and progression of cardiovascular disease (CVD), which is characterised by variable expansion of adipose tissue (AT) mass across the body as well as by phenotypic alterations in AT. AT is able to secrete a diverse spectrum of biologically active substances called adipocytokines, which reach the cardiovascular system via both endocrine and paracrine routes, potentially regulating a variety of physiological and pathophysiological responses in the vasculature and heart. Such responses include regulation of inflammation and oxidative stress as well as cell proliferation, migration and hypertrophy. Furthermore, clinical observations such as the “obesity paradox,” namely the fact that moderately obese patients with CVD have favourable clinical outcome, strongly indicate that the biological “quality” of AT may be far more crucial than its overall mass in the regulation of CVD pathogenesis. In this work, we describe the anatomical and biological diversity of AT in health and metabolic disease; we next explore its association with CVD and, importantly, novel evidence for its dynamic crosstalk with the cardiovascular system, which could regulate CVD pathogenesis. PMID:28955384

Cardiovascular disease risk profiles among 'healthy' siblings of patients with early-onset cardiovascular disease: application of the new SCORE system.

PubMed

Horan, Paul G; Kamaruddin, Muhammad S; Moore, Michael J; McCarty, David; Spence, Mark S; McGlinchey, Paul G; Murphy, Gillian; Jardine, Tracy C L; Patterson, Chris C; McKeown, Pascal P

2007-08-01

Cardiovascular disease (CVD) occurs more frequently in individuals with a family history of premature CVD. Within families the demographics of CVD are poorly described. We examined the risk estimation based on the Systematic Coronary Risk Evaluation (SCORE) system and the Joint British Guidelines (JBG) for older unaffected siblings of patients with premature CVD (onset

Charge multiplication effect in thin diamond films

DOE Office of Scientific and Technical Information (OSTI.GOV)

Skukan, N., E-mail: nskukan@irb.hr; Grilj, V.; Sudić, I.

2016-07-25

Herein, we report on the enhanced sensitivity for the detection of charged particles in single crystal chemical vapour deposition (scCVD) diamond radiation detectors. The experimental results demonstrate charge multiplication in thin planar diamond membrane detectors, upon impact of 18 MeV O ions, under high electric field conditions. Avalanche multiplication is widely exploited in devices such as avalanche photo diodes, but has never before been reproducibly observed in intrinsic CVD diamond. Because enhanced sensitivity for charged particle detection is obtained for short charge drift lengths without dark counts, this effect could be further exploited in the development of sensors based on avalanchemore » multiplication and radiation detectors with extreme radiation hardness.« less

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.

Cardiovascular disease incidence in adolescent and young adult cancer survivors: a retrospective cohort study.

PubMed

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.

Ultrasensitive label-free detection of DNA hybridization by sapphire-based graphene field-effect transistor biosensor

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.

High Yield Chemical Vapor Deposition Growth of High Quality Large-Area AB Stacked Bilayer Graphene

PubMed Central

Liu, Lixin; Zhou, Hailong; Cheng, Rui; Yu, Woo Jong; Liu, Yuan; Chen, Yu; Shaw, Jonathan; Zhong, Xing; Huang, Yu; Duan, Xiangfeng

2012-01-01

Bernal stacked (AB stacked) bilayer graphene is of significant interest for functional electronic and photonic devices due to the feasibility to continuously tune its band gap with a vertical electrical field. Mechanical exfoliation can be used to produce AB stacked bilayer graphene flakes but typically with the sizes limited to a few micrometers. Chemical vapor deposition (CVD) has been recently explored for the synthesis of bilayer graphene but usually with limited coverage and a mixture of AB and randomly stacked structures. Herein we report a rational approach to produce large-area high quality AB stacked bilayer graphene. We show that the self-limiting effect of graphene growth on Cu foil can be broken by using a high H2/CH4 ratio in a low pressure CVD process to enable the continued growth of bilayer graphene. A high temperature and low pressure nucleation step is found to be critical for the formation of bilayer graphene nuclei with high AB stacking ratio. A rational design of a two-step CVD process is developed for the growth of bilayer graphene with high AB stacking ratio (up to 90 %) and high coverage (up to 99 %). The electrical transport studies demonstrated that devices made of the as-grown bilayer graphene exhibit typical characteristics of AB stacked bilayer graphene with the highest carrier mobility exceeding 4,000 cm2/V·s at room temperature, comparable to that of the exfoliated bilayer graphene. PMID:22906199

A Comparative Study of Three Different Chemical Vapor Deposition (CVD) Techniques of Carbon Nanotube Growth on Diamond Films

DTIC Science & Technology

2013-01-01

FCT-CVD) with xylene and ferrocene liquid mixture without any prior catalyst deposition. T-CVD is a low cost system that can easily be set up to grow...iron catalysts, respectively. For the FCT-CVD approach, ferrocene is used as an iron source to promote CNT growth. Based on these repeatable results...kept at 250 ° C while the high temperature furnace is ramped up to the growth temperature of 750 ° C. Ferrocene was dissolved into xylene solvent in

Atmospheric-Pressure Chemical Vapor Deposition of Iron Pyrite Thin Films

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berry, Nicholas; Cheng, Ming; Perkins, Craig L.

2012-10-23

Iron pyrite (cubic FeS{sub 2}) is a promising candidate absorber material for earth-abundant thin-film solar cells. In this report, single-phase, large-grain, and uniform polycrystalline pyrite thin films are fabricated on glass and molybdenum-coated glass substrates by atmospheric-pressure chemical vapor deposition (AP-CVD) using the reaction of iron(III) acetylacetonate and tert-butyl disulfide in argon at 300 C, followed by sulfur annealing at 500--550 C to convert marcasite impurities to pyrite. The pyrite-marcasite phase composition depends strongly on the concentration of sodium in the growth substrate and the sulfur partial pressure during annealing. Phase and elemental composition of the films are characterized bymore » X-ray diffraction, Raman spectroscopy, Auger electron spectroscopy, secondary ion mass spectrometry, Rutherford backscattering spectrometry, and X-ray photoelectron spectroscopy. The in-plane electrical properties are surprisingly insensitive to phase and elemental impurities, with all films showing p-type, thermally activated transport with a small activation energy ({approx}30 meV), a room- temperature resistivity of {approx}1 {Omega} cm, and low mobility. These ubiquitous electrical properties may result from robust surface effects. These CVD pyrite thin films are well suited to fundamental electrical studies and the fabrication of pyrite photovoltaic device stacks.« less

Does Sufficient Evidence Exist to Support a Causal Association between Vitamin D Status and Cardiovascular Disease Risk? An Assessment Using Hill’s Criteria for Causality

PubMed Central

Weyland, Patricia G.; Grant, William B.; Howie-Esquivel, Jill

2014-01-01

Serum 25-hydroxyvitamin D (25(OH)D) levels have been found to be inversely associated with both prevalent and incident cardiovascular disease (CVD) risk factors; dyslipidemia, hypertension and diabetes mellitus. This review looks for evidence of a causal association between low 25(OH)D levels and increased CVD risk. We evaluated journal articles in light of Hill’s criteria for causality in a biological system. The results of our assessment are as follows. Strength of association: many randomized controlled trials (RCTs), prospective and cross-sectional studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Consistency of observed association: most studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors in various populations, locations and circumstances. Temporality of association: many RCTs and prospective studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Biological gradient (dose-response curve): most studies assessing 25(OH)D levels and CVD risk found an inverse association exhibiting a linear biological gradient. Plausibility of biology: several plausible cellular-level causative mechanisms and biological pathways may lead from a low 25(OH)D level to increased risk for CVD with mediators, such as dyslipidemia, hypertension and diabetes mellitus. Experimental evidence: some well-designed RCTs found increased CVD risk factors with decreasing 25(OH)D levels. Analogy: the association between serum 25(OH)D levels and CVD risk is analogous to that between 25(OH)D levels and the risk of overall cancer, periodontal disease, multiple sclerosis and breast cancer. Conclusion: all relevant Hill criteria for a causal association in a biological system are satisfied to indicate a low 25(OH)D level as a CVD risk factor. PMID:25184368

Friction and Wear of Ion-Beam-Deposited Diamondlike Carbon on Chemical-Vapor-Deposited, Fine-Grain Diamond

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.

Mortality from cardiovascular diseases in Bavi District, Vietnam.

PubMed

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.

Cardiovascular risk estimation by professionally active cardiovascular nurses: results from the Basel 2005 Nurses Cohort.

PubMed

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.

Health policy analysis for prevention and control of cardiovascular diseases and diabetes mellitus in Turkey.

PubMed

Kilic, Bulent; Kalaca, Sibel; Unal, Belgin; Phillimore, Peter; Zaman, Shahaduz

2015-01-01

Current capacity of the Turkish health system is reviewed to evaluate and develop appropriate policies for cardiovascular diseases (CVD), diabetes mellitus (DM) and related risk factors. This paper qualitatively evaluates existing policies; interviews with key informants (KIs); and rapid appraisal fieldwork in clinical settings about CVD-DM through the framework of Walt and Gilson (Health Policy Plan 9:353-370, 1994). Document review shows that prevention and control of CVD-DM were strongly addressed in Turkey, yet no document mentioned country-wide early detection or screening programs. KIs indicated over-fragmented management of CVD-DM by the Ministry of Health (MoH). Coordination among the MoH, organizational structure at provincial level and civil society organizations are poor where mutual trust is a significant problem according to KIs. Clinical setting findings point to a complete lack of a referral structure and a lack of follow-up, compounding the absence of functioning health information systems for patient records. Primary care services for CVD-DM require urgent attention, focusing particularly on the training of staff in public facilities, the integration of patient data, referrals and follow-up across all levels of the health system.

SYSTEMIC BIOMARKERS AND CARDIAC GENE EXPRESSION PROFILES OF RAT DISEASE MODELS EMPLOYED IN AIR POLLUTION STUDIES

EPA Science Inventory

Cardiovascular disease (CVD) models are used for identification of mechanisms of susceptibility to air pollution. We hypothesized that baseline systemic biomarkers and cardiac gene expression in CVD rat models will have influence on their ozone-induced lung inflammation. Male 12-...

Social-Strata-Related Cardiovascular Health Disparity and Comorbidity in an Aging Society: Implications for Professional Care

ERIC Educational Resources Information Center

Ai, Amy L.; Carrigan, Lynn T.

2007-01-01

Cardiovascular disease (CVD) is on the rise in the aging population of the United States. Heart disease is the leading cause of death, hospital bed use, and social security disability. Enhancing knowledge about CVD may improve social work's professional role in the health care system. This article focuses on a pressing CVD-related issue that needs…

Growth and microstructural evolution of WS2 nanostructures with tunable field and light modulated electrical transport

NASA Astrophysics Data System (ADS)

Kumar, Pawan; Balakrishnan, Viswanath

2018-04-01

We report CVD growth of WS2 nanostructures with the ability to control the evolution of 1D to 2D microstructural changes for light and field effect transistor applications. Detailed mechanistic growth sequences from WO3 nanorod to nanotube, monolayer and pyramidal structures of WS2 has been achieved using atmospheric pressure chemical vapor deposition (APCVD). Electron microscopy and Raman spectroscopy analysis showed the growth evolution of different nanostructures and their formation mechanism. Location specific growth of different WS2 nanostructures can be achieved by drop casting dispersed WO3 nanorods on required substrate. Layer dependent photoluminescence (PL) properties of WS2 indicate the effect of quantum confinement induced radiative recombination and enhanced PL intensity in monolayer WS2 provides suitability for nanoscale photodetector application. The fabricated device shows light as well as field modulated switching at ultra-low biased voltage in hybrid WS2 nanostructure that contains 1D (nanotube)-2D (flake) interface. The demonstrated aspects of CVD growth and hybrid device characteristics provide opportunities to tune electrical transport of WS2 nanostructures at low active power.

High-Density Three-Dimension Graphene Macroscopic Objects for High-Capacity Removal of Heavy Metal Ions

PubMed Central

Li, Weiwei; Gao, Song; Wu, Liqiong; Qiu, Shengqiang; Guo, Yufen; Geng, Xiumei; Chen, Mingliang; Liao, Shutian; Zhu, Chao; Gong, Youpin; Long, Mingsheng; Xu, Jianbao; Wei, Xiangfei; Sun, Mengtao; Liu, Liwei

2013-01-01

The chemical vapor deposition (CVD) fabrication of high-density three-dimension graphene macroscopic objects (3D-GMOs) with a relatively low porosity has not yet been realized, although they are desirable for applications in which high mechanical and electrical properties are required. Here, we explore a method to rapidly prepare the high-density 3D-GMOs using nickel chloride hexahydrate (NiCl2·6H2O) as a catalyst precursor by CVD process at atmospheric pressure. Further, the free-standing 3D-GMOs are employed as electrolytic electrodes to remove various heavy metal ions. The robust 3D structure, high conductivity (~12 S/cm) and large specific surface area (~560 m2/g) enable ultra-high electrical adsorption capacities (Cd2+ ~ 434 mg/g, Pb2+ ~ 882 mg/g, Ni2+ ~ 1,683 mg/g, Cu2+ ~ 3,820 mg/g) from aqueous solutions and fast desorption. The current work has significance in the studies of both the fabrication of high-density 3D-GMOs and the removal of heavy metal ions. PMID:23821107

The effect of Au nanoparticles on the strain-dependent electrical properties of CVD graphene

NASA Astrophysics Data System (ADS)

Bai, Jing; Nan, Haiyan; Qi, Han; Bing, Dan; Du, Ruxia

2018-03-01

We conducted an experimental study of the effect of Au nanoparticles (NPs) on the strain-dependent electrical properties in chemical vapor deposition grown graphene. We used 5-nm thick Au NPs as an effective cover (and doping) layer for graphene, and found that Au NPs decrease electrical resistance by two orders of magnitude. In addition, the Au NPs suppress the effect of strain on resistance because the intrinsic topological cracks and grain boundaries in graphene are filled with Au nanoparticles. This method has a big potential to advance industrial production of large-area, high-quality electronic devices and graphene-based transparent electrodes.

Theory of coherent van der Waals matter.

PubMed

Kulić, Igor M; Kulić, Miodrag L

2014-12-01

We explain in depth the previously proposed theory of the coherent van der Waals (cvdW) interaction, the counterpart of van der Waals (vdW) force, emerging in spatially coherently fluctuating electromagnetic fields. We show that cvdW driven matter is dominated by many-body interactions, which are significantly stronger than those found in standard van der Waals (vdW) systems. Remarkably, the leading two- and three-body interactions are of the same order with respect to the distance (∝R(-6)), in contrast to the usually weak vdW three-body effects (∝R(-9)). From a microscopic theory we show that the anisotropic cvdW many-body interactions drive the formation of low-dimensional structures such as chains, membranes, and vesicles with very unusual, nonlocal properties. In particular, cvdW chains display a logarithmically growing stiffness with the chain length, while cvdW membranes have a bending modulus growing linearly with their size. We argue that the cvdW anisotropic many-body forces cause local cohesion but also a negative effective "surface tension." We conclude by deriving the equation of state for cvdW materials and propose experiments to test the theory, in particular the unusual three-body nature of cvdW.

Theory of coherent van der Waals matter

NASA Astrophysics Data System (ADS)

Kulić, Igor M.; Kulić, Miodrag L.

2014-12-01

We explain in depth the previously proposed theory of the coherent van der Waals (cvdW) interaction, the counterpart of van der Waals (vdW) force, emerging in spatially coherently fluctuating electromagnetic fields. We show that cvdW driven matter is dominated by many-body interactions, which are significantly stronger than those found in standard van der Waals (vdW) systems. Remarkably, the leading two- and three-body interactions are of the same order with respect to the distance (∝R-6) , in contrast to the usually weak vdW three-body effects (∝R-9 ). From a microscopic theory we show that the anisotropic cvdW many-body interactions drive the formation of low-dimensional structures such as chains, membranes, and vesicles with very unusual, nonlocal properties. In particular, cvdW chains display a logarithmically growing stiffness with the chain length, while cvdW membranes have a bending modulus growing linearly with their size. We argue that the cvdW anisotropic many-body forces cause local cohesion but also a negative effective "surface tension." We conclude by deriving the equation of state for cvdW materials and propose experiments to test the theory, in particular the unusual three-body nature of cvdW.

Quantifying the limits of through-plane thermal dissipation in 2D-material-based systems

NASA Astrophysics Data System (ADS)

Yasaei, Poya; Behranginia, Amirhossein; Hemmat, Zahra; El-Ghandour, Ahmed I.; Foster, Craig D.; Salehi-Khojin, Amin

2017-09-01

Through-plane thermal transport accounts for a major fraction of heat dissipation from hot-spots in many existing devices made of two-dimensional (2D) materials. In this report, we performed a set of electrical thermometry measurements and 3D finite element analyses to quantify the limits of power dissipation in monolayer graphene, a representative of 2D materials, fabricated on various technologically viable substrates such as chemical vapor deposited (CVD) diamond, tape-casted (sintered) aluminum nitride (AlN), and single crystalline c-plane sapphire as well as silicon with different oxide layers. We demonstrate that the heat dissipation through graphene on AlN substrate near room temperature outperforms those of CVD diamond and other studied substrates, owing to its superior thermal boundary conductance (TBC). At room temperature, our measurements reveal a TBC of 33.5 MW · m-2 · K-1 for graphene on AlN compared to 6.2 MW · m-2 · K-1 on diamond. This study highlights the importance of simultaneous optimization of the interfaces and the substrate and provides a route to maximize the heat removal capability of 2D-material-based devices.

Selective synthesis and device applications of semiconducting single-walled carbon nanotubes using isopropyl alcohol as feedstock.

PubMed

Che, Yuchi; Wang, Chuan; Liu, Jia; Liu, Bilu; Lin, Xue; Parker, Jason; Beasley, Cara; Wong, H-S Philip; Zhou, Chongwu

2012-08-28

The development of guided chemical vapor deposition (CVD) growth of single-walled carbon nanotubes provides a great platform for wafer-scale integration of aligned nanotubes into circuits and functional electronic systems. However, the coexistence of metallic and semiconducting nanotubes is still a major obstacle for the development of carbon-nanotube-based nanoelectronics. To address this problem, we have developed a method to obtain predominantly semiconducting nanotubes from direct CVD growth. By using isopropyl alcohol (IPA) as the carbon feedstock, a semiconducting nanotube purity of above 90% is achieved, which is unambiguously confirmed by both electrical and micro-Raman measurements. Mass spectrometric study was performed to elucidate the underlying chemical mechanism. Furthermore, high performance thin-film transistors with an on/off ratio above 10(4) and mobility up to 116 cm(2)/(V·s) have been achieved using the IPA-synthesized nanotube networks grown on silicon substrate. The method reported in this contribution is easy to operate and the results are highly reproducible. Therefore, such semiconducting predominated single-walled carbon nanotubes could serve as an important building block for future practical and scalable carbon nanotube electronics.

Testosterone and Cardiovascular Disease

PubMed Central

Tambo, Amos; Roshan, Mohsin H.K.; Pace, Nikolai P.

2016-01-01

Cardiovascular disease [CVD] is a leading cause of mortality accounting for a global incidence of over 31%. Atherosclerosis is the primary pathophysiology underpinning most types of CVD. Historically, modifiable and non-modifiable risk factors were suggested to precipitate CVD. Recently, epidemiological studies have identified emerging risk factors including hypotestosteronaemia, which have been associated with CVD. Previously considered in the realms of reproductive biology, testosterone is now believed to play a critical role in the cardiovascular system in health and disease. The actions of testosterone as they relate to the cardiac vasculature and its implication in cardiovascular pathology is reviewed. PMID:27014372

Influence of CVD diamond tips and Er:YAG laser irradiation on bonding of different adhesive systems to dentin.

PubMed

da Silva, Melissa Aline; Di Nicolo, Rebeca; Barcellos, Daphne Camara; Batista, Graziela Ribeiro; Pucci, Cesar Rogerio; Rocha Gomes Torres, Carlos; Borges, Alessandra Bühler

2013-01-01

The aim of this study was to compare the microtensile bond strength of three adhesive systems, using different methods of dentin preparation. A hundred and eight bovine teeth were used. The dentin from buccal face was exposed and prepared with three different methods, divided in 3 groups: Group 1 (DT)- diamond tip on a high-speed handpiece; Group 2 (CVD)-CVD tip on a ultrasonic handpiece; Group 3 (LA)-Er: YAG laser. The teeth were divided into 3 subgroups, according adhesive systems used: Subgroup 1-Adper Single Bond Plus/3M ESPE (SB) total-etch adhesive; Subgroup 2-Adper Scotchbond SE/3M ESPE (AS) selfetching adhesive; Subgroup 3-Clearfil SE Bond/Kuraray (CS) selfetching adhesive. Blocks of composite (Filtek Z250-3M ESPE) 4 mm high were built up and specimens were stored in deionized water for 24 hours at 37°C. Serial mesiodistal and buccolingual cuts were made and stick-like specimens were obtained, with transversal section of 1.0 mm(2). The samples were submitted to microtensile test at 1 mm/min and load of 10 kg in a universal testing machine. Data (MPa) were subjected to ANOVA and Tukey's tests (p < 0.05). Surface treatment with Diamond or CVD tips associated with Clearfil SE Bond adhesive produced significantly lower bond strength values compared to other groups. Surface treatment with Er: YAG laser associated with Single Bond Plus or Clearfil SE Bond adhesives and surface treatment with CVD tip associated with Adper Scotchbond SE adhesive produced significantly lower bond strength values compared to surface treatment with diamond or CVD tips associated with Single Bond Plus or Adper Scotchbond SE adhesives. Interactions between laser and the CVD tip technologies and the different adhesive systems can produce a satisfactory bonding strength result, so that these associations may be beneficial and enhance the clinical outcomes.

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.

Cardiovascular Disease and Associated Risk Factors in Cuba: Prospects for Prevention and Control

PubMed Central

Cooper, Richard S.; Orduñez, Pedro; Iraola Ferrer, Marcos D.; Munoz, Jose Luis Bernal; Espinosa-Brito, Alfredo

2006-01-01

Objectives. An adequate description of the trends in cardiovascular disease (CVD) is not available for most of the developing world. Cuba provides an important exception, and we sought to use available data to offer insights into the changing patterns of CVD there. Methods. We reviewed Cuban public health statistics, surveys, and reports of health services. Results. CVD has been the leading cause of death since 1970. A 45% reduction in heart disease deaths was observed from 1970 to 2002; the decline in stroke was more limited. There are moderate prevalences of all major risk factors. Conclusions. The Cuban medical care system has responded vigorously to the challenge of CVD; levels of control of hypertension are the highest in the world. Nonindustrialized countries can decisively control CVD. PMID:16317211

Deposition of amorphous carbon thin films by aerosol-assisted CVD method

NASA Astrophysics Data System (ADS)

Fadzilah, A. N.; Dayana, K.; Rusop, M.

2018-05-01

This paper reports on the deposition of amorphous carbon (a-C) by Aerosol-assisted Chemical Vapor Deposition (AACVD) using natural source of camphor oil as the precursor material. 4 samples were deposited at 4 different deposition flow rate from 15 sccm to 20 sccm, with 5 sccm interval for each sample. The analysis includes the electrical, optical and structural analysis of the data. The a-C structure which came from the manipulation of synthesis parameter was characterized by the solar simulator system, UV-VIS-NIR, Raman spectroscope and AFM. The properties of a-C are highly dependent on the deposition techniques and deposition parameters; hence the influences of gas flow rate were studied.

Large-scale Growth and Simultaneous Doping of Molybdenum Disulfide Nanosheets

PubMed Central

Kim, Seong Jun; Kang, Min-A; Kim, Sung Ho; Lee, Youngbum; Song, Wooseok; Myung, Sung; Lee, Sun Sook; Lim, Jongsun; An, Ki-Seok

2016-01-01

A facile method that uses chemical vapor deposition (CVD) for the simultaneous growth and doping of large-scale molybdenum disulfide (MoS2) nanosheets was developed. We employed metalloporphyrin as a seeding promoter layer for the uniform growth of MoS2 nanosheets. Here, a hybrid deposition system that combines thermal evaporation and atomic layer deposition (ALD) was utilized to prepare the promoter. The doping effect of the promoter was verified by X-ray photoelectron spectroscopy and Raman spectroscopy. In addition, the carrier density of the MoS2 nanosheets was manipulated by adjusting the thickness of the metalloporphyrin promoter layers, which allowed the electrical conductivity in MoS2 to be manipulated. PMID:27044862

Wearable Improved Vision System for Color Vision Deficiency Correction

PubMed Central

Riccio, Daniel; Di Perna, Luigi; Sanniti Di Baja, Gabriella; De Nino, Maurizio; Rossi, Settimio; Testa, Francesco; Simonelli, Francesca; Frucci, Maria

2017-01-01

Color vision deficiency (CVD) is an extremely frequent vision impairment that compromises the ability to recognize colors. In order to improve color vision in a subject with CVD, we designed and developed a wearable improved vision system based on an augmented reality device. The system was validated in a clinical pilot study on 24 subjects with CVD (18 males and 6 females, aged 37.4 ± 14.2 years). The primary outcome was the improvement in the Ishihara Vision Test score with the correction proposed by our system. The Ishihara test score significantly improved (\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$p = 0.03$ \\end{document}) from 5.8 ± 3.0 without correction to 14.8 ± 5.0 with correction. Almost all patients showed an improvement in color vision, as shown by the increased test scores. Moreover, with our system, 12 subjects (50%) passed the vision color test as normal vision subjects. The development and preliminary validation of the proposed platform confirm that a wearable augmented-reality device could be an effective aid to improve color vision in subjects with CVD. PMID:28507827

Worksite health and wellness programs: Canadian achievements & prospects.

PubMed

Després, Jean-Pierre; Alméras, Natalie; Gauvin, Lise

2014-01-01

Canada has experienced a substantial reduction in mortality related to cardiovascular disease (CVD). There is a general consensus that more effective and widespread health promotion interventions may lead to further reductions in CVD risk factors and actual disease states. In this paper, we briefly outline the prevalence of selected risk factors for CVD in Canada, describe characteristics of the Canadian labor market and workforce, and depict what is known about health and wellness program delivery systems in Canadian workplaces. Our review indicates that there have been numerous and diverse relevant legislative and policy initiatives to create a context conducive to improve the healthfulness of Canadian workplaces. However, there is still a dearth of evidence on the effectiveness of the delivery system and the actual impact of workplace health and wellness programs in reducing CVD risk in Canada. Thus, while a promising model, more research is needed in this area. Copyright © 2014 Elsevier Inc. All rights reserved.

Preparing nurses for leadership roles in cardiovascular disease prevention.

PubMed

Lanuza, Dorothy M; Davidson, Patricia M; Dunbar, Sandra B; Hughes, Suzanne; De Geest, Sabina

2011-01-01

Cardiovascular disease (CVD) is a critical global health issue, and cardiovascular nurses play a vital role in decreasing the global burden and contributing to improving outcomes in individuals and communities. Cardiovascular nurses require the knowledge, skills, and resources that will enable them to function as leaders in CVD. This article addresses the education, training, and strategies that are needed to prepare nurses for leadership roles in preventing and managing CVD. Building on the World Health Organization core competencies for 21st-century health care workers, the specific competencies of cardiovascular nurses working in prevention are outlined. These can be further strengthened by investing in the development of cultural, system change and leadership competencies. Mentorship is proposed as a powerful strategy for promoting the cardiovascular nursing role and equipping individual nurses to contribute meaningfully to health system reform and community engagement in CVD risk reduction.

CVD and obesity in transitional Syria: a perspective from the Middle East

PubMed Central

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.

PubMed

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.

Management of Cardiovascular Risk in Patients with Chronic Inflammatory Diseases: Current Evidence and Future Perspectives.

PubMed

Lindhardsen, Jesper; Kristensen, Søren Lund; Ahlehoff, Ole

2016-02-01

An increased risk of cardiovascular disease (CVD) has been observed in a range of chronic inflammatory diseases (CID), including rheumatoid arthritis (RA), psoriasis, inflammatory bowel diseases (IBD), and systemic lupus erythematosus (SLE). The increased risk of CVDs and reduced life expectancy in these conditions has stimulated considerable research and started an ongoing discussion on the need for a multidisciplinary approach and dedicated guidelines on CVD prevention in these patients. In addition, the possibility of inhibiting inflammation as a means to preventing CVD in these patients has gained considerable interest in recent years. We briefly summarize the current level of evidence of the association between CIDs and CVD and cardiovascular risk management recommendations. Perspectives of ongoing and planned trials are discussed in consideration of potential ways to improve primary and secondary CVD prevention in patients with CID.

Network-based association of hypoxia-responsive genes with cardiovascular diseases

NASA Astrophysics Data System (ADS)

Wang, Rui-Sheng; Oldham, William M.; Loscalzo, Joseph

2014-10-01

Molecular oxygen is indispensable for cellular viability and function. Hypoxia is a stress condition in which oxygen demand exceeds supply. Low cellular oxygen content induces a number of molecular changes to activate regulatory pathways responsible for increasing the oxygen supply and optimizing cellular metabolism under limited oxygen conditions. Hypoxia plays critical roles in the pathobiology of many diseases, such as cancer, heart failure, myocardial ischemia, stroke, and chronic lung diseases. Although the complicated associations between hypoxia and cardiovascular (and cerebrovascular) diseases (CVD) have been recognized for some time, there are few studies that investigate their biological link from a systems biology perspective. In this study, we integrate hypoxia genes, CVD genes, and the human protein interactome in order to explore the relationship between hypoxia and cardiovascular diseases at a systems level. We show that hypoxia genes are much closer to CVD genes in the human protein interactome than that expected by chance. We also find that hypoxia genes play significant bridging roles in connecting different cardiovascular diseases. We construct a hypoxia-CVD bipartite network and find several interesting hypoxia-CVD modules with significant gene ontology similarity. Finally, we show that hypoxia genes tend to have more CVD interactors in the human interactome than in random networks of matching topology. Based on these observations, we can predict novel genes that may be associated with CVD. This network-based association study gives us a broad view of the relationships between hypoxia and cardiovascular diseases and provides new insights into the role of hypoxia in cardiovascular biology.

Ternary Precursors for Depositing I-III-VI2 Thin Films for Solar Cells via Spray CVD

NASA Technical Reports Server (NTRS)

Banger, K. K.; Hollingsworth, J. A.; Jin, M. H.-C.; Harris, J. D.; Duraj, S. A.; Smith, M.; Scheiman, D.; Bohannan, E. W.; Switzer, J. A.; Buhro, W. E.

2002-01-01

The development of thin-film solar cells on flexible, lightweight, space-qualified substrates provides an attractive cost solution to fabricating solar arrays with high specific power (W/kg). Thin-film fabrication studies demonstrate that ternary single source precursors (SSP's) can be used in either a hot or cold-wall spray chemical vapour deposition (CVD) reactor, for depositing CuInS2, CuGaS2, and CuGaInS2 at reduced temperatures (400 to 450 C), which display good electrical and optical properties suitable for photovoltaic (PV) devices. X-ray diffraction studies, energy dispersive spectroscopy (EDS), and scanning electron microscopy (SEM) confirmed the formation of the single phase CIS, CGS, CIGS thin-films on various substrates at reduced temperatures.

Zero bias thermally stimulated currents in synthetic diamond

NASA Astrophysics Data System (ADS)

Mori, R.; Miglio, S.; Bruzzi, M.; Bogani, F.; De Sio, A.; Pace, E.

2009-06-01

Zero bias thermally stimulated currents (ZBTSCs) have been observed in single crystal high pressure high temperature (HPHT) and polycrystalline chemical vapor deposited (pCVD) diamond films. The ZBTSC technique is characterized by an increased sensitivity with respect to a standard TSC analysis. Due to the absence of the thermally activated background current, new TSC peaks have been observed in both HPHT and pCVD diamond films, related to shallow activation energies usually obscured by the emission of the dominant impurities. The ZBTSC peaks are explained in terms of defect discharge in the nonequilibrium potential distribution created by a nonuniform traps filling at the metal-diamond junctions. The electric field due to the charged defects has been estimated in a quasizero bias TSC experiment by applying an external bias.

Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015.

PubMed

Roth, Gregory A; Johnson, Catherine; Abajobir, Amanuel; Abd-Allah, Foad; Abera, Semaw Ferede; Abyu, Gebre; Ahmed, Muktar; Aksut, Baran; Alam, Tahiya; Alam, Khurshid; Alla, François; Alvis-Guzman, Nelson; Amrock, Stephen; Ansari, Hossein; Ärnlöv, Johan; Asayesh, Hamid; Atey, Tesfay Mehari; Avila-Burgos, Leticia; Awasthi, Ashish; Banerjee, Amitava; Barac, Aleksandra; Bärnighausen, Till; Barregard, Lars; Bedi, Neeraj; Belay Ketema, Ezra; Bennett, Derrick; Berhe, Gebremedhin; Bhutta, Zulfiqar; Bitew, Shimelash; Carapetis, Jonathan; Carrero, Juan Jesus; Malta, Deborah Carvalho; Castañeda-Orjuela, Carlos Andres; Castillo-Rivas, Jacqueline; Catalá-López, Ferrán; Choi, Jee-Young; Christensen, Hanne; Cirillo, Massimo; Cooper, Leslie; Criqui, Michael; Cundiff, David; Damasceno, Albertino; Dandona, Lalit; Dandona, Rakhi; Davletov, Kairat; Dharmaratne, Samath; Dorairaj, Prabhakaran; Dubey, Manisha; Ehrenkranz, Rebecca; El Sayed Zaki, Maysaa; Faraon, Emerito Jose A; Esteghamati, Alireza; Farid, Talha; Farvid, Maryam; Feigin, Valery; Ding, Eric L; Fowkes, Gerry; Gebrehiwot, Tsegaye; Gillum, Richard; Gold, Audra; Gona, Philimon; Gupta, Rajeev; Habtewold, Tesfa Dejenie; Hafezi-Nejad, Nima; Hailu, Tesfaye; Hailu, Gessessew Bugssa; Hankey, Graeme; Hassen, Hamid Yimam; Abate, Kalkidan Hassen; Havmoeller, Rasmus; Hay, Simon I; Horino, Masako; Hotez, Peter J; Jacobsen, Kathryn; James, Spencer; Javanbakht, Mehdi; Jeemon, Panniyammakal; John, Denny; Jonas, Jost; Kalkonde, Yogeshwar; Karimkhani, Chante; Kasaeian, Amir; Khader, Yousef; Khan, Abdur; Khang, Young-Ho; Khera, Sahil; Khoja, Abdullah T; Khubchandani, Jagdish; Kim, Daniel; Kolte, Dhaval; Kosen, Soewarta; Krohn, Kristopher J; Kumar, G Anil; Kwan, Gene F; Lal, Dharmesh Kumar; Larsson, Anders; Linn, Shai; Lopez, Alan; Lotufo, Paulo A; El Razek, Hassan Magdy Abd; Malekzadeh, Reza; Mazidi, Mohsen; Meier, Toni; Meles, Kidanu Gebremariam; Mensah, George; Meretoja, Atte; Mezgebe, Haftay; Miller, Ted; Mirrakhimov, Erkin; Mohammed, Shafiu; Moran, Andrew E; Musa, Kamarul Imran; Narula, Jagat; Neal, Bruce; Ngalesoni, Frida; Nguyen, Grant; Obermeyer, Carla Makhlouf; Owolabi, Mayowa; Patton, George; Pedro, João; Qato, Dima; Qorbani, Mostafa; Rahimi, Kazem; Rai, Rajesh Kumar; Rawaf, Salman; Ribeiro, Antônio; Safiri, Saeid; Salomon, Joshua A; Santos, Itamar; Santric Milicevic, Milena; Sartorius, Benn; Schutte, Aletta; Sepanlou, Sadaf; Shaikh, Masood Ali; Shin, Min-Jeong; Shishehbor, Mehdi; Shore, Hirbo; Silva, Diego Augusto Santos; Sobngwi, Eugene; Stranges, Saverio; Swaminathan, Soumya; Tabarés-Seisdedos, Rafael; Tadele Atnafu, Niguse; Tesfay, Fisaha; Thakur, J S; Thrift, Amanda; Topor-Madry, Roman; Truelsen, Thomas; Tyrovolas, Stefanos; Ukwaja, Kingsley Nnanna; Uthman, Olalekan; Vasankari, Tommi; Vlassov, Vasiliy; Vollset, Stein Emil; Wakayo, Tolassa; Watkins, David; Weintraub, Robert; Werdecker, Andrea; Westerman, Ronny; Wiysonge, Charles Shey; Wolfe, Charles; Workicho, Abdulhalik; Xu, Gelin; Yano, Yuichiro; Yip, Paul; Yonemoto, Naohiro; Younis, Mustafa; Yu, Chuanhua; Vos, Theo; Naghavi, Mohsen; Murray, Christopher

2017-07-04

The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden. CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75. CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

The increasing financial impact of chronic kidney disease in australia.

PubMed

Tucker, Patrick S; Kingsley, Michael I; Morton, R Hugh; Scanlan, Aaron T; Dalbo, Vincent J

2014-01-01

The aim of this investigation was to determine and compare current and projected expenditure associated with chronic kidney disease (CKD), renal replacement therapy (RRT), and cardiovascular disease (CVD) in Australia. Data published by Australia and New Zealand Dialysis and Transplant Registry, Australian Institute of Health and Welfare, and World Bank were used to compare CKD-, RRT-, and CVD-related expenditure and prevalence rates. Prevalence and expenditure predictions were made using a linear regression model. Direct statistical comparisons of rates of annual increase utilised indicator variables in combined regressions. Statistical significance was set at P < 0.05. Dollar amounts were adjusted for inflation prior to analysis. Between 2012 and 2020, prevalence, per-patient expenditure, and total disease expenditure associated with CKD and RRT are estimated to increase significantly more rapidly than CVD. RRT prevalence is estimated to increase by 29%, compared to 7% in CVD. Average annual RRT per-patient expenditure is estimated to increase by 16%, compared to 8% in CVD. Total CKD- and RRT-related expenditure had been estimated to increase by 37%, compared to 14% in CVD. Per-patient, CKD produces a considerably greater financial impact on Australia's healthcare system, compared to CVD. Research focusing on novel preventative/therapeutic interventions is warranted.

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...

Prospects of Two-Dimensional Devices: Electrical and Optical Characterization of Transition Metal Dichalcogenide Films

NASA Astrophysics Data System (ADS)

Klee, Velveth

Understanding the electrical and optical properties of 2D materials down to their monolayer limit is important for establishing their potential for novel applications. Prominent among 2D materials are transition metal dichalcogenides (TMDs), such as MoS2 and MoSe2. These materials have attracted attention because of their intriguing properties, such as a transition from an indirect bandgap for few layers to a direct bandgap for monolayers. New synthetic routes like chemical vapor deposition (CVD) allow for high-quality, centimeter-scale growth and tuning of the direct optical gap continuously between the values of single-layer MoS2 (1.87eV) and MoSe 2 (1.55eV). In the first part of this work, we perform optoelectronic measurements of alloy devices fabricated on CVD-grown, monolayer MoS2, MoS 2(1-x)Se2x, and MoSe2 islands. For all alloy compositions there is an unusual superlinear dependence of the photocurrent on light intensity. We also establish the photoconductive nature of the photoresponse, with the photocurrent originating from recombination and field-induced carrier separation in the channel. The study of transport characteristics of TMDs is extended to explore the effects of devices on a piezoelectric substrate as a route towards establishing fabrication processes suited for industry. In this work, we show that CVD-growth of MoS2 monolayer films onto periodically poled lithium niobate is possible while maintaining the substrate polarization pattern. Electrical transport measurements indicate an inversion of the MoS2 from n-type to p-type behavior under application of an external voltage depending on the domain orientation of the ferroelectric substrate. Sensitivity to ferroelectric substrate polarization opens the possibility for ferroelectric nonvolatile gating of TMDs in scalable devices fabricated free of exfoliation and transfer. Optimizing CVD techniques allows for preparation of TMD films in different phases that are reported to exhibit semiconducting and metallic properties. Here, we show optical and electronic characterization of few-layer films of MoTe2 in three distinct structural phases: 2H, 1T' and 1T. Depending on process parameters, either of the phases can be prepared using MoO3 and elemental tellurium precursors. Experimental and computed Raman spectra are presented for each phase. Transport measurements validate predictions from DFT-based band structure calculations on the metallic character of the centrosymmetric 1T phase.

Targeting inflammation in the prevention of cardiovascular disease in patients with inflammatory arthritis.

PubMed

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.

Exercise and the Cardiovascular System: Clinical Science and Cardiovascular Outcomes

PubMed Central

Lavie, Carl J.; Arena, Ross; Swift, Damon L.; Johannsen, Neil M.; Sui, Xuemei; Lee, Duck-chul; Earnest, Conrad P.; Church, Timothy S.; O’Keefe, James H.; Milani, Richard V.; Blair, Steven N.

2015-01-01

Substantial evidence has established the value of high levels of physical activity (PA), exercise training (ET), and overall cardiorespiratory fitness (CRF) in the prevention and treatment of cardiovascular diseases (CVD). This paper reviews some basics of exercise physiology and the acute and chronic responses of ET, as well as the impact of PA and CRF on CVD. This review also surveys data from epidemiologic and ET studies in the primary and secondary prevention of CVD, particularly coronary heart disease (CHD) and heart failure (HF). These data strongly support the routine prescription of ET to all patients and referrals for patients with CVD, especially CHD and HF, to specific cardiac rehabilitation and ET programs. PMID:26139859

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.

The interplay between adipose tissue and the cardiovascular system: is fat always bad?

PubMed

Akoumianakis, Ioannis; Antoniades, Charalambos

2017-07-01

Obesity is a risk factor for cardiovascular disease (CVD). However, clinical research has revealed a paradoxically protective role for obesity in patients with chronic diseases including CVD, suggesting that the biological 'quality' of adipose tissue (AT) may be more important than overall AT mass or body weight. Importantly, AT is recognised as a dynamic organ secreting a wide range of biologically active adipokines, microRNAs, gaseous messengers, and other metabolites that affect the cardiovascular system in both endocrine and paracrine ways. Despite being able to mediate normal cardiovascular function under physiological conditions, AT undergoes a phenotypic shift characterised by acquisition of pro-oxidant and pro-inflammatory properties in cases of CVD. Crucially, recent evidence suggests that AT depots such as perivascular AT and epicardial AT are able to modify their phenotype in response to local signals of vascular and myocardial origin, respectively. Utilisation of this unique property of certain AT depots to dynamically track cardiovascular biology may reveal novel diagnostic and prognostic tools against CVD. Better understanding of the mechanisms controlling the 'quality' of AT secretome, as well as the communication links between AT and the cardiovascular system, is required for the efficient management of CVD. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

A point-based prediction model for cardiovascular risk in orthotopic liver transplantation: The CAR-OLT score.

PubMed

VanWagner, Lisa B; Ning, Hongyan; Whitsett, Maureen; Levitsky, Josh; Uttal, Sarah; Wilkins, John T; Abecassis, Michael M; Ladner, Daniela P; Skaro, Anton I; Lloyd-Jones, Donald M

2017-12-01

Cardiovascular disease (CVD) complications are important causes of morbidity and mortality after orthotopic liver transplantation (OLT). There is currently no preoperative risk-assessment tool that allows physicians to estimate the risk for CVD events following OLT. We sought to develop a point-based prediction model (risk score) for CVD complications after OLT, the Cardiovascular Risk in Orthotopic Liver Transplantation risk score, among a cohort of 1,024 consecutive patients aged 18-75 years who underwent first OLT in a tertiary-care teaching hospital (2002-2011). The main outcome measures were major 1-year CVD complications, defined as death from a CVD cause or hospitalization for a major CVD event (myocardial infarction, revascularization, heart failure, atrial fibrillation, cardiac arrest, pulmonary embolism, and/or stroke). The bootstrap method yielded bias-corrected 95% confidence intervals for the regression coefficients of the final model. Among 1,024 first OLT recipients, major CVD complications occurred in 329 (32.1%). Variables selected for inclusion in the model (using model optimization strategies) included preoperative recipient age, sex, race, employment status, education status, history of hepatocellular carcinoma, diabetes, heart failure, atrial fibrillation, pulmonary or systemic hypertension, and respiratory failure. The discriminative performance of the point-based score (C statistic = 0.78, bias-corrected C statistic = 0.77) was superior to other published risk models for postoperative CVD morbidity and mortality, and it had appropriate calibration (Hosmer-Lemeshow P = 0.33). The point-based risk score can identify patients at risk for CVD complications after OLT surgery (available at www.carolt.us); this score may be useful for identification of candidates for further risk stratification or other management strategies to improve CVD outcomes after OLT. (Hepatology 2017;66:1968-1979). © 2017 by the American Association for the Study of Liver Diseases.

Synthesis and Application of Graphene Based Nanomaterials

NASA Astrophysics Data System (ADS)

Peng, Zhiwei

Graphene, a two-dimensional sp2-bonded carbon material, has recently attracted major attention due to its excellent electrical, optical and mechanical properties. Depending on different applications, graphene and its derived hybrid nanomaterials can be synthesized by either bottom-up chemical vapor deposition (CVD) methods for electronics, or various top-down chemical reaction methods for energy generation and storage devices. My thesis begins with the investigation of CVD synthesis of graphene thin films in Chapter 1, including the direct growth of bilayer graphene on insulating substrates and synthesis of "rebar graphene": a hybrid structure with graphene and carbon or boron nitride nanotubes. Chapter 2 discusses the synthesis of nanoribbon-shaped materials and their applications, including splitting of vertically aligned multi-walled carbon nanotube carpets for supercapacitors, synthesis of dispersable ferromagnetic graphene nanoribbon stacks with enhanced electrical percolation properties in magnetic field, graphene nanoribbon/SnO 2 nanocomposite for lithium ion batteries, and enhanced electrocatalysis for hydrogen evolution reactions from WS2 nanoribbons. Next, Chapter 3 discusses graphene coated iron oxide nanomaterials and their use in energy storage applications. Finally, Chapter 4 introduces the development, characterization, and fabrication of laser induced graphene and its application as supercapacitors.

2D Semiconductors for Valley-Polarized LEDs and Photodetectors

NASA Astrophysics Data System (ADS)

Yu, Ting

The recently discovered two-dimensional (2D) semiconductors, such as transitional-metal-dichalcogenide monolayers, have aroused great interest due to the underlying quantum physics and the appealing optoelectronic applications like atomically thin light-emitting diodes (LEDs) and photodetectors. On the one hand, valley-polarized electroluminescence and photocurrent from such monolayers have not caused enough attention but highly demanded as building blocks for the new generation valleytronic applications. On the other hand, most reports on these devices are based on the mechanically exfoliated small samples. Considering real applications, a strategy which could offer mass-product and high compatibility to the current planar processes is greatly demanded. Large-area samples prepared by chemical vapour deposition (CVD) are perfect candidates towards such a goal. Here, we report electrically tunable valley-polarized electroluminescence and the selective spin-valley-coupled photocurrent in optoelectronic devices based on monolayer WS2 and MoS2 grown by CVD, exhibiting large electroluminescence and photocurrent dichroisms of 81% and 60%, respectively. The controllable valley polarization and emission components of the electroluminescence have been realized by varying electrical injection of carriers. For the observed helicity-dependent photocurrent, the circular photogalvanic effect at resonant excitations has been found to take the dominant responsibility.

A System Dynamics Model for Planning Cardiovascular Disease Interventions

PubMed Central

Homer, Jack; Evans, Elizabeth; Zielinski, Ann

2010-01-01

Planning programs for the prevention and treatment of cardiovascular disease (CVD) is a challenge to every community that wants to make the best use of its limited resources. Selecting programs that provide the greatest impact is difficult because of the complex set of causal pathways and delays that link risk factors to CVD. We describe a system dynamics simulation model developed for a county health department that incorporates and tracks the effects of those risk factors over time on both first-time and recurrent events. We also describe how the model was used to evaluate the potential impacts of various intervention strategies for reducing the county's CVD burden and present the results of those policy tests. PMID:20167899

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.

The Burden of Cardiovascular Disease in Low- and Middle-Income Countries: Epidemiology and Management.

PubMed

Bowry, Ashna D K; Lewey, Jennifer; Dugani, Sagar B; Choudhry, Niteesh K

2015-09-01

Cardiovascular disease (CVD) is the second leading cause of mortality worldwide, accounting for 17 million deaths in 2013. More than 80% of these cases were in low- and middle-income countries (LMICs). Although the risk factors for the development of CVD are similar throughout the world, the evolving change in lifestyle and health behaviours in LMICs-including tobacco use, decreased physical activity, and obesity-are contributing to the escalating presence of CVD and mortality. Although CVD mortality is falling in high-income settings because of more effective preventive and management programs, access to evidence-based interventions for combating CVD in resource-limited settings is variable. The existing pressures on both human and financial resources impact the efforts of controlling CVD. The implementation of emerging innovative interventions to improve medication adherence, introducing m-health programs, and decentralizing the management of chronic diseases are promising methods to reduce the burden of chronic disease management on such fragile health care systems. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Translating evidence into policy for cardiovascular disease control in India

PubMed Central

2011-01-01

Cardiovascular diseases (CVD) are leading causes of premature mortality in India. Evidence from developed countries shows that mortality from these can be substantially prevented using population-wide and individual-based strategies. Policy initiatives for control of CVD in India have been suggested but evidence of efficacy has emerged only recently. These initiatives can have immediate impact in reducing morbidity and mortality. Of the prevention strategies, primordial involve improvement in socioeconomic status and literacy, adequate healthcare financing and public health insurance, effective national CVD control programme, smoking control policies, legislative control of saturated fats, trans fats, salt and alcohol, and development of facilities for increasing physical activity through better urban planning and school-based and worksite interventions. Primary prevention entails change in medical educational curriculum and improved healthcare delivery for control of CVD risk factors-smoking, hypertension, dyslipidemia and diabetes. Secondary prevention involves creation of facilities and human resources for optimum acute CVD care and secondary prevention. There is need to integrate various policy makers, develop effective policies and modify healthcare systems for effective delivery of CVD preventive care. PMID:21306620

Update on RAAS Modulation for the Treatment of Diabetic Cardiovascular Disease.

PubMed

Bernardi, Stella; Michelli, Andrea; Zuolo, Giulia; Candido, Riccardo; Fabris, Bruno

2016-01-01

Since the advent of insulin, the improvements in diabetes detection and the therapies to treat hyperglycemia have reduced the mortality of acute metabolic emergencies, such that today chronic complications are the major cause of morbidity and mortality among diabetic patients. More than half of the mortality that is seen in the diabetic population can be ascribed to cardiovascular disease (CVD), which includes not only myocardial infarction due to premature atherosclerosis but also diabetic cardiomyopathy. The importance of renin-angiotensin-aldosterone system (RAAS) antagonism in the prevention of diabetic CVD has demonstrated the key role that the RAAS plays in diabetic CVD onset and development. Today, ACE inhibitors and angiotensin II receptor blockers represent the first line therapy for primary and secondary CVD prevention in patients with diabetes. Recent research has uncovered new dimensions of the RAAS and, therefore, new potential therapeutic targets against diabetic CVD. Here we describe the timeline of paradigm shifts in RAAS understanding, how diabetes modifies the RAAS, and what new parts of the RAAS pathway could be targeted in order to achieve RAAS modulation against diabetic CVD.

Update on RAAS Modulation for the Treatment of Diabetic Cardiovascular Disease

PubMed Central

Michelli, Andrea; Zuolo, Giulia; Candido, Riccardo; Fabris, Bruno

2016-01-01

Since the advent of insulin, the improvements in diabetes detection and the therapies to treat hyperglycemia have reduced the mortality of acute metabolic emergencies, such that today chronic complications are the major cause of morbidity and mortality among diabetic patients. More than half of the mortality that is seen in the diabetic population can be ascribed to cardiovascular disease (CVD), which includes not only myocardial infarction due to premature atherosclerosis but also diabetic cardiomyopathy. The importance of renin-angiotensin-aldosterone system (RAAS) antagonism in the prevention of diabetic CVD has demonstrated the key role that the RAAS plays in diabetic CVD onset and development. Today, ACE inhibitors and angiotensin II receptor blockers represent the first line therapy for primary and secondary CVD prevention in patients with diabetes. Recent research has uncovered new dimensions of the RAAS and, therefore, new potential therapeutic targets against diabetic CVD. Here we describe the timeline of paradigm shifts in RAAS understanding, how diabetes modifies the RAAS, and what new parts of the RAAS pathway could be targeted in order to achieve RAAS modulation against diabetic CVD. PMID:27652272

Cardiovascular disease guideline adherence and self-reported statin use in longstanding type 1 diabetes: results from the Canadian study of longevity in diabetes cohort.

PubMed

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.

The pulse-mass index as a predictor of cardiovascular events in women with systemic lupus erythematosus.

PubMed

García-Villegas, Elsy Aidé; Márquez-González, Horacio; Flores-Suárez, Luis Felipe; Villa-Romero, Antonio Rafael

2017-01-20

Patients with systemic lupus erythematosus (SLE) have 3times the risk of death compared to the rest of the population, with cardiovascular events (CVD) being one of the main causes. Índices such as waist-height (W-Ht I), waist-hip (W-Hp I) and pulse-mass (PMI) predict CVD, though the behaviour is unknown in patients with SLE. The aim of this study was to determine the prognostic value of PMI in the development of CVD in premenopausal women with SLE. Cohort study. Included were premenopausal women with SLE without prior CVD; excluded were those patients with antiphospholipid syndrome (APS), pregnancy, thyroid disease, recent liposuction, and chronic kidney disease. Exposure variables were: PMI, W-Ht I, W-Hp I and metabolic syndrome at onset of the cohort. Considered confounding variables were time of evolution, disease activity, cumulative damage and treatment. Through semi-annual appointments, accident and emergency admittance and hospitalisation records the CVD were screened. Analysis was performed with Cox for proportional hazards and survival with Kaplan Meier. We included 238 women with a median age of 31 (18-52) years, with a follow-up of 8years. We identified 22 (9.6%) cases of CVD. In the Cox proportional hazards analysis, the prognostic variables were: PMI with HR=8.1 (95% CI: 1.1-65), metabolic syndrome with 2.4 (95% CI: 1-5.8), cumulative damage with HR=1.5 (95% CI: 1.1-2.2) and body fat percentage HR=2.8 (95% CI: 1.1-6.9) CONCLUSIONS: The PMI is a better predictor factor of CVD in women with SLE. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Metabolomic Quantitative Trait Loci (mQTL) Mapping Implicates the Ubiquitin Proteasome System in Cardiovascular Disease Pathogenesis.

PubMed

Kraus, William E; Muoio, Deborah M; Stevens, Robert; Craig, Damian; Bain, James R; Grass, Elizabeth; Haynes, Carol; Kwee, Lydia; Qin, Xuejun; Slentz, Dorothy H; Krupp, Deidre; Muehlbauer, Michael; Hauser, Elizabeth R; Gregory, Simon G; Newgard, Christopher B; Shah, Svati H

2015-11-01

Levels of certain circulating short-chain dicarboxylacylcarnitine (SCDA), long-chain dicarboxylacylcarnitine (LCDA) and medium chain acylcarnitine (MCA) metabolites are heritable and predict cardiovascular disease (CVD) events. Little is known about the biological pathways that influence levels of most of these metabolites. Here, we analyzed genetics, epigenetics, and transcriptomics with metabolomics in samples from a large CVD cohort to identify novel genetic markers for CVD and to better understand the role of metabolites in CVD pathogenesis. Using genomewide association in the CATHGEN cohort (N = 1490), we observed associations of several metabolites with genetic loci. Our strongest findings were for SCDA metabolite levels with variants in genes that regulate components of endoplasmic reticulum (ER) stress (USP3, HERC1, STIM1, SEL1L, FBXO25, SUGT1) These findings were validated in a second cohort of CATHGEN subjects (N = 2022, combined p = 8.4x10-6-2.3x10-10). Importantly, variants in these genes independently predicted CVD events. Association of genomewide methylation profiles with SCDA metabolites identified two ER stress genes as differentially methylated (BRSK2 and HOOK2). Expression quantitative trait loci (eQTL) pathway analyses driven by gene variants and SCDA metabolites corroborated perturbations in ER stress and highlighted the ubiquitin proteasome system (UPS) arm. Moreover, culture of human kidney cells in the presence of levels of fatty acids found in individuals with cardiometabolic disease, induced accumulation of SCDA metabolites in parallel with increases in the ER stress marker BiP. Thus, our integrative strategy implicates the UPS arm of the ER stress pathway in CVD pathogenesis, and identifies novel genetic loci associated with CVD event risk.

Metabolomic Quantitative Trait Loci (mQTL) Mapping Implicates the Ubiquitin Proteasome System in Cardiovascular Disease Pathogenesis

PubMed Central

Kraus, William E.; Muoio, Deborah M.; Stevens, Robert; Craig, Damian; Bain, James R.; Grass, Elizabeth; Haynes, Carol; Kwee, Lydia; Qin, Xuejun; Slentz, Dorothy H.; Krupp, Deidre; Muehlbauer, Michael; Hauser, Elizabeth R.; Gregory, Simon G.; Newgard, Christopher B.; Shah, Svati H.

2015-01-01

Levels of certain circulating short-chain dicarboxylacylcarnitine (SCDA), long-chain dicarboxylacylcarnitine (LCDA) and medium chain acylcarnitine (MCA) metabolites are heritable and predict cardiovascular disease (CVD) events. Little is known about the biological pathways that influence levels of most of these metabolites. Here, we analyzed genetics, epigenetics, and transcriptomics with metabolomics in samples from a large CVD cohort to identify novel genetic markers for CVD and to better understand the role of metabolites in CVD pathogenesis. Using genomewide association in the CATHGEN cohort (N = 1490), we observed associations of several metabolites with genetic loci. Our strongest findings were for SCDA metabolite levels with variants in genes that regulate components of endoplasmic reticulum (ER) stress (USP3, HERC1, STIM1, SEL1L, FBXO25, SUGT1) These findings were validated in a second cohort of CATHGEN subjects (N = 2022, combined p = 8.4x10-6–2.3x10-10). Importantly, variants in these genes independently predicted CVD events. Association of genomewide methylation profiles with SCDA metabolites identified two ER stress genes as differentially methylated (BRSK2 and HOOK2). Expression quantitative trait loci (eQTL) pathway analyses driven by gene variants and SCDA metabolites corroborated perturbations in ER stress and highlighted the ubiquitin proteasome system (UPS) arm. Moreover, culture of human kidney cells in the presence of levels of fatty acids found in individuals with cardiometabolic disease, induced accumulation of SCDA metabolites in parallel with increases in the ER stress marker BiP. Thus, our integrative strategy implicates the UPS arm of the ER stress pathway in CVD pathogenesis, and identifies novel genetic loci associated with CVD event risk. PMID:26540294

Depression and Anxiety Screens as Predictors of 8-Year Incidence of Myocardial Infarction and Stroke in Primary Care Patients.

PubMed

Stewart, Jesse C; Hawkins, Misty A W; Khambaty, Tasneem; Perkins, Anthony J; Callahan, Christopher M

2016-06-01

Because depression and anxiety are typically studied in isolation, our purpose was to examine the relative importance of these overlapping emotional factors in predicting incident cardiovascular disease (CVD). We examined depression and anxiety screens, and their individual items, as predictors of incident hard CVD events, myocardial infarction, and stroke for 8 years in a diverse sample of 2041 older primary care patients initially free of CVD. At baseline, participants completed self-report depression and anxiety screens. Data regarding CVD events were obtained from an electronic medical record system and the Centers for Medicare and Medicaid Services analytic files. During follow-up, 683 (33%) experienced a CVD event. Cox proportional hazards models-adjusted for demographic and CVD risk factors-revealed that a positive anxiety screen, but not a positive depression screen, was associated with an increased risk of a hard CVD event in separate models (Years 0-3: anxiety hazard ratio [HR] = 1.54, 95% confidence interval [CI] = 1.21-1.96, p < .001; Years 3+: anxiety HR = 0.99, CI = 0.81-1.21), p = .93; depression HR = 1.10, CI = 0.88-1.36, p = .41), as well as when entered into the same model (Years 0-3: anxiety HR = 1.53, CI = 1.20-1.95, p < .001; Years 3+: anxiety HR = 0.99, CI = 0.80-1.21, p = .99; depression HR = 1.03, CI = 0.82-1.29, p = .82). Analyses examining individual items and secondary outcomes showed that the anxiety-CVD association was largely driven by the feeling anxious item and the myocardial infarction outcome. Anxiety, especially feeling anxious, is a unique risk factor for CVD events in older adults, independent of conventional risk factors and depression. Anxiety deserves increased attention as a potential factor relevant to CVD risk stratification and a potential target of CVD primary prevention efforts.

Growth-substrate induced performance degradation in chemically synthesized monolayer MoS{sub 2} field effect transistors

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

Nonaligned carbon nanotubes anchored on porous alumina: formation, process modeling, gas-phase analysis, and field-emission properties.

PubMed

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.

Large-scale synthesis of high-quality hexagonal boron nitride nanosheets for large-area graphene electronics.

PubMed

Lee, Kang Hyuck; Shin, Hyeon-Jin; Lee, Jinyeong; Lee, In-yeal; Kim, Gil-Ho; Choi, Jae-Young; Kim, Sang-Woo

2012-02-08

Hexagonal boron nitride (h-BN) has received a great deal of attention as a substrate material for high-performance graphene electronics because it has an atomically smooth surface, lattice constant similar to that of graphene, large optical phonon modes, and a large electrical band gap. Herein, we report the large-scale synthesis of high-quality h-BN nanosheets in a chemical vapor deposition (CVD) process by controlling the surface morphologies of the copper (Cu) catalysts. It was found that morphology control of the Cu foil is much critical for the formation of the pure h-BN nanosheets as well as the improvement of their crystallinity. For the first time, we demonstrate the performance enhancement of CVD-based graphene devices with large-scale h-BN nanosheets. The mobility of the graphene device on the h-BN nanosheets was increased 3 times compared to that without the h-BN nanosheets. The on-off ratio of the drain current is 2 times higher than that of the graphene device without h-BN. This work suggests that high-quality h-BN nanosheets based on CVD are very promising for high-performance large-area graphene electronics. © 2012 American Chemical Society

Preparing nurses for leadership roles in cardiovascular disease prevention.

PubMed

Lanuza, Dorothy M; Davidson, Patricia M; Dunbar, Sandra B; Hughes, Suzanne; De Geest, Sabina

2011-07-01

Cardiovascular disease (CVD) is a critical global health issue, and cardiovascular nurses play a vital role in decreasing the global burden and contributing to improving outcomes in individuals and communities. Cardiovascular nurses require the knowledge, skills, and resources that will enable them to function as leaders in CVD. This article addresses the education, training, and strategies that are needed to prepare nurses for leadership roles in preventing and managing CVD. Building on the World Health Organization core competencies for 21st-century health care workers, the specific competencies of cardiovascular nurses working in prevention are outlined. These can be further strengthened by investing in the development of cultural, system change and leadership competencies. Mentorship is proposed as a powerful strategy for promoting the cardiovascular nursing role and equipping individual nurses to contribute meaningfully to health system reform and community engagement in CVD risk reduction. Copyright © 2011 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

Diagnostic Techniques Used to Study Chemical-Vapor-Deposited Diamond Films

NASA Technical Reports Server (NTRS)

Miyoshi, Kazuhisa

2000-01-01

The advantages and utility of chemical-vapor-deposited (CVD) diamond as an industrial ceramic can only be realized if the price and quality are right. Until recently, this technology was of interest only to the academic and basic research community. However, interest has grown because of advances made by leading CVD diamond suppliers: 1) Reduction of the cost of CVD polycrystalline diamond deposition below $5/carat ($8/sq cm); 2) Installation of production capacity; 3) Epitaxial growth of CVD single-crystal diamond. Thus, CVD diamond applications and business are an industrial reality. At present, CVD diamond is produced in the form of coatings or wafers. CVD diamond film technology offers a broader technological potential than do natural and high-pressure synthetic diamonds because size, geometry, and eventually cost will not be as limiting. Now that they are cost effective, diamond coatings - with their extreme properties - can be used in a variety of applications. Diamond coatings can improve many of the surface properties of engineering substrate materials, including erosion, corrosion, and wear resistance. Examples of actual and potential applications, from microelectromechanical systems to the wear parts of diamond coatings and related superhard coatings are described. For example, diamond coatings can be used as a chemical and mechanical barrier for the space shuttles check valves, particularly on the guide pins and seat assemblies.

Improving compliance in remote healthcare systems through smartphone battery optimization.

PubMed

Alshurafa, Nabil; Eastwood, Jo-Ann; Nyamathi, Suneil; Liu, Jason J; Xu, Wenyao; Ghasemzadeh, Hassan; Pourhomayoun, Mohammad; Sarrafzadeh, Majid

2015-01-01

Remote health monitoring (RHM) has emerged as a solution to help reduce the cost burden of unhealthy lifestyles and aging populations. Enhancing compliance to prescribed medical regimens is an essential challenge to many systems, even those using smartphone technology. In this paper, we provide a technique to improve smartphone battery consumption and examine the effects of smartphone battery lifetime on compliance, in an attempt to enhance users' adherence to remote monitoring systems. We deploy WANDA-CVD, an RHM system for patients at risk of cardiovascular disease (CVD), using a wearable smartphone for detection of physical activity. We tested the battery optimization technique in an in-lab pilot study and validated its effects on compliance in the Women's Heart Health Study. The battery optimization technique enhanced the battery lifetime by 192% on average, resulting in a 53% increase in compliance in the study. A system like WANDA-CVD can help increase smartphone battery lifetime for RHM systems monitoring physical activity.

Interferon-γ-Mediated Allograft Rejection Exacerbates Cardiovascular Disease of Hyperlipidemic Murine Transplant Recipients

PubMed Central

Zhou, Jing; Qin, Lingfeng; Yi, Tai; Ali, Rahmat; Li, Qingle; Jiao, Yang; Li, Guangxin; Tobiasova, Zuzana; Huang, Yan; Zhang, Jiasheng; Yun, James J.; Sadeghi, Mehran M.; Giordano, Frank J.; Pober, Jordan S.; Tellides, George

2015-01-01

Rationale Transplantation, the most effective therapy for end-stage organ failure, is markedly limited by early-onset cardiovascular disease (CVD) and premature death of the host. The mechanistic basis of this increased CVD is not fully explained by known risk factors. Objective To investigate the role of alloimmune responses in promoting CVD of organ transplant recipients. Methods and Results We established an animal model of graft-exacerbated host CVD by combining murine models of atherosclerosis (apolipoprotein E-deficient recipients on standard diet) and of intra-abdominal graft rejection (heterotopic cardiac transplantation without immunosuppression). CVD was absent in normolipidemic hosts receiving allogeneic grafts and varied in severity among hyperlipidemic grafted hosts according to recipient-donor genetic disparities, most strikingly across an isolated major histocompatibility complex class II antigen barrier. Host disease manifested as increased atherosclerosis of the aorta that also involved the native coronary arteries and new findings of decreased cardiac contractility, ventricular dilatation, and diminished aortic compliance. Exacerbated CVD was accompanied by greater levels of circulating cytokines, especially interferon-γ and other Th1-type cytokines, and showed both systemic and intra-lesional activation of leukocytes, particularly T helper cells. Serologic neutralization of interferon-γ after allotransplantation prevented graft-related atherosclerosis, cardiomyopathy, and aortic stiffening in the host. Conclusions Our study reveals that sustained activation of the immune system due to chronic allorecognition exacerbates the atherogenic diathesis of hyperlipidemia and results in de novo cardiovascular dysfunction in organ transplant recipients. PMID:26399469

Saturated fat, carbohydrates and cardiovascular disease.

PubMed

Kuipers, R S; de Graaf, D J; Luxwolda, M F; Muskiet, M H A; Dijck-Brouwer, D A J; Muskiet, F A J

2011-09-01

The dietary intake of saturated fatty acids (SAFA) is associated with a modest increase in serum total cholesterol, but not with cardiovascular disease (CVD). Replacing dietary SAFA with carbohydrates (CHO), notably those with a high glycaemic index, is associated with an increase in CVD risk in observational cohorts, while replacing SAFA with polyunsaturated fatty acids (PUFA) is associated with reduced CVD risk. However, replacing a combination of SAFA and trans-fatty acids with n-6 PUFA (notably linoleic acid) in controlled trials showed no indication of benefit and a signal toward increased coronary heart disease risk, suggesting that n-3 PUFA may be responsible for the protective association between total PUFA and CVD. High CHO intakes stimulate hepatic SAFA synthesis and conservation of dietary SAFA . Hepatic de novo lipogenesis from CHO is also stimulated during eucaloric dietary substitution of SAFA by CHO with high glycaemic index in normo-insulinaemic subjects and during hypocaloric high-CHO/low-fat diets in subjects with the metabolic syndrome. The accumulation of SAFA stimulates chronic systemic low-grade inflammation through its mimicking of bacterial lipopolysaccharides and÷or the induction of other pro-inflammatory stimuli. The resulting systemic low-grade inflammation promotes insulin resistance, reallocation of energy-rich substrates and atherogenic dyslipidaemia that concertedly give rise to increased CVD risk. We conclude that avoidance of SAFA accumulation by reducing the intake of CHO with high glycaemic index is more effective in the prevention of CVD than reducing SAFA intake per se.

Onset conditions for gas phase reaction and nucleation in the CVD of transition metal oxides

NASA Technical Reports Server (NTRS)

Collins, J.; Rosner, D. E.; Castillo, J.

1992-01-01

A combined experimental/theoretical study is presented of the onset conditions for gas phase reaction and particle nucleation in hot substrate/cold gas CVD of transition metal oxides. Homogeneous reaction onset conditions are predicted using a simple high activation energy reacting gas film theory. Experimental tests of the basic theory are underway using an axisymmetric impinging jet CVD reactor. No vapor phase ignition has yet been observed in the TiCl4/O2 system under accessible operating conditions (below substrate temperature Tw = 1700 K). The goal of this research is to provide CVD reactor design and operation guidelines for achieving acceptable deposit microstructures at the maximum deposition rate while simultaneously avoiding homogeneous reaction/nucleation and diffusional limitations.

CVD-grown horizontally aligned single-walled carbon nanotubes: synthesis routes and growth mechanisms.

PubMed

Ibrahim, Imad; Bachmatiuk, Alicja; Warner, Jamie H; Büchner, Bernd; Cuniberti, Gianaurelio; Rümmeli, Mark H

2012-07-09

Single-walled carbon nanotubes (SWCNTs) have attractive electrical and physical properties, which make them very promising for use in various applications. For some applications however, in particular those involving electronics, SWCNTs need to be synthesized with a high degree of control with respect to yield, length, alignment, diameter, and chirality. With this in mind, a great deal of effort is being directed to the precision control of vertically and horizontally aligned nanotubes. In this review the focus is on the latter, horizontally aligned tubes grown by chemical vapor deposition (CVD). The reader is provided with an in-depth review of the established vapor deposition orientation techniques. Detailed discussions on the characterization routes, growth parameters, and growth mechanisms are also provided. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The role of the apelinergic and vasopressinergic systems in the regulation of the cardiovascular system and the pathogenesis of cardiovascular disease.

PubMed

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.

Utility of arterial blood gas, CBC, biochemistry and cardiac hormones as evaluation parameters of cardiovascular disease in nonhuman primates.

PubMed

Nakayama, Shunya; Koie, Hiroshi; Kanayama, Kiichi; Katakai, Yuko; Ito-Fujishiro, Yasuyo; Sankai, Tadashi; Yasutomi, Yasuhiro; Ageyama, Naohide

2018-06-11

Cardiovascular disease (CVD) has a tremendous impact on the quality of life of humans. While experimental animals are valuable to medical research as models of human diseases, cardiac systems differ widely across various animal species. Thus, we examined a CVD model in cynomolgus monkeys. Laboratory primates are precious resources, making it imperative that symptoms of diseases and disorders are detected as early as possible. Thus, in this study we comprehensively examined important indicators of CVD in cynomolgus monkeys, including arterial blood gas, complete blood count (CBC), biochemistry, and cardiac hormones. The control group included 20 healthy macaques showing non-abnormal findings in screening tests, whereas the CVD group included 20 macaques with valvular disease and cardiomyopathy. An increase of red blood cell distribution width was observed in the CBC, indicating chronic inflammation related to CVD. An increase of HCO 3 was attributed to the correction of acidosis. Furthermore, development of the CVD model was supported by significant increases in natriuretic peptides. It is suggested that these results indicated a correlation between human CVD and the model in monkeys. Moreover, blood tests including arterial blood gas are non-invasive and can be performed more easily than other technical tests. CVD affected animals easily change their condition by anesthesia and surgical invasion. Pay attention to arterial blood gas and proper respond to their condition are important for research. This data may facilitate human research and aid in the management and veterinary care of nonhuman primates.

Formation of 3D graphene foams on soft templated metal monoliths

NASA Astrophysics Data System (ADS)

Tynan, Michael K.; Johnson, David W.; Dobson, Ben P.; Coleman, Karl S.

2016-07-01

Graphene foams are leading contenders as frameworks for polymer thermosets, filtration/pollution control and for use as an electrode material in energy storage devices, taking advantage of graphene's high electrical conductivity and the porous structure of the foam. Here we demonstrate a simple synthesis of a macroporous 3D graphene material templated from a dextran/metal salt gel, where the metal was cobalt, nickel, copper, and iron. The gel was annealed to form a metal oxide foam prior to a methane chemical vapour deposition (CVD). Cobalt metal gels were shown to afford the highest quality material as determined by electron microscopy (SEM and TEM) and Raman spectroscopy.Graphene foams are leading contenders as frameworks for polymer thermosets, filtration/pollution control and for use as an electrode material in energy storage devices, taking advantage of graphene's high electrical conductivity and the porous structure of the foam. Here we demonstrate a simple synthesis of a macroporous 3D graphene material templated from a dextran/metal salt gel, where the metal was cobalt, nickel, copper, and iron. The gel was annealed to form a metal oxide foam prior to a methane chemical vapour deposition (CVD). Cobalt metal gels were shown to afford the highest quality material as determined by electron microscopy (SEM and TEM) and Raman spectroscopy. Electronic supplementary information (ESI) available: Raman, EDX, PXRD, TGA, electrical conductivity data and SEM. See DOI: 10.1039/c6nr02455f

Evaluation of HDL-modulating interventions for cardiovascular risk reduction using a systems pharmacology approach[S

PubMed Central

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

Evaluation of HDL-modulating interventions for cardiovascular risk reduction using a systems pharmacology approach.

PubMed

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.

An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy.

PubMed

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.

A Comparative Study of Three Different Chemical Vapor Deposition Techniques of Carbon Nanotube Growth on Diamond Films

DTIC Science & Technology

2013-01-01

catalyst thermal CVD (FCT-CVD) with xylene and ferrocene liquid mixture without any prior catalyst deposition. T-CVD is a low-cost system that can... ferrocene is used as an iron source to promoteCNT growth. Based on these repeatable results, the CNT growth parameters were used to grow CNTs on the...temperature 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

Sex Differences in Type-2 Diabetes: Implications for Cardiovascular Risk Management.

PubMed

Raparelli, Valeria; Morano, Susanna; Franconi, Flavia; Lenzi, Andrea; Basili, Stefania

2017-01-01

Among individuals with Type 2 diabetes (T2DM), cardiovascular disease (CVD) is the leading cause of morbidity and mortality. Sex and gender differences (SGDs) in the cardiovascular consequences of T2DM are relevant suggesting the need for a more aggressive CVD preventive strategy in diabetic women as they lose the so-called &quot;female advantage&quot; in terms of CVD risk comparing with the nondiabetic population. Multiple factors may explain the disproportion in CVD risk among women with diabetes comparing with diabetic men or non-diabetic women. Both genetic and hormonal factors only partially explain SGDs in CVD risk in diabetes. However, women likely reach diagnosis later and in worse conditions, they undergo both diagnostic and therapeutic supports in lower percentage and, finally, they are not able to obtain therapeutic goals recommended by guidelines. Concerning the cardiovascular system, diabetes amplifies the extent of damage at both micro- and macrovascular level differently among sexes. The aim of this review is to clarify, in a sex and gender perspective, the impact of diabetes in CVD risk and to summarize the most important SGDs in CVD primary and secondary prevention strategies such as antiplatelet drugs and statins. The efficacy of ASA and/or statins in secondary prevention is documented in both sexes independently by the presence of T2DM. A different approach to CVD primary prevention with ASA using the age cut-off to discriminate sex differences has been recommended. The use of statins for primary prevention in women should be accurately monitored for the occurrence of myalgia and risk of developing diabetes. A gender approach in CVD prevention strategies is urgently required to achieve a sensible reduction of adverse CV events. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Chronic kidney disease, inflammation, and cardiovascular disease risk in rheumatoid arthritis.

PubMed

Kochi, Masako; Kohagura, Kentaro; Shiohira, Yoshiki; Iseki, Kunitoshi; Ohya, Yusuke

2018-03-01

Rheumatoid arthritis (RA), a prototypic systemic autoimmune inflammatory condition, confers an increased risk of cardiovascular disease (CVD). Recently, chronic kidney disease (CKD) was suggested to increase the risk of CVD in RA patients, and inflammation was identified as a critical, nontraditional CKD-associated risk factor for CVD. This study aimed to examine the combined effects of CKD and CVD in RA patients. In this retrospective evaluation of 428 RA patients, the outcome of interest was the incidence of CVD. CKD was defined as an estimated glomerular filtration rate of <60mL/min/1.73m 2 and/or positive dipstick tests for proteinuria of ≥3 months duration. C-reactive protein (CRP) was used as an inflammation marker, and a high CRP level was defined as a mean CRP value of ≥0.57mg/dL during the first 6 months of follow-up. Patients were categorized as follows: non-CKD with low CRP, non-CKD with high CRP, CKD with low CRP, and CKD with high CRP. During a median follow-up of 89 months, 67 patients (16%) had CKD, and 38 (9%) developed CVD. Using patients with non-CKD and low CRP as a reference group, the adjusted hazard ratios (HR, 95% confidence interval) for CVD were 1.88 (0.25-9.44) for patients with CKD/low CRP and 9.71 (3.27-31.97) for those with CKD/high CRP. The coexistence of CKD and inflammation was associated with a higher risk of CVD than either condition alone in RA patients. Inflammation might increase the risk of CVD especially in patients with CKD. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Imbalanced plasma ACE and ACE2 level in the uremic patients with cardiovascular diseases and its change during a single hemodialysis session.

PubMed

Yang, Chung-Wei; Lu, Li-Che; Chang, Chia-Chu; Cho, Ching-Chang; Hsieh, Wen-Yeh; Tsai, Chin-Hung; Lin, Yi-Chang; Lin, Chih-Sheng

2017-11-01

The renin-angiotensin system (RAS) has significant influences on heart and renal disease progression. Angiotensin converting enzyme (ACE) and angiotensin converting enzyme II (ACE2) are major peptidases of RAS components and play counteracting functions through angiotensin II (Ang II)/ATIR and angiotensin-(1-7) (Ang-(1-7))/Mas axis, respectively. There were 360 uremic patients on regular hemodialysis (HD) treatment (inclusive of 119 HD patients with cardiovascular diseases (CVD) and 241 HD patients without CVD and 50 healthy subjects were enrolled in this study. Plasma ACE, ACE2, Ang II and Ang-(1-7) levels of the HD patients were determined. We compared pre-HD levels of plasma ACE, ACE2, Ang II and Ang-(1-7) in the HD patients with and without CVD to those of the controls. The HD patients, particularly those with CVD, showed a significant increase in the levels of ACE and Ang II, whereas ACE2 and Ang-(1-7) levels were lower than those in the healthy controls. Therefore, imbalanced ACE/ACE2 was observed in the HD patients with CVD. In the course of a single HD session, the plasma ACE, ACE/ACE2 and Ang II levels in the HD patients with CVD were increased from pre-HD to post-HD. On the contrary, ACE2 levels were decreased after the HD session. These changes were not detected in the HD patients without CVD. Pathogenically imbalanced circulating ACE/ACE2 was detected in the HD patients, particularly those with CVD. HD session could increase ACE/Ang II/AT1R axis and decrease ACE2/Ang-(1-7)/Mas axis activity in the circulation of HD patients with CVD.

Effect of magnetic and electric coupling fields on micro- and nano- structure of carbon films in the CVD diamond process and their electron field emission property

NASA Astrophysics Data System (ADS)

Wang, Yijia; Li, Jiaxin; Hu, Naixiu; Jiang, Yunlu; Wei, Qiuping; Yu, Zhiming; Long, Hangyu; Zhu, Hekang; Xie, Youneng; Ma, Li; Lin, Cheng-Te; Su, Weitao

2018-03-01

In this paper, both electric field and magnetic field were used to assist the hot filament chemical vapor deposition (HFCVD) and we systematically investigated the effects of which on the (1) phase composition, (2) grain size, (3) thickness and (4) preferred orientation of diamond films through SEM, Raman and XRD. The application of magnetic field in electric field, so called ‘the magnetic and electric coupling fields’, enhanced the graphitization and refinement of diamond crystals, slowed down the decrease of film thickness along with the increase of bias current, and suppressed diamond (100) orientation. During the deposition process, the electric field provided additional energy to HFCVD system and generated large number of energetic particles which might annihilate at the substrate and lose kinetic energy, while the Lorentz force, provided by magnetic field, could constrict charged particles (including electrons) to do spiral movement, which prolonged their moving path and life, thus the system energy increased. With the graphitization of diamond films intensified, the preferred orientation of diamond films completely evolved from (110) to (100), until the orientation and diamond phase disappeared, which can be attributed to (I) the distribution and concentration ratio of carbon precursors (C2H2 and CH3) and (II) graphitization sequence of diamond crystal facets. Since the electron field emission property of carbon film is sensitive to the phase composition, thickness and preferred orientation, nano- carbon cones, prepared by the negative bias current of 20 mA and magnetic field strength of 80 Gauss, exhibited the lowest turn-on field of 6.1 V -1 μm-1.

Mediterranean studies of cardiovascular disease and hyperglycemia: analytical modeling of population socio-economic transitions (MedCHAMPS)--rationale and methods.

PubMed

Maziak, Wasim; Critchley, Julia; Zaman, Shahaduz; Unwin, Nigel; Capewell, Simon; Bennett, Kathleen; Unal, Belgin; Husseini, Abdullatif; Romdhane, Habiba Ben; Phillimore, Peter

2013-08-01

In response to the escalating epidemic of cardiovascular disease (CVD) in the Mediterranean Region (MR), an international collaboration aiming at understanding the burden of CVD and evaluating cost-effective strategies to combat it was recently established. This paper describes the rationale and methods of the project MedCHAMPS to disseminate this successful experience. The framework of MedCHAMPS is exceptional in combining multiple disciplines (e.g. epidemiology, anthropology, economics), countries [Turkey, Syria, occupied Palestinian territory (oPt), Tunisia, UK, Ireland], research methods (situational and policy analysis, quantitative and qualitative studies, statistical modeling), and involving local stakeholders at all levels to assess trends of CVD/diabetes in the society and attributes of the local health care systems to provide optimal policy recommendations to reduce the burden of CVD/diabetes. MedCHAMPS provides policy makers in the MR and beyond needed guidance about the burden of CVD, and best cost-effective ways to combat it. Our approach of building developed-developing countries collaboration also provides a roadmap for other researchers seeking to build research base into CVD epidemiology and prevention in developing countries.

Significance of vapor phase chemical reactions on CVD rates predicted by chemically frozen and local thermochemical equilibrium boundary layer theories

NASA Technical Reports Server (NTRS)

Gokoglu, Suleyman A.

1988-01-01

This paper investigates the role played by vapor-phase chemical reactions on CVD rates by comparing the results of two extreme theories developed to predict CVD mass transport rates in the absence of interfacial kinetic barrier: one based on chemically frozen boundary layer and the other based on local thermochemical equilibrium. Both theories consider laminar convective-diffusion boundary layers at high Reynolds numbers and include thermal (Soret) diffusion and variable property effects. As an example, Na2SO4 deposition was studied. It was found that gas phase reactions have no important role on Na2SO4 deposition rates and on the predictions of the theories. The implications of the predictions of the two theories to other CVD systems are discussed.

The impact of a point-of-care testing device on CVD risk assessment completion in New Zealand primary-care practice: A cluster randomised controlled trial and qualitative investigation.

PubMed

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.

Cardiovascular disease in autoimmune rheumatic diseases.

PubMed

Hollan, Ivana; Meroni, Pier Luigi; Ahearn, Joseph M; Cohen Tervaert, J W; Curran, Sam; Goodyear, Carl S; Hestad, Knut A; Kahaleh, Bashar; Riggio, Marcello; Shields, Kelly; Wasko, Mary C

2013-08-01

Various autoimmune rheumatic diseases (ARDs), including rheumatoid arthritis, spondyloarthritis, vasculitis and systemic lupus erythematosus, are associated with premature atherosclerosis. However, premature atherosclerosis has not been uniformly observed in systemic sclerosis. Furthermore, although experimental models of atherosclerosis support the role of antiphospholipid antibodies in atherosclerosis, there is no clear evidence of premature atherosclerosis in antiphospholipid syndrome (APA). Ischemic events in APA are more likely to be caused by pro-thrombotic state than by enhanced atherosclerosis. Cardiovascular disease (CVD) in ARDs is caused by traditional and non-traditional risk factors. Besides other factors, inflammation and immunologic abnormalities, the quantity and quality of lipoproteins, hypertension, insulin resistance/hyperglycemia, obesity and underweight, presence of platelets bearing complement protein C4d, reduced number and function of endothelial progenitor cells, apoptosis of endothelial cells, epigenetic mechanisms, renal disease, periodontal disease, depression, hyperuricemia, hypothyroidism, sleep apnea and vitamin D deficiency may contribute to the premature CVD. Although most research has focused on systemic inflammation, vascular inflammation may play a crucial role in the premature CVD in ARDs. It may be involved in the development and destabilization of both atherosclerotic lesions and of aortic aneurysms (a known complication of ARDs). Inflammation in subintimal vascular and perivascular layers appears to frequently occur in CVD, with a higher frequency in ARD than in non-ARD patients. It is possible that this inflammation is caused by infections and/or autoimmunity, which might have consequences for treatment. Importantly, drugs targeting immunologic factors participating in the subintimal inflammation (e.g., T- and B-cells) might have a protective effect on CVD. Interestingly, vasa vasorum and cardiovascular adipose tissue may play an important role in atherogenesis. Inflammation and complement depositions in the vessel wall are likely to contribute to vascular stiffness. Based on biopsy findings, also inflammation in the myocardium and small vessels may contribute to premature CVD in ARDs (cardiac ischemia and heart failure). There is an enormous need for an improved CVD prevention in ARDs. Studies examining the effect of DMARDs/biologics on vascular inflammation and CV risk are warranted. Copyright © 2013 Elsevier B.V. All rights reserved.

Retinal vascular imaging in early life: insights into processes and risk of cardiovascular disease

PubMed Central

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

Electrical and optical performance of transparent conducting oxide films deposited by electrostatic spray assisted vapour deposition.

PubMed

Hou, Xianghui; Choy, Kwang-Leong; Liu, Jun-Peng

2011-09-01

Transparent conducting oxide (TCO) films have the remarkable combination of high electrical conductivity and optical transparency. There is always a strong motivation to produce TCO films with good performance at low cost. Electrostatic Spray Assisted Vapor Deposition (ESAVD), as a variant of chemical vapour deposition (CVD), is a non-vacuum and low-cost deposition method. Several types of TCO films have been deposited using ESAVD process, including indium tin oxide (ITO), antimony-doped tin oxide (ATO), and fluorine doped tin oxide (FTO). This paper reports the electrical and optical properties of TCO films produced by ESAVD methods, as well as the effects of post treatment by plasma hydrogenation on these TCO films. The possible mechanisms involved during plasma hydrogenation of TCO films are also discussed. Reduction and etching effect during plasma hydrogenation are the most important factors which determine the optical and electrical performance of TCO films.

Transition Metal Dichalcogenide Growth via Close Proximity Precursor Supply

NASA Astrophysics Data System (ADS)

O'Brien, Maria; McEvoy, Niall; Hallam, Toby; Kim, Hye-Young; Berner, Nina C.; Hanlon, Damien; Lee, Kangho; Coleman, Jonathan N.; Duesberg, Georg S.

2014-12-01

Reliable chemical vapour deposition (CVD) of transition metal dichalcogenides (TMDs) is currently a highly pressing research field, as numerous potential applications rely on the production of high quality films on a macroscopic scale. Here, we show the use of liquid phase exfoliated nanosheets and patterned sputter deposited layers as solid precursors for chemical vapour deposition. TMD monolayers were realized using a close proximity precursor supply in a CVD microreactor setup. A model describing the growth mechanism, which is capable of producing TMD monolayers on arbitrary substrates, is presented. Raman spectroscopy, photoluminescence, X-ray photoelectron spectroscopy, atomic force microscopy, transmission electron microscopy, scanning electron microscopy and electrical transport measurements reveal the high quality of the TMD samples produced. Furthermore, through patterning of the precursor supply, we achieve patterned growth of monolayer TMDs in defined locations, which could be adapted for the facile production of electronic device components.

Intrinsic electrical transport and performance projections of synthetic monolayer MoS2 devices

NASA Astrophysics Data System (ADS)

Smithe, Kirby K. H.; English, Chris D.; Suryavanshi, Saurabh V.; Pop, Eric

2017-03-01

We demonstrate monolayer (1L) MoS2 grown by chemical vapor deposition (CVD) with transport properties comparable to those of the best exfoliated 1L devices over a wide range of carrier densities (up to ˜1013 cm-2) and temperatures (80-500 K). Transfer length measurements decouple the intrinsic material mobility from the contact resistance, at practical carrier densities (>1012 cm-2). We demonstrate the highest current density reported to date (˜270 μA μm-1 or 44 MA cm-2) at 300 K for an 80 nm long device from CVD-grown 1L MoS2. Using simulations, we discuss what improvements of 1L MoS2 are still required to meet technology roadmap requirements for low power and high performance applications. Such results are an important step towards large-area electronics based on 1L semiconductors.

EDC-mediated DNA attachment to nanocrystalline CVD diamond films.

PubMed

Christiaens, P; Vermeeren, V; Wenmackers, S; Daenen, M; Haenen, K; Nesládek, M; vandeVen, M; Ameloot, M; Michiels, L; Wagner, P

2006-08-15

Chemical vapour deposited (CVD) diamond is a very promising material for biosensor fabrication owing both to its chemical inertness and the ability to make it electrical semiconducting that allows for connection with integrated circuits. For biosensor construction, a biochemical method to immobilize nucleic acids to a diamond surface has been developed. Nanocrystalline diamond is grown using microwave plasma-enhanced chemical vapour deposition (MPECVD). After hydrogenation of the surface, 10-undecenoic acid, an omega-unsaturated fatty acid, is tethered by 254 nm photochemical attachment. This is followed by 1-ethyl-3-[3-dimethylaminopropyl]carbodiimide (EDC)-mediated attachment of amino (NH(2))-modified dsDNA. The functionality of the covalently bound dsDNA molecules is confirmed by fluorescence measurements, PCR and gel electrophoresis during 35 denaturation and rehybridisation steps. The linking method after the fatty acid attachment can easily be applied to other biomolecules like antibodies and enzymes.

Optical, electrical, and photovoltaic properties of PbS thin films by anionic and cationic dopants

NASA Astrophysics Data System (ADS)

Cheraghizade, Mohsen; Jamali-Sheini, Farid; Yousefi, Ramin

2017-06-01

Lead sulfide (PbS) thin films were deposited by CVD method to examine the effects of anionic and cationic dopants on optical and electrical properties for photovoltaic applications. XRD diffractograms verified the formation of cubic phase of multicrystalline PbS thin films. FESEM images showed surface morphologies in nano-dimensions (rods and flowers). UV-Vis-NIR spectrum revealed absorbance in the visible and NIR regions for all samples, in which dopants decreased the intensity of absorbance. Se as an anionic dopant for PbS thin films increased electrical resistance, acceptor concentrations, and crystallite defects, and decreased flat-band voltage and depletion width. Finally, photovoltaic measurements indicated that Zn-doped PbS thin film, as a photovoltaic cell, exhibited higher conversion efficiency and external quantum efficiency (EQE).

Risk scoring for the primary prevention of cardiovascular disease.

PubMed

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.

Tractable Chemical Models for CVD of Silicon and Carbon

NASA Technical Reports Server (NTRS)

Blanquet, E.; Gokoglu, S. A.

1993-01-01

Tractable chemical models are validated for the CVD of silicon and carbon. Dilute silane (SiH4) and methane (CH4) in hydrogen are chosen as gaseous precursors. The chemical mechanism for each systems Si and C is deliberately reduced to three reactions in the models: one in the gas phase and two at the surface. The axial-flow CVD reactor utilized in this study has well-characterized flow and thermal fields and provides variable deposition rates in the axial direction. Comparisons between the experimental and calculated deposition rates are made at different pressures and temperatures.

A wearable smartphone-based platform for real-time cardiovascular disease detection via electrocardiogram processing.

PubMed

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.

CVD growth of large-area and high-quality HfS2 nanoforest on diverse substrates

NASA Astrophysics Data System (ADS)

Zheng, Binjie; Wang, Zegao; Qi, Fei; Wang, Xinqiang; Yu, Bo; Zhang, Wanli; Chen, Yuanfu

2018-03-01

Two-dimensional layered transition metal dichalcogenides (TMDs) have attracted burgeoning attention due to their various properties and wide potential applications. As a new TMD, hafnium disulfide (HfS2) is theoretically predicted to have better electrical performance than widely studied MoS2. The experimental researches also confirmed the extraordinary feature in electronics and optoelectronics. However, the maximal device performance may not be achieved due to its own limitation of planar structure and challenge of transfer without contamination. Here, through the chemical vapor deposition (CVD) technique, inch-size HfS2 nanoforest has been directly grown on diverse objective substrates covering insulating, semiconducting and conducting substrates. This direct CVD growth without conventional transfer process avoids contamination and degradation in quality, suggesting its promising and wide applications in high-quality and multifarious devices. It is noted that all the HfS2 nanoforests grown on diverse substrates are constructed with vertically aligned few-layered HfS2 nanosheets with high crystalline quality and edge orientation. Moreover, due to its unique structure, the HfS2 nanoforest owns abundant exposed edge sites and large active surface area, which is essential to apply in high-performance catalyst, sensor, and energy storage or field emitter.

Alternative group V precursors for CVD applications

NASA Astrophysics Data System (ADS)

Lum, R. M.; Klingert, J. K.

1991-01-01

The chemical vapor deposition (CVD) techniques used to grow III/V semiconductors films, such as metalorganic vapor phase epitaxy (MOVPE), hydride VPE, chemical beam epitaxy (CBE) and gas source molecular beam epitaxy (GS-MBE), all use hydrides (AsH 3 and PH 3) as the Group V source. However, the hydrides are extremely toxic gases which are stored under high pressure (200-2000 psi). To reduce the safety hazards associated with these gases, alternative Group V precursors have been investigated. Organoarsenic and phosphorous compounds have received the most attention as replacements for AsH 3 and PH 3 because they are typically low vapor pressure liquids, and thus present significantly lower exposure risks than the hydrides. For AsH 3 these have included the methyl, ethyl and butyl-based derivatives RnAsH 3- n, with varying degrees ( n = 1-3) of hydrogen atom substitution. In this paper the growth properties, thermochemistry and toxicity of the various alkylarsine precursors are compared with arsine. Data are presented on the impact of the thermochemistry of these compounds on film electrical properties, and on the effects of precursor composition and purity on overall film quality. The suitability of alternative As-precursors for device applications is demonstrated, and selection criteria are presented for the most effective alkylarsine compound for a particular CVD growth process.

Chemical Vapor Deposition Synthesis of Graphene-Based Materials and Chemical Modulation of Graphene Electronics

NASA Astrophysics Data System (ADS)

Yan, Zheng

Graphene, a two-dimensional sp2-bonded carbon material, has attracted enormous attention due to its excellent electrical, optical and mechanical properties. Recently developed chemical vapor deposition (CVD) methods could produce large-size and uniform polycrystalline graphene films, limited to gas carbon sources, metal catalyst substrates and degraded properties induced by grain boundaries. Meanwhile, pristine monolayer graphene exhibits a standard ambipolar behavior with a zero neutrality point in field-effect transistors (FETs), limiting its future electronic applications. This thesis starts with the investigation of CVD synthesis of pristine and N-doped graphene with controlled thickness using solid carbon sources on metal catalyst substrates (chapter 1), and then discusses the direct growth of bilayer graphene on insulating substrates, including SiO2, h-BN, Si3N4 and Al2O3, without needing further transfer-process (chapter 2). Chapter 3 discusses the synthesis of high-quality graphene single crystals and hexagonal onion-ring-like graphene domains, and also explores the basic growth mechanism of graphene on Cu substrates. To extend graphene's potential applications, both vertical and planar graphene-carbon nanotube hybrids are fabricated using CVD method and their interesting properties are investigated (chapter 4). Chapter 5 discusses how to use chemical methods to modulate graphene's electronic behaviors.

Role of mitochondrial dysfunction and altered autophagy in cardiovascular aging and disease: from mechanisms to therapeutics

PubMed Central

Marzetti, Emanuele; Csiszar, Anna; Dutta, Debapriya; Balagopal, Gauthami; Calvani, Riccardo

2013-01-01

Advanced age is associated with a disproportionate prevalence of cardiovascular disease (CVD). Intrinsic alterations in the heart and the vasculature occurring over the life course render the cardiovascular system more vulnerable to various stressors in late life, ultimately favoring the development of CVD. Several lines of evidence indicate mitochondrial dysfunction as a major contributor to cardiovascular senescence. Besides being less bioenergetically efficient, damaged mitochondria also produce increased amounts of reactive oxygen species, with detrimental structural and functional consequences for the cardiovascular system. The age-related accumulation of dysfunctional mitochondrial likely results from the combination of impaired clearance of damaged organelles by autophagy and inadequate replenishment of the cellular mitochondrial pool by mitochondriogenesis. In this review, we summarize the current knowledge about relevant mechanisms and consequences of age-related mitochondrial decay and alterations in mitochondrial quality control in the cardiovascular system. The involvement of mitochondrial dysfunction in the pathogenesis of cardiovascular conditions especially prevalent in late life and the emerging connections with neurodegeneration are also illustrated. Special emphasis is placed on recent discoveries on the role played by alterations in mitochondrial dynamics (fusion and fission), mitophagy, and their interconnections in the context of age-related CVD and endothelial dysfunction. Finally, we discuss pharmacological interventions targeting mitochondrial dysfunction to delay cardiovascular aging and manage CVD. PMID:23748424

Mechanisms of vascular aging: What can we learn from Hutchinson-Gilford progeria syndrome?

PubMed

Del Campo, Lara; Hamczyk, Magda R; Andrés, Vicente; Martínez-González, José; Rodríguez, Cristina

Aging is the main risk factor for cardiovascular disease (CVD). The increased prevalence of CVD is partly due to the global increase in life expectancy. In this context, it is essential to identify the mechanisms by which aging induces CVD, with the ultimate aim of reducing its incidence. Both atherosclerosis and heart failure significantly contribute to age-associated CVD morbidity and mortality. Hutchinson-Gilford progeria syndrome (HGPS) is a rare genetic disorder caused by the synthesis of progerin, which is noted for accelerated aging and CVD. This mutant form of prelamin A induces generalised atherosclerosis, vascular calcification, and cardiac electrophysiological abnormalities, leading to premature aging and death, mainly due to myocardial infarction and stroke. This review discusses the main vascular structural and functional abnormalities during physiological and premature aging, as well as the mechanisms involved in the exacerbated CVD and accelerated aging induced by the accumulation of progerin and prelamin A. Both proteins are expressed in non-HGPS individuals, and physiological aging shares many features of progeria. Research into HGPS could therefore shed light on novel mechanisms involved in the physiological aging of the cardiovascular system. Copyright © 2018 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

Cardiovascular disease prevention and lifestyle interventions: effectiveness and efficacy.

PubMed

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.

The relationship of brachial-ankle pulse wave velocity to future cardiovascular disease events in the general Japanese population: the Takashima Study.

PubMed

Takashima, N; Turin, T C; Matsui, K; Rumana, N; Nakamura, Y; Kadota, A; Saito, Y; Sugihara, H; Morita, Y; Ichikawa, M; Hirose, K; Kawakani, K; Hamajima, N; Miura, K; Ueshima, H; Kita, Y

2014-05-01

Brachial-ankle pulse wave velocity (baPWV) is a non-invasive measure of arterial stiffness obtained using an automated system. Although baPWVs have been widely used as a non-invasive marker for evaluation of arterial stiffness, evidence for the prognostic value of baPWV in the general population is scarce. In this study, we assessed the association between baPWV and future cardiovascular disease (CVD) incidence in a Japanese population. From 2002 to 2009, baPWV was measured in a total of 4164 men and women without a history of CVD, and they were followed up until the end of 2009 with a median follow-up period of 6.5 years. Hazard ratios (HRs) for CVD incidence according to baPWV levels were calculated using a Cox proportional hazards model adjusted for potential confounding factors, including seated or supine blood pressure (BP). During the follow-up period, we observed 40 incident cases of CVD. In multivariable-adjusted model, baPWV as a continuous variable was not significantly associated with future CVD risk after adjustment for supine BP. However, compared with lower baPWV category (<18 m s(-1)), higher baPWV (< or = 18.0 m s(-1)) was significantly associated with an increased CVD risk (HR: 2.70, 95% confidence interval: 1.18-6.19). Higher baPWV (< or = 18.0 m s(-1)) would be an independent predictor of future CVD event in the general Japanese population.

E-Bra system for women ECG measurement with GPRS communication, Nanosensor, and motion artifact remove algorithm

NASA Astrophysics Data System (ADS)

Kwon, Hyeokjun; Oh, Sechang; Kumar, Prashanth S.; Varadan, Vijay K.

2012-10-01

CardioVascular Disease(CVD)s lead the sudden cardiac death due to irregular phenomenon of the cardiac signal by the abnormal case of blood vessel and cardiac structure. For last two decades, cardiac disease research for man is under active discussion. As a result, the death rate by cardiac disease in men has been falling gradually compared with relatively increasing the women death rate due to CVD[2]. The main reason of this phenomenon causes the lack a sense of the seriousness to female CVD and different symptom of female CVD compared with the symptoms of male CVD. Usually, because the women CVD accompanies with ordinary symptoms unrecognizing the heart abnormality signal such as unusual fatigue, sleep disturbances, shortness of breath, anxiety, chest discomfort, and indigestion dyspepsia, most women CVD patients do not realize that these symptoms are related to the CVD symptoms. Therefore, periodic ECG signal observation is required for women cardiac disease patients. ElectroCardioGram(ECG) detection, treadmill test/exercise ECG, nuclear scan, coronary angiography, and intracoronary ultrasound are used to diagnose abnormality of heart. Among the medical checkup methods for CVDs checkup, it is very effective method for the diagnosis of cardiac disease and the early detection of heart abnormality to monitor ECG periodically. This paper suggests the effective ECG monitoring system for woman by attaching the system on woman's brassiere by using augmented chest lead attachment method. The suggested system in this paper consists of ECG signal transmission system and a server program to display and analyze the transmitted ECG. The ECG signal transmission system consists of three parts such as ECG physical signal detection part with two electrodes made by gold nanowire structure, data acquisition with AD converter, and data transmission part with GPRS(General Packet Radio Service) communication. Usually, to detect human bio signal, Ag/AgCl or gold cup electrodes are used with conductive gel. However, the gel can be dried when taking long time monitoring. The gold nanowire structure electrodes without consideration of uncomfortable usage of gel are attached on beneath the chest position of a brassiere, and the electrodes convert the physical ECG signal to voltage potential signal. The voltage potential ECG signal is converted to digital signal by AD converter included in microprocessor. The converted ECG signal by AD converter is saved on every 1 sec period in the internal RAM in microprocessor. For transmission of the saved data in the internal RAM to a server computer locating at remote area, the system uses the GPRS communication technology, which can develop the wide area network(WAP) without any gateway and repeater. In addition, the transmission system is operated on client mode of GPRS communication. The remote server is installed a program including the functions of displaying and analyzing the transmitted ECG. To display the ECG data, the program is operated with TCP/IP server mode and static IP address, and to analyze the ECG data, the paper suggests motion artifact remove algorithm including adaptive filter with LMS(least mean square), baseline detection algorithm using predictability estimation theory, a filter with moving weighted factor, low pass filter, peak to peak detection, and interpolation.

Differences in subclinical cardiovascular disease between African American and Caucasian women with systemic lupus erythematosus.

PubMed

Rhew, Elisa Y; Manzi, Susan M; Dyer, Alan R; Kao, Amy H; Danchenko, Natalya; Barinas-Mitchell, Emma; Sutton-Tyrrell, Kim; McPherson, David D; Pearce, William; Edmundowicz, Daniel; Kondos, George T; Ramsey-Goldman, Rosalind

2009-02-01

Racial differences exist in disease rates and mortality in both cardiovascular disease (CVD) and systemic lupus erythematosus (SLE). The objective of this cross-sectional study was to compare the frequency and risk factors for subclinical CVD in African American (AA) and Caucasian women with SLE and no prior CVD events. Traditional CVD risk factors and SLE-related factors were assessed in 309 SLE women. Subclinical CVD was assessed by carotid ultrasound to measure intimamedial thickness (IMT) and plaque, and electron beam computed tomography (EBCT) was used to measure coronary artery calcium (CAC). AA women had less education and higher levels of body mass index, blood pressure, lipoprotein(a), C-reactive protein (CRP), fibrinogen, and erythrocyte sedimentation rate (ESR). However, AA women had lower albumin, more and longer duration of corticosteroid use, higher SLE disease activity and damage, and more dsDNA antibodies compared with Caucasian women after adjustment for age and study site. More AA women had carotid plaque (adjusted odds ratio [OR], 1.94; 95% confidence interval [CI], 1.03-3.65) and higher carotid IMT (0.620 vs 0.605 mm, P = 0.07) but similar CAC compared with Caucasians. A multivariate analysis revealed that the following risk factor variables were significantly different between the racial groups and associated with plaque: blood pressure, current corticosteroid use, SLE disease activity, and SLE damage. All factors contributed to the result, but no individual risk factor fully accounted for the association between race and plaque. In conclusion, the presence of carotid plaque was higher in AA compared with Caucasian women with SLE, in contrast to studies of non-SLE subjects, in which AA have similar or less plaque than Caucasians. A combination of SLE-related and traditional CVD risk factors explained the racial difference in plaque burden.

Differences in Subclinical Cardiovascular Disease between African American and Caucasian Women with Systemic Lupus Erythematosus

PubMed Central

Rhew, Elisa Y.; Manzi, Susan M.; Dyer, Alan R.; Kao, Amy H.; Danchenko, Natalya; Barinas-Mitchell, Emma; Sutton-Tyrrell, Kim; McPherson, David D.; Pearce, William; Edmundowicz, Daniel; Kondos, George T.; Ramsey-Goldman, Rosalind

2009-01-01

Racial differences exist in disease rates and mortality in both cardiovascular disease (CVD) and Systemic Lupus Erythematosus (SLE). The objective of this cross-sectional study was to compare the frequency of and risk factors for subclinical CVD in African-American (AA) and Caucasian women with SLE and no prior CVD events. Traditional CVD risk factors and SLE-related factors were assessed in 309 SLE women. Subclinical CVD was assessed by carotid ultrasound to measure intima-medial thickness (IMT) and plaque, and electron beam computed tomography (EBCT) to measure coronary artery calcium (CAC). AA had less education, higher body mass index, blood pressure, lipoprotein(a), CRP, fibrinogen, and ESR, but lower albumin; more and longer duration of corticosteroid use; higher SLE disease activity and damage; and more had dsDNA antibodies compared to Caucasian women, after adjustment for age and study-site. More AA had carotid plaque (adjusted OR 1.94, 95%CI 1.03, 3.65) and higher carotid IMT (0.620 vs. 0.605mm, p=0.07) compared with Caucasians, but similar CAC. Multivariate analysis included risk factor variables significantly different between the racial groups and associated with plaque: blood pressure, current corticosteroid use, SLE disease activity and damage. All factors contributed, but no individual risk factor fully accounted for the association between race and plaque. In conclusion, the presence of carotid plaque was higher in AA compared with Caucasian women with SLE, in contrast to studies of non-SLE subjects, where AA have similar or less plaque than Caucasians. A combination of SLE-related and traditional CVD risk factors explained the racial difference in plaque burden. PMID:19138649

Exercise Prescription in Patients with Different Combinations of Cardiovascular Disease Risk Factors: A Consensus Statement from the EXPERT Working Group.

PubMed

Hansen, Dominique; Niebauer, Josef; Cornelissen, Veronique; Barna, Olga; Neunhäuserer, Daniel; Stettler, Christoph; Tonoli, Cajsa; Greco, Eugenio; Fagard, Robert; Coninx, Karin; Vanhees, Luc; Piepoli, Massimo F; Pedretti, Roberto; Ruiz, Gustavo Rovelo; Corrà, Ugo; Schmid, Jean-Paul; Davos, Constantinos H; Edelmann, Frank; Abreu, Ana; Rauch, Bernhard; Ambrosetti, Marco; Braga, Simona Sarzi; Beckers, Paul; Bussotti, Maurizio; Faggiano, Pompilio; Garcia-Porrero, Esteban; Kouidi, Evangelia; Lamotte, Michel; Reibis, Rona; Spruit, Martijn A; Takken, Tim; Vigorito, Carlo; Völler, Heinz; Doherty, Patrick; Dendale, Paul

2018-05-04

Whereas exercise training is key in the management of patients with cardiovascular disease (CVD) risk (obesity, diabetes, dyslipidaemia, hypertension), clinicians experience difficulties in how to optimally prescribe exercise in patients with different CVD risk factors. Therefore, a consensus statement for state-of-the-art exercise prescription in patients with combinations of CVD risk factors as integrated into a digital training and decision support system (the EXercise Prescription in Everyday practice & Rehabilitative Training (EXPERT) tool) needed to be established. EXPERT working group members systematically reviewed the literature for meta-analyses, systematic reviews and/or clinical studies addressing exercise prescriptions in specific CVD risk factors and formulated exercise recommendations (exercise training intensity, frequency, volume and type, session and programme duration) and exercise safety precautions, for obesity, arterial hypertension, type 1 and 2 diabetes, and dyslipidaemia. The impact of physical fitness, CVD risk altering medications and adverse events during exercise testing was further taken into account to fine-tune this exercise prescription. An algorithm, supported by the interactive EXPERT tool, was developed by Hasselt University based on these data. Specific exercise recommendations were formulated with the aim to decrease adipose tissue mass, improve glycaemic control and blood lipid profile, and lower blood pressure. The impact of medications to improve CVD risk, adverse events during exercise testing and physical fitness was also taken into account. Simulations were made of how the EXPERT tool provides exercise prescriptions according to the variables provided. In this paper, state-of-the-art exercise prescription to patients with combinations of CVD risk factors is formulated, and it is shown how the EXPERT tool may assist clinicians. This contributes to an appropriately tailored exercise regimen for every CVD risk patient.

Evidence for increased chylomicron remnants in rheumatoid arthritis.

PubMed

Burggraaf, Benjamin; van Breukelen-van der Stoep, Deborah F; van Zeben, Jendé; van der Meulen, Noelle; van de Geijn, Gert-Jan M; Liem, Anho; Valdivielso, Pedro; Rioja Villodres, José; Ramírez-Bollero, José; van der Zwan, Ellen; Castro Cabezas, Manuel

2018-02-01

Levels of apolipoprotein (apo) B48 may be increased in conditions associated with systemic inflammation and increased cardiovascular disease (CVD) risk such as rheumatoid arthritis (RA). We aimed to evaluate apo B48 levels in patients with RA in relation to subclinical atherosclerosis. Patients with RA (without CVD) and controls without RA but with high CVD risk (based on the presence of diabetes mellitus or a history of CVD) and healthy controls were included in this cross-sectional study. Carotid intima-media thickness (cIMT) was measured as a surrogate for vascular damage. In total, 312 patients with RA, 65 controls with high CVD risk and 36 healthy controls were included. Patients with RA had the highest mean apo B48 (10.00 ± 6.65 mg/L) compared to controls with high CVD risk and healthy controls (8.37 ± 5.16 and 5.22 ± 2.46, P < .001). Triglycerides levels were comparable with controls. In RA, apo B48 correlated positively with triglycerides (r = .645; P < .001) but not with cIMT. However, in RA subjects not using lipid or blood pressure lowering medication, a weak correlation was found with cIMT (r = .157; P = .014). RA patients in the highest apo B48 tertile were more often rheumatoid factor positive and anti-CCP positive compared to the lowest tertile. Rheumatoid arthritis patients have higher levels of apo B48 compared to controls with high CVD risk and healthy controls, with normal levels of triglycerides. This accumulation of atherogenic chylomicron remnants may contribute to the elevated CVD risk in RA patients. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

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.

A beam radiation monitor based on CVD diamonds for SuperB

NASA Astrophysics Data System (ADS)

Cardarelli, R.; Di Ciaccio, A.

2013-08-01

Chemical Vapor Deposition (CVD) diamond particle detectors are in use in the CERN experiments at LHC and at particle accelerator laboratories in Europe, USA and Japan mainly as beam monitors. Nowadays it is considered a proven technology with a very fast signal read-out and a very high radiation tolerance suitable for measurements in high radiation environment zones i.e. near the accelerators beam pipes. The specific properties of CVD diamonds make them a prime candidate for measuring single particles as well as high-intensity particle cascades, for timing measurements on the sub-nanosecond scale and for beam protection systems in hostile environments. A single-crystalline CVD (scCVD) diamond sensor, read out with a new generation of fast and high transition frequency SiGe bipolar transistor amplifiers, has been tested for an application as radiation monitor to safeguard the silicon vertex tracker in the SuperB detector from excessive radiation damage, cumulative dose and instantaneous dose rates. Test results with 5.5 MeV alpha particles from a 241Am radioactive source and from electrons from a 90Sr radioactive source are presented in this paper.

Synthesis of sea urchin-like carbon nanotubes on nano-diamond powder.

PubMed

Hwang, E J; Lee, S K; Jeong, M G; Lee, Y B; Lim, D S

2012-07-01

Carbon nanotubes (CNTs) have unique atomic structure and properties, such as a high aspect ratio and high mechanical, electrical and thermal properties. On the other hand, the agglomeration and entanglement of CNTs restrict their applications. Sea urchin-like multiwalled carbon nanotubes, which have a small aspect ratio, can minimize the problem of dispersion. The high hardness, thermal conductivity and chemical inertness of the nano-diamond powder make it suitable for a wide range of applications in the mechanical and electronic fields. CNTs were synthesized on nano-diamond powder by thermal CVD to fabricate a filler with suitable mechanical properties and chemical stability. This paper reports the growth of CNTs with a sea urchin-like structure on the surface of the nano-diamond powder. Nano-diamond powders were dispersed in an attritional milling system using zirconia beads in ethanol. After the milling process, 3-aminopropyltrimethoxysilane (APS) was added as a linker. Silanization was performed between the nano-diamond particles and the metal catalyst. Iron chloride was used as a catalyst for the fabrication of the CNTs. After drying, catalyst-attached nano-diamond powders could be achieved. The growth of the carbon nanotubes was carried out by CVD. The CNT morphology was examined by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The mean diameter and length of the CNTs were 201 nm and 3.25 microm, respectively.

Centimeter Scale Patterned Growth of Vertically Stacked Few Layer Only 2D MoS2/WS2 van der Waals Heterostructure.

PubMed

Choudhary, Nitin; Park, Juhong; Hwang, Jun Yeon; Chung, Hee-Suk; Dumas, Kenneth H; Khondaker, Saiful I; Choi, Wonbong; Jung, Yeonwoong

2016-05-05

Two-dimensional (2D) van der Waal (vdW) heterostructures composed of vertically-stacked multiple transition metal dichalcogenides (TMDs) such as molybdenum disulfide (MoS2) and tungsten disulfide (WS2) are envisioned to present unprecedented materials properties unobtainable from any other material systems. Conventional fabrications of these hybrid materials have relied on the low-yield manual exfoliation and stacking of individual 2D TMD layers, which remain impractical for scaled-up applications. Attempts to chemically synthesize these materials have been recently pursued, which are presently limited to randomly and scarcely grown 2D layers with uncontrolled layer numbers on very small areas. Here, we report the chemical vapor deposition (CVD) growth of large-area (>2 cm(2)) patterned 2D vdW heterostructures composed of few layer, vertically-stacked MoS2 and WS2. Detailed structural characterizations by Raman spectroscopy and high-resolution/scanning transmission electron microscopy (HRTEM/STEM) directly evidence the structural integrity of two distinct 2D TMD layers with atomically sharp vdW heterointerfaces. Electrical transport measurements of these materials reveal diode-like behavior with clear current rectification, further confirming the formation of high-quality heterointerfaces. The intrinsic scalability and controllability of the CVD method presented in this study opens up a wide range of opportunities for emerging applications based on the unconventional functionalities of these uniquely structured materials.

Management of Coronary Artery Disease in South Asian Populations: Why and How to Prevent and Treat Differently.

PubMed

Ahmed, Emad; El-Menyar, Ayman

2016-03-01

The South Asian (SA) population constitutes one of the largest ethnic groups in the world. Several studies that compared host and migrant populations around the world indicate that SAs have a higher risk of developing cardiovascular disease (CVD) than their native-born counterparts. Herein, we review the literature to address the role of the screening tools, scoring systems, and guidelines for primary, secondary, and tertiary prevention in these populations. Management based on screening for the CVD risk factors in a high-risk population such as SAs can improve health care outcomes. There are many scoring tools for calculating 10-year CVD risk; however, each scoring system has its limitations in this particular ethnicity. Further work is needed to establish a unique scoring and guidelines in SAs. © The Author(s) 2015.

Robofurnace: A semi-automated laboratory chemical vapor deposition system for high-throughput nanomaterial synthesis and process discovery

PubMed Central

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

Growth of High-Quality Carbon Nanotudes on Free-Standing Diamond Substrates (Postprint)

DTIC Science & Technology

2010-03-01

thickness and consisting of 20 nm diameter tubes were observed to grow in a thermal CVD system using C2H2 as precursor, Transmission electron microscopy...multi walled CNTs forming a mat of 5 lm thickness and consisting of 20 nm diameter tubes were observed to grow in a thermal CVD system using C2H2...desired devices. For example, chip cooling with CNT microfin architectures have been recently proposed by Kordas et al. [5]. CNT films as thermal

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

Shift work and cardiovascular disease - pathways from circadian stress to morbidity.

PubMed

Puttonen, Sampsa; Härmä, Mikko; Hublin, Christer

2010-03-01

In order to establish a causal relation between shift work and cardiovascular disease (CVD), we need to verify the pathways from the former to the latter. This paper aims to review the current knowledge of the mechanisms between shift work and CVD. Shift work can increase the risk of CVD by several interrelated psychosocial, behavioral, and physiological mechanisms. The psychosocial mechanisms relate to difficulties in controlling working hours, decreased work-life balance, and poor recovery following work. The most probable behavioral changes are weight gain and smoking. The plausible physiological and biological mechanisms are related to the activation of the autonomic nervous system, inflammation, changed lipid and glucose metabolism, and related changes in the risk for atherosclerosis, metabolic syndrome, and type II diabetes. The data provide evidence for possible disease mechanisms between shift work and CVD, but compelling evidence on any specific mechanism is missing.

iCVD Cyclic Polysiloxane and Polysilazane as Nanoscale Thin-Film Electrolyte: Synthesis and Properties.

PubMed

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.

The enhancement in electrical analysis of the nitrogen doped amorphous carbon thin films (a-C:N) prepared by aerosol-assisted CVD

NASA Astrophysics Data System (ADS)

Fadzilah, A. N.; Dayana, K.; Rusop, M.

2018-05-01

This paper reports on the deposition of Nitrogen doped amorphous carbon (a-C:N) by Aerosol-assisted Chemical Vapor Deposition (AACVD) using natural source of camphor oil as the precursor material. 5 samples were deposited at 5 different deposition times from 15 min to 90 min, with 15 min interval for each sample. The highest slope of linear graph was noted at the sample with 45 min deposition time, showing the lowest electrical resistance of the sample. From I-V characteristic, the sample deposited at 45 min has the highest electrical conductivity due to high sp2 carbon bonding ratio. Nanostructured behavior of N doped a-C:N was also investigated by FESEM micrograph resulting with the particle size less than 100nm.

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.

Direct growth of ZnO tetrapod on glass substrate by Chemical Vapor Deposition Technique

NASA Astrophysics Data System (ADS)

Fadzil, M. F. M.; Rahman, R. A.; Azhar, N. E. A.; Aziz, T. N. T. A.; Zulkifli, Z.

2018-03-01

This research demonstrates the growth of ZnO tetrapod structure on glass substrate for different types of flow gas and at different growth temperatures. The study on the morphological structure and electrical properties of ZnO thin film growth by Chemical Vapour Deposition (CVD) technique showed that the optimum growth temperature was obtained at 750°C with ZnO nanotetrapod morphological structure. Introducing Nitrogen gas flow during the growth process exhibited leg-to-leg linking ZnO tetrapods morphology. The electrical properties of ZnO tetrapods film were measured by using two point probes and it shows that, the sample growth in Ar and O2 atmosphere have better I-V characteristic.

MIS capacitor studies on silicon carbide single crystals

NASA Technical Reports Server (NTRS)

Kopanski, J. J.

1990-01-01

Cubic SIC metal-insulator-semiconductor (MIS) capacitors with thermally grown or chemical-vapor-deposited (CVD) insulators were characterized by capacitance-voltage (C-V), conductance-voltage (G-V), and current-voltage (I-V) measurements. The purpose of these measurements was to determine the four charge densities commonly present in an MIS capacitor (oxide fixed charge, N(f); interface trap level density, D(it); oxide trapped charge, N(ot); and mobile ionic charge, N(m)) and to determine the stability of the device properties with electric-field stress and temperature. The section headings in the report include the following: Capacitance-voltage and conductance-voltage measurements; Current-voltage measurements; Deep-level transient spectroscopy; and Conclusions (Electrical characteristics of SiC MIS capacitors).

The Biphasic Effect of Vitamin D on the Musculoskeletal and Cardiovascular System

PubMed Central

2017-01-01

This narrative review summarizes beneficial and harmful vitamin D effects on the musculoskeletal and cardiovascular system. Special attention is paid to the dose-response relationship of vitamin D with clinical outcomes. In infants and adults, the risk of musculoskeletal diseases is highest at circulating 25-hydroxyvitamin D (25OHD) concentrations below 25 nmol/L and is low if 40–60 nmol/L are achieved. However, evidence is also accumulating that in elderly people the risk of falls and fractures increases again at circulating 25OHD levels > 100 nmol/L. Cohort studies report a progressive increase in cardiovascular disease (CVD) events at 25OHD levels < 50 nmol/L. Nevertheless, meta-analyses of randomized controlled trials suggest only small beneficial effects of vitamin D supplements on surrogate parameters of CVD risk and no reduction in CVD events. Evidence is accumulating for adverse vitamin D effects on CVD outcomes at 25OHD levels > 100 nmol/L, but the threshold may be influenced by the level of physical activity. In conclusion, dose-response relationships indicate deleterious effects on the musculoskeletal system and probably on the cardiovascular system at circulating 25OHD levels < 40–60 nmol/L and >100 nmol/L. Future studies should focus on populations with 25OHD levels < 40 nmol/L and should avoid vitamin D doses achieving 25OHD levels > 100 nmol/L. PMID:28912809

The Biphasic Effect of Vitamin D on the Musculoskeletal and Cardiovascular System.

PubMed

Zittermann, Armin

2017-01-01

This narrative review summarizes beneficial and harmful vitamin D effects on the musculoskeletal and cardiovascular system. Special attention is paid to the dose-response relationship of vitamin D with clinical outcomes. In infants and adults, the risk of musculoskeletal diseases is highest at circulating 25-hydroxyvitamin D (25OHD) concentrations below 25 nmol/L and is low if 40-60 nmol/L are achieved. However, evidence is also accumulating that in elderly people the risk of falls and fractures increases again at circulating 25OHD levels > 100 nmol/L. Cohort studies report a progressive increase in cardiovascular disease (CVD) events at 25OHD levels < 50 nmol/L. Nevertheless, meta-analyses of randomized controlled trials suggest only small beneficial effects of vitamin D supplements on surrogate parameters of CVD risk and no reduction in CVD events. Evidence is accumulating for adverse vitamin D effects on CVD outcomes at 25OHD levels > 100 nmol/L, but the threshold may be influenced by the level of physical activity. In conclusion, dose-response relationships indicate deleterious effects on the musculoskeletal system and probably on the cardiovascular system at circulating 25OHD levels < 40-60 nmol/L and >100 nmol/L. Future studies should focus on populations with 25OHD levels < 40 nmol/L and should avoid vitamin D doses achieving 25OHD levels > 100 nmol/L.

Is plasminogen activator inhibitor-1 a physiological bottleneck bridging major depressive disorder and cardiovascular disease?

PubMed

Savoy, C; Van Lieshout, R J; Steiner, M

2017-04-01

Major depressive disorder (MDD) is estimated to affect one in twenty people worldwide. MDD is highly comorbid with cardiovascular disease (CVD), itself one of the single largest causes of mortality worldwide. A number of pathological changes observed in MDD are believed to contribute to the development of cardiovascular disease, although no single mechanism has been identified. There are also no biological markers capable of predicting the future risk of developing heart disease in depressed individuals. Plasminogen activator inhibitor-1 (PAI-1) is a prothrombotic plasma protein secreted by endothelial tissue and has long been implicated in CVD. An expanding body of literature has recently implicated it in the pathogenesis of major depressive disorder as well. In this study, we review candidate pathways implicating MDD in CVD and consider how PAI-1 might act as a mediator by which MDD induces CVD development: chiefly through sleep disruption, adiposity, brain-derived neurotrophic factor (BDNF) metabolism, systemic inflammation and hypothalamic-pituitary-adrenal (HPA)-axis dysregulation. As both MDD and CVD are more prevalent in women than in men, and incidence of either condition is dramatically increased during reproductive milestones, we also explore hormonal and sex-specific associations between MDD, PAI-1 and CVD. Of special interest is the role PAI-1 plays in perinatal depression and in cardiovascular complications of pregnancy. Finally, we propose a theoretical model whereby PAI-1 might serve as a useful biomarker for CVD risk in those with depression, and as a potential target for future treatments. © 2016 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

Autoantibody Profiles in Collagen Disease Patients with Interstitial Lung Disease (ILD): Antibodies to Major Histocompatibility Complex Class I-Related Chain A (MICA) as Markers of ILD

PubMed Central

Furukawa, Hiroshi; Oka, Shomi; Shimada, Kota; Masuo, Kiyoe; Nakajima, Fumiaki; Funano, Shunichi; Tanaka, Yuki; Komiya, Akiko; Fukui, Naoshi; Sawasaki, Tatsuya; Tadokoro, Kenji; Nose, Masato; Tsuchiya, Naoyuki; Tohma, Shigeto

2015-01-01

Interstitial lung disease (ILD) is frequently associated with collagen disease. It is then designated as collagen vascular disease-associated ILD (CVD-ILD), and influences patients’ prognosis. The prognosis of acute-onset diffuse ILD (AoDILD) occurring in patients with collagen disease is quite poor. Here, we report our investigation of auto-antibody (Ab) profiles to determine whether they may be useful in diagnosing CVD-ILD or AoDILD in collagen disease. Auto-Ab profiles were analyzed using the Lambda Array Beads Multi-Analyte System, granulocyte immunofluorescence test, Proto-Array Human Protein Microarray, AlphaScreen assay, and glutathione S-transferase capture enzyme-linked immunosorbent assay in 34 patients with rheumatoid arthritis (RA) with or without CVD-ILD and in 15 patients with collagen disease with AoDILD. The average anti-major histocompatibility complex class I-related chain A (MICA) Ab levels were higher in RA patients with CVD-ILD than in those without (P = 0.0013). The ratio of the average anti-MICA Ab level to the average anti-human leukocyte antigen class I Ab level (ie, MICA/Class I) was significantly higher in RA patients with CVD-ILD compared with those without (P = 4.47 × 10−5). To the best of our knowledge, this is the first report of auto-Ab profiles in CVD-ILD. The MICA/Class I ratio could be a better marker for diagnosing CVD-ILD than KL-6 (Krebs von den lungen-6). PMID:26327779

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liao, Ya-Tang; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan; Genomics Research Center, Academia Sinica, Taiwan

Arsenic ingestion has been linked to increasing global prevalence of and mortality from cardiovascular disease (CVD); arsenic can be removed from drinking water to reduce related health effects. Lactate dehydrogenase (LDH) is used for the evaluation of acute arsenic toxicity in vivo and in vitro, but it is not validated for the evaluation of long-term, chronic arsenic exposure. The present study examined the long-term effect of chronic arsenic exposure on CVD and serum LDH levels, after consideration of arsenic metabolism capacity. A total of 380 subjects from an arseniasis-endemic area and 303 from a non-endemic area of southwestern Taiwan weremore » recruited in 2002. Various urinary arsenic species were analyzed using high-performance liquid chromatography (HPLC) and hydride generation systems. Fasting serum was used for quantitative determination of the total LDH activity. A significant dose–response relationship was observed between arsenic exposure and LDH elevation, independent of urinary arsenic profiles (P < 0.001). Furthermore, abnormal LDH elevation was associated with CVD mortality after adjustment for Framingham risk scores for 10-year CVD and arsenic exposure (hazard ratio, 3.98; 95% confidence interval, 1.07–14.81). LDH was elevated in subjects with arsenic exposure in a dose-dependent manner. LDH is a marker of arsenic toxicity associated with CVD mortality. Results of this study have important implications for use in ascertaining long-term arsenic exposure risk of CVD. -- Highlights: ► We showed that arsenic exposure was correlated with LDH elevation. ► LDH elevation was related to arsenic methylation capacity. ► Abnormal LDH elevation can be a marker of susceptibility to CVD mortality.« less

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.

Engineering a mobile health tool for resource-poor settings to assess and manage cardiovascular disease risk: SMARThealth study.

PubMed

Raghu, Arvind; Praveen, Devarsetty; Peiris, David; Tarassenko, Lionel; Clifford, Gari

2015-04-29

The incidence of chronic diseases in low- and middle-income countries is rapidly increasing both in urban and rural regions. A major challenge for health systems globally is to develop innovative solutions for the prevention and control of these diseases. This paper discusses the development and pilot testing of SMARTHealth, a mobile-based, point-of-care Clinical Decision Support (CDS) tool to assess and manage cardiovascular disease (CVD) risk in resource-constrained settings. Through pilot testing, the preliminary acceptability, utility, and efficiency of the CDS tool was obtained. The CDS tool was part of an mHealth system comprising a mobile application that consisted of an evidence-based risk prediction and management algorithm, and a server-side electronic medical record system. Through an agile development process and user-centred design approach, key features of the mobile application that fitted the requirements of the end users and environment were obtained. A comprehensive analytics framework facilitated a data-driven approach to investigate four areas, namely, system efficiency, end-user variability, manual data entry errors, and usefulness of point-of-care management recommendations to the healthcare worker. A four-point Likert scale was used at the end of every risk assessment to gauge ease-of-use of the system. The system was field-tested with eleven village healthcare workers and three Primary Health Centre doctors, who screened a total of 292 adults aged 40 years and above. 34% of participants screened by health workers were identified by the CDS tool to be high CVD risk and referred to a doctor. In-depth analysis of user interactions found the CDS tool feasible for use and easily integrable into the workflow of healthcare workers. Following completion of the pilot, further technical enhancements were implemented to improve uptake of the mHealth platform. It will then be evaluated for effectiveness and cost-effectiveness in a cluster randomized controlled trial involving 54 southern Indian villages and over 16000 individuals at high CVD risk. An evidence-based CVD risk prediction and management tool was used to develop an mHealth platform in rural India for CVD screening and management with proper engagement of health care providers and local communities. With over a third of screened participants being high risk, there is a need to demonstrate the clinical impact of the mHealth platform so that it could contribute to improved CVD detection in high risk low resource settings.

The Aging Cardiovascular System: Understanding It at the Cellular and Clinical Levels.

PubMed

Paneni, Francesco; Diaz Cañestro, Candela; Libby, Peter; Lüscher, Thomas F; Camici, Giovanni G

2017-04-18

Cardiovascular disease (CVD) presents a great burden for elderly patients, their caregivers, and health systems. Structural and functional alterations of vessels accumulate throughout life, culminating in increased risk of developing CVD. The growing elderly population worldwide highlights the need to understand how aging promotes CVD in order to develop new strategies to confront this challenge. This review provides examples of some major unresolved clinical problems encountered in daily cardiovascular practice as we care for elderly patients. Next, the authors summarize the current understanding of the mechanisms implicated in cardiovascular aging, and the potential for targeting novel pathways implicated in endothelial dysfunction, mitochondrial oxidative stress, chromatin remodeling, and genomic instability. Lastly, the authors consider critical aspects of vascular repair, including autologous transplantation of bone marrow-derived stem cells in elderly patients. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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.

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

The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors.

PubMed

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.

Evaluation of community health screening participants' knowledge of cardiovascular risk factors.

PubMed

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.

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.

The status of glutathione peroxidase, superoxide dismutase, vitamins A, C, E and malondialdehyde in patients with cardiovascular disease in Zahedan, Southeast Iran.

PubMed

Karajibani, Mansour; Hashemi, Mohammad; Montazerifar, Farzaneh; Bolouri, Ahmad; Dikshit, Madhurima

2009-08-01

Growing evidence has demonstrated that oxidative stress and increased altered oxygen utilization contribute to atherogenesis and cardiovascular disease (CVD) progression. Antioxidants protect the body from damage caused by free radicals. The objective of this study was to determine antioxidants status in CVD patients. This cross-sectional study was performed on 71 patients clinically diagnosed with CVD and 63 healthy individuals. Plasma malondialdehyde (MDA) level was measured for lipid peroxidation product and erythrocyte SOD and GPx activities as enzymatic antioxidants. The serum levels of vitamins A and E were assayed using HPLC and vitamin C by the photometric method. Total antioxidant capacity (TAC) was measured using the ferric reducing ability of plasma (FRAP) method. The results showed a significant reduction in antioxidant status (enzymatic and non-enzymatic) with a concomitant increase in the concentrations of lipid peroxidation products in CVD patients. There was a significant inverse correlation among TAC, SOD, GPx and vitamin C with MDA. It can be concluded that the antioxidant defense system plays an important role in preventing the development and progression of CVD with the ability to control oxidative stress.

Relationship of Advanced Glycation End Products With Cardiovascular Disease in Menopausal Women

PubMed Central

Pertynska-Marczewska, Magdalena

2015-01-01

Cardiovascular disease (CVD) represents the most significant cause of death in postmenopausal women. Advanced glycation end products (AGEs) are formed by nonenzymatic modification of proteins, lipids, and nucleic acids by glucose. This review focuses on the contribution of AGEs and their receptors to the development of CVD in menopause. Advanced glycation end products circulate and activate the proinflammatory endothelial cell surface receptor called RAGE, bind to the extracellular matrix of the cardiovascular system, or bind to the circulating anti-inflammatory soluble form of RAGE (sRAGE). Data emerging from human and animal studies suggest that AGEs and both receptors (RAGE and sRAGE) are implicated in the pathophysiology of CVD. Particular emphasis has been given to the role of AGE–RAGE axis in oxidative stress, inflammation, endothelial cell toxicity, and progression of atherosclerosis in menopause. Data accruing from human and animal studies suggest that RAGE expression level and circulating sRAGE level are associated with estradiol and are correlated with CVD risk factors, such as adiposity, dyslipidemia, insulin resistance, diabetes, and metabolic syndrome. By recognizing the impact of AGEs on atherosclerosis, pharmacological strategies targeting the AGE–RAGE pathway hold therapeutic potential for CVD in menopausal women. PMID:25228634

Relationship of Advanced Glycation End Products With Cardiovascular Disease in Menopausal Women.

PubMed

Pertynska-Marczewska, Magdalena; Merhi, Zaher

2015-07-01

Cardiovascular disease (CVD) represents the most significant cause of death in postmenopausal women. Advanced glycation end products (AGEs) are formed by nonenzymatic modification of proteins, lipids, and nucleic acids by glucose. This review focuses on the contribution of AGEs and their receptors to the development of CVD in menopause. Advanced glycation end products circulate and activate the proinflammatory endothelial cell surface receptor called RAGE, bind to the extracellular matrix of the cardiovascular system, or bind to the circulating anti-inflammatory soluble form of RAGE (sRAGE). Data emerging from human and animal studies suggest that AGEs and both receptors (RAGE and sRAGE) are implicated in the pathophysiology of CVD. Particular emphasis has been given to the role of AGE-RAGE axis in oxidative stress, inflammation, endothelial cell toxicity, and progression of atherosclerosis in menopause. Data accruing from human and animal studies suggest that RAGE expression level and circulating sRAGE level are associated with estradiol and are correlated with CVD risk factors, such as adiposity, dyslipidemia, insulin resistance, diabetes, and metabolic syndrome. By recognizing the impact of AGEs on atherosclerosis, pharmacological strategies targeting the AGE-RAGE pathway hold therapeutic potential for CVD in menopausal women. © The Author(s) 2014.

Effect of growth temperature and precursor concentration on synthesis of CVD-graphene from camphor

NASA Astrophysics Data System (ADS)

Rajaram, Narasimman; Patel, Biren; Ray, Abhijit; Mukhopadhyay, Indrajit

2018-05-01

Here, we have synthesized CVD-graphene from camphor by using atmospheric pressure (AP)-CVD system on Cu foil. We have studied the effect of growth temperature and camphor concentration by using scanning electron microscopy (SEM) and Raman spectroscopy. The domain size of the graphene is increasing with an increase in the temperature and camphor quantity. The complete coverage of graphene on the Cu foil achieved at 1020 °C. Higher camphor quantity leads to growth of multilayer graphene. The graphene is transferred by PMMA-assisted method onto the glass substrate. The sheet resistance and transmittance of the graphene are 1.5 kohm/sq and 92.7%, respectively.

Parental Age of Onset of Cardiovascular Disease as a Predictor for Offspring Age of Onset of Cardiovascular Disease.

PubMed

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.

4H-SiC p i n diodes grown by sublimation epitaxy in vacuum (SEV) and their application as microwave diodes

NASA Astrophysics Data System (ADS)

Camara, N.; Zekentes, K.; Zelenin, V. V.; Abramov, P. L.; Kirillov, A. V.; Romanov, L. P.; Boltovets, N. S.; Krivutsa, V. A.; Thuaire, A.; Bano, E.; Tsoi, E.; Lebedev, A. A.

2008-02-01

Sublimation epitaxy under vacuum (SEV) was investigated as a method for growing 4H-SiC epitaxial structures for p-i-n diode fabrication. The SEV-grown 4H-SiC material was investigated with scanning electron microscopy (SEM), atomic force microscopy (AFM), x-ray diffraction, photo-luminescence spectroscopy (PL), cathodo-luminescence (CL) spectroscopy, photocurrent method for carrier diffusion length determination, electro-luminescence microscopy (EL), deep level transient spectroscopy (DLTS), C-V profiling and Hall-effect measurements. When possible, the same investigation techniques were used in parallel with similar layers grown by chemical vapour deposition (CVD) epitaxy and the physical properties of the two kind of epitaxied layers were compared. p-i-n diodes were fabricated in parallel on SEV and CVD-grown layers and showed close electrical performances in dc mode in term of capacitance, resistance and transient time switching, despite the lower mobility and the diffusion length of the SEV-grown layers. X-band microwave switches based on the SEV-grown p-i-n diodes have been demonstrated with insertion loss lower than 4 dB and an isolation higher than 17 dB. These single-pole single-throw (SPST) switches were able to handle a pulsed power up to 1800 W in isolation mode, similar to the value obtained with switches incorporating diodes with CVD-grown layers.

Evaluating electrically insulating films deposited on V-4% Cr-4% Ti by reactive CVD

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, J.H.; Cho, W.D.

1997-04-01

Previous CaO coatings on V-4%Cr-4%Ti exhibited high-ohmic insulator behavior even though a small amount of vanadium from the alloy was incorporated in the coating. However, when the vanadium concentration in the coatings is > 15 wt%, the coating becomes conductive. When the vanadium concentration is high in localized areas, a calcium vanadate phase that exhibits semiconductor behavior can form. To explore this situation, CaO and Ca-V-O coatings were produced on vanadium alloys by chemical vapor deposition (CVD) and by a metallic-vapor process to investigate the electrical resistance of the coatings. Initially, the vanadium alloy specimens were either charged with oxygenmore » in argon that contained trace levels of oxygen, or oxidized for 1.5-3 h in a 1% CO-CO{sub 2} gas mixture or in air to form vanadium oxide at 625-650{degrees}C. Most of the specimens were exposed to calcium vapor at 800-850{degrees}C. Initial and final weights were obtained to monitor each step, and surveillance samples were removed for examination by optical and scanning electron microscopy and electron-energy-dispersive and X-ray diffraction analysis; the electrical resistivity was also measured. The authors found that Ca-V-O films exhibited insulator behavior when the ratio of calcium concentration to vanadium concentration R in the film was > 0.9, and semiconductor or conductor behavior for R < 0.8. However, in some cases, semiconductor behavior was observed when CaO-coated samples with R > 0.98 were exposed in liquid lithium. Based on these studies, the authors conclude that semiconductor behavior occurs if a conductive calcium vanadate phase is present in localized regions in the CaO coating.« less

Skin Autofluorescence and Mortality in Patients on Peritoneal Dialysis

PubMed Central

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

Reducing salt intake for prevention of cardiovascular diseases in high-risk patients by advanced health education intervention (RESIP-CVD study), Northern Thailand: study protocol for a cluster randomized trial

PubMed Central

2012-01-01

Background Decreasing salt consumption can prevent cardiovascular diseases (CVD). Practically, it is difficult to promote people’s awareness of daily salt intake and to change their eating habits in terms of reducing salt intake for better cardiovascular health. Health education programs visualizing daily dietary salt content and intake may promote lifestyle changes in patients at high risk of cardiovascular diseases. Methods/Design This is a cluster randomized trial. A total of 800 high-CVD-risk patients attending diabetes and hypertension clinics at health centers in Muang District, Chiang Rai province, Thailand, will be studied with informed consent. A health center recruiting 100 participants is a cluster, the unit of randomization. Eight clusters will be randomized into intervention and control arms and followed up for 1 year. Within the intervention clusters the following will be undertaken: (1) salt content in the daily diet will be measured and shown to study participants; (2) 24-hour salt intake will be estimated in overnight-collected urine and the results shown to the participants; (3) a dietician will assist small group health education classes in cooking meals with less salt. The primary outcome is blood pressure change at the 1-year follow-up. Secondary outcomes at the 1-year follow-up are estimated 24-hoursalt intake, incidence of CVD events and CVD death. The intention-to-treat analysis will be followed. Blood pressure and estimated 24-hour salt intake will be compared between intervention and control groups at the cluster and individual level at the 1-year follow-up. Clinical CVD events and deaths will be analyzed by time-event analysis. Retinal blood vessel calibers of CVD-risk patients will be assessed cross-sectionally. Behavioral change to reduce salt intake and the influencing factors will be determined by structured equation model (SEM). Multilevel regression analyses will be applied. Finally, the cost effectiveness of the intervention will be analyzed. Discussion This study is unique as it will recruit the individuals most vulnerable to CVD morbidity and mortality by applying the general Framingham CVD risk scoring system. Dietary salt reduction will be applied as a prioritized, community level intervention for the prevention of CVD in a developing country. Trial registration ISRCTN39416277 PMID:22947342

Reducing salt intake for prevention of cardiovascular diseases in high-risk patients by advanced health education intervention (RESIP-CVD study), Northern Thailand: study protocol for a cluster randomized trial.

PubMed

Aung, Myo Nyein; Yuasa, Motoyuki; Moolphate, Saiyud; Nedsuwan, Supalert; Yokokawa, Hidehiro; Kitajima, Tsutomu; Minematsu, Kazuo; Tanimura, Susumu; Fukuda, Hiroshi; Hiratsuka, Yoshimune; Ono, Koichi; Kawai, Sachio; Marui, Eiji

2012-09-04

Decreasing salt consumption can prevent cardiovascular diseases (CVD). Practically, it is difficult to promote people's awareness of daily salt intake and to change their eating habits in terms of reducing salt intake for better cardiovascular health. Health education programs visualizing daily dietary salt content and intake may promote lifestyle changes in patients at high risk of cardiovascular diseases. This is a cluster randomized trial. A total of 800 high-CVD-risk patients attending diabetes and hypertension clinics at health centers in Muang District, Chiang Rai province, Thailand, will be studied with informed consent. A health center recruiting 100 participants is a cluster, the unit of randomization. Eight clusters will be randomized into intervention and control arms and followed up for 1 year. Within the intervention clusters the following will be undertaken: (1) salt content in the daily diet will be measured and shown to study participants; (2) 24-hour salt intake will be estimated in overnight-collected urine and the results shown to the participants; (3) a dietician will assist small group health education classes in cooking meals with less salt. The primary outcome is blood pressure change at the 1-year follow-up. Secondary outcomes at the 1-year follow-up are estimated 24-hoursalt intake, incidence of CVD events and CVD death. The intention-to-treat analysis will be followed.Blood pressure and estimated 24-hour salt intake will be compared between intervention and control groups at the cluster and individual level at the 1-year follow-up. Clinical CVD events and deaths will be analyzed by time-event analysis. Retinal blood vessel calibers of CVD-risk patients will be assessed cross-sectionally. Behavioral change to reduce salt intake and the influencing factors will be determined by structured equation model (SEM). Multilevel regression analyses will be applied. Finally, the cost effectiveness of the intervention will be analyzed. This study is unique as it will recruit the individuals most vulnerable to CVD morbidity and mortality by applying the general Framingham CVD risk scoring system. Dietary salt reduction will be applied as a prioritized, community level intervention for the prevention of CVD in a developing country. ISRCTN39416277.

Diagnosis of Normal and Abnormal Color Vision with Cone-Specific VEPs.

PubMed

Rabin, Jeff C; Kryder, Andrew C; Lam, Dan

2016-05-01

Normal color vision depends on normal long wavelength (L), middle wavelength (M), and short wavelength sensitive (S) cones. Hereditary "red-green" color vision deficiency (CVD) is due to a shift in peak sensitivity or lack of L or M cones. Hereditary S cone CVD is rare but can be acquired as an early sign of disease. Current tests detect CVD but few diagnose type or severity, critical for linking performance to real-world demands. The anomaloscope and newer subjective tests quantify CVD but are not applicable to infants or cognitively impaired patients. Our purpose was to develop an objective test of CVD with sensitivity and specificity comparable to current tests. A calibrated visual-evoked potential (VEP) display and Food and Drug Administration-approved system was used to record L, M, and S cone-specific pattern-onset VEPs from 18 color vision normals (CVNs) and 13 hereditary CVDs. VEP amplitudes and latencies were compared between groups to establish VEP sensitivity and specificity. Cone VEPs show 100% sensitivity for diagnosis of CVD and 94% specificity for confirming CVN. L cone (protan) CVDs showed a significant increase in L cone latency (53.1 msec, P < 0.003) and decreased amplitude (10.8 uV, P < 0.0000005) but normal M and S cone VEPs ( P > 0.31). M cone (deutan) CVDs showed a significant increase in M cone latency (31.0 msec, P < 0.000004) and decreased amplitude (8.4 uV, P < 0.006) but normal L and S cone VEPs ( P > 0.29). Cone-specific VEPs offer a rapid, objective test to diagnose hereditary CVD and show potential for detecting acquired CVD in various diseases. This paper describes the efficacy of cone-specific color VEPs for quantification of normal and abnormal color vision. The rapid, objective nature of this approach makes it suitable for detecting color sensitivity loss in infants and the cognitively impaired.

Classical cardiovascular disease risk factors associate with vascular function and morphology in rheumatoid arthritis: a six-year prospective study

PubMed Central

2013-01-01

Introduction Patients with rheumatoid arthritis (RA) are at an increased risk for cardiovascular disease (CVD). An early manifestation of CVD is endothelial dysfunction which can lead to functional and morphological vascular abnormalities. Classical CVD risk factors and inflammation are both implicated in causing endothelial dysfunction in RA. The objective of the present study was to examine the effect of baseline inflammation, cumulative inflammation, and classical CVD risk factors on the vasculature following a six-year follow-up period. Methods A total of 201 RA patients (155 females, median age (25th to 75th percentile): 61 years (53 to 67)) were examined at baseline (2006) for presence of classical CVD risk factors and determination of inflammation using C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). At follow-up (2012) patients underwent assessments of microvascular and macrovascular endothelium-dependent and endothelium-independent function, along with assessment of carotid atherosclerosis. The CRP and ESR were recorded from the baseline study visit to the follow-up visit for each patient to calculate cumulative inflammatory burden. Results Classical CVD risk factors, but not RA disease-related inflammation, predicted microvascular endothelium-dependent and endothelium-independent function, macrovascular endothelium-independent function and carotid atherosclerosis. These findings were similar in a sub-group of patients free from CVD, and not receiving non-steroidal anti-inflammatory drugs, cyclooxygenase 2 inhibitors or biologics. Cumulative inflammation was not associated with microvascular and macrovascular endothelial function, but a weak association was apparent between area under the curve for CRP and carotid atherosclerosis. Conclusions Classical CVD risk factors may be better long-term predictors of vascular function and morphology than systemic disease-related inflammation in patients with RA. Further studies are needed to confirm if assessments of vascular function and morphology are predictive of long-term CV outcomes in RA. PMID:24289091

Carrier dynamics in silicon nanowires studied using optical-pump terahertz-probe spectroscopy

NASA Astrophysics Data System (ADS)

Beaudoin, Alexandre; Salem, Bassem; Baron, Thierry; Gentile, Pascal; Morris, Denis

2014-03-01

The advance of non-contact measurements involving pulsed terahertz radiation presents great interests for characterizing electrical properties of a large ensemble of nanowires. In this work, N-doped and undoped silicon nanowires (SiNWs) grown by chemical vapour deposition (CVD) on quartz substrate were characterized using optical-pump terahertz probe (OPTP) transmission experiments. Our results show that defects and ionized impurities introduced by N-doping the CVD-grown SiNWs tend to reduce the photoexcited carrier lifetime and degrade their conductivity properties. Capture mechanisms by the surface trap states play a key role on the photocarrier dynamics in theses small diameters' (~100 nm) SiNWs and the doping level is found to alter this dynamics. We propose convincing capture and recombination scenarios that explain our OPTP measurements. Fits of our photoconductivity data curves, from 0.5 to 2 THz, using a Drude-plasmon conductivity model allow determining photocarrier mobility values of 190 and 70 cm2/V .s, for the undoped and N-doped NWs samples, respectively.

Enhanced photoresponse characteristics of transistors using CVD-grown MoS2/WS2 heterostructures

NASA Astrophysics Data System (ADS)

Shan, Junjie; Li, Jinhua; Chu, Xueying; Xu, Mingze; Jin, Fangjun; Fang, Xuan; Wei, Zhipeng; Wang, Xiaohua

2018-06-01

Semiconductor heterostructures based on transition metal dichalcogenides provide a broad platform to research two-dimensional nanomaterials and design atomically thin devices for fundamental and applied interests. The MoS2/WS2 heterostructure was prepared on SiO2/Si substrate by chemical vapor deposition (CVD) in our research. And the optical properties of the heterostructure was characterized by Raman and photoluminescence (PL) spectroscopy. The similar 2 orders of magnitude decrease of PL intensity in MoS2/WS2 heterostructures was tested, which is attribute to the electrical and optical modulation effects are connected with the interfacial charge transfer between MoS2 and WS2 films. Using MoS2/WS2 heterostructure as channel material of the phototransistor, we demonstrated over 50 folds enhanced photoresponsivity of multilayer MoS2 field-effect transistor. The results indicate that the MoS2/WS2 films can be a promising heterostructure material to enhance the photoresponse characteristics of MoS2-based phototransistors.

Study of the interaction mechanisms between absorbed NO{sub 2} and por-Si/SnO{sub x} nanocomposite layers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bolotov, V. V.; Kan, V. E., E-mail: kan@obisp.oscsbras.ru; Makushenko, R. K.

2013-10-15

The interaction mechanisms between NO{sub 2} molecules and the surface of por-Si/SnO{sub x} nanocomposites obtained by magnetron deposition and chemical vapor deposition (CVD) are studied by infrared absorption spectroscopy and electron paramagnetic resonance methods. The observed increase in the free carrier concentration in the por-Si/SnO{sub x} nanocomposite layers is explained by a change in the charge state of P{sub b} centers due to the formation of neutral 'surface defect-adsorbed NO{sub 2} molecule' complexes with free carrier generation in the crystallite bulk. In the nanocomposite layers grown by the CVD method, the increase in the free hole concentration during NO{sub 2}more » adsorption is much less pronounced in comparison with the composite grown by magnetron deposition, which is caused by the competing interaction channel of NO{sub 2} molecules with electrically neutral P{sub b} centers.« less

Flexible low-power RF nanoelectronics in the GHz regime using CVD MoS2

NASA Astrophysics Data System (ADS)

Yogeesh, Maruthi

Two-dimensional (2D) materials have attracted substantial interest for flexible nanoelectronics due to the overall device mechanical flexibility and thickness scalability for high mechanical performance and low operating power. In this work, we demonstrate the first MoS2 RF transistors on flexible substrates based on CVD-grown monolayers, featuring record GHz cutoff frequency (5.6 GHz) and saturation velocity (~1.8×106 cm/s), which is significantly superior to contemporary organic and metal oxide thin-film transistors. Furthermore, multicycle three-point bending results demonstrated the electrical robustness of our flexible MoS2 transistors after 10,000 cycles of mechanical bending. Additionally, basic RF communication circuit blocks such as amplifier, mixer and wireless AM receiver have been demonstrated. These collective results indicate that MoS2 is an ideal advanced semiconducting material for low-power, RF devices for large-area flexible nanoelectronics and smart nanosystems owing to its unique combination of large bandgap, high saturation velocity and high mechanical strength.

Ultrasensitive Plasmonic Biosensors for Real-Time Parallel Detection of Alpha-L-Fucosidase and Cardiac-Troponin-I in Whole Human Blood.

PubMed

Han, Xu; Shokri Kojori, Hossein; Leblanc, Roger M; Kim, Sung Jin

2018-06-19

Cancers and many other diseases, such as hepatocellular carcinoma (HCC) and cardiovascular diseases (CVD), have threatened human lives for centuries. Therefore, a novel technique for such disease prediction is in an urgent demand for timely treatment. Biomarkers, alpha-L-fucosidase (AFU) for HCC and cardiac troponin I (cTnI) for CVD, have proven to be essential in the role of disease detection. Herein, we report on an ultrasensitive plasmonic biosensor that converts plasmonic absorption to electrical current in order to detect AFU and cTnI using whole human blood in a real-time and parallel fashion. The detection limit was calculated to be 0.016 U/L for AFU and 0.015 ng/mL for cTnI, respectively. Combined with the versatility of the strategies for different biomarkers, these results demonstrate that the developed biosensor exhibits a promising application for the prediction of cancers and many other diseases.

Formation of Graphene Grain Boundaries on Cu(100) Surface and a Route Towards Their Elimination in Chemical Vapor Deposition Growth

NASA Astrophysics Data System (ADS)

Yuan, Qinghong; Song, Guangyao; Sun, Deyan; Ding, Feng

2014-10-01

Grain boundaries (GBs) in graphene prepared by chemical vapor deposition (CVD) greatly degrade the electrical and mechanical properties of graphene and thus hinder the applications of graphene in electronic devices. The seamless stitching of graphene flakes can avoid GBs, wherein the identical orientation of graphene domain is required. In this letter, the graphene orientation on one of the most used catalyst surface -- Cu(100) surface, is explored by density functional theory (DFT) calculations. Our calculation demonstrates that a zigzag edged hexagonal graphene domain on a Cu(100) surface has two equivalent energetically preferred orientations, which are 30 degree away from each other. Therefore, the fusion of graphene domains on Cu(100) surface during CVD growth will inevitably lead to densely distributed GBs in the synthesized graphene. Aiming to solve this problem, a simple route, that applies external strain to break the symmetry of the Cu(100) surface, was proposed and proved efficient.

Using impedance cardiography to detect asymptomatic cardiovascular disease in prehypertensive adults with risk factors.

PubMed

DeMarzo, Arthur P

2013-06-01

Early detection of cardiovascular disease (CVD) in prehypertension could initiate appropriate treatment and prevent progression. Impedance cardiography (ICG) is a noninvasive technology that can be used to assess cardiovascular function. This study used ICG waveform analysis with postural change to detect CVD in asymptomatic prehypertensive adults over 40 years of age with no history of CVD and at least 2 cardiovascular risk factors: cigarette smoking, poor diet, physical inactivity, central obesity, family history of premature CVD, elevated blood glucose, and dyslipidemia. A study group of 25 apparently healthy adults was tested by ICG in standing and supine positions. Criteria for an age-matched control group of 16 healthy subjects included an active lifestyle, no risk factor, and no history of CVD. In addition to hemodynamic measurements of systemic vascular resistance (SVR) and cardiac index (CI), ICG used SVR to assess vascular resistive load, an index of arterial compliance and a widening of the systolic waveform to assess vascular pulsatile load, and waveform analysis and measured wave amplitude to detect ventricular dysfunction. All subjects in the study group had some abnormal ICG data, with an average of 2.9 ± 1.5 abnormalities per person. ICG indicated that 24 (96%) had elevated vascular load, 13 (52%) had some type of ventricular dysfunction, and 12 (48%) had abnormal hemodynamics. For the control group, ICG showed none (0%) with elevated vascular load, none (0%) with ventricular dysfunction, and 7 (44%) with high CI. Prehypertensives over 40 years of age with multiple risk factors have different cardiovascular abnormalities. This ICG test could be used as part of a prevention program for early detection of CVD. An abnormal ICG test could expedite the initiation of customized treatment that targets the subclinical CVD.

Radiation Risk of Cardiovascular Diseases in the Cohort of Russian Emergency Workers of the Chernobyl Accident.

PubMed

Kashcheev, V V; Chekin, S Yu; Karpenko, S V; Maksioutov, M A; Menyaylo, A N; Tumanov, K A; Kochergina, E V; Kashcheeva, P V; Gorsky, A I; Shchukina, N V; Lovachev, S S; Vlasov, O K; Ivanov, V K

2017-07-01

This paper continues a series of publications that analyze the impact of radiation on incidence of circulatory system diseases in the cohort of Russian recovery operation workers (liquidators) and presents the results of the analysis of cardiovascular disease (CVD) incidence. The studied cohort consists of 53,772 liquidators who arrived in the Chernobyl accident zone within the first year after the accident (26 April 1986 to 26 April 1987). The individual doses varied from 0.0001 Gy to 1.42 Gy, and the mean external whole body dose in the cohort was 0.161 Gy. A total of 27,456 cases of CVD were diagnosed during the follow-up period 1986-2012 as a result of annual health examinations. A Poisson regression model was applied to estimate radiation risks and other risk factors associated with CVD. The following factors were identified as risk factors for CVD: the dose, duration of the liquidators' work in the Chernobyl zone, and concomitant diseases (diabetes mellitus, hypertension, overweight, and alcohol dependence). The baseline incidence of CVD is statistically significantly (p < 0.001) associated with all studied concomitant diseases. The incidence of CVD has revealed a statistically significant dose response with the lack of a latent period and with the average ERR Gy = 0.47, 95% CI = 0.31, 0.63, p < 0.001. Radiation risks of CVD statistically significantly (p = 0.01) varied with the duration of liquidators' stay in the Chernobyl zone; for those who stayed in the Chernobyl zone less than 6 wk, ERR/Gy = 0.80, 95% CI = 0.53; 1.08, p < 0.001.

Shared genetic regulatory networks for cardiovascular disease and type 2 diabetes in multiple populations of diverse ethnicities in the United States

PubMed Central

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

Under-utilisation of preventive medication in patients with cardiovascular disease is greatest in younger age groups (PREDICT-CVD 15).

PubMed

Mehta, Suneela; Wells, Sue; Riddell, Tania; Kerr, Andrew; Pylypchuk, Romana; Marshall, Roger; Ameratunga, Shanthi; Chan, Wing Cheuk; Thornley, Simon; Crengle, Sue; Harrison, Jeff; Drury, Paul; Elley, C Raina; Bell, Fionna; Jackson, Rod

2011-06-01

Blood pressure-lowering (BPL) and lipid-lowering (LL) medications together reduce estimated absolute five-year cardiovascular disease (CVD) risk by >40%. International studies indicate that the proportion of people with CVD receiving pharmacotherapy increases with advancing age. To compare BPL and LL medications, by sociodemographic characteristics, for patients with known CVD in primary care settings. The study population included patients aged 35-74 with known CVD assessed in primary care from July 2006 to October 2009 using a web-based computerised decision support system (PREDICT) for risk assessment and management. Clinical data linked anonymously to national sociodemographic and pharmaceutical dispensing databases. Differences in dispensing BPL and LL medications in six months before first PREDICT assessment was analysed according to age, sex, ethnicity and deprivation. Of 7622 people with CVD, 1625 <55 years old, 2862 were women and 4609 lived in deprived areas (NZDep quintiles 4/5). The study population included 4249 European, 1556 Maori, 1151 Pacific and 329 Indian peoples. BPL medications were dispensed to 81%, LL medications to 73%, both BPL and LL medications to 67%, and 87% received either class of medication. Compared with people aged 65-75, people aged 35-44 were 30-40% less likely and those aged 45-54 were 10-15% less likely to be dispensed BPL, LL medications or both. There were minimal differences in likelihood of dispensing according to sex, ethnicity or deprivation. BPL and LL medications are under-utilised in patients with known CVD in New Zealand. Only two-thirds of patients in this cohort are on both. Younger patients are considerably less likely to be on recommended medications.

Oral Hygiene and Cardiometabolic Disease Risk in the Survey of the Health of Wisconsin

PubMed Central

VanWormer, Jeffrey J.; Acharya, Amit; Greenlee, Robert T.; Nieto, F. Javier

2012-01-01

Objectives Poor oral health is an increasingly recognized risk factor for cardiovascular disease (CVD) and type 2 diabetes (T2D), but little is known about the association between toothbrushing or flossing and cardiometabolic disease risk. The purpose of this study was to examine the degree to which an oral hygiene index was associated with CVD and T2D risk scores among disease-free adults in the Survey of the Health of Wisconsin. Methods All variables were measured in 2008–2010 in this cross-sectional design. Based on toothbrushing and flossing frequency, and oral hygiene index (poor, fair, good, excellent) was created as the primary predictor variable. The outcomes, CVD and T2D risk score, were based on previous estimates from large cohort studies. There were 712 and 296 individuals with complete data available for linear regression analyses in the CVD and T2D samples, respectively. Results After covariate adjustment, the final model indicated that participants in the excellent (β±SE=−0.019±0.008, p=0.020) oral hygiene category had a significantly lower CVD risk score as compared to participants in the poor oral hygiene category. Sensitivity analyses indicated that both toothbrushing and flossing were independently associated with CVD risk score, and various modifiable risk factors. Oral hygiene was not significantly associated with T2D risk score. Conclusions Regular toothbrushing and flossing are associated with a more favorable CVD risk profile, but more experimental research is needed in this area to precisely determine the effects of various oral self-care maintenance behaviors on the control of individual cardiometabolic risk factors. These findings may inform future joint medical-dental initiatives designed to close gaps in the primary prevention of oral and systemic diseases. PMID:23106415

Risk of Obstructive Sleep Apnea and Its Association with Cardiovascular and Noncardiac Vascular Risk in Patients with Rheumatoid Arthritis: A Population-based Study.

PubMed

Wilton, Katelynn M; Matteson, Eric L; Crowson, Cynthia S

2018-01-01

To define the incidence of obstructive sleep apnea (OSA) in patients with rheumatoid arthritis (RA) and determine whether OSA diagnosis predicts future cardiovascular disease (CVD) and noncardiac vascular events. Medical information pertaining to RA, OSA, CVD, and vascular diagnoses was extracted from a comprehensive medical record system for a geographically defined population of 813 patients previously diagnosed with RA and 813 age- and sex-matched comparator subjects. The risk for OSA in persons with RA versus comparators was elevated, although not reaching statistical significance (HR 1.32, 95% CI 0.98-1.77; p = 0.07). Patients with RA were more likely to be diagnosed with OSA if they had traditional risk factors for OSA, including male sex, current smoking status, hypertension, diabetes, dyslipidemia, and increased body mass index. Features of RA disease associated with OSA included large joint swelling and joint surgery. Patients with RA with decreased renal function were also at higher risk of OSA. The increased risk of overall CVD among patients with RA who have OSA was similar to the increased CVD risk associated with OSA in the comparator cohort (interaction p = 0.86). OSA diagnosis was associated with an increased risk of both CVD (HR 1.9, 95% CI 1.08-3.27), and cerebrovascular disease (HR 2.4, 95% CI 1.14-5.26) in patients with RA. Patients with RA may be at increased risk of OSA secondary to both traditional and RA-related risk factors. Diagnosis with OSA predicts future CVD in RA and may provide an opportunity for CVD intervention.

Radiation damage in the diamond based beam condition monitors of the CMS experiment at the Large Hadron Collider (LHC) at CERN

NASA Astrophysics Data System (ADS)

Guthoff, Moritz; Afanaciev, Konstantin; Dabrowski, Anne; de Boer, Wim; Lange, Wolfgang; Lohmann, Wolfgang; Stickland, David

2013-12-01

The Beam Condition Monitor (BCM) of the CMS detector at the LHC is a protection device similar to the LHC Beam Loss Monitor system. While the electronics used is the same, poly-crystalline Chemical Vapor Deposition (pCVD) diamonds are used instead of ionization chambers as the BCM sensor material. The main purpose of the system is the protection of the silicon Pixel and Strip tracking detectors by inducing a beam dump, if the beam losses are too high in the CMS detector. By comparing the detector current with the instantaneous luminosity, the BCM detector efficiency can be monitored. The number of radiation-induced defects in the diamond, reduces the charge collection distance, and hence lowers the signal. The number of these induced defects can be simulated using the FLUKA Monte Carlo simulation. The cross-section for creating defects increases with decreasing energies of the impinging particles. This explains, why diamond sensors mounted close to heavy calorimeters experience more radiation damage, because of the high number of low energy neutrons in these regions. The signal decrease was stronger than expected from the number of simulated defects. Here polarization from trapped charge carriers in the defects is a likely candidate for explaining the difference, as suggested by Transient Current Technique (TCT) measurements. A single-crystalline (sCVD) diamond sensor shows a faster relative signal decrease than a pCVD sensor mounted at the same location. This is expected, since the relative increase in the number of defects is larger in sCVD than in pCVD sensors.

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…

Realization of MEMS-IC Vertical Integration Utilizing Smart Bumpless Bonding

NASA Astrophysics Data System (ADS)

Shiozaki, Masayoshi; Moriguchi, Makoto; Sasaki, Sho; Oba, Masatoshi

This paper reports fundamental technologies, properties, and new experimental results of SBB (Smart Bumpless Bonding) to realize MEMS-IC vertical integration. Although conventional bonding technologies have had difficulties integrating MEMS and its processing circuit because of their rough bonding surfaces, fragile structures, and thermal restriction, SBB technology realized the vertical integration without thermal treatment, any adhesive materials including bumps, and chemical mechanical polishing. The SBB technology bonds sealing parts for vacuum sealing and electrodes for electrical connection simultaneously as published in previous experimental study. The plasma CVD SiO2 is utilized to realize vacuum sealing as sealing material. And Au projection studs are formed on each electrode and connected electrically between two wafers by compressive plastic deformation and surface activation. In this paper, new experimental results including vacuum sealing properties, electrical improvement, IC bonding results on the described fundamental concept and properties are reported.

Computer-Assisted versus Oral-and-Written History Taking for the Prevention and Management of Cardiovascular Disease: a Systematic Review of the Literature.

PubMed

Pappas, Yannis; Všetečková, Jitka; Poduval, Shoba; Tseng, Pei Ching; Car, Josip

CVD is an important global healthcare issue; it is the leading cause of global mortality, with an increasing incidence identified in both developed and developing countries. It is also an extremely costly disease for healthcare systems unless managed effectively. In this review we aimed to: - Assess the effect of computer-assisted versus oral-and-written history taking on the quality of collected information for the prevention and management of CVD. - Assess the effect of computer-assisted versus oral-and-written history taking on the prevention and management of CVD. A systematic review of randomised controlled trials that included participants of 16 years or older at the beginning of the study, who were at risk of CVD (prevention) or were either previously diagnosed with CVD (management). We searched all major databases. We assessed risk of bias using the Cochrane Collaboration tool. Two studies met the inclusion criteria. One comparing the two methods of history-taking for the prevention of cardiovascular disease n = 75. The study shows that generally the patients in the experimental group underwent more laboratory procedures, had more biomarker readings recorded and/or were given (or had reviewed), more dietary changes than the control group. The other study compares the two methods of history-taking for the management of cardiovascular disease (n = 479). The study showed that the computerized decision aid appears to increase the proportion of patients who responded to invitations to discuss CVD prevention with their doctor. The Computer- Assisted History Taking Systems (CAHTS) increased the proportion of patients who discussed CHD risk reduction with their doctor from 24% to 40% and increased the proportion who had a specific plan to reduce their risk from 24% to 37%. With only one study meeting the inclusion criteria, for prevention of CVD and one study for management of CVD we did not gather sufficient evidence to address all of the objectives of the review. We were unable to report on most of the secondary patient outcomes in our protocol. We tentatively conclude that CAHTS can provide individually-tailored information about CVD prevention. However, further primary studies are needed to confirm these findings. We cannot draw any conclusions in relation to any other clinical outcomes at this stage. There is a need to develop an evidence base to support the effective development and use of CAHTS in this area of practice. In the absence of evidence on effectiveness, the implementation of computer-assisted history taking may only rely on the clinicians' tacit knowledge, published monographs and viewpoint articles.

Improving Medication Adherence in Cardiometabolic Disease

PubMed Central

Ferdinand, Keith C.; Senatore, Fortunato Fred; Clayton-Jeter, Helene; Cryer, Dennis R.; Lewin, John C.; Nasser, Samar A.; Fiuzat, Mona; Califf, Robert M.

2017-01-01

Medication nonadherence, a major problem in cardiovascular disease (CVD), contributes yearly to approximately 125,000 preventable deaths, which is partly attributable to only about one-half of CVD patients consistently taking prescribed life-saving medications. Current interest has focused on how labeling and education influence adherence. This paper summarizes the scope of CVD nonadherence, describes key U.S. Food and Drug Administration initiatives, and identifies potential targets for improvement. We describe key adherence factors, methods, and technological applications for simplifying regimens and enhancing adherence, and 4 areas where additional collaborative research and implementation involving the regulatory system and clinical community could substantially reduce nonadherence: 1) identifying monitoring methods; 2) improving the evidence base to better understand adherence; 3) developing patient/health provider team-based engagement strategies; and 4) alleviating health disparities. Alignment of U.S. Food and Drug Administration approaches to dissemination of information about appropriate use with clinical practice could improve adherence, and thereby reduce CVD death and disability. PMID:28126162

Family history of cardiovascular disease (CVD), perceived CVD risk, and health-related behavior: A review of the literature

PubMed Central

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

Work-related cerebro-cardiovascular diseases in Korea.

PubMed

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

PubMed Central

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

The use of CVD diamond burs for ultraconservative cavity preparations: a report of two cases.

PubMed

Carvalho, Carlos Augusto R; Fagundes, Ticiane C; Barata, Terezinha J E; Trava-Airoldi, Vladimir Jesus; Navarro, Maria Fidela L

2007-01-01

During the past decades, scientific developments in cutting instruments have changed the conventional techniques used to remove caries lesions. Ultrasound emerged as an alternative for caries removal since the 1950s. However, the conventional technology for diamond powder aggregation with nickel metallic binders could not withstand ultrasonic power. Around 5 years ago, an alternative approach using chemical vapor deposition (CVD) resulted in synthetic diamond technology. CVD diamond burs are obtained with high adherence of the diamond as a unique stone on the metallic surface with excellent abrading performance. This technology allows for diamond deposition with coalescent granulation in different formats of substrates. When connected to an ultrasonic handpiece, CVD diamond burs become an option for cavity preparation, maximizing preservation of tooth structure. Potential advantages such as reduced noise, minimal damage to the gingival tissue, extended bur durability, improved proximal cavity access, reduced risk of hitting the adjacent tooth resulting from the high inclination angles, and minimal patient's risk of metal contamination. These innovative instruments also potentially eliminate some problems regarding decreased cutting efficiency of conventional diamond burs. This clinical report presents the benefits of using CVD diamond burs coupled with an ultrasonic handpiece in the treatment of incipient caries. CVD diamond burs coupled with an ultrasonic device offer a promising alternative for removal of carious lesions when ultraconservative cavity preparations are required. Additionally, this system provides a less-painful technique for caries removal, with minimal noise.

Overview of Coronary Heart Disease Risk Initiatives in South Asia.

PubMed

Kalra, Ankur; Bhatt, Deepak L; Rajagopalan, Sanjay; Suri, Kunal; Mishra, Sundeep; Iqbal, Romaina; Virani, Salim S

2017-06-01

Cardiovascular disease (CVD) is now the leading cause of morbidity and mortality worldwide. Industrialization and economic growth have led to an unprecedented increment in the burden of CVD and their risk factors in less industrialized regions of the world. While there are abundant data on CVD and their risk factors from longitudinal cohort studies done in the West, good-quality data from South Asia are lacking. Several multi-institutional, observational, prospective registries, and epidemiologic cohorts in South Asia have been established to systematically evaluate the burden of CVD and their risk factors. The PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP), the Kerala Acute Coronary Syndrome (ACS), and Trivandrum Heart Failure registries have focused on secondary prevention of CVD and performance measurement in both outpatient and inpatient settings, respectively. The Prospective Urban and Rural Epidemiology (PURE), Centre for Cardiometabolic Risk Reduction in South Asia (CARRS), and other epidemiologic and genetic studies have focused on primary prevention of CVD and evaluated variables such as environment, smoking, physical activity, health systems, food and nutrition policy, dietary consumption patterns, socioeconomic factors, and healthy neighborhoods. The international cardiovascular community has been responsive to a burgeoning cardiovascular disease burden in South Asia. Several collaborations have formed between the West (North America in particular) and South Asia to catalyze evidence-based and data-driven changes in the federal health policy in this part of the world to promote cardiovascular health and mitigate cardiovascular risk.

Engineering Graphene Films from Coal

NASA Astrophysics Data System (ADS)

Vijapur, Santosh H.

Graphene is a unique material with remarkable properties suitable for a wide array of applications. Chemical vapor deposition (CVD) is a simple technique for synthesis of large area and high quality graphene films on various metal substrates. Among the metal substrates, copper has been shown to be an excellent support for the growth of graphene films. Traditionally, hydrocarbon gases are used for the graphene synthesis via CVD. Unconventional solid carbon sources such as various polymers and food waste have also shown great potential for synthesis of graphene films. Coal is one such carbon enriched and abundantly available unconventional source. Utilization of coal as a carbon source to synthesize large area, transparent, and high quality few-layer graphene films via CVD has been demonstrated in the present work. Hydrocarbon gases are released as products of coal pyrolysis at temperatures ≥400 °C. This study hypothesized that, these hydrocarbon gases act as precursors for the synthesis of graphene films on the copper substrate. Hence, atmospheric pressure CVD and low temperature of 400 °C were utilized initially for the production of graphene films. These conditions were suitable for the formation of amorphous carbon (a-C) films but not crystalline graphene films that were the objective of this work. The synthesized a-C films on the copper substrate were shown to be uniform and transparent with large surface area. The thickness and surface roughness of the a-C films were determined to have typical values of 5 nm and 0.55 nm, respectively. The a-C film has >95 % optical transmittance and sheet resistivity of 0.6 MO sq-1. These values are comparable to other carbon thin films synthesized at higher temperatures. Further, the a-C films were transferred onto any type of substrate such as silicon wafer and titanium foil, and can be utilized for diverse applications. However, crystalline graphene films were not produced by implementing atmospheric pressure CVD and low temperature operation. Annealing of copper support was required to remove the oxide layer present on its surface and low pressure operation was demonstrated to be suitable for crystalline graphene film formation. The CVD system and the synthesis procedure were modified to address these issues. This was done by increasing the synthesis temperature, incorporating a vacuum pump for low pressure operation, and implementing two step procedure of annealing the copper substrate followed by subsequent coal pyrolysis for the synthesis of crystalline graphene films. The synthesized few layer graphene films were uniform and continuous with thickness in the range of 3-7 nm. The optical transmittance and electrical conductivity measurements demonstrated that the graphene films have >95 % transparency and sheet resistivity of 5.0 kO sq-1, respectively. An investigation of growth mechanism of coal derived graphene films synthesized via CVD was conducted utilizing spectroscopy, microscopy, and chromatography techniques. Gas collection was performed at the graphene synthesis conditions utilizing the CVD reactor without vacuum in operation. Various gases released as products of coal pyrolysis in the CVD reactor were collected and analyzed using gas chromatography. The analysis showed the presence of methane, ethane, ethene, propane, propene, carbon monoxide, and carbon dioxide as coal pyrolysis products. The hydrocarbon gases act as precursors for graphene growth. Raman spectroscopy, selected area electron diffraction (SAED), and X-ray photoelectron spectroscopy (XPS) confirmed the formation of crystalline graphene films at 1055 °C and 18-30 min synthesis. The growth mechanism involves copper catalyzed reaction to produce amorphous carbon film within the first few minutes of synthesis. Raman spectroscopy and SAED validated that lower synthesis times (6-12 min) produced hybrid amorphous carbon films. This is followed by hydrogen catalyzed graphitization of the underlying carbon film to form graphene domains. Optical microscopy and Raman spectra demonstrated the formation of these oval shaped graphene domains as synthesis time was increased (18-30 min). The graphene films are formed by growth and merging of these graphene domains on the copper substrate. The growth mechanism of coal derived crystalline graphene films is presented in the current work.

Electrical Characterization of Amorphous Silicon MIS-Based Structures for HIT Solar Cell Applications.

PubMed

García, Héctor; Castán, Helena; Dueñas, Salvador; Bailón, Luis; García-Hernansanz, Rodrigo; Olea, Javier; Del Prado, Álvaro; Mártil, Ignacio

2016-12-01

A complete electrical characterization of hydrogenated amorphous silicon layers (a-Si:H) deposited on crystalline silicon (c-Si) substrates by electron cyclotron resonance chemical vapor deposition (ECR-CVD) was carried out. These structures are of interest for photovoltaic applications. Different growth temperatures between 30 and 200 °C were used. A rapid thermal annealing in forming gas atmosphere at 200 °C during 10 min was applied after the metallization process. The evolution of interfacial state density with the deposition temperature indicates a better interface passivation at higher growth temperatures. However, in these cases, an important contribution of slow states is detected as well. Thus, using intermediate growth temperatures (100-150 °C) might be the best choice.

Electrical Characterization of Amorphous Silicon MIS-Based Structures for HIT Solar Cell Applications

NASA Astrophysics Data System (ADS)

García, Héctor; Castán, Helena; Dueñas, Salvador; Bailón, Luis; García-Hernansanz, Rodrigo; Olea, Javier; del Prado, Álvaro; Mártil, Ignacio

2016-07-01

A complete electrical characterization of hydrogenated amorphous silicon layers (a-Si:H) deposited on crystalline silicon (c-Si) substrates by electron cyclotron resonance chemical vapor deposition (ECR-CVD) was carried out. These structures are of interest for photovoltaic applications. Different growth temperatures between 30 and 200 °C were used. A rapid thermal annealing in forming gas atmosphere at 200 °C during 10 min was applied after the metallization process. The evolution of interfacial state density with the deposition temperature indicates a better interface passivation at higher growth temperatures. However, in these cases, an important contribution of slow states is detected as well. Thus, using intermediate growth temperatures (100-150 °C) might be the best choice.

Ultrathin, wafer-scale hexagonal boron nitride on dielectric surfaces by diffusion and segregation mechanism

NASA Astrophysics Data System (ADS)

Sonde, Sushant; Dolocan, Andrei; Lu, Ning; Corbet, Chris; Kim, Moon J.; Tutuc, Emanuel; Banerjee, Sanjay K.; Colombo, Luigi

2017-06-01

Chemical vapor deposition (CVD) of two-dimensional (2D) hexagonal boron nitride (h-BN) is at the center of numerous studies for its applications in novel electronic devices. However, a clear understanding of the growth mechanism is lacking for its wider industrial adoption on technologically relevant substrates such as SiO2. Here, we demonstrate a controllable growth method of thin, wafer scale h-BN films on arbitrary substrates. We also clarify the growth mechanism to be diffusion and surface segregation (D-SS) of boron (B) and nitrogen (N) in Ni and Co thin films on SiO2/Si substrates after exposure to diborane and ammonia precursors at high temperature. The segregation was found to be independent of the cooling rates employed in this report, and to our knowledge has not been found nor reported for 2D h-BN growth so far, and thus provides an important direction for controlled growth of h-BN. This unique segregation behavior is a result of a combined effect of high diffusivity, small film thickness and the inability to achieve extremely high cooling rates in CVD systems. The resulting D-SS h-BN films exhibit excellent electrical insulating behavior with an optical bandgap of about 5.8 eV. Moreover, graphene-on-h-BN field effect transistors using the as-grown D-SS h-BN films show a mobility of about 6000 cm2 V-1 s-1 at room temperature.

Geographic Variation in Morbidity and Mortality of Cerebrovascular Diseases in Korea during 2011-2015.

PubMed

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.

Vivir Con Un Corazón Saludable: a Community-Based Educational Program Aimed at Increasing Cardiovascular Health Knowledge in High-Risk Hispanic Women.

PubMed

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.

Quantitative Analysis of Scattering Mechanisms in Highly Crystalline CVD MoS2 through a Self-Limited Growth Strategy by Interface Engineering.

PubMed

Wan, Xi; Chen, Kun; Xie, Weiguang; Wen, Jinxiu; Chen, Huanjun; Xu, Jian-Bin

2016-01-27

The electrical performance of highly crystalline monolayer MoS2 is remarkably enhanced by a self-limited growth strategy on octadecyltrimethoxysilane self-assembled monolayer modified SiO2 /Si substrates. The scattering mechanisms in low-κ dielectric, including the dominant charged impurities, acoustic deformation potentials, optical deformation potentials), Fröhlich interaction, and the remote interface phonon interaction in dielectrics, are quantitatively analyzed. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Freedom poverty: a new tool to identify the multiple disadvantages affecting those with CVD.

PubMed

Callander, Emily J; Schofield, Deborah J; Shrestha, Rupendra N

2013-06-20

It is recognised that CVD affects an individual's financial situation, placing them in income poverty. However, recent developments in poverty measurement practice recognises other forms of disadvantage other than low income, such as poor health and insufficient education also affect living standards. Using the Freedom Poverty Measure, the multiple forms of disadvantage experienced by those with no health condition, heart disease, other diseases of the circulatory system, and all other health conditions was assessed using data on the adult Australian population contained in the 2003 Survey of Disability, Ageing and Carers. 24% of those with heart disease and 23% of those with other diseases of the circulatory system were in freedom poverty, suffering from multiple forms of disadvantage. Those with heart disease and those with other diseases of the circulatory system were around three times more likely to be in freedom poverty (OR 3.02, 95% CI: 2.29-3.99, p<.0001; OR 2.78, 95% CI: 1.94-3.98, p<.0001) than those with no health condition. Recognising the multiple forms of disadvantage suffered by those with CVD provides a clearer picture of their living standards than just looking at their income alone and the high proportion of individuals with CVD that are suffering from multiple forms of disadvantage should make them a target for policy makers wishing to improve living standards. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Can cardiovascular magnetic resonance prompt early cardiovascular/rheumatic treatment in autoimmune rheumatic diseases? Current practice and future perspectives.

PubMed

Mavrogeni, Sophie I; Sfikakis, Petros P; Dimitroulas, Theodoros; Koutsogeorgopoulou, Loukia; Katsifis, Gikas; Markousis-Mavrogenis, George; Kolovou, Genovefa; Kitas, George D

2018-06-01

Life expectancy in autoimmune rheumatic diseases (ARDs) remains lower compared to the general population, due to various comoborbidities. Cardiovascular disease (CVD) represents the main contributor to premature mortality. Conventional and biologic disease-modifying antirheumatic drugs (DMARDs) have considerably improved long-term outcomes in ARDs not only by suppressing systemic inflammation but also by lowering CVD burden. Regarding atherosclerotic disease prevention, EULAR has recommended tight disease control accompanied by regular assessment of traditional CVD risk factors and lifestyle changes. However, this approach, although rational and evidence-based, does not account for important issues such as myocardial inflammation and the long asymptomatic period that usually proceeds clinical manifestations of CVD disease in ARDs before or after the diagnosis of systemic disease. Cardiovascular magnetic resonance (CMR) can offer reliable, reproducible and operator independent information regarding myocardial inflammation, ischemia and fibrosis. Some studies suggest a role for CMR in the risk stratification of ARDs and demonstrate that oedema/fibrosis visualisation with CMR may have the potential to inform cardiac and rheumatic treatment modification in ARDs with or without abnormal routine cardiac evaluation. In this review, we discuss how CMR findings could influence anti-rheumatic treatment decisions targeting optimal control of both systemic and myocardial inflammation irrespective of clinical manifestations of cardiac disease. CMR can provide a different approach that is very promising for risk stratification and treatment modification; however, further studies are needed before the inclusion of CMR in the routine evaluation and treatment of patients with ARDs.

Work stress and cardiovascular disease: a life course perspective.

PubMed

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.

Pharmacological Strategies to Retard Cardiovascular Aging

PubMed Central

Alfaras, Irene; Di Germanio, Clara; Bernier, Michel; Csiszar, Anna; Ungvari, Zoltan; Lakatta, Edward G.; de Cabo, Rafael

2016-01-01

Aging is the major risk factor for cardiovascular diseases (CVD), which are the leading cause of death in the United States. Traditionally, the effort to prevent CVD has been focused on addressing the conventional risk factors, including hypertension, hyperglycemia, hypercholesterolemia, and high circulating levels of triglycerides. However, recent preclinical studies have identified new approaches to combat CVD. Calorie restriction has been reproducibly shown to prolong lifespan in various experimental model animals. This has led to the development of calorie restriction mimetics and other pharmacological interventions capable to delay age-related diseases. In this review, we will address the mechanistic effects of aging per se on the cardiovascular system and focus on the pro-longevity benefits of various therapeutic strategies that support cardiovascular health. PMID:27174954

The primary prevention of cardiovascular disease: nurse practitioners using behaviour modification strategies.

PubMed

Farrell, Todd Charles; Keeping-Burke, Lisa

2014-01-01

Cardiovascular disease (CVD) places great financial strain on the health care system and dramatically affects individual quality of life. As primary health care providers, nurse practitioners (NPs) are ideally positioned to advise clients on risk factor and lifestyle modifications that ameliorate the impact of CVD. While the lifestyle targets for CVD prevention are established, the most effective means of achieving these goals remain uncertain. Behaviour modification strategies, including motivational interviewing (MI) and the transtheoretical model (TTM), have been suggested, but neither approach is established as being more efficacious than the other. In this paper, evidence on the effectiveness of the two approaches for modifying smoking, diet, and exercise behaviour are presented, and a recommendation for NP practice is made.

Challenges in graphene integration for high-frequency electronics

NASA Astrophysics Data System (ADS)

Giannazzo, F.; Fisichella, G.; Greco, G.; Roccaforte, F.

2016-06-01

This paper provides an overview of the state-of-the-art research on graphene (Gr) for high-frequency (RF) devices. After discussing current limitations of lateral Gr RF transistors, novel vertical devices concepts such as the Gr Base Hot Electron Transistor (GBHET) will be introduced and the main challenges in Gr integration within these architectures will be discussed. In particular, a GBHET device based on Gr/AlGaN/GaN heterostructure will be considered. An approach to the fabrication of this heterostructure by transfer of CVD grown Gr on copper to the AlGaN surface will be presented. The morphological and electrical properties of this system have been investigated at nanoscale by atomic force microscopy (AFM) and conductive atomic force microscopy (CAFM). In particular, local current-voltage measurements by the CAFM probe revealed the formation of a Schottky contact with low barrier height (˜0.41 eV) and excellent lateral uniformity between Gr and AlGaN. Basing on the electrical parameters extracted from this characterization, the theoretical performances of a GBHET formed by a metal/Al2O3/Gr/AlGaN/GaN stack have been evaluated.

Cardiovascular disease risk factors and the perception of general health among male law enforcement officers: encouraging behavioral change.

PubMed

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.

Risks of restrictive red blood cell transfusion strategies in patients with cardiovascular disease (CVD): a meta-analysis.

PubMed

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)

PubMed Central

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

Red Blood Cell Function and Dysfunction: Redox Regulation, Nitric Oxide Metabolism, Anemia

PubMed Central

Kuhn, Viktoria; Diederich, Lukas; Keller, T.C. Stevenson; Kramer, Christian M.; Lückstädt, Wiebke; Panknin, Christina; Suvorava, Tatsiana; Isakson, Brant E.; Kelm, Malte

2017-01-01

Abstract Significance: Recent clinical evidence identified anemia to be correlated with severe complications of cardiovascular disease (CVD) such as bleeding, thromboembolic events, stroke, hypertension, arrhythmias, and inflammation, particularly in elderly patients. The underlying mechanisms of these complications are largely unidentified. Recent Advances: Previously, red blood cells (RBCs) were considered exclusively as transporters of oxygen and nutrients to the tissues. More recent experimental evidence indicates that RBCs are important interorgan communication systems with additional functions, including participation in control of systemic nitric oxide metabolism, redox regulation, blood rheology, and viscosity. In this article, we aim to revise and discuss the potential impact of these noncanonical functions of RBCs and their dysfunction in the cardiovascular system and in anemia. Critical Issues: The mechanistic links between changes of RBC functional properties and cardiovascular complications related to anemia have not been untangled so far. Future Directions: To allow a better understanding of the complications associated with anemia in CVD, basic and translational science studies should be focused on identifying the role of noncanonical functions of RBCs in the cardiovascular system and on defining intrinsic and/or systemic dysfunction of RBCs in anemia and its relationship to CVD both in animal models and clinical settings. Antioxid. Redox Signal. 26, 718–742. PMID:27889956

Factors associated with blue-collar workers' risk perception of cardiovascular disease.

PubMed

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.

Highly conducting and wide band gap phosphorous doped nc-Si–QD/a-SiC films as n-type window layers for solar cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kar, Debjit; Das, Debajyoti, E-mail: erdd@iacs.res.in

2016-05-23

Nano-crystalline silicon quantum dots (Si-QDs) embedded in the phosphorous doped amorphous silicon carbide (a-SiC) matrix has been successfully prepared at a low temperature (300 °C) by inductively coupled plasma assisted chemical vapor deposition (ICP-CVD) system from (SiH{sub 4} + CH{sub 4})-plasma with PH{sub 3} as the doping gas. The effect of PH{sub 3} flow rate on structural, optical and electrical properties of the films has been studied. Phosphorous doped nc-Si–QD/a-SiC films with high optical band gap (>1.9 eV) and superior conductivity (~10{sup −2} S cm{sup −1}) are obtained, which could be appropriately used as n-type window layers for nc-Si solarmore » cells in n-i-p configuration.« less

Fabrication and Performance Study on Individual Zno Nanowires Based Bioelectrode

NASA Astrophysics Data System (ADS)

Zhao, Yanguang; Yan, Xiaoqin; Kang, Zhuo; Lin, Pei

2012-08-01

One-dimensional zinc oxide nanowires (ZnO NWs) have unique advantages for use in biosensors as follows: oxide stable surface, excellent biosafety, high specific surface area, high isoelectric point (IEP = 9.5). In this work, we have prepared a kind of electrochemical bioelectrode based on individual ZnO NWs. Here, ZnO NWs with high quality were successfully synthesized by CVD method, which were characterized by scanning electron microscopy, X-ray diffraction and photoluminescence. Then the Raman spectra and electrical characterization demonstrated the adsorption of uricase on ZnO wires. At last, a series of electrochemical measurements were carried out by using an electrochemical workstation with a conventional three-electrode system to obtain the cyclic voltammetry characteristics of the bioelectrodes. The excellent performance of the fabricated bioelectrode implies the potential application for single ZnO nanowire to construct electrochemical biosensor for the detection of uric acid.

The @RISK Study: Risk communication for patients with type 2 diabetes: design of a randomised controlled trial.

PubMed

Welschen, Laura M C; Bot, Sandra D M; Dekker, Jacqueline M; Timmermans, Daniëlle R M; van der Weijden, Trudy; Nijpels, Giel

2010-08-05

Patients with type 2 diabetes mellitus (T2DM) have an increased risk to develop severe diabetes related complications, especially cardiovascular disease (CVD). The risk to develop CVD can be estimated by means of risk formulas. However, patients have difficulties to understand the outcomes of these formulas. As a result, they may not recognize the importance of changing lifestyle and taking medication in time. Therefore, it is important to develop risk communication methods, that will improve the patients' understanding of risks associated with having diabetes, which enables them to make informed choices about their diabetes care.The aim of this study is to investigate the effects of an intervention focussed on the communication of the absolute 10-year risk to develop CVD on risk perception, attitude and intention to change lifestyle behaviour in patients with T2DM. The conceptual framework of the intervention is based on the Theory of Planned Behaviour and the Self-regulation Theory. A randomised controlled trial will be performed in the Diabetes Care System West-Friesland (DCS), a managed care system. Newly referred T2DM patients of the DCS, younger than 75 years will be eligible for the study. The intervention group will be exposed to risk communication on CVD, on top of standard managed care of the DCS. This intervention consists of a simple explanation on the causes and consequences of CVD, and possibilities for prevention. The probabilities of CVD in 10 year will be explained in natural frequencies and visualised by a population diagram. The control group will receive standard managed care. The primary outcome is appropriateness of risk perception. Secondary outcomes are attitude and intention to change lifestyle behaviour and illness perception. Differences between baseline and follow-up (2 and 12 weeks) between groups will be analysed according to the intention-to-treat principle. The study was powered on 120 patients in each group. This innovative risk communication method based on two behavioural theories might improve patient's appropriateness of risk perception and attitude concerning lifestyle change. With a better understanding of their CVD risk, patients will be able to make informed choices concerning diabetes care. The trial is registered as NTR1556 in the Dutch Trial Register.

Prognostic value of metabolic syndrome for the development of cardiovascular disease in a cohort of premenopausal women with systemic lupus erythematosus.

PubMed

García-Villegas, Elsy Aidé; Lerman-Garber, Israel; Flores-Suárez, Luis Felipe; Aguilar-Salinas, Carlos; Márquez González, Horacio; Villa-Romero, Antonio Rafael

2015-04-08

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease of unknown etiology. In lupus patients there is an increased cardiovascular risk due to an accelerated atherogenesis. Furthermore, Metabolic Syndrome (MS) adds an independent risk for developing Cardiovascular Disease (CVD) in the population. Therefore, it is important to determine whether lupus patients have an increased risk of developing Cardiovascular Disease in the presence of MS. To estimate the prognostic value of MS in the incidence of cardiovascular events in a cohort of premenopausal patients with SLE. Cohort study in 238 patients was carried out. Clinical, biochemical, dietetic and anthropometric evaluations were performed. Patients were classified according to the prevalence of MS in 2001. There was a patient follow-up from 2001 to 2008. In 2008, after studying the records, we obtained the "cases" (patients with CVD) and the "no cases" (patients without CVD). The basal prevalence of MS in the cohort was of 21.8% (ATPIII). The MS component with the highest prevalence in the population studied in 2001 was low HDL-Cholesterol (<50mg/dL) with a prevalence of 55.0%. The cumulative incidence of CVD in the group with MS was 17.3% and in the group without MS it was 7.0% with a Relative Risk (RR) of 2.48 (1.12-5.46) and p<0.05. In the multivariable analysis it was noted that MS is a predictive factor of CVD. We observed the prognostic value of MS for an increased risk of cardiovascular damage in premenopausal patients with lupus. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Local innovation for improving primary care cardiology in resource-limited African settings: an insight on the Cardio Pad(®) project in Cameroon.

PubMed

Noubiap, Jean Jacques N; Jingi, Ahmadou M; Kengne, André Pascal

2014-10-01

Cardiovascular disease (CVD) is an emerging threat to the health of populations in Africa. With the inadequate health infrastructures, understaffed and underfunded health systems, African countries are ill-prepared to cope with the increasing demand for care for CVD, particularly for populations in remote and underserved rural areas, where 60% of the population currently reside. Task shifting and telehealth have been suggested as strategies to overcome the current health workforce shortage in African countries, and to increase access to prevention and curative services for emerging CVD. However, strategies for promoting their incorporation into the existing health systems, have yet to be developed. The Cardio Pad(®) initiative (originating from Cameroon) seeks to provide appropriate solutions to improve the application of telemedicine for CVD prevention and control in remote African settings. The Cardio Pad(®) is a tele-cardiology device which provides a number of advantages in terms of cost, ease of use, autonomy and reduced technology requirements. It is a fully touch screen medical device which enables cardiac tests such as electrocardiograms (ECG) to be performed in remote underserved areas (rural areas for instance), while the test results are transferred wirelessly via mobile phone connection, to specialist physicians who can interpret them and provide assistance with case management. While most of the current telemedicine clinical services on the African continent receive most expertise from developed countries, the Cardio Pad(®), a local invention by a 26-year-old Cameroon-trained engineer demonstrates how much innovative solutions to combat CVD and other health issues could and should be developed locally in Africa.

Community cardiovascular disease risk from cross-sectional general practice clinical data: a spatial analysis.

PubMed

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.

Chronic Inflammatory Diseases and Atherosclerotic Cardiovascular Disease: Innocent Bystanders or Partners in Crime?

PubMed

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.

Development and optimization of carvedilol orodispersible tablets: enhancement of pharmacokinetic parameters in rabbits

PubMed Central

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

Electrical properties of epitaxial 3C- and 6H-SiC p-n junction diodes produced side-by-side on 6H-SiC substrates

NASA Technical Reports Server (NTRS)

Neudeck, Philip G.; Larkin, David J.; Starr, Jonathan E.; Powell, J. Anthony; Salupo, Carl S.; Matus, Lawrence G.

1994-01-01

3C-SiC (beta-SiC) and 6H-SiC p-n junction diodes have been fabricated in regions of both 3C-SiC and 6H-SiC epitaxial layers which were grown side-by-side on low-tilt-angle 6H-SiC substrates via a chemical vapor deposition (CVD) process. Several runs of diodes exhibiting state-of-the-art electrical characteristics were produced, and performance characteristics were measured and compared as a function of doping, temperature, and polytype. The first 3C-SiC diodes which rectify to reverse voltages in excess of 300 V were characterized, representing a six-fold blocking voltage improvement over experimental 3C-SiC diodes produced by previous techniques. When placed under sufficient forward bias, the 3C-SiC diodes emit significantly bright green-yellow light while the 6H-SiC diodes emit in the blue-violet. The 6H-SiC p-n junction diodes represent the first reported high-quality 6H-SiC devices to be grown by CVD on very low-tilt-angle (less than 0.5 deg off the (0001) silicon face) 6H substrates. The reverse leakage current of a 200 micron diameter circular device at 1100 V reverse bias was less than 20 nA at room temperature, and excellent rectification characteristics were demonstrated at the peak characterization temperature of 400 C.

Economic efficiency of primary care for CVD prevention and treatment in Eastern European countries

PubMed Central

2013-01-01

Background Cardiovascular disease (CVD) is the main cause of morbidity and mortality worldwide, but it also is highly preventable. The prevention rate mainly depends on the patients’ readiness to follow recommendations and the state’s capacity to support patients. Our study aims to show that proper primary care can decrease the CVD-related morbidity rate and increase the economic efficiency of the healthcare system. Since their admission to the European Union (EU), the Eastern European countries have been in a quest to achieve the Western European standards of living. As a representative Eastern European country, Romania implemented the same strategies as the rest of Eastern Europe, reflected in the health status and lifestyle of its inhabitants. Thus, a valid health policy implemented in Romania should be valid for the rest of the Eastern European countries. Methods Based on the data collected during the EUROASPIRE III Romania Follow Up study, the potential costs of healthcare were estimated for various cases over a 10-year time period. The total costs were split into patient-supported costs and state-supported costs. The state-supported costs were used to deduce the rate of patients with severe CVD that can be treated yearly. A statistical model for the evolution of this rate was computed based on the readiness of the patients to comply with proper primary care treatment. Results We demonstrate that for patients ignoring the risks, a severe CVD has disadvantageous economic consequences, leading to increased healthcare expenses and even poverty. In contrast, performing appropriate prevention activities result in a decrease of the expenses allocated to a (eventual) CVD. In the long-term, the number of patients with severe CVD that can be treated increases as the number of patients receiving proper primary care increases. Conclusions Proper primary care can not only decrease the risk of major CVD but also decrease the healthcare costs and increase the number of patients that can be treated. Most importantly, the health standards of the EU can be achieved more rapidly when primary care is delivered appropriately. JEL I18, H51 PMID:23433501

Dietary Choline and Betaine and Risk of CVD: A Systematic Review and Meta-Analysis of Prospective Studies

PubMed Central

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

Dietary Choline and Betaine and Risk of CVD: A Systematic Review and Meta-Analysis of Prospective Studies.

PubMed

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.

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

Is cardiovascular risk in women with PCOS a real risk? Current insights.

PubMed

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.

Plasma markers of inflammation and prediction of cardiovascular disease and mortality in African Americans with type 1 diabetes.

PubMed

Roy, Monique S; Janal, Malvin N; Crosby, Juan; Donnelly, Robert

2016-04-01

To determine whether plasma levels of markers of inflammation are predictive of the incidence of cardiovascular disease (CVD), hypertension, or mortality in African Americans with type 1 diabetes mellitus. A total of 484 African Americans with type 1 diabetes were included. At baseline and 6-year follow-up, a clinical interview and examination were conducted to document CVD and systemic hypertension. Venous blood for glycated hemoglobin and cholesterol was obtained and albumin excretion rate measured. Mortality was assessed annually between baseline and 6-year follow-up by review of the social security death index. Baseline plasma levels of 28 inflammatory biomarkers were measured using multiplex bead analysis system. After adjusting for baseline age and other confounders, African Americans with type 1 diabetes in the highest quartile of plasma interferon-inducible protein 10 (IP-10) were three times more likely to develop CVD than those in the lowest quartile. African Americans with type 1 diabetes in the lowest quartiles of plasma stromal derived factor-1 (SDF-1) had a 75% higher risk of death than patients in the highest quartile, independently of age, low density lipoprotein cholesterol, body mass index, hypertension, and albuminuria. In African Americans with type 1 diabetes, high plasma IP-10 is an independent predictor for incident CVD and low SDF-1 an independent predictor for mortality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Advanced purification of petroleum refinery wastewater by catalytic vacuum distillation.

PubMed

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.

Review of controlled research on the transcendental meditation program and cardiovascular disease. Risk factors, morbidity, and mortality.

PubMed

Walton, Kenneth G; Schneider, Robert H; Nidich, Sanford

2004-01-01

Because of growing evidence for stress as a major factor contributing to cardiovascular disease (CVD), techniques of meditation are being increasingly used. The Transcendental Meditation (TM) technique is distinct from other techniques of meditation not only in its origin and procedure, but also in the amount and breadth of research testing it. Evidence for its ability to reduce traditional and novel risk factors for CVD includes: 1) decreases in blood pressure, 2) reduced use of tobacco and alcohol, 3) lowering of high cholesterol and lipid oxidation, and 4) decreased psychosocial stress. Changes expected to result from reducing these risk factors, namely, reversal of atherosclerosis, reduction of myocardial ischemia and left ventricular hypertrophy, reduced health insurance claims for CVD, and reduced mortality, also have been found with TM practice. Research on mechanisms suggests that some of the CVD-related benefits as a result of this technique could arise from normalization of neuroendocrine systems whose function has been distorted by chronic stress. Further randomized clinical trials are in progress with a focus on underserved minority populations.

Review of Controlled Research on the Transcendental Meditation Program and Cardiovascular Disease

PubMed Central

Walton, Kenneth G.; Schneider, Robert H.; Nidich, Sanford

2007-01-01

Because of growing evidence for stress as a major factor contributing to cardiovascular disease (CVD), techniques of meditation are being increasingly used. The Transcendental Meditation (TM) technique is distinct from other techniques of meditation not only in its origin and procedure, but also in the amount and breadth of research testing it. Evidence for its ability to reduce traditional and novel risk factors for CVD includes: 1) decreases in blood pressure, 2) reduced use of tobacco and alcohol, 3) lowering of high cholesterol and lipid oxidation, and 4) decreased psychosocial stress. Changes expected to result from reducing these risk factors, namely, reversal of atherosclerosis, reduction of myocardial ischemia and left ventricular hypertrophy, reduced health insurance claims for CVD, and reduced mortality, also have been found with TM practice. Research on mechanisms suggests that some of the CVD-related benefits as a result of this technique could arise from normalization of neuroendocrine systems whose function has been distorted by chronic stress. Further randomized clinical trials are in progress with a focus on underserved minority populations. PMID:15316306

Improving Medication Adherence in Cardiometabolic Disease: Practical and Regulatory Implications.

PubMed

Ferdinand, Keith C; Senatore, Fortunato Fred; Clayton-Jeter, Helene; Cryer, Dennis R; Lewin, John C; Nasser, Samar A; Fiuzat, Mona; Califf, Robert M

2017-01-31

Medication nonadherence, a major problem in cardiovascular disease (CVD), contributes yearly to approximately 125,000 preventable deaths, which is partly attributable to only about one-half of CVD patients consistently taking prescribed life-saving medications. Current interest has focused on how labeling and education influence adherence. This paper summarizes the scope of CVD nonadherence, describes key U.S. Food and Drug Administration initiatives, and identifies potential targets for improvement. We describe key adherence factors, methods, and technological applications for simplifying regimens and enhancing adherence, and 4 areas where additional collaborative research and implementation involving the regulatory system and clinical community could substantially reduce nonadherence: 1) identifying monitoring methods; 2) improving the evidence base to better understand adherence; 3) developing patient/health provider team-based engagement strategies; and 4) alleviating health disparities. Alignment of U.S. Food and Drug Administration approaches to dissemination of information about appropriate use with clinical practice could improve adherence, and thereby reduce CVD death and disability. Copyright © 2017 American College of Cardiology Foundation. Published by 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.

Racial and Ethnic Disparities in Cardiovascular Disease: An Assessment of Obstetrician-Gynecologists' Knowledge, Attitudes, and Practice Patterns.

PubMed

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.

Effects of high-intensity aerobic interval training on cardiovascular disease risk in testicular cancer survivors: A phase 2 randomized controlled trial.

PubMed

Adams, Scott C; DeLorey, Darren S; Davenport, Margie H; Stickland, Michael K; Fairey, Adrian S; North, Scott; Szczotka, Alexander; Courneya, Kerry S

2017-10-15

Testicular cancer survivors (TCS) have an increased risk of treatment-related cardiovascular disease (CVD), which may limit their overall survival. We evaluated the effects of high-intensity aerobic interval training (HIIT) on traditional and novel CVD risk factors and surrogate markers of mortality in a population-based sample of TCS. This phase 2 trial (ClinicalTrials.gov identifier NCT02459132) randomly assigned 63 TCS to usual care (UC) or 12 weeks of supervised HIIT (ie, alternating periods of vigorous-intensity and light-intensity aerobic exercise). The primary outcome was peak aerobic fitness (VO 2peak ) assessed via a treadmill-based maximal cardiorespiratory exercise test. Secondary endpoints included CVD risk (eg, Framingham Risk Score), arterial health, parasympathetic nervous system function, and blood-based biomarkers. Postintervention VO 2peak data were obtained for 61 participants (97%). HIIT participants attended 99% of the exercise sessions and achieved 98% of the target exercise intensity. Analysis of covariance demonstrated that HIIT was superior to UC for improving VO 2peak (adjusted between-group mean difference, 3.7 mL O 2 /kg/min; 95% confidence interval, 2.4-5.1 [P<.001]) and multiple secondary outcomes including CVD risk (P = .011), arterial thickness (P<.001), arterial stiffness (P<.001), postexercise parasympathetic reactivation (P = .001), inflammation (P = .045), and low-density lipoprotein (P = .014). Overall, HIIT reduced the prevalence of modifiable CVD risk factors by 20% compared with UC. This randomized trial provides the first evidence that HIIT improves cardiorespiratory fitness, multiple pathways of CVD risk, and surrogate markers of mortality in TCS. These findings have important implications for the management of TCS. Further research concerning the long-term effects of HIIT on CVD morbidity and mortality in TCS is warranted. Cancer 2017;123:4057-65. © 2017 American Cancer Society. © 2017 American Cancer Society.

Development, Testing, and Implementation of a Training Curriculum for Nonphysician Health Workers to Reduce Cardiovascular Disease.

PubMed

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.

Effects of High Intensity Statin Therapy in the Treatment of Diabetic Dyslipidemia in Patients with Coronary Artery Disease.

PubMed

Vavlukis, Marija; Kedev, Sasko

2018-01-01

Diabetic dyslipidemia has specifics that differ from dyslipidemia in patients without diabetes, which contributes to accelerated atherosclerosis equally as dysglycemia. The aim of this study was to deduce the interdependence of diabetic dyslipidemia and cardiovascular diseases (CVD), therapeutic strategies and the risk of diabetes development with statin therapy. We conducted a literature review of English articles through PubMed, PubMed Central and Cochrane, on the role of diabetic dyslipidemia in atherosclerosis, the antilipemic treatment with statins, and the role of statin therapy in newly developed diabetes, by using key words: atherosclerosis, diabetes mellitus, diabetic dyslipidemia, CVD, statins, nicotinic acid, fibrates, PCSK9 inhibitors. hyperglycemia and dyslipidemia cannot be treated separately in patients with diabetes. It seems that dyslipidemia plays one of the key roles in the development of atherosclerosis. High levels of TG, decreased levels of HDL-C and increased levels of small dense LDL- C particles in the systemic circulation are the most specific attributes of diabetic dyslipidemia, all of which originate from an inflated flux of free fatty acids occurring due to the preceding resistance to insulin, and exacerbated by elevated levels of inflammatory adipokines. Statins are a fundamental treatment for diabetic dyslipidemia, both for dyslipidemia and for CVD prevention. The use of statin treatment with high intensity is endorsed for all diabetes-and-CVD patients, while a moderate - intensity treatment can be applied to patients with diabetes, having additional risk factors for CVD. Statins alone are thought to possess a small, although of statistical significance, risk of incident diabetes, outweighed by their benefits. As important as hyperglycemia and glycoregulation are in CVD development in patients with diabetes, diabetic dyslipidemia plays an even more important role. Statins remain the cornerstone of antilipemic treatment in diabetic dyslipidemia, and their protective effects in CVD progression overcome the risk of statin- associated incident diabetes. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Effects of oxidative stress on fatty acid- and one-carbon-metabolism in psychiatric and cardiovascular disease comorbidity

PubMed Central

Assies, J; Mocking, R J T; Lok, A; Ruhé, H G; Pouwer, F; Schene, A H

2014-01-01

Objective Cardiovascular disease (CVD) is the leading cause of death in severe psychiatric disorders (depression, schizophrenia). Here, we provide evidence of how the effects of oxidative stress on fatty acid (FA) and one-carbon (1-C) cycle metabolism, which may initially represent adaptive responses, might underlie comorbidity between CVD and psychiatric disorders. Method We conducted a literature search and integrated data in a narrative review. Results Oxidative stress, mainly generated in mitochondria, is implicated in both psychiatric and cardiovascular pathophysiology. Oxidative stress affects the intrinsically linked FA and 1-C cycle metabolism: FAs decrease in chain length and unsaturation (particularly omega-3 polyunsaturated FAs), and lipid peroxidation products increase; the 1-C cycle shifts from the methylation to transsulfuration pathway (lower folate and higher homocysteine and antioxidant glutathione). Interestingly, corresponding alterations were reported in psychiatric disorders and CVD. Potential mechanisms through which FA and 1-C cycle metabolism may be involved in brain (neurocognition, mood regulation) and cardiovascular system functioning (inflammation, thrombosis) include membrane peroxidizability and fluidity, eicosanoid synthesis, neuroprotection and epigenetics. Conclusion While oxidative-stress-induced alterations in FA and 1-C metabolism may initially enhance oxidative stress resistance, persisting chronically, they may cause damage possibly underlying (co-occurrence of) psychiatric disorders and CVD. This might have implications for research into diagnosis and (preventive) treatment of (CVD in) psychiatric patients. PMID:24649967

The Renin-Angiotensin-Aldosterone System in Vascular Inflammation and Remodeling

PubMed Central

Pacurari, Maricica; Kafoury, Ramzi; Tchounwou, Paul B.; Ndebele, Kenneth

2014-01-01

The RAAS through its physiological effectors plays a key role in promoting and maintaining inflammation. Inflammation is an important mechanism in the development and progression of CVD such as hypertension and atherosclerosis. In addition to its main role in regulating blood pressure and its role in hypertension, RAAS has proinflammatory and profibrotic effects at cellular and molecular levels. Blocking RAAS provides beneficial effects for the treatment of cardiovascular and renal diseases. Evidence shows that inhibition of RAAS positively influences vascular remodeling thus improving CVD outcomes. The beneficial vascular effects of RAAS inhibition are likely due to decreasing vascular inflammation, oxidative stress, endothelial dysfunction, and positive effects on regeneration of endothelial progenitor cells. Inflammatory factors such as ICAM-1, VCAM-1, TNFα, IL-6, and CRP have key roles in mediating vascular inflammation and blocking RAAS negatively modulates the levels of these inflammatory molecules. Some of these inflammatory markers are clinically associated with CVD events. More studies are required to establish long-term effects of RAAS inhibition on vascular inflammation, vascular cells regeneration, and CVD clinical outcomes. This review presents important information on RAAS's role on vascular inflammation, vascular cells responses to RAAS, and inhibition of RAAS signaling in the context of vascular inflammation, vascular remodeling, and vascular inflammation-associated CVD. Nevertheless, the review also equates the need to rethink and rediscover new RAAS inhibitors. PMID:24804145

Reinforced carbon nanotubes as electrically conducting and flexible films for space applications.

PubMed

Atar, Nurit; Grossman, Eitan; Gouzman, Irina; Bolker, Asaf; Hanein, Yael

2014-11-26

Chemical vapor deposition (CVD)-grown entangled carbon nanotube (CNT) sheets are characterized by high electrical conductivity and durability to bending and folding. However, since freestanding CNT sheets are mechanically weak, they cannot be used as stand-alone flexible films. In this work, polyimide (PI) infiltration into entangled cup-stacked CNT (CSCNT) sheets was studied to form electrically conducting, robust, and flexible films for space applications. The infiltration process preserved CNTs' advantageous properties (i.e., conductivity and flexibility), prevented CNT agglomeration, and enabled CNT patterning. In particular, the CNT-PI films exhibited ohmic electrical conductance in both the lateral and vertical directions, with a sheet resistivity as low as 122 Ω/□, similar to that of as-grown CNT sheets, with minimal effect of the insulating matrix. Moreover, this high conductivity was preserved under mechanical and thermal manipulations. These properties make the reported CNT-PI films excellent candidates for applications where flexibility, thermal stability, and electrical conductivity are required. Particularly, the developed CNT-PI films were found to be durable in space environment hazards such as high vacuum, thermal cycling, and ionizing radiation, and hence they are suggested as an alternative for the electrostatic discharge (ESD) protection layer in spacecraft thermal blankets.

EULAR task force recommendations on annual cardiovascular risk assessment for patients with rheumatoid arthritis: an audit of the success of implementation in a rheumatology outpatient clinic.

PubMed

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.

PubMed

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.

Increased Arterial Stiffness in Systemic Lupus Erythematosus (SLE) Patients at Low Risk for Cardiovascular Disease: A Cross-Sectional Controlled Study

PubMed Central

Sacre, Karim; Escoubet, Brigitte; Pasquet, Blandine; Chauveheid, Marie-Paule; Zennaro, Maria-Christina; Tubach, Florence; Papo, Thomas

2014-01-01

Cardiovascular disease (CVD) is a major cause of death in systemic lupus erythematosus (SLE) patients. Although the risk for cardiovascular events in patients with SLE is significant, the absolute number of events per year in any given cohort remains small. Thus, CVD risks stratification in patients with SLE focuses on surrogate markers for atherosclerosis at an early stage, such as reduced elasticity of arteries. Our study was designed to determine whether arterial stiffness is increased in SLE patients at low risk for CVD and analyze the role for traditional and non-traditional CVD risk factors on arterial stiffness in SLE. Carotid-femoral pulse wave velocity (PWV) was prospectively assessed as a measure of arterial stiffness in 41 SLE patients and 35 controls (CTL). Adjustment on age or Framingham score was performed using a logistic regression model. Factors associated with PWV were identified separately in SLE patients and in controls using Pearson's correlation coefficient for univariate analysis and multiple linear regression for multivariate analysis. SLE patients and controls displayed a low 10-year risk for CVD according to Framingham score (1.8±3.6% in SLE vs 1.6±2.8% in CTL, p = 0.46). Pulse wave velocity was, however, higher in SLE patients (7.1±1.6 m/s) as compared to controls (6.3±0.8 m/s; p = 0.01, after Framingham score adjustment) and correlated with internal carotid wall thickness (p = 0.0017). In multivariable analysis, only systolic blood pressure (p = 0.0005) and cumulative dose of glucocorticoids (p = 0.01) were associated with PWV in SLE patients. Interestingly, the link between systolic blood pressure (SBP) and arterial stiffness was also confirmed in SLE patients with normal systolic blood pressure. In conclusion, arterial stiffness is increased in SLE patients despite a low risk for CVD according to Framingham score and is associated with systolic blood pressure and glucocorticoid therapy. PMID:24722263

Utilization of the Behavior Change Wheel framework to develop a model to improve cardiometabolic screening for people with severe mental illness.

PubMed

Mangurian, Christina; Niu, Grace C; Schillinger, Dean; Newcomer, John W; Dilley, James; Handley, Margaret A

2017-11-14

Individuals with severe mental illness (e.g., schizophrenia, bipolar disorder) die 10-25 years earlier than the general population, primarily from premature cardiovascular disease (CVD). Contributing factors are complex, but include systemic-related factors of poorly integrated primary care and mental health services. Although evidence-based models exist for integrating mental health care into primary care settings, the evidence base for integrating medical care into specialty mental health settings is limited. Such models are referred to as "reverse" integration. In this paper, we describe the application of an implementation science framework in designing a model to improve CVD outcomes for individuals with severe mental illness (SMI) who receive services in a community mental health setting. Using principles from the theory of planned behavior, focus groups were conducted to understand stakeholder perspectives of barriers to CVD risk factor screening and treatment identify potential target behaviors. We then applied results to the overarching Behavior Change Wheel framework, a systematic and theory-driven approach that incorporates the COM-B model (capability, opportunity, motivation, and behavior), to build an intervention to improve CVD risk factor screening and treatment for people with SMI. Following a stepped approach from the Behavior Change Wheel framework, a model to deliver primary preventive care for people that use community mental health settings as their de facto health home was developed. The CRANIUM (cardiometabolic risk assessment and treatment through a novel integration model for underserved populations with mental illness) model focuses on engaging community psychiatrists to expand their scope of practice to become responsible for CVD risk, with significant clinical decision support. The CRANIUM model was designed by integrating behavioral change theory and implementation theory. CRANIUM is feasible to implement, is highly acceptable to, and targets provider behavior change, and is replicable and efficient for helping to integrate primary preventive care services in community mental health settings. CRANIUM can be scaled up to increase CVD preventive care delivery and ultimately improve health outcomes among people with SMI served within a public mental health care system.

A comparative analysis of cardiovascular disease risk profiles of five Pacific ethnic groups assessed in New Zealand primary care practice: PREDICT CVD-13.

PubMed

Grey, Corina; Wells, Sue; Riddell, Tania; Pylypchuk, Romana; Marshall, Roger; Drury, Paul; Elley, Raina; Ameratunga, Shanthi; Gentles, Dudley; Erick-Peletiy, Stephanie; Bell, Fionna; Kerr, Andrew; Jackson, Rod

2010-11-05

Data on the cardiovascular disease risk profiles of Pacific peoples in New Zealand is usually aggregated and treated as a single entity. Little is known about the comparability or otherwise of cardiovascular disease (CVD) risk between different Pacific groups. To compare CVD risk profiles for the main Pacific ethnic groups assessed in New Zealand primary care practice to determine if it is reasonable to aggregate these data, or if significant differences exist. A web-based clinical decision support system for CVD risk assessment and management (PREDICT) has been implemented in primary care practices in nine PHOs throughout Auckland and Northland since 2002, covering approximately 65% of the population of these regions. Between 2002 and January 2009, baseline CVD risk assessments were carried out on 11,642 patients aged 35-74 years identifying with one or more Pacific ethnic groups (4933 Samoans, 1724 Tongans, 1366 Cook Island Maori, 880 Niueans, 1341 Fijians and 1398 people identified as Other Pacific or Pacific Not Further Defined). Fijians were subsequently excluded from the analyses because of a probable misclassification error that appears to combine Fijian Indians with ethnic Fijians. Prevalences of smoking, diabetes and prior history of CVD, as well as mean total cholesterol/HDL ratio, systolic and diastolic blood pressures, and Framingham 5-year CVD risk were calculated for each Pacific group. Age-adjusted risk ratios and mean differences stratified by gender were calculated using Samoans as the reference group. Cook Island women were almost 60% more likely to smoke than Samoan women. While Tongan men had the highest proportion of smoking (29%) among Pacific men, Tongan women had the lowest smoking proportion (10%) among Pacific women. Tongan women and Niuean men and women had a higher burden of diabetes than other Pacific ethnic groups, which were 20-30% higher than their Samoan counterparts. Niuean men and women had lower blood pressure levels than all other Pacific groups while Tongan men and women had the highest total cholesterol to HDL ratios. Tongan men and women had higher absolute 5-year CVD risk scores, as estimated by the Framingham equation, than their Samoan counterparts (Age-adjusted mean differences 0.71% [95% CI 0.36% to 1.06%] for Tongan men and 0.52% [95% CI 0.17% to 0.86%] for Tongan women) although these risk differences were only about 10% higher in relative terms. The validity of the analyses depend on the assumption that the selection of participants for CVD risk assessment in primary care is similar between Pacific groups. The ethnic-specific CVD risk profiles presented do not represent estimates of population prevalence. Almost all previous Pacific data has been aggregated with Pacific peoples treated as a single entity because of small sample sizes. We have analysed data from the largest study to date measuring CVD risk factors in Pacific peoples living in New Zealand. Our findings suggest that aggregating Pacific population data appears to be reasonable in terms of assessing absolute CVD risk, however there are differences for specific CVD risk factors between Pacific ethnic groups that may be important for targeting community level interventions.

Epidemiology of ischemic heart disease in HIV.

PubMed

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

PubMed Central

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

Prediction of cardiovascular risk in rheumatoid arthritis: performance of original and adapted SCORE algorithms.

PubMed

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/

Carotid Plaque Score and Risk of Cardiovascular Mortality in the Oldest Old: Results from the TOOTH Study.

PubMed

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.

Impact of anti-rheumatic treatment on cardiovascular risk in Asian patients with rheumatoid arthritis.

PubMed

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.

Standard cardiovascular disease risk algorithms underestimate the risk of cardiovascular disease in schizophrenia: evidence from a national primary care database.

PubMed

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.

Why are kids with lupus at an increased risk of cardiovascular disease?

PubMed

Quinlan, Catherine; Marks, Stephen D; Tullus, Kjell

2016-06-01

Juvenile-onset systemic lupus erythematosus (SLE) is an aggressive multisystem autoimmune disease. Despite improvements in outcomes for adult patients, children with SLE continue to have a lower life expectancy than adults with SLE, with more aggressive disease, a higher incidence of lupus nephritis and there is an emerging awareness of their increased risk of cardiovascular disease (CVD). In this review, we discuss the evidence for an increased risk of CVD in SLE, its pathogenesis, and the clinical approach to its management.

Low Temperature Graphene Growth and Its Applications in Electronic and Optical Devices

NASA Astrophysics Data System (ADS)

Chugh, Sunny

Graphene, a two dimensional allotrope of carbon in a honeycomb lattice, has gathered wide attention due to its excellent electrical, thermal, optical and mechanical properties. It has extremely high electron/hole mobility, very high thermal conductivity and fascinating optical properties, and combined with its mechanical strength and elasticity, graphene is believed to find commercial applications in existing as well as novel technologies. One of the biggest reasons behind the rapid development in graphene research during the last decade is the fact that laboratory procedures to obtain high quality graphene are rather cheap and simple. However, any new material market is essentially driven by the progress in its large scale commercial production with minimal costs, with properties that are suited for different applications. And it is in this aspect that graphene is still required to make a huge progress before its commercial benefits can be derived. Laboratory graphene synthesis techniques such as mechanical exfoliation, liquid phase exfoliation and SiC graphene growth pose several challenges in terms of cost, reliability and scalability. To this end, Chemical Vapor Deposition (CVD) growth of graphene has emerged as a widely used synthesis method that overcomes these problems. Unfortunately, conventional thermal CVD requires a high temperature of growth and a catalytic metal substrate, making the undesirable step of graphene transfer a necessity. Besides requiring a catalyst, the high temperature of growth also limits the range of growth substrates. In this work, I have successfully demonstrated low temperature ( 550 °C) growth of graphene directly on dielectric materials using a Plasma-Enhanced CVD (PECVD) process. The PECVD technique described here solves the issues faced by conventional CVD methods and provides a direct route for graphene synthesis on arbitrary materials at relatively low temperatures. Detailed growth studies, as described here, illustrate the difference between the PECVD and the CVD growth mechanisms. This work also provides the first experimental comparison of graphene growth rates on different substrates using PECVD. In the second part of my thesis, I have discussed some of the potential applications of PECVD graphene, including graphene as a diffusion barrier, ultra-dark graphene metamaterials, graphene-protected metal plasmonics and copper-graphene hybrids for RF transmission line applications. The experimental findings discussed here lay a solid platform for integration of graphene in damascene structures, low-loss plasmonic materials, flexible electronics and dark materials, among others.

High thermal stability of abrupt SiO2/GaN interface with low interface state density

NASA Astrophysics Data System (ADS)

Truyen, Nguyen Xuan; Taoka, Noriyuki; Ohta, Akio; Makihara, Katsunori; Yamada, Hisashi; Takahashi, Tokio; Ikeda, Mitsuhisa; Shimizu, Mitsuaki; Miyazaki, Seiichi

2018-04-01

The effects of postdeposition annealing (PDA) on the interface properties of a SiO2/GaN structure formed by remote oxygen plasma-enhanced chemical vapor deposition (RP-CVD) were systematically investigated. X-ray photoelectron spectroscopy clarified that PDA in the temperature range from 600 to 800 °C has almost no effects on the chemical bonding features at the SiO2/GaN interface, and that positive charges exist at the interface, the density of which can be reduced by PDA at 800 °C. The capacitance-voltage (C-V) and current density-SiO2 electric field characteristics of the GaN MOS capacitors also confirmed the reduction in interface state density (D it) and the improvement in the breakdown property of the SiO2 film after PDA at 800 °C. Consequently, a high thermal stability of the SiO2/GaN structure with a low fixed charge density and a low D it formed by RP-CVD was demonstrated. This is quite informative for realizing highly robust GaN power devices.

Direct transfer of wafer-scale graphene films

NASA Astrophysics Data System (ADS)

Kim, Maria; Shah, Ali; Li, Changfeng; Mustonen, Petri; Susoma, Jannatul; Manoocheri, Farshid; Riikonen, Juha; Lipsanen, Harri

2017-09-01

Flexible electronics serve as the ubiquitous platform for the next-generation life science, environmental monitoring, display, and energy conversion applications. Outstanding multi-functional mechanical, thermal, electrical, and chemical properties of graphene combined with transparency and flexibility solidifies it as ideal for these applications. Although chemical vapor deposition (CVD) enables cost-effective fabrication of high-quality large-area graphene films, one critical bottleneck is an efficient and reproducible transfer of graphene to flexible substrates. We explore and describe a direct transfer method of 6-inch monolayer CVD graphene onto transparent and flexible substrate based on direct vapor phase deposition of conformal parylene on as-grown graphene/copper (Cu) film. The method is straightforward, scalable, cost-effective and reproducible. The transferred film showed high uniformity, lack of mechanical defects and sheet resistance for doped graphene as low as 18 Ω/sq and 96.5% transparency at 550 nm while withstanding high strain. To underline that the introduced technique is capable of delivering graphene films for next-generation flexible applications we demonstrate a wearable capacitive controller, a heater, and a self-powered triboelectric sensor.

Tungsten Contact and Line Resistance Reduction with Advanced Pulsed Nucleation Layer and Low Resistivity Tungsten Treatment

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.

Large-area synthesis of high-quality and uniform monolayer WS2 on reusable Au foils

PubMed Central

Gao, Yang; Liu, Zhibo; Sun, Dong-Ming; Huang, Le; Ma, Lai-Peng; Yin, Li-Chang; Ma, Teng; Zhang, Zhiyong; Ma, Xiu-Liang; Peng, Lian-Mao; Cheng, Hui-Ming; Ren, Wencai

2015-01-01

Large-area monolayer WS2 is a desirable material for applications in next-generation electronics and optoelectronics. However, the chemical vapour deposition (CVD) with rigid and inert substrates for large-area sample growth suffers from a non-uniform number of layers, small domain size and many defects, and is not compatible with the fabrication process of flexible devices. Here we report the self-limited catalytic surface growth of uniform monolayer WS2 single crystals of millimetre size and large-area films by ambient-pressure CVD on Au. The weak interaction between the WS2 and Au enables the intact transfer of the monolayers to arbitrary substrates using the electrochemical bubbling method without sacrificing Au. The WS2 shows high crystal quality and optical and electrical properties comparable or superior to mechanically exfoliated samples. We also demonstrate the roll-to-roll/bubbling production of large-area flexible films of uniform monolayer, double-layer WS2 and WS2/graphene heterostructures, and batch fabrication of large-area flexible monolayer WS2 film transistor arrays. PMID:26450174

Effect of the energy of bombarding electrons on the conductivity of n-4H-SiC (CVD) epitaxial layers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kozlovski, V. V., E-mail: kozlovski@physics.spbstu.ru; Lebedev, A. A.; Strel’chuk, A. M.

The electrical characteristics of epitaxial layers of n-4H-SiC (CVD) irradiated with 0.9 and 3.5MeV electrons are studied. It is shown that the donor removal rate becomes nearly four times higher as the energy of impinging electrons increases by a factor of 4, although the formation cross section of primary radiation defects (Frenkel pairs in the carbon sublattice) responsible for conductivity compensation of the material is almost energy independent in this range. It is assumed that the reason for the observed differences is the influence exerted by primary knocked-out atoms. First, cascade processes start to manifest themselves with increasing energy ofmore » primary knocked-out atoms. Second, the average distance between genetically related Frenkel pairs grows, and, as a consequence, the fraction of defects that do not recombine under irradiation becomes larger. The recombination radius of Frenkel pairs in the carbon sublattice is estimated and the possible charge state of the recombining components is assessed.« less

Spatially resolved mapping of electrical conductivity across individual domain (grain) boundaries in graphene.

PubMed

Clark, Kendal W; Zhang, X-G; Vlassiouk, Ivan V; He, Guowei; Feenstra, Randall M; Li, An-Ping

2013-09-24

All large-scale graphene films contain extended topological defects dividing graphene into domains or grains. Here, we spatially map electronic transport near specific domain and grain boundaries in both epitaxial graphene grown on SiC and CVD graphene on Cu subsequently transferred to a SiO2 substrate, with one-to-one correspondence to boundary structures. Boundaries coinciding with the substrate step on SiC exhibit a significant potential barrier for electron transport of epitaxial graphene due to the reduced charge transfer from the substrate near the step edge. Moreover, monolayer-bilayer boundaries exhibit a high resistance that can change depending on the height of substrate step coinciding at the boundary. In CVD graphene, the resistance of a grain boundary changes with the width of the disordered transition region between adjacent grains. A quantitative modeling of boundary resistance reveals the increased electron Fermi wave vector within the boundary region, possibly due to boundary induced charge density variation. Understanding how resistance change with domain (grain) boundary structure in graphene is a crucial first step for controlled engineering of defects in large-scale graphene films.

Solid-State Spun Fibers from 1 mm Long Carbon Nanotube Forests Synthesized by Water-Assisted Chemical Vapor Deposition

NASA Technical Reports Server (NTRS)

Zhang, Shanju; Zhu, Lingbo; Minus, Marilyn L.; Chae, han Gi; Jagannathan, Sudhakar; Wong, Ching-Ping; Kowalik, Janusz; Roberson, Luke B.; Kumar, Satish

2007-01-01

In this work, we report continuous carbon nanotube fibers dry-drawn directly from water-assisted CVD grown forests with millimeter scale length. As-drawn nanotube fibers exist as aerogel and can be transformed into more compact fibers through twisting or densification with a volatile liquid. Nanotube fibers are characterized by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), Raman microscopy and wide-angle X-ray diffraction (WAXD). Mechanical behavior and electrical conductivity of the post-treated nanotube fibers are investigated.

Circulating Branched-Chain Amino Acids and Incident Cardiovascular Disease in a Prospective Cohort of US Women.

PubMed

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.

Role of pharmacist in cardiovascular disease-related health promotion and in hypertension and dyslipidemia management: a cross-sectional study in the State of Qatar.

PubMed

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.

Results of a Markov model analysis to assess the cost-effectiveness of statin therapy for the primary prevention of cardiovascular disease in Korea: the Korean Individual-Microsimulation Model for Cardiovascular Health Interventions.

PubMed

Kang, Hye-Young; Ko, Su-Kyoung; Liew, Danny

2009-12-01

Although hyperlipidemia is well recognized as a risk factor for cardiovascular disease (CVD), there has been no appraisal of the economic impact of statin therapy in Korea. The aim of this model analysis was to determine the cost-effectiveness of statin therapy versus no treatment for the primary prevention of CVD over a lifetime in Korea, from a health care system perspective. We developed the Korean Individual-Microsimulation Model for Cardiovascular Health Interventions (KIMCHI), an epidemiologic and economic Markov model of first-onset CVD in Korea in which all individuals began the simulation in the health state alive without CVD, and moved among the 4 health states (alive without CVD, alive with CVD, dead from CVD, and dead from non-CVD causes) in yearly cycles for any specified time horizon, up to 40 years. KIMCHI was populated with 372 subjects from the 2005 Korean National Health and Nutrition Examination Survey (KNHNES) who were aged > or =45 years, did not have a history of myocardial infarction or ischemic stroke, and met current Korean reimbursement criteria for treatment with lipid-lowering medications. The probability of first-onset CVD was estimated for each study participant individually, based on an Asian population-specific risk equation that relied on an individual's sex, age, serum total cholesterol, systolic blood pressure, current smoking status, diabetes mellitus status, and body mass index. Statin treatment was represented by a hybrid of atorvastatin and simvastatin (the most popular statins in Korea), the lipid-modifying effects of which were de rived from a published meta-analysis. Data regarding utilities and costs of CVD (both those covered and not covered by insurance) were derived from published local sources. In the base case, the estimated incremental costutility ratio was 15,134,284 Korean won (KRW) per quality-adjusted life-year (QALY) gained, and the estimated incremental cost-effectiveness ratio was 20,657,829 KRW per life-year gained (LYG) (1200 KRW approximately US $1). Based on a willingness-to-pay (WTP) threshold of 30 million KRW per QALY saved, there was a 93.7% probability that statin therapy would be cost-effective. Given a WTP threshold of 20 million KRW per QALY, there was a 53.8% probability of being cost-effective. The probabilities at WTP thresholds of 30 and 20 million KRW per LYG were 62.4% and 25.8%, respectively. Based on this analysis using data from the 2005 KNHNES and the KIMCHI model, statin therapy is likely to be cost-effective for the primary prevention of CVD among Koreans aged > or =45 years. The probability of being cost-effective was greater at a threshold of 30 million KRW per QALY (93.7%) than at 20 million KRW per QALY (53.8%). Copyright 2009 Excerpta Medica Inc. All rights reserved.

Knowledge, Attitude, and Practice Regarding the Risk of Cardiovascular Diseases in Patients Attending Outpatient Clinic in Kuantan, Malaysia.

PubMed

Mohammad, Nursyafiza B; Rahman, Nor Azlina A; Haque, Mainul

2018-01-01

Cardiovascular disease (CVD) is a leading cause of death around the world including Malaysia. Ischemic heart disease (IHD) is the single largest cause of death in the developed countries and is one of the main contributors to the disease burden in developing countries. This was a cross-sectional study conducted to determine knowledge, attitude, and practice (KAP) regarding the risk of CVD in patients attending an outpatient clinic in Kuantan, Malaysia. A total of 100 patients comprising 52 male and 48 female subjects were selected through convenient sampling method. Of the total subjects, 86% were Malays. The mean scores (standard deviation) for KAP were 60.75±4.823, 54.36±8.711, and 33.43±4.046, respectively, whereas the maximum scores obtained by the subjects for KAP were 71, 65, and 43, respectively. Regarding questions related to knowledge, 88% subjects knew irregular eating pattern can cause disease and the benefits of vegetable intake. Most subjects recognized that smoking and obesity were CVD risk factors. Regarding questions related to attitude, 96% agreed that exercise can prevent CVD. More than half of the subjects followed healthy lifestyle. There were statistically significant differences observed in knowledge level between sexes ( P = 0.046) and races ( P = 0.001). Nevertheless, there was no statistically significant difference observed in KAP across different education levels of the subjects regarding the risk of CVD ( P -value = 0.332, 0.185, and 0.160, respectively). This study revealed that patients had good knowledge and attitude regarding CVD risk factors. Yet, the number of smokers is still quite high. Development of better public information system is essential for the well-being of the society.

Does Cost-Related Medication Nonadherence among Cardiovascular Disease Patients Vary by Gender? Evidence from a Nationally Representative Sample.

PubMed

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.

Cardiovascular Diseases in India: Current Epidemiology and Future Directions.

PubMed

Prabhakaran, Dorairaj; Jeemon, Panniyammakal; Roy, Ambuj

2016-04-19

Cardiovascular diseases (CVDs) have now become the leading cause of mortality in India. A quarter of all mortality is attributable to CVD. Ischemic heart disease and stroke are the predominant causes and are responsible for >80% of CVD deaths. The Global Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100 000 population in India is higher than the global average of 235 per 100 000 population. Some aspects of the CVD epidemic in India are particular causes of concern, including its accelerated buildup, the early age of disease onset in the population, and the high case fatality rate. In India, the epidemiological transition from predominantly infectious disease conditions to noncommunicable diseases has occurred over a rather brief period of time. Premature mortality in terms of years of life lost because of CVD in India increased by 59%, from 23.2 million (1990) to 37 million (2010). Despite wide heterogeneity in the prevalence of cardiovascular risk factors across different regions, CVD has emerged as the leading cause of death in all parts of India, including poorer states and rural areas. The progression of the epidemic is characterized by the reversal of socioeconomic gradients; tobacco use and low fruit and vegetable intake have become more prevalent among those from lower socioeconomic backgrounds. In addition, individuals from lower socioeconomic backgrounds frequently do not receive optimal therapy, leading to poorer outcomes. Countering the epidemic requires the development of strategies such as the formulation and effective implementation of evidence-based policy, reinforcement of health systems, and emphasis on prevention, early detection, and treatment with the use of both conventional and innovative techniques. Several ongoing community-based studies are testing these strategies. © 2016 American Heart Association, Inc.

Comparative cost-effectiveness of metformin-based dual therapies associated with risk of cardiovascular diseases among Chinese patients with type 2 diabetes: Evidence from a population-based national cohort in Taiwan.

PubMed

Ou, Huang-Tz; Chen, Yen-Ting; Liu, Ya-Ming; Wu, Jin-Shang

2016-06-01

To assess the cost-effectiveness of metformin-based dual therapies associated with cardiovascular disease (CVD) risk in a Chinese population with type 2 diabetes. We utilized Taiwan's National Health Insurance Research Database (NHIRD) 1997-2011, which is derived from the claims of National Health Insurance, a mandatory-enrollment single-payer system that covers over 99% of Taiwan's population. Four metformin-based dual therapy cohorts were used, namely a reference group of metformin plus sulfonylureas (Metformin-SU) and metformin plus acarbose, metformin plus thiazolidinediones (Metformin-TZD), and metformin plus glinides (Metformin-glinides). Using propensity scores, each subject in a comparison cohort was 1:1 matched to a referent. The effectiveness outcome was CVD risk. Only direct medical costs were included. The Markov chain model was applied to project lifetime outcomes, discounted at 3% per annum. The bootstrapping technique was performed to assess uncertainty in analysis. Metformin-glinides was most cost-effective in the base-case analysis; Metformin-glinides saved $194 USD for one percentage point of reduction in CVD risk, as compared to Metformin-SU. However, for the elderly or those with severe diabetic complications, Metformin-TZD, especially pioglitazone, was more suitable; as compared to Metformin-SU, Metformin-TZD saved $840.1 USD per percentage point of reduction in CVD risk. Among TZDs, Metformin-pioglitazone saved $1831.5 USD per percentage point of associated CVD risk reduction, as compared to Metformin-rosiglitazone. When CVD is considered an important clinical outcome, Metformin-pioglitazone is cost-effective, in particular for the elderly and those with severe diabetic complications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Cognitive vulnerability to depression during middle childhood: Stability and associations with maternal affective styles and parental depression

PubMed Central

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

Dietary antioxidant capacity of the patients with cardiovascular disease in a cross-sectional study.

PubMed

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.

Screening for Cardiovascular Disease Risk With Electrocardiography: US Preventive Services Task Force Recommendation Statement.

PubMed

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).

Correlates for cardiovascular diseases among diabetic/hypertensive patients attending outreach clinics in two Nairobi slums, Kenya

PubMed Central

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

Fibrinogen concentration and its role in CVD risk in black South Africans--effect of urbanisation.

PubMed

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.

Temperature dependent transport characteristics of graphene/n-Si diodes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parui, S.; Ruiter, R.; Zomer, P. J.

2014-12-28

Realizing an optimal Schottky interface of graphene on Si is challenging, as the electrical transport strongly depends on the graphene quality and the fabrication processes. Such interfaces are of increasing research interest for integration in diverse electronic devices as they are thermally and chemically stable in all environments, unlike standard metal/semiconductor interfaces. We fabricate such interfaces with n-type Si at ambient conditions and find their electrical characteristics to be highly rectifying, with minimal reverse leakage current (<10{sup −10} A) and rectification of more than 10{sup 6}. We extract Schottky barrier height of 0.69 eV for the exfoliated graphene and 0.83 eV for themore » CVD graphene devices at room temperature. The temperature dependent electrical characteristics suggest the influence of inhomogeneities at the graphene/n-Si interface. A quantitative analysis of the inhomogeneity in Schottky barrier heights is presented using the potential fluctuation model proposed by Werner and Güttler.« less

Report of work done for technical assistance agreement 1269 between Sandia National Laboratories and the Watkins-Johnson Company: Chemical reaction mechanisms for computational models of SiO{sub 2} CVD

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

Molecular effects of exercise training in patients with cardiovascular disease: focus on skeletal muscle, endothelium, and myocardium.

PubMed

Adams, Volker; Reich, Bernhard; Uhlemann, Madlen; Niebauer, Josef

2017-07-01

For decades, we have known that exercise training exerts beneficial effects on the human body, and clear evidence is available that a higher fitness level is associated with a lower incidence of suffering premature cardiovascular death. Despite this knowledge, it took some time to also incorporate physical exercise training into the treatment plan for patients with cardiovascular disease (CVD). In recent years, in addition to continuous exercise training, further training modalities such as high-intensity interval training and pyramid training have been introduced for coronary artery disease patients. The beneficial effect for patients with CVD is clearly documented, and during the last years, we have also started to understand the molecular mechanisms occurring in the skeletal muscle (limb muscle and diaphragm) and endothelium, two systems contributing to exercise intolerance in these patients. In the present review, we describe the effects of the different training modalities in CVD and summarize the molecular effects mainly in the skeletal muscle and cardiovascular system. Copyright © 2017 the American Physiological Society.

The role of angiotensin receptor-neprilysin inhibitors in cardiovascular disease-existing evidence, knowledge gaps, and future directions.

PubMed

Ambrosy, Andrew P; Mentz, Robert J; Fiuzat, Mona; Cleland, John G F; Greene, Stephen J; O'Connor, Christopher M; Teerlink, John R; Zannad, Faiez; Solomon, Scott D

2018-02-21

Although traditional renin-angiotensin system antagonists including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have revolutionized the treatment of cardiovascular disease (CVD), the pivotal PARADIGM-HF trial demonstrated that sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), was superior to an angiotensin-converting enzyme inhibitor in reducing cardiovascular morbidity and mortality in patients with heart failure and reduced ejection fraction. However, despite international regulatory approval and strong recommendations in the guidelines, uptake of sacubitril/valsartan has been disappointing. Sacubitril/valsartan is now the focus of a large programme of clinical trials testing the hypothesis that ARNIs may supplant conventional renin-angiotensin system inhibitors across the spectrum of CVD, including hypertension, secondary prevention after myocardial infarction, and heart failure with preserved ejection fraction. This review summarizes the existing evidence, knowledge gaps, and future directions of ARNIs in CVD based on discussions between clinical trialists, industry representatives, and regulatory authorities at the 2016 Global CardioVascular Clinical Trialists Forum in Washington, D.C. © 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.

Anxiety sensitivity in smokers with indicators of cardiovascular disease.

PubMed

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.

Combination pharmacotherapy to prevent cardiovascular disease: present status and challenges.

PubMed

Yusuf, Salim; Attaran, Amir; Bosch, Jackie; Joseph, Philip; Lonn, Eva; McCready, Tara; Mente, Andrew; Nieuwlaat, Robby; Pais, Prem; Rodgers, Anthony; Schwalm, J-D; Smith, Richard; Teo, Koon; Xavier, Denis

2014-02-01

Combination pills containing aspirin, multiple blood pressure (BP) lowering drugs, and a statin have demonstrated safety, substantial risk factor reductions, and improved medication adherence in the prevention of cardiovascular disease (CVD). The individual medications in combination pills are already recommended for use together in secondary CVD prevention. Therefore, current information on their pharmacokinetics, impact on the risk factors, and tolerability should be sufficient to persuade regulators and clinicians to use fixed-dose combination pills in high-risk individuals, such as in secondary prevention. Long-term use of these medicines, in a polypill or otherwise, is expected to reduce CVD risk by at least 50-60% in such groups. This risk reduction needs confirmation in prospective randomized trials for populations for whom concomitant use of the medications is not currently recommended (e.g. primary prevention). Given their additive benefits, the combined estimated relative risk reduction (RRR) in CVD from both lifestyle modification and a combination pill is expected to be 70-80%. The first of several barriers to the widespread use of combination therapy in CVD prevention is physician reluctance to use combination pills. This reluctance may originate from the belief that lifestyle modification should take precedence, and that medications should be introduced one drug at a time, instead of regarding combination pills and lifestyle modification as complementary and additive. Second, widespread availability of combination pills is also impeded by the reluctance of large pharmaceutical companies to invest in development of novel co-formulations of generic (or 'mature') drugs. A business model based on 'mass approaches' to drug production, packaging, marketing, and distribution could make the combination pill available at an affordable price, while at the same time providing a viable profit for the manufacturers. A third barrier is regulatory approval for novel multidrug combination pills, as there are few precedents for the approval of combination products with four or more components for CVD. Acceptance of combination therapy in other settings suggests that with concerted efforts by academics, international health agencies, research funding bodies, governments, regulators, and pharmaceutical manufacturers, combination pills for prevention of CVD in those with disease or at high risk (e.g. those with multiple risk factors) can be made available worldwide at affordable prices. It is anticipated that widespread use of combination pills with lifestyle modifications can lead to substantial risk reductions (as much as an 80% estimated RRR) in CVD. Heath care systems need to deploy these strategies widely, effectively, and efficiently. If implemented, these strategies could avoid several millions of fatal and non-fatal CVD events every year worldwide.

Crystal-proven Gout and Characteristic Gout Severity Factors are Associated with Cardiovascular Disease.

PubMed

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.

Density of calcium in the ascending thoracic aorta and risk of incident cardiovascular disease events.

PubMed

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.

Who Must We Target Now to Minimize Future Cardiovascular Events and Total Mortality?: Lessons From the Surveillance, Prevention and Management of Diabetes Mellitus (SUPREME-DM) Cohort Study.

PubMed

Desai, Jay R; Vazquez-Benitez, Gabriela; Xu, Zhiyuan; Schroeder, Emily B; Karter, Andrew J; Steiner, John F; Nichols, Gregory A; Reynolds, Kristi; Xu, Stanley; Newton, Katherine; Pathak, Ram D; Waitzfelder, Beth; Lafata, Jennifer Elston; Butler, Melissa G; Kirchner, H Lester; Thomas, Abraham; O'Connor, Patrick J

2015-09-01

Examining trends in cardiovascular events and mortality in US health systems can guide the design of targeted clinical and public health strategies to reduce cardiovascular events and mortality rates. We conducted an observational cohort study from 2005 to 2011 among 1.25 million diabetic subjects and 1.25 million nondiabetic subjects from 11 health systems that participate in the Surveillance, Prevention and Management of Diabetes Mellitus (SUPREME-DM) DataLink. Annual rates (per 1000 person-years) of myocardial infarction/acute coronary syndrome (International Classification of Diseases-Ninth Revision, 410.0–410.91, 411.1–411.8), stroke (International Classification of Diseases-Ninth Revision, 430–432.9, 433–434.9), heart failure (International Classification of Diseases-Ninth Revision, 428–428.9), and all-cause mortality were monitored by diabetes mellitus (DM) status, age, sex, race/ethnicity, and a prior cardiovascular history. We observed significant declines in cardiovascular events and mortality rates in subjects with and without DM. However, there was substantial variation by age, sex, race/ethnicity, and prior cardiovascular history. Mortality declined from 44.7 to 27.1 (P<0.0001) for those with DM and cardiovascular disease (CVD), from 11.2 to 10.9 (P=0.03) for those with DM only, and from 18.9 to 13.0 (P<0.0001) for those with CVD only. Yet, in the [almost equal to]85% of subjects with neither DM nor CVD, overall mortality (7.0 to 6.8; P=0.10) and stroke rates (1.6–1.6; P=0.77) did not decline and heart failure rates increased (0.9–1.15; P=0.0005). To sustain improvements in myocardial infarction, stroke, heart failure, and mortality, health systems that have successfully focused on care improvement in high-risk adults with DM or CVD must broaden their improvement strategies to target lower risk adults who have not yet developed DM or CVD.

Saturated Fatty Acids and Cardiovascular Disease: Replacements for Saturated Fat to Reduce Cardiovascular Risk

PubMed Central

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

Investigating cholesterol metabolism and ageing using a systems biology approach.

PubMed

Morgan, A E; Mooney, K M; Wilkinson, S J; Pickles, N A; Mc Auley, M T

2017-08-01

CVD accounted for 27 % of all deaths in the UK in 2014, and was responsible for 1·7 million hospital admissions in 2013/2014. This condition becomes increasingly prevalent with age, affecting 34·1 and 29·8 % of males and females over 75 years of age respectively in 2011. The dysregulation of cholesterol metabolism with age, often observed as a rise in LDL-cholesterol, has been associated with the pathogenesis of CVD. To compound this problem, it is estimated by 2050, 22 % of the world's population will be over 60 years of age, in culmination with a growing resistance and intolerance to pre-existing cholesterol regulating drugs such as statins. Therefore, it is apparent research into additional therapies for hypercholesterolaemia and CVD prevention is a growing necessity. However, it is also imperative to recognise this complex biological system cannot be studied using a reductionist approach; rather its biological uniqueness necessitates a more integrated methodology, such as that offered by systems biology. In this review, we firstly discuss cholesterol metabolism and how it is affected by diet and the ageing process. Next, we describe therapeutic strategies for hypercholesterolaemia, and finally how the systems biology paradigm can be utilised to investigate how ageing interacts with complex systems such as cholesterol metabolism. We conclude by emphasising the need for nutritionists to work in parallel with the systems biology community, to develop novel approaches to studying cholesterol metabolism and its interaction with ageing.

Cardiovascular Disease is Associated with COPD Severity and Reduced Functional Status and Quality of Life

PubMed Central

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

Challenges of developing a cardiovascular risk calculator for patients with rheumatoid arthritis.

PubMed

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.

Perceived and actual risk of cardiovascular disease in patients with rheumatoid arthritis in Korea: A cross-sectional study.

PubMed

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.

Effect of gender on awareness of cardiovascular risk factors, preventive action taken, and barriers to cardiovascular health in a group of Austrian subjects.

PubMed

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.

Rheumatoid Arthritis, Anti-CCP Positivity, and Cardiovascular Disease Risk in the Women’s Health Initiative

PubMed Central

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

Australian community pharmacists' awareness and practice in supporting secondary prevention of cardiovascular disease.

PubMed

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.

N-terminal pro-brain-type natriuretic peptide (NT-pro-BNP) and mortality risk in early inflammatory polyarthritis: results from the Norfolk Arthritis Registry (NOAR)

PubMed Central

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

Alzheimer biomarkers and clinical Alzheimer disease were not associated with increased cerebrovascular disease in a memory clinic population.

PubMed

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.

Validation of a model to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD: the rotterdam ischemic heart disease and stroke computer simulation (RISC) model.

PubMed

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.

Exercise and cardiovascular outcomes by hypertensive status: NHANES I epidemiological follow-up study, 1971-1992.

PubMed

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.

Plasma and blood viscosity in the prediction of cardiovascular disease and mortality in the Scottish Heart Health Extended Cohort Study.

PubMed

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.

Cerebrovascular disease, beta-amyloid and cognition in aging

PubMed Central

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

Sub-10-nm patterning via directed self-assembly of block copolymer films with a vapour-phase deposited topcoat

DOE Office of Scientific and Technical Information (OSTI.GOV)

Suh, Hyo Seon; Kim, Do Han; Moni, Priya

2017-03-27

Directed self-assembly (DSA) of the domain structure in block copolymer (BCP) thin films is a promising approach for sub-10-nm surface patterning. DSA requires the control of interfacial properties on both interfaces of a BCP film to induce the formation of domains that traverse the entire film with a perpendicular orientation. Here we show a methodology to control the interfacial properties of BCP films that uses a polymer topcoat deposited by initiated chemical vapour deposition (iCVD). The iCVD topcoat forms a crosslinked network that grafts to and immobilizes BCP chains to create an interface that is equally attractive to both blocksmore » of the underlying copolymer. The topcoat, in conjunction with a chemically patterned substrate, directs the assembly of the grating structures in BCP films with a half-pitch dimension of 9.3 nm. As the iCVD topcoat can be as thin as 7 nm, it is amenable to pattern transfer without removal. As a result, the ease of vapour-phase deposition, applicability to high-resolution BCP systems and integration with pattern-transfer schemes are attractive properties of iCVD topcoats for industrial applications.« less

Increased cardiovascular disease, resource use, and costs before the clinical diagnosis of diabetes in veterans in the southeastern U.S.

PubMed

Olson, Darin E; Zhu, Ming; Long, Qi; Barb, Diana; Haw, Jeehea S; Rhee, Mary K; Mohan, Arun V; Watson-Williams, Phyllis I; Jackson, Sandra L; Tomolo, Anne M; Wilson, Peter W F; Narayan, K M Venkat; Lipscomb, Joseph; Phillips, Lawrence S

2015-06-01

Screening for diabetes might be more widespread if adverse associations with cardiovascular disease (CVD), resource use, and costs were known to occur earlier than conventional clinical diagnosis. The purpose of this study was to determine whether adverse effects associated with diabetes begin prior to clinical diagnosis. Veterans with diabetes were matched 1:2 with controls by follow-up, age, race/ethnicity, gender, and VA facility. CVD was obtained from ICD-9 codes, and resource use and costs from VA datasets. VA facilities in SC, GA, and AL. Patients with and without diagnosed diabetes. Diagnosed CVD, resource use, and costs. In this study, the 2,062 diabetic patients and 4,124 controls were 63 years old on average, 99 % male, and 29 % black; BMI was 30.8 in diabetic patients vs. 27.8 in controls (p<0.001). CVD prevalence was higher and there were more outpatient visits in Year -4 before diagnosis through Year +4 after diagnosis among diabetic vs. control patients (all p<0.01); in Year -2, CVD prevalence was 31 % vs. 24 %, and outpatient visits were 22 vs. 19 per year, respectively. Total VA costs/year/veteran were higher in diabetic than control patients from Year -4 ($4,083 vs. $2,754) through Year +5 ($8,347 vs. $5,700) (p<0.003) for each, reflecting underlying increases in outpatient, inpatient, and pharmacy costs (p<0.05 for each). Regression analysis showed that diabetes contributed an average of $1,748/year to costs, independent of CVD (p<0.001). VA costs per veteran are higher--over $1,000/year before and $2,000/year after diagnosis of diabetes--due to underlying increases in outpatient, inpatient, and pharmacy costs, greater number of outpatient visits, and increased CVD. Moreover, adverse associations with veterans' health and the VA healthcare system occur early in the natural history of the disease, several years before diabetes is diagnosed. Since adverse associations begin before diabetes is recognized, greater consideration should be given to systematic screening in order to permit earlier detection and initiation of preventive management. Keeping frequency of CVD and marginal costs in line with those of patients before diabetes is currently diagnosed has the potential to save up to $2 billion a year.

New Materials for Structural Composites and Protective Coatings

NASA Technical Reports Server (NTRS)

2008-01-01

The objective of this Phase I project was to create novel conductive materials that are lightweight and strong enough for multiple ground support equipment and Exploration applications. The long-term goal is to combine these materials within specially designed devices to create composites or coatings with diagnostic capabilities, increased strength, and tunable properties such as transparency, electroluminescence, and fire resistance. One such technology application is a smart windows system. In such a system, the transmission of light through a window is controlled by electrical power. In the future, these materials may also be able to absorb sunlight and convert it into electrical energy to produce light, thereby creating a self-sufficient lighting system. This experiment, conducted in collaboration with the Georgia Institute of Technology, demonstrated enhancements in fabricating fiber materials from carbon nanotubes (CNT). These nanotubes were grown as forests in an ultra-high-purity chemical vapor deposition (CVD) furnace and then drawn, using novel processing techniques, into fibers and yarns that would be turned into filaments. This work was submitted to the Journal of Advanced Functional Materials. The CNT fibers were initially tested as filament materials at atmospheric pressure; however, even under high current loads, the filaments produced only random sparking. The CNT fibers were also converted into transparent, hydrophobic, and conductive sheets. Filament testing at low vacuum pressures is in progress, and the technology will be enhanced in 2008. As initial proof of the smart-windows application concept, the use of CNT sheets as composites/ protective coatings was demonstrated in collaboration with Nanocomp Technologies of Concord, New Hampshire.

Fish consumption and its motives in households with versus without self-reported medical history of CVD: A consumer survey from five European countries

PubMed Central

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

Motion artifact removal algorithm by ICA for e-bra: a women ECG measurement system

NASA Astrophysics Data System (ADS)

Kwon, Hyeokjun; Oh, Sechang; Varadan, Vijay K.

2013-04-01

Wearable ECG(ElectroCardioGram) measurement systems have increasingly been developing for people who suffer from CVD(CardioVascular Disease) and have very active lifestyles. Especially, in the case of female CVD patients, several abnormal CVD symptoms are accompanied with CVDs. Therefore, monitoring women's ECG signal is a significant diagnostic method to prevent from sudden heart attack. The E-bra ECG measurement system from our previous work provides more convenient option for women than Holter monitor system. The e-bra system was developed with a motion artifact removal algorithm by using an adaptive filter with LMS(least mean square) and a wandering noise baseline detection algorithm. In this paper, ICA(independent component analysis) algorithms are suggested to remove motion artifact factor for the e-bra system. Firstly, the ICA algorithms are developed with two kinds of statistical theories: Kurtosis, Endropy and evaluated by performing simulations with a ECG signal created by sgolayfilt function of MATLAB, a noise signal including 0.4Hz, 1.1Hz and 1.9Hz, and a weighed vector W estimated by kurtosis or entropy. A correlation value is shown as the degree of similarity between the created ECG signal and the estimated new ECG signal. In the real time E-Bra system, two pseudo signals are extracted by multiplying with a random weighted vector W, the measured ECG signal from E-bra system, and the noise component signal by noise extraction algorithm from our previous work. The suggested ICA algorithm basing on kurtosis or entropy is used to estimate the new ECG signal Y without noise component.

Polycrystalline CVD diamond device level modeling for particle detection applications

NASA Astrophysics Data System (ADS)

Morozzi, A.; Passeri, D.; Kanxheri, K.; Servoli, L.; Lagomarsino, S.; Sciortino, S.

2016-12-01

Diamond is a promising material whose excellent physical properties foster its use for radiation detection applications, in particular in those hostile operating environments where the silicon-based detectors behavior is limited due to the high radiation fluence. Within this framework, the application of Technology Computer Aided Design (TCAD) simulation tools is highly envisaged for the study, the optimization and the predictive analysis of sensing devices. Since the novelty of using diamond in electronics, this material is not included in the library of commercial, state-of-the-art TCAD software tools. In this work, we propose the development, the application and the validation of numerical models to simulate the electrical behavior of polycrystalline (pc)CVD diamond conceived for diamond sensors for particle detection. The model focuses on the characterization of a physically-based pcCVD diamond bandgap taking into account deep-level defects acting as recombination centers and/or trap states. While a definite picture of the polycrystalline diamond band-gap is still debated, the effect of the main parameters (e.g. trap densities, capture cross-sections, etc.) can be deeply investigated thanks to the simulated approach. The charge collection efficiency due to β -particle irradiation of diamond materials provided by different vendors and with different electrode configurations has been selected as figure of merit for the model validation. The good agreement between measurements and simulation findings, keeping the traps density as the only one fitting parameter, assesses the suitability of the TCAD modeling approach as a predictive tool for the design and the optimization of diamond-based radiation detectors.

Specific Amino Acids Affect Cardiovascular Diseases and Atherogenesis via Protection against Macrophage Foam Cell Formation: Review Article.

PubMed

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.

Inhibitory Effect of Natural Anti-Inflammatory Compounds on Cytokines Released by Chronic Venous Disease Patient-Derived Endothelial Cells

PubMed Central

Tisato, Veronica; Zauli, Giorgio; Rimondi, Erika; Gianesini, Sergio; Brunelli, Laura; Menegatti, Erica; Zamboni, Paolo; Secchiero, Paola

2013-01-01

Large vein endothelium plays important roles in clinical diseases such as chronic venous disease (CVD) and thrombosis; thus to characterize CVD vein endothelial cells (VEC) has a strategic role in identifying specific therapeutic targets. On these bases we evaluated the effect of the natural anti-inflammatory compounds α-Lipoic acid and Ginkgoselect phytosome on cytokines/chemokines released by CVD patient-derived VEC. For this purpose, we characterized the levels of a panel of cytokines/chemokines (n = 31) in CVD patients' plasma compared to healthy controls and their release by VEC purified from the same patients, in unstimulated and TNF-α stimulated conditions. Among the cytokines/chemokines released by VEC, which recapitulated the systemic profile (IL-8, TNF-α, GM-CSF, INF-α2, G-CSF, MIP-1β, VEGF, EGF, Eotaxin, MCP-1, CXCL10, PDGF, and RANTES), we identified those targeted by ex vivo treatment with α-Lipoic acid and/or Ginkgoselect phytosome (GM-CSF, G-CSF, CXCL10, PDGF, and RANTES). Finally, by investigating the intracellular pathways involved in promoting the VEC release of cytokines/chemokines, which are targeted by natural anti-inflammatory compounds, we documented that α-Lipoic acid significantly counteracted TNF-α-induced NF-κB and p38/MAPK activation while the effects of Ginkgo biloba appeared to be predominantly mediated by Akt. Our data provide new insights into the molecular mechanisms of CVD pathogenesis, highlighting new potential therapeutic targets. PMID:24489443

Effects of Estrogen in Gender-dependent Fetal Programming of Adult Cardiovascular Dysfunction.

PubMed

Chen, Zewen; Wang, Lei; Ke, Jun; Xiao, DaLiao

2018-03-01

Epidemiological studies and experimental studies have demonstrated that intrauterine adverse environment increases the risk of cardiovascular disease (CVD) in adulthood. However, whether an individual develops a cardiovascular dysfunctional phenotype may depend on genetic background, age, and sex. In this review, we summarize some of the recent experimental animal studies in the developmental programming of adult CVD with an emphasis on sex differences and the potential role of estrogen in mediating sexual dimorphism. Few epidemiological studies report the effect of sex on the developmental programming of CVD. However, numerous experimental animal studies have shown a sex difference in fetal programming of adult cardiovascular dysfunction. Most of the animal studies indicate that male offspring develop cardiovascular dysfunction and CVD in adulthood, whereas adult females appear to be protected. Estrogen is one of the key factors that contributes to the sex difference of adult CVD. Estrogen/its receptor (ER) may interact with the RAS system by changes of DNA methylation patterns at the target gene promoter, serve as an antioxidant to counteract the prenatal insults-induced heightened ROS, and function as an eNOS activator to increase vasodilation, resulting in the protection of female offspring from the development of hypertension and other CVDs. These studies suggest that estrogen/ER may contribute to sex differences in cardiovascular response to an adverse intrauterine environment and play a significant role in modulating the cardiovascular response in adulthood. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Cardiovascular risk assessment of South Asians in a religious setting: a feasibility study.

PubMed

Rao, N; Eastwood, S V; Jain, A; Shah, M; Leurent, B; Harvey, D; Robertson, L; Walters, K; Persaud, J W; Mikhailidis, D P; Nair, D R

2012-03-01

South Asians in the UK have high cardiovascular disease (CVD) mortality. Therefore, this population is likely to benefit from screening programmes. To address this issue, an initiative was set up between the Royal Free Hampstead NHS Trust, H.E.A.R.T. UK and two Hindu temples in North London to provide screening for CVD risk factors in the community. A total of 434 individuals of Gujarati Indian origin were screened. Measurements included anthropometry, blood pressure and lipid profiles. Three different scoring systems: Framingham, Joint British Societies' 2 and QRISK2 were used to estimate CVD risk. At least one modifiable CVD risk factor was present in 92% of the individuals screened; 52% were hypertensive, 40% were obese, 75% had central adiposity and 10% had total cholesterol/high density lipoprotein cholesterol ratio > 6. In addition, 37% of a subset of 104 individuals with a fasting sample fulfilled the diagnostic criteria for metabolic syndrome. Overall, 15% of participants screened had a 10-year CV risk score > 20% using QRISK2. The three risk score calculators showed moderate agreement: QRISK2 and JBS2 (kappa 0.61, 95% CI 0.54-0.67), QRISK2 and Framingham (kappa 0.63, 95% CI 0.57-0.70) and JBS2 and Framingham (kappa 0.70, 95% CI 0.64-0.75). A high prevalence of modifiable risk factors for CVD was detected in the population screened. © 2011 Blackwell Publishing Ltd.

Conductive stability of graphene on PET and glass substrates under blue light irradiation

NASA Astrophysics Data System (ADS)

Cao, Xueying; Liu, Xianming; Li, Xiangdi; Lei, Xiaohua; Chen, Weimin

2018-01-01

Electrical properties of graphene transparent conductive film under visible light irradiation are investigated. The CVD-grown graphene on Polyethylene Terephthalate (PET) and glass substrates for flexible and rigid touch screen display application are chosen for research. The resistances of graphene with and without gold trichloride (AuCl3) doping are measured in vacuum and atmosphere environment under blue light irradiation. Results show that the conductivities of all samples change slowly under light irradiation. The change rate and degree are related to the substrate material, doping, environment and lighting power. Graphene on flexible PET substrate is more stable than that on rigid glass substrate. Doping can improve the electrical conductivity but induce instability under light irradiation. Finally, the main reason resulting in the graphene resistance slowly increasing under blue light irradiation is analyzed.

Globalization, Work, and Cardiovascular Disease.

PubMed

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

PubMed Central

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

Sick Populations and Sick Subpopulations: Reducing Disparities in Cardiovascular Disease Between Blacks and Whites in the United States.

PubMed

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.

Acarbose Treatment and the Risk of Cardiovascular Disease in Type 2 Diabetic Patients: A Nationwide Seven-Year Follow-Up Study

PubMed Central

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

Acarbose treatment and the risk of cardiovascular disease in type 2 diabetic patients: a nationwide seven-year follow-up study.

PubMed

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.

Small artery elasticity predicts future cardiovascular events in chinese patients with angiographic coronary artery disease.

PubMed

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.

PubMed

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.

Correlation of Paraoxonase Status with Disease Activity Score and Systemic Inflammation in Rheumatoid Arthritic Patients.

PubMed

Bindal, Usha Dudeja; Saxena, Rahul; Siddiqui, Merajul Haque; Sharma, Dilutpal

2016-03-01

Despite, various preventive efforts on conventional cardiovascular disease (CVD) risk factors, the incidence of CVD in rheumatoid arthritis (RA) patients increases continuously. To solve this conundrum one needs more investigations. The present study was conducted to evaluate the plasma paraoxonase (PON) activity along with the markers of systemic inflammation, oxidative stress and disease activity score-28 (DAS28) in RA patients and clarify their role in determining the probability of RA patients to develop future CVD risk. Plasma PON, total antioxidant activity (TAA), C-reactive protein (CRP), synovial interleukin-6 (IL-6) and erythrocyte malondialdehyde (MDA) levels were estimated in 40 RA patients aged 40-55 years aged and 40 age-matched healthy controls. The data obtained were compared statistically by using Student's t-test and Pearson correlation test. Besides dyslipidaemia, marked reduction in plasma PON and TAA (p< 0.05) were observed in RA patients as compared with that of healthy controls. Erythrocyte MDA, plasma CRP and synovial IL-6 levels were increased significantly (p<0.05) in RA patients. PON was negatively correlated with MDA (r = - 0.672; p < 0.001), CRP (r = -0.458; p<0.05), IL-6 (r = -0.426; p<0.05) and DAS28 (r = -0.598; p < 0.001), and positively correlated with HDL cholesterol (r = 0.648; p<0.001) and TAA (r = 0.608; p< 0.001) levels in RA patients. Alteration in PON activity might contribute to the progression of future CVD risk in RA patients, which may result from interplay of several confounding factors, such as inflammation, oxidative stress and dyslipidaemia. Furthermore, plasma PON activity, CRP and TAA levels could be considered as non-traditional factors to predict CVD risk. Thus, it is suggested that future drugs could be developed to target the non-traditional risk factors in RA patients.

Integrating cardiovascular diseases, hypertension, and diabetes with HIV services: a systematic review.

PubMed

Haldane, Victoria; Legido-Quigley, Helena; Chuah, Fiona Leh Hoon; Sigfrid, Louise; Murphy, Georgina; Ong, Suan Ee; Cervero-Liceras, Francisco; Watt, Nicola; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Buse, Kent; McKee, Martin; Piot, Peter; Perel, Pablo

2018-01-01

Non-communicable diseases (NCDs), including cardiovascular diseases (CVD), hypertension and diabetes together with HIV infection are among the major public health concerns worldwide. Health services for HIV and NCDs require health systems that provide for people's chronic care needs, which present an opportunity to coordinate efforts and create synergies between programs to benefit people living with HIV and/or AIDS and NCDs. This review included studies that reported service integration for HIV and/or AIDS with coronary heart diseases, chronic CVD, cerebrovascular diseases (stroke), hypertension or diabetes. We searched multiple databases from inception until October 2015. Articles were screened independently by two reviewers and assessed for risk of bias. 11,057 records were identified with 7,616 after duplicate removal. After screening titles and abstracts, 14 papers addressing 17 distinct interventions met the inclusion criteria. We categorized integration models by diseases (HIV with diabetes, HIV with hypertension and diabetes, HIV with CVD and finally HIV with hypertension and CVD and diabetes). Models also looked at integration from micro (patient focused integration) to macro (system level integrations). Most reported integration of hypertension and diabetes with HIV and AIDS services and described multidisciplinary collaboration, shared protocols, and incorporating screening activities into community campaigns. Integration took place exclusively at the meso-level, with no micro- or macro-level integrations described. Most were descriptive studies, with one cohort study reporting evaluative outcomes. Several innovative initiatives were identified and studies showed that CVD and HIV service integration is feasible. Integration should build on existing protocols and use the community as a locus for advocacy and health services, while promoting multidisciplinary teams, including greater involvement of pharmacists. There is a need for robust and well-designed studies at all levels - particularly macro-level studies, research looking at long-term outcomes of integration, and research in a more diverse range of countries.

Commentary: Using Impedance Cardiography to Detect Asymptomatic Cardiovascular Disease in Prehypertensive Adults with Risk Factors.

PubMed

DeMarzo, Arthur P

2018-06-01

New guidelines on hypertension eliminated the classification of prehypertension and divided those blood pressure (BP) levels into elevated BP and stage 1 hypertension. For elevated BP, this study showed that cardiovascular (CV) abnormalities were prevalent in adults over 40 years of age with at least 2 CV risk factors. Detecting abnormalities of the CV system moves a patient from being at high risk to having earlystage cardiovascular disease (CVD) and supports a decision to treat. By redefining stage 1 and lowering the target BP, the new guidelines have set an ambitious goal for early intervention to prevent progression of CVD. Proper drug selection and titration are critical. Hypertensive patients have diverse CV abnormalities that can be quantified by impedance cardiography. By stratifying patients with ventricular, vascular, and hemodynamic abnormalities, treatment can be customized based on the abnormal underlying mechanisms to rapidly control BP and prevent progression of CVD.

Comparison of observed and modeled seasonal crustal vertical displacements derived from multi-institution GPS and GRACE solutions

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.

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

Measurements and Diagnostics of Diamond Films and Coatings

NASA Technical Reports Server (NTRS)

Miyoshi, Kazuhisa; Wu, Richard L. C.

1999-01-01

The commercial potential of chemical-vapor-deposited (CVD) diamond films has been established and a number of applications have been identified through university, industry, and government research studies. This paper discusses the methodologies used for property measurement and diagnostic of CVD diamond films and coatings. Measurement and diagnostic techniques studied include scanning electron microscopy, transmission electron microscopy, atomic force microscopy, stylus profilometry, x-ray diffraction, electron diffraction, Raman spectroscopy, Rutherford backscattering, elastic recoil spectroscopy, and friction examination. Each measurement and diagnostic technique provides unique information. A combination of techniques can provide the technical information required to understand the quality and properties of CVD diamond films, which are important to their application in specific component systems and environments. In this study the combination of measurement and diagnostic techniques was successfully applied to correlate deposition parameters and resultant diamond film composition, crystallinity, grain size, surface roughness, and coefficient of friction.

Redox signaling in cardiovascular health and disease

PubMed Central

Madamanchi, Nageswara R.; Runge, Marschall S.

2013-01-01

Spatiotemporal regulation of the activity of a vast array of intracellular proteins and signaling pathways by reactive oxygen species (ROS) governs normal cardiovascular function. However, data from experimental and animal studies strongly support that dysregulated redox signaling, resulting from hyper-activation of various cellular oxidases or mitochondrial dysfunction, is integral to the pathogenesis and progression of cardiovascular disease (CVD). In this review, we address how redox signaling modulates the protein function, the various sources of increased oxidative stress in CVD, and the labyrinth of redox-sensitive molecular mechanisms involved in the development of atherosclerosis, hypertension, cardiac hypertrophy and heart failure, and ischemia–reperfusion injury. Advances in redox biology and pharmacology for inhibiting ROS production in specific cell types and subcellular organelles combined with the development of nanotechnology-based new in vivo imaging systems and targeted drug delivery mechanisms may enable fine-tuning of redox signaling for the treatment and prevention of CVD. PMID:23583330

Association between Floods and Acute Cardiovascular Diseases: A Population-Based Cohort Study Using a Geographic Information System Approach

PubMed Central

Vanasse, Alain; Cohen, Alan; Courteau, Josiane; Bergeron, Patrick; Dault, Roxanne; Gosselin, Pierre; Blais, Claudia; Bélanger, Diane; Rochette, Louis; Chebana, Fateh

2016-01-01

Background: Floods represent a serious threat to human health beyond the immediate risk of drowning. There is few data on the potential link between floods and direct consequences on health such as on cardiovascular health. This study aimed to explore the impact of one of the worst floods in the history of Quebec, Canada on acute cardiovascular diseases (CVD). Methods: A cohort study with a time series design with multiple control groups was built with the adult population identified in the Quebec Integrated Chronic Disease Surveillance System. A geographic information system approach was used to define the study areas. Logistic regressions were performed to compare the occurrence of CVD between groups. Results: The results showed a 25%–27% increase in the odds in the flooded population in spring 2011 when compared with the population in the same area in springs 2010 and 2012. Besides, an increase up to 69% was observed in individuals with a medical history of CVD. Conclusion: Despite interesting results, the association was not statistically significant. A possible explanation to this result can be that the population affected by the flood was probably too small to provide the statistical power to answer the question, and leaves open a substantial possibility for a real and large effect. PMID:26828511

Association between Floods and Acute Cardiovascular Diseases: A Population-Based Cohort Study Using a Geographic Information System Approach.

PubMed

Vanasse, Alain; Cohen, Alan; Courteau, Josiane; Bergeron, Patrick; Dault, Roxanne; Gosselin, Pierre; Blais, Claudia; Bélanger, Diane; Rochette, Louis; Chebana, Fateh

2016-01-28

Floods represent a serious threat to human health beyond the immediate risk of drowning. There is few data on the potential link between floods and direct consequences on health such as on cardiovascular health. This study aimed to explore the impact of one of the worst floods in the history of Quebec, Canada on acute cardiovascular diseases (CVD). A cohort study with a time series design with multiple control groups was built with the adult population identified in the Quebec Integrated Chronic Disease Surveillance System. A geographic information system approach was used to define the study areas. Logistic regressions were performed to compare the occurrence of CVD between groups. The results showed a 25%-27% increase in the odds in the flooded population in spring 2011 when compared with the population in the same area in springs 2010 and 2012. Besides, an increase up to 69% was observed in individuals with a medical history of CVD. Despite interesting results, the association was not statistically significant. A possible explanation to this result can be that the population affected by the flood was probably too small to provide the statistical power to answer the question, and leaves open a substantial possibility for a real and large effect.

Redox modification of caveolar proteins in the cardiovascular system- role in cellular signalling and disease.

PubMed

Bubb, Kristen J; Birgisdottir, Asa Birna; Tang, Owen; Hansen, Thomas; Figtree, Gemma A

2017-08-01

Rapid and coordinated release of a variety of reactive oxygen species (ROS) such as superoxide (O 2 .- ), hydrogen peroxide (H 2 O 2 ) and peroxynitrite, in specific microdomains, play a crucial role in cell signalling in the cardiovascular system. These reactions are mediated by reversible and functional modifications of a wide variety of key proteins. Dysregulation of this oxidative signalling occurs in almost all forms of cardiovascular disease (CVD), including at the very early phases. Despite the heavily publicized failure of "antioxidants" to improve CVD progression, pharmacotherapies such as those targeting the renin-angiotensin system, or statins, exert at least part of their large clinical benefit via modulating cellular redox signalling. Over 250 proteins, including receptors, ion channels and pumps, and signalling proteins are found in the caveolae. An increasing proportion of these are being recognized as redox regulated-proteins, that reside in the immediate vicinity of the two major cellular sources of ROS, nicotinamide adenine dinucleotide phosphate oxidase (Nox) and uncoupled endothelial nitric oxide synthase (eNOS). This review focuses on what is known about redox signalling within the caveolae, as well as endogenous protective mechanisms utilized by the cell, and new approaches to targeting dysregulated redox signalling in the caveolae as a therapeutic strategy in CVD. Copyright © 2017. Published by Elsevier Inc.

Complement Activation: An Emerging Player in the Pathogenesis of Cardiovascular Disease

PubMed Central

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

A Comparative Study of Three Different Chemical Vapor Deposition Techniques of Carbon Nanotube Growth on Diamond Films

DTIC Science & Technology

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

Evaluating Periodontal Treatment to Prevent Cardiovascular Disease: Challenges and Possible Solutions.

PubMed

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.

Cardiovascular Disease Prevention: Training Opportunities, the Challenges, and Future Directions.

PubMed

Saeed, Anum; Dabhadkar, Kaustubh; Virani, Salim S; Jones, Peter H; Ballantyne, Christie M; Nambi, Vijay

2018-05-21

Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality worldwide, necessitating major efforts in prevention. This review summarizes the currently available training opportunities in CVD prevention for fellows-in-training (FITs) and residents. We also highlight the challenges and future directions for CVD prevention as a field and propose a structure for an inclusive CVD prevention training program. At present, there is a lack of centralized training resources for FITs and residents interested in pursuing a career in CVD prevention. Training in CVD prevention is not an accredited subspecialty fellowship by the American Council of Graduate Medical Education (ACGME). Although there are several independent training programs under the broad umbrella of CVD prevention focusing on different aspects of prevention, there is no unified curriculum or training. More collaborative efforts are needed to identify CVD prevention as an ACGME-accredited subspecialty fellowship. Providing more resources can encourage and produce more leaders in this essential field.

Assessment of Cardiovascular Disease Risk in South Asian Populations

PubMed Central

Hussain, S. Monira; Oldenburg, Brian; Zoungas, Sophia; Tonkin, Andrew M.

2013-01-01

Although South Asian populations have high cardiovascular disease (CVD) burden in the world, their patterns of individual CVD risk factors have not been fully studied. None of the available algorithms/scores to assess CVD risk have originated from these populations. To explore the relevance of CVD risk scores for these populations, literature search and qualitative synthesis of available evidence were performed. South Asians usually have higher levels of both “classical” and nontraditional CVD risk factors and experience these at a younger age. There are marked variations in risk profiles between South Asian populations. More than 100 risk algorithms are currently available, with varying risk factors. However, no available algorithm has included all important risk factors that underlie CVD in these populations. The future challenge is either to appropriately calibrate current risk algorithms or ideally to develop new risk algorithms that include variables that provide an accurate estimate of CVD risk. PMID:24163770

Prevalence of undiagnosed cardiovascular risk factors and 10-year CVD risk in male steel industry workers.

PubMed

Gray, Benjamin J; Bracken, Richard M; Turner, Daniel; Morgan, Kerry; Mellalieu, Stephen D; Thomas, Michael; Williams, Sally P; Williams, Meurig; Rice, Sam; Stephens, Jeffrey W

2014-05-01

To assess the prevalence of undiagnosed cardiovascular disease (CVD) in a cohort of male steelworkers in South Wales, UK. Male steel industry workers (n = 221) with no prior diagnosis of CVD or diabetes accepted a CVD risk assessment within the work environment. Demographic, anthropometric, family, and medical histories were all recorded and capillary blood samples obtained. The 10-year CVD risk was predicted using the QRISK2-2012 algorithm. Up to 81.5% of workers were either overweight or obese. More than 20% of workers were found to have diastolic hypertension, high total cholesterol, and/or a total cholesterol/high-density lipoprotein ratio of six or more. Over one quarter of workers assessed had an increased 10-year CVD risk. Despite a physically demanding occupation, risk assessment in the workplace uncovered significant occult factors in CVD risk in a sample of male heavy industry workers.

Relationship between calcified carotid atheromas in digital panoramic radiographs and underlying systemic diseases in implant patients.

PubMed

Ngamsom, Supak; Arayasantiparb, Raweewan; Pornprasertsuk-Damrongsri, Suchaya; Sureephong, Boonchoo

2015-11-01

The aim of the present study was to evaluate the correlation between calcified carotid atheromas (CCA) detected on digital panoramic radiographs and underlying systemic diseases. Panoramic radiographs and underlying systemic diseases of retained mandibular denture implants in 265 patients (56 males, 209 females) aged over 50 years were retrospectively evaluated at the Dental Unit of Prasat Neurological Institute, Bangkok, Thailand. The mean age of the patients was 71 ± 7.1 years. The prevalence of CCA was 38.49%. The major underlying systemic diseases were hypertension, hyperlipidemia, diabetes mellitus, and cardiovascular diseases (CVD), respectively. No relationship was found among these four systemic diseases in detecting CCA on panoramic radiographs. Similar findings were also observed in patients with only one systemic disease versus in combination with other diseases. The presence of CCA on dental panoramic radiographs was not found to be related to the presence of underlying systemic diseases, including hypertension, hyperlipidemia, diabetes mellitus, and CVD. © 2014 Wiley Publishing Asia Pty Ltd.

Association of educational status with cardiovascular disease: Teheran Lipid and Glucose Study.

PubMed

Hajsheikholeslami, Farhad; Hatami, Masumeh; Hadaegh, Farzad; Ghanbarian, Arash; Azizi, Fereidoun

2011-06-01

The aim of this study was to evaluate the associations between educational level and cardiovascular disease (CVD) in an older Iranian population. To estimate the odds ratio (OR) of educational level in a cross-sectional study, logistic regression analysis was used on 1,788 men and 2,204 women (222 men and 204 women positive based on their CVD status) aged ≥ 45 years. In men, educational levels of college degree and literacy level below diploma were inversely associated with CVD in the multivariate model [0.52 (0.28-0.94), 0.61 (0.40-0.92), respectively], but diploma level did not show any significant association with CVD, neither in the crude model nor in the multivariate model. In women, increase in educational level was inversely associated with risk of CVD in the crude model, but in the multivariate adjusted model, literacy level below diploma decreased risk of CVD by 39%, compared with illiteracy. Our findings support those of developed countries that, along with other CVD risk factors, educational status has an inverse association with CVD among a representative Iranian population of older men and women.

Cardiovascular risk-factor knowledge and risk perception among HIV-infected adults.

PubMed

Cioe, Patricia A; Crawford, Sybil L; Stein, Michael D

2014-01-01

Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in HIV-infected adults. Research in noninfected populations has suggested that knowledge of CVD risk factors significantly influences perceptions of risk. This cross-sectional study describes CVD risk factor knowledge and risk perception in HIV-infected adults. We recruited 130 HIV-infected adults (mean age = 48 years, 62% male, 56% current smokers, mean years since HIV diagnosis, 14.7). The mean CVD risk factor knowledge score was fairly high. However, controlling for age, CVD risk factor knowledge was not predictive of perceived risk [F(1, 117) = 0.13, p > .05]. Estimated risk and perceived risk were weakly but significantly correlated; r (126) = .24, p = .01. HIV-infected adults are at increased risk for CVD. Despite having adequate risk-factor knowledge, CVD risk perception was inaccurate. Improving risk perception and developing CVD risk reduction interventions for this population are imperative. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Prediction of cardiovascular disease risk among low-income urban dwellers in metropolitan Kuala Lumpur, Malaysia.

PubMed

Su, Tin Tin; Amiri, Mohammadreza; Mohd Hairi, Farizah; Thangiah, Nithiah; Bulgiba, Awang; Majid, Hazreen Abdul

2015-01-01

We aimed to predict the ten-year cardiovascular disease (CVD) risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS) models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM). Altogether 882 adults (≥30 years old with no CVD history) were randomly selected. The classic FRS model (figures in parentheses are from the modified model) revealed that 20.5% (21.8%) and 38.46% (38.9%) of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

Obesity-related inflammation & cardiovascular disease: efficacy of a yoga-based lifestyle intervention.

PubMed

Sarvottam, Kumar; Yadav, Raj Kumar

2014-06-01

Obesity is a global health burden and its prevalence is increasing substantially due to changing lifestyle. Chronic adiposity is associated with metabolic imbalance leading to dyslipidaemia, diabetes, hypertension and cardiovascular diseases (CVD). Adipose tissue acts as an endocrine organ releasing several adipocytokines, and is associated with increased levels of tissue and circulating inflammatory biomolecules causing vascular inflammation and atherogenesis. Further, inflammation is also associated independently with obesity as well as CVD. Keeping this in view, it is possible that a reduction in weight may lead to a decrease in inflammation, resulting in CVD risk reduction, and better management of patients with CVD. Lifestyle intervention has been endorsed by several health authorities in prevention and management of chronic diseases. A yoga-based lifestyle intervention appears to be a promising option in reducing the risk for CVD as well as management of patients with CVD as it is simple to follow and cost-effective with high compliance. The efficacy of such lifestyle intervention programmes is multifaceted, and is achieved via reduction in weight, obesity-related inflammation and stress, thereby culminating into risk reduction towards several chronic diseases including CVD. In this review, the association between obesity-related inflammation and CVD, and the role of yoga-based lifestyle intervention in prevention and management of CVD are discussed.

Genetic variation associated with cardiovascular risk in autoimmune diseases

PubMed Central

Perrotti, Pedro P.; Aterido, Adrià; Fernández-Nebro, Antonio; Cañete, Juan D.; Ferrándiz, Carlos; Tornero, Jesús; Gisbert, Javier P.; Domènech, Eugeni; Fernández-Gutiérrez, Benjamín; Gomollón, Fernando; García-Planella, Esther; Fernández, Emilia; Sanmartí, Raimon; Gratacós, Jordi; Martínez-Taboada, Víctor Manuel; Rodríguez-Rodríguez, Luís; Palau, Núria; Tortosa, Raül; Corbeto, Mireia L.; Lasanta, María L.; Marsal, Sara; Julià, Antonio

2017-01-01

Autoimmune diseases have a higher prevalence of cardiovascular events compared to the general population. The objective of this study was to investigate the genetic basis of cardiovascular disease (CVD) risk in autoimmunity. We analyzed genome-wide genotyping data from 6,485 patients from six autoimmune diseases that are associated with a high socio-economic impact. First, for each disease, we tested the association of established CVD risk loci. Second, we analyzed the association of autoimmune disease susceptibility loci with CVD. Finally, to identify genetic patterns associated with CVD risk, we applied the cross-phenotype meta-analysis approach (CPMA) on the genome-wide data. A total of 17 established CVD risk loci were significantly associated with CVD in the autoimmune patient cohorts. From these, four loci were found to have significantly different genetic effects across autoimmune diseases. Six autoimmune susceptibility loci were also found to be associated with CVD risk. Genome-wide CPMA analysis identified 10 genetic clusters strongly associated with CVD risk across all autoimmune diseases. Two of these clusters are highly enriched in pathways previously associated with autoimmune disease etiology (TNFα and IFNγ cytokine pathways). The results of this study support the presence of specific genetic variation associated with the increase of CVD risk observed in autoimmunity. PMID:28982122

Comparison of the quality of single-crystal diamonds grown on two types of seed substrates by MPCVD

NASA Astrophysics Data System (ADS)

Zhao, Yun; Guo, Yanzhao; Lin, Liangzhen; Zheng, Yuting; Hei, Lifu; Liu, Jinlong; Wei, Junjun; Chen, Liangxian; Li, Chengming

2018-06-01

Microwave plasma chemical vapor deposition (MPCVD) was used to grow single-crystal diamonds on two types of single-crystal diamond seed substrates prepared by high-pressure, high-temperature (HPHT) and chemical vapor deposition (CVD) methods. The quality of diamonds grown on the different seed substrates was compared. Fluorescence characteristics showed that the sectors of the HPHT seed substrates were obviously partitioned. Raman and absorption spectra showed that the CVD seed substrate produced higher-quality crystals with fewer nitrogen impurities. X-ray topography showed that the HPHT seed substrate had obvious growth sector boundaries, inclusions, dislocations, and stacking faults. The polarization characteristics of HPHT seed substrate were obvious, and the stress distribution was not uniform. When etching HPHT and CVD seed substrates using the same parameters, the etching morphology and extent of different growth sectors of the two substrates differed. Although extended defects were inevitably formed at the interface and propagated in the CVD layer, the dislocation density of a 1 mm-thick CVD layer grown on a CVD seed substrate was only half that of a 1 mm-thick CVD layer grown on an HPHT seed substrate. Therefore, the use of CVD seed substrate enabled the growth of a relatively higher-quality CVD single-crystal diamond.

Prediction of Cardiovascular Disease Risk among Low-Income Urban Dwellers in Metropolitan Kuala Lumpur, Malaysia

PubMed Central

Su, Tin Tin; Amiri, Mohammadreza; Mohd Hairi, Farizah; Thangiah, Nithiah; Majid, Hazreen Abdul

2015-01-01

We aimed to predict the ten-year cardiovascular disease (CVD) risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS) models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM). Altogether 882 adults (≥30 years old with no CVD history) were randomly selected. The classic FRS model (figures in parentheses are from the modified model) revealed that 20.5% (21.8%) and 38.46% (38.9%) of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers. PMID:25821810

Sarcopenic-obesity and cardiovascular disease risk in the elderly.

PubMed

Stephen, W C; Janssen, I

2009-05-01

To determine: 1) whether sarcopenic-obesity is a stronger predictor of cardiovascular disease (CVD) than either sarcopenia or obesity alone in the elderly, and 2) whether muscle mass or muscular strength is a stronger marker of CVD risk. Prospective cohort study. Participants included 3366 community-dwelling older (>or= 65 years) men and women who were free of CVD at baseline. Waist circumference (WC), bioimpedance analysis, and grip strength were used to measure abdominal obesity, whole-body muscle mass, and muscular strength, respectively. Subjects were classified as normal, sarcopenic, obese, or sarcopenic-obese based on measures of WC and either muscle mass or strength. Participants were followed for 8 years for CVD development and proportional hazard regression models were used to compare risk estimates for CVD in the four groups after adjusting for age, sex, race, income, smoking, alcohol, and cognitive status. Compared with the normal group, CVD risk was not significantly elevated within the obese, sarcopenic, or sarcopenic-obese groups as determined by WC and muscle mass. When determined by WC and muscle strength, CVD risk was not significantly increased in the sarcopenic or obese groups, but was increased by 23% (95% confidence interval: 0.99-1.54, P=0.06) within the sarcopenic-obese group. Sarcopenia and obesity alone were not sufficient to increase CVD risk. Sarcopenic-obesity, based on muscle strength but not muscle mass, was modestly associated with increased CVD risk. These findings imply that strength may be more important than muscle mass for CVD protection in old age.

Canada's contribution to global research in cardiovascular diseases.

PubMed

Nguyen, Hai V; de Oliveira, Claire; Wijeysundera, Harindra C; Wong, William W L; Woo, Gloria; Grootendorst, Paul; Liu, Peter P; Krahn, Murray D

2013-06-01

The burden of cardiovascular disease (CVD) in Canada and other developed countries is growing, in part because of the aging of the population and the alarming rise of obesity. Studying Canada's contribution to the global body of CVD research output will shed light on the effectiveness of investments in Canadian CVD research and inform if Canada has been responding to its CVD burden. Search was conducted using the Web-of-Science database for publications during 1981 through 2010 on major areas and specific interventions in CVD. Search was also conducted using Canadian and US online databases for patents issued between 1981 and 2010. Search data were used to estimate the proportions of the world's pool of research publications and of patents conducted by researchers based in Canada. The results indicate that Canada contributed 6% of global research in CVD during 1981 through 2010. Further, Canada's contribution shows a strong upward trend during the period. Based on patent data, Canada's contribution level was similar (5%-7%). Canada's contribution to the global pool of CVD research is on par with France and close to the UK, Japan, and Germany. Canada's contribution in global CVD research is higher than its average contribution in all fields of research (6% vs 3%). As the burden of chronic diseases including CVD rises with Canada's aging population, the increase in Canadian research into CVD is encouraging. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

"Ikigai", Subjective Wellbeing, as a Modifier of the Parity-Cardiovascular Mortality Association　- The Japan Collaborative Cohort Study.

PubMed

Yasukawa, Sumiyo; Eguchi, Eri; Ogino, Keiki; Tamakoshi, Akiko; Iso, Hiroyasu

2018-04-25

Nulliparity is associated with an excess risk of cardiovascular disease (CVD). "Ikigai", subjective wellbeing in Japan, is associated with reduced risk of CVD. The impact of ikigai on the association between parity and the risk of CVD, however, has not been reported.Methods and Results:A total of 39,870 Japanese women aged 40-79 years without a history of CVD, cancer or insufficient information at baseline in 1988-1990, were enrolled and followed until the end of 2009. They were categorized into 7 groups according to parity number 0-≥6. Using Cox regression hazard modeling, the associations between parity and mortality from stroke, coronary artery disease, and total CVD were investigated. During the follow-up period, 2,121 total CVD deaths were documented. No association was observed between parity and stroke and CVD mortality in women with ikigai, but there was an association in those without ikigai. The multivariable hazard ratios of stroke and total CVD mortality for nulliparous women without ikigai vs. those with 1 child were 1.87 (95% CI: 1.15-3.05) and 1.46 (95% CI: 1.07-2.01), respectively, and that for stroke mortality in high parity women without ikigai was 1.56 (95% CI: 1.00-2.45). Nulliparous or high parity women without ikigai had higher mortality from stroke and/or total CVD, suggesting that ikigai attenuated the association between parity and CVD mortality in Japanese women.

Cocoa Polyphenols: Evidence from Epidemiological Studies.

PubMed

Matsumoto, Chisa

2018-01-01

Accumulating evidence suggests potential preventive effects of chocolate/cocoa on the risk of cardio vascular disease (CVD). However, cocoa products also contain high levels of sugar and fat, which increase CVD risk factors. Even, the identity of the substance in chocolate/cocoa that has a favorable effect on CVD and CVD risk factors remains unclear, growing evidence from experimental studies suggests that cocoa polyphenols might be a major contributor to cardiovascular-protective effects. However, epidemiological studies, which are necessary to evaluate an association between the risk of CVD and cocoa polyphenol, remain sparse. We will discuss recent evidence regarding the association between cocoa polyphenol consumption and the risks of CVD and its risk factors by reviewing recent epidemiological studies. We shall also provide some guidance for patient counseling and will discuss the public health implications for recommending cocoa polyphenol consumption to prevent CVD. Epidemiological studies evaluating the association between cocoa polyphenol itself and the risk of CVD are sparse. However, evidence from limited epidemiological studies suggests that cocoa polyphenol consumption may lower the risk of CVD. Given the potential adverse effects of the consumption of cocoa products with high fat and sugar and the fact that the most appropriate dose of cocoa polyphenol for cardio-protective effects has not yet been established, health care providers should remain cautious about recommending cocoa/cocoa polyphenol consumption to their patients to reduce the risk of CVD, taking the characteristics of individual patients into careful consideration. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Association of resting heart rate and cardiovascular disease mortality in hypertensive and normotensive rural Chinese.

PubMed

Zhang, Ming; Han, Chengyi; Wang, Chongjian; Wang, Jinjin; Li, Linlin; Zhang, Lu; Wang, Bingyuan; Ren, Yongcheng; Zhang, Hongyan; Yang, Xiangyu; Zhao, Yang; Zhou, Junmei; Pang, Chao; Yin, Lei; Feng, Tianping; Zhao, Jingzhi; Luo, Xinping; Hu, Dongsheng

2017-05-01

Studies have demonstrated an increased risk of cardiovascular disease (CVD)-associated death (CVD death) with increased resting heart rate (RHR); however, whether the association is consistent in rural Chinese with hypertension and normotension is unknown. We examined the association of RHR and CVD death by hypertension and normotension status in rural Chinese people. Baseline data for 20,069 participants ≥18 years old were collected during July to August of 2007 and July to August of 2008; 17,151 (85.5%) participants were followed up in July to August of 2013 and July to October of 2014. The association of RHR and CVD death was determined by Cox proportional hazards regression. During a mean of 5.88 years (100,889 person-years) of follow-up, we recorded 479 CVD deaths (309 in hypertensive participants). CVD death increased significantly with increasing RHR, beginning from 80 beats per minute (bpm), for hypertensive and normotensive participants. After adjusting for pulse pressure and other covariates, for hypertensive participants, risk of CVD death was increased with RHR 80-89 and ≥90bpm. However, for normotensive participants, risk of CVD death was increased with only RHR≥90bpm. Risk of CVD death was associated with elevated RHR for both hypertensive and normotensive rural Chinese, and for hypertensive participants, even slightly elevated RHR was associated with CVD death. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Physical Therapists’ Perceptions of Knowledge and Clinical Behavior Regarding Cardiovascular Disease Prevention

PubMed Central

Van Zant, R Scott; Cape, Kelly Jo; Roach, Katrina; Sweeney, Janie

2013-01-01

Purpose The study purpose was to assess perceptions of physical therapists (PTs) regarding the role of physical therapy in cardiovascular disease (CVD) prevention. Methods A 25-item survey, validated by expert cardiovascular/pulmonary (CVP) PTs, was sent electronically to 2,673 PTs. Each item represented an element of clinical practice behavior: education of CVD/risk factors (EDCVD), administration of primary CVD prevention (PRECVD), identifying underlying CVD/risk factors (IDCVD), monitoring CV status in patients with CVD (MONCVD). Responses were assigned numeric values (strongly agree = 5 to strongly disagree = 1), and mean element scores were analyzed. Results Most of the 516 respondents were APTA Section members (34% CVP Section, 42% other Section membership) and worked in academia (53%). Items showing a high (> 95%) level of agreement included patient education of smoking (97%) and monitoring exercise intensity (99%), assessing exercise benefits (99%), clinically identifying obesity (97%) and hypertension (97%), and monitoring CV response to exercise (99%). Items failing to reach 80% overall agreement were patient education of CVD medications (79%) and blood chemistry (72%), and assessing CVD family history (75%), patient BMI (60%), and body composition (33%). Identifying underlying CVD (77.2%) was the only practice behavior failing to reach 80% agreement. Outpatient PTs agreed significantly less to all elements vs. academics, and to IDCVD vs. all PTs except home health. Conclusions Physical therapists support most CVD prevention behaviors, but not given elements of patient education and identifying underlying CVD/risk factors. PMID:23801901

Circulating interleukin-10 and risk of cardiovascular events: a prospective study in the elderly at risk.

PubMed

Welsh, Paul; Murray, Heather M; Ford, Ian; Trompet, Stella; de Craen, Anton J M; Jukema, J Wouter; Stott, David J; McInnes, Iain B; Packard, Chris J; Westendorp, Rudi G J; Sattar, Naveed

2011-10-01

The goal of this study was to examine the association of the antiinflammatory interleukin-10 (IL-10) with risk of cardiovascular disease (CVD). In the PROSPER (PROspective Study of Pravastatin in the Elderly at Risk) cohort, we related baseline concentrations of circulating IL-10 to risk of CVD events in a nested case (n=819)-control (n=1618) study of 3.2 years of follow-up. Circulating IL-10 showed few strong associations with classical risk factors but was positively correlated with IL-6 and C-reactive protein. IL-10 was positively associated with risk of CVD events (odds ratio [OR] 1.17, 95% CI 1.05 to 1.31 per unit increase in log IL-10) after adjusting for classical risk factors and C-reactive protein. Furthermore, IL-10 was associated more strongly with CVD risk among those with no previous history of CVD (OR 1.42, 95% CI 1.18 to 1.70), compared with those with previous CVD (OR 1.04, 95% CI 0.90 to 1.19; P=0.018). Overall, IL-10 showed a modest ability to add discrimination to classical risk factors (C-statistic +0.005, P=0.002). Baseline circulating levels of the antiinflammatory IL-10 are positively associated with risk of CVD among the elderly without prior CVD events, although the association is less evident in those with a history of CVD. Additional epidemiological and mechanistic studies investigating the role of IL-10 in CVD are warranted.

The health effects of US unemployment insurance policy: does income from unemployment benefits prevent cardiovascular disease?

PubMed

Walter, Stefan; Glymour, Maria; Avendano, Mauricio

2014-01-01

Previous studies suggest that unemployment predicts increased cardiovascular disease (CVD) risk, but whether unemployment insurance programs mitigate this risk has not been assessed. Exploiting US state variations in unemployment insurance benefit programs, we tested the hypothesis that more generous benefits reduce CVD risk. Cohort data came from 16,108 participants in the Health and Retirement Study (HRS) aged 50-65 at baseline interviewed from 1992 to 2010. Data on first and recurrent CVD diagnosis assessed through biennial interviews were linked to the generosity of unemployment benefit programmes in each state and year. Using state fixed-effect models, we assessed whether state changes in the generosity of unemployment benefits predicted CVD risk. States with higher unemployment benefits had lower incidence of CVD, so that a 1% increase in benefits was associated with 18% lower odds of CVD (OR:0.82, 95%-CI:0.71-0.94). This association remained after introducing US census regional division fixed effects, but disappeared after introducing state fixed effects (OR:1.02, 95%-CI:0.79-1.31).This was consistent with the fact that unemployment was not associated with CVD risk in state-fixed effect models. Although states with more generous unemployment benefits had lower CVD incidence, this appeared to be due to confounding by state-level characteristics. Possible explanations are the lack of short-term effects of unemployment on CVD risk. Future studies should assess whether benefits at earlier stages of the life-course influence long-term risk of CVD.

Projected Impact of Salt Restriction on Prevention of Cardiovascular Disease in China: A Modeling Study

PubMed Central

Liu, Jing; Coxson, Pamela G.; Penko, Joanne; Goldman, Lee; Bibbins-Domingo, Kirsten; Zhao, Dong

2016-01-01

Objectives To estimate the effects of achieving China’s national goals for dietary salt (NaCl) reduction or implementing culturally-tailored dietary salt restriction strategies on cardiovascular disease (CVD) prevention. Methods The CVD Policy Model was used to project blood pressure lowering and subsequent downstream prevented CVD that could be achieved by population-wide salt restriction in China. Outcomes were annual CVD events prevented, relative reductions in rates of CVD incidence and mortality, quality-adjusted life-years (QALYs) gained, and CVD treatment costs saved. Results Reducing mean dietary salt intake to 9.0 g/day gradually over 10 years could prevent approximately 197 000 incident annual CVD events [95% uncertainty interval (UI): 173 000–219 000], reduce annual CVD mortality by approximately 2.5% (2.2–2.8%), gain 303 000 annual QALYs (278 000–329 000), and save approximately 1.4 billion international dollars (Int$) in annual CVD costs (Int$; 1.2–1.6 billion). Reducing mean salt intake to 6.0 g/day could approximately double these benefits. Implementing cooking salt-restriction spoons could prevent 183 000 fewer incident CVD cases (153 000–215 000) and avoid Int$1.4 billion in CVD treatment costs annually (1.2–1.7 billion). Implementing a cooking salt substitute strategy could lead to approximately three times the health benefits of the salt-restriction spoon program. More than three-quarters of benefits from any dietary salt reduction strategy would be realized in hypertensive adults. Conclusion China could derive substantial health gains from implementation of population-wide dietary salt reduction policies. Most health benefits from any dietary salt reduction program would be realized in adults with hypertension. PMID:26840409

Predictive Properties of Plasma Amino Acid Profile for Cardiovascular Disease in Patients with Type 2 Diabetes

PubMed Central

Kume, Shinji; Araki, Shin-ichi; Ono, Nobukazu; Shinhara, Atsuko; Muramatsu, Takahiko; Araki, Hisazumi; Isshiki, Keiji; Nakamura, Kazuki; Miyano, Hiroshi; Koya, Daisuke; Haneda, Masakazu; Ugi, Satoshi; Kawai, Hiromichi; Kashiwagi, Atsunori; Uzu, Takashi; Maegawa, Hiroshi

2014-01-01

Prevention of cardiovascular disease (CVD) is an important therapeutic object of diabetes care. This study assessed whether an index based on plasma free amino acid (PFAA) profiles could predict the onset of CVD in diabetic patients. The baseline concentrations of 31 PFAAs were measured with high-performance liquid chromatography-electrospray ionization-mass spectrometry in 385 Japanese patients with type 2 diabetes registered in 2001 for our prospective observational follow-up study. During 10 years of follow-up, 63 patients developed cardiovascular composite endpoints (myocardial infarction, angina pectoris, worsening of heart failure and stroke). Using the PFAA profiles and clinical information, an index (CVD-AI) consisting of six amino acids to predict the onset of any endpoints was retrospectively constructed. CVD-AI levels were significantly higher in patients who did than did not develop CVD. The area under the receiver-operator characteristic curve of CVD-AI (0.72 [95% confidence interval (CI): 0.64–0.79]) showed equal or slightly better discriminatory capacity than urinary albumin excretion rate (0.69 [95% CI: 0.62–0.77]) on predicting endpoints. A multivariate Cox proportional hazards regression analysis showed that the high level of CVD-AI was identified as an independent risk factor for CVD (adjusted hazard ratio: 2.86 [95% CI: 1.57–5.19]). This predictive effect of CVD-AI was observed even in patients with normoalbuminuria, as well as those with albuminuria. In conclusion, these results suggest that CVD-AI based on PFAA profiles is useful for identifying diabetic patients at risk for CVD regardless of the degree of albuminuria, or for improving the discriminative capability by combining it with albuminuria. PMID:24971671

Developing a synthetic national population to investigate the impact of different cardiovascular disease risk management strategies: A derivation and validation study

PubMed Central

Jackson, Rod

2017-01-01

Background Many national cardiovascular disease (CVD) risk factor management guidelines now recommend that drug treatment decisions should be informed primarily by patients’ multi-variable predicted risk of CVD, rather than on the basis of single risk factor thresholds. To investigate the potential impact of treatment guidelines based on CVD risk thresholds at a national level requires individual level data representing the multi-variable CVD risk factor profiles for a country’s total adult population. As these data are seldom, if ever, available, we aimed to create a synthetic population, representing the joint CVD risk factor distributions of the adult New Zealand population. Methods and results A synthetic population of 2,451,278 individuals, representing the actual age, gender, ethnicity and social deprivation composition of people aged 30–84 years who completed the 2013 New Zealand census was generated using Monte Carlo sampling. Each ‘synthetic’ person was then probabilistically assigned values of the remaining cardiovascular disease (CVD) risk factors required for predicting their CVD risk, based on data from the national census national hospitalisation and drug dispensing databases and a large regional cohort study, using Monte Carlo sampling and multiple imputation. Where possible, the synthetic population CVD risk distributions for each non-demographic risk factor were validated against independent New Zealand data sources. Conclusions We were able to develop a synthetic national population with realistic multi-variable CVD risk characteristics. The construction of this population is the first step in the development of a micro-simulation model intended to investigate the likely impact of a range of national CVD risk management strategies that will inform CVD risk management guideline updates in New Zealand and elsewhere. PMID:28384217

Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies.

PubMed

Ding, Ming; Bhupathiraju, Shilpa N; Satija, Ambika; van Dam, Rob M; Hu, Frank B

2014-02-11

Considerable controversy exists on the association between coffee consumption and cardiovascular disease (CVD) risk. A meta-analysis was performed to assess the dose-response relationship of long-term coffee consumption with CVD risk. PubMed and EMBASE were searched for prospective cohort studies of the relationship between coffee consumption and CVD risk, which included coronary heart disease, stroke, heart failure, and CVD mortality. Thirty-six studies were included with 1 279 804 participants and 36 352 CVD cases. A nonlinear relationship of coffee consumption with CVD risk was identified (P for heterogeneity=0.09, P for trend <0.001, P for nonlinearity <0.001). Compared with the lowest category of coffee consumption (median, 0 cups per day), the relative risk of CVD was 0.95 (95% confidence interval, 0.87-1.03) for the highest category (median, 5 cups per day) category, 0.85 (95% confidence interval, 0.80-0.90) for the second highest category (median, 3.5 cups per day), and 0.89 (95% confidence interval, 0.84-0.94) for the third highest category (median, 1.5 cups per day). Looking at separate outcomes, coffee consumption was nonlinearly associated with both coronary heart disease (P for heterogeneity=0.001, P for trend <0.001, P for nonlinearity <0.001) and stroke (P for heterogeneity=0.07, P for trend <0.001, P for nonlinearity <0.001; P for trend differences >0.05) risks. A nonlinear association between coffee consumption and CVD risk was observed in this meta-analysis. Moderate coffee consumption was inversely significantly associated with CVD risk, with the lowest CVD risk at 3 to 5 cups per day, and heavy coffee consumption was not associated with elevated CVD risk.

Cardiorespiratory Fitness Cutoff Points for Early Detection of Present and Future Cardiovascular Risk in Children: A 2-Year Follow-up Study.

PubMed

Castro-Piñero, José; Perez-Bey, Alejandro; Segura-Jiménez, Víctor; Aparicio, Virginia A; Gómez-Martínez, Sonia; Izquierdo-Gomez, Rocio; Marcos, Ascensión; Ruiz, Jonatan R

2017-12-01

To examine the association between cardiorespiratory fitness (CRF) at baseline and cardiovascular disease (CVD) risk in 6- to 10-year-olds (cross-sectional) and 2 years later (8- to 12-year-olds [longitudinal]) and whether changes with age in CRF are associated with CVD risk in children aged 8 to 12 years. Spanish primary schoolchildren (n=236) aged 6 to 10 years participated at baseline. Of the 23 participating primary schools, 22% (n=5) were private schools and 78% (n=18) were public schools. The dropout rate at 2-year follow-up was 9.7% (n=23). The 20-m shuttle run test was used to estimate CRF. The CVD risk score was computed as the mean of 5 CVD risk factor standardized scores: sum of 2 skinfolds, systolic blood pressure, insulin/glucose, triglycerides, and total cholesterol/high-density lipoprotein cholesterol. At baseline, CRF was inversely associated with single CVD risk factors (all P<.05) and CVD risk score at baseline and follow-up (P<.001). Cardiorespiratory fitness cutoff points of 39.0 mL/kg per minute or greater in boys and 37.5 mL/kg per minute or greater in girls are discriminative to identify CVD risk in childhood (area under the curve, >0.85; P<.001) and to predict CVD risk 2 years later (P=.004). Persistent low CRF or the decline of CRF from 6-10 to 8-12 years of age is associated with increased CVD risk at age 8 to 12 years (P<.001). During childhood, CRF is a strong predictor of CVD risk and should be monitored to identify children with potential CVD risk. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Impact of Renal Impairment on Cardiovascular Disease Mortality After Liver Transplantation for Nonalcoholic Steatohepatitis Cirrhosis

PubMed Central

VanWagner, Lisa B.; Lapin, Brittany; Skaro, Anton I.; Lloyd-Jones, Donald M.; Rinella, Mary E.

2016-01-01

BACKGROUND & AIMS Non-alcoholic steatohepatitis (NASH) is an independent risk factor for cardiovascular disease (CVD) morbidity after liver transplantation, but its impact on CVD mortality is unknown. We sought to assess the impact of NASH on CVD mortality after liver transplantation and to predict which NASH recipients are at highest risk of a CVD-related death following a liver transplant. METHODS Using the Organ Procurement and Transplantation Network database we examined associations between NASH and post liver transplant CVD mortality, defined as primary cause of death from thromboembolism, arrhythmia, heart failure, myocardial infarction, or stroke. A physician panel reviewed cause of death. RESULTS Of 48,360 liver transplants (2/2002–12/2011), 5,057 (10.5%) were performed for NASH cirrhosis. NASH recipients were more likely to be older, female, obese, diabetic, and have history of renal failure or prior CVD versus non-NASH (p<0.001 for all). Although there was no difference in overall all-cause mortality (log-rank p=0.96), both early (30-day) and long-term CVD-specific mortality was increased among NASH recipients (Odds ratio=1.30, 95% Confidence interval (CI): 1.02–1.66; Hazard ratio=1.42, 95% CI: 1.07–1.41, respectively). These associations were no longer significant after adjustment for pre-transplant diabetes, renal impairment or CVD. A risk score comprising age ≥ 55, male sex, diabetes and renal impairment was developed for prediction of post liver transplant CVD mortality (c-statistic 0.60). CONCLUSION NASH recipients have an increased risk of CVD mortality after liver transplantation explained by a high prevalence of co-morbid cardiometabolic risk factors that in aggregate identify those at highest risk of post-transplant CVD mortality. PMID:25977117

Left Ventricular Structure and Risk of Cardiovascular Events: A Framingham Heart Study Cardiac Magnetic Resonance Study

PubMed Central

Tsao, Connie W; Gona, Philimon N; Salton, Carol J; Chuang, Michael L; Levy, Daniel; Manning, Warren J; O’Donnell, Christopher J

2015-01-01

Background Elevated left ventricular mass index (LVMI) and concentric left ventricular (LV) remodeling are related to adverse cardiovascular disease (CVD) events. The predictive utility of LV concentric remodeling and LV mass in the prediction of CVD events is not well characterized. Methods and Results Framingham Heart Study Offspring Cohort members without prevalent CVD (n=1715, 50% men, aged 65±9 years) underwent cardiovascular magnetic resonance for LVMI and geometry (2002–2006) and were prospectively followed for incident CVD (myocardial infarction, coronary insufficiency, heart failure, stroke) or CVD death. Over 13 808 person-years of follow-up (median 8.4, range 0.0 to 10.5 years), 85 CVD events occurred. In multivariable-adjusted proportional hazards regression models, each 10-g/m2 increment in LVMI and each 0.1 unit in relative wall thickness was associated with 33% and 59% increased risk for CVD, respectively (P=0.004 and P=0.009, respectively). The association between LV mass/LV end-diastolic volume and incident CVD was borderline significant (P=0.053). Multivariable-adjusted risk reclassification models showed a modest improvement in CVD risk prediction with the incorporation of cardiovascular magnetic resonance LVMI and measures of LV concentricity (C-statistic 0.71 [95% CI 0.65 to 0.78] for the model with traditional risk factors only, improved to 0.74 [95% CI 0.68 to 0.80] for the risk factor model additionally including LVMI and relative wall thickness). Conclusions Among adults free of prevalent CVD in the community, greater LVMI and LV concentric hypertrophy are associated with a marked increase in adverse incident CVD events. The potential benefit of aggressive primary prevention to modify LV mass and geometry in these adults requires further investigation. PMID:26374295

Developing a synthetic national population to investigate the impact of different cardiovascular disease risk management strategies: A derivation and validation study.

PubMed

Knight, Josh; Wells, Susan; Marshall, Roger; Exeter, Daniel; Jackson, Rod

2017-01-01

Many national cardiovascular disease (CVD) risk factor management guidelines now recommend that drug treatment decisions should be informed primarily by patients' multi-variable predicted risk of CVD, rather than on the basis of single risk factor thresholds. To investigate the potential impact of treatment guidelines based on CVD risk thresholds at a national level requires individual level data representing the multi-variable CVD risk factor profiles for a country's total adult population. As these data are seldom, if ever, available, we aimed to create a synthetic population, representing the joint CVD risk factor distributions of the adult New Zealand population. A synthetic population of 2,451,278 individuals, representing the actual age, gender, ethnicity and social deprivation composition of people aged 30-84 years who completed the 2013 New Zealand census was generated using Monte Carlo sampling. Each 'synthetic' person was then probabilistically assigned values of the remaining cardiovascular disease (CVD) risk factors required for predicting their CVD risk, based on data from the national census national hospitalisation and drug dispensing databases and a large regional cohort study, using Monte Carlo sampling and multiple imputation. Where possible, the synthetic population CVD risk distributions for each non-demographic risk factor were validated against independent New Zealand data sources. We were able to develop a synthetic national population with realistic multi-variable CVD risk characteristics. The construction of this population is the first step in the development of a micro-simulation model intended to investigate the likely impact of a range of national CVD risk management strategies that will inform CVD risk management guideline updates in New Zealand and elsewhere.

Long-Term Coffee Consumption and Risk of Cardiovascular Disease: A Systematic Review and a Dose-Response Meta-Analysis of Prospective Cohort Studies

PubMed Central

Ding, Ming; Bhupathiraju, Shilpa N; Satija, Ambika; van Dam, Rob M; Hu, Frank B

2013-01-01

Background Considerable controversy exists regarding the association between coffee consumption and cardiovascular disease (CVD) risk. A meta-analysis was performed to assess the dose-response relationship of long-term coffee consumption with CVD risk. Methods and Results Pubmed and EMBASE were searched for prospective cohort studies of the relationship between coffee consumption and CVD risk, which included coronary heart disease, stroke, heart failure, and CVD mortality. Thirty-six studies were included with 1,279,804 participants and 36,352 CVD cases. A non-linear relationship of coffee consumption with CVD risk was identified (P for heterogeneity = 0.09, P for trend < 0.001, P for non-linearity < 0.001). Compared with the lowest category of coffee consumption (median: 0 cups/d), the relative risk of CVD was 0.95 (95% CI, 0.87 to 1.03) for the highest (median: 5 cups/d) category, 0.85 (0.80 to 0.90) for the second highest (median: 3.5 cups/d), and 0.89 (0.84 to 0.94) for the third highest category (median: 1.5 cups/d). Looking at separate outcomes, coffee consumption was non-linearly associated with both CHD (P for heterogeneity = 0.001, P for trend < 0.001, P for non-linearity < 0.001) and stroke risks (P for heterogeneity = 0.07, P for trend < 0.001, P for non-linearity< 0.001) (P for trend differences > 0.05). Conclusions A non-linear association between coffee consumption with CVD risk was observed in this meta-analysis. Moderate coffee consumption was inversely significantly associated with CVD risk, with the lowest CVD risk at 3 to 5 cups/d, and heavy coffee consumption was not associated with elevated CVD risk. PMID:24201300

Outdoor temperature, blood pressure, and cardiovascular disease mortality among 23 000 individuals with diagnosed cardiovascular diseases from China.

PubMed

Yang, Ling; Li, Liming; Lewington, Sarah; Guo, Yu; Sherliker, Paul; Bian, Zheng; Collins, Rory; Peto, Richard; Liu, Yun; Yang, Rong; Zhang, Yongrui; Li, Guangchun; Liu, Shumei; Chen, Zhengming

2015-05-14

Blood pressure is a major cause of cardiovascular disease (CVD) and both may increase as outdoor temperatures fall. However, there are still limited data about seasonal variation in blood pressure and CVD mortality among patients with prior-CVD. We analysed data on 23 000 individuals with prior-CVD who were recruited from 10 diverse regions into the China Kadoorie Biobank during 2004-8. After 7 years of follow-up, 1484 CVD deaths were recorded. Baseline survey data were used to assess seasonal variation in systolic blood pressure (SBP) and its association with outdoor temperature. Cox regression was used to examine the association of usual SBP with subsequent CVD mortality, and seasonal variation in CVD mortality was assessed by Poisson regression. All analyses were adjusted for age, sex, and region. Mean SBP was significantly higher in winter than in summer (145 vs. 136 mmHg, P < 0.001), especially among those without central heating. Above 5°C, each 10°C lower outdoor temperature was associated with 6.2 mmHg higher SBP. Systolic blood pressure predicted subsequent CVD mortality, with each 10 mmHg higher usual SBP associated with 21% (95% confidence interval: 16-27%) increased risk. Cardiovascular disease mortality varied by season, with 41% (21-63%) higher risk in winter compared with summer. Among adult Chinese with prior-CVD, there is both increased blood pressure and CVD mortality in winter. Careful monitoring and more aggressive blood pressure lowering treatment in the cold months are needed to help reduce the winter excess CVD mortality in high-risk individuals. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

Late-Onset Asthma Predicts Cardiovascular Disease Events: The Wisconsin Sleep Cohort.

PubMed

Tattersall, Matthew C; Barnet, Jodi H; Korcarz, Claudia E; Hagen, Erika W; Peppard, Paul E; Stein, James H

2016-08-24

Asthma is a heterogeneous syndrome with different clinical subtypes that is associated with an increased risk for cardiovascular disease (CVD). We hypothesized that the late-onset subtype of asthma is associated with a higher risk of incident CVD. Participants from the Wisconsin Sleep Cohort free of CVD at baseline were followed for a mean (SD) of 13.9 (5.9) years for development of CVD (myocardial infarction, angina, stroke, coronary revascularization, heart failure, or CVD death). Late-onset asthma was defined as physician-diagnosed asthma at age ≥18 years. Multivariable Cox regression models adjusted for age, sex, and CVD risk factors were used to assess associations of late-onset asthma and incident CVD. The 1269 participants were 47.3 (8.0) years old; 166 participants had asthma (111 late-onset, 55 early-onset). Participants with late-onset asthma compared to nonasthmatics were more likely to be female (67% versus 44%) and to have a higher body-mass index (32.2 versus 29.4 kg/m(2)) (P<0.05). Mean age of asthma diagnosis in the late-onset group was 39.5 (9.6) years versus 8.9 (5.7) years in the early-onset group (P<0.0001). Late-onset asthmatics had a higher adjusted risk of incident CVD than nonasthmatics (hazard ratio 1.57, 95% CI 1.01-2.45, P=0.045). There was no interaction between body-mass index and age of asthma diagnosis on incident CVD (P=0.83). In a large cohort study of adults followed prospectively for over a decade, late-onset asthmatics had an increased risk of incident CVD events that persisted after adjustment for age, sex, and CVD risk factors. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Fatty acids linked to cardiovascular mortality are associated with risk factors

PubMed Central

Ebbesson, Sven O. E.; Voruganti, Venkata S.; Higgins, Paul B.; Fabsitz, Richard R.; Ebbesson, Lars O.; Laston, Sandra; Harris, William S.; Kennish, John; Umans, Benjamin D.; Wang, Hong; Devereux, Richard B.; Okin, Peter M.; Weissman, Neil J.; MacCluer, Jean W.; Umans, Jason G.; Howard, Barbara V.

2015-01-01

Background Although saturated fatty acids (FAs) have been linked to cardiovascular mortality, it is not clear whether this outcome is attributable solely to their effects on low-density lipoprotein cholesterol (LDL-C) or whether other risk factors are also associated with FAs. The Western Alaskan Native population, with its rapidly changing lifestyles, shift in diet from unsaturated to saturated fatty acids and dramatic increase in cardiovascular disease (CVD), presents an opportunity to elucidate any associations between specific FAs and known CVD risk factors. Objective We tested the hypothesis that the specific FAs previously identified as related to CVD mortality are also associated with individual CVD risk factors. Methods In this community-based, cross-sectional study, relative proportions of FAs in plasma and red blood cell membranes were compared with CVD risk factors in a sample of 758 men and women aged ≥35 years. Linear regression analyses were used to analyze relations between specific FAs and CVD risk factors (LDL-C, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, systolic blood pressure, diastolic blood pressure, heart rate, body mass index, fasting glucose and fasting insulin, 2-hour glucose and 2-hour insulin). Results The specific saturated FAs previously identified as related to CVD mortality, the palmitic and myristic acids, were adversely associated with most CVD risk factors, whereas unsaturated linoleic acid (18:2n-6) and the marine n-3 FAs were not associated or were beneficially associated with CVD risk factors. Conclusions The results suggest that CVD risk factors are more extensively affected by individual FAs than hitherto recognized, and that risk for CVD, MI and stroke can be reduced by reducing the intake of palmitate, myristic acid and simple carbohydrates and improved by greater intake of linoleic acid and marine n-3 FAs. PMID:26274054

Body Composition Indices and Single and Clustered Cardiovascular Disease Risk Factors in Adolescents: Providing Clinical-Based Cut-Points.

PubMed

Gracia-Marco, Luis; Moreno, Luis A; Ruiz, Jonatan R; Ortega, Francisco B; de Moraes, Augusto César Ferreira; Gottrand, Frederic; Roccaldo, Romana; Marcos, Ascensión; Gómez-Martínez, Sonia; Dallongeville, Jean; Kafatos, Anthony; Molnar, Denes; Bueno, Gloria; de Henauw, Stefaan; Widhalm, Kurt; Wells, Jonathan C

2016-01-01

The aims of the present study in adolescents were 1) to examine how various body composition-screening tests relate to single and clustered cardiovascular disease (CVD) risk factors, 2) to examine how lean mass and body fatness (independently of each other) relate to clustered CVD risk factors, and 3) to calculate specific thresholds for body composition indices associated with an unhealthier clustered CVD risk. We measured 1089 European adolescents (46.7% boys, 12.5-17.49years) in 2006-2007. CVD risk factors included: systolic blood pressure, maximum oxygen uptake, homeostasis model assessment, C-reactive protein (n=748), total cholesterol/high density lipoprotein cholesterol and triglycerides. Body composition indices included: height, body mass index (BMI), lean mass, the sum of four skinfolds, central/peripheral skinfolds, waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR). Most body composition indices are associated with single CVD risk factors. The sum of four skinfolds, WHtR, BMI, WC and lean mass are strong and positively associated with clustered CVD risk. Interestingly, lean mass is positively associated with clustered CVD risk independently of body fatness in girls. Moderate and highly accurate thresholds for the sum of four skinfolds, WHtR, BMI, WC and lean mass are associated with an unhealthier clustered CVD risk (all AUC>0.773). In conclusion, our results support an association between most of the assessed body composition indices and single and clustered CVD risk factors. In addition, lean mass (independent of body fatness) is positively associated with clustered CVD risk in girls, which is a novel finding that helps to understand why an index such as BMI is a good index of CVD risk but a bad index of adiposity. Moderate to highly accurate thresholds for body composition indices associated with a healthier clustered CVD risk were found. Further studies with a longitudinal design are needed to confirm these findings. Copyright © 2015 Elsevier Inc. All rights reserved.

Racial differences in risks for first cardiovascular events and noncardiovascular death: the Atherosclerosis Risk in Communities study, the Cardiovascular Health Study, and the Multi-Ethnic Study of Atherosclerosis.

PubMed

Feinstein, Matthew; Ning, Hongyan; Kang, Joseph; Bertoni, Alain; Carnethon, Mercedes; Lloyd-Jones, Donald M

2012-07-03

No studies have compared first cardiovascular disease (CVD) events and non-CVD death between races in a competing risks framework, which examines risks for numerous events simultaneously. We used competing Cox models to estimate hazards for first CVD events and non-CVD death within and between races in 3 multicenter, National Heart, Lung, and Blood Institute-sponsored cohorts. Of 14 569 Atherosclerosis Risk in Communities (ARIC) study participants aged 45 to 64 years with mean follow-up of 10.5 years, 11.6% had CVD and 5.0% had non-CVD death as first events; among 4237 Cardiovascular Health Study (CHS) study participants aged 65 to 84 years and followed for 8.5 years, these figures were 43.2% and 15.7%, respectively. Middle-aged blacks were significantly more likely than whites to experience any CVD as a first event; this disparity disappeared by older adulthood and after adjustment for CVD risk factors. The pattern of results was similar for Multi-Ethnic Study of Atherosclerosis (MESA) participants. Traditional Cox and competing risks models yielded different results for coronary heart disease risk. Black men appeared somewhat more likely than white men to experience coronary heart disease with use of a standard Cox model (hazard ratio 1.06; 95% CI 0.90, 1.26), whereas they appeared less likely than white men to have a first coronary heart disease event with use of a competing risks model (hazard ratio, 0.77; 95% CI, 0.60, 1.00). CVD affects blacks at an earlier age than whites; this may be attributable in part to elevated CVD risk factor levels among blacks. Racial disparities in first CVD incidence disappear by older adulthood. Competing risks analyses may yield somewhat different results than traditional Cox models and provide a complementary approach to examining risks for first CVD events.

The Burden of Cardiovascular Diseases Among US States, 1990-2016.

PubMed

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.

Public knowledge of cardiovascular disease and its risk factors in Kuwait: a cross-sectional survey.

PubMed

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.

Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD): A large, nationally representative survey in the Australian population

PubMed Central

2012-01-01

Background Co-morbid major depressive disorder (MDD) and cardiovascular disease (CVD) is associated with poor clinical and psychological outcomes. However, the full extent of the burden of, and interaction between, this co-morbidity on important vocational outcomes remains less clear, particularly at the population level. We examine the association of co-morbid MDD with work outcomes in persons with and without CVD. Methods This study utilised cross-sectional, population-based data from the 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841) to compare work outcomes of individuals with diagnostically-defined MDD and CVD, MDD but not CVD, CVD but not MDD, with a reference group of "healthy" Australians. Workforce participation was defined as being in full- or part-time employment. Work functioning was measured using a WHO Disability Assessment Schedule item. Absenteeism was assessed using the 'days out of role' item. Results Of the four groups, those with co-morbid MDD and CVD were least likely to report workforce participation (adj OR:0.4, 95% CI: 0.3-0.6). Those with MDD only (adj OR:0.8, 95% CI:0.7-0.9) and CVD only (adj OR:0.8, 95% CI: 0.6-0.9) also reported significantly reduced odds of participation. Employed individuals with co-morbid MDD and CVD were 8 times as likely to experience impairments in work functioning (adj OR:8.1, 95% CI: 3.8- 17.3) compared with the reference group. MDD was associated with a four-fold increase in impaired functioning. Further, individuals with co-morbid MDD and CVD reported greatest likelihood of workplace absenteeism (adj. OR:3.0, 95% CI: 1.4-6.6). Simultaneous exposure to MDD and CVD conferred an even greater likelihood of poorer work functioning. Conclusions Co-morbid MDD and CVD is associated with significantly poorer work outcomes. Specifically, the effects of these conditions on work functioning are synergistic. The development of specialised treatment programs for those with co-morbid MDD and CVD is required. PMID:22257700

Photoconductive switch package

DOEpatents

Ca[rasp, George J

2013-10-22

A photoconductive switch is formed of a substrate that has a central portion of SiC or other photoconductive material and an outer portion of cvd-diamond or other suitable material surrounding the central portion. Conducting electrodes are formed on opposed sides of the substrate, with the electrodes extending beyond the central portion and the edges of the electrodes lying over the outer portion. Thus any high electric fields produced at the edges of the electrodes lie outside of and do not affect the central portion, which is the active switching element. Light is transmitted through the outer portion to the central portion to actuate the switch.

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.

Surface Design and Engineering Toward Wear-Resistant, Self-Lubricant Diamond Films and Coatings. Chapter 10

NASA Technical Reports Server (NTRS)

Miyoshi, Kazuhisa

1999-01-01

This chapter describes three studies on the surface design, surface engineering, and tribology of chemical-vapor-deposited (CVD) diamond films and coatings toward wear-resistant, self-lubricating diamond films and coatings. Friction mechanisms and solid lubrication mechanisms of CVD diamond are stated. Effects of an amorphous hydrogenated carbon on CVD diamond, an amorphous, nondiamond carbon surface layer formed on CVD diamond by carbon and nitrogen ion implantation, and a materials combination of cubic boron nitride and CVD diamond on the adhesion, friction, and wear behaviors of CVD diamond in ultrahigh vacuum are described. How surface modification and the selected materials couple improved the tribological functionality of coatings, giving low coefficient of friction and good wear resistance, is explained.

The relationship between race, cigarette smoking and carotid intimal medial thickness in systemic lupus erythematosus.

PubMed

Scalzi, L V; Bhatt, S; Gilkeson, R C; Shaffer, M L

2009-12-01

Racial differences are known to account for a higher incidence of systemic lupus erythematosus (SLE), as well as increased disease severity and mortality. The purpose of this study was to determine whether there are any race-specific risk factors that affect measures of subclinical atherosclerosis in SLE patients. Traditional and SLE-related cardiovascular disease (CVD) risk factors were assessed in 106 female SLE patients. Carotid medial intimal medial thickness (mIMT) and coronary artery calcification (CAC) were measured on all subjects. Differences were evaluated between races for all clinical, serologic, and CVD risk factors and the racial interactions with all covariables. Outcomes included mIMT and CAC. There were no significant differences between races with regard to mIMT or CAC. Significant covariables in the final model for mIMT included age, triglycerides, glucose, and race-age and race-smoking interactions. A prediction model with fixed significant covariables demonstrated that Black subjects with a smoking history had a significantly higher mIMT than Blacks who had never smoked, an effect not seen in Whites. There were no differences between having CAC or with the CAC scores between the races. In the final model for CAC, age and SLE disease duration were significant covariables impacting CAC. When controlling for other significant CVD covariables and interactions, Black women, but not White, with SLE with a history of smoking have higher mIMT measurements than those who have never smoked. This is the first report documenting the race-specific effect of smoking on subclinical measures of CVD in SLE.

Methods for establishing a surveillance system for cardiovascular diseases in Indian industrial populations.

PubMed Central

Reddy, K. S.; Prabhakaran, D.; Chaturvedi, V.; Jeemon, P.; Thankappan, K. R.; Ramakrishnan, L.; Mohan, B. V. M.; Pandav, C. S.; Ahmed, F. U.; Joshi, P. P.; Meera, R.; Amin, R. B.; Ahuja, R. C.; Das, M. S.; Jaison, T. M.

2006-01-01

OBJECTIVE: To establish a surveillance network for cardiovascular diseases (CVD) risk factors in industrial settings and estimate the risk factor burden using standardized tools. METHODS: We conducted a baseline cross-sectional survey (as part of a CVD surveillance programme) of industrial populations from 10 companies across India, situated in close proximity to medical colleges that served as study centres. The study subjects were employees (selected by age and sex stratified random sampling) and their family members. Information on behavioural, clinical and biochemical determinants was obtained through standardized methods (questionnaires, clinical measurements and biochemical analysis). Data collation and analyses were done at the national coordinating centre. FINDINGS: We report the prevalence of CVD risk factors among individuals aged 20-69 years (n = 19 973 for the questionnaire survey, n = 10 442 for biochemical investigations); mean age was 40 years. The overall prevalence of most risk factors was high, with 50.9% of men and 51.9% of women being overweight, central obesity was observed among 30.9% of men and 32.8% of women, and 40.2% of men and 14.9% of women reported current tobacco use. Self-reported prevalence of diabetes (5.3%) and hypertension (10.9%) was lower than when measured clinically and biochemically (10.1% and 27.7%, respectively). There was marked heterogeneity in the prevalence of risk factors among the study centres. CONCLUSION: There is a high burden of CVD risk factors among industrial populations across India. The surveillance system can be used as a model for replication in India as well as other developing countries. PMID:16799730

Validation of methods to control for immortal time bias in a pharmacoepidemiologic analysis of renin-angiotensin system inhibitors in type 2 diabetes.

PubMed

Yang, Xilin; Kong, Alice Ps; Luk, Andrea Oy; Ozaki, Risa; Ko, Gary Tc; Ma, Ronald Cw; Chan, Juliana Cn; So, Wing Yee

2014-01-01

Pharmacoepidemiologic analysis can confirm whether drug efficacy in a randomized controlled trial (RCT) translates to effectiveness in real settings. We examined methods used to control for immortal time bias in an analysis of renin-angiotensin system (RAS) inhibitors as the reference cardioprotective drug. We analyzed data from 3928 patients with type 2 diabetes who were recruited into the Hong Kong Diabetes Registry between 1996 and 2005 and followed up to July 30, 2005. Different Cox models were used to obtain hazard ratios (HRs) for cardiovascular disease (CVD) associated with RAS inhibitors. These HRs were then compared to the HR of 0.92 reported in a recent meta-analysis of RCTs. During a median follow-up period of 5.45 years, 7.23% (n = 284) patients developed CVD and 38.7% (n = 1519) were started on RAS inhibitors, with 39.1% of immortal time among the users. In multivariable analysis, time-dependent drug-exposure Cox models and Cox models that moved immortal time from users to nonusers both severely inflated the HR, and time-fixed models that included immortal time deflated the HR. Use of time-fixed Cox models that excluded immortal time resulted in a HR of only 0.89 (95% CI, 0.68-1.17) for CVD associated with RAS inhibitors, which is closer to the values reported in RCTs. In pharmacoepidemiologic analysis, time-dependent drug exposure models and models that move immortal time from users to nonusers may introduce substantial bias in investigations of the effects of RAS inhibitors on CVD in type 2 diabetes.

Circulating Wnt inhibitory factor 1 levels are associated with development of cardiovascular disease.

PubMed

Ress, Claudia; Paulweber, Mariya; Goebel, Georg; Willeit, Karin; Rufinatscha, Kerstin; Strobl, Anna; Salzmann, Karin; Kedenko, Ludmilla; Tschoner, Alexander; Staudacher, Gabriele; Iglseder, Bernhard; Tilg, Herbert; Paulweber, Bernhard; Kaser, Susanne

2018-03-29

Wnt signaling is involved in atherosclerotic plaque formation directly and indirectly by modulating cardiovascular risk factors. We investigated whether circulating concentrations of Wnt inhibitors are associated with cardiovascular events in subjects with intermediate cardiovascular risk. 904 non-diabetic subjects participating in the SAPHIR study were assessed. In the SAPHIR study, middle-aged women without overt atherosclerotic disease at study entry were followed up for 10 years. 88 patients of our study cohort developed cardiovascular disease at follow-up (CVD group). Subjects of the CVD group were 1:2 case-control matched for age, sex, BMI and smoking behavior with subjects without overt cardiovascular disease after a 10 year-follow-up (control group). 18 patients of the CVD group and 19 subjects of the control group were retrospectively excluded due to fulfilling exclusion criteria. Baseline circulating sclerostin, dickkopf (DKK)-1, secreted frizzled-related protein (SFRP)-1 and Wnt inhibitory factor (WIF)-1 levels were assessed by ELISA. Baseline systemic SFRP-1 and WIF-1 levels were significantly higher in patients with cardiovascular events (n = 70) when compared to healthy controls (n = 157) while DKK-1 and sclerostin levels were similar in both groups. Logistic regression analysis revealed WIF-1 as a significant predictor of future cardiovascular events. Our data suggest that increased SFRP-1 and WIF-1 levels precede the development of symptomatic atherosclerotic disease. Assessment of systemic WIF-1 levels, which turned out to be independently associated with CVD, might help to early identify patients at intermediate cardiovascular risk. Copyright © 2018 Elsevier B.V. All rights reserved.

Results of a Markov model analysis to assess the cost-effectiveness of a single tablet of fixed-dose amlodipine and atorvastatin for the primary prevention of cardiovascular disease in Korea.

PubMed

Liew, Danny; Park, Hye-Jin; Ko, Su-Kyoung

2009-10-01

In Korea, the treatment of hypertension and dyslipidemia constitutes an important strategy for the prevention of cardiovascular disease (CVD). This study sought to investigate the cost-effectiveness (from the Korean health care system perspective) of prescribing a proprietary formulation single-tablet fixed-dose combination of amlodipine and atorvastatin (at weighted mean doses of 5 mg and 10.25 mg, respectively) to all eligible patients aged > or = 45 years for the primary prevention of CVD (ie, coronary heart disease and ischemic stroke) in Korea, compared with currently observed patterns of blood-pressure and lipid-lowering medication prescription and use. A Markov model was developed with 4 health states: alive without CVD, alive with CVD, dead from CVD, and dead from non-CVD causes. The model population comprised 244 Koreans aged >/=45 years from the 2005 Korean National Health and Nutrition Examination Survey (KNHNES) without a history of myocardial infarction (MI) or stroke who met current criteria for both blood-pressure and lipid-lowering treatment. From a 2008 baseline, follow-up was simulated for 40 years. Cardiovascular risk was estimated for each subject individually using a multivariate, Asian population-specific equation, and updated with ongoing cycles. Decision analysis compared the effects of prescribing the fixed-dose combination to all subjects versus currently observed patterns of treatment. Data regarding the blood-pressure and lipid-lowering efficacies of combination therapy were drawn from the Respond trial. Costs of the fixed-dose combination tablet and CVD were sourced from pharmaceutical pricing lists and Korean Health Insurance Review and Assessment Services estimates, respectively. Utility values for CVD were obtained from a large Korean utility study. In the model, of the 244 treatment-eligible subjects, 126 (51.6%) and 13 (5.3%) were taking blood-pressure and lipid-lowering therapy, respectively. Use of single-tablet fixed-dose combination amlodipine and atorvastatin by all subjects was associated with estimated incremental cost-effectiveness ratios of 7,773,063 Korean won (KRW) per quality-adjusted life-year gained and 10,378,230 KRW per overall life-year gained (1300 KRW approximately US $1). Sensitivity and uncertainty analyses indicated these results to be robust. In this model, based on data from the 2005 KNHNES, hypertension and dyslipidemia were undertreated among Koreans aged > or = 45 years without a history of MI or stroke. The administration of single-tablet fixed-dose combination amlodipine and atorvastatin to all such individuals was likely to represent a cost-effective means of preventing first-onset CVD (ie, coronary heart disease and ischemic stroke) in this subgroup, compared with current patterns of treatment.

Cardiovascular disease prevention and health promotion with the transcendental meditation program and Maharishi consciousness-based health care.

PubMed

Schneider, Robert H; Walton, Kenneth G; Salerno, John W; Nidich, Sanford I

2006-01-01

This article summarizes the background, rationale, and clinical research on a traditional system of natural health care that may be useful in the prevention of cardiovascular disease (CVD) and promotion of health. Results recently reported include reductions in blood pressure, psychosocial stress, surrogate markers for atherosclerotic CVD, and mortality. The randomized clinical trials conducted so far have involved applications to both primary and secondary prevention as well as to health promotion more generally. The results support the applicability of this approach for reducing ethnic health disparities associated with environmental and psychosocial stress. Proposed mechanisms for the effects of this traditional system include enhanced resistance to physiological and psychological stress and improvements in homeostatic and self-repair processes. This system may offer clinical and cost effectiveness advantages for health care, particularly in preventive cardiology.

Scanning Tunneling Microscopy Studies of Diamond Films and Optoelectronic Materials

NASA Technical Reports Server (NTRS)

Perez, Jose M.

1996-01-01

We present a summary of the research, citations of publications resulting from the research and abstracts of such publications. We have made no inventions in the performance of the work in this project. The main goals of the project were to set up a Chemical Vapor Deposition (CVD) diamond growth system attached to an UltraHigh Vacuum (UHV) atomic resolution Scanning Tunneling Microscopy (STM) system and carry out experiments aimed at studying the properties and growth of diamond films using atomic resolution UHV STM. We successfully achieved these goals. We observed, for the first time, the atomic structure of the surface of CVD grown epitaxial diamond (100) films using UHV STM. We studied the effects of atomic hydrogen on the CVD diamond growth process. We studied the electronic properties of the diamond (100) (2x1) surface, and the effect of alkali metal adsorbates such as Cs on the work function of this surface using UHV STM spectroscopy techniques. We also studied, using STM, new electronic materials such as carbon nanotubes and gold nanostructures. This work resulted in four publications in refereed scientific journals and five publications in refereed conference proceedings.

Implementation strategies of Systems Medicine in clinical research and home care for cardiovascular disease patients.

PubMed

Montecucco, Fabrizio; Carbone, Federico; Dini, Frank Lloyd; Fiuza, Manuela; Pinto, Fausto J; Martelli, Antonietta; Palombo, Domenico; Sambuceti, Gianmario; Mach, François; De Caterina, Raffaele

2014-11-01

Insights from the "-omics" science have recently emphasized the need to implement an overall strategy in medical research. Here, the development of Systems Medicine has been indicated as a potential tool for clinical translation of basic research discoveries. Systems Medicine also gives the opportunity of improving different steps in medical practice, from diagnosis to healthcare management, including clinical research. The development of Systems Medicine is still hampered however by several challenges, the main one being the development of computational tools adequate to record, analyze and share a large amount of disparate data. In addition, available informatics tools appear not yet fully suitable for the challenge because they are not standardized, not universally available, or with ethical/legal concerns. Cardiovascular diseases (CVD) are a very promising area for translating Systems Medicine into clinical practice. By developing clinically applied technologies, the collection and analysis of data may improve CV risk stratification and prediction. Standardized models for data recording and analysis can also greatly broaden data exchange, thus promoting a uniform management of CVD patients also useful for clinical research. This advance however requires a great organizational effort by both physicians and health institutions, as well as the overcoming of ethical problems. This narrative review aims at providing an update on the state-of-art knowledge in the area of Systems Medicine as applied to CVD, focusing on current critical issues, providing a road map for its practical implementation. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

CREATE Wellness: A multi-component behavioral intervention for patients not responding to traditional Cardiovascular disease management.

PubMed

Miller-Rosales, Chris; Sterling, Stacy A; Wood, Sabrina B; Ross, Thekla; Makki, Mojdeh; Zamudio, Cindy; Kane, Irene M; Richardson, Megan C; Samayoa, Claudia; Charvat-Aguilar, Nancy; Lu, Wendy Y; Vo, Michelle; Whelan, Kimberly; Uratsu, Connie S; Grant, Richard W

2017-12-01

Cardiovascular disease (CVD) is the leading cause of death in the US. Many patients do not benefit from traditional disease management approaches to CVD risk reduction. Here we describe the rationale, development, and implementation of a multi-component behavioral intervention targeting patients who have persistently not met goals of CVD risk factor control. Informed by published evidence, relevant theoretical frameworks, stakeholder advice, and patient input, we developed a group-based intervention (Changing Results: Engage and Activate to Enhance Wellness; "CREATE Wellness") to address the complex needs of patients with elevated or unmeasured CVD-related risk factors. We are testing this intervention in a randomized trial among patients with persistent (i.e > 2 years) sub-optimal risk factor control despite being enrolled in an advanced and highly successful CVD disease management program. The CREATE Wellness intervention is designed as a 3 session, group-based intervention combining proven elements of patient activation, health system engagement skills training, shared decision making, care planning, and identification of lifestyle change barriers. Our key learnings in designing the intervention included the value of multi-level stakeholder input and the importance of pragmatic skills training to address barriers to care. The CREATE Wellness intervention represents an evidence-based, patient-centered approach for patients not responding to traditional disease management. The trial is currently underway at three medical facilities within Kaiser Permanente Northern California and next steps include an evaluation of efficacy, adaptation for non-English speaking patient populations, and modification of the curriculum for web- or phone-based versions. NCT02302612.

Application of spatial synoptic classification in evaluating links between heat stress and cardiovascular mortality and morbidity in Prague, Czech Republic

NASA Astrophysics Data System (ADS)

Urban, Aleš; Kyselý, Jan

2018-01-01

Spatial synoptic classification (SSC) is here first employed in assessing heat-related mortality and morbidity in Central Europe. It is applied for examining links between weather patterns and cardiovascular (CVD) mortality and morbidity in an extended summer season (16 May-15 September) during 1994-2009. As in previous studies, two SSC air masses (AMs)—dry tropical (DT) and moist tropical (MT)—are associated with significant excess CVD mortality in Prague, while effects on CVD hospital admissions are small and insignificant. Excess mortality for ischaemic heart diseases is more strongly associated with DT, while MT has adverse effect especially on cerebrovascular mortality. Links between the oppressive AMs and excess mortality relate also to conditions on previous days, as DT and MT occur in typical sequences. The highest CVD mortality deviations are found 1 day after a hot spell's onset, when temperature as well as frequency of the oppressive AMs are highest. Following this peak is typically DT- to MT-like weather transition, characterized by decrease in temperature and increase in humidity. The transition between upward (DT) and downward (MT) phases is associated with the largest excess CVD mortality, and the change contributes to the increased and more lagged effects on cerebrovascular mortality. The study highlights the importance of critically evaluating SSC's applicability and benefits within warning systems relative to other synoptic and epidemiological approaches. Only a subset of days with the oppressive AMs is associated with excess mortality, and regression models accounting for possible meteorological and other factors explain little of the mortality variance.

Global tobacco prevention and control in relation to a cardiovascular health promotion and disease prevention framework: A narrative review.

PubMed

Carroll, Allison J; Labarthe, Darwin R; Huffman, Mark D; Hitsman, Brian

2016-12-01

The purpose of this review is to emphasize the role of tobacco prevention and control in cardiovascular health (CVH) promotion and cardiovascular disease (CVD) prevention, including the importance of these endpoints for measuring the full impact of tobacco-related policies, programs, and practices. In this review, we describe an overview of tobacco control interventions that have led to substantial declines in tobacco use and the relationship between these declines with CVH and CVD. We review interventions that have had success in high-income countries (HICs) as well as those that are gaining traction in low- and middle-income countries (LMICs). We emphasize the challenges to comprehensive tobacco prevention and control strategies faced by LMICs, and highlight the special role of cardiovascular health professionals in achieving CVH promotion and CVD prevention endpoints through tobacco control. Tobacco prevention and control strategies have a strong scientific basis, yet a distinct gap remains between this evidence and implementation of tobacco control policies, particularly in LMICs. Health professionals can contribute to tobacco control efforts, especially through patient-level clinical interventions, when supported by a health care system and government that recognize and support tobacco control as a critical strategy for CVH promotion and CVD prevention. Understanding, supporting, and applying current and evolving policies, programs, and practices in tobacco prevention and control is the province of all health professionals, especially those concerned with CVH promotion and CVD prevention. A new tobacco control roadmap from the World Heart Federation provides a strong impetus to the needed interdisciplinary collaboration. Copyright © 2016 Elsevier Inc. All rights reserved.

Global tobacco prevention and control in relation to a cardiovascular health promotion and disease prevention framework: A narrative review

PubMed Central

Carroll, Allison J.; Labarthe, Darwin R.; Huffman, Mark D.; Hitsman, Brian

2016-01-01

The purpose of this review is to emphasize the role of tobacco prevention and control in cardiovascular health (CVH) promotion and cardiovascular disease (CVD) prevention, including the importance of these endpoints for measuring the full impact of tobacco-related policies, programs, and practices. In this review, we describe an overview of tobacco control interventions that have led to substantial declines in tobacco use and the relationship between these declines with CVH and CVD. We review interventions that have had success in high-income countries (HICs) as well as those that are gaining traction in low- and middle-income countries (LMICs). We emphasize the challenges to comprehensive tobacco prevention and control strategies faced by LMICs, and highlight the special role of cardiovascular health professionals in achieving CVH promotion and CVD prevention endpoints through tobacco control. Tobacco prevention and control strategies have a strong scientific basis, yet a distinct gap remains between this evidence and implementation of tobacco control policies, particularly in LMICs. Health professionals can contribute to tobacco control efforts, especially through patient-level clinical interventions, when supported by a health care system and government that recognize and support tobacco control as a critical strategy for CVH promotion and CVD prevention. Understanding, supporting, and applying current and evolving policies, programs, and practices in tobacco prevention and control is the province of all health professionals, especially those concerned with CVH promotion and CVD prevention. A new tobacco control roadmap from the World Heart Federation provides a strong impetus to the needed interdisciplinary collaboration. PMID:27717667

SIRT1 and SIRT6 Signaling Pathways in Cardiovascular Disease Protection

PubMed Central

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

Cardiovascular Disease Among Transgender Adults Receiving Hormone Therapy: A Narrative Review.

PubMed

Streed, Carl G; Harfouch, Omar; Marvel, Francoise; Blumenthal, Roger S; Martin, Seth S; Mukherjee, Monica

2017-08-15

Recent reports estimate that 0.6% of adults in the United States, or approximately 1.4 million persons, identify as transgender. Despite gains in rights and media attention, the reality is that transgender persons experience health disparities, and a dearth of research and evidence-based guidelines remains regarding their specific health needs. The lack of research to characterize cardiovascular disease (CVD) and CVD risk factors in transgender populations receiving cross-sex hormone therapy (CSHT) limits appropriate primary and specialty care. As with hormone therapy in cisgender persons (that is, those whose sex assigned at birth aligns with their gender identity), existing research in transgender populations suggests that CVD risk factors are altered by CSHT. Currently, systemic hormone replacement for cisgender adults requires a nuanced discussion based on baseline risk factors and age of administration of exogenous hormones because of concern regarding an increased risk for myocardial infarction and stroke. For transgender adults, CSHT has been associated with the potential for worsening CVD risk factors (such as blood pressure elevation, insulin resistance, and lipid derangements), although these changes have not been associated with increases in morbidity or mortality in transgender men receiving CSHT. For transgender women, CSHT has known thromboembolic risk, and lower-dose transdermal estrogen formulations are preferred over high-dose oral formulations. In addition, many studies of transgender adults focus predominantly on younger persons, limiting the generalizability of CSHT in older transgender adults. The lack of randomized controlled trials comparing various routes and formulations of CSHT, as well as the paucity of prospective cohort studies, limits knowledge of any associations between CSHT and CVD.

Uric acid and cardiovascular disease.

PubMed

Ndrepepa, Gjin

2018-05-24

Uric acid (UA) is an end product of purine metabolism in humans and great apes. UA acts as an antioxidant and it accounts for 50% of the total antioxidant capacity of biological fluids in humans. When present in cytoplasm of the cells or in acidic/hydrophobic milieu in atherosclerotic plaques, UA converts into a pro-oxidant agent and promotes oxidative stress and through this mechanism participates in the pathophysiology of human disease including cardiovascular disease (CVD). Most epidemiological studies but not all of them suggested the existence of an association between elevated serum UA level and CVD, including coronary heart disease (CHD), stroke, congestive heart failure, arterial hypertension and atrial fibrillation as well as an increased risk for mortality due to CVD in general population and subjects with confirmed CHD. Evidence available also suggests an association between elevated UA and traditional cardiovascular risk factors, metabolic syndrome, insulin resistance, obesity, non-alcoholic fatty liver disease and chronic kidney disease. Experimental and clinical studies have evidenced several mechanisms through which elevated UA level exerts deleterious effects on cardiovascular health including increased oxidative stress, reduced availability of nitric oxide and endothelial dysfunction, promotion of local and systemic inflammation, vasoconstriction and proliferation of vascular smooth muscle cells, insulin resistance and metabolic dysregulation. Although the causality in the relationship between UA and CVD remains unproven, UA may be pathogenic and participate in the pathophysiology of CVD by serving as a bridging mechanism mediating (enabling) or potentiating the deleterious effects of cardiovascular risk factors on vascular tissue and myocardium. Copyright © 2018 Elsevier B.V. All rights reserved.

Scanning tunneling microscopy studies of diamond films and optoelectronic materials

NASA Technical Reports Server (NTRS)

Perez, Jose M.

1993-01-01

In this report, we report on progress achieved from 12/1/92 to 10/1/93 under the grant entitled 'Scanning Tunneling Microscopy Studies of Diamond Films and Optoelectronic Materials'. We have set-up a chemical vapor deposition (CVD) diamond film growth system and a Raman spectroscopy system to study the nucleation and growth of diamond films with atomic resolution using scanning tunneling microscopy (STM). A unique feature of the diamond film growth system is that diamond films can be transferred directly to the ultrahigh vacuum (UHV) chamber of a scanning tunneling microscope without contaminating the films by exposure to air. The University of North Texas (UNT) provided $20,000 this year as matching funds for the NASA grant to purchase the diamond growth system. In addition, UNT provided a Coherent Innova 90S Argon ion laser, a Spex 1404 double spectrometer, and a Newport optical table costing $90,000 to set-up the Raman spectroscopy system. The CVD diamond growth system and Raman spectroscopy system will be used to grow and characterize diamond films with atomic resolution using STM as described in our proposal. One full-time graduate student and one full-time undergraduate student are supported under this grant. In addition, several graduate and undergraduate students were supported during the summer to assist in setting-up the diamond growth and Raman spectroscopy systems. We have obtained research results concerning STM of the structural and electronic properties of CVD grown diamond films, and STM and scanning tunneling spectroscopy of carbon nanotubes. In collaboration with the transmission electron microscopy (TEM) group at UNT, we have also obtained results concerning the optoelectronic material siloxene. These results were published in refereed scientific journals, submitted for publication, and presented as invited and contributed talks at scientific conferences.

Elevated Circulating Osteoprotegerin and Renal Dysfunction Predict 15-Year Cardiovascular and All-Cause Mortality: A Prospective Study of Elderly Women

PubMed Central

Zhu, Kun; Lim, Ee M.; Bollerslev, Jens; Prince, Richard L.

2015-01-01

Background Data on the predictive role of estimated glomerular filtration rate (eGFR) and osteoprotegerin (OPG) for cardiovascular (CVD) and all-cause mortality risk have been presented by our group and others. We now present data on the interactions between OPG with stage I to III chronic kidney disease (CKD) for all-cause and CVD mortality. Methods and Results The setting was a 15-year study of 1,292 women over 70 years of age initially randomized to a 5-year controlled trial of 1.2 g of calcium daily. Serum OPG and creatinine levels with complete mortality records obtained from the Western Australian Data Linkage System were available. Interactions were detected between OPG levels and eGFR for both CVD and all-cause mortality (P < 0.05). Compared to participants with eGFR ≥60ml/min/1.73m2 and low OPG, participants with eGFR of <60ml/min/1.73m2 and elevated OPG had a 61% and 75% increased risk of all-cause and CVD mortality respectively (multivariate-adjusted HR, 1.61; 95% CI, 1.27-2.05; P < 0.001 and HR, 1.75; 95% CI, 1.22-2.55; P = 0.003). This relationship with mortality was independent of decline in renal function (P<0.05). Specific causes of death in individuals with elevated OPG and stage III CKD highlighted an excess of coronary heart disease, renal failure and chronic obstructive pulmonary disease deaths (P < 0.05). Conclusion The association between elevated OPG levels with CVD and all-cause mortality was more evident in elderly women with poorer renal function. Assessment of OPG in the context of renal function may be important in studies investigating its relationship with all-cause and CVD mortality. PMID:26222774

Statin Eligibility and Outpatient Care Prior to ST-Segment Elevation Myocardial Infarction.

PubMed

Miedema, Michael D; Garberich, Ross F; Schnaidt, Lucas J; Peterson, Erin; Strauss, Craig; Sharkey, Scott; Knickelbine, Thomas; Newell, Marc C; Henry, Timothy D

2017-04-12

The impact of the 2013 American College of Cardiology/American Heart Association cholesterol guidelines on statin eligibility in individuals otherwise destined to experience cardiovascular disease (CVD) events is unclear. We analyzed a prospective cohort of consecutive ST-segment elevation myocardial infarction (STEMI) patients from a regional STEMI system with data on patient demographics, low-density lipoprotein cholesterol levels, CVD risk factors, medication use, and outpatient visits over the 2 years prior to STEMI. We determined pre-STEMI eligibility according to American College of Cardiology/American Heart Association guidelines and the prior Third Report of the Adult Treatment Panel guidelines. Our sample included 1062 patients with a mean age of 63.7 (13.0) years (72.5% male), and 761 (71.7%) did not have known CVD prior to STEMI. Only 62.5% and 19.3% of individuals with and without prior CVD were taking a statin before STEMI, respectively. In individuals not taking a statin, median (interquartile range) low-density lipoprotein cholesterol levels in those with and without known CVD were low (108 [83, 138]  mg/dL and 110 [87, 133] mg/dL). For individuals not taking a statin, only 38.7% were statin eligible by ATP III guidelines. Conversely, 79.0% would have been statin eligible according to American College of Cardiology/American Heart Association guidelines. Less than half of individuals with (49.2%) and without (41.1%) prior CVD had seen a primary care provider during the 2 years prior to STEMI. In a large cohort of STEMI patients, application of American College of Cardiology/American Heart Association guidelines more than doubled pre-STEMI statin eligibility compared with Third Report of the Adult Treatment Panel guidelines. However, access to and utilization of health care, a necessity for guideline implementation, was suboptimal prior to STEMI. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Use of medications and lifestyles of hypertensive patients with high risk of cardiovascular disease in rural China.

PubMed

Zou, Guanyang; Zhang, Zhitong; Walley, John; Gong, Weiwei; Yu, Yunxian; Hu, Ruying; Yin, Jia; Yu, Min; Wei, Xiaolin

2015-01-01

Hypertension, with a global prevalence of 40%, is a risk factor for cardiovascular diseases (CVD). We conducted an exploratory study in Zhejiang China to understand the prevention of CVD among hypertensive patients with a 10 year CVD risk of 20% or higher. We assessed current practices in a rural 'township hospital' (a primary care facility), and compared them with international evidence-based practice. A questionnaire survey was conducted to examine the use of modern drugs (antihypertensive drugs, statins and aspirin) and traditional drugs, compliance to medications and lifestyle among 274 hypertensive patients aged 40-74, with a CVD risk of 20% or higher (using the Asian Equation). The majority (72%) were diagnosed with hypertension at township hospitals. Only 15% of study participants used two anti-hypertensive drugs, 0.7% took statin and 2.9% aspirin. Only 2.9% combined two types of modern drugs, while 0.4% combined three types (antihypertensives, statins and aspirin). Herbal compounds, sometimes with internationally rarely recommended drugs such as Reserpine were taken by 44%. Analysis of drug adherence showed that 9.8% had discontinued their drug therapy by themselves. 16% had missed doses and these were on less anti-hypertensive drugs than those who did not (t=-5.217, P=0.003). Of all participants, 28% currently smoked, 39% drank regularly and only 21% exercised frequently. The average salt intake per day was 7.1 (±3.8) g, while the national recommended level is 6g. The study revealed outdated and inadequate treatment and health education for hypertensive patients, especially for those who have high risk scores for CVD. There is a need to review the community-based guidelines for hypertension management. Health providers and patients should make a transition from solely treating hypertension, towards prevention of CVD. Health system issues need addressing including improving rural health insurance cover and primary care doctors' capacity to manage chronic disease patients.

Incremental Value of Repeated Risk Factor Measurements for Cardiovascular Disease Prediction in Middle-Aged Korean Adults: Results From the NHIS-HEALS (National Health Insurance System-National Health Screening Cohort).

PubMed

Cho, In-Jeong; Sung, Ji Min; Chang, Hyuk-Jae; Chung, Namsik; Kim, Hyeon Chang

2017-11-01

Increasing evidence suggests that repeatedly measured cardiovascular disease (CVD) risk factors may have an additive predictive value compared with single measured levels. Thus, we evaluated the incremental predictive value of incorporating periodic health screening data for CVD prediction in a large nationwide cohort with periodic health screening tests. A total of 467 708 persons aged 40 to 79 years and free from CVD were randomly divided into development (70%) and validation subcohorts (30%). We developed 3 different CVD prediction models: a single measure model using single time point screening data; a longitudinal average model using average risk factor values from periodic screening data; and a longitudinal summary model using average values and the variability of risk factors. The development subcohort included 327 396 persons who had 3.2 health screenings on average and 25 765 cases of CVD over 12 years. The C statistics (95% confidence interval [CI]) for the single measure, longitudinal average, and longitudinal summary models were 0.690 (95% CI, 0.682-0.698), 0.695 (95% CI, 0.687-0.703), and 0.752 (95% CI, 0.744-0.760) in men and 0.732 (95% CI, 0.722-0.742), 0.735 (95% CI, 0.725-0.745), and 0.790 (95% CI, 0.780-0.800) in women, respectively. The net reclassification index from the single measure model to the longitudinal average model was 1.78% in men and 1.33% in women, and the index from the longitudinal average model to the longitudinal summary model was 32.71% in men and 34.98% in women. Using averages of repeatedly measured risk factor values modestly improves CVD predictability compared with single measurement values. Incorporating the average and variability information of repeated measurements can lead to great improvements in disease prediction. URL: https://www.clinicaltrials.gov. Unique identifier: NCT02931500. © 2017 American Heart Association, Inc.

Relationship between lower urinary tract symptoms and cardiovascular risk scores including Framingham risk score and ACC/AHA risk score.

PubMed

Lee, Bora; Lee, Sang Wook; Kang, Hye Rim; Kim, Dae In; Sun, Hwa Yeon; Kim, Jae Heon

2018-01-01

This study attempted to investigate the association between lower urinary tract symptoms (LUTS) and cardiovascular disease (CVD) risk using International Prostate Symptom Score (IPSS) and CVD risk scores and to overcome the limitations of previous relevant studies. A total of 2994 ostensibly healthy males, who participated in a voluntary health check in a health promotion center from January 2010 to December 2014, were reviewed. CVD risk scores were calculated using Framingham risk score and American College of Cardiology (ACC)/American Heart Association (AHA) score. Correlation and multivariate logistic regression analysis to predict the CVD risk severity were performed. Correlation between total IPSS with CVD risk scores demonstrated significant positive associations, which showed higher correlation with ACC/AHA score than the Framingham score (r = 0.18 vs 0.09, respectively). For ACC/AHA score, the partial correlation after adjustment of body mass index (BMI) showed significant positive correlations between all LUTS parameters and PSA. For the Framingham score, all variables, except IPSS Q2 and IPSS Q6, showed significant positive correlations. After adjustment of BMI, prostate volume and PSA, only the severe LUTS group showed significant relationship with intermediate-high CVD risk severity, as compared with normal LUTS group (OR = 2.97, 95%CI (1.35-6.99)). Using two validated CVD risk calculators, we observed that LUTS is closely associated with future CVD risk. To predict the intermediate-high CVD risk severity, severe LUTS was a sentinel sign, the presence of which warrants the importance of an earlier screening for CVD. © 2017 Wiley Periodicals, Inc.

Osteoprotegerin concentrations relate independently to established cardiovascular disease in rheumatoid arthritis.

PubMed

López-Mejias, Raquel; Ubilla, Begoña; Genre, Fernanda; Corrales, Alfonso; Hernández, José L; Ferraz-Amaro, Ivan; Tsang, Linda; Llorca, Javier; Blanco, Ricardo; González-Juanatey, Carlos; Gonzalez-Gay, Miguel A; Dessein, Patrick H

2015-01-01

We determined whether osteoprotegerin (OPG) concentrations are associated with established cardiovascular disease (CVD) among patients with rheumatoid arthritis (RA). OPG concentrations were measured by ELISA in 151 patients with RA (54 with CVD) and 62 age-matched control subjects without CVD. Established CVD was composed of documented ischemic heart disease, cerebrovascular disease, and peripheral artery disease. In patients with RA, age, body mass index (BMI), rheumatoid factor (RF) positivity, anticyclic citrullinated peptide (anti-CCP) antibody positivity, and joint erosion status were associated with OPG concentrations [partial R (p) = 0.175 (0.03), -0.277 (0.0009), 0.323 (< 0.0001), 0.217 (0.008), and 0.159 (0.05), respectively]. Median (interquartile range) OPG concentrations increased from 6.38 (3.46-9.31) to 7.07 (5.04-10.65) and 8.64 (6.00-11.52) ng/ml in controls and patients with RA who had CVD and those who did not, respectively (p = 0.0002). Upon adjustment for age, sex, traditional risk factors, and BMI in mixed regression models, OPG concentrations remained lower in controls compared to patients with RA without CVD (p = 0.05) and in the latter compared to those with CVD (p = 0.03); the association of OPG concentrations with CVD among patients with RA also persisted after additional adjustment for RF and anti-CCP antibody positivity, and erosion status (p = 0.04). OPG concentrations are associated with disease severity and CVD prevalence in patients with RA. Whether consideration of OPG concentrations can improve CVD risk stratification in RA merits future longitudinal investigation.

Cardiovascular disease mortality in British merchant shipping and among British seafarers ashore in Britain.

PubMed

Roberts, Stephen E; Jaremin, Bogdan

2010-01-01

The objective was to investigate trends in work-related mortality from cardiovascular disease (CVD) among seafarers employed in British merchant shipping from 1919 to 2005, to compare CVD mortality among British seafarers at work in British shipping - and ashore in Britain - with that in the general British population, and to investigate work-related CVD mortality in British shipping during recent years according to factors such as rank, nationality, location, and type of ship. A longitudinal study based on examination of death inquiry files and death registers, official death returns, and information from occupational mortality decennial supplements. The main outcome measures were population-based mortality rates and standardised mortality ratios. There was an increase in work-related CVD mortality throughout much of the period from 1919 to 1962, but a subsequent reduction to 2005. Work-related mortality from CVD and ischaemic heart disease (IHD) was lower among seafarers employed in British shipping than in the corresponding general population (SMRs = 0.35 to 0.46), but mortality from CVD among British seafarers ashore in Britain was often increased. An elevated risk of work-related CVD mortality was also identified among the crews of North Sea offshore ships. This study shows a healthy worker effect against CVD mortality among seafarers at work in British shipping, but increased risks among British seafarers ashore in Britain, which would include seafarers discharged through CVD morbidity and other illnesses. The high risks of CVD mortality among seafarers in North Sea supply ships may reflect particular work-related hazards in this sector.

Prevalence of cardiovascular disease and major risk factors in patients with rheumatoid arthritis: a multinational cross-sectional study.

PubMed

Pappas, Dimitrios A; Nyberg, Fredrik; Kremer, Joel M; Lampl, Kathy; Reed, George W; Horne, Laura; Ho, Meilien; Onofrei, Alina; Malaviya, Anand N; Rillo, Oscar L; Radominski, Sebastiao C; Gal, Janos; Gibofsky, Allan; Popkova, Tatiana V; Laurindo, Leda; Kerzberg, Eduardo M; Zahora, Roman; Pons-Estel, Bernado A; Curtis, Jeffrey R; Furst, Daniel E; Greenberg, Jeffrey D

2018-04-25

To compare the prevalence of cardiovascular disease (CVD) and major CVD risk factors among rheumatoid arthritis (RA) patients enrolled in a large US and multinational registry. We compared CVD and CVD risk factor prevalence from 11 countries enrolled in the CORRONA US and CORRONA International registries; patients from the 10 ex-US participating countries were grouped by region (Eastern Europe, Latin America, and India). Unadjusted summary data were presented for demographics and disease characteristics; comparisons for prevalence of CVD risk factors and CVD were age/gender standardized to the age/gender distribution of the US enrolled patients. Overall, 25,987 patients were included in this analysis. Compared to patients from the ex-US regions, US participants had longer disease duration and lower disease activity, yet were more likely to receive a biologic agent. Additionally, CORRONA US participants had the highest body mass index (BMI). Enrolled patients in India had the lowest BMI, were more rarely smokers, and had a low prevalence of hyperlipidemia, hypertension, and prior CVD compared to the US and other ex-US regions. Participants from Eastern Europe had a higher prevalence of hypertension and hyperlipidemia and highest prevalence of all manifestations of CVD. Differences in the prevalence of both CVD and major CVD risk factors were observed across the four regions investigated. Observed differences may be influenced by variations in both non-modifiable/modifiable characteristics of patient populations, and may contribute to heterogeneity on the observed safety of investigational and approved therapies in studies involving RA patients from different origins.

Adherence to Mediterranean Diet Offers an Additive Protection Over the Use of Statin Therapy: Results from the ATTICA Study (2002-2012).

PubMed

Panagiotakos, Demosthenes B; Georgousopoulou, Ekavi N; Georgiopoulos, Georgios A; Pitsavos, Christos; Chrysohoou, Christina; Skoumas, Ioannis; Ntertimani, Maria; Laskaris, Alexandros; Papadimitriou, Lampros; Tousoulis, Dimitrios; Stefanadis, Christodoulos

2015-01-01

The protective role of Mediterranean diet on cardiovascular disease (CVD) risk has been extensively discussed in the literature, but its incremental effect over the use of CVD risk reducing agents (such as hypolipidemic treatment) has rarely been evaluated. The ATTICA study was carried out in the Athens area during 2001-2002 and included 3042 participants free of CVD at baseline (49.8% men, aged 18-89 years). Adherence to Mediterranean diet was assessed using the MedDietScore (range 0-55) and statin use was recorded for all subjects. During 2011-2012, 2583 out of the 3042 baseline participants attended the 10-year follow-up of the ATTICA study (15% lost-to-follow-up) and CVD development was recorded. Adherence to Mediterranean diet (highest tertile) decreased CVD risk by 29.3% (Hazard Ratio (HR): 0.707, 95% Confidence Intervals (CI): 0.537-0.831) as compared with the lowest tertile, independently of statin use. Patients with hyperlipidemia on a statin that adopted unhealthy dietary habits (lowest tertile) had 75% increased CVD risk than normolipidemic subjects with healthy dietary habits (HR=1.75, 95%CI: 1.33-2.29). The addition of Mediterranean diet tertiles in the multivariable model reclassified 46.7% of the participants to CVD risk categories. Adherence to Mediterranean diet confers a considerable reduction in CVD risk, independently of gender, age, family history of CVD, diabetes mellitus, smoking status, hypertension and physical activity status. Therefore, CVD prevention strategies should involve the implementation of a Mediterranean diet in both the general population and patients on a statin.

The Health Effects of US Unemployment Insurance Policy: Does Income from Unemployment Benefits Prevent Cardiovascular Disease?

PubMed Central

Walter, Stefan; Glymour, Maria; Avendano, Mauricio

2014-01-01

Objective Previous studies suggest that unemployment predicts increased cardiovascular disease (CVD) risk, but whether unemployment insurance programs mitigate this risk has not been assessed. Exploiting US state variations in unemployment insurance benefit programs, we tested the hypothesis that more generous benefits reduce CVD risk. Methods Cohort data came from 16,108 participants in the Health and Retirement Study (HRS) aged 50–65 at baseline interviewed from 1992 to 2010. Data on first and recurrent CVD diagnosis assessed through biennial interviews were linked to the generosity of unemployment benefit programmes in each state and year. Using state fixed-effect models, we assessed whether state changes in the generosity of unemployment benefits predicted CVD risk. Results States with higher unemployment benefits had lower incidence of CVD, so that a 1% increase in benefits was associated with 18% lower odds of CVD (OR:0.82, 95%-CI:0.71–0.94). This association remained after introducing US census regional division fixed effects, but disappeared after introducing state fixed effects (OR:1.02, 95%-CI:0.79–1.31).This was consistent with the fact that unemployment was not associated with CVD risk in state-fixed effect models. Conclusion Although states with more generous unemployment benefits had lower CVD incidence, this appeared to be due to confounding by state-level characteristics. Possible explanations are the lack of short-term effects of unemployment on CVD risk. Future studies should assess whether benefits at earlier stages of the life-course influence long-term risk of CVD. PMID:25025281

A cross-sectional analysis of cardiovascular disease in the hemophilia population

PubMed Central

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

Gaps in Addressing Cardiovascular Risk in Rheumatoid Arthritis: Assessing Performance Using Cardiovascular Quality Indicators.

PubMed

Barber, Claire E H; Esdaile, John M; Martin, Liam O; Faris, Peter; Barnabe, Cheryl; Guo, Selynne; Lopatina, Elena; Marshall, Deborah A

2016-11-01

Cardiovascular disease (CVD) is a major comorbidity for patients with rheumatoid arthritis (RA). This study sought to determine the performance of 11 recently developed CVD quality indicators (QI) for RA in clinical practice. Medical charts for patients with RA (early disease or biologic-treated) followed at 1 center were retrospectively reviewed. A systematic assessment of adherence to 11 QI over a 2-year period was completed. Performance on the QI was reported as a percentage pass rate. There were 170 charts reviewed (107 early disease and 63 biologic-treated). The most frequent CVD risk factors present at diagnosis (early disease) and biologic start (biologic-treated) included hypertension (26%), obesity (25%), smoking (21%), and dyslipidemia (15%). Performance on the CVD QI was highly variable. Areas of low performance (< 10% pass rates) included documentation of a formal CVD risk assessment, communication to the primary care physician (PCP) that patients with RA were at increased risk of CVD, body mass index documentation and counseling if overweight, communication to a PCP about an elevated blood pressure, and discussion of risks and benefits of antiinflammatories in patients at CVD risk. Rates of diabetes screening and lipid screening were 67% and 69%, respectively. The area of highest performance was observed for documentation of intent to taper corticosteroids (98%-100% for yrs 1 and 2, respectively). Gaps in CVD risk management were found and highlight the need for quality improvements. Key targets for improvement include coordination of CVD care between rheumatology and primary care, and communication of increased CVD risk in RA.

A tragic triad: coronary artery disease, nicotine addiction, and depression.

PubMed

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.

Differences in the Cardiometabolic Control in Type 2 Diabetes according to Gender and the Presence of Cardiovascular Disease: Results from the eControl Study

PubMed Central

Mata-Cases, Manel; Vinagre, Irene; Patitucci, Flor; Hermosilla, Eduard; Casellas, Aina; Bolivar, Bonaventura; Mauricio, Dídac

2014-01-01

The objective of this cross-sectional study was to assess differences in the control and treatment of modifiable cardiovascular risk factors (CVRF: HbA1c, blood pressure [BP], LDL-cholesterol, body mass index, and smoking habit) according to gender and the presence of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) in Catalonia, Spain. The study included available data from electronic medical records for a total of 286,791 patients. After controlling for sex, age, diabetes duration, and treatment received, both men and women with prior CVD had worse cardiometabolic control than patients without previous CVD; women with prior CVD had worse overall control of CVRFs than men except for smoking; and women without prior CVD were only better than men at controlling smoking and BP, with no significant differences in glycemic control. Finally, although the proportion of women treated with lipid-lowering medications was similar to (with prior CVD) or even higher (without CVD) than men, LDL-cholesterol levels were remarkably uncontrolled in both women with and women without CVD. The results stress the need to implement measures to better prevent and treat CVRF in the subgroup of diabetic women, specifically with more intensive statin treatment in those with CVD. PMID:25328520

Effects of prediabetes mellitus alone or plus hypertension on subsequent occurrence of cardiovascular disease and diabetes mellitus: longitudinal study.

PubMed

Qiu, Miaoyan; Shen, Weili; Song, Xiaomin; Ju, Liping; Tong, Wenxin; Wang, Haiyan; Zheng, Sheng; Jin, Yan; Wu, Yixin; Wang, Weiqing; Tian, Jingyan

2015-03-01

Whether prediabetes mellitus alone or combined with other disorders means a higher risk for cardiovascular disease (CVD) is still controversial. This study aimed to investigate the association between prediabetes mellitus and CVD and diabetes mellitus and to explore whether prediabetes mellitus alone or combined with other syndromes, such as hypertension, could promote CVD risks significantly. This longitudinal population-based study of 1609 residents from Shanghai in Southern China was conducted between 2002 and 2014. Participants with a history of CVD at baseline were excluded from analysis. Multivariate log-binomial regression models were used to adjust possible coexisting factors. Incidence of CVD during follow-up was 10.1%. After adjusting for age, sex, and other factors, the association between prediabetes mellitus and CVD was not observed. When hypertension was incorporated in stratifying factors, adjusted CVD risk was elevated significantly (odds ratio, 2.41; 95% confidence interval, 1.25-4.64) in prediabetes mellitus and hypertension combined group, and coexistence of diabetes mellitus and hypertension made CVD risk highly significantly increased, reaching 3.43-fold higher than the reference group. Blood glucose level within prediabetic range is significantly associated with elevated risks for diabetes mellitus after multivariable adjustment, but only when it is concurrent with other disorders, such as hypertension, it will significantly increase CVD risk. © 2015 American Heart Association, Inc.

Plasma and serum L-selectin and clinical and subclinical the Multi-Ethnic Study of Atherosclerosis (MESA)cardiovascular disease

PubMed Central

BERARDI, CECILIA; DECKER, PAUL A.; KIRSCH, PHILLIP S.; DE ANDRADE, MARIZA; TSAI, MICHAEL Y.; PANKOW, JAMES S.; SALE, MICHELE M.; SICOTTE, HUGUES; TANG, WEIHONG; HANSON, NAOMI; POLAK, JOSEPH F.; BIELINSKI, SUZETTE J.

2014-01-01

L-selectin has been suggested to play a role in atherosclerosis. Previous studies on cardiovascular disease (CVD) and serum or plasma L-selectin are inconsistent. The association of serum L-selectin (sL-selectin) with carotid intima-media thickness, coronary artery calcium, ankle-brachial index (subclinical CVD) and incident CVD was assessed within 2403 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Regression analysis and the Tobit model were used to study subclinical disease; Cox Proportional Hazards regression for incident CVD. Mean age was 63 ± 10, 47% were males; mean sL-selectin was significantly different across ethnicities. Within each race/ethnicity, sL-selectin was associated with age and sex; among Caucasians and African Americans, it was associated with smoking status and current alcohol use. sL-selectin levels did not predict subclinical or clinical CVD after correction for multiple comparisons. Conditional logistic regression models were used to study plasma L-selectin and CVD within 154 incident CVD cases, occurred in a median follow up of 8.5 years, and 306 age-, sex-, and ethnicity-matched controls. L-selectin levels in plasma were significantly lower than in serum and the overall concordance was low. Plasma levels were not associated with CVD. In conclusion, this large multi-ethnic population, soluble L-selectin levels did not predict clinical or subclinical CVD. PMID:24631064

Relationships between the risk of cardiovascular disease in type 2 diabetes patients and both visit-to-visit variability and time-to-effect differences in blood pressure.

PubMed

Takao, Toshiko; Kimura, Kumiko; Suka, Machi; Yanagisawa, Hiroyuki; Kikuchi, Masatoshi; Kawazu, Shoji; Matsuyama, Yutaka

2015-07-01

To determine whether visit-to-visit blood pressure (BP) variability can predict cardiovascular disease (CVD) incidence in type 2 diabetes patients independently of mean BP, and to analyze the time-to-effect relationship between BP and CVD risk. We retrospectively enrolled 629 type 2 diabetes patients with no history of CVD who first visited our hospital between 1995 and 1996, made at least one hospital visit per year, were followed-up for at least 1 year, and had undergone four or more BP measurements. The patients were followed until June 2012 at the latest. CVD occurred in 66 patients. Variability in systolic or diastolic BP (SBP and DBP, respectively) was a significant predictor of CVD incidence, independent of mean SBP or DBP. CVD incidence was significantly associated with SBP during the preceding 3-5 years, with the highest risk occurring during the preceding 3 years. Visit-to-visit BP variability independently predicts CVD incidence in type 2 diabetes patients. Increased SBP over the preceding 3-5 years indicated a significant CVD risk. To prevent CVD, BP management should focus on stable and well-timed control. In particular, BP stabilization at an early phase and BP control during late phases are important. Copyright © 2015 Elsevier Inc. All rights reserved.

Current Status of Cardiovascular Disease-Related Smartphone Apps Downloadable in China.

PubMed

Xiao, Qian; Lu, Sai; Wang, Yanling; Sun, Liu; Wu, Ying

2017-03-01

Smartphone apps present a great opportunity for the management of cardiovascular disease (CVD) as the adoption of apps becomes increasingly popular in China. Yet, little is known about the status of CVD-related Smartphone apps in the country. The aim of this study was to examine the current status of CVD-related smartphone apps available for download in China. Using CVD-related keywords written either in Chinese or English, the top 6 most popular smartphone app online stores in China were searched in September 2015. The information accountability of the selected apps was assessed with the Silberg scale. The key topic areas identified from the European Guidelines on cardiovascular disease prevention served to determine information coverage of the top 5 downloaded apps. The average Silberg score of 151 apps was 2.87 (out of 9) with most apps not revealing authors' qualifications and information references. There was also a lack of sponsorship disclosure and information update. Moreover, none of the top 5 downloaded apps covered all key areas of CVD management as recommended by the European Guidelines on cardiovascular disease prevention. There was little evidence of health professionals' involvement in the formation of the CVD-related apps. This study identified areas for improvement concerning information accountability and the scope of coverage of CVD-related apps downloadable in China. The findings may guide the future advancement of CVD-related apps and benefit CVD management in China.

Assessment of medium-term cardiovascular disease risk after Japan’s 2011 Fukushima Daiichi nuclear accident: a retrospective analysis

PubMed Central

Nomura, Shuhei; Gilmour, Stuart; Oikawa, Tomoyoshi; Lee, Kiwon; Kiyabu, Grace Y; Shibuya, Kenji

2017-01-01

Objective To assess the medium-term indirect impact of the 2011 Fukushima Daiichi nuclear accident on cardiovascular disease (CVD) risks and to identify whether risk factors for CVD changed after the accident. Participants Residents aged 40 years and over participating in annual public health check-ups from 2009 to 2012, administered by Minamisoma city, located about 10 to 40 km from the Fukushima Daiichi nuclear plant. Methods The sex-specific Framingham CVD risk score was considered as the outcome measure and was compared before (2009–2010) and after the accident (2011–2012). A multivariate regression analysis was employed to evaluate risk factors for CVD. Results Data from 563 individuals (60.2% women) aged 40 to 74 years who participated in the check-ups throughout the study period was analysed. After adjusting for covariates, no statistically significant change was identified in the CVD risk score postaccident in both sexes, which may suggest no obvious medium-term health impact of the Fukushima nuclear accident on CVD risk. The risk factors for CVD and their magnitude and direction (positive/negative) did not change after the accident. Conclusions There was no obvious increase in CVD risks in Minamisoma city, which may indicate successful management of health risks associated with CVD in the study sample. PMID:29275343

Chemical-Vapor-Deposited Diamond Film

NASA Technical Reports Server (NTRS)

Miyoshi, Kazuhisa

1999-01-01

This chapter describes the nature of clean and contaminated diamond surfaces, Chemical-vapor-deposited (CVD) diamond film deposition technology, analytical techniques and the results of research on CVD diamond films, and the general properties of CVD diamond films. Further, it describes the friction and wear properties of CVD diamond films in the atmosphere, in a controlled nitrogen environment, and in an ultra-high-vacuum environment.

Cumulative Lifetime Marijuana Use and Incident Cardiovascular Disease in Middle Age: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

PubMed

Reis, Jared P; Auer, Reto; Bancks, Michael P; Goff, David C; Lewis, Cora E; Pletcher, Mark J; Rana, Jamal S; Shikany, James M; Sidney, Stephen

2017-04-01

To investigate the effects of marijuana in the development of incident cardiovascular and cerebrovascular outcomes. Participants were 5113 adults aged 18 to 30 years at baseline (1985-1986) from the Coronary Artery Risk Development in Young Adults study, who were followed for more than 25 years. We estimated cumulative lifetime exposure to marijuana using repeated assessments collected at examinations every 2 to 5 years. The primary outcome was incident cardiovascular disease (CVD) through 2013. A total of 84% (n = 4286) reported a history of marijuana use. During a median 26.9 years (131 990 person-years), we identified 215 CVD events, including 62 strokes or transient ischemic attacks, 104 cases of coronary heart disease, and 50 CVD deaths. Compared with no marijuana use, cumulative lifetime and recent marijuana use showed no association with incident CVD, stroke or transient ischemic attacks, coronary heart disease, or CVD mortality. Marijuana use was not associated with CVD when stratified by age, gender, race, or family history of CVD. Neither cumulative lifetime nor recent use of marijuana is associated with the incidence of CVD in middle age.

[Ecological Correlates of Cardiovascular Disease Risk in Korean Blue-collar Workers: A Multi-level Study].

PubMed

Hwang, Won Ju; Park, Yunhee

2015-12-01

The purpose of this study was to investigate individual and organizational level of cardiovascular disease (CVD) risk factors associated with CVD risk in Korean blue-collar workers working in small sized companies. Self-report questionnaires and blood sampling for lipid and glucose were collected from 492 workers in 31 small sized companies in Korea. Multilevel modeling was conducted to estimate effects of related factors at the individual and organizational level. Multilevel regression analysis showed that workers in the workplace having a cafeteria had 1.81 times higher CVD risk after adjusting for factors at the individual level (p=.022). The explanatory power of variables related to organizational level variances in CVD risk was 17.1%. The results of this study indicate that differences in the CVD risk were related to organizational factors. It is necessary to consider not only individual factors but also organizational factors when planning a CVD risk reduction program. The factors caused by having cafeteria in the workplace can be reduced by improvement in the CVD-related risk environment, therefore an organizational-level intervention approach should be available to reduce CVD risk of workers in small sized companies in Korea.

Synthesis of ultrathin polymer insulating layers by initiated chemical vapour deposition for low-power soft electronics.

PubMed

Moon, Hanul; Seong, Hyejeong; Shin, Woo Cheol; Park, Won-Tae; Kim, Mincheol; Lee, Seungwon; Bong, Jae Hoon; Noh, Yong-Young; Cho, Byung Jin; Yoo, Seunghyup; Im, Sung Gap

2015-06-01

Insulating layers based on oxides and nitrides provide high capacitance, low leakage, high breakdown field and resistance to electrical stresses when used in electronic devices based on rigid substrates. However, their typically high process temperatures and brittleness make it difficult to achieve similar performance in flexible or organic electronics. Here, we show that poly(1,3,5-trimethyl-1,3,5-trivinyl cyclotrisiloxane) (pV3D3) prepared via a one-step, solvent-free technique called initiated chemical vapour deposition (iCVD) is a versatile polymeric insulating layer that meets a wide range of requirements for next-generation electronic devices. Highly uniform and pure ultrathin films of pV3D3 with excellent insulating properties, a large energy gap (>8 eV), tunnelling-limited leakage characteristics and resistance to a tensile strain of up to 4% are demonstrated. The low process temperature, surface-growth character, and solvent-free nature of the iCVD process enable pV3D3 to be grown conformally on plastic substrates to yield flexible field-effect transistors as well as on a variety of channel layers, including organics, oxides, and graphene.

25th anniversary article: CVD polymers: a new paradigm for surface modification and device fabrication.

PubMed

Coclite, Anna Maria; Howden, Rachel M; Borrelli, David C; Petruczok, Christy D; Yang, Rong; Yagüe, Jose Luis; Ugur, Asli; Chen, Nan; Lee, Sunghwan; Jo, Won Jun; Liu, Andong; Wang, Xiaoxue; Gleason, Karen K

2013-10-11

Well-adhered, conformal, thin (<100 nm) coatings can easily be obtained by chemical vapor deposition (CVD) for a variety of technological applications. Room temperature modification with functional polymers can be achieved on virtually any substrate: organic, inorganic, rigid, flexible, planar, three-dimensional, dense, or porous. In CVD polymerization, the monomer(s) are delivered to the surface through the vapor phase and then undergo simultaneous polymerization and thin film formation. By eliminating the need to dissolve macromolecules, CVD enables insoluble polymers to be coated and prevents solvent damage to the substrate. CVD film growth proceeds from the substrate up, allowing for interfacial engineering, real-time monitoring, and thickness control. Initiated-CVD shows successful results in terms of rationally designed micro- and nanoengineered materials to control molecular interactions at material surfaces. The success of oxidative-CVD is mainly demonstrated for the deposition of organic conducting and semiconducting polymers. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Childhood obesity and cardiovascular disease: links and prevention strategies

PubMed Central

Nadeau, Kristen J.; Maahs, David M.; Daniels, Stephen R.; Eckel, Robert H.

2015-01-01

The prevalence and severity of pediatric obesity have dramatically increased since the late 1980s, raising concerns about a subsequent increase in cardiovascular outcomes. Strong evidence, particularly from autopsy studies, supports the concept that precursors of adult cardiovascular disease (CVD) begin in childhood, and that pediatric obesity has an important influence on overall CVD risk. Lifestyle patterns also begin early and impact CVD risk. In addition, obesity and other CVD risk factors tend to persist over time. However, whether childhood obesity causes adult CVD directly, or does so by persisting as adult obesity, or both, is less clear. Regardless, sufficient data exist to warrant early implementation of both obesity prevention and treatment in youth and adults. In this Review, we examine the evidence supporting the impact of childhood obesity on adult obesity, surrogate markers of CVD, components of the metabolic syndrome, and the development of CVD. We also evaluate how obesity treatment strategies can improve risk factors and, ultimately, adverse clinical outcomes. PMID:21670745

Nutrition and Cardiovascular Disease: Finding the Perfect Recipe for Cardiovascular Health

PubMed Central

Ravera, Alice; Carubelli, Valentina; Sciatti, Edoardo; Bonadei, Ivano; Gorga, Elio; Cani, Dario; Vizzardi, Enrico; Metra, Marco; Lombardi, Carlo

2016-01-01

The increasing burden of cardiovascular disease (CVD) despite the progress in management entails the need of more effective preventive and curative strategies. As dietary-associated risk is the most important behavioral factor influencing global health, it appears the best target in the challenge against CVD. Although for many years, since the formulation of the cholesterol hypothesis, a nutrient-based approach was attempted for CVD prevention and treatment, in recent years a dietary-based approach resulted more effective in reducing cardiovascular risk worldwide. After the publication of randomized trials on the remarkable effects of the Mediterranean diet and the Dietary Approach to Stop Hypertension (DASH) diet on CVD, new efforts were put on research about the effects of complex dietary interventions on CVD. The purpose of this paper is to review the evidence on dietary interventions in the prevention and disease modification of CVD, focusing on coronary artery disease and heart failure, the main disease responsible for the enormous toll taken by CVD worldwide. PMID:27314382

Emerging Burden of Cardiovascular Diseases in Bangladesh.

PubMed

Al Mamun, Mohammad; Rumana, Nahid; Pervin, Kumkum; Azad, Muhammad Chanchal; Shahana, Nahid; Choudhury, Sohel Reza; Zaman, M Mostafa; Turin, Tanvir Chowdhury

2016-01-01

As a result of an epidemiological transition from communicable to non-communicable diseases for last few decades, cardiovascular diseases (CVD) are being considered as an important cause of mortality and morbidity in many developing countries including Bangladesh. Performing an extensive literature search, we compiled, summarized, and categorized the existing information about CVD mortality and morbidity among different clusters of Bangladeshi population. The present review reports that the burden of CVD in terms of mortality and morbidity is on the rise in Bangladesh. Despite a few non-communicable disease prevention and control programs currently running in Bangladesh, there is an urgent need for well-coordinated national intervention strategies and public health actions to minimize the CVD burden in Bangladesh. As the main challenge for CVD control in a developing country is unavailability of adequate epidemiological data related to various CVD events, the present review attempted to accumulate such data in the current context of Bangladesh. This may be of interest to all stakeholder groups working for CVD prevention and control across the country and globe.

Nutrition and Cardiovascular Disease: Finding the Perfect Recipe for Cardiovascular Health.

PubMed

Ravera, Alice; Carubelli, Valentina; Sciatti, Edoardo; Bonadei, Ivano; Gorga, Elio; Cani, Dario; Vizzardi, Enrico; Metra, Marco; Lombardi, Carlo

2016-06-14

The increasing burden of cardiovascular disease (CVD) despite the progress in management entails the need of more effective preventive and curative strategies. As dietary-associated risk is the most important behavioral factor influencing global health, it appears the best target in the challenge against CVD. Although for many years, since the formulation of the cholesterol hypothesis, a nutrient-based approach was attempted for CVD prevention and treatment, in recent years a dietary-based approach resulted more effective in reducing cardiovascular risk worldwide. After the publication of randomized trials on the remarkable effects of the Mediterranean diet and the Dietary Approach to Stop Hypertension (DASH) diet on CVD, new efforts were put on research about the effects of complex dietary interventions on CVD. The purpose of this paper is to review the evidence on dietary interventions in the prevention and disease modification of CVD, focusing on coronary artery disease and heart failure, the main disease responsible for the enormous toll taken by CVD worldwide.

Is procrastination a vulnerability factor for hypertension and cardiovascular disease? Testing an extension of the procrastination-health model.

PubMed

Sirois, Fuschia M

2015-06-01

Personality is an important epidemiological factor for understanding health outcomes. This study investigated the associations of trait procrastination with hypertension and cardiovascular disease (HT/CVD) and maladaptive coping by testing an extension of the procrastination-health model among individuals with and without HT/CVD. Individuals with self-reported HT/CVD (N = 182) and healthy controls (N = 564), from a community sample, completed an online survey including measures of personality, coping, and health outcomes. Logistic regression analysis controlling for demographic and higher order personality factors found that older age, lower education level and higher procrastination scores were associated with HT/CVD. Moderated mediation analyses with bootstrapping revealed that procrastination was more strongly associated with maladaptive coping behaviours in participants with HT/CVD than the healthy controls, and the indirect effects on stress through maladaptive coping were larger for the HT/CVD sample. Results suggest procrastination is a vulnerability factor for poor adjustment to and management of HT/CVD.

Probiotics and Prebiotics: Present Status and Future Perspectives on Metabolic Disorders.

PubMed

Yoo, Ji Youn; Kim, Sung Soo

2016-03-18

Metabolic disorders, including type 2 diabetes (T2DM) and cardiovascular disease (CVD), present an increasing public health concern and can significantly undermine an individual's quality of life. The relative risk of CVD, the primary cause of death in T2DM patients, is two to four times higher in people with T2DM compared with those who are non-diabetic. The prevalence of metabolic disorders has been associated with dynamic changes in dietary macronutrient intake and lifestyle changes over recent decades. Recently, the scientific community has considered alteration in gut microbiota composition to constitute one of the most probable factors in the development of metabolic disorders. The altered gut microbiota composition is strongly conducive to increased adiposity, β-cell dysfunction, metabolic endotoxemia, systemic inflammation, and oxidative stress. Probiotics and prebiotics can ameliorate T2DM and CVD through improvement of gut microbiota, which in turn leads to insulin-signaling stimulation and cholesterol-lowering effects. We analyze the currently available data to ascertain further potential benefits and limitations of probiotics and prebiotics in the treatment of metabolic disorders, including T2DM, CVD, and other disease (obesity). The current paper explores the relevant contemporary scientific literature to assist in the derivation of a general perspective of this broad area.

Probiotics and Prebiotics: Present Status and Future Perspectives on Metabolic Disorders

PubMed Central

Yoo, Ji Youn; Kim, Sung Soo

2016-01-01

Metabolic disorders, including type 2 diabetes (T2DM) and cardiovascular disease (CVD), present an increasing public health concern and can significantly undermine an individual’s quality of life. The relative risk of CVD, the primary cause of death in T2DM patients, is two to four times higher in people with T2DM compared with those who are non-diabetic. The prevalence of metabolic disorders has been associated with dynamic changes in dietary macronutrient intake and lifestyle changes over recent decades. Recently, the scientific community has considered alteration in gut microbiota composition to constitute one of the most probable factors in the development of metabolic disorders. The altered gut microbiota composition is strongly conducive to increased adiposity, β-cell dysfunction, metabolic endotoxemia, systemic inflammation, and oxidative stress. Probiotics and prebiotics can ameliorate T2DM and CVD through improvement of gut microbiota, which in turn leads to insulin-signaling stimulation and cholesterol-lowering effects. We analyze the currently available data to ascertain further potential benefits and limitations of probiotics and prebiotics in the treatment of metabolic disorders, including T2DM, CVD, and other disease (obesity). The current paper explores the relevant contemporary scientific literature to assist in the derivation of a general perspective of this broad area. PMID:26999199

Perovskite Solar Cells with Large-Area CVD-Graphene for Tandem Solar Cells.

PubMed

Lang, Felix; Gluba, Marc A; Albrecht, Steve; Rappich, Jörg; Korte, Lars; Rech, Bernd; Nickel, Norbert H

2015-07-16

Perovskite solar cells with transparent contacts may be used to compensate for thermalization losses of silicon solar cells in tandem devices. This offers a way to outreach stagnating efficiencies. However, perovskite top cells in tandem structures require contact layers with high electrical conductivity and optimal transparency. We address this challenge by implementing large-area graphene grown by chemical vapor deposition as a highly transparent electrode in perovskite solar cells, leading to identical charge collection efficiencies. Electrical performance of solar cells with a graphene-based contact reached those of solar cells with standard gold contacts. The optical transmission by far exceeds that of reference devices and amounts to 64.3% below the perovskite band gap. Finally, we demonstrate a four-terminal tandem device combining a high band gap graphene-contacted perovskite top solar cell (Eg = 1.6 eV) with an amorphous/crystalline silicon bottom solar cell (Eg = 1.12 eV).

Biosensors based on DNA-Functionalized Graphene

NASA Astrophysics Data System (ADS)

Vishnubhotla, Ramya; Ping, Jinglei; Vrudhula, Amey; Johnson, A. T. Charlie

Since its discovery, graphene has been used for sensing applications due to its outstanding electrical properties and biocompatibility. Here, we demonstrate the capabilities of field effect transistors (FETs) based on CVD-grown graphene functionalized with commercially obtained DNA oligomers and aptamers for detection of various biomolecular targets (e.g., complementary DNA and small molecule drug targets). Graphene FETs were created with a scalable photolithography process that produces arrays consisting of 50-100 FETs with a layout suitable for multiplexed detection of four molecular targets. FETs were characterized via AFM to confirm the presence of the aptamer. From the measured electrical characteristics, it was determined that binding of molecular targets by the DNA chemical recognition element led to a reproducible, concentration-dependent shift in the Dirac voltage. This biosensor class is potentially suitable for applications in drug detection. This work is funded by NIH through the Center for AIDS Research at the University of Pennsylvania.

Rheumatoid Arthritis and Cardiovascular Disease: Update on Treatment Issues

PubMed Central

Barbhaiya, Medha; Solomon, Daniel H.

2016-01-01

Purpose of review This review examines thresholds for treatment of traditional cardiovascular disease (CVD) risk factors among RA patients and whether RA-specific treatment modulates cardiovascular risk. Recent findings There are substantial data demonstrating an increased CVD risk among patients with RA. Both traditional CVD risk factors and inflammation contribute to this risk. Recent epidemiologic studies strengthen the case that aggressive immunosuppression with biologic DMARDs, such as TNF antagonists, is associated with a reduced risk of CVD events. However, to data, there are no randomized controlled trials published regarding the management of CVD in RA. Summary Epidemiologic evidence continues to accumulate regarding the relationship between the effects of traditional CVD risk factors and RA-specific treatments on CV outcomes in RA. The field needs randomized controlled trials to better guide management. PMID:23466960

Numerical Simulations of a 96-rod Polysilicon CVD Reactor

NASA Astrophysics Data System (ADS)

Guoqiang, Tang; Cong, Chen; Yifang, Cai; Bing, Zong; Yanguo, Cai; Tihu, Wang

2018-05-01

With the rapid development of the photovoltaic industry, pressurized Siemens belljar-type polysilicon CVD reactors have been enlarged from 24 rods to 96 rods in less than 10 years aimed at much greater single-reactor productivity. A CFD model of an industry-scale 96-rod CVD reactor was established to study the internal temperature distribution and the flow field of the reactor. Numerical simulations were carried out and compared with actual growth results from a real CVD reactor. Factors affecting polysilicon depositions such as inlet gas injections, flow field, and temperature distribution in the CVD reactor are studied.

Comparative assessment of absolute cardiovascular disease risk characterization from non-laboratory-based risk assessment in South African populations

PubMed Central

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

Excessive and premature new-onset cardiovascular disease among adults with bipolar disorder in the US NESARC cohort.

PubMed

Goldstein, Benjamin I; Schaffer, Ayal; Wang, Shuai; Blanco, Carlos

2015-02-01

Cross-sectional studies demonstrate increased prevalence of cardiovascular disease (CVD) among adults with bipolar disorder. However, there is a paucity of prospective data regarding new-onset CVD among adults with bipolar disorder. Analyses compared the 3-year incidence of CVD (via participant-reported physician diagnoses) among participants with DSM-IV diagnoses of bipolar I disorder (n = 1,047), bipolar II disorder (n = 392), major depressive disorder (MDD; n = 4,396), or controls (n = 26,266), who completed Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Analyses also compared the age of participants with new-onset CVD across groups. Multivariable analyses controlled for age, sex, race, cigarette smoking, hypertension, obesity, and alcohol and drug use disorders. The 3-year incidence of CVD among adults with bipolar I disorder, bipolar II disorder, MDD, and among controls was 6.30%, 5.74%, 3.98%, and 3.70%, respectively. The covariate-adjusted incidence of CVD was significantly greater among participants with bipolar I and II disorders versus controls and versus participants with MDD. Adjusted odds ratios (95% CI) were 2.58 (1.84-3.61; P < .0001) for bipolar I disorder vs controls; 2.76 (1.60-4.74; P = .0004) for bipolar II disorder vs controls; 2.11 (1.46-3.04; P = .0001) for bipolar I disorder vs MDD; 2.25 (1.26-4.01; P = .007) for bipolar II disorder vs MDD; and 1.22 (0.99-1.51; P = .06) for MDD vs controls. Bipolar I disorder participants with new-onset CVD were 10.70 ± 2.77 years younger than MDD participants with new-onset CVD and 16.78 ± 2.51 years younger than controls. Bipolar II disorder participants with new-onset CVD were 7.92 ± 3.27 years younger than MDD participants with new-onset CVD and 13.99 ± 2.79 years younger than controls. Adults with bipolar disorder are at significantly and meaningfully increased risk to develop CVD over the course of 3 years, even as compared to adults with MDD, and despite controlling for multiple potential confounds. Combined with very early age of CVD onset, this finding underscores the need for early and assertive CVD prevention strategies for people with bipolar disorder. © Copyright 2015 Physicians Postgraduate Press, Inc.

Cardiovascular risk prediction in HIV-infected patients: comparing the Framingham, atherosclerotic cardiovascular disease risk score (ASCVD), Systematic Coronary Risk Evaluation for the Netherlands (SCORE-NL) and Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) risk prediction models.

PubMed

Krikke, M; Hoogeveen, R C; Hoepelman, A I M; Visseren, F L J; Arends, J E

2016-04-01

The aim of the study was to compare the predictions of five popular cardiovascular disease (CVD) risk prediction models, namely the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) model, the Framingham Heart Study (FHS) coronary heart disease (FHS-CHD) and general CVD (FHS-CVD) models, the American Heart Association (AHA) atherosclerotic cardiovascular disease risk score (ASCVD) model and the Systematic Coronary Risk Evaluation for the Netherlands (SCORE-NL) model. A cross-sectional design was used to compare the cumulative CVD risk predictions of the models. Furthermore, the predictions of the general CVD models were compared with those of the HIV-specific D:A:D model using three categories (< 10%, 10-20% and > 20%) to categorize the risk and to determine the degree to which patients were categorized similarly or in a higher/lower category. A total of 997 HIV-infected patients were included in the study: 81% were male and they had a median age of 46 [interquartile range (IQR) 40-52] years, a known duration of HIV infection of 6.8 (IQR 3.7-10.9) years, and a median time on ART of 6.4 (IQR 3.0-11.5) years. The D:A:D, ASCVD and SCORE-NL models gave a lower cumulative CVD risk, compared with that of the FHS-CVD and FHS-CHD models. Comparing the general CVD models with the D:A:D model, the FHS-CVD and FHS-CHD models only classified 65% and 79% of patients, respectively, in the same category as did the D:A:D model. However, for the ASCVD and SCORE-NL models, this percentage was 89% and 87%, respectively. Furthermore, FHS-CVD and FHS-CHD attributed a higher CVD risk to 33% and 16% of patients, respectively, while this percentage was < 6% for ASCVD and SCORE-NL. When using FHS-CVD and FHS-CHD, a higher overall CVD risk was attributed to the HIV-infected patients than when using the D:A:D, ASCVD and SCORE-NL models. This could have consequences regarding overtreatment, drug-related adverse events and drug-drug interactions. © 2015 British HIV Association.

Payment Reform to Enhance Collaboration of Primary Care and Cardiology: A Review.

PubMed

Farmer, Steven A; Casale, Paul N; Gillam, Linda D; Rumsfeld, John S; Erickson, Shari; Kirschner, Neil M; de Regnier, Kevin; Williams, Bruce R; Martin, R Shawn; McClellan, Mark B

2018-01-01

The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform. The product of a collaboration between primary care and cardiology clinicians, this review describes a conceptual approach to delivery and payment reforms that aim to better support primary care-cardiology comanagement of chronic cardiovascular disease (CVD). Few existing alternative payment models specifically address long-term management of CVD. Primary care medical homes and accountable care organizations come closest, but both emphasize primary care, and cardiologists have often not been well engaged. A collaborative care framework should articulate distinct roles and responsibilities for primary care and cardiology in CVD comanagement. Finally, a series of payment models aim to better support clinicians in providing accountable, seamless, and patient-centered cardiac care. Clinical leadership is essential during this time of change in the health care system. Patients often struggle to navigate a fragmented and expensive system, whereas clinicians often practice with incomplete information about tests, treatments, and recommendations by their colleagues. The payment models described in this review offer an opportunity to create more satisfying approaches to patient care while improving value. These models have potential to support more effective coordination and to facilitate broader health care system transformation.

Pharmacogenomic Challenges in Cardiovascular Diseases: Examples of Drugs and Considerations for Future Integration in Clinical Practice.

PubMed

Chatelin, Jerome; Stathopoulou, Maria G; Arguinano, Alex-Ander A; Xie, Ting; Visvikis-Siest, Sophie

2017-01-01

Even if cardiovascular disease (CVD) drugs are supported by high level proofs, the results of CVD treatment present great disparities: there are still patients dying with supposed optimal treatment, patients facing adverse events and CVD remains the primary cause of death in the world. Pharmacogenomics is the basis of personalisation of the treatment able to allow higher medication success rates. In this review, we will present detailed examples of CVD drugs to highlight the complexity of this challenging field and we will discuss novel concepts that should be considered for a fastest integration of pharmacogenomics in clinical practice of CVD. Areas Covered: The complexity of pharmacogenetics and pharmacogenomics of CVD drugs are presented though examples of medications such as statins, with a focus on their effectiveness and adverse effects. Expert Opinion: The application of personalised medicine in the CVD medical practice requires the study of human genome with regard to drugs pharmacokinetics, pharmacodynamics, interactions and tolerance profile. The existing state -of-the-art of CVD drugs gives hopes for a future revolution in the drug development that will maximise cardiovascular patients benefit while decreasing their risks for adverse effects. Article Highlights Box: • Coronary heart disease (CHD) remains the first cause of death worldwide. • Cardiovascular treatment has a significant percentage of insufficient efficacy, poor tolerance and compliance. • Predicting the response to therapy while diminishing the side effects is the basis of personalised medicine; pharmacogenomics is leading towards this direction. • The response to CVD therapy and side effects are in the heart of CVD pharmacogenomics and significant progress has been noted. • The application of pharmacogenomics in the CVD medical practice is facing many methodological, technical, ethical, behavioral and financial issues, while cost-effectiveness is the main prerequisite. • The consideration of gene × gene × environment interactions and the inclusion of "omics" data in pharmacogenomic studies of CVD drugs will facilitate the generation of reliable results and will promote tailored treatments and new strategies of drug research and development. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Glycated hemoglobin measurement and prediction of cardiovascular disease.

PubMed

Di Angelantonio, Emanuele; Gao, Pei; Khan, Hassan; Butterworth, Adam S; Wormser, David; Kaptoge, Stephen; Kondapally Seshasai, Sreenivasa Rao; Thompson, Alex; Sarwar, Nadeem; Willeit, Peter; Ridker, Paul M; Barr, Elizabeth L M; Khaw, Kay-Tee; Psaty, Bruce M; Brenner, Hermann; Balkau, Beverley; Dekker, Jacqueline M; Lawlor, Debbie A; Daimon, Makoto; Willeit, Johann; Njølstad, Inger; Nissinen, Aulikki; Brunner, Eric J; Kuller, Lewis H; Price, Jackie F; Sundström, Johan; Knuiman, Matthew W; Feskens, Edith J M; Verschuren, W M M; Wald, Nicholas; Bakker, Stephan J L; Whincup, Peter H; Ford, Ian; Goldbourt, Uri; Gómez-de-la-Cámara, Agustín; Gallacher, John; Simons, Leon A; Rosengren, Annika; Sutherland, Susan E; Björkelund, Cecilia; Blazer, Dan G; Wassertheil-Smoller, Sylvia; Onat, Altan; Marín Ibañez, Alejandro; Casiglia, Edoardo; Jukema, J Wouter; Simpson, Lara M; Giampaoli, Simona; Nordestgaard, Børge G; Selmer, Randi; Wennberg, Patrik; Kauhanen, Jussi; Salonen, Jukka T; Dankner, Rachel; Barrett-Connor, Elizabeth; Kavousi, Maryam; Gudnason, Vilmundur; Evans, Denis; Wallace, Robert B; Cushman, Mary; D'Agostino, Ralph B; Umans, Jason G; Kiyohara, Yutaka; Nakagawa, Hidaeki; Sato, Shinichi; Gillum, Richard F; Folsom, Aaron R; van der Schouw, Yvonne T; Moons, Karel G; Griffin, Simon J; Sattar, Naveed; Wareham, Nicholas J; Selvin, Elizabeth; Thompson, Simon G; Danesh, John

2014-03-26

The value of measuring levels of glycated hemoglobin (HbA1c) for the prediction of first cardiovascular events is uncertain. To determine whether adding information on HbA1c values to conventional cardiovascular risk factors is associated with improvement in prediction of cardiovascular disease (CVD) risk. Analysis of individual-participant data available from 73 prospective studies involving 294,998 participants without a known history of diabetes mellitus or CVD at the baseline assessment. Measures of risk discrimination for CVD outcomes (eg, C-index) and reclassification (eg, net reclassification improvement) of participants across predicted 10-year risk categories of low (<5%), intermediate (5% to <7.5%), and high (≥ 7.5%) risk. During a median follow-up of 9.9 (interquartile range, 7.6-13.2) years, 20,840 incident fatal and nonfatal CVD outcomes (13,237 coronary heart disease and 7603 stroke outcomes) were recorded. In analyses adjusted for several conventional cardiovascular risk factors, there was an approximately J-shaped association between HbA1c values and CVD risk. The association between HbA1c values and CVD risk changed only slightly after adjustment for total cholesterol and triglyceride concentrations or estimated glomerular filtration rate, but this association attenuated somewhat after adjustment for concentrations of high-density lipoprotein cholesterol and C-reactive protein. The C-index for a CVD risk prediction model containing conventional cardiovascular risk factors alone was 0.7434 (95% CI, 0.7350 to 0.7517). The addition of information on HbA1c was associated with a C-index change of 0.0018 (0.0003 to 0.0033) and a net reclassification improvement of 0.42 (-0.63 to 1.48) for the categories of predicted 10-year CVD risk. The improvement provided by HbA1c assessment in prediction of CVD risk was equal to or better than estimated improvements for measurement of fasting, random, or postload plasma glucose levels. In a study of individuals without known CVD or diabetes, additional assessment of HbA1c values in the context of CVD risk assessment provided little incremental benefit for prediction of CVD risk.

Prediction of Cardiovascular Disease by the Framingham-REGICOR Equation in the High-Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata.

PubMed

Amor, Antonio J; Serra-Mir, Mercè; Martínez-González, Miguel A; Corella, Dolores; Salas-Salvadó, Jordi; Fitó, Montserrat; Estruch, Ramón; Serra-Majem, Lluis; Arós, Fernando; Babio, Nancy; Ros, Emilio; Ortega, Emilio

2017-03-13

The usefulness of cardiovascular disease (CVD) predictive equations in different populations is debatable. We assessed the efficacy of the Framingham-REGICOR scale, validated for the Spanish population, to identify future CVD in participants, who were predefined as being at high-risk in the PREvención con DIeta MEDiterránea (PREDIMED) study-a nutrition-intervention primary prevention trial-and the impact of adherence to the Mediterranean diet on CVD across risk categories. In a post hoc analysis, we assessed the CVD predictive value of baseline estimated risk in 5966 PREDIMED participants (aged 55-74 years, 57% women; 48% with type 2 diabetes mellitus). Major CVD events, the primary PREDIMED end point, were an aggregate of myocardial infarction, stroke, and cardiovascular death. Multivariate-adjusted Cox regression was used to calculate hazard ratios for major CVD events and effect modification from the Mediterranean diet intervention across risk strata (low, moderate, high, very high). The Framingham-REGICOR classification of PREDIMED participants was 25.1% low risk, 44.5% moderate risk, and 30.4% high or very high risk. During 6-year follow-up, 188 major CVD events occurred. Hazard ratios for major CVD events increased in parallel with estimated risk (2.68, 4.24, and 6.60 for moderate, high, and very high risk), particularly in men (7.60, 13.16, and 15.85, respectively, versus 2.16, 2.28, and 3.51, respectively, in women). Yet among those with low or moderate risk, 32.2% and 74.3% of major CVD events occurred in men and women, respectively. Mediterranean diet adherence was associated with CVD risk reduction regardless of risk strata ( P >0.4 for interaction). Incident CVD increased in parallel with estimated risk in the PREDIMED cohort, but most events occurred in non-high-risk categories, particularly in women. Until predictive tools are improved, promotion of the Mediterranean diet might be useful to reduce CVD independent of baseline risk. URL: http://www.Controlled-trials.com. Unique identifier: ISRCTN35739639. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Ultrahigh-Gain Photodetectors Based on Atomically Thin Graphene-MoS2 Heterostructures

PubMed Central

Zhang, Wenjing; Chuu, Chih-Piao; Huang, Jing-Kai; Chen, Chang-Hsiao; Tsai, Meng-Lin; Chang, Yung-Huang; Liang, Chi-Te; Chen, Yu-Ze; Chueh, Yu-Lun; He, Jr-Hau; Chou, Mei-Yin; Li, Lain-Jong

2014-01-01

Due to its high carrier mobility, broadband absorption, and fast response time, the semi-metallic graphene is attractive for optoelectronics. Another two-dimensional semiconducting material molybdenum disulfide (MoS2) is also known as light- sensitive. Here we show that a large-area and continuous MoS2 monolayer is achievable using a CVD method and graphene is transferable onto MoS2. We demonstrate that a photodetector based on the graphene/MoS2 heterostructure is able to provide a high photogain greater than 108. Our experiments show that the electron-hole pairs are produced in the MoS2 layer after light absorption and subsequently separated across the layers. Contradictory to the expectation based on the conventional built-in electric field model for metal-semiconductor contacts, photoelectrons are injected into the graphene layer rather than trapped in MoS2 due to the presence of a perpendicular effective electric field caused by the combination of the built-in electric field, the applied electrostatic field, and charged impurities or adsorbates, resulting in a tuneable photoresponsivity. PMID:24451916

A generic approach for vertical integration of nanowires.

PubMed

Latu-Romain, E; Gilet, P; Noel, P; Garcia, J; Ferret, P; Rosina, M; Feuillet, G; Lévy, F; Chelnokov, A

2008-08-27

We report on the collective integration technology of vertically aligned nanowires (NWs). Si and ZnO NWs have been used in order to develop a generic technological process. Both mineral and organic planarizations of the as-grown nanowires have been achieved. Chemical vapour deposition (CVD) oxides, spin on glass (SOG), and polymer have been investigated as filling materials. Polishing and/or etching of the composite structures have been set up so as to obtain a suitable morphology for the top and bottom electrical contacts. Electrical and optical characterizations of the integrated NWs have been performed. Contacts ohmicity has been demonstrated and specific contact resistances have been reported. The photoconducting properties of polymer-integrated ZnO NWs have also been investigated in the UV-visible range through collective electrical contacts. A small increase of the resistivity in the ZnO NWs under sub-bandgap illumination has been observed and discussed. A comparison of the photoluminescence (PL) spectra at 300 K of the as-grown and SOG-integrated ZnO nanowires has shown no significant impact of the integration process on the crystal quality of the NWs.

Current role of neprilysin inhibitors in hypertension and heart failure.

PubMed

von Lueder, Thomas G; Atar, Dan; Krum, Henry

2014-10-01

Cardiovascular diseases (CVD) continue to represent the major cause of death, morbidity and healthcare expenditure worldwide. Current medical therapy fails to effectively halt disease progression and to reduce adverse clinical outcomes, reflecting incomplete understanding of pathomechanisms as well as the need to expand current pharmacotherapeutic strategies. Hypertension and heart failure, the most important CVD entities, are associated with imbalance in neurohormonal systems activity such as the renin-angiotensin-aldosterone system (RAAS), the sympathetic nervous system and the endothelin system. Blockade of the RAAS constitutes the most successful pharmacotherapeutic concept in hypertension and heart failure to date. The RAAS-opposing natriuretic peptide system constitutes the body's own BP-lowering system, and mediates a multitude of beneficial actions within cardiovascular tissues. The metallopeptidase neprilysin (NEP) hydrolyzes natriuretic peptides. Conceptually, NEP inhibition would increase salutary natriuretic peptide actions in CVD. However, stand-alone NEP inhibitors (NEPi) lacked efficacy beyond standard pharmacotherapy. Combined blockers of NEP and the endothelin system demonstrated efficacy in preclinical studies but have not been evaluated in clinical trials. A decade ago, omapatrilat and other dual-acting NEPi-ACEi (vasopeptidase-inhibitors) were promising agents for hypertension and heart failure. Despite greater efficacy, development of vasopeptidase-inhibitors was halted due to significant off-target effects in some cohorts, most notably increased frequency of angioedema in hypertensive subjects. Novel angiotensin-receptor-neprilysin-inhibitors (ARNi) seek to fully exploit clinical efficacy of combined RAAS-blockade and NEPi-mediated natriuretic peptide augmentation, and hopefully do so with improved clinical safety. We herein review current knowledge of NEPi as stand-alone and combined pharmacotherapeutic agents in hypertension and heart failure. Copyright © 2014. Published by Elsevier Inc.

Elevated lipoprotein(a) levels predict cardiovascular disease in type 2 diabetes mellitus: a 10-year prospective cohort study.

PubMed

Lim, Tae-Seok; Yun, Jae-Seung; Cha, Seon-Ah; Song, Ki-Ho; Yoo, Ki-Dong; Ahn, Yu-Bae; Park, Yong-Moon; Ko, Seung-Hyun

2016-11-01

Elevated lipoprotein(a) (Lp[a]) level is known to be a risk factor for cardiovascular disease (CVD). However, the data that has been reported on the association between the Lp(a) level and CVD in type 2 diabetes has been limited and incoherent. The aim of this study was to investigate the relationship between the Lp(a) concentration and new onset CVD in type 2 diabetes. From March 2003 to December 2004, patients with type 2 diabetes without a prior history of CVD were consecutively enrolled. CVD was defined as the occurrence of coronary artery disease or ischemic stroke. Cox proportional hazards models were used to identify the associations between the Lp(a) and CVD after adjusting for confounding variables. Of the 1,183 patients who were enrolled, 833 participants were evaluated with a median follow-up time of 11.1 years. A total of 202 participants were diagnosed with CVD (24.2%). The median Lp(a) level for 1st and 4th quartile group was 5.4 (3.5 to 7.1) and 55.7 mg/dL (43.1 to 75.3). Compared with patients without CVD, those with CVD were older, had a longer duration of diabetes and hypertension, and used more insulin and angiotensin converting enzyme inhibitors/angiotensin receptor blockers at baseline. A Cox hazard regression analysis revealed that the development of CVD was significantly associated with serum Lp(a) level (hazard ratio, 1.92; 95% confidence interval [CI], 1.26 to 2.92; p < 0.001, comparing the 4th vs. 1st quartile of Lp[a]). Elevated Lp(a) level was an independent predictable risk factor for CVD in type 2 diabetes. Other cardiovascular risk factors should be treated more intensively in type 2 diabetic patients with high Lp(a) levels.

Anthropometric measurements of general and central obesity and the prediction of cardiovascular disease risk in women: a cross-sectional study

PubMed Central

Goh, Louise G H; Dhaliwal, Satvinder S; Welborn, Timothy A; Lee, Andy H; Della, Phillip R

2014-01-01

Objectives It is important to ascertain which anthropometric measurements of obesity, general or central, are better predictors of cardiovascular disease (CVD) risk in women. 10-year CVD risk was calculated from the Framingham risk score model, SCORE risk chart for high-risk regions, general CVD and simplified general CVD risk score models. Increase in CVD risk associated with 1 SD increment in each anthropometric measurement above the mean was calculated, and the diagnostic utility of obesity measures in identifying participants with increased likelihood of being above the treatment threshold was assessed. Design Cross-sectional data from the National Heart Foundation Risk Factor Prevalence Study. Setting Population-based survey in Australia. Participants 4487 women aged 20–69 years without heart disease, diabetes or stroke. Outcome measures Anthropometric obesity measures that demonstrated the greatest increase in CVD risk as a result of incremental change, 1 SD above the mean, and obesity measures that had the greatest diagnostic utility in identifying participants above the respective treatment thresholds of various risk score models. Results Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio had larger effects on increased CVD risk compared with body mass index (BMI). These central obesity measures also had higher sensitivity and specificity in identifying women above and below the 20% treatment threshold than BMI. Central obesity measures also recorded better correlations with CVD risk compared with general obesity measures. WC and WHR were found to be significant and independent predictors of CVD risk, as indicated by the high area under the receiver operating characteristic curves (>0.76), after controlling for BMI in the simplified general CVD risk score model. Conclusions Central obesity measures are better predictors of CVD risk compared with general obesity measures in women. It is equally important to maintain a healthy weight and to prevent central obesity concurrently. PMID:24503301

Anthropometric measurements of general and central obesity and the prediction of cardiovascular disease risk in women: a cross-sectional study.

PubMed

Goh, Louise G H; Dhaliwal, Satvinder S; Welborn, Timothy A; Lee, Andy H; Della, Phillip R

2014-02-06

It is important to ascertain which anthropometric measurements of obesity, general or central, are better predictors of cardiovascular disease (CVD) risk in women. 10-year CVD risk was calculated from the Framingham risk score model, SCORE risk chart for high-risk regions, general CVD and simplified general CVD risk score models. Increase in CVD risk associated with 1 SD increment in each anthropometric measurement above the mean was calculated, and the diagnostic utility of obesity measures in identifying participants with increased likelihood of being above the treatment threshold was assessed. Cross-sectional data from the National Heart Foundation Risk Factor Prevalence Study. Population-based survey in Australia. 4487 women aged 20-69 years without heart disease, diabetes or stroke. Anthropometric obesity measures that demonstrated the greatest increase in CVD risk as a result of incremental change, 1 SD above the mean, and obesity measures that had the greatest diagnostic utility in identifying participants above the respective treatment thresholds of various risk score models. Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio had larger effects on increased CVD risk compared with body mass index (BMI). These central obesity measures also had higher sensitivity and specificity in identifying women above and below the 20% treatment threshold than BMI. Central obesity measures also recorded better correlations with CVD risk compared with general obesity measures. WC and WHR were found to be significant and independent predictors of CVD risk, as indicated by the high area under the receiver operating characteristic curves (>0.76), after controlling for BMI in the simplified general CVD risk score model. Central obesity measures are better predictors of CVD risk compared with general obesity measures in women. It is equally important to maintain a healthy weight and to prevent central obesity concurrently.

Changes in erectile dysfunction over time in relation to Framingham cardiovascular risk in the Boston Area Community Health (BACH) Survey.

PubMed

Fang, Shona C; Rosen, Raymond C; Vita, Joseph A; Ganz, Peter; Kupelian, Varant

2015-01-01

Erectile dysfunction (ED) is associated with cardiovascular disease (CVD); however, the association between change in ED status over time and future underlying CVD risk is unclear. The aim of this study was to investigate the association between change in ED status and Framingham CVD risk, as well change in Framingham risk. We studied 965 men free of CVD in the Boston Area Community Health (BACH) Survey, a longitudinal cohort study with three assessments. ED was assessed with the five-item International Index of Erectile Function at BACH I (2002-2005) and BACH II (2007-2010) and classified as no ED/transient ED/persistent ED. CVD risk was assessed with 10-year Framingham CVD risk algorithm at BACH I and BACH III (2010-2012). Linear regression models controlled for baseline age, socio-demographic and lifestyle factors, as well as baseline Framingham risk. Models were also stratified by age (≥/< 50 years). Framingham CVD risk and change in Framingham CVD risk were the main outcome measures. Transient and persistent ED was significantly associated with increased Framingham risk and change in risk over time in univariate and age-adjusted models. In younger men, persistent ED was associated with a Framingham risk that was 1.58 percentage points higher (95% confidence interval [CI]: 0.11, 3.06) and in older men, a Framingham risk that was 2.54 percentage points higher (95% CI: -1.5, 6.59), compared with those without ED. Change in Framingham risk over time was also associated with transient and persistent ED in men <50 years, but not in older men. Data suggest that even after taking into account other CVD risk factors, transient and persistent ED is associated with Framingham CVD risk and a greater increase in Framingham risk over time, particularly in younger men. Findings further support clinical assessment of CVD risk in men presenting with ED, especially those under 50 years. © 2014 International Society for Sexual Medicine.

Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association.

PubMed

Sacks, Frank M; Lichtenstein, Alice H; Wu, Jason H Y; Appel, Lawrence J; Creager, Mark A; Kris-Etherton, Penny M; Miller, Michael; Rimm, Eric B; Rudel, Lawrence L; Robinson, Jennifer G; Stone, Neil J; Van Horn, Linda V

2017-07-18

Cardiovascular disease (CVD) is the leading global cause of death, accounting for 17.3 million deaths per year. Preventive treatment that reduces CVD by even a small percentage can substantially reduce, nationally and globally, the number of people who develop CVD and the costs of caring for them. This American Heart Association presidential advisory on dietary fats and CVD reviews and discusses the scientific evidence, including the most recent studies, on the effects of dietary saturated fat intake and its replacement by other types of fats and carbohydrates on CVD. In summary, randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced CVD by ≈30%, similar to the reduction achieved by statin treatment. Prospective observational studies in many populations showed that lower intake of saturated fat coupled with higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of CVD and of other major causes of death and all-cause mortality. In contrast, replacement of saturated fat with mostly refined carbohydrates and sugars is not associated with lower rates of CVD and did not reduce CVD in clinical trials. Replacement of saturated with unsaturated fats lowers low-density lipoprotein cholesterol, a cause of atherosclerosis, linking biological evidence with incidence of CVD in populations and in clinical trials. Taking into consideration the totality of the scientific evidence, satisfying rigorous criteria for causality, we conclude strongly that lowering intake of saturated fat and replacing it with unsaturated fats, especially polyunsaturated fats, will lower the incidence of CVD. This recommended shift from saturated to unsaturated fats should occur simultaneously in an overall healthful dietary pattern such as DASH (Dietary Approaches to Stop Hypertension) or the Mediterranean diet as emphasized by the 2013 American Heart Association/American College of Cardiology lifestyle guidelines and the 2015 to 2020 Dietary Guidelines for Americans. © 2017 American Heart Association, Inc.

Left Ventricular Structure and Risk of Cardiovascular Events: A Framingham Heart Study Cardiac Magnetic Resonance Study.

PubMed

Tsao, Connie W; Gona, Philimon N; Salton, Carol J; Chuang, Michael L; Levy, Daniel; Manning, Warren J; O'Donnell, Christopher J

2015-09-15

Elevated left ventricular mass index (LVMI) and concentric left ventricular (LV) remodeling are related to adverse cardiovascular disease (CVD) events. The predictive utility of LV concentric remodeling and LV mass in the prediction of CVD events is not well characterized. Framingham Heart Study Offspring Cohort members without prevalent CVD (n=1715, 50% men, aged 65±9 years) underwent cardiovascular magnetic resonance for LVMI and geometry (2002-2006) and were prospectively followed for incident CVD (myocardial infarction, coronary insufficiency, heart failure, stroke) or CVD death. Over 13 808 person-years of follow-up (median 8.4, range 0.0 to 10.5 years), 85 CVD events occurred. In multivariable-adjusted proportional hazards regression models, each 10-g/m(2) increment in LVMI and each 0.1 unit in relative wall thickness was associated with 33% and 59% increased risk for CVD, respectively (P=0.004 and P=0.009, respectively). The association between LV mass/LV end-diastolic volume and incident CVD was borderline significant (P=0.053). Multivariable-adjusted risk reclassification models showed a modest improvement in CVD risk prediction with the incorporation of cardiovascular magnetic resonance LVMI and measures of LV concentricity (C-statistic 0.71 [95% CI 0.65 to 0.78] for the model with traditional risk factors only, improved to 0.74 [95% CI 0.68 to 0.80] for the risk factor model additionally including LVMI and relative wall thickness). Among adults free of prevalent CVD in the community, greater LVMI and LV concentric hypertrophy are associated with a marked increase in adverse incident CVD events. The potential benefit of aggressive primary prevention to modify LV mass and geometry in these adults requires further investigation. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

NEXAFS Study of the Annealing Effect on the Local Structure of FIB-CVD DLC

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saikubo, Akihiko; Kato, Yuri; Igaki, Jun-ya

2007-01-19

Annealing effect on the local structure of diamond like carbon (DLC) formed by focused ion beam-chemical vapor deposition (FIB-CVD) was investigated by the measurement of near edge x-ray absorption fine structure (NEXAFS) and energy dispersive x-ray (EDX) spectra. Carbon K edge absorption NEXAFS spectrum of FIB-CVD DLC was measured in the energy range of 275-320 eV. In order to obtain the information on the location of the gallium in the depth direction, incidence angle dependence of NEXAFS spectrum was measured in the incident angle range from 0 deg. to 60 deg. . The peak intensity corresponding to the resonance transitionmore » of 1s{yields}{sigma}* originating from carbon-gallium increased from the FIB-CVD DLC annealed at 200 deg. C to the FIB-CVD DLC annealed at 400 deg. C and decreased from that at 400 deg. C to that at 600 deg. C. Especially, the intensity of this peak remarkably enhanced in the NEXAFS spectrum of the FIB-CVD DLC annealed at 400 deg. C at the incident angle of 60 deg. . On the contrary, the peak intensity corresponding to the resonance transition of 1s{yields}{pi}* originating from carbon double bonding of emission spectrum decreased from the FIB-CVD DLC annealed at 200 deg. C to that at 400 deg. C and increased from that at 400 deg. C to that at 600 deg. C. Gallium concentration in the FIB-CVD DLC decreased from {approx_equal}2.2% of the as-deposited FIB-CVD DLC to {approx_equal}1.5% of the FIB-CVD DLC annealed at 600 deg. C from the elementary analysis using EDX. Both experimental results indicated that gallium atom departed from FIB-CVD DLC by annealing at the temperature of 600 deg. C.« less

Trauma Exposure and Posttraumatic Stress Disorder Symptoms Predict Onset of Cardiovascular Events in Women

PubMed Central

Sumner, Jennifer A.; Kubzansky, Laura D.; Elkind, Mitchell S. V.; Roberts, Andrea L.; Agnew-Blais, Jessica; Chen, Qixuan; Cerdá, Magdalena; Rexrode, Kathryn M.; Rich-Edwards, Janet W.; Spiegelman, Donna; Suglia, Shakira F.; Rimm, Eric B.; Koenen, Karestan C.

2015-01-01

Background Psychological stress is a proposed risk factor for cardiovascular disease (CVD), and posttraumatic stress disorder (PTSD), the sentinel stress-related mental disorder, occurs twice as frequently in women as men. However, whether PTSD contributes to CVD risk in women is not established. Methods and Results We examined trauma exposure and PTSD symptoms in relation to incident CVD over a 20-year period in 49,978 women in the Nurses’ Health Study II. Proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD events confirmed by additional information or medical record review [n=548, including myocardial infarction (n=277) and stroke (n=271)]. Trauma exposure and PTSD symptoms were assessed using the Brief Trauma Questionnaire and a PTSD screen. Compared to no trauma exposure, endorsing 4 or more PTSD symptoms was associated with increased CVD risk after adjusting for age, family history, and childhood factors (HR=1.60 [95% CI, 1.20–2.13]). Being trauma-exposed and endorsing no PTSD symptoms was associated with elevated CVD risk (HR=1.45 [95% CI, 1.15–1.83]), although being trauma-exposed and endorsing 1–3 PTSD symptoms was not. After adjusting for adult health behaviors and medical risk factors, this pattern of findings was maintained. Health behaviors and medical risk factors accounted for 14% of the trauma/no symptoms-CVD association and 47% of the trauma/4+ symptoms-CVD association. Conclusion Trauma exposure and elevated PTSD symptoms may increase risk of CVD in this population of women. These findings suggest screening for CVD risk and reducing health risk behaviors in trauma-exposed women may be promising avenues for prevention and intervention. PMID:26124186

Association of central blood pressure and cardiovascular diseases in diabetic patients with hypertension.

PubMed

Yang, Lei; Qin, Bo; Zhang, Xiaojuan; Chen, Yanrong; Hou, Jian

2017-10-01

To evaluate association of central blood pressure (BP) and cardiovascular disease (CVD) in diabetic patients with hypertension.This was a cross-section study and 360 participants were enrolled. Baseline characteristics were collected and indices of central BP including central systolic/diastolic BP (SBP/DBP), augmentation index adjusted for 75 beats per minute of heart rate (AIx@75) were measured. Participants were separated into with and without CVD groups and between-group differences were assessed. Linear regression analysis was used to evaluate potential risk factors for increased AIx@75. Logistic regression analysis was used to evaluate association between central SBP and AIx@75 with CVD.Mean age was 50.6 years and male participants accounted for 57.8%. Thirty-five and 43 participants had coronary heart disease and ischemic stroke. Compared with participants without CVD, those with CVD were more likely to be male and smokers and had higher glycated hemoglobin level. Additionally, participants with CVD had significantly higher central SBP and AIx@75 compared with those without CVD. Ageing, male gender, and presence of coronary heart disease and ischemic stroke were associated with increased AIx@75, whereas renin-angiotensin-axis inhibitor was associated with reduced AIx@75. After adjusted for traditional risk factors including brachial SBP, both central SBP, and AIx@75 remained significantly associated with CVD, with odds ratio and 95% confidence interval of 1.09 (1.08-1.31) and 1.20 (1.15-1.42), respectively.Diabetic patients with hypertension, ageing, male gender, and presence of CVD are independent risk factors of central BP increase; and increased central SBP and AIx@75 are significantly associated with CVD.

Risk of Cardiovascular and All-Cause Mortality: Impact of Impaired Health-Related Functioning and Diabetes

PubMed Central

Williams, Emily D.; Rawal, Lal; Oldenburg, Brian F.; Renwick, Carla; Shaw, Jonathan E.; Tapp, Robyn J.

2012-01-01

OBJECTIVE There is an established link between health-related functioning (HRF) and cardiovascular disease (CVD) mortality, and it is known that those with diabetes predominantly die of CVD. However, few studies have determined the combined impact of diabetes and impaired HRF on CVD mortality. We investigated whether this combination carries a higher CVD risk than either component alone. RESEARCH DESIGN AND METHODS The Australian Diabetes, Obesity and Lifestyle (AusDiab) study included 11,247 adults aged ≥25 years from 42 randomly selected areas of Australia. At baseline (1999–2000), diabetes status was defined using the World Health Organization criteria and HRF was assessed using the SF-36 questionnaire. RESULTS Overall, after 7.4 years of follow-up, 57 persons with diabetes and 105 without diabetes had died from CVD. In individuals with and without diabetes, HRF measures were significant predictors of increased CVD mortality. The CVD mortality risks among those with diabetes or impaired physical health component summary (PCS) alone were similar (diabetes only: hazard ratio 1.4 [95% CI 0.7–2.7]; impaired PCS alone: 1.5 [1.0–2.4]), while those with both diabetes and impaired PCS had a much higher CVD mortality (2.8 [1.6–4.7]) compared with those without diabetes and normal PCS (after adjustment for multiple covariates). Similar results were found for the mental health component summary. CONCLUSIONS This study demonstrates that the combination of diabetes and impaired HRF is associated with substantially higher CVD mortality. This suggests that, among those with diabetes, impaired HRF is likely to be important in the identification of individuals at increased risk of CVD mortality. PMID:22446177

Communicating cardiovascular disease risk: an interview study of General Practitioners' use of absolute risk within tailored communication strategies.

PubMed

Bonner, Carissa; Jansen, Jesse; McKinn, Shannon; Irwig, Les; Doust, Jenny; Glasziou, Paul; McCaffery, Kirsten

2014-05-29

Cardiovascular disease (CVD) prevention guidelines encourage assessment of absolute CVD risk - the probability of a CVD event within a fixed time period, based on the most predictive risk factors. However, few General Practitioners (GPs) use absolute CVD risk consistently, and communication difficulties have been identified as a barrier to changing practice. This study aimed to explore GPs' descriptions of their CVD risk communication strategies, including the role of absolute risk. Semi-structured interviews were conducted with a purposive sample of 25 GPs in New South Wales, Australia. Transcribed audio-recordings were thematically coded, using the Framework Analysis method to ensure rigour. GPs used absolute CVD risk within three different communication strategies: 'positive', 'scare tactic', and 'indirect'. A 'positive' strategy, which aimed to reassure and motivate, was used for patients with low risk, determination to change lifestyle, and some concern about CVD risk. Absolute risk was used to show how they could reduce risk. A 'scare tactic' strategy was used for patients with high risk, lack of motivation, and a dismissive attitude. Absolute risk was used to 'scare' them into taking action. An 'indirect' strategy, where CVD risk was not the main focus, was used for patients with low risk but some lifestyle risk factors, high anxiety, high resistance to change, or difficulty understanding probabilities. Non-quantitative absolute risk formats were found to be helpful in these situations. This study demonstrated how GPs use three different communication strategies to address the issue of CVD risk, depending on their perception of patient risk, motivation and anxiety. Absolute risk played a different role within each strategy. Providing GPs with alternative ways of explaining absolute risk, in order to achieve different communication aims, may improve their use of absolute CVD risk assessment in practice.

Evidence for increased cardiovascular events in the fathers but not mothers of women with polycystic ovary syndrome.

PubMed

Taylor, Mary C; Reema Kar, A; Kunselman, Allen R; Stetter, Christy M; Dunaif, Andrea; Legro, Richard S

2011-08-01

Polycystic ovary syndrome (PCOS) is a familial syndrome, associated with multiple cardiovascular disease (CVD) risk factors. Thus, parents of affected women may have a higher prevalence of CVD events than the general population. PCOS probands (n = 410) and their participating parents (n = 180 fathers and 211 mothers) were queried for CVD events in themselves and non-participating family members. In order to include the family CVD history of all parents, agreement between the proband and parental reports of CVD events was assessed. Estimated 10-year coronary heart disease (CHD) risk was calculated using the Framingham risk calculator. The National Health and Nutrition Examination Survey (NHANES) 2001-2002 database was used to generate gender, age and body mass index-relevant population parameters of CVD prevalence in the USA population. Ninety-eight percent of the parents' self-reporting of CVD events agreed with the proband's report of parental heart attack history [Kappa = 0.82; 95% CI: (0.69, 0.94)] and 99% with parental stroke history [Kappa = 0.79; 95% CI: (0.62, 0.97)]. Fathers of women with PCOS had a higher prevalence of heart attack and stroke compared with the reference NHANES population (heart attack: 11.1 versus 5.3%, P < 0.0001; stroke: 3.0 versus 1.0%, P = 0.002). Fathers of women with PCOS had an elevated 10-year risk for CHD (11.5 versus 9.9% in NHANES, P = 0.03). No statistically significant increased prevalence of CVD events or 10-year risk was noted in probands or mothers. Fathers, and not mothers, may be disproportionately burdened with CVD in PCOS families. The strengths of this study include the size of our cohort, the consistent phenotyping and the validation of proband's reporting of parental CVD events.

Common genetic variants and subclinical atherosclerosis: The Multi-Ethnic Study of Atherosclerosis (MESA).

PubMed

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.

Total antioxidant capacity of diet and risk of stroke: a population-based prospective cohort of women.

PubMed

Rautiainen, Susanne; Larsson, Susanna; Virtamo, Jarmo; Wolk, Alicja

2012-02-01

Consumption of antioxidant-rich foods may reduce the risk of stroke by inhibition of oxidative stress and inflammation. Total antioxidant capacity (TAC) takes into account all antioxidants and the synergistic effects between them. We examined the association between dietary TAC and stroke incidence in cardiovascular disease (CVD)-free women and in women with CVD history at baseline. The study included women (31,035 CVD-free and 5680 with CVD history at baseline), aged 49 to 83 years, from the Swedish Mammography Cohort. Diet was assessed with a food frequency questionnaire. Dietary TAC was calculated using oxygen radical absorbance capacity values. Stroke cases were ascertained by linkage with the Swedish Hospital Discharge Registry. During follow-up (September 1997 to December 2009), we identified 1322 stroke cases (988 cerebral infarctions, 226 hemorrhagic strokes, and 108 unspecified strokes) among CVD-free women and 1007 stroke cases (796 cerebral infarctions, 100 hemorrhagic strokes, and 111 unspecified strokes) among women with a CVD history. The multivariable hazard ratio of total stroke comparing the highest with the lowest quintile of dietary TAC was 0.83 (95% CI, 0.70-0.99; P for trend=0.04) in CVD-free women. Among women with a CVD history, the hazard ratios for the highest versus lowest quartile of TAC were 0.90 (95% CI, 0.75-1.07; P for trend=0.30) for total stroke and 0.55 (95% CI, 0.32-0.95; P for trend=0.03) for hemorrhagic stroke. These findings suggest that dietary TAC is inversely associated with total stroke among CVD-free women and hemorrhagic stroke among women with CVD history.

The multi-faceted outcomes of conjunct diabetes and cardiovascular familial history in type 2 diabetes.

PubMed

Hermans, Michel P; Ahn, Sylvie A; Rousseau, Michel F

2012-01-01

Familial history of early-onset CHD (EOCHD) is a major risk factor for CHD. Familial diabetes history (FDH) impacts β-cell function. Some transmissible, accretional gradient of CHD risk may exist when diabetes and EOCHD familial histories combine. We investigated whether the impact of such combination is neutral, additive, or potentiating in T2DM descendants, as regards cardiometabolic phenotype, glucose homeostasis and micro-/macroangiopathies. Cross-sectional retrospective cohort study of 796 T2DM divided according to presence (Diab[+]) or absence (Diab[-]) of 1st-degree diabetes familial history and/or EOCHD (CVD(+) and (-)). Four subgroups: (i) [Diab(-)CVD(-)] (n=355); (ii) [Diab(+)CVD(-)] (n=338); (iii) [Diab(-)CVD(+)] (n=47); and (iv) [Diab(+)CVD(+)] (n=56). No interaction on subgroup distribution between presence of both familial histories, the combination of which translated into additive detrimental outcomes and higher rates of fat mass, sarcopenia, (hs)CRP and retinopathy. FDH(+) had lower insulinemia, insulin secretion, hyperbolic product, and accelerated hyperbolic product loss. An EOCHD family history affected neither insulin secretion nor sensitivity. There were significant differences regarding macroangiopathy/CAD, more prevalent in [Diab(-)CVD(+)] and [Diab(+)CVD(+)]. Among CVD(+), the highest macroangiopathy prevalence was observed in [Diab(-)CVD(+)], who had 66% macroangiopathy, and 57% CAD, rates higher (absolute-relative) by 23%-53% (overall) and 21%-58% (CAD) than [Diab(+)CVD(+)], who inherited the direst cardiometabolic familial history (p 0.0288 and 0.0310). A parental history for diabetes markedly affects residual insulin secretion and secretory loss rate in T2DM offspring without worsening insulin resistance. It paradoxically translated into lower macroangiopathy with concurrent familial EOCHD. Conjunct diabetes and CV familial histories generate multi-faceted vascular outcomes in offspring, including lesser macroangiopathy/CAD. Copyright © 2012 Elsevier Inc. All rights reserved.

Comorbid depression and anxiety symptoms as predictors of cardiovascular events: results from the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE) study.

PubMed

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.

The efficiency of cardiovascular risk assessment: do the right patients get statin treatment?

PubMed Central

van Staa, Tjeerd-Pieter; Smeeth, Liam; Ng, Edmond S-W; Goldacre, Ben; Gulliford, Martin

2013-01-01

Objective To evaluate targeting of statin prescribing for primary prevention to those with high cardiovascular disease (CVD) risk. Design Two cohort studies including the general population and initiators of statins aged 35–74 years. Setting UK primary care records in the Clinical Practice Research Datalink. Patients 3.8 million general population patients and 300 914 statin users. Intervention Statin prescribing. Main outcome measures Statin prescribing by CVD risk; observed 5-year CVD risks; variability between practices. Results Statin prescribing increased substantially over time to patients with high 10-year CVD risk (≥20%): 7.0% of these received a statin prior to 2007, and 30.4% in 2007 onwards. Prescribing to patients with low risk (<15%) also increased (from 1.9% to 5.0%). Only about half the patients initiating statin treatment were high risk according to CVD risk score. The 5-year CVD risks, as observed during statin treatment, reduced over calendar time (from 17.0% to 7.1%). There was a large variation between general practices in the percentage of high-risk patients prescribed a statin in 2007 onwards, ranging from 8.2% to 61.5%. For low-risk patients, these varied from 2.1% to 29.1%. Conclusions There appeared to be substantive overuse in low CVD risk and underuse in high CVD risk (600 000 and 850 000 patients, respectively, in the UK since 2007). There is wide variation between practices in statin prescribing to patients at high CVD risk. There is a clear need for randomised trials for the best strategy to target statin treatment and manage CVD risk for primary prevention. PMID:23735939

Development of Micro and Nano Crystalline CVD Diamond TL/OSL Radiation Detectors for Clinical Applications

NASA Astrophysics Data System (ADS)

Barboza-Flores, Marcelino

2015-03-01

Modern radiotherapy methods requires the use of high photon radiation doses delivered in a fraction to small volumes of cancer tumors. An accurate dose assessment for highly energetic small x-ray beams in small areas, as in stereotactic radiotherapy, is necessary to avoid damage to healthy tissue surrounding the tumor. Recent advances on the controlled synthesis of CVD diamond have demonstrated the possibility of using high quality micro and nano crystalline CVD as an efficient detector and dosimeter suitable for high energy photons and energetic particle beams. CVD diamond is a very attractive material for applications in ionizing radiation dosimetry, particularly in the biomedical field since the radiation absorption by a CVD diamond is very close to that of soft tissue. Furthermore, diamond is stable, non-toxic and radiation hard. In the present work we discuss the CVD diamond properties and dosimeter performance and discuss its relevance and advantages of various dosimetry methods, including thermally stimulated luminescence (TL) as well as optically stimulated luminescence (OSL). The recent CVD improved method of growth allows introducing precisely controlled impurities into diamond to provide it with high dosimetry sensitivity. For clinical dosimetry applications, high accuracy of dose measurements, low fading, high sensitivity, good reproducibility and linear dose response characteristics are very important parameters which all are found in CVD diamonds specimens. In some cases, dose linearity and reproducibility in CVD diamond have been found to be higher than standard commercial TLD materials like LiF. In the present work, we discuss the state-of-the art developments in dosimetry applications using CVD diamond. The financial support from Conacyt (Mexico) is greatly acknowledged

Mapping eQTLs in the Norfolk Island Genetic Isolate Identifies Candidate Genes for CVD Risk Traits

PubMed Central

Benton, Miles C.; Lea, Rod A.; Macartney-Coxson, Donia; Carless, Melanie A.; Göring, Harald H.; Bellis, Claire; Hanna, Michelle; Eccles, David; Chambers, Geoffrey K.; Curran, Joanne E.; Harper, Jacquie L.; Blangero, John; Griffiths, Lyn R.

2013-01-01

Cardiovascular disease (CVD) affects millions of people worldwide and is influenced by numerous factors, including lifestyle and genetics. Expression quantitative trait loci (eQTLs) influence gene expression and are good candidates for CVD risk. Founder-effect pedigrees can provide additional power to map genes associated with disease risk. Therefore, we identified eQTLs in the genetic isolate of Norfolk Island (NI) and tested for associations between these and CVD risk factors. We measured genome-wide transcript levels of blood lymphocytes in 330 individuals and used pedigree-based heritability analysis to identify heritable transcripts. eQTLs were identified by genome-wide association testing of these transcripts. Testing for association between CVD risk factors (i.e., blood lipids, blood pressure, and body fat indices) and eQTLs revealed 1,712 heritable transcripts (p < 0.05) with heritability values ranging from 0.18 to 0.84. From these, we identified 200 cis-acting and 70 trans-acting eQTLs (p < 1.84 × 10−7) An eQTL-centric analysis of CVD risk traits revealed multiple associations, including 12 previously associated with CVD-related traits. Trait versus eQTL regression modeling identified four CVD risk candidates (NAAA, PAPSS1, NME1, and PRDX1), all of which have known biological roles in disease. In addition, we implicated several genes previously associated with CVD risk traits, including MTHFR and FN3KRP. We have successfully identified a panel of eQTLs in the NI pedigree and used this to implicate several genes in CVD risk. Future studies are required for further assessing the functional importance of these eQTLs and whether the findings here also relate to outbred populations. PMID:24314549

The association between major depressive disorder in childhood and risk factors for cardiovascular disease in adolescence.

PubMed

Rottenberg, Jonathan; Yaroslavsky, Ilya; Carney, Robert M; Freedland, Kenneth E; George, Charles J; Baji, Ildikó; Dochnal, Roberta; Gádoros, Júlia; Halas, Kitti; Kapornai, Krisztina; Kiss, Eniko; Osváth, Viola; Varga, Hedvig; Vetró, Agnes; Kovacs, Maria

2014-02-01

Depression in adults is associated with risk factors for cardiovascular disease (CVD). It is unclear, however, when the association between clinical depression and cardiac risk factors develops or how early in life this association can be detected. In an ongoing study of pediatric depression, we compared CVD risk factors including smoking, obesity, physical activity level, sedentary behavior, and parental history of CVD across three samples of adolescents: probands with established histories of childhood-onset major depressive disorder (n = 210), never-depressed siblings of probands (n = 195), and controls with no history of any major psychiatric disorder (n = 161). When assessed during adolescence, 85% of the probands were not in a major depressive episode. Nevertheless, at that assessment, probands had a higher prevalence of regular smoking (odds ratio [OR] = 12.54, 95% confidence interval [CI] = 4.36-36.12) and were less physically active than controls (OR = 0.59, CI = 0.43-0.81) and siblings (OR = 0.70, CI = 0.52-0.94) and had a higher rate of obesity than did controls (OR = 3.67, CI = 1.42-9.52). Parents of probands reported high rates of CVD (significantly higher than did parents of controls), including myocardial infarction and CVD-related hospitalization (ORs = 1.62-4.36, CIs = 1.03-15.40). Differences in CVD risk factors between probands and controls were independent of parental CVD. Major depression in childhood is associated with an unfavorable CVD risk profile in adolescence, and risks for pediatric depression and CVD may coincide in families. Effective prevention and treatment of childhood depression may be a means to reduce the incidence of adult CVD.

Trajectories of Metabolic Risk Factors and Biochemical Markers prior to the Onset of Cardiovascular Disease – The Doetinchem Cohort Study

PubMed Central

Hulsegge, Gerben; Spijkerman, Annemieke M. W.; van der Schouw, Yvonne T.; Bakker, Stephan J. L.; Gansevoort, Ron T.; Smit, Henriette A.; Verschuren, W. M. Monique

2016-01-01

Risk factors often develop at young age and are maintained over time, but it is not fully understood how risk factors develop over time preceding cardiovascular disease (CVD). Our objective was to examine how levels and trajectories of metabolic risk factors and biochemical markers prior to diagnosis differ between people with and without CVD over a period of up to 15–20 years. A total of 449 incident non-fatal and fatal CVD cases and 1,347 age- and sex-matched controls were identified in a prospective cohort between 1993 and 2011. Metabolic risk factors and biochemical markers were measured at five-year intervals prior to diagnosis. Trajectories of metabolic risk factors and biochemical markers were analysed using random coefficient analyses. Although not always statistically significant, participants with CVD had slightly more unfavourable levels for most metabolic risk factors and biochemical markers 15–20 years before diagnosis than controls. Subsequent trajectories until diagnosis were similar in participants with incident CVD and controls for body mass index, diastolic blood pressure, total cholesterol, HDL cholesterol, random glucose, triglycerides, gamma glutamyltransferase, C-reactive protein and uric acid. Trajectories were more unfavourable in participants with CVD than controls for systolic blood pressure, waist circumference and estimated glomerular filtration rate (p≤0.05). For example, among participants with CVD, systolic blood pressure increased on average by 9 mmHg over the 18-year period preceding diagnosis, whereas the increase among controls was 4 mmHg. In conclusion, unfavourable levels of metabolic risk factors and biochemical markers are present long before CVD, which indicates that the risk of CVD is already partly determined in young adulthood. This underscores the need for early prevention to reduce the burden of CVD. PMID:27203599

Atherosclerosis profile and incidence of cardiovascular events: a population-based survey.

PubMed

Robinson, Jennifer G; Fox, Kathleen M; Bullano, Michael F; Grandy, Susan

2009-09-15

Atherosclerosis is a chronic progressive disease often presenting as clinical cardiovascular disease (CVD) events. This study evaluated the characteristics of individuals with a diagnosis of atherosclerosis and estimated the incidence of CVD events to assist in the early identification of high-risk individuals. Respondents to the US SHIELD baseline survey were followed for 2 years to observe incident self-reported CVD. Respondents had subclinical atherosclerosis if they reported a diagnosis of narrow or blocked arteries/carotid artery disease without a past clinical CVD event (heart attack, stroke or revascularization). Characteristics of those with atherosclerosis and incident CVD were compared with those who did not report atherosclerosis at baseline but had CVD in the following 2 years using chi-square tests. Logistic regression model identified characteristics associated with atherosclerosis and incident events. Of 17,640 respondents, 488 (2.8%) reported having subclinical atherosclerosis at baseline. Subclinical atherosclerosis was associated with age, male gender, dyslipidemia, circulation problems, hypertension, past smoker, and a cholesterol test in past year (OR = 2.2) [all p < 0.05]. Incident CVD was twice as high in respondents with subclinical atherosclerosis (25.8%) as in those without atherosclerosis or clinical CVD (12.2%). In individuals with subclinical atherosclerosis, men (RR = 1.77, p = 0.050) and individuals with circulation problems (RR = 2.36, p = 0.003) were at greatest risk of experiencing CVD events in the next 2 years. Self-report of subclinical atherosclerosis identified an extremely high-risk group with a >25% risk of a CVD event in the next 2 years. These characteristics may be useful for identifying individuals for more aggressive diagnostic and therapeutic efforts.

Wrist circumference as a novel predictor of hypertension and cardiovascular disease: results of a decade follow up in a West Asian cohort.

PubMed

Mohebi, Reza; Mohebi, Ahmad; Sheikholeslami, Farhad; Azizi, Fereidoun; Hadaegh, Farzad

2014-11-01

No study has yet evaluated the effect of wrist circumference on risk of incident hypertension and cardiovascular disease (CVD) in an adult population. The present study included 3642 women, aged ≥30 years, free of CVD at baseline, who had undergone health examinations between January 1999 and 2001 and were followed up until March 2010. Cox proportional hazard regression was performed to assess the hazard ratios (HRs) of wrist circumference for CVD and hypertension events. During 10 years of follow-up, 284 cases of first CVD and 615 cases of incident hypertension occurred. In a model adjusted for conventional CVD risk factors, the HR of 1 cm increase in wrist circumference was 1.15 (1.06-1.25) for hypertension and was marginally significant for CVD (HR, 1.12 [1.00-1.25]; P-value 0.052). After considering body mass index and waist circumference in the model, we found significant interaction between waist circumference and wrist circumference in risk prediction of hypertension and CVD (P < .001). In non-centrally obese women (waist circumference <95 cm), in multivariable model plus body mass index and waist circumference, increase in wrist circumference was independently associated with both hypertension (HR, 1.17 [1.02-1.35]) and CVD (HR, 1.29 [1.03-1.61]). However, among centrally obese women (waist circumference ≥95 cm), wrist circumference increase could not predict either hypertension (HR, 0.97 [0.84-1.18]) or CVD events (HR, 0.90 [0.75-1.07]). Wrist circumference as a novel anthropometric measure was an independent predictor for incident hypertension and CVD events among non-centrally obese women. Copyright © 2014 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Aortic Arch Pulse Wave Velocity Assessed by Magnetic Resonance Imaging as a Predictor of Incident Cardiovascular Events: The MESA (Multi-Ethnic Study of Atherosclerosis).

PubMed

Ohyama, Yoshiaki; Ambale-Venkatesh, Bharath; Noda, Chikara; Kim, Jang-Young; Tanami, Yutaka; Teixido-Tura, Gisela; Chugh, Atul R; Redheuil, Alban; Liu, Chia-Ying; Wu, Colin O; Hundley, W Gregory; Bluemke, David A; Guallar, Eliseo; Lima, Joao A C

2017-09-01

The predictive value of aortic arch pulse wave velocity (PWV) assessed by magnetic resonance imaging for cardiovascular disease (CVD) events has not been fully established. The aim of the present study was to evaluate the association of arch PWV with incident CVD events in MESA (Multi-Ethnic Study of Atherosclerosis). Aortic arch PWV was measured using magnetic resonance imaging at baseline in 3527 MESA participants (mean age, 62±10 years at baseline; 47% men) free of overt CVD. Cox regression was used to evaluate the risk of incident CVD (coronary heart disease, stroke, transient ischemic attack, or heart failure) in relation to arch PWV adjusted for age, sex, race, and CVD risk factors. The median value of arch PWV was 7.4 m/s (interquartile range, 5.6-10.2). There was significant interaction between arch PWV and age for outcomes, so analysis was stratified by age categories (45-54 and >54 years). There were 456 CVD events during the 10-year follow-up. Forty-five to 54-year-old participants had significant association of arch PWV with incident CVD independent of CVD risk factors (hazard ratio, 1.44; 95% confidence interval, 1.07-1.95; P =0.018; per 1-SD increase for logarithmically transformed PWV), whereas >54-year group did not ( P =0.93). Aortic arch PWV assessed by magnetic resonance imaging is a significant predictor of CVD events among middle-aged (45-54 years old) individuals, whereas arch PWV is not associated with CVD among an elderly in a large multiethnic population. © 2017 American Heart Association, Inc.

The Association between Major Depressive Disorder in Childhood and Risk Factors for Cardiovascular Disease in Adolescence

PubMed Central

Rottenberg, Jonathan; Yaroslavsky, Ilya; Carney, Robert M.; Freedland, Kenneth E.; George, Charles J.; Baji, Ildikó; Dochnal, Roberta; Gádoros, Júlia; Halas, Kitti; Kapornai, Krisztina; Kiss, Enikő; Osváth, Viola; Varga, Hedvig; Vetró, Ágnes; Kovacs, Maria

2014-01-01

Objective Depression in adults is associated with risk factors for cardiovascular disease (CVD). It is unclear, however, when the association between clinical depression and cardiac risk factors develops, or how early in life this association can be detected. Methods In an ongoing study of pediatric depression, we compared CVD risk factors, including smoking, obesity, physical activity level, sedentary behavior, and parental history of CVD, across three samples of adolescents: probands with established histories of childhood-onset major depressive disorder (MDD; N=210), never-depressed siblings of probands (N=195), and controls with no history of any major psychiatric disorder (N=161). Results When assessed during adolescence, 85% of the probands were not in a major depressive episode. Nevertheless, at that assessment, probands had a higher prevalence of regular smoking ([odds ratio [OR] 12.54, 95% confidence interval [CI] = 4.36–36.12) and were less physically active than controls (OR .59, CI = .43–.81) and siblings (OR .70, CI = .52–.94), and had a higher rate of obesity than did controls (OR 3.67, CI = 1.42–9.52). Parents of probands reported high rates of CVD (significantly higher than did parents of controls), including myocardial infarction and CVD-related hospitalization (ORs 1.62–4.36; CIs = 1.03–15.40). Differences in CVD risk factors between probands and controls were independent of parental CVD. Conclusions Major depression in childhood is associated with an unfavorable CVD risk profile in adolescence, and risks for pediatric depression and CVD may coincide in families. Effective prevention and treatment of childhood depression may be a means to reduce the incidence of adult CVD. PMID:24470130

Diet quality and the risk of cardiovascular disease: the Women's Health Initiative (WHI)123

PubMed Central

Belin, Rashad J; Greenland, Philip; Allison, Matthew; Martin, Lisa; Shikany, James M; Larson, Joseph; Tinker, Lesley; Howard, Barbara V; Lloyd-Jones, Donald

2011-01-01

Background: The association between diet quality and risk of incident cardiovascular disease (CVD) or heart failure (HF) in postmenopausal women is uncertain. Objective: This study aimed to determine whether a conventional index [Alternate Healthy Eating Index (AHEI)] or a novel index [Women's Health Initiative (WHI) Dietary Modification Index (DMI)] of diet quality was associated with the risk of incident CVD or HF in the WHI Observational Study (WHI-OS). Design: The WHI-OS is an observational cohort study of 93,676 women aged 50–79 y of diverse ethnicity and backgrounds followed for an average of 10.0 y for CVD events. The individual components of the AHEI and DMI were determined from the baseline WHI food-frequency questionnaire. Incident CVD was a composite of nonfatal myocardial infarction, coronary heart disease death, stroke, coronary revascularization, and incident HF. The association between AHEI or DMI and incident CVD or incident HF was determined by using Cox models adjusted for traditional CVD and HF risk factors. Results: Women with a DMI in the highest quintile had hazard ratios (HRs) of 0.88 (95% CI: 0.80, 0.95) and 0.91 (95% CI: 0.78, 1.06) for incident CVD and HF, respectively. Women with an AHEI in the highest quintile had HRs of 0.77 (95% CI: 0.70, 0.84) and 0.70 (95% CI: 0.59, 0.82) for incident CVD and HF, respectively. Conclusion: Overall, adherence to current nutrient guidelines (as indexed by the DMI) are associated with lower total CVD risk, and additional dietary factors (as indexed by the AHEI) were associated with a lower risk of CVD and HF. PMID:21613562

Progressively Worsening Premature Coronary Artery Disease: Adding Anticoagulation Stabilizes-Reverses Clinical Symptomatic Disease Progression in Thrombophilic-Atherothrombotic Patients: A Pilot Study.

PubMed

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.

Low-grade albuminuria and incidence of cardiovascular disease and all-cause mortality in nondiabetic and normotensive individuals.

PubMed

Tanaka, Fumitaka; Komi, Ryosuke; Makita, Shinji; Onoda, Toshiyuki; Tanno, Kozo; Ohsawa, Masaki; Itai, Kazuyoshi; Sakata, Kiyomi; Omama, Shinichi; Yoshida, Yuki; Ogasawara, Kuniaki; Ishibashi, Yasuhiro; Kuribayashi, Toru; Okayama, Akira; Nakamura, Motoyuki

2016-03-01

Recent studies indicate that, in people with diabetes or hypertension and in the general population, low-grade albuminuria (LGA) below the microalbuminuria threshold is a predictor for incidence of cardiovascular disease (CVD) and mortality. However, it remains unclear whether LGA predicts the risk of CVD incidence and death in nondiabetic and normotensive individuals. A total of 3599 individuals aged not less than 40 years from the general population who are free of CVD in nondiabetic and normotensive individuals with preserved glomerular filtration rate were followed for CVD incidence and all-cause death. LGA was defined as urinary albumin to creatinine ratio (UACR) less than 30  mg/g. It was examined whether there is an association between LGA and CVD incidence or all-cause death. During the average 5.9 years of follow-up, 61 individuals had first CVD events, and 85 individuals died. The hazard ratios (HRs) for CVD incidence and all-cause death after full adjustment by potential confounders increased significantly in the top tertile of LGA (UACR ≥ 9.6  mg/g for men, ≥ 12.0  mg/g for women) compared with the first tertile [HR = 2.79, 95% confidence interval (CI), 1.41-5.52, HR = 1.69, 95% CI, 1.00-2.84, respectively]. Population-attributable fractions of the top tertile of LGA for CVD incidence and all-cause death were 37.9 and 20.1%, respectively. In apparently healthy individuals with optimal blood pressure and no diabetes, LGA independently predicts CVD incidence and all-cause death, particularly with the large contribution to the excessive incidence of CVD.