315 research outputs found
Evaluation of pulse wave analysis to assess coronary artery disease
Full text linkConventional risk factors for cardiovascular disease, such as age, gender, hyperlipidaemia and hypertension are useful clinical markers of coronary artery disease (CAD) in asymptomatic patients or those without a prior history of atherosclerosis. In patients referred for a cardiology opinion, modification of risk factors by lifestyle changes and cardiac medications as well as confounding co-morbidities limit the value of these markers. Patients are often referred for diagnostic coronary angiography to determine the presence and severity of CAD, stratify the risk of future events and determine appropriate management. Despite the use of a variety of tests to best identify those requiring angiography, up to half of all patients referred do not have significant disease.
Pulse wave analysis (PWA) is a novel method to derive indices of central (aortic) blood pressure and arterial stiffness. Pressure waveforms are obtained non-invasively from the radial artery using a simple tonometry method and have been shown to correlate with clinical outcomes and cardiovascular events in selected populations. This thesis will explore, for the first time, the clinical potential for PWA as a non-invasive marker of CAD in an unselected contemporary cohort of patients referred for elective coronary angiography. The main hypotheses tested are first that PWA is a suitable tool for clinical use, including those with cardiac and non-cardiac co-morbidities and second that abnormalities of PWA are independent predictors of the presence and severity of CAD. Data have been derived from a prospective, protocol-driven, multi-centre cohort of 550 patients recruited from 2006-8.
Results suggest that PWA has a useful clinical role in stratifying the risk of coronary disease. PWA variables were independent of conventional blood pressure measurement and superior to baseline risk factors, biomarkers and other non-invasive tests
Direct oral anticoagulants halve thromboembolic events after cardioversion of AF compared with warfarin
Full text linkGhana's labor market (1987-92)
Full text linkUsing the household survey and other data sources, the authors analyze returns to education and other aspects of Ghana's labor market profile from 1987 to 1991. The labor force grew slower than the population did between 1980 and 1990, but the supply of labor is expected to increase as the population of youth is expected to grow faster from 1990 to 2000. And labor force participation rates for 26- to 45-year-olds have been increasing rapidly. Over time, the average labor force participation rates of women have become equal to men's; that of children younger than 15 has remained unchanged at 38 percent. More than half of Ghana's child laborers are employed in agriculture. The formal sector's share of employment is on the decline, while the private informal sector's share has increased, especially in urban areas. Over time, the informal sector (in which most workers have a primary education or less) has absorbed more labor than the formal sector (in which most workers have middle or secondary schooling). Unemployment is pervasive in urban areas, and is less visible in rural areas. Labor productivity may not have increased and is possibly declining. Between 1987 and 1992, there was reverse migration, with many people moving from urban to rural areas, mostly for family reasons. Employment-related migration has also been on the increase. As is true elsewhere, the level of education affects participation in the labor force. Literacy rates for women are lower than those for men, which is one reason men dominate the private formal sector. The rate of return to education increases with higher education and work experience. The return for each additional year of schooling rangesfrom 4 percent to 6 percent in Ghana, quite high for a Sub-Saharan African country. Private and social returns to education are greater for primary than for secondary or postsecondary education.Public Health Promotion,Health Economics&Finance,Health Monitoring&Evaluation,Labor Policies,Environmental Economics&Policies,Health Monitoring&Evaluation,Environmental Economics&Policies,Health Economics&Finance,Labor Standards,Poverty Assessment
Effect of Solid State Diffusion on Microsegregation in Steels
Full text linkTitle: Effect of Solid State Diffusion on Microsegregation in Steels, Author: Dipak B. Moharil, Location: ThodeControlled solidification of Fe-2wt% Ni binary and Fe-2 wt% Ni-Xwt%C ternary alloys was carried out in a travelling furnace. Metallographic studies were used to observe the effect of carbon on the morphology of growth. Electron probe microanalysis was carried out to obtain
quantitative results on the microsegregation of Ni in the binary and ternary alloys. The extent of homogenization of Ni, occurring both during and after solidification was quantitatively estimated.ThesisMaster of Engineering (ME
Malaysian labor markets under structural adjustment
Full text linkMalaysia's sustained growth in the 1970s was boosted by windfall gains during two oil price hikes plus a commodity boom. Oil and commodity prices fell in the 1980s and Malaysia, an oil exporter, bungled into a rather severe depression in 1985-86. But it recovered quickly, to the surprise of some - and growth resumed in 1987. The events that led to the recession and quick turnaround are a Southeast Asia prototype. The author analyzes the key relationships in this cyclical behavior. He then focuses on long-term labor market issues of interest during the economy's 20-year transformation. It was found that the real exchange rate appreciated because of the inflow of foreign capital to support the government's budget deficit. And the increase in average wages in the period leading up to the recession was not corrected with the rise in the domestic exchange rate in a fully employed economy. Wages increased more than labor productivity did at a time when employment growth had slowed and the rate of unemployment had risen. The author also concluded that rising labor costs were only part of the problem of rising costs before the recession. The whole package of fiscal, monetary, and exchange rate policies - together with the labor market behavior - led to the recession.Banks&Banking Reform,Environmental Economics&Policies,Economic Theory&Research,Economic Stabilization,Markets and Market Access
Dynamic risk assessment to improve quality of care in patients with atrial fibrillation: the 7th AFNET/EHRA Consensus Conference
No full textAims The risk of developing atrial fibrillation (AF) and its complications continues to increase, despite good progress in preventing AF-related strokes. Methods and results This article summarizes the outcomes of the 7th Consensus Conference of the Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA) held in Lisbon in March 2019. Sixty-five international AF specialists met to present new data and find consensus on pressing issues in AF prevention, management and future research to improve care for patients with AF and prevent AF-related complications. This article is the main outcome of an interactive, iterative discussion between breakout specialist groups and the meeting plenary. AF patients have dynamic risk profiles requiring repeated assessment and risk-based therapy stratification to optimize quality of care. Interrogation of deeply phenotyped datasets with outcomes will lead to a better understanding of the cardiac and systemic effects of AF, interacting with comorbidities and predisposing factors, enabling stratified therapy. New proposals include an algorithm for the acute management of patients with AF and heart failure, a call for a refined, data-driven assessment of stroke risk, suggestions for anticoagulation use in special populations, and a call for rhythm control therapy selection based on risk of AF recurrence. Conclusion The remaining morbidity and mortality in patients with AF needs better characterization. Likely drivers of the remaining AF-related problems are AF burden, potentially treatable by rhythm control therapy, and concomitant conditions, potentially treatable by treating these conditions. Identifying the drivers of AF-related complications holds promise for stratified therapy
Author Correction: The flying spider-monkey tree fern genome provides insights into fern evolution and arborescence (Nature Plants, (2022), 8, 5, (500-512), 10.1038/s41477-022-01146-6)
Full text linkCorrection to: Nature Plantshttps://doi.org/10.1038/s41477-022-01146-6, published online 9 May 2022. In the version of the article initially published, Dipak Khadka, who collected the samples in Nepal, was thanked in the Acknowledgements instead of being listed as an author. His name and affiliation (GoldenGate International College, Tribhuvan University, Battisputali, Kathmandu, Nepal) have been added to the authorship in the HTML and PDF versions of the article
Assessment of optical transmission and image contrast at infrared wavelengths using tissue simulating phantoms and biological tissues
No full textIn vivo fluorescence imaging is an emerging technique with potential for usage in non-invasive cancer screening, surveillance, real-time surgical guidance, and staging. Fluorescence imaging uses the interaction of non-ionizing optical radiation with endogenous fluorophores or fluorescent labels to provide real-time wide-field images of tissue structure and/or functional components. When imaging in vivo, excitation light must travel through overlying tissue to reach the fluorescent target and emitted fluorescence must then propagate back through the overlying tissue in order to be imaged onto a camera. Recently, fluorescent contrast agents have been developed with excitation and emission wavelengths in the near infrared (NIR) spectrum (~700 – 1,000 nm) in order to minimize attenuation and maximize the measured signal from tissue. While several clinical trials have shown the potential benefits of NIR contrast agents over visible fluorophores, there may still be room for improvement by moving to even longer wavelengths. As scattering is reduced as wavelength increases, some researchers are investigating fluorophores that emit in the short-wave infrared (SWIR) wavelength region (~1,000 – 2,300 nm). This study focuses on examining optical transmission and image contrast at NIR wavelengths and SWIR wavelengths to determine which wavelength region may be optimal for development of fluorescent contrast agents. Transmission and contrast measurements were performed on both tissue simulating phantoms and real biological tissues using 780 nm, 980 nm, and 1550 nm wavelengths. From the experiments conducted, it appears that fluorophore emissions should be chosen based on the goals of the specific application. For an application that requires simple detection of signal, near infrared wavelengths will be better as they can be detected with higher signal levels. For an application that focuses on imaging fluorophore-labeled tissues, short-wave infrared wavelengths will be the better option as they provided better image contrastM.S.Includes bibliographical referencesby Khushbu Dipak Pate
Is it time to treat post-operative atrial fibrillation just like regular atrial fibrillation?
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