Evaluating the clinical effectiveness of the NHS Health Check programme: a prospective analysis in the Genetics and Vascular Health Check (GENVASC) study

OBJECTIVE: The aim of the study was to assess the clinical effectiveness of the national cardiovascular disease (CVD) prevention programme-National Health Service Health Check (NHSHC) in reduction of CVD risk. DESIGN: Prospective cohort study. SETTING: 147 primary care practices in Leicestershire and Northamptonshire in England, UK. PARTICIPANTS: 27 888 individuals undergoing NHSHC with a minimum of 18 months of follow-up data. OUTCOME MEASURES: The primary outcomes were NHSHC attributed detection of CVD risk factors, prescription of medications, changes in values of individual risk factors and frequency of follow-up. RESULTS: At recruitment, 18% of participants had high CVD risk (10%-20% 10-year risk) and 4% very high CVD risk (>20% 10-year risk). New diagnoses or hypertension (HTN) was made in 2.3% participants, hypercholesterolaemia in 0.25% and diabetes mellitus in 0.9%. New prescription of stains and antihypertensive medications was observed in 5.4% and 5.4% of participants, respectively. Total cholesterol was decreased on average by 0.38 mmol/L (95% CI -0.34 to -0.41) and 1.71 mmol/L (-1.48 to -1.94) in patients with initial cholesterol >5 mmol/L and >7.5 mmol/L, respectively. Systolic blood pressure was decreased on average by 2.9 mm Hg (-2.3 to -3.7), 15.7 mm Hg (-14.1 to -17.5) and 33.4 mm Hg (-29.4 to -37.7), in patients with grade 1, 2 and 3 HTN, respectively. About one out of three patients with increased CVD risk had no record of follow-up or treatment. CONCLUSIONS: Majority of patients identified with increased CVD risk through the NHSHC were followed up and received effective clinical interventions. However, one-third of high CVD risk patients had no follow-up and therefore did not receive any treatment. Our study highlights areas of focus which could improve the effectiveness of the programme. TRIAL REGISTRATION NUMBER: NCT04417387

SECURE KEY MANAGEMENT IN AD-HOC NETWORK: A REVIEW

An ad hoc network is a decentralized type of network. The network is ad hoc because it does not have a preexisting infrastructure. An ad hoc network is a common wireless network that can communicate with each other without any centralized administration or pre-existing infrastructure. Due to nature of Inconstant Wireless medium Data Transfer is a major problem in ad hoc it lacks Security and Reliability of Data. Cryptographic techniques are often used for secure Data transmission wireless networks. Most cryptographic technique can be symmetric and asymmetric, depending on the way they use keys. However, all cryptographic techniques is good for nothing if key management is weak. There are various type of key management schemes that have been proposed for ad hoc. In this survey, we present a complete study of various key management techniques to find an efficient key management for Secure and Reliable Data transmission in ad hoc

Development of biomimetic electrospun polymeric biomaterials for bone tissue engineering. A Review

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Management and Outcome of Patients with Pancreatic Trauma

Introduction: Pancreatic trauma is a rare entity occurring in 0.2% of patients with blunt trauma abdomen. Once the diagnosis is made, the management of patients is dependent on multiple variables. Conservative management, suture repair, drainage, and resection have been utilized with varying degree of success. This study is aimed to evaluate the management of patients with pancreatic trauma.Materials and Methods: This was a prospective study done in the Department of Surgery in Dayanand Medical College and Hospital where forty hemodynamically stable patients diagnosed to have pancreatic trauma on contrast‑enhanced computed tomography abdomen were included in the study. Results: Out of forty patients taken in this study, 38 were male and two were female with age ranging from 3 to 50 years. Road traffic accident was the most common cause of pancreatic injury. Pancreatic injuries were graded according to the American Association for Surgery in Trauma scale. Twelve patients had Grade I and II injuries. Grade III was the most common injury occurring in 14 patients.  Twenty‑four patients underwent surgical management. Mortality rate was 45% and it was in direct correlation with the severity of injury.Conclusion: Grade I and II pancreatic injury can be managed conservatively depending upon the hemodynamic status of the patient. Grade III and IV injuries have a better prognosis if managed surgically.Keywords: American Association for Surgery in Trauma pancreatic injury, blunt trauma abdomen, pancreatic traum

Fabrication, Characterization and In Vitro Biocompatibility of Electrospun Hydroxyethyl Cellulose/poly (vinyl) Alcohol Nanofibrous Composite Biomaterial for Bone Tissue Engineering

Development ofnovel scaffold materials that mimic the extracellular matrix, architecturally and func- tionally, is becoming highly important to meet the demands of the advances in bone tissue engineering. This paper reports, the fabrication of natural polymer cellulose derived hydroxyethyl cellulose(HEC) based nanostructured scaffolds with uniform fiber morphology through electrospinning. Poly(vinyl alcohol) (PVA) was used as anionic solvent for supporting the electrospinning of HEC. Scanning electron microscopy and ImageJ analysis revealed the formation of non-woven nanofibers with well-defined porous architecture. The interactions between HECandPVA in the electrospun nanofibers were studied by differential scanning calorimetry, X-raydiffraction, dynamic mechanical analysis thermo-gravimetric analysis; Fourier transform-infrared spectroscopy,X-ray photoelectronspectroscopy and tensiletest. The mechanical properties of scaffolds were significantly altered with different ratios of HEC/PVA. Further, the biocompatibility of HEC/PVAscaffolds was evaluated using human osteosarcomacells. TheSEM images revealed favorable cellsattachment and spreading on the nanofibrous scaffolds and MTS assay showed increased cell proliferation afterdifferent time periods. Thus, these results indicate that HEC based nanofibrous scaffolds will be a promising candidate for bone tissue engineering

Percutaneous Coronary Intervention (PCI) Strategies under Hemodynamic Support for Cardiogenic Shock: A Single-Center Experience with Two Patients

We describe two cases of profound cardiogenic shock complicating acute myocardial infarction (CSAMI) requiring mechanical circulatory support (MCS) with venoarterial extracorporeal membrane oxygenation (VA-ECMO) allowing complex, high-risk, and staged percutaneous interventions with successful decannulation but with unfortunate outcomes

Fabrication, characterization and in vitro biocompatibility of electrospun hydroxyethyl cellulose/poly (vinyl) alcohol nanofibrous composite biomaterial for bone tissue engineering

Development of novel scaffold materials that mimic the extracellular matrix, architecturally and functionally, is becoming highly important to meet the demands of the advances in bone tissue engineering. This paper reports, the fabrication of natural polymer cellulose derived hydroxyethyl cellulose (HEC) based nanostructured scaffolds with uniform fiber morphology through electrospinning. Poly (vinyl alcohol) (PVA) was used as an ionic solvent for supporting the electrospinning of HEC. Scanning electron microscopy and ImageJ analysis revealed the formation of non-woven nanofibers with well-defined porous architecture. The interactions between HEC and PVA in the electrospun nanofibers were studied by differential scanning calorimetry, X-ray diffraction, dynamic mechanical analysis thermo-gravimetric analysis; Fourier transform-infrared spectroscopy, X-ray photoelectron spectroscopy and tensile test. The mechanical properties of scaffolds were significantly altered with different ratios of HEC/PVA. Further, the biocompatibility of HEC/PVA scaffolds was evaluated using human osteosarcoma cells. The SEM images revealed favorable cells attachment and spreading on the nanofibrous scaffolds and MTS assay showed increased cell proliferation after different time periods. Thus, these results indicate that HEC based nanofibrous scaffolds will be a promising candidate for bone tissue engineering

Nanohydroxyapatite-coated hydroxyethyl cellulose/poly (vinyl) alcohol electrospun scaffolds and their cellular response

The present study focused on the preparation of nanohydroxyapatite (nHA)-coated hydroxyethyl cellulose/polyvinyl alcohol (HEC/PVA) nanofibrous scaffolds for bone tissue engineering application. The electrospun HEC/PVA scaffolds were mineralized via alternate soaking process. FESEM revealed that the nHA was formed uniformly over the nanofibers. The nHA mineralization enhanced the tensile strength and reduced the elongation at breakage of scaffolds. The wettability of the nanofibrous scaffolds was significantly improved. The in vitro biocompatibility of scaffolds was evaluated with human osteosarcoma cells. nHA-coated scaffolds had a favorable effect on the proliferation and differentiation of osteosarcoma cell and could be a potential candidate for bone regeneration

Electrospun hydroxyethyl cellulose nanofibers functionalized with calcium phosphate coating for bone tissue engineering

The aim of this study is to develop a facile and efficient scaffold from electrospun hydroxyethyl cellulose (HEC) functionalized with bone-like calcium phosphate (CaP). The HEC/PVA nanofibers were fabricated by electrospinning and mineralized by incubating in 10× simulated body fluid (SBF) for different period of times. After 24h of incubation, the nanofibers were uniformly coated by a thin layer of mineral deposit. SEM, FTIR, and FESEM-EDS analysis confirm the deposition of CaP on the nanofibers. The nanostructured biomaterial maintained its fibrous and porous structure after mineralization. The XRD results suggest that the deposited mineral phase is a mixture of calcium phosphate hydrate and apatite. The mechanical properties of CaP coated scaffolds has similar tensile strength and elastic modulus with that of trabecular and proximal femoral bones. The cytocompatibility of the CaP coated HEC/PVA scaffolds were evaluated using human osteosarcoma cells. The CaP coated HEC/PVA scaffolds supports cellular attachment and proliferation of osteosarcoma cells and will be a promising candidate for bone tissue engineering