588 research outputs found
Development of a decision support tool to facilitate primary care management of patients with abnormal liver function tests without clinically apparent liver disease [HTA03/38/02]. Abnormal Liver Function Investigations Evaluation (ALFIE)
Liver function tests (LFTs) are routinely performed in primary care, and are often the gateway to further invasive and/or expensive investigations. Little is known of the consequences in people with an initial abnormal liver function (ALF) test in primary care and with no obvious liver disease. Further investigations may be dangerous for the patient and expensive for Health Services. The aims of this study are to determine the natural history of abnormalities in LFTs before overt liver disease presents in the population and identify those who require minimal further investigations with the potential for reduction in NHS costs
Phase behaviour of charged colloidal sphere dispersions with added polymer chains
We study the stability of mixtures of highly screened repulsive charged
spheres and non-adsorbing ideal polymer chains in a common solvent using free
volume theory. The effective interaction between charged colloids in an aqueous
salt solution is described by a screened-Coulomb pair potential, which
supplements the pure hard-sphere interaction. The ideal polymer chains are
treated as spheres that are excluded from the colloids by a hard-core
interaction, whereas the interaction between two ideal chains is set to zero.
In addition, we investigate the phase behaviour of charged colloid-polymer
mixtures in computer simulations, using the two-body (Asakura-Oosawa pair
potential) approximation to the effective one-component Hamiltonian of the
charged colloids. Both our results obtained from simulations and from free
volume theory show similar trends. We find that the screened-Coulomb repulsion
counteracts the effect of the effective polymer-mediated attraction. For
mixtures of small polymers and relatively large charged colloidal spheres, the
fluid-crystal transition shifts to significantly larger polymer concentrations
with increasing range of the screened-Coulomb repulsion. For relatively large
polymers, the effect of the screened-Coulomb repulsion is weaker. The resulting
fluid-fluid binodal is only slightly shifted towards larger polymer
concentrations upon increasing the range of the screened-Coulomb repulsion. In
conclusion, our results show that the miscibility of dispersions containing
charged colloids and neutral non-adsorbing polymers increases, upon increasing
the range of the screened-Coulomb repulsion, or upon lowering the salt
concentration, especially when the polymers are small compared to the colloids.Comment: 25 pages,13 figures, accepted for publication on J.Phys.:Condens.
Matte
The connection between stellar mass, age and quenching timescale in massive quiescent galaxies at
We present a spectro-photometric study of a mass-complete sample of quiescent
galaxies at with
drawn from the
VANDELS survey, exploring the relationship between stellar mass, age and
star-formation history. Within our sample of 114 galaxies, we derive a
stellar-mass vs stellar-age relation with a slope of Gyr
per decade in stellar mass. When combined with recent literature results, we
find evidence that the slope of this relation remains consistent over the
redshift interval . The galaxies within the VANDELS quiescent display a
wide range of star-formation histories, with a mean star-formation timescale of
Gyr and a mean quenching timescale of Gyr. We also
find a large scatter in the quenching timescales of the VANDELS quiescent
galaxies, in agreement with previous evidence that galaxies at cease
star formation via multiple mechanisms. We then focus on the oldest galaxies in
our sample, finding that the number density of galaxies that quenched before with stellar masses is . Although
uncertain, this estimate is in good agreement with the latest observational
results at , tentatively suggesting that neither rejuvenation nor merger
events are playing a major role in the evolution of the oldest massive
quiescent galaxies within the redshift interval .Comment: Accepted for publication in MNRAS, 11 pages, 6 figure
Association between GDF-15 levels and changes in vascular and physical function in older patients with hypertension
Background:
Growth differentiation factor-15 (GDF-15) may be a biomarker of disease, protective response and/or prognosis, in older people with hypertension.
Aims:
To correlate baseline GDF-15 levels with physical and vascular health data in this population.
Methods:
Baseline blood samples were analysed using a GDF-15 ELISA assay kit. Correlations with baseline and 12-month outcome data, including measures of physical and vascular function, were performed.
Results:
A total of 147 individuals, mean age 76.8 ± 4.7 years, were included. 77 (52 %) were male. Baseline log10GDF-15 showed significant correlations with age (r = 0.37, p < 0.001), total cholesterol (r = â0.33, p < 0.001) and 6-min walking distance (r = â0.37, p < 0.001). Age remained significantly associated with log10GDF-15 in multivariable analysis (beta = â0.29, p = 0.001). Baseline log10GDF-15 was significantly associated with decline in 6-min walk distance over 12 months (beta = â0.27, p = 0.01) in multivariable models. No significant correlations were seen with changes in vascular function over 12 months.
Conclusion:
Baseline GDF-15 predicts declining physical, but not vascular, function in our population
Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke
Background
Recurrent stroke is a frequent, disabling event after ischemic stroke. This study compared
the efficacy and safety of two antiplatelet regimens â aspirin plus extendedrelease
dipyridamole (ASAâERDP) versus clopidogrel.
Methods
In this double-blind, 2-by-2 factorial trial, we randomly assigned patients to receive
25 mg of aspirin plus 200 mg of extended-release dipyridamole twice daily or to receive
75 mg of clopidogrel daily. The primary outcome was first recurrence of stroke.
The secondary outcome was a composite of stroke, myocardial infarction, or death
from vascular causes. Sequential statistical testing of noninferiority (margin of 1.075),
followed by superiority testing, was planned.
Results
A total of 20,332 patients were followed for a mean of 2.5 years. Recurrent stroke
occurred in 916 patients (9.0%) receiving ASAâERDP and in 898 patients (8.8%) receiving
clopidogrel (hazard ratio, 1.01; 95% confidence interval [CI], 0.92 to 1.11). The
secondary outcome occurred in 1333 patients (13.1%) in each group (hazard ratio for
ASAâERDP, 0.99; 95% CI, 0.92 to 1.07). There were more major hemorrhagic events
among ASAâERDP recipients (419 [4.1%]) than among clopidogrel recipients (365
[3.6%]) (hazard ratio, 1.15; 95% CI, 1.00 to 1.32), including intracranial hemorrhage
(hazard ratio, 1.42; 95% CI, 1.11 to 1.83). The net risk of recurrent stroke or major
hemorrhagic event was similar in the two groups (1194 ASAâERDP recipients [11.7%],
vs. 1156 clopidogrel recipients [11.4%]; hazard ratio, 1.03; 95% CI, 0.95 to 1.11).
Conclusions
The trial did not meet the predefined criteria for noninferiority but showed similar rates
of recurrent stroke with ASAâERDP and with clopidogrel. There is no evidence that either
of the two treatments was superior to the other in the prevention of recurrent
stroke. (ClinicalTrials.gov number, NCT00153062.
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