Multiple Biomarkers for the prediction of ischemic stroke: the PRIME study

Objective: To simultaneously evaluate 14 biomarkers from distinct biological pathways for risk prediction of ischemic stroke, including biomarkers of hemostasis, inflammation, and endothelial activation as well as chemokines and adipocytokines.
Methods and Results: The Prospective Epidemiological Study on Myocardial Infarction (PRIME) is a cohort of 9771 healthy men 50 to 59 years of age who were followed up over 10 years. In a nested case–control study, 95 ischemic stroke cases were matched with 190 controls. After multivariable adjustment for traditional risk factors, fibrinogen (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.03–2.28), E-selectin (OR, 1.76; 95% CI, 1.06–2.93), interferon-γ-inducible-protein-10 (OR, 1.72; 95% CI, 1.06–2.78), resistin (OR, 2.86; 95% CI, 1.30–6.27), and total adiponectin (OR, 1.82; 95% CI, 1.04–3.19) were significantly associated with ischemic stroke. Adding E-selectin and resistin to a traditional risk factor model significantly increased the area under the receiver-operating characteristic curve from 0.679 (95% CI, 0.612–0.745) to 0.785 and 0.788, respectively, and yielded a categorical net reclassification improvement of 29.9% (P=0.001) and 28.4% (P=0.002), respectively. Their simultaneous inclusion in the traditional risk factor model increased the area under the receiver-operating characteristic curve to 0.824 (95% CI, 0.770–0.877) and resulted in an net reclassification improvement of 41.4% (P<0.001). Results were confirmed when using continuous net reclassification improvement.
Conclusion: Among multiple biomarkers from distinct biological pathways, E-selectin and resistin provided incremental and additive value to traditional risk factors in predicting ischemic stroke.

Self-Feedback Motion Control for Cable-Driven Parallel Manipulators

This article proposes a closed-loop control scheme based on joint-angle feedback for cable-driven parallel manipulators (CDPMs), which is able to overcome various difficulties resulting from the flexible nature of the driven cables to achieve higher control accuracy. By introducing a unique structure design that accommodates built-in encoders in passive joints, the seven degrees of freedom (7-DOF) CDPM can obtain joint angle values without external sensing devices, and it is used for feedback control together with a proper closed-loop control algorithm. The control algorithm has been derived from the time differential of the kinematic formulation, which relates the joint angular velocities to the time derivative of cable lengths. In addition, the Lyapunov stability theory and Monte Carlo method have been used to mathematically verify the self-feedback control law that has tolerance for parameter errors. With the aid of co-simulation technique, the self-feedback closed-loop control is applied on a 7-DOF CDPM and it shows higher motion accuracy than the one with an open-loop control. The trajectory tracking experiment on the motion control of the 7-DOF CDPM demonstrated a good performance of the self-feedback control method.

Effects of particle/matrix interface and strengthening mechanisms on the mechanical properties of metal matrix composites

A randomly distributed multi-particle model considering the effects of particle/matrix interface and strengthening mechanisms introduced by the particles has been constructed. Particle shape, distribution, volume fraction and the particles/matrix interface due to the factors including element diffusion were considered in the model. The effects of strengthening mechanisms, caused by the introduction of particles on the mechanical properties of the composites, including grain refinement strengthening, dislocation strengthening and Orowan strengthening, are incorporated. In the model, the particles are assumed to have spheroidal shape, with uniform distribution of the centre, long axis length and inclination angle. The axis ratio follows a right half-normal distribution. Using Monte Carlo method, the location and shape parameters of the spheroids are randomly selected. The particle volume fraction is calculated using the area ratio of the spheroids. Then, the effects of particle/matrix interface and strengthening mechanism on the distribution of Mises stress and equivalent strain and the flow behaviour for the composites are discussed.

IMRT for image-guided single vocal cord irradiation

PURPOSE: We have been developing an image-guided single vocal cord irradiation technique to treat patients with stage T1a glottic carcinoma. In the present study, we compared the dose coverage to the affected vocal cord and the dose delivered to the organs at risk using conventional, intensity-modulated radiotherapy (IMRT) coplanar, and IMRT non-coplanar techniques.

METHODS AND MATERIALS: For 10 patients, conventional treatment plans using two laterally opposed wedged 6-MV photon beams were calculated in XiO (Elekta-CMS treatment planning system). An in-house IMRT/beam angle optimization algorithm was used to obtain the coplanar and non-coplanar optimized beam angles. Using these angles, the IMRT plans were generated in Monaco (IMRT treatment planning system, Elekta-CMS) with the implemented Monte Carlo dose calculation algorithm. The organs at risk included the contralateral vocal cord, arytenoids, swallowing muscles, carotid arteries, and spinal cord. The prescription dose was 66 Gy in 33 fractions.

RESULTS: For the conventional plans and coplanar and non-coplanar IMRT plans, the population-averaged mean dose ± standard deviation to the planning target volume was 67 ± 1 Gy. The contralateral vocal cord dose was reduced from 66 ± 1 Gy in the conventional plans to 39 ± 8 Gy and 36 ± 6 Gy in the coplanar and non-coplanar IMRT plans, respectively. IMRT consistently reduced the doses to the other organs at risk.

CONCLUSIONS: Single vocal cord irradiation with IMRT resulted in good target coverage and provided significant sparing of the critical structures. This has the potential to improve the quality-of-life outcomes after RT and maintain the same local control rates.

Solar Flare Impulsive Phase Emission Observed with SDO/EVE

Differential emission measures (DEMs) during the impulsive phase of solar flares were constructed using observations from the EUV Variability Experiment (EVE) and the Markov-Chain Monte Carlo method. Emission lines from ions formed over the temperature range log Te = 5.8-7.2 allow the evolution of the DEM to be studied over a wide temperature range at 10 s cadence. The technique was applied to several M- and X-class flares, where impulsive phase EUV emission is observable in the disk-integrated EVE spectra from emission lines formed up to 3-4 MK and we use spatially unresolved EVE observations to infer the thermal structure of the emitting region. For the nine events studied, the DEMs exhibited a two-component distribution during the impulsive phase, a low-temperature component with peak temperature of 1-2 MK, and a broad high-temperature component from 7 to 30 MK. A bimodal high-temperature component is also found for several events, with peaks at 8 and 25 MK during the impulsive phase. The origin of the emission was verified using Atmospheric Imaging Assembly images to be the flare ribbons and footpoints, indicating that the constructed DEMs represent the spatially average thermal structure of the chromospheric flare emission during the impulsive phase.

Ferroelectric Vortices and Related Configurations

This chapter discusses that the theoretical studies, using both atomistic and phenomenological approaches, have made clear predictions about the existence and behaviour of ferroelectric (FE) vortices. Effective Hamiltonians can be implemented within both Monte Carlo (MC) and molecular dynamics (MD) simulations. In contrast to the effective Hamiltonian method, which is atomistic in nature, the phase field method employs a continuum approach, in which the polarization field is the order parameter. Properties of FE nanostructures are largely governed by the existence of a depolarization field, which is much stronger than the demagnetization field in magnetic nanosystems. The topological patterns seen in rare earth manganites are often referred to as vortices and yet this claim never seems to be explicitly justified. By inspection, the form of a vortex structure is such that there is a continuous rotation in the orientation of dipole vectors around the singularity at the centre of the vortex.

Comparing impact and cost-effectiveness of primary prevention strategies for lipid-lowering.

BACKGROUND: Lipid-lowering therapy is costly but effective at reducing coronary heart disease (CHD) risk. OBJECTIVE: To assess the cost-effectiveness and public health impact of Adult Treatment Panel III (ATP III) guidelines and compare with a range of risk- and age-based alternative strategies. DESIGN: The CHD Policy Model, a Markov-type cost-effectiveness model. DATA SOURCES: National surveys (1999 to 2004), vital statistics (2000), the Framingham Heart Study (1948 to 2000), other published data, and a direct survey of statin costs (2008). TARGET POPULATION: U.S. population age 35 to 85 years. Time Horizon: 2010 to 2040. PERSPECTIVE: Health care system. INTERVENTION: Lowering of low-density lipoprotein cholesterol with HMG-CoA reductase inhibitors (statins). OUTCOME MEASURE: Incremental cost-effectiveness. RESULTS OF BASE-CASE ANALYSIS: Full adherence to ATP III primary prevention guidelines would require starting (9.7 million) or intensifying (1.4 million) statin therapy for 11.1 million adults and would prevent 20,000 myocardial infarctions and 10,000 CHD deaths per year at an annual net cost of $3.6 billion ($42,000/QALY) if low-intensity statins cost $2.11 per pill. The ATP III guidelines would be preferred over alternative strategies if society is willing to pay $50,000/QALY and statins cost $1.54 to $2.21 per pill. At higher statin costs, ATP III is not cost-effective; at lower costs, more liberal statin-prescribing strategies would be preferred; and at costs less than $0.10 per pill, treating all persons with low-density lipoprotein cholesterol levels greater than 3.4 mmol/L (>130 mg/dL) would yield net cost savings. RESULTS OF SENSITIVITY ANALYSIS: Results are sensitive to the assumptions that LDL cholesterol becomes less important as a risk factor with increasing age and that little disutility results from taking a pill every day. LIMITATION: Randomized trial evidence for statin effectiveness is not available for all subgroups. CONCLUSION: The ATP III guidelines are relatively cost-effective and would have a large public health impact if implemented fully in the United States. Alternate strategies may be preferred, however, depending on the cost of statins and how much society is willing to pay for better health outcomes. FUNDING: Flight Attendants' Medical Research Institute and the Swanson Family Fund. The Framingham Heart Study and Framingham Offspring Study are conducted and supported by the National Heart, Lung, and Blood Institute.

Coronary heart disease and cerebrovascular disease mortality in young adults: recent trends in Europe.

Background: Over the last two decades, mortality from coronary heart disease (CHD) and cerebrovascular disease (CVD) declined by about 30% in the European Union (EU). Design: We analyzed trends in CHD (X ICD codes: I20-I25) and CVD (X ICD codes: I60-I69) mortality in young adults (age 35-44 years) in the EU as a whole and in 12 selected European countries, over the period 1980-2007. Methods: Data were derived from the World Health Organization mortality database. With joinpoint regression analysis, we identified significant changes in trends and estimated average annual percent changes (AAPC). Results: CHD mortality rates at ages 35-44 years have decreased in both sexes since the 1980s for most countries, except for Russia (130/100,000 men and 24/100,000 women, in 2005-7). The lowest rates (around 9/100,000 men, 2/100,000 women) were in France, Italy and Sweden. In men, the steepest declines in mortality were in the Czech Republic (AAPC = -6.1%), the Netherlands (-5.2%), Poland (-4.5%), and England and Wales (-4.5%). Patterns were similar in women, though with appreciably lower rates. The AAPC in the EU was -3.3% for men (rate = 16.6/100,000 in 2005-7) and -2.1% for women (rate = 3.5/100,000). For CVD, Russian rates in 2005-7 were 40/100,000 men and 16/100,000 women, 5 to 10-fold higher than in most western European countries. The steepest declines were in the Czech Republic and Italy for men, in Sweden and the Czech Republic for women. The AAPC in the EU was -2.5% in both sexes, with steeper declines after the mid-late 1990s (rates = 6.4/100,000 men and 4.3/100,000 women in 2005-7). Conclusions: CHD and CVD mortality steadily declined in Europe, except in Russia, whose rates were 10 to 15-fold higher than those of France, Italy or Sweden. Hungary and Poland, and also Scotland, where CHD trends were less favourable than in other western European countries, also emerge as priorities for preventive interventions.

Calculation of nondifferential properties for atomic ground states /

A new method for sampling the exact (within the nodal error) ground state distribution and nondiflPerential properties of multielectron systems is developed and applied to firstrow atoms. Calculated properties are the distribution moments and the electronic density at the nucleus (the 6 operator). For this purpose, new simple trial functions are developed and optimized. First, using Hydrogen as a test case, we demonstrate the accuracy of our algorithm and its sensitivity to error in the trial function. Applications to first row atoms are then described. We obtain results which are more satisfactory than the ones obtained previously using Monte Carlo methods, despite the relative crudeness of our trial functions. Also, a comparison is made with results of highly accurate post-Hartree Fock calculations, thereby illuminating the nodal error in our estimates. Taking into account the CPU time spent, our results, particularly for the 8 operator, have a relatively large variance. Several ways of improving the eflSciency together with some extensions of the algorithm are suggested.

Exchange energy calculation of He-He with supermolecular one-matrix

Exch~nge energy of the He-He system is calculated using the one-density matrix which has been modified according to the supermolecular density formula quoted by Kolos. The exchange energy integrals are computed analytically and by the Monte Carlo method. The results obtained from both ways compared favourably,with the results obtained from the SCF program HONDO

Optimization of the valence energy variance of the CuH molecule

We developed the concept of split-'t to deal with the large molecules (in terms of the number of electrons and nuclear charge Z). This naturally leads to partitioning the local energy into components due to each electron shell. The minimization of the variation of the valence shell local energy is used to optimize a simple two parameter CuH wave function. Molecular properties (spectroscopic constants and the dipole moment) are calculated for the optimized and nearly optimized wave functions using the Variational Quantum Monte Carlo method. Our best results are comparable to those from the single and double configuration interaction (SDCI) method.

Étude des facteurs de perturbation de chambres d’ionisation sous conditions non standard

Durant la dernière décennie, les développements technologiques en radiothérapie ont transformé considérablement les techniques de traitement. Les nouveaux faisceaux non standard améliorent la conformité de la dose aux volumes cibles, mais également complexifient les procédures dosimétriques. Puisque des études récentes ont démontré l’invalidité de ces protocoles actuels avec les faisceaux non standard, un nouveau protocole applicable à la dosimétrie de référence de ces faisceaux est en préparation par l’IAEA-AAPM. Le but premier de cette étude est de caractériser les facteurs responsables des corrections non unitaires en dosimétrie des faisceaux non standard, et ainsi fournir des solutions conceptuelles afin de minimiser l’ordre de grandeur des corrections proposées dans le nouveau formalisme de l’IAEA-AAPM. Le deuxième but de l’étude est de construire des méthodes servant à estimer les incertitudes d’une manière exacte en dosimétrie non standard, et d’évaluer les niveaux d’incertitudes réalistes pouvant être obtenus dans des situations cliniques. Les résultats de l’étude démontrent que de rapporter la dose au volume sensible de la chambre remplie d’eau réduit la correction d’environ la moitié sous de hauts gradients de dose. Une relation théorique entre le facteur de correction de champs non standard idéaux et le facteur de gradient du champ de référence est obtenue. En dosimétrie par film radiochromique, des niveaux d’incertitude de l’ordre de 0.3% sont obtenus par l’application d’une procédure stricte, ce qui démontre un intérêt potentiel pour les mesures de faisceaux non standard. Les résultats suggèrent également que les incertitudes expérimentales des faisceaux non standard doivent être considérées sérieusement, que ce soit durant les procédures quotidiennes de vérification ou durant les procédures de calibration. De plus, ces incertitudes pourraient être un facteur limitatif dans la nouvelle génération de protocoles.

É́tude sur la cinétique des défauts structuraux dans le silicium amorphe.

Cette thèse présente à la fois des résultats de simulations numériques en plus de ré- sultats expérimentaux obtenus en laboratoire sur le rôle joué par les défauts de structure dans le silicium amorphe. Nos travaux de simulation numérique furent réalisés avec une nouvelle méthode de simulation Monte-Carlo cinétique pour décrire l’évolution tempo- relle de modèles de silicium amorphe endommagés sur plusieurs échelles de temps jus- qu’à une seconde à la température pièce. Ces simulations montrent que les lacunes dans le silicium amorphe sont instables et ne diffusent pas sans être détruites. Nous montrons également que l’évolution d’un modèle de silicium amorphe endommagé par une colli- sion ionique lors d’un recuit peut être divisée en deux phases : la première est dominée exclusivement par la diffusion et la création/destruction de défauts de liaison, alors que la deuxième voit les créations/destructions de liens remplacées par des échanges de liens entre atomes parfaitement coordonnés. Les défauts ont aussi un effet sur la viscosité du silicium amorphe. Afin d’approfondir cette question, nous avons mesuré la viscosité du silicium amorphe et du silicium amorphe hydrogéné sous l’effet d’un faisceau d’ions. Nous montrons que la variation de la viscosité dans les deux matériaux est différente : le silicium amorphe hydrogéné a une viscosité constante en fonction de la fluence des ions alors que le silicium amorphe pur a une viscosité qui augmente de façon linéaire. Pour de faibles fluences, la viscosité du silicium hydrogéné est plus grande que la viscosité sans hydrogène. La présence d’hydrogène diminue également l’amplitude de la variation logarithmique de la contrainte observée lors de la relaxation à la température de la pièce.

Approche bayésienne de la construction d'intervalles de crédibilité simultanés à partir de courbes simulées

Ce mémoire porte sur la simulation d'intervalles de crédibilité simultanés dans un contexte bayésien. Dans un premier temps, nous nous intéresserons à des données de précipitations et des fonctions basées sur ces données : la fonction de répartition empirique et la période de retour, une fonction non linéaire de la fonction de répartition. Nous exposerons différentes méthodes déjà connues pour obtenir des intervalles de confiance simultanés sur ces fonctions à l'aide d'une base polynomiale et nous présenterons une méthode de simulation d'intervalles de crédibilité simultanés. Nous nous placerons ensuite dans un contexte bayésien en explorant différents modèles de densité a priori. Pour le modèle le plus complexe, nous aurons besoin d'utiliser la simulation Monte-Carlo pour obtenir les intervalles de crédibilité simultanés a posteriori. Finalement, nous utiliserons une base non linéaire faisant appel à la transformation angulaire et aux splines monotones pour obtenir un intervalle de crédibilité simultané valide pour la période de retour.