Monotherapy with major antihypertensive drug classes and risk of hospital admissions for mood disorders

Major depressive and bipolar disorders predispose to atherosclerosis, and there is accruing data from animal model, epidemiological, and genomic studies that commonly used antihypertensive drugs may have a role in the pathogenesis or course of mood disorders. In this study, we propose to determine whether antihypertensive drugs have an impact on mood disorders through the analysis of patients on monotherapy with different classes of antihypertensive drugs from a large hospital database of 525 046 patients with follow-up for 5 years. There were 144 066 eligible patients fulfilling the inclusion criteria: age 40 to 80 years old at time of antihypertensive prescription and medication exposure >90 days. The burden of comorbidity assessed by Charlson and Elixhauser scores showed an independent linear association with mood disorder diagnosis. The median time to hospital admission with mood disorder was 847 days for the 299 admissions (641 685 person-years of follow-up). Patients on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers had the lowest risk for mood disorder admissions, and compared with this group, those on β-blockers (hazard ratio=2.11; [95% confidence interval, 1.12–3.98]; P=0.02) and calcium antagonists (2.28 [95% confidence interval, 1.13–4.58]; P=0.02) showed higher risk, whereas those on no antihypertensives (1.63 [95% confidence interval, 0.94–2.82]; P=0.08) and thiazide diuretics (1.56 [95% confidence interval, 0.65–3.73]; P=0.32) showed no significant difference. Overall, our exploratory findings suggest possible differential effects of antihypertensive medications on mood that merits further study: calcium antagonists and β-blockers may be associated with increased risk, whereas angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may be associated with a decreased risk of mood disorders

Prototype of a new Engineering Masters project model: Working with marketing and software faculties to commercially kickstart university research

We describe a Master of Engineering (500-level) project modelled on the real-world arrangement where engineers work with marketing and software groups to prepare a product for commercialisation. A 4-member software team to develop and test embedded firmware and support applications on a mobile platform was provided through a final-year undergraduate software-engineering project course based outside the engineering school, in a separate faculty. A marketing team consisting of interns prepared logos, product names, and advertising materials, with input from a creative 200-level class. This team also considered possible exit strategies based on analysis of the market size and activity. This marketing effort was organised through the management communications group in the management school. The masters student acts as project manager and it is their remit to guide the product towards release on the crowd-sourced venture-capital site kickstarter.com. A small but original product idea is required to provide a viable vehicle for the project. Financial commitment to manufacture, even on a small scale, represents a novel outcome for a university project

A Surrogate Model of Gravitational Waveforms from Numerical Relativity Simulations of Precessing Binary Black Hole Mergers

We present the first surrogate model for gravitational waveforms from the coalescence of precessing binary black holes. We call this surrogate model NRSur4d2s. Our methodology significantly extends recently introduced reduced-order and surrogate modeling techniques, and is capable of directly modeling numerical relativity waveforms without introducing phenomenological assumptions or approximations to general relativity. Motivated by GW150914, LIGO's first detection of gravitational waves from merging black holes, the model is built from a set of $276$ numerical relativity (NR) simulations with mass ratios $q \leq 2$, dimensionless spin magnitudes up to $0.8$, and the restriction that the initial spin of the smaller black hole lies along the axis of orbital angular momentum. It produces waveforms which begin $\sim 30$ gravitational wave cycles before merger and continue through ringdown, and which contain the effects of precession as well as all $\ell \in \{2, 3\}$ spin-weighted spherical-harmonic modes. We perform cross-validation studies to compare the model to NR waveforms \emph{not} used to build the model, and find a better agreement within the parameter range of the model than other, state-of-the-art precessing waveform models, with typical mismatches of $10^{-3}$. We also construct a frequency domain surrogate model (called NRSur4d2s_FDROM) which can be evaluated in $50\, \mathrm{ms}$ and is suitable for performing parameter estimation studies on gravitational wave detections similar to GW150914.Comment: 34 pages, 26 figure

Apgar score and the risk of cause specific infant mortality: a population based cohort study of 1,029,207 livebirths

Background<p></p> The Apgar score has been used worldwide as an index of early neonatal condition for more than 60 years. With advances in health-care service provision, neonatal resuscitation, and infant care, its present relevance is unclear. The aim of the study was to establish the strength of the relation between Apgar score at 5 min and the risk of neonatal and infant mortality, subdivided by specific causes.<p></p> Methods<p></p> We linked routine discharge and mortality data for all births in Scotland, UK between 1992 and 2010. We restricted our analyses to singleton livebirths, in women aged over 10 years, with a gestational age at delivery between 22 and 44 weeks, and excluded deaths due to congenital anomalies or isoimmunisation. We calculated the relative risks (RRs) of neonatal and infant death of neonates with low (0–3) and intermediate (4–6) Apgar scores at 5 min referent to neonates with normal Apgar score (7–10) using binomial log-linear modelling with adjustment for confounders. Analyses were stratified by gestational age at birth because it was a significant effect modifier. Missing covariate data were imputed.<p></p> Findings<p></p> Complete data were available for 1 029 207 eligible livebirths. Across all gestational strata, low Apgar score at 5 min was associated with an increased risk of neonatal and infant death. However, the strength of the association (adjusted RR, 95% CI referent to Apgar 7–10) was strongest at term (p<0·0001). A low Apgar (0–3) was associated with an adjusted RR of 359·4 (95% CI 277·3–465·9) for early neonatal death, 30·5 (18·0–51·6) for late neonatal death, and 50·2 (42·8–59·0) for infant death. We noted similar associations of a lower magnitude for intermediate Apgar (4–6). The strongest associations were for deaths attributed to anoxia and low Apgar (0–3) for term infants (RR 961·7, 95% CI 681·3–1357·5) and preterm infants (141·7, 90·1–222·8). No association between Apgar score at 5 min and the risk of sudden infant death syndrome was noted at any gestational age (RR 0·6, 95% CI 0·1–4·6 at term; 1·2, 0·3–4·8 at preterm).<p></p> Interpretation<p></p> Low Apgar score at 5 min was strongly associated with the risk of neonatal and infant death. Our findings support its continued usefulness in contemporary practice

Testing General Relativity with Current Cosmological Data

Deviations from general relativity, such as could be responsible for the cosmic acceleration, would influence the growth of large scale structure and the deflection of light by that structure. We clarify the relations between several different model independent approaches to deviations from general relativity appearing in the literature, devising a translation table. We examine current constraints on such deviations, using weak gravitational lensing data of the CFHTLS and COSMOS surveys, cosmic microwave background radiation data of WMAP5, and supernova distance data of Union2. Markov Chain Monte Carlo likelihood analysis of the parameters over various redshift ranges yields consistency with general relativity at the 95% confidence level.Comment: 11 pages; 7 figures; typographical errors corrected; this is the published versio

Patient Perspectives of the Doctor-at-Home Service

Introduction. Home health care has been established as an effective model for reducing mortality in the elderly. The Doctor-at-Home Service at the Community Health Centers of Burlington (CHCB) has offered home health care to Burlington residents since January 2015. Dr. Karen Sokol, MD, alone provides care to 176 patients at their homes, including at-home palliative care. CHCB hope to expand this program by hiring more providers. Objective. To understand the impact of the Doctor-at-Home Service from the pa- tients’ perspective. Methods. A survey was administered to a cohort of eighteen patients over an 8- week period and addressed topics such as barriers to healthcare, benefits, and costs associated with doctor-at-home programs. A theme analysis on the responses was then conducted to reflect patient opinions. Available summary data describing the pa- tient population was also analyzed. Results. The Doctor- at- Home program serves patients ranging from 26 to 100 years old, with the majority of the patient population comprised of senior citizens. Prior to at home care, patients faced barriers such as lack of transportation, negative past experi- ences, anxiety, and distance from relatives. Four main themes from patient responses were physician-patient relationship, convenience, quality of care, and environment of care. Discussion. Evidence is compelling that there is a desire and need for an exten- sion of the Doctor-at-Home program to reach additional patients. Doctor-at-Home pro- grams could eliminate identified barriers and provide quality care to patients, especially those with specific barriers to access.https://scholarworks.uvm.edu/comphp_gallery/1256/thumbnail.jp

Evaluation of Voting with Form Dropout Techniques for Ballot Vote Counting

Vote counting accuracy has become a well-known issue in the vote collection process. Digital image processing techniques can be incorporated in the analysis of printed election ballots. Current image processing techniques in the vote collection process are heavily dependent on the anticipated, geometric positioning of the vote. These techniques don’t account for markings made outside of the requested field of input. Using various form dropout techniques, however, every mark on the form can be extracted and used by the machine to make an intelligent decision. Most methods will still miss a few marks and result in a few false alarms. This paper explores methods of voting between the results of the different mark extraction methods to improve recognition. To provide diversity a simple image subtraction technique is paired with a distance transform and a morphology based algorithm. The result has a higher detection rate and a lower false alarm rate

Design of a Direct-Detection Wind and Aerosol Lidar for Mars Orbit

The present knowledge of the Mars atmosphere is greatly limited by a lack of global measurements of winds and aerosols. Hence, measurements of height-resolved wind and aerosol profiles are a priority for new Mars orbiting missions. We have designed a direct-detection lidar (MARLI) to provide global measurements of dust, winds and water ice profiles from Mars orbit. From a 400-km polar orbit, the instrument is designed to provide wind and backscatter measurements with a vertical resolution of 2 km and with resolution of 2 in latitude along track. The instrument uses a single-frequency, seeded Nd:YAG laser that emits 4 mJ pulses at 1064 nm at a 250 Hz pulse rate. The receiver utilizes a 50-cm diameter telescope and a double edge Fabry-Prot etalon as a frequency discriminator to measure the Doppler shift of the aerosol-backscatter profiles. The receiver also includes a polarization-sensitive channel to detect the cross-polarized backscatter profiles from water ice. The receiver uses a sensitive 4 4 pixel HgCdTe avalanche photodiode array as a detector for all signals. Here we describe the measurement concept, instrument design, and calculate its performance for several cases of Mars atmospheric conditions. The calculations show that under a range of atmospheric conditions MARLI is capable of measuring wind speed profiles with random error of 24 m/s within the first three scale heights, enabling vertically resolved mapping of transport processes in this important region of the atmosphere

Re-living anatomy: medical student use of lecture capture

Lecture capture resources have become common place within UK Higher education to enhance and support learning in addition to the tradition lecture. These resources can be particularly useful for medical students in anatomy teaching where time dedicated to anatomy within the curriculum has been reduced compared to previous generations(1). This study aimed to investigate how lecture capture aided student learning Qualitative feedback was also collected in view to further improve the resources to cater for the student’s need