1,015 research outputs found
Enhanced postoperative surveillance versus standard of care to reduce mortality among adult surgical patients in Africa (ASOS-2) : a cluster-randomised controlled trial
No full textFunding Information: R M Pearse reports grants from Edwards Lifesciences and Intersurgical; and personal fees from Edwards Lifesciences and GlaxoSmithKline, outside of the submitted work. R M Pearse also reports being a member of the editorial boards of the British Journal of Anaesthesia and the British Journal of Surgery. A B A Prempah was the recipient of the World Federation of Societies of Anaesthesiologists–International Anesthesia Research Society Clinical Research Fellow in Global Surgery and Anaesthesia in Africa. All other authors declare no competing interests. Funding Information: The ASOS-2 pilot and trial were partially supported by a grant (OPP#1161108) from the Bill & Melinda Gates Foundation, as a subaward from Praekelt. Researchers for the process evaluation were supported by a grant from the World Federation of Societies of Anaesthesiologists. Publisher Copyright: © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licensePeer reviewe
Internet technologies relevant to private investigators’ working practices
No full textMuch has been written and discussed especially in the various US media and in legislative organs, about how the Internet is used illegally (hacking, stalking for instance), but hardly if any research has been done as to how the investigative industry employs the new medium to its benefit. The author described in this thesis how private investigators (PIs) execute their profession these days using the facilities the Internet avail them in contrast to the time before the dawn of the Internet. This contrast is also investigated in an international context, an important part of the thesis, drawn from the author's 32 years of international business experience and that of PIs worldwide. The availability of the various online facilities in different countries are compared. To better understand the new medium, and its facilities a short outline of the Internet’s history, it’s set up in general and for the use of PIs in particular is supplied. PIs also face limitations in their daily work, limitations originating from online, legal, educational, financial and international causes. The new medium not only helps PIs in their investigative, but also in their office work. Finally PIs' wishes for new tools to facilitate their daily investigative work and their outlook as to where the new medium will head are also discussed
DNA Glycosylases Involved in Base Excision Repair May Be Associated with Cancer Risk in BRCA1 and BRCA2 Mutation Carriers.
No full textSingle Nucleotide Polymorphisms (SNPs) in genes involved in the DNA Base Excision Repair (BER) pathway could be
associated with cancer risk in carriers of mutations in the high-penetrance susceptibility genes BRCA1 and BRCA2, given the relation of synthetic lethality that exists between one of the components of the BER pathway, PARP1 (poly ADP ribose
polymerase), and both BRCA1 and BRCA2. In the present study, we have performed a comprehensive analysis of 18 genes involved in BER using a tagging SNP approach in a large series of BRCA1 and BRCA2 mutation carriers. 144 SNPs were analyzed in a two stage study involving 23,463 carriers from the CIMBA consortium (the Consortium of Investigators of Modifiers of BRCA1 and BRCA2). Eleven SNPs showed evidence of association with breast and/or ovarian cancer at p,0.05 in the combined analysis. Four of the five genes for which strongest evidence of association was observed were DNA glycosylases. The strongest evidence was for rs1466785 in the NEIL2 (endonuclease VIII-like 2) gene (HR: 1.09, 95% CI (1.03– 1.16), p = 2.761023) for association with breast cancer risk in BRCA2 mutation carriers, and rs2304277 in the OGG1 (8-guanine DNA glycosylase) gene, with ovarian cancer risk in BRCA1 mutation carriers (HR: 1.12 95%CI: 1.03–1.21,
p = 4.861023). DNA glycosylases involved in the first steps of the BER pathway may be associated with cancer risk in BRCA1/ 2 mutation carriers and should be more comprehensively studied
Thrombolysis is associated with consistent functional improvement across baseline stroke severity: a comparison of outcomes in patients from the Virtual International Stroke Trials Archive (VISTA)
No full text<p><b>Background and Purpose:</b> Baseline stroke severity predicts outcomes among thrombolysed patients. The baseline National Institutes of Health Stroke Scale (NIHSS) thresholds are sometimes used to select patients for thrombolysis, clinical trial enrollment, or both. Using data lodged with Virtual International Stroke Trials Archive, we compared adjusted outcomes between thrombolysed and nonthrombolysed patients enrolled in neuroprotection trials (1998-2007) to assess the influence of various levels of baseline NIHSS.</p>
<p><b>Method:</b> We assessed the association of treatment with outcome, measured across the modified Rankin scale score distribution, in patients categorized by baseline NIHSS in increments of 4. We used an age and baseline NIHSS adjusted Cochran-Mantel-Haenszel test followed by proportional odds logistic regression analysis. We report the Cochran-Mantel-Haenszel P values and estimated odds ratios (OR) for improved modified Rankin scale score distribution with treatment for patients within each baseline NIHSS category.</p>
<p><b>Results:</b> Data were available for 5817 patients (1585 thrombolysed and 4232 nonthrombolysed). Baseline severity was greater among thrombolysed than nonthrombolysed (median baseline NIHSS, 14 vs 13; P<0.05). An association of treatment with outcome was seen independently and was of similar magnitude within each of the baseline NIHSS categories 5 to 8 (P=0.04; OR, 1.25; 95% confidence interval [CI], 1.0-1.6; N=278/934 thrombolysed/nonthrombolysed), 9 to 12 (P=0.01; OR, 1.3; 95% CI, 1.1-1.6; N=404/942), 13 to 16 (P<0.05; OR, 1.6; 95% CI, 1.3-2.1; N=342/814), 17 to 20 (P<0.05; OR, 1.7; 95% CI, 1.3-2.1; N=311/736), and 21 to 24 (P<0.05; OR, 1.6; 95% CI, 1.1-2.1; N=178/466). No association was observed within baseline NIHSS categories 1 to 4 (P=0.8; OR, 1.1; 95% CI, 0.3-4.4; N=8/161) or >= 25 (P=0.08; OR, 1.1; 95% CI, 0.7-1.9; N=64/179).</p>
<p><b>Conclusions:</b> In this nonrandomized comparison, outcomes after thrombolysis were significantly better than in untreated comparators across baseline NIHSS 5 to 24. The significant association was lost only at extremes of baseline NIHSS when sample sizes were small and confidence limits were wide.</p>
Non-valvular atrial fibrillation and stroke : implications for management
No full textNonvalvular Atrial Fibrillation is more prevalent with increasing age. It is associated with a six-fold excess risk of stroke; and a cumulative lifetime stroke risk of 35%. 15% of ischaemic strokes are directly attributable to it. Five trials have established the safety of warfarin in reducing the risk by 70% in well selected patients, with stringent monitoring. Thromboembolism, cardiac failure, hypertension and echocardiographic abnormalities identify higher risk patients. The management of NVAF is changing from rate control, to cardioversion and anticoagulation (or use of antithrombotics) to reduce the embolic risk.peer-reviewe
A bibliography of planetary geology principal investigators and their associates, 1979 - 1980
No full textThis bibliography cites 698 reports and articles published from May 1979 through May 1980 by principal investigators and associates who received support from NASA's Office of Space Science, as part of the Planetary Geology program. Entries are arranged in the following categories: (1) general interest; (2) solar system, asteroids, comets, and satellites; (3) structure, tectonics, and stratigraphy; (4) regolith and volatiles; (5) volcanism; (6) impact craters; (7) Eolian glacial An author index is provided. The bibliography serves as a companion document to NASA TM 81776, "Reports of Planetary Geology Programs, 1979-1980"
Witnessing-condition Heterogeneity and Witnesses’ Versus Investigators’ Confidence in the Accuracy of Witnesses’ Identification Decisions
No full text©American Psychological Association, [2000]. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. Please do not copy or cite without author's permission. The final article is available, upon publication, at: [https://doi.apa.org/doi/10.1023/A:1005504320565]Undergraduate participants were tested in 144 pairs, with one member of each pair randomly assigned to a “witness” role and the other to an “:investigator” role. Each witness viewed a target person on video under good or poor witnessing conditions and was then interviewed by an investigator, who administered a photo lineup and rated his or her confidence in the witness. Witnesses also (separately) rated their own confidence. Investigators discriminated between accurate and inaccurate witnesses, but did so less well than witnesses' own confidence ratings and were biased toward accepting witnesses' decisions. Moreover, investigators' confidence made no unique contribution to the prediction of witnesses' accuracy. Witnesses' confidence and accuracy were affected in the same direction by witnessing conditions, and there was a substantial confidence–accuracy correlation when data were collapsed across witnessing conditions. Confidence can be strongly indicative of accuracy when witnessing conditions vary widely, and witnesses' confidence may be a better indicator than investigators'Funder 1,This research was supported by a Natural Sciences and Engineering Research Council of Canada grant to the first
author || Funder 2, Natural Sciences and Engineering Research Council of Canada grant to the third author
PREVALENCE OF ORAL MUCOSAL LESIONS IN HEMODIALYSIS PATIENTS AND ASSOCIATION WITH MORTALITY: A PROSPECTIVE COHORT STUDY
No full textINTRODUCTION AND AIMS: Oral infections, mucosal lesions and impaired oral
health are highly prevalent and frequently severe for adults treated with long-term
hemodialysis. We aimed to evaluate the prevalence of mucosal lesions and association
with mortality outcomes among hemodialysis patients.
METHODS: Data were obtained from the ORAL-D study. The ORAL-D study was a
multinational cohort study that involved a comprehensive, standardized oral and dental
examination among 4726 patients with end-stage kidney disease treated with long
term hemodialysis in 7 countries in Europe and South America. Oral mucosal lesions
were ulceration, white stain, red stain, neoformation, petechial lesions, geographical
tongue, scrotal tongue, thrush, and herpes, assessed by trained dentists according to
standardWHOguidelines. The association between mucosal lesions and all-cause and
cardiovascular mortality was estimated using a Cox proportional hazard regression
model. Analyses were adjusted for sociodemographic and clinical variables (country,
age, sex, education, smoking history, prior myocardial infarction, diabetes, hemoglobin,
serum albumin, serum phosphorus, time on dialysis and body mass index). The
primary outcome was all-cause mortality.
RESULTS: Overall, 70 participants (1.7%) had mucosal ulceration, 147 (3.5%) participants
had white stain, 169 (4%) had red stain, 85 (2%) had neoformation, and 331
(7.9%) had petechial lesions. 207 (4.9%) had geographical tongue and 450 (10.7%) had
scrotal tongue. Thrush was observed in 192 participants ( 4.6%). Twenty-one participants
had oral herpetic lesions. During a median 3.47 (1.55-5.78) months of follow-up,
there were 2114 deaths including 1013 cardiovascular deaths. In unadjusted survival
analyses, the proportion of patients who died was higher among those with red stain,
scrotal tongue, and petechial lesions. Similarly, the estimated proportion of patients
who had a cardiovascular death was higher among those with red stain, scrotal tongue,
oral petechial lesions, neoformation, and oral thrush. When adjusting for clinical and
sociodemographic factors, only the presence of oral thrush was significantly associated
with an increased risk of all cause (adjusted HR 1.37, 95% CI 1-1.86) and cardiovascular
mortality (adjusted HR 1.64, 95% CI 1.09-2.46). This association was confirmed in
competing risks analysis and using a shared frailty model to account for clustering by
country.
CONCLUSIONS: There is generally limited evidence of an independent association
between oral mucosal lesions and mortality outcomes among hemodialysis patients
Contrast-enhanced CMR in patients after percutaneous closure of the left atrial appendage: A pilot study
No full textAbstract Background To evaluate the feasibility and value of first-pass contrast-enhanced dynamic and post-contrast 3D CMR in patients after transcatheter occlusion of left atrial appendage (LAA) to identify incorrect placement and persistent leaks. Methods 7 patients with different occluder systems (n = 4 PLAATO; n = 2 Watchman; n = 1 ACP) underwent 2 contrast-enhanced (Gd-DOTA) CMR sequences (2D TrueFISP first-pass perfusion and 3D-TurboFLASH) to assess localization, artifact size and potential leaks of the devices. Perfusion CMR was analyzed visually and semi-quantitatively to identify potential leaks. Results All occluders were positioned within the LAA. The ACP occluder presented the most extensive artifact size. Visual assessment revealed a residual perfusion of the LAA apex in 4 cases using first-pass perfusion and 3D-TurboFLASH indicating a suboptimal LAA occlusion. By assessing signal-to-time-curves the cases with a visually detected leak showed a 9-fold higher signal-peak in the LAA apex (567 ± 120% increase from baseline signal) than those without a leak (61 ± 22%; p Conclusion This CMR pilot study provides valuable non-invasive information in patients after transcatheter occlusion of the LAA to identify correct placement and potential leaks. We recommend incorporating CMR in future clinical studies to evaluate new device types.</p
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