Summary Background Acute exposure to air pollution has been linked to myocardial infarction, but its effect on heart failure is uncertain. We did a systematic review and meta-analysis to assess the ...association between air pollution and acute decompensated heart failure including hospitalisation and heart failure mortality. Methods Five databases were searched for studies investigating the association between daily increases in gaseous (carbon monoxide, sulphur dioxide, nitrogen dioxide, ozone) and particulate (diameter <2·5 μm PM2·5 or <10 μm PM10 ) air pollutants, and heart failure hospitalisations or heart failure mortality. We used a random-effects model to derive overall risk estimates per pollutant. Findings Of 1146 identified articles, 195 were reviewed in-depth with 35 satisfying inclusion criteria. Heart failure hospitalisation or death was associated with increases in carbon monoxide (3·52% per 1 part per million; 95% CI 2·52–4·54), sulphur dioxide (2·36% per 10 parts per billion; 1·35–3·38), and nitrogen dioxide (1·70% per 10 parts per billion; 1·25–2·16), but not ozone (0·46% per 10 parts per billion; −0·10 to 1·02) concentrations. Increases in particulate matter concentration were associated with heart failure hospitalisation or death (PM2·5 2·12% per 10 μg/m3 , 95% CI 1·42–2·82; PM10 1·63% per 10 μg/m3 , 95% CI 1·20–2·07). Strongest associations were seen on the day of exposure, with more persistent effects for PM2·5 . In the USA, we estimate that a mean reduction in PM2·5 of 3·9 μg/m3 would prevent 7978 heart failure hospitalisations and save a third of a billion US dollars a year. Interpretation Air pollution has a close temporal association with heart failure hospitalisation and heart failure mortality. Although more studies from developing nations are required, air pollution is a pervasive public health issue with major cardiovascular and health economic consequences, and it should remain a key target for global health policy. Funding British Heart Foundation.
In general, the photovoltaic (PV) is considered as the best selection among renewable energy resources due to its nonpolluted operation and good flexibility condition. The PV system is affected ...because of the partial shading conditions (PSCs), which reduce the generated power. During steady‐state operating conditions, there occurs a time delay in tracking the Global maximum power point (GMPP) and Local maximum power point (LMPP) under PSCs using the perturb and observe (P&O) method. In order to overcome such shortcomings, this paper proposed a hybrid algorithm with a P&O technique to improve the maximum power point tracking (MPPT) for the PV system under PSC. In addition to this, the P&O technique is utilized to achieve the LMPP in the first section, and the hybrid algorithm is utilized to achieve the GMPP in the second section. Here, the hybrid technique is the integration of Cauchy preferential crossover (CC) with the flower pollination algorithm (FPA). Furthermore, the exploitation ability of the FPA is enhanced by the CC, and the combined hybrid algorithm has the ability to produce the optimal duty cycle for the DC–DC boost converter for MPPT. Then the proposed method will be executed in MATLAB/Simulink model, and it is contrasted with the existing methods such as CC, current sensorless (CS), and FPA, respectively. The experimental results and analysis reveal that the proposed approach provides better performances when compared with several other metaheuristic algorithms.
This paper proposed a hybrid algorithm with a P&O technique to improve the maximum power point tracking (MPPT) for the PV system under PSC. In addition to this, the P&O technique is utilized to achieve the LMPP in the first section, and the hybrid algorithm is utilized to achieve the GMPP in the second section. Here, the hybrid technique is the integration of Cauchy preferential crossover (CC) with the flower pollination algorithm (FPA).
In Kerala, a coastal land in India, Ginger is cultivated as a rainfed annual. The current study on morphological characters of seed rhizomes stored in Zero Energy Cool Chambers recorded a weight loss ...of 28% at three months after storage. The number of sprouting buds was maximum (12.25) in the seed rhizomes stored for three months. The dimensions of the bud measured at the varied periods of storage interval showed variation. The length of the bud increased from 0.847μm to 2.19 μm and the breadth reduced from 1.19 μm to 0.703μm in three months of storage. The current study provides the anatomical morphology of ginger seed rhizomes. Histochemical studies of seed rhizome for three months storage showed that the number of cork layers varied from 5-15, size of starch grain decreased on storage from 40 μm to 20 μm and the oil globules found inside the parenchymatous cells increased from 20 μm to 40 μm. These results will be helpful to understand the bud development of ginger seed rhizome during storage.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
5.
Effect of Vaccination on Transmission of SARS-CoV-2 Shah, Anoop S.V; Gribben, Ciara; Bishop, Jennifer ...
New England journal of medicine/The New England journal of medicine,
10/2021, Letnik:
385, Številka:
18
Journal Article
Recenzirano
Odprti dostop
In this report from Scotland, vaccination of health care workers for SARS-CoV-2 was associated with a decrease in household transmission.
Health-related quality of life metrics evaluate treatments in ways that matter to patients, so are often included in randomised clinical trials (hereafter trials). Multimorbidity, where individuals ...have 2 or more conditions, is negatively associated with quality of life. However, whether multimorbidity predicts change over time or modifies treatment effects for quality of life is unknown. Therefore, clinicians and guideline developers are uncertain about the applicability of trial findings to people with multimorbidity. We examined whether comorbidity count (higher counts indicating greater multimorbidity) (i) is associated with quality of life at baseline; (ii) predicts change in quality of life over time; and/or (iii) modifies treatment effects on quality of life.
Included trials were registered on the United States trials registry for selected index medical conditions and drug classes, phase 2/3, 3 or 4, had ≥300 participants, a nonrestrictive upper age limit, and were available on 1 of 2 trial repositories on 21 November 2016 and 18 May 2018, respectively. Of 124 meeting these criteria, 56 trials (33,421 participants, 16 index conditions, and 23 drug classes) collected a generic quality of life outcome measure (35 EuroQol-5 dimension (EQ-5D), 31 36-item short form survey (SF-36) with 10 collecting both). Blinding and completeness of follow up were examined for each trial. Using trials where individual participant data (IPD) was available from 2 repositories, a comorbidity count was calculated from medical history and/or prescriptions data. Linear regressions were fitted for the association between comorbidity count and (i) quality of life at baseline; (ii) change in quality of life during trial follow up; and (iii) treatment effects on quality of life. These results were then combined in Bayesian linear models. Posterior samples were summarised via the mean, 2.5th and 97.5th percentiles as credible intervals (95% CI) and via the proportion with values less than 0 as the probability (PBayes) of a negative association. All results are in standardised units (obtained by dividing the EQ-5D/SF-36 estimates by published population standard deviations). Per additional comorbidity, adjusting for age and sex, across all index conditions and treatment comparisons, comorbidity count was associated with lower quality of life at baseline and with a decline in quality of life over time (EQ-5D -0.02 95% CI -0.03 to -0.01, PBayes > 0.999). Associations were similar, but with wider 95% CIs crossing the null for SF-36-PCS and SF-36-MCS (-0.05 -0.10 to 0.01, PBayes = 0.956 and -0.05 -0.10 to 0.01, PBayes = 0.966, respectively). Importantly, there was no evidence of any interaction between comorbidity count and treatment efficacy for either EQ-5D or SF-36 (EQ-5D -0.0035 95% CI -0.0153 to -0.0065, PBayes = 0.746; SF-36-MCS (-0.0111 95% CI -0.0647 to 0.0416, PBayes = 0.70 and SF-36-PCS -0.0092 95% CI -0.0758 to 0.0476, PBayes = 0.631.
Treatment effects on quality of life did not differ by multimorbidity (measured via a comorbidity count) at baseline-for the medical conditions studied, types and severity of comorbidities and level of quality of life at baseline, suggesting that evidence from clinical trials is likely to be applicable to settings with (at least modestly) higher levels of comorbidity.
A prespecified protocol was registered on PROSPERO (CRD42018048202).
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The use of non-invasive imaging to identify ruptured or high-risk coronary atherosclerotic plaques would represent a major clinical advance for prevention and treatment of coronary artery disease. We ...used combined PET and CT to identify ruptured and high-risk atherosclerotic plaques using the radioactive tracers 18F-sodium fluoride (18F-NaF) and 18F-fluorodeoxyglucose (18F-FDG).
In this prospective clinical trial, patients with myocardial infarction (n=40) and stable angina (n=40) underwent 18F-NaF and 18F-FDG PET-CT, and invasive coronary angiography. 18F-NaF uptake was compared with histology in carotid endarterectomy specimens from patients with symptomatic carotid disease, and with intravascular ultrasound in patients with stable angina. The primary endpoint was the comparison of 18F-fluoride tissue-to-background ratios of culprit and non-culprit coronary plaques of patients with acute myocardial infarction.
In 37 (93%) patients with myocardial infarction, the highest coronary 18F-NaF uptake was seen in the culprit plaque (median maximum tissue-to-background ratio: culprit 1·66 IQR 1·40–2·25 vs highest non-culprit 1·24 1·06–1·38, p<0·0001). By contrast, coronary 18F-FDG uptake was commonly obscured by myocardial uptake and where discernible, there were no differences between culprit and non-culprit plaques (1·71 1·40–2·13 vs 1·58 1·28–2·01, p=0·34). Marked 18F-NaF uptake occurred at the site of all carotid plaque ruptures and was associated with histological evidence of active calcification, macrophage infiltration, apoptosis, and necrosis. 18 (45%) patients with stable angina had plaques with focal 18F-NaF uptake (maximum tissue-to-background ratio 1·90 IQR 1·61–2·17) that were associated with more high-risk features on intravascular ultrasound than those without uptake: positive remodelling (remodelling index 1·12 1·09–1·19 vs 1·01 0·94–1·06; p=0·0004), microcalcification (73% vs 21%, p=0·002), and necrotic core (25% 21–29 vs 18% 14–22, p=0·001).
18F-NaF PET-CT is the first non-invasive imaging method to identify and localise ruptured and high-risk coronary plaque. Future studies are needed to establish whether this method can improve the management and treatment of patients with coronary artery disease.
Chief Scientist Office Scotland and British Heart Foundation.
For researchers, denoising of Magnetic Resonance (MR) image is a greatest challenge in digital image processing. In this paper, the impulse noise and Rician noise in the medical MR images are removed ...by using Bilateral Filter (BF). The novel approaches are presented in this paper; Enhanced grasshopper optimization algorithm (EGOA) is used to optimize the BF parameters. To simulate the medical MR images (with different variances), the impulse and Rician noises are added. The EGOA is applied to the noisy image in searching regions of window size, spatial and intensity domain to obtain the filter parameters optimally. The PSNR is taken as fitness value for optimization. We examined the proposed technique results with other MR images After the optimal parameters assurance. In order to comprehend the BF parameters selection importance, the results of proposed denoising method is contrasted with other previously used BFs, genetic algorithm (GA), gravitational search algorithm (GSA) using the quality metrics such as signal-to-noise ratio (SNR), structural similarity index metric (SSIM), mean squared error (MSE), and PSNR. The outcome shows that the EOGA method with BF shows good results than the earlier methods in both edge preservation and noise elimination from medical MR images. The experimental results demonstrate the performance of the proposed method with the accuracy, computational time, and maximum deviation, Peak Signal to Noise Ratio (PSNR), MSE, SSIM, and entropy values of MR images over the existing methods.
Mpox has been declared a Public Health Emergency of International Concern by the World Health Organization on July 23, 2022. Since early May 2022, Mpox has been continuously reported in several ...endemic countries with alarming death rates. This led to several discussions and deliberations on the Mpox virus among the general public through social media and platforms such as health forums. This study proposes natural language processing techniques such as topic modeling to unearth the general public's perspectives and sentiments on growing Mpox cases worldwide.
This was a detailed qualitative study using natural language processing on the user-generated comments from social media.
A detailed analysis using topic modeling and sentiment analysis on Reddit comments (n = 289,073) that were posted between June 1 and August 5, 2022, was conducted. While the topic modeling was used to infer major themes related to the health emergency and user concerns, the sentiment analysis was conducted to see how the general public responded to different aspects of the outbreak.
The results revealed several interesting and useful themes, such as Mpox symptoms, Mpox transmission, international travel, government interventions, and homophobia from the user-generated contents. The results further confirm that there are many stigmas and fear of the unknown nature of the Mpox virus, which is prevalent in almost all topics and themes unearthed.
Analyzing public discourse and sentiments toward health emergencies and disease outbreaks is highly important. The insights that could be leveraged from the user-generated comments from public forums such as social media may be important for community health intervention programs and infodemiology researchers. The findings from this study effectively analyzed the public perceptions that may enable quantifying the effectiveness of measures imposed by governmental administrations. The themes unearthed may also benefit health policy researchers and decision-makers to make informed and data-driven decisions.
Abstract Background Cardiac troponin is an independent predictor of cardiovascular mortality in individuals without symptoms or signs of cardiovascular disease. The mechanisms for this association ...are uncertain, and a role for troponin testing in the prevention of coronary heart disease has yet to be established. Objectives This study sought to determine whether troponin concentration could predict coronary events, be modified by statins, and reflect response to therapy in a primary prevention population. Methods WOSCOPS (West of Scotland Coronary Prevention Study) randomized men with raised low-density lipoprotein cholesterol and no history of myocardial infarction to pravastatin 40 mg once daily or placebo for 5 years. Plasma cardiac troponin I concentration was measured with a high-sensitivity assay at baseline and at 1 year in 3,318 participants. Results Baseline troponin was an independent predictor of myocardial infarction or death from coronary heart disease (hazard ratio HR: 2.3; 95% confidence interval CI: 1.4 to 3.7) for the highest (≥5.2 ng/l) versus lowest (≤3.1 ng/l) quarter of troponin (p < 0.001). There was a 5-fold greater reduction in coronary events when troponin concentrations decreased by more than a quarter, rather than increased by more than a quarter, for both placebo (HR: 0.29; 95% CI: 0.12 to 0.72 vs. HR: 1.95; 95% CI: 1.09 to 3.49; p < 0.001 for trend) and pravastatin (HR: 0.23; 95% CI: 0.10 to 0.53 vs. HR: 1.08; 95% CI: 0.53 to 2.21; p < 0.001 for trend). Pravastatin reduced troponin concentration by 13% (10% to 15%; placebo adjusted, p < 0.001) and doubled the number of men whose troponin fell more than a quarter (p < 0.001), which identified them as having the lowest risk for future coronary events (1.4% over 5 years). Conclusions Troponin concentration predicts coronary events, is reduced by statin therapy, and change at 1 year is associated with future coronary risk independent of cholesterol lowering. Serial troponin measurements have major potential to assess cardiovascular risk and monitor the impact of therapeutic interventions.
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