156 research outputs found

    Small airways dysfunction:The importance of utilising Z-scores to define MMEF abnormalities in clinical practice

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    BACKGROUND: The small airways comprise the largest cross-sectional area of the lungs, however, assessing and reporting abnormalities for this region of the bronchial tree has been practically and scientifically uncertain.METHODS: Using routinely collected spirometry data for patients with either asthma or COPD, the accuracy of % predicted values for defining small airways dysfunction was assessed. A z-score of ≤ -1.645 of the maximal-mid expiratory flow (MMEF) was used as the gold standard for defining abnormality in the small airways.RESULTS: Records of 3396 patients were included in the analysis. The false positive (FP) rates were 24.6 %, 16.1 %, 11.5 %, or 7.9 % when the % predicted value of 80 %, 70 %, 65 %, or 60 % were used, respectively. Sex, age, and BMI were associated with FP rates. Males were more likely to be categorised as FP with odds ratio (OR) between 1.10 and 1.49 across % predicted groups. Age was associated with FP rates with an OR between 1.01 and 1.08. The BMI was also associated with FP rates with an OR of 1.03 across all % predicted groups. Assessing the association of age groups with FP rate showed that those above 60 years old were more likely to be categorised as FP with an OR between 1.23 and 73.2 compared to those less than 30 years old.CONCLUSION: When assessing the small airways in clinical practice or for scientific purposes, the % predicted values overestimate the actual impairment leading to FP interpretation. Utilising z-score values are recommended to assess the small airways using the spirometric index, MMEF.</p

    The prevalence of bronchodilator responsiveness of the small airway (using mid-maximal expiratory flow) in COPD - a retrospective study

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    Abstract Background Bronchodilator responsiveness (BDR) using FEV1 is often utilised to separate COPD patients from asthmatics, although it can be present in some COPD patients. With the advent of treatments with distal airway deposition, BDR in the small airways (SA) may be of value in the management of COPD. We aimed to identify the prevalence of BDR in the SA, utilizing maximal mid-expiratory flow (MMEF) as a measure of SA. We further evaluated the prevalence of BDR in MMEF with and without BDR in FEV1 and its association with baseline demographics, including conventional airflow obstruction severity and smoking history. Methods Lung function data of ever-smoking COPD patients were retrospectively analysed. BDR was evaluated 20 min after administering 2.5 mg of salbutamol via jet nebulizer. Increase in percent change of ≥ 12% and absolute change of ≥ 200 ml was used to define a BDR in FEV1, whereas an increase percent change of MMEF ≥ 30% was used to define a BDR in MMEF. Patients were classified as one of three groups according to BDR levels: group 1 (BDR in MMEF and FEV1), group 2 (BDR in MMEF alone) and group 3 (no BDR in either measure). Result BDR in MMEF was present in 59.2% of the patients. Of note, BDR in MMEF was present in all patients with BDR in FEV1 (group 1) but also in 37.9% of the patients without BDR in FEV1 (group 2). Patients in group 1 were younger than in groups 2 and 3. BMI was higher in group 1 than in group 3. Baseline FEV1% predicted and FVC % predicted were also higher in groups 1 and 2 than in group 3. Conclusion BDR in the SA (evaluated by MMEF) is common in COPD, and it is also feature seen in all patients with BDR in FEV1. Even in the absence of BDR in FEV1, BDR in MMEF is detected in some patients with COPD, potentially identifying a subgroup of patients who may benefit from different treatment strategies

    Relationships of academic expectation stress & self-efficacy, efficacy for self-regulated learning with academic performance during Covid pandemic

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    Background: Academic expectation stress & self-efficacy and efficacy for self-regulated learning may affect academic performance. The Covid pandemic has affected the physical and psychological well-being of all, including students. However, there is a paucity of studies examining these variables in college students in Saudi Arabia. Objectives: This study was conducted to explore the levels and relationships of academic expectation stress & self-efficacy, self-regulated learning, and its relationships with academic performance in college students of ---- University during the Covid pandemic. Material and Methods: A total of 302 students were recruited in this cross-sectional study. They were assessed with sociodemographic and academic proforma designed for this study, the Academic expectation stress inventory (ASE), the Academic self-efficacy scale (AES), and the efficacy of the self-regulated learning scale (SRL). Results: Results revealed that the mean score of AES, SRL, and ASE was 29.18, 35.38, and 41.11, respectively. On linear regression analysis exam score was statistically significant positively predicted by the score on SRL, and the Score of AES was statistically significantly predicted by the score of SRL (+ve) and the score of ASE (-ve). Conclusions: It may be concluded that efficacy for self-regulated learning may mediate academic performance and academic self-efficacy during the Covid pandemic. Enhancing self-regulated learning may improve academic performance during the pandemic

    WEB ATTACKS AND DEFENSES

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    Because of the limited data that web applications collect from users, they are subject to information security risks. The most effective way to retain data in the modern era is through online applications. The process of providing data and data systems with appropriate procedural and sophisticated security safeguards is known as cybersecurity. Threats to cyber security are increasing at times. A flaw or weakness in a computer system, security tactics, internal controls, planning, or implementation that can compromise the security policy of a framework is known as a web vulnerability. The social, economic and political spheres of governments can be disrupted due to a vulnerability in the Internet, which can have an impact on the state. An effort is made to identify the defects and weaknesses while studying the weakness in order to take advantage of these weaknesses. The aim of this study is to identify the types of intrusions, find vulnerabilities, and review regulations for vulnerable systems detected in online applications

    Physical activity recognition by utilising smartphone sensor signals

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    Human physical motion activity identification has many potential applications in various fields, such as medical diagnosis, military sensing, sports analysis, and human-computer security interaction. With the recent advances in smartphones and wearable technologies, it has become common for such devices to have embedded motion sensors that are able to sense even small body movements. This study collected human activity data from 60 participants across two different days for a total of six activities recorded by gyroscope and accelerometer sensors in a modern smartphone. The paper investigates to what extent different activities can be identified by utilising machine learning algorithms using approaches such as majority algorithmic voting. More analyses are also provided that reveal which time and frequency domain-based features were best able to identify individuals' motion activity types. Overall, the proposed approach achieved a classification accuracy of 98% in identifying four different activities: walking, walking upstairs, walking downstairs, and sitting (on a chair) while the subject is calm and doing a typical desk-based activity

    Association Between Cytomegalovirus Infection and Bad Obstetric Outcomes in Women From Kirkuk

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    The human cytomegalovirus (CMV) is one of the common viral infections worldwide that represent a major causes of congenital infections. To determine the seroprevalence of CMV in women with bad obstetric history and sociodemographic characteristics that may influence the seropositivity, a case control descriptive prospective study was conducted in Kirkuk, Iraq. A 838 women with age range from 14 to 48 were included in the study. Of the total, 547 women were with bad obstetric history(BOH) and 291 women with normal previous pregnancy as control group. All the serum samples collected from the study and control groups were tested for CMV IgM and IgG antibodies by ELISA kits. CMV IgM seroprevalence was higher in women with BOH. CMV IgG seroprevalence was with no significant difference between BOH and control. CMV IgG seroprevalence significantly influenced by age, education, smoking, and family size. However, CMV IgM seroprevalence significantly associated with pregnancy, residence, and animal exposure. Odd ratio confirmed the association between CMV IgG and age, crowding index, residence, smoking, and number of abortion in women with BOH. In addition, current CMV infection significantly associated with residence in women with BOH

    Analysis of Intra-Aortic Balloon Performance in Open-Heart Surgery

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    A failing heart can be supported in several ways, including cardiopulmonary bypass pumps (CPB), extracorporeal membrane oxygenators (ECMOs), and other types of auxiliary heart pumps. The intra-aortic-balloon-pump (IABP) is one technique of internal counter-pulsation that supports maintaining the circulatory system It continues to be used as a vascular support device to critically unwell cardiac patients. Many recent studies have focused on the problems of the (IABP) in open-heart surgery, while other researchers concentrated on the positioning and size of the balloon, some of them studied the timing of the balloon's inflation and deflation. this paper has reviewed a brief Introduction, the basic principles of the balloon, how to trigger the balloon pump as well as the use of IABP in Coronary Artery Bypass Graft (CABG), balloon mistiming of inflation and deflation, balloon timing usage within open-heart surgery and finally a balloon position and sizing

    A systematic review and meta-analysis of heart rate variability in COPD

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    Background: Chronic obstructive pulmonary disease (COPD) is associated with disruption in autonomic nervous control of the heart rhythm. We present here quantitative evidence of the reduction in HRV measures as well as the challenges to clinical application of HRV in COPD clinics. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we search in June 2022 Medline and Embase databases for studies reporting HRV in COPD patients using relevant medical subject headings (MeSH) terms. The quality of included studies was assessed using the modified version of the Newcastle–Ottawa Scale (NOS). Descriptive data were extracted, while standardized mean difference was computed for changes in HRV due to COPD. Leave-one-out sensitivity test was performed to assess exaggerated effect size and funnel plots to assess publication bias. Results: The databases search yielded 512 studies, of which we included 27 that met the inclusion criteria. The majority of the studies (73%) had a low risk of bias and included a total of 839 COPD patients. Although there were high between-studies heterogeneity, HRV time and frequency domains were significantly reduced in COPD patients compared with controls. Sensitivity test showed no exaggerated effect sizes and the funnel plot showed general low publication bias. Conclusion: COPD is associated with autonomic nervous dysfunction as measured by HRV. Both sympathetic and parasympathetic cardiac modulation were decreased, but there is still a predominance of sympathetic activity. There is high variability in the HRV measurement methodology, which affects clinical applicability
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