Background The incidence of atherosclerotic cardiovascular disease has declined in the past 2 decades. However, these benefits may not extend to young patients. The objective of this work was to assess temporal trends in the incidence, risk profiles, sex‐related differences, and outcomes in a contemporary population of young patients presenting with coronary artery disease ( CAD ) in British Columbia, Canada. Methods and Results We used a provincial cardiac registry to identify young patients (men aged <50 years, women aged <55 years), with a first presentation of CAD between 2000 and 2016, who had either ≥50% stenosis of ≥1 coronary arteries on angiography or underwent coronary revascularization. A total of 12 519 patients (30% women) met our inclusion criteria. The incidence of CAD remained stable and was higher for men than women (46–53 versus 18–23 per 100 000). Of patients, 92% had at least one traditional cardiovascular risk factor and 67% had multiple risk factors. The prevalence of diabetes mellitus, obesity, and hypertension increased during the study period and was higher for women. Women had fewer emergent procedures and revascularizations. Mortality rates decreased by 31% between 2000 and 2007, then were stable for the remaining 9 years. Mortality was significantly higher for women aged <45 years compared with men. Conclusions The incidence of premature CAD has not declined, and the prevalence of 3 major cardiovascular risk factors increased between 2000 and 2016. The risk burden and mortality rates were worse for women. These data have important implications for the design of strategies to prevent CAD in young adults.
Liquid crystalline elastomers (LCE) are stimuli‐responsive materials with a distinguished mechanical response. LCE have been subject to numerous recent functional examinations in robotics, health sciences, and optics. The liquid crystallinity of the elastomeric polymer networks of LCE are largely derived from liquid crystalline monomer precursors. Recent reports have utilized commercially available liquid crystalline diacrylate monomers in chain extension reactions to prepare LCE. These reactions have been largely based on monomeric precursors originally to enhance the and thermal stability of optical films. Here, it is demonstrated that preparing LCE via a liquid crystalline diacrylate with reduced mesogen–mesogen interaction enhances and sharpens the thermotropic actuation of these materials. Robust composition‐response correlations are demonstrated in LCE prepared by three common synthetic methods. The enhanced thermotropic response of LCE prepared from this precursor increases the thermomechanical efficiency by sixfold. Accordingly, this work addresses important limitations in utilizing the thermal response of LCE in robotics, health care, and consumer goods.
Background: Optimal design of clinical programs for patients with premature atherosclerotic cardiovascular disease (ASCVD) (men aged 50 years, women aged 55 years) requires an understanding of their priorities. We aimed to explore patient and family priorities for services in clinical programs. Methods: We co-designed this study with a Patient Partner Committee using a sequential exploratory mixed-methods design. In Phase I, we conducted semistructured interviews with participants from the Study to Avoid Cardiovascular Events in British Columbia (SAVE BC) (n ¼ 15). In Phase II, we designed a questionnaire based on Phase I data and distributed it to all current SAVE BC participants. We collected closeended responses (n ¼ 116) and stratified data using participant category (index, family member), age, sex, and number of clinic visits. Results: We identified 4 major priorities for services in clinical programs: social support (weight: 62.6%), patient education (weight: 83.5%), mental health (weight: 50.7%), and lifestyle changes (85.1%).
Atherosclerotic cardiovascular disease (ASCVD) is highly heritable, particularly when it occurs at a young age. The screening of individuals with premature ASCVD, although often recommended, is not routinely performed. Strategies to address this gap in care are essential. We designed the Study to Avoid CardioVascular Events in British Columbia (SAVE BC) as a prospective, observational study of individuals with a new diagnosis of very premature ASCVD (defined as age ≤ 50 years in males and age ≤ 55 years in females) and their first-degree relatives (FDRs) and spouses. FDRs and spouses will undergo screening for cardiovascular (CV) risk factors and subclinical ASCVD using a structured screening algorithm. All subjects will be followed longitudinally for ≥10 years. The overall goal of SAVE BC is to evaluate the yield of a structured screening program for identifying individuals at risk of premature ASCVD. The primary objectives of SAVE BC are to identify and follow index cases with very premature ASCVD and their FDRs and to determine the diagnostic yield of a structured screening program for these individuals. We will collect data on CV risk factors, medication use, CV events, and healthcare costs in these individuals. SAVE BC will provide insight regarding approaches to identify individuals at risk for premature ASCVD with implications for prevention and treatment in this population.
Liquid crystalline elastomers (LCE) are thermally cyclable, compliant actuators with compelling mechanical properties. The large and programmable deformation of LCE has led to numerous functional examinations spanning optics, medical devices, and robotics. A well-established method to prepare complex LCE actuators is to utilize surface-enforced photoalignment. Herein, a facile and scalable approach is reported to circumvent the physical limits of surface-enforced alignment (e.g., samples that are 50 μm or less) to amplify the achievable force output in LCE. Applying an approach termed direct layering, the thermomechanical response of LCE elements prepared with +1 disclination patterns in a range of compositions and thicknesses is contrasted. The design and preparation of +1 disclination patterns and arrays is explored to assess the contribution of sample geometry and overlap to deformation and force output. The methodology detailed in this contribution allows for the preparation of elements ≈1 mm in thickness that are capable of actuating large objects. Furthermore, the fabrication of these elements uniquely enables the realization of mechanical instabilities to hasten the actuation rate in response to thermal change and to enable leaping.
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