To explore the clinical characteristics and impact of diabetes mellitus (DM) on prognosis in patients with nonvalvular atrial fibrillation (AF).
Data of nonvalvular AF patients in the Chinese ...Emergency Atrial Fibrillation Registry Study were retrospectively analyzed. The eligible patients were divided into the DM group and the non-DM group. Uni- and multi-variate Cox regression analysis were used to explore risk factors of 1-year outcomes.
A total of 1 644 patients were enrolled in the study with 227 patients combined with DM (16.8%). Compared with non-DM group, patients with DM were older and had higher body weight, had higher prevalence of myocardial infarction, coronary heart disease, hypertension and stroke, and were at higher risk of thromboembolism. The proportion of anticoagulant treatment was low in both groups (10.1% vs 7.4%, P=0.141). Compared with patients without DM, patients with DM had higher all-cause mortality (19.5% vs 12.7%, P=0.004), cardiovascular death (10.8% vs 7.02%, P=0.047) and combin
Bone anchored hearing aid (Baha) implant is an option for patient with canal atresia, single sided deafness(SSD) and chronically discharging ears despite treatments. This retrospective study was ...conducted from 2001 to 2011 to evaluate the surgical outcome of Baha implant surgery. Thirty-three patients were identified during this study period. Their age at implantation ranged from 5 to 40 years. Of 33 patients, 29 (87.9 %) patients had bilateral microtia and canal atresia, 3 (9.1 %) patients had unilateral microtia and canal atresia and 1 (3.0 %) patients have SSD following labyrinthitis. One patient (3.2 %) had major complication which is lost of implant due to failure of osseointegration. Soft tissue reactions were seen 7 patients (21.1 %). Of these 7 patients, 4 patients required 3–4 procedures as day care operation for excision of the skin overgrowth surrounding the abutment. Recurrent antibiotic treatment was required in 3 patients (9.7 %). None of our patient had history of intraoperative or peri-operative complication following Baha surgery. The commonest complications are local infection and inflammation at the implant site. None of our patient had history of intraoperative or peri-operative complication following Baha implant surgery.
Inconel 718 fabricated by laser-powder bed fusion (L-PBF) exhibits a hierarchical microstructure, rendering traditional standard heat treatment processes not entirely suitable. To enhance the tensile ...properties, a novel heat treatment strategy to simultaneously tailor the grain structure and precipitates of L-PBFed Inconel 718 is proposed. This study aims to investigate the effects of homogenization time, coupled with water cooling, on grain structure, precipitation, and room-temperature tensile properties. The results demonstrate that increasing the homogenization time from 1 h to 4 h results in a significant improvement of tensile ductility by 33.7%, while maintaining higher tensile strength compared to the wrought counterparts. The utilization of water cooling following homogenization effectively suppresses the formation of undesirable δ phases and promotes the precipitation of γ′′ phases during subsequent aging treatment, leading to exceptional tensile strength. Furthermore, the prolonged homogenization time facilitates recrystallization and promotes uniform deformation between adjacent grains, thereby enhancing the material's ductility. This study provides theoretical guidance for the development of customized heat treatment processes to achieve superior mechanical properties in additive-manufactured metallic materials.
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•An enhanced tensile strength-ductility synergy is achieved via a novel heat treatment process.•Extending homogenization time from 1 h to 4 h improves tensile ductility by 33.7%.•Water cooling after homogenization treatment enhances the material's strength.
Preliminary experiment has been carried out using irradiated Au-198 as radiotracer inside the laboratory porous media. The objectives are to check the compatibility of Au-198 as the radiotracer ...inside the porous media as well as to provide insights of fluid hydrodynamics inside the media using gamma camera.198Au is gamma emitter isotope with half-life of 2.7 days and energy of 0.41 MeV (99%). The porous media consists of fine sandstone with grain size 850μm, lubricant as the mimic of original oil in plant (OOIP) or trapped oil and a layer of cement on top of the rig as the bed rock. Gamma camera is arranged next to the porous media in order to capture the movement of radiotracer which has been set to 1minute per frame. Initially, the gold wire which has isotope of 197Au was irradiated inside the rotary rack of Reactor Triga PUSPATI (RTP) to produce 198Au. RTP is located in Nuclear Malaysia, Bangi has energy of 750kW and neutron flux of 5 × 102 n/cm2/s. 198Au, which is in liquid form, is injected inside the porous media and monitored and recorded by gamma camera. The gamma camera gives a quantitative determination of local fluid saturations over the area of observation.
Corneal ulceration remains one of the major causes of blindness in developing countries, including Malaysia. Our objective is to determine the epidemiological characteristics, clinical features, risk ...factors and the aetiology of microbial keratitis in patients admitted to Hospital Universiti Sains Malaysia (HUSM).
All patients with microbial keratitis admitted to our hospital over a 16-month period from January 2004 to April 2005 were included in the study. Sociodemographic data and information pertaining to risk factors were recorded. All patients underwent examination with slit lamp biomicroscopy and corneal scrapings were sent for microbiological diagnosis.
42 patients were included in the study; 26 were male and 16 were female, with mean age of 44.5 (+/- 20.9) years. History of previous corneal trauma was present in 26 (61.9 percent) patients. Central location ulcers were more predominant (69 percent) than peripheral ulcers. Cultures from corneal scrapings were positive in 29 cases (69 percent). Of those individuals with positive cultures, 23 (79.3 percent) had pure bacterial infection, four (13.8 percent) had pure fungal infection and two (6.9 percent) had mixed growth. The most common bacterial pathogen isolated was Pseudomonas aeruginosa (40.5 percent), followed by Streptococcus pneumoniae (7.5 percent). Fungal pathogens which were isolated include Fusarium spp. (4.7 percent) and Aspergillus spp. (2.4 percent).
Central corneal ulceration is a problem among patients presenting with microbial keratitis in HUSM. It often occurs after corneal trauma. These findings have important public health implications for the treatment and prevention of visual morbidity due to an infective cause.
Mesoporous CO-Al sub(2)O sub(3) catalysts were prepared by one-pot synthesis and, for the first time, used in the partial oxidation of methane to synthesis gas. Compared with the catalysts prepared ...by impregnation methods, the catalysts prepared by one-pot synthesis showed superior catalytic performance for this reaction. The results showed that mesoporous CO-Al sub(2)O sub(3) catalysts have high surface areas, large pore volumes, and an ordered hexagonal mesostructure. In the catalysts, Co species are highly dispersed, resulting in high dispersion of the metal after reduction. A confinement effect, provided by the mesopores, on metal nanoparticles could effectively enhance resistance to metal sintering.
Introduction
To compare intrasession agreement and repeatability of wavefront aberration measurements from three different aberrometers obtained using Hartmann–Shack, ray tracing and automated ...retinoscopy methods, as well as their interdevice agreement.
Methods
Three consecutive measurements were obtained using the Pentacam AXL Wave, the iTrace and the OPD‐Scan III in 47 eyes of 47 patients. Wavefront refractions, root mean square of total aberrations (RMS total), RMS of higher‐order aberrations (HOA) and second‐, third‐ and fourth‐order HOAs were exported for 4‐mm pupils. Wavefront refractions were converted into vector components: M, J0 and J45. Intrasession agreement and repeatability were evaluated using intraclass correlation coefficients (ICCs) and repeatability coefficients (RCs); interdevice agreement was assessed using the Bland–Altman method.
Results
The intrasession agreement and repeatability of RMS HOA were comparable between the three devices; both the Pentacam AXL Wave and the OPD‐Scan III had better intrasession agreement and repeatability for the RMS total than the iTrace (p ≤ 0.02). Intrasession repeatability for the majority of second‐ and third‐order aberrations was better on the Pentacam AXL Wave than on the iTrace (p ≤ 0.01) and OPD‐Scan III (p ≤ 0.04), although their agreement and repeatability in spherical aberration were comparable (p ≥ 0.24). Significant systematic differences and proportional bias were detected for almost all refraction power vectors and Zernike coefficients among the three devices.
Conclusions
In this study, all three devices provided good‐to‐excellent agreement for aberration measurements. Most of the individual Zernike's components were not exchangeable between different aberrometers. Their relative intrasession performance in agreement and repeatability varied significantly across different ocular aberration parameters.
Abstract The present study examined the relationships between diurnal cortisol patterns and perceived stress, lifestyle factors, psychotic symptoms, neurological deficits, and daily functioning in ...patients with chronic schizophrenia. The participants were 149 Chinese patients with chronic schizophrenia. Salivary cortisol was collected upon waking, before lunchtime, and before bedtime at baseline (Time 1). Self-reported measures on perceived stress and lifestyle factors such as body-mass index and daily exercise span were recorded at Time 1. Diagnostic assessments on psychotic symptoms, neurological deficits, and daily functioning were made at Time 1 and Time 2 (3 months later). Latent growth modeling and path modeling analysis were performed to investigate the diurnal cortisol patterns and the relationships with the study variables. Higher levels of perceived stress and body-mass index and less physical activity were significantly linked to reduced cortisol decline. Reduced cortisol decline at Time 1 significantly predicted greater psychotic (positive and negative) symptoms and more severe neurological deficits in motor coordination and sequencing of complex motor acts at Time 2. The present results contribute to a better understanding of the diurnal cortisol patterns among patients with chronic schizophrenia and the associations with lifestyle factors, psychotic symptoms, and neurological deficits. The findings lend support to the neural diathesis–stress model and suggest that hypothalamic–pituitary–adrenal axis may potentially mediate the effects of lifestyle factors on psychotic symptoms and neurological deficits.
The purpose of this study was to review the results of our patients with congenital canal atresia after implantation of bone-anchored hearing aids (BAHA). The occurrence of complications was also ...reviewed.
This was a retrospective analysis of the first 16 patients who had BAHA implantation at Universiti Kebangsaan Malaysia Medical Centre, Malaysia. Audiometric assessment was done preoperatively and postoperatively for each patient using the standard procedure. The surgical procedure was described and its complications discussed.
The 16 patients consisted of 11 male and five female patients. Their mean age was 8.9 years at the time of the surgery. The main indication was bilateral canal atresia. 11 patients had implantation of BAHA performed in two stages, while the other five patients had it as a single-staged procedure. The complications that occurred were failure of osseointegration (one patient), granulation tissue overgrowth into the abutment (two patients) and cellulitis surrounding the abutment (three patients). The average preoperative unaided air conduction threshold was 64.9 dB and the average postoperative aided hearing threshold was 29.7 dB. The overall mean functional gain was 35.2 dB.
BAHA has many advantages over the conventional hearing aid in the form of cosmesis, discomfort and hearing gain. It is a reliable hearing rehabilitation tool with good predictable hearing outcome in patients with bilateral canal atresia, especially those unsuitable for canalplasty. Despite its higher cost and the need for surgical implantation, its use is justifiable in properly selected patients.
Abstract
Background
In a phase 3 trial, letermovir reduced clinically significant cytomegalovirus infections (CS-CMVi) and all-cause mortality at week 24 versus placebo in CMV-seropositive allogeneic ...hematopoietic cell transplantation (HCT) recipients. This post hoc analysis of phase 3 data further investigated the effects of letermovir on all-cause mortality.
Methods
Kaplan-Meier survival curves were generated by treatment group for all-cause mortality. Observations were censored at trial discontinuation for reasons other than death or at trial completion. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox modeling, adjusting for risk factors associated with mortality.
Results
Of 495 patients with no detectable CMV DNA at randomization, 437 had vital-status data available through week 48 post-HCT at trial completion (101 deaths, 20.4%). Following letermovir prophylaxis, the HR for all-cause mortality was 0.58 (95% CI, 0.35–0.98; P = .04) at week 24 and 0.74 (95% CI, 0.49–1.11; P = .14) at week 48 post-HCT versus placebo. Incidence of all-cause mortality through week 48 post-HCT in the letermovir group was similar in patients with or without CS-CMVi (15.8 vs 19.4%; P = .71). However, in the placebo group, all-cause mortality at week 48 post-HCT was higher in patients with versus those without CS-CMVi (31.0% vs 18.2%; P = .02). The HR for all-cause mortality in patients with CS-CMVi was 0.45 (95% CI, 0.21–1.00; P = .05) at week 48 for letermovir versus placebo.
Conclusions
Letermovir may reduce mortality by preventing or delaying CS-CMVi in HCT recipients.
Clinical Trials Registration
clinicaltrials.gov, NCT02137772.
This post hoc mortality analysis of phase 3 data suggests that letermovir prophylaxis reduced all-cause mortality versus placebo in cytomegalovirus (CMV)-seropositive allogeneic hematopoietic-cell transplantation recipients by preventing or delaying clinically significant CMV infections.
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