47 research outputs found

    Use of 3D rotational angiography to perform computational fluid dynamics and virtual interventions in aortic coarctation

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    Computational fluid dynamics (CFD) can be used to analyze blood flow and to predict hemodynamic outcomes after interventions for coarctation of the aorta and other cardiovascular diseases. We report the first use of cardiac 3‐dimensional rotational angiography for CFD and show not only feasibility but also validation of its hemodynamic computations with catheter‐based measurements in three patients.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154333/1/ccd28507.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154333/2/ccd28507_am.pd

    Descriptive study of the role of household type and household composition on women’s reproductive health outcomes in urban Uttar Pradesh, India

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    Abstract Background More needs to be known about the role intra-familial power dynamics play in women’s reproductive health outcomes, particularly in societies like Northern India characterized by patriarchy and extended families. The key research question we explore is: how important are living arrangements (e.g., presence of the mother-in-law, presence of an elder sister-in-law, and living in the husband’s natal home) on contraceptive use behaviors and decision to deliver at an institution? Methods Representative data collected in 2010 from six cities in Uttar Pradesh are used to examine the above research question. This study uses multivariable logistic regression methods to examine the association between women’s household type (husband’s natal home vs. not husband’s natal home) and household composition (lives with mother-in-law; and lives with elder sister-in-law) and modern family planning use and institutional delivery. Results More than sixty percent of women in the sample live in their husband’s natal home, one-third live with their mother-in-law, and only three percent live with an elder sister-in-law. Findings demonstrate that women who live either with the mother-in-law or in the husband’s natal home are more likely to use modern family planning than those women living neither with the mother-in-law nor in the husband’s natal home. In addition, living with an elder sister-in-law is associated with less family planning use. For institutional delivery, women who live with the mother-in-law have higher institutional delivery than those not living with the mother-in-law. Multivariable analyses demonstrate that, controlling for other factors associated with modern family planning use, women living with neither the mother-in-law nor in the husband’s natal home are the least likely to use modern family planning. Similar findings are found for institutional delivery such that those women living with neither the mother-in-law nor in the husband’s natal home are the least likely to have an institutional delivery, controlling for demographic factors associated with institutional delivery. Conclusions Where women live and who they live with matters. Future reproductive health programs for urban India should consider these context specific factors in programs seeking to improve women’s reproductive health outcomes

    Physical activity patterns during pregnancy through postpartum

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    The aim of the study was to describe the mode, frequency, duration, and intensity of physical activity among pregnant women, to explore whether these women reached the recommended levels of activity, and to explore how these patterns changed during pregnancy

    Impact evaluation of the Urban Health Initiative in urban Uttar Pradesh, India

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    The Urban Health Initiative (UHI) was initiated in 2009 with the goal of increasing family planning (FP) use among the poor in urban areas of Uttar Pradesh, India. The Measurement, Learning & Evaluation project (MLE) was tasked with rigorous impact evaluation of the UHI. This paper presents the impact evaluation findings of the UHI program

    Comparative physical maps derived from BAC end sequences of tilapia (Oreochromis niloticus)

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    Background: The Nile tilapia is the second most important fish in aquaculture. It is an excellent laboratory model, and is closely related to the African lake cichlids famous for their rapid rates of speciation. A suite of genomic resources has been developed for this species, including genetic maps and ESTs. Here we analyze BAC endsequences to develop comparative physical maps, and estimate the number of genome rearrangements, between tilapia and other model fish species. Results: We obtained sequence from one or both ends of 106,259 tilapia BACs. BLAST analysis against the genome assemblies of stickleback, medaka and pufferfish allowed identification of homologies for approximately 25,000 BACs for each species. We calculate that rearrangement breakpoints between tilapia and these species occur about every 3 Mb across the genome. Analysis of 35,000 clones previously assembled into contigs by restriction fingerprints allowed identification of longer-range syntenies. Conclusions: Our data suggest that chromosomal evolution in recent teleosts is dominated by alternate loss of gene duplicates, and by intra-chromosomal rearrangements (~one per million years). These physical maps are a useful resource for comparative positional cloning of traits in cichlid fishes. The paired BAC end sequences from these clones will be an important resource for scaffolding forthcoming shotgun sequence assemblies of the tilapia genome. (Résumé d'auteur

    Effect of Early versus Deferred Antiretroviral Therapy for HIV on Survival

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    BACKGROUND The optimal time for the initiation of antiretroviral therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection is uncertain. METHODS We conducted two parallel analyses involving a total of 17,517 asymptomatic patients with HIV infection in the United States and Canada who received medical care during the period from 1996 through 2005. None of the patients had undergone previous antiretroviral therapy. In each group, we stratified the patients according to the CD4+ count (351 to 500 cells per cubic millimeter or >500 cells per cubic millimeter) at the initiation of antiretroviral therapy. In each group, we compared the relative risk of death for patients who initiated therapy when the CD4+ count was above each of the two thresholds of interest (early-therapy group) with that of patients who deferred therapy until the CD4+ count fell below these thresholds (deferred-therapy group). RESULTS In the first analysis, which involved 8362 patients, 2084 (25%) initiated therapy at a CD4+ count of 351 to 500 cells per cubic millimeter, and 6278 (75%) deferred therapy. After adjustment for calendar year, cohort of patients, and demographic and clinical characteristics, among patients in the deferred-therapy group there was an increase in the risk of death of 69%, as compared with that in the early-therapy group (relative risk in the deferred-therapy group, 1.69; 95% confidence interval [CI], 1.26 to 2.26; P<0.001). In the second analysis involving 9155 patients, 2220 (24%) initiated therapy at a CD4+ count of more than 500 cells per cubic millimeter and 6935 (76%) deferred therapy. Among patients in the deferred-therapy group, there was an increase in the risk of death of 94% (relative risk, 1.94; 95% CI, 1.37 to 2.79; P<0.001). CONCLUSIONS The early initiation of antiretroviral therapy before the CD4+ count fell below two prespecified thresholds significantly improved survival, as compared with deferred therapy

    End-Stage Renal Disease Among HIV-Infected Adults in North America

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    Background. Human immunodeficiency virus (HIV)-infected adults, particularly those of black race, are at high-risk for end-stage renal disease (ESRD), but contributing factors are evolving. We hypothesized that improvements in HIV treatment have led to declines in risk of ESRD, particularly among HIV-infected blacks
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