Project Based Learning: Promoting Cross-Cultural Understanding using Android Application at an Indian University in Gujarat

Students in a project-based learning environment get experience with actual, hands-on projects. In this article, we present the experience obtained in a Mobile Application Development course. In addition, available multi-country criteria of this research enable us to investigate probable cross-cultural variances. The purpose of this project was to design and create apps (or simply app) for Android-based devices. The chosen methodology, based on Project-Based Learning, boosted both cooperation and rivalry among students. This research offers the outcomes from a heuristic assessment by students at Indian university in Gujarat for the students of three nations. Total 120 students are recruited for this research from a university in Gujarat. "It was established that a project-based learning approach is an effective and engaging way for translation students to experiment with their translation skills and different translation theories, achieve linguistic and cross-cultural understanding of different cultures while participating actively in various organised learning activities.'' More significantly, they have elevated their intercultural awareness and strengthened their intercultural communication ability. As students engage in this kind of project-based, introspective, and exploratory learning, they grow in their confidence as communicators (both verbally and in writing), their willingness to take intellectual risks, and their awareness of cultural variety. Its educational ramifications are examined

Impact of left ventricular ejection fraction on 10-year mortality in the SYNTAX trial

Backgrounds: The impact of reduced left ventricular ejection fraction (LVEF) on very long-term prognosis following percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) has been debated. The aim of this study was to investigate the impact of LVEF at baseline on 10-year mortality in the SYNTAX trial. Methods: Patients (n = 1800) were categorized into three sub-groups: reduced (rEF ≤ 40 %), mildly reduced (mrEF 41–49 %), and preserved LVEF (pEF ≥ 50 %). The SYNTAX score 2020 (SS-2020) was applied in patients with LVEF&lt;50 % and ≥ 50 %. Results: Ten-year mortalities were 44.0 %, 31.8 %, and 22.6 % (P &lt; 0.001) in patients with rEF (n = 168), mrEF (n = 179), and pEF (n = 1453). Although no significant differences were observed, the mortality with PCI was higher than with CABG in patients with rEF (52.9 % vs 39.6 %, P = 0.054) and mrEF (36.0 % vs. 28.6 %, P = 0.273), and comparable in pEF (23.9 % vs. 22.2 %, P = 0.275). Calibration and discrimination of the SS-2020 in patients with LVEF&lt;50 % were poor, whilst they were reasonable in those with LVEF≥50 %. The proportion of patients eligible for PCI who had a predicted equipoise in mortality with CABG was estimated to be 57.5 % in patients with LVEF≥50 %. CABG was safer than PCI in 62.2 % of patients with LVEF&lt;50 %. Conclusions: Reduced LVEF was associated with an increased risk of 10-year mortality in patients revascularized either surgically or percutaneously. Compared to PCI, CABG was safe revascularization in patients with LVEF≤40 %. In patients with LVEF≥50 % individualized 10-year all-cause mortality predicted by SS-2020 was helpful in decision-making whilst the predictivity in patients with LVEF&lt;50 % was poor.</p

Off‐pump coronary artery bypass grafting: department of veteran affairs’ use and outcomes

Background: Coronary artery bypass can be performed off pump (OPCAB) without cardiopulmonary bypass. However, trends over time for OPCAB versus on‐pump (ONCAB) use and long‐term outcome has not been reported, nor has their long‐term outcome been compared. Methods and Results: We queried the national Veterans Affairs database (2005–2019) to identify isolated coronary artery bypass procedures. Procedures were classified as OPCAB on ONCAB using the as‐treated basis. Trend analyses were performed to evaluate longitudinal changes in the preference for OPCAB. The median follow‐up period was 6.6 (3.5–10) years. An inverse probability weighted Cox model was used to compare all‐cause mortality between OPCAB and ONCAB. From 47 685 patients, 6759 (age 64±8 years) received OPCAB (14%). OPCAB usage declined from 16% (2005–2009) to 8% (2015–2019). Patients with triple vessel disease who received OPCAB received a lower mean number of grafts (2.8±0.8 versus 3.2±0.8; P&lt;0.01). The ONCAB 5‐, 10‐, and 15‐year survival rates were 82.9% (82.5–83.3), 60.4% (59.8–61.1), and 37.2% (36.1–38.4); correspondingly, OPCAB rates were 80.7% (79.7–81.7), 57.4% (56–58.7), and 34.1% (31.7–36.6) (P&lt;0.01). OPCAB was associated with increased risk‐adjusted all‐cause mortality (hazard ratio, 1.15 [1.13–1.18]; P&lt;0.01) and myocardial infarction (incident rate ratio, 1.16 [1.05–1.28]; P&lt;0.01). Conclusions: Over 15 years, OPCAB use declined considerably in Veterans Affairs medical centers. In Veterans Affairs hospitals, late all‐cause mortality and myocardial infarction rates were higher in the OPCAB cohort

Assessing the functional structure of genomic data

Motivation: The availability of genome-scale data has enabled an abundance of novel analysis techniques for investigating a variety of systems-level biological relationships. As thousands of such datasets become available, they provide an opportunity to study high-level associations between cellular pathways and processes. This also allows the exploration of shared functional enrichments between diverse biological datasets, and it serves to direct experimenters to areas of low data coverage or with high probability of new discoveries

Ten-year all-cause mortality according to smoking status in patients with severe coronary artery disease undergoing surgical or percutaneous revascularization

Aims To evaluate the impact of various smoking status on 10-year all-cause mortality and to examine a relative treatment benefit of coronary artery bypass grafting (CABG) vs. percutaneous coronary intervention (PCI) according to smoking habits. Methods and results The SYNTAX Extended Survival study evaluated vital status up to 10 years in 1800 patients with de novo three-vessel disease and/or left main coronary artery disease randomized to CABG or PCI in the SYNTAX trial. In the present analysis, patients were divided into three groups (current, former, or never smokers), and the primary endpoint of 10-year all-cause mortality was assessed according to smoking status. Smoking status was available in 1793 (99.6%) patients at the time of randomization, of whom 363 were current smokers, 798 were former smokers, and 632 were never smokers. The crude rates of 10-year all-cause mortality were 29.7% in current smokers, 25.3% in former smokers, and 25.9% in never smokers (Log-rank P = 0.343). After adjustment for imbalances in baseline characteristics, current smokers had a significantly higher risk of 10-year all-cause mortality than never smokers [adjusted hazard ratio (aHR): 2.29; 95% confidence interval (CI): 1.60-3.27; P < 0.001], whereas former smokers did not. PCI was associated with a higher risk of all-cause mortality than CABG among current smokers (HR: 1.60; 95% CI: 1.09-2.35; P = 0.017), but it failed to show a significant interaction between revascularization strategies and smoking status (P-interaction = 0.910). Conclusion Current smokers had a higher adjusted risk of 10-year all-cause mortality, whereas former smokers did not. The treatment effect of CABG vs. PCI did not differ significantly according to smoking status

РАННИЕ ОСЛОЖНЕНИЯ И ОТСРОЧЕННЫЕ РЕЗУЛЬТАТЫ ПОВТОРНЫХ ОПЕРАЦИЙ НА АОРТАЛЬНОМ КЛАПАНЕ. ОПЫТ ЦЕНТРА СЕРДЦА УНИВЕРСИТЕТА ЛЕЙПЦИГА (ГЕРМАНИЯ)

Introduction. The number of patients that need repeated operations on aortic valve due to dysfunction or degeneration of previously implanted prosthesis is constantly increasing throughout the world because of the constant growth of number of operated patients. The aim of our study was to assess the clinical outcomes of repeated surgeries for aortic valves, held at the Heart Centre of the University of Leipzig (Germany) from 1994 to 2008. Materials and methods. The study included 155 patients, 86 patients of which have had aortic valve prosthesis without reconstruction of the aortic root (rAVS) and 69 patients aortic root replacement (rAVR). The average time between operations amounted to 6.7 ± 7.9 years for all patients; 2.9 ± 3.1 and 8.8 ± 6.7 years for patients with implanted mechanical and biological valves, respectively. Results. The findings showed early lethality of 4.5% for all patients (3.5% for rAVS without root and 5.8% for rAVR with root, p = 0.5). Five-and eight-year survival is 66 ± 5% and 61 ± 6% for all patients and does not differ between surgical groups. Left ventricular ejection fraction is less than 30% (OR 9.2, 95% CI 1.1 -80.3) and initial neurological deficit (OR 22.1, 95% CI 2.3 -197.4) were independent predictors of early mortality. Independent predictors of late mortality were: NYHA functional class IV (HR, 95% CI 2.2 = 1.5, p -3.2 &lt; 0.01) and infective endocarditis (HR 2.2, 95% CI = 1.4 -3.1 p &lt; 0.01). Conclusions. Thus, repeated surgeries on aortic valve is associated with the acceptable early and late survival.Введение. Ввиду постоянного роста популяции пациентов, перенесших протезирование аортального клапана, количество нуждающихся в проведении повторных операций на клапанном аппарате сердца в связи с дисфункцией или дегенерацией ранее имплантированных протезов постоянно увеличивается. Цель нашего исследования заключалась в оценке клинических результатов повторных хирургических вмешательств на аортальном клапане, проведенных на базе Центра сердца Университета Лейпцига (Германия) с 1994 по 2008 годы. Материалы и методы. В исследование были включены 155 пациентов, из которых 86-ти провели репротезирование аортального клапана без реконструкции корня аорты (рПАК) и 69 пациентам протезирование корня аорты (ПКА). Среднее время между операциями составило 6,7±7,9 года для всех пациентов; 2,9±3,1 и 8,8±6,7 года для пациентов с имплантированными биопротезными и механическими клапанами соответственно. Результаты. Установлено, что ранняя летальность составляет 4,5% для всех пациентов (3,5% для ПАК без корня и 5,8% для рПКА, p = 0,5). Пяти- и восьмилетняя выживаемость составляет 66 ± 5% и 61±6% для всех пациентов и не различается между хирургическими группами. Фракция выброса левого желудочка менее 30% (OR 9,2, 95% CI 1,1-80,3) и исходный неврологический дефицит (OR 22,1, 95% CI 2,3197,4) являются независимыми предикторами ранней летальности. Независимыми предикторами летальности в отсроченном периоде установлены функциональный класс NYHA IV (HR 2,2, 95% CI = 1,5-3,2, p &lt;0,01) и инфекционный эндокардит (HR 2,2, 95% CI = 1,4-3,1 р &lt;0,01). Заключение. Таким образом, повторные оперативные вмешательства при патологиях аортального клапана связаны с приемлемыми ранними и отсроченными показателями выживаемости и частотой осложнений

Mapping Genetically Compensatory Pathways from Synthetic Lethal Interactions in Yeast

Background: Synthetic lethal genetic interaction analysis has been successfully applied to predicting the functions of genes and their pathway identities. In the context of synthetic lethal interaction data alone, the global similarity of synthetic lethal interaction patterns between two genes is used to predict gene function. With physical interaction data, such as proteinprotein interactions, the enrichment of physical interactions within subsets of genes and the enrichment of synthetic lethal interactions between those subsets of genes are used as an indication of compensatory pathways. Result: In this paper, we propose a method of mapping genetically compensatory pathways from synthetic lethal interactions. Our method is designed to discover pairs of gene-sets in which synthetic lethal interactions are depleted among the genes in an individual set and where such gene-set pairs are connected by many synthetic lethal interactions. By its nature, our method could select compensatory pathway pairs that buffer the deleterious effect of the failure of either one, without the need of physical interaction data. By focusing on compensatory pathway pairs where genes in each individual pathway have a highly homogenous cellular function, we show that many cellular functions have genetically compensatory properties. Conclusion: We conclude that synthetic lethal interaction data are a powerful source to map genetically compensatory pathways, especially in systems lacking physical interaction information, and that the cellular function network contain

10-Year Follow-Up After Revascularization in Elderly Patients With Complex Coronary Artery Disease

BACKGROUND The optimal revascularization strategy for the elderly with complex coronary artery disease remains unclear. OBJECTIVES The goal of this study was to investigate 10-year all-cause mortality, life expectancy, 5-year major adverse cardiac or cerebrovascular events (MACCE), and 5-year quality of life (QOL) after percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in elderly individuals (>70 years old) with 3-vessel disease (3VD) and/or left main disease (LMD). METHODS In the present pre-specified analysis on age of the SYNTAX Extended Survival study, 10-year all-cause death and 5-year MACCE were compared with Kaplan-Meier estimates and Cox proportional hazards models among elderly or nonelderly patients. Life expectancy was estimated by restricted mean survival time within 10 years, and QOL status according to the Seattle Angina Questionnaire up to 5 years was assessed by linear mixed-effects models. RESULTS Among 1,800 randomized patients, 575 patients (31.9%) were elderly. Ten-year mortality did not differ significantly between PCI and CABG in elderly (44.1% vs. 41.1%; hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 0.84 to 1.40) and nonelderly patients (21.1% vs. 16.6%; HR: 1.30; 95% CI: 1.00 to 1.69; p(interaction) = 0.332). Among elderly patients, 5-year MACCE was comparable between PCI and CABG (39.4% vs. 35.1%; HR: 1.18; 95% CI: 0.90 to 1.56), whereas it was significantly higher in PCI over CABG among nonelderly patients (36.3% vs. 23.0%; HR: 1.69; 95% CI: 1.36 to 2.10; p(interaction) = 0.043). There were no significant difference in life expectancy (mean difference: 0.2 years in favor of CABG; 95% CI: -0.4 to 0.7) and 5-year QOL status between PCI and CABG among elderly patients. CONCLUSIONS Elderly patients with 3VD and/or LMD had comparable 10-year all-cause death, life expectancy, 5-year MACCE, and 5-year QOL status irrespective of revascularization mode. (C) 2021 by the American College of Cardiology Foundation