Evaluation of the association between dyslipidemia and hypertensive disorder of pregnancy: a nested case control study

Background: Hypertensive disorders of pregnancy are an elusive group of diseases with multifactorial etiopathologies and varied manifestation. Abnormal pre pregnancy lipid profile is shown to have a positive correlation with endothelial dysfunction which in turn leads to development of hypertensive disorder of pregnancy.Methods: A total of 222 pregnant women who were aged between 18-35 years, with no obstetric and medical risk factors and less than 16 weeks of gestation who gave informed written consent were recruited for the study. Their baseline demographics and fasting blood samples were collected, blood samples were centrifuged, and serum was stored at -80-degree celsius. Patients were followed up till delivery and those with hypertensive disorders in pregnancy (n=22) was identified, defined as case. Control was selected after matching for body mass index and frozen serum samples were analyzed.Results: Overall incidence of hypertensive disorders in pregnancy in the study group was 12.4%. The mean early trimester fasting lipid values were higher in patients who developed hypertensive disorders, difference in mean between cases and controls was TC  - 16.25 mg/dl (p-0.061), TGL- 21.45 mg/dl (p-0.143),  LDL- 2.4 mg/dl (p-0.82) and for HDL 4.55 mg/dl (p-0.25). However, on stratification of early trimester fasting lipid level based on National Cholesterol Education Program (NCEP) criteria, Total cholesterol level greater than 160 mg/dl showed an odds ratio of 12.66 (p-0). Patients with early trimester fasting total cholesterol levels greater than 160mg/dl has a higher risk of developing hypertensive disorder in pregnancy.

Gravitational self-torque and spin precession in compact binaries

We calculate the effect of self-interaction on the "geodetic" spin precession of a compact body in a strong-field orbit around a black hole. Specifically, we consider the spin precession angle $\psi$ per radian of orbital revolution for a particle carrying mass $\mu$ and spin $s \ll (G/c) \mu^2$ in a circular orbit around a Schwarzschild black hole of mass $M \gg \mu$. We compute $\psi$ through $O(\mu/M)$ in perturbation theory, i.e, including the correction $\delta\psi$ (obtained numerically) due to the torque exerted by the conservative piece of the gravitational self-field. Comparison with a post-Newtonian (PN) expression for $\delta\psi$, derived here through 3PN order, shows good agreement but also reveals strong-field features which are not captured by the latter approximation. Our results can inform semi-analytical models of the strong-field dynamics in astrophysical binaries, important for ongoing and future gravitational-wave searches.Comment: 5 pages, 1 table, 1 figure. Minor changes to match published versio

Development of a Non-Reacting LES Solver for Unstructured Grid

The present thesis consists of development of an LES based explicit solver which could simulate non reacting flows. The numerical simulation is carried out using Dynamic k equation subgrid scale model. Along with solving the Navier- Stokes equation a convection diffusion equation for mass fraction is also solved which would correct the equivalent density.The length and time scales for the mesh and simulations are calculated based on the Kolmogorov’s hypothesis and the CFL number is calculated accordingly.An explicit solver is used because of the fact that the calculated CFL number is extremely lower than 1. Two cases were validated using the above developed code, first is the case of an axisymmetric turbulent jet of air entering a quiscent atmosphere and the second one is the case where a variable density fluid(here Helium) entering the same quiscent air. The development of the plumes are captured.The development of the plume structures of both the cases are discussed. The averaged velocity profiles are also discussed. The mean velocity , turbulent fluctuations and Reynolds stresses are plotted. A brief study on the parallelisation technique used in OpenFoam is also done. Finally using the fluctuating data from both simulations the energy spectrum graphs are plotted which ensures that the mesh is suitable for the present study

DRUG UTILIZATION PATTERN AMONG GERIATRIC PATIENTS IN A TERTIARY CARE TEACHING HOSPITAL

Objectives: The objectives of this study are to assess the prescribing pattern in geriatrics, analyze the prescriptions using World Health Organization(WHO) core prescribing indicators, and to assess the appropriateness of prescriptions using Beers criteria 2012.Methods: This retrospective drug utilization review study was conducted for a period of 6-month. Prescriptions of in-patients above 65 years werecollected and documented. Collected data were then analyzed with the WHO core prescribing indicators and 2012 American Geriatrics Society Beerscriteria for potentially inappropriate medication use in older adults.Results: A total of 205 in-patient prescriptions were collected. The majority of patients (73.66%) were in the age group of 65-74 years. The mostcommonly found comorbidities were hypertension and diabetes mellitus. Average number of drugs per prescription was 9.09. Percentage ofencounters with an antibiotic and injection prescribed were 81.46% and 95.12%, respectively. A total number of drugs prescribed by its genericname were 235 (12.60%). Among 1865 medicines prescribed, 1215 (65.15%) were prescribed from National List of Essential Medicine (NLEM).Gastrointestinal agents (17.28%) were the most frequently prescribed class of drug followed by cardiovascular drugs (17.14%). Based on 2012 Beerscriteria, 66 (32.19%) prescriptions were found inappropriate.Conclusions: Our study suggests that current practice in our hospital is associated with greater polypharmacy and inappropriate medication use.Prescribing from NLEM was fair. Use of injectables and antibiotics were high. Drugs prescribed in generic name were low. In future, multidisciplinaryapproach should be endorsed for rational drug use in the geriatric population.Keywords: Drug utilization, Geriatrics, Beers criteria, National List of Essential Medicine, World Health Organization core prescribing indicators.Â

Creating a SNOMED CT reference set for common endocrine disorders based on routine clinic correspondence

We are grateful to the staff and patients of the endocrine clinic at Aberdeen Royal Infirmary (ARI) for the survey responses and provision of data used in this study. We are also thankful to Dr Charlotte Lee and Dr Wendy Yap for their help with data analysis. No external funding was sought or obtained for this study.Peer reviewe

REDAffectiveLM: Leveraging Affect Enriched Embedding and Transformer-based Neural Language Model for Readers' Emotion Detection

Technological advancements in web platforms allow people to express and share emotions towards textual write-ups written and shared by others. This brings about different interesting domains for analysis; emotion expressed by the writer and emotion elicited from the readers. In this paper, we propose a novel approach for Readers' Emotion Detection from short-text documents using a deep learning model called REDAffectiveLM. Within state-of-the-art NLP tasks, it is well understood that utilizing context-specific representations from transformer-based pre-trained language models helps achieve improved performance. Within this affective computing task, we explore how incorporating affective information can further enhance performance. Towards this, we leverage context-specific and affect enriched representations by using a transformer-based pre-trained language model in tandem with affect enriched Bi-LSTM+Attention. For empirical evaluation, we procure a new dataset REN-20k, besides using RENh-4k and SemEval-2007. We evaluate the performance of our REDAffectiveLM rigorously across these datasets, against a vast set of state-of-the-art baselines, where our model consistently outperforms baselines and obtains statistically significant results. Our results establish that utilizing affect enriched representation along with context-specific representation within a neural architecture can considerably enhance readers' emotion detection. Since the impact of affect enrichment specifically in readers' emotion detection isn't well explored, we conduct a detailed analysis over affect enriched Bi-LSTM+Attention using qualitative and quantitative model behavior evaluation techniques. We observe that compared to conventional semantic embedding, affect enriched embedding increases ability of the network to effectively identify and assign weightage to key terms responsible for readers' emotion detection

Process evaluation protocol for the I-WOTCH study : an opioid tapering support programme for people with chronic non-malignant pain

Introduction The Improving the Wellbeing of people with Opioid Treated CHronic Pain (I-WOTCH) randomised controlled trial uses a multicomponent self-management intervention to help people taper their opioid use. This approach is not widely used and its efficacy is unknown. A process evaluation alongside the trial will help to assess how the intervention was delivered, looking at the dose of intervention received and the fidelity of the delivery. We will explore how the intervention may have brought about change through the experiences of the participants receiving and the staff delivering the intervention and whether there were contextual factors involved. Methods and analysis A mixed methods process evaluation will assess how the processes of the I-WOTCH intervention fared and whether these affected the outcomes. We will collect quantitative data, for example, group attendance analysed with statistical methods. Qualitative data, for example, from interviews and feedback forms will be analysed using framework analysis. We will use a ‘following a thread’ and a mixed methods matrix for the final integrated analysis. Ethics and dissemination The I-WOTCH trial and process evaluation were granted full ethics approval by Yorkshire and The Humber—South Yorkshire Research Ethics Committee on 13 September 2016 (16/YH/0325). All data were collected in accordance with data protection guidelines. Participants provided written informed consent for the main trial, and all interviewees provided additional written informed consent. The results of the process evaluation will be published and presented at conferences