1,514 research outputs found
Effect of Clopidogrel on the Rate and function severity of stroke among high vascular risk patients.A prespecified substudy of the clopidogrel for high atherotrombotic risk and stabilization,management and avoidance(CHARISMA)Trial
No full textEffects of moderate weight loss on anginal symptoms and indices of coagulation and fibrinolysis in overweight patients with angina pectoris
No full textObjective: To evaluate the effects of moderate weight loss, in overweight patients with angina, on plasma coagulation, fibrinolytic indicies and pain frequency. Design: Single- stranded 12-week dietary intervention, an individualised eating plan with quantitative advice delivered by a dietitian. Target weight loss of 0.5 kg per week. Setting: Outpatient research clinic. Subjects: Fifty-four volunteers with angina pectoris were recruited. Five subjects withdrew, so 27 males, 22 females, mean body mass index (BMI) 29.3 (s.d. 4.3) kg/m(2) and age 60.3 (s.d. 6.5) y completed the intervention. Measurements: Body weight and frequency of anginal pain. Plasma fibrinogen, red cell aggregation (RCA), viscosity, factor VII activity, plasminogen activator inhibitor (PAI) activity, tissue plasminogen activator antigen (t-PA), plasma cholesterol, triglyceride and insulin. Results: After the 12-week dietary intervention period, mean body weight fell by 3.5 (s.d. 2.6) kg or 4.3% (P = 0.0001), range -11.7 to +1.7 kg. Mean angina frequency fell by 1.8 (s.d. 3.6) from 3.2 to 1.4 episodes/week (P = 0.009) and plasma cholesterol by 0.4 (s.d. 0.7) from 6.3 to 5.9 mmol/1 (P = 0.0001). HDL cholesterol and triglyceride were unchanged. Of the coagulation and fibrinolytic factors, factor VII activity and RCA were significantly reduced by 5 (s.d. 20), IU/dl (P = 0.04) and 1.3 (s.d. 1.3) arbitrary units (P = 0.014), respectively. Conclusions: A conventional dietetic intervention, resulting in 4% weight loss, offers the potential to reduce atherosclerotic and thrombotic risk, and to reduce pain frequency, in angina patients. Given the importance of this result in a public health context, these results indicate that this may be a fruitful area for future nutrition research
Apixaban versus aspirin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a predefined subgroup analysis from AVERROES, a randomised trial.
No full textAbstract
BACKGROUND:
In the AVERROES study, apixaban, a novel factor Xa inhibitor, reduced the risk of stroke or systemic embolism in patients with atrial fibrillation who were at high risk of stroke but unsuitable for vitamin K antagonist therapy. We aimed to investigate whether the subgroup of patients with previous stroke or transient ischaemic attack (TIA) would show a greater benefit from apixaban compared with aspirin than would patients without previous cerebrovascular events.
METHODS:
In AVERROES, 5599 patients (mean age 70 years) with atrial fibrillation who were at increased risk of stroke and unsuitable for vitamin K antagonist therapy were randomly assigned to receive apixaban (5 mg twice daily) or aspirin (81-324 mg per day). The mean follow-up was 1·1 years. The primary efficacy outcome was stroke or systemic embolism; the primary safety outcome was major bleeding. Patients and investigators were masked to study treatment. In this prespecified subgroup analysis, we used Kaplan-Meier estimates of 1-year event risk and Cox proportional hazards regression models to compare the effects of apixaban in patients with and without previous stroke or TIA. AVERROES is registered at ClinicalTrials.gov, number NCT00496769.
FINDINGS:
In patients with previous stroke or TIA, ten events of stroke or systemic embolism occurred in the apixaban group (n=390, cumulative hazard 2·39% per year) compared with 33 in the aspirin group (n=374, 9·16% per year; hazard ratio [HR] 0·29, 95% CI 0·15-0·60). In those without previous stroke or TIA, 41 events occurred in the apixaban group (n=2417, 1·68% per year) compared with 80 in the aspirin group (n=2415, 3·06% per year; HR 0·51, 95% CI 0·35-0·74). The p value for interaction of the effects of aspirin and apixaban with previous cerebrovascular events was 0·17. Major bleeding was more frequent in patients with history of stroke or TIA than in patients without (HR 2·88, 95% CI 1·77-4·55) but risk of this event did not differ between treatment groups.
INTERPRETATION:
In patients with atrial fibrillation, apixaban is similarly effective whether or not patients have had a previous stroke or TIA. Given that those with previous stroke or TIA have a higher risk of stroke, the absolute benefits might be greater in these patients
Recommended from our members
GJ 3929: High-precision Photometric and Doppler Characterization of an Exo-Venus and Its Hot, Mini-Neptune-mass Companion
No full textWe detail the follow-up and characterization of a transiting exo-Venus identified by TESS, GJ 3929b (TOI-2013b), and its nontransiting companion planet, GJ 3929c (TOI-2013c). GJ 3929b is an Earth-sized exoplanet in its star’s Venus zone (P b = 2.616272 ± 0.000005 days; Sb = 17.3 − 0.7 + 0.8 S ⊕) orbiting a nearby M dwarf. GJ 3929c is most likely a nontransiting sub-Neptune. Using the new, ultraprecise NEID spectrometer on the WIYN 3.5 m Telescope at Kitt Peak National Observatory, we are able to modify the mass constraints of planet b reported in previous works and consequently improve the significance of the mass measurement to almost 4σ confidence (M b = 1.75 ± 0.45 M ⊕). We further adjust the orbital period of planet c from its alias at 14.30 ± 0.03 days to the likely true period of 15.04 ± 0.03 days, and we adjust its minimum mass to m sin i = 5.71 ± 0.92 M ⊕. Using the diffuser-assisted ARCTIC imager on the ARC 3.5 m telescope at Apache Point Observatory, in addition to publicly available TESS and LCOGT photometry, we are able to constrain the radius of planet b to R p = 1.09 ± 0.04 R ⊕. GJ 3929b is a top candidate for transmission spectroscopy in its size regime (TSM = 14 ± 4), and future atmospheric studies of GJ 3929b stand to shed light on the nature of small planets orbiting M dwarfs. © 2022. The Author(s). Published by the American Astronomical Society.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]
Differing risk factor profiles of ischemic stroke subtypes: evidence for a distinct lacunar arteriopathy?
No full textCaroline A. Jackson, Aidan Hutchison, Martin S. Dennis, Joanna M. Wardlaw, Arne Lindgren, Bo Norrving, Craig S. Anderson, Graeme J. Hankey, Konrad Jamrozik, Peter Appelros, Cathie L.M. Sudlowhttp://stroke.ahajournals.org/cgi/content/abstract/41/4/62
The Optimization of the Performance Management for Operators in GJ Company Xiamen
No full text本文以绩效管理的基本理论和GJ厦门厂的实际情况为基础，分析了GJ厦门厂一线作业员绩效管理的问题点，并结合公司目前的实际情况提出一线作业员的绩效管理改善方案。该方案以平衡计分卡的绩效管理体系为逻辑，将公司的战略目标分解到制造处，再分解至一线作业员，让作业员的绩效也能从财务面、客户面、内部运营面、学习成长面四个维度上对公司的战略发展起到支撑作用，以促进组织战略目标的实现。 在绩效管理改进方案中，作者特别强调沟通在绩效管理过程中的重要作用，它贯穿了绩效管理的整个过程。沟通有助于促进员工个人绩效的提升和员工个人的成长，从而提升组织的整体效益。 根据GJ厦门厂的实际情况，将一线作业员的绩效考核结...In this paper, operators’ performance management problems in GJ Company are analyzed based on the basic theory of performance management and the real situation of the company. The author propose to break down the company’s strategic targets to lower levels with balanced scorecard system by four levels of financial, customer, internal operation, learning and developing. So that operators’ performa...学位：管理学硕士院系专业：管理学院_工商管理硕士(工商管理硕士)学号：1792012115103
Exergy comparison of lunar propellant manufacturing and insertion into LEO using a fully reusable refueling rocket
No full textQuantifying the exergy requirement of propellant insertion into LEO can lead to insight into the feasibility of a lunar propellant-generating architecture. Spacecraft leaving from Earth can greatly reduce their lift-off mass if in-space refueling would possible. Exergy analyses quantify the available energy of a system and show where a reduction in usable energy occurs. Insight into the exergy destruction and input provides a key parameter into the scaling and design of processes and corresponding power systems. The present study aims to define an exergy environment in the lunar PSRs and then to analyze the exergy destruction related to the production of oxygen, ALICE, and hydrolox, in terms of both manufacturing and transportation using a two-stage fully reusable rocket. Extraction processes for ALICE and hydrolox were selected and analyzed w.r.t. the lunar environment to get an understanding of the exergy input. The behavior and exergy requirements of an LEO propellant depot was described. Two fully reusable two-stage rockets using ALICE and hydrolox were designed and compared based on their payload-to-propellant ratio for the oxygen, ALICE, and hydrolox payloads. The study found that the exergetic cost for the insertion of oxygen, hydrolox, and ALICE in LEO were 1.32 GJ/kg , 1.64 GJ/kg, and GJ/kg and 23.3 GJ/kg, 23.4 GJ/kg and 26.9 GJ/kg for the hydrolox and ALICE rocket, respectively.Aerospace Engineerin
Risk factors for chest infection in acute stroke: a prospective cohort study
No full text<p><b>Background and Purpose:</b> Pneumonia is a major cause of morbidity and mortality after stroke. We aimed to determine key characteristics that would allow prediction of those patients who are at highest risk for poststroke pneumonia.</p>
<p><b>Methods:</b> We studied a series of consecutive patients with acute stroke who were admitted to hospital. Detailed evaluation included the modified National Institutes of Health Stroke Scale; the Abbreviated Mental Test; and measures of swallow, respiratory, and oral health status. Pneumonia was diagnosed by set criteria. Patients were followed up at 3 months after stroke.</p>
<p><b>Results:</b> We studied 412 patients, 391 (94.9%) with ischemic stroke and 21 (5.1%) with hemorrhagic stroke; 78 (18.9%) met the study criteria for pneumonia. Subjects who developed pneumonia were older (mean±SD age, 75.9±11.4 vs 64.9±13.9 years), had higher modified National Institutes of Health Stroke Scale scores, a history of chronic obstructive pulmonary disease, lower Abbreviated Mental Test scores, and a higher oral cavity score, and a greater proportion tested positive for bacterial cultures from oral swabs. In binary logistic-regression analysis, independent predictors (P<0.05) of pneumonia were age >65 years, dysarthria or no speech due to aphasia, a modified Rankin Scale score ≥4, an Abbreviated Mental Test score <8, and failure on the water swallow test. The presence of 2 or more of these risk factors carried 90.9% sensitivity and 75.6% specificity for the development of pneumonia.</p>
<p><b>Conclusions:</b> Pneumonia after stroke is associated with older age, dysarthria/no speech due to aphasia, severity of poststroke disability, cognitive impairment, and an abnormal water swallow test result. Simple assessment of these variables could be used to identify patients at high risk of developing pneumonia after stroke.</p>
Recommended from our members
Double Trouble: Two Transits of the Super-Earth GJ 1132 b Observed with JWST NIRSpec G395H
No full textThe search for rocky planet atmospheres with JWST has focused on planets transiting M dwarfs. Such planets have favorable planet-to-star size ratios, enhancing the amplitude of atmospheric features. Since the expected signal strength of atmospheric features is similar to the single-transit performance of JWST, multiple observations are required to confirm any detection. Here, we present two transit observations of the rocky planet GJ 1132 b with JWST NIRSpec G395H, covering 2.8-5.2 μm. Previous Hubble Space Telescope WFC3 observations of GJ 1132 b were inconclusive, with evidence reported for either an atmosphere or a featureless spectrum based on analyses of the same data set. Our JWST data exhibit substantial differences between the two visits. One transit is consistent with either an H2O-dominated atmosphere containing ∼1% CH4 and trace N2O ( χ ν 2 = 1.13 ) or stellar contamination from unocculted starspots ( χ ν 2 = 1.36 ). However, the second transit is consistent with a featureless spectrum. Neither visit is consistent with a previous report of HCN. Atmospheric variability is unlikely to explain the scale of the observed differences between the visits. Similarly, our out-of-transit stellar spectra show no evidence of changing stellar inhomogeneity between the two visits—observed 8 days apart, only 6.5% of the stellar rotation rate. We further find no evidence of differing instrumental systematic effects between visits. The most plausible explanation is an unlucky random noise draw leading to two significantly discrepant transmission spectra. Our results highlight the importance of multivisit repeatability with JWST prior to claiming atmospheric detections for these small, enigmatic planets. © 2023. The Author(s). Published by the American Astronomical Society.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]
- …
