69,256 research outputs found
The UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factors
No full textThe UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factor
Pulse oximetry adoption and oxygen orders at paediatric admission over 7 years in Kenya: a multihospital retrospective cohort study
No full textObjectives To characterise adoption and explore specific clinical and patient factors that might influence pulse oximetry and oxygen use in low-income and middle-income countries (LMICs) over time; to highlight useful considerations for entities working on programmes to improve access to pulse oximetry and oxygen.
Design A multihospital retrospective cohort study.
Settings All admissions (n=132 737) to paediatric wards of 18 purposely selected public hospitals in Kenya that joined a Clinical Information Network (CIN) between March 2014 and December 2020.
Outcomes Pulse oximetry use and oxygen prescription on admission; we performed growth-curve modelling to investigate the association of patient factors with study outcomes over time while adjusting for hospital factors.
Results Overall, pulse oximetry was used in 48.8% (64 722/132 737) of all admission cases. Use rose on average with each month of participation in the CIN (OR: 1.11, 95% CI 1.05 to 1.18) but patterns of adoption were highly variable across hospitals suggesting important factors at hospital level influence use of pulse oximetry. Of those with pulse oximetry measurement, 7% (4510/64 722) had hypoxaemia (SpO2 <90%). Across the same period, 8.6% (11 428/132 737) had oxygen prescribed but in 87%, pulse oximetry was either not done or the hypoxaemia threshold (SpO2 <90%) was not met. Lower chest-wall indrawing and other respiratory symptoms were associated with pulse oximetry use at admission and were also associated with oxygen prescription in the absence of pulse oximetry or hypoxaemia.
Conclusion The adoption of pulse oximetry recommended in international guidelines for assessing children with severe illness has been slow and erratic, reflecting system and organisational weaknesses. Most oxygen orders at admission seem driven by clinical and situational factors other than the presence of hypoxaemia. Programmes aiming to implement pulse oximetry and oxygen systems will likely need a long-term vision to promote adoption, guideline development and adherence and continuously examine impact
Global distributions of age- and sex-related arterial stiffness: systematic review and meta-analysis of 167 studies with 509,743 participants
No full textBackground: Arterial stiffening is central to the vascular ageing process and a powerful predictor and cause of diverse vascular pathologies and mortality. We investigated age and sex trajectories, regional differences, and global reference values of arterial stiffness as assessed by pulse wave velocity (PWV).
Methods: Measurements of brachial-ankle or carotid-femoral PWV (baPWV or cfPWV) in generally healthy participants published in three electronic databases between database inception and August 24th, 2020 were included, either as individual participant-level or summary data received from collaborators (n = 248,196) or by extraction from published reports (n = 274,629). Quality was appraised using the Joanna Briggs Instrument. Variation in PWV was estimated using mixed-effects meta-regression and Generalized Additive Models for Location, Scale, and Shape.
Findings: The search yielded 8920 studies, and 167 studies with 509,743 participants from 34 countries were included. PWV depended on age, sex, and country. Global age-standardised means were 12.5 m/s (95% confidence interval: 12.1-12.8 m/s) for baPWV and 7.45 m/s (95% CI: 7.11-7.79 m/s) for cfPWV. Males had higher global levels than females of 0.77 m/s for baPWV (95% CI: 0.75-0.78 m/s) and 0.35 m/s for cfPWV (95% CI: 0.33-0.37 m/s), but sex differences in baPWV diminished with advancing age. Compared to Europe, baPWV was substantially higher in the Asian region (+1.83 m/s, P = 0.0014), whereas cfPWV was higher in the African region (+0.41 m/s, P < 0.0001) and differed more by country (highest in Poland, Russia, Iceland, France, and China; lowest in Spain, Belgium, Canada, Finland, and Argentina). High vs. other country income was associated with lower baPWV (-0.55 m/s, P = 0.048) and cfPWV (-0.41 m/s, P < 0.0001).
Interpretation: China and other Asian countries featured high PWV, which by known associations with central blood pressure and pulse pressure may partly explain higher Asian risk for intracerebral haemorrhage and small vessel stroke. Reference values provided may facilitate use of PWV as a marker of vascular ageing, for prediction of vascular risk and death, and for designing future therapeutic interventions.
Funding: This study was supported by the excellence initiative VASCage funded by the Austrian Research Promotion Agency, by the National Science Foundation of China, and the Science and Technology Planning Project of Hunan Province. Detailed funding information is provided as part of the Acknowledgments after the main text
The effect of pulse stimulation on marine biota - Research in relation to ICES advice - Progress report on the effects on benthic invertebrates
No full textIn response to ecosystem related concerns about bottom trawling and particularly beam trawling that were raised by various scientists in the last decades of the previous century. Many studies were done in the 1970s and 1980s, but in spite of promising results commercial uptake was lacking. The development of pulse trawling was again taken up in the 1990s by a private company (Verburg:Holland Ltd.) in The Netherlands. Meanwhile questions about ecosystem effects of introducing pulse beam trawling in the Dutch flatfish fishery were raised by the European Scientific, Technical and Economic Committee for Fisheries (STECF) and the Inter: national Council for the Exploration of the Sea (ICES) and discussed at the meeting of the ICES Working Group on Fishing Technology and Fish Behaviour (WGFTFB) in 2006. These questions led to field strength measurements in situ onboard the commercial beam trawler, and research on the effects of pulse stimulation on cod (Gadus morhua L.), and elasmobranch fish
An assessment of pulse transit time for detecting heavy blood loss during surgical operation
No full textCopyright @ Wang et al.; Licensee Bentham Open.
This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License
(http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the
work is properly cited.The main contribution of this paper is the use of non-invasive measurements such as electrocardiogram (ECG) and photoplethysmographic (PPG) pulse oximetry waveforms to develop a new physiological signal analysis technique for detecting blood loss during surgical operation. Urological surgery cases were considered as the control group due to its generality, and cardiac surgery as experimental group since it involves blood loss and water supply. Results show that the control group has the tendency of a reduction of the pulse transient time (PTT), and this indicates an increment in the blood flow velocity changes from slow to fast. While for the experimental group, the PTT indicates high values during blood loss, and low values during water supply. Statistical analysis shows considerable differences (i.e., P <0.05) between both groups leading to the conclusion that PTT could be a good indicator for monitoring patients' blood loss during a surgical operation.The National Science Council (NSC) of Taiwan and the Centre for Dynamical Biomarkers and Translational Medicine, National Central University, Taiwan
The effect of electric pulse stimulation to juvenile cod and cod of commercial landing size
No full textThe first pilot study on the effects of electric pulse stimulation on larger cod carried out in 2008 was based on a single nominal setting of the Verburg-Holland UK153 pulse system with the intention to determine the range of pulse characteristics with which injuries to the fish occurred. This study was designed to obtain a more detailed view on the effects of the pulse characteristics and to investigate if a specific pulse parameter has a key role in the effects. Lower pulse amplitudes with longer pulse width and higher frequency could induce different effects than pulses with higher amplitudes, shorter pulse width and lower frequency. In this way the effects can be related to a specific pulse parameter and its threshold value. Another aim of major importance is that this research also carried out on the electrically exposed fish that would normally escape through the cod-end meshes with unknown longer term effects. This was already recommended after the first experiment in 2008
Electromagnetic modelling of a monolithic pulse reshaper based on a photonic crystal waveguide integrated with a SOA
No full textFinite difference time domain (FDTD) and finite element (FE) frequency domain methods are used to study the propagation of arbitrary chirped pulses in photonic crystal (PhC) waveguide. An arbitrary chirped pulse is derived from a separate Semiconductor optical amplifier (SOA) model and is passed through a mini-stop band (MSB) in a photonic crystal waveguide. Good agreement is shown between the FDTD and FE models and pulse compression is observe
Comparative study of the efficacy of olmesartan/amlodipine vs. perindopril/amlodipine in peripheral blood pressure after missed dose in type 2 diabetes
No full textINTRODUCTION: Combination therapy is needed to control blood pressure (BP) in a large number of hypertensive patients with diabetes mellitus. Adherence to treatment is a major clinical problem; therefore, the time duration of the antihypertensive action of a drug determines BP control when a dose is skipped.
OBJECTIVES: The aim was to determine whether the fixed-dose combination of olmesartan/amlodipine provides equal efficacy and safety as the perindopril/amlodipine combination when a drug dose is missed.
METHODS: In this noninferiority trial with a randomized, double-blind, double-dummy parallel group, controlled design, 260 patients received either olmesartan 20-40 mg/amlodipine 5-10 mg or perindopril 4-8 mg/amlodipine 5-10 mg for 24 weeks. The main outcome was the sitting office DBP after 24 weeks of treatment at 48 h from last administration.
RESULTS: The olmesartan/amlodipine combination reached noninferiority criteria in reduction of office DBP after 24 weeks of treatment and after the missed dose, compared with the perindopril/amlodipine combination (-11.7 and -10.5 mmHg, respectively). Office SBP and pulse pressure were significantly lower in both groups after 24 weeks of treatment and 48 h after the missed dose, observing a trend to greater SBP reduction in the olmesartan/amlodipine group.
CONCLUSIONS: The combination olmesartan/amlodipine is safe, well tolerated, and as effective as the combination of perindopril/amlodipine in the control of essential hypertension in patients with diabetes mellitus. A missed dose does not leave the patients unprotected in both treatments; however, a faster control with less dose increment is observed with olmesartan/amlodipine
Comparative study of the efficacy of olmesartan/amlodipine vs. perindopril/amlodipine in peripheral blood pressure after missed dose in type 2 diabetes
No full textINTRODUCTION:
Combination therapy is needed to control blood pressure (BP) in a large number of hypertensive patients with diabetes mellitus. Adherence to treatment is a major clinical problem; therefore, the time duration of the antihypertensive action of a drug determines BP control when a dose is skipped.
OBJECTIVES:
The aim was to determine whether the fixed-dose combination of olmesartan/amlodipine provides equal efficacy and safety as the perindopril/amlodipine combination when a drug dose is missed.
METHODS:
In this noninferiority trial with a randomized, double-blind, double-dummy parallel group, controlled design, 260 patients received either olmesartan 20-40 mg/amlodipine 5-10 mg or perindopril 4-8 mg/amlodipine 5-10 mg for 24 weeks. The main outcome was the sitting office DBP after 24 weeks of treatment at 48 h from last administration.
RESULTS:
The olmesartan/amlodipine combination reached noninferiority criteria in reduction of office DBP after 24 weeks of treatment and after the missed dose, compared with the perindopril/amlodipine combination (-11.7 and -10.5 mmHg, respectively). Office SBP and pulse pressure were significantly lower in both groups after 24 weeks of treatment and 48 h after the missed dose, observing a trend to greater SBP reduction in the olmesartan/amlodipine group.
CONCLUSIONS:
The combination olmesartan/amlodipine is safe, well tolerated, and as effective as the combination of perindopril/amlodipine in the control of essential hypertension in patients with diabetes mellitus. A missed dose does not leave the patients unprotected in both treatments; however, a faster control with less dose increment is observed with olmesartan/amlodipine
Landings and discards on the pulse trawl MFV "Vertrouwen"TX68 in 2009
No full textThe catches in terms of landings and discards were monitored onboard MFV “Vertrouwen” TX68, fishing with two pulse trawls using the Verburg-Holland system during four weeks in June-August 2009. The average fishing speed was about 5 knots. The fishing area of the four trips was east of the coast of England and fishing depth was 36m on average with a minimum depth of 20 m and a maximum depth of 46 m. For this study the standard sampling procedure for the yearly monitoring of discards of conventional beam trawl fleet was applied (van Helmond and van Overzee, 2008). Sampled numbers of fish per haul were raised to numbers and weight per hour, for both. When compared with conventional beam trawls in previous years it seems that with the pulse trawl more sole in number and weights per unit of time was discarded and less plaice was discarded. However, the average discard percentages of as well plaice as sole for the pulse trawl of this study were within range with the average discard percentages of conventional beam trawls in 2005, 2006 and 2007 (van Keeken, 2006; van Helmond and van Overzee, 2007; van Helmond and van Overzee, 2008) . This study gives a general impression of the performance in terms of catches of fishing with a pulse trawl using the Verburg-Holland system. However it is recommended to conduct a comparative study on performance of a beam trawl and a pulse trawl, where the two vessels of similar size fish simultaneously, like was done in 2006 by van Marlen et al. This is to exclude the effects of time and area of fishing
- …
