2,321 research outputs found
Intonation in unaccompanied singing: Accuracy, drift, and a model of reference pitch memory
Copyright 2014 Acoustical Society of America. This article may be downloaded for personal use only. Any other use requires prior permission of the author and the Acoustical Society of America.
The following article appeared in J. Acoust. Soc. Am. 136, 401 (2014) and may be found at http://dx.doi.org/10.1121/1.4881915
Seasonal variation in the interactions between piscivorous fish, planktivorous fish and zooplankton in a shallow eutrophic lake
Peripheral Artery Disease Patients May Benefit More from Aggressive Secondary Prevention than Aneurysm Patients to Improve Survival
BACKGROUND AND AIMS: Although it has become clear that aneurysmal and occlusive arterial disease represent two distinct etiologic entities, it is still unknown whether the two vascular pathologies are prognostically different. We aim to assess the long-term vital prognosis of patients with abdominal aortic aneurysmal disease (AAA) or peripheral artery disease (PAD), focusing on possible differences in survival, prognostic risk profiles and causes of death.
METHODS: Patients undergoing elective surgery for isolated AAA or PAD between 2003 and 2011 were retrospectively included. Differences in postoperative survival were determined using Kaplan-Meier and Cox regression analysis. Prognostic risk profiles were also established with Cox regression analysis.
RESULTS: 429 and 338 patients were included in the AAA and PAD groups, respectively. AAA patients were older (71.7 vs. 63.3 years, p < 0.001), yet overall survival following surgery did not differ (HR: 1.16, 95% CI: 0.87-1.54). Neither was type of vascular disease associated with postoperative cardiovascular nor cancer-related death. However, in comparison with age- and gender-matched general populations, cardiovascular mortality was higher in PAD than AAA patients (48.3% vs. 17.3%). Survival of AAA and PAD patients was negatively affected by age, history of cancer and renal insufficiency. Additional determinants in the PAD group were diabetes and ischemic heart disease.
CONCLUSIONS: Long-term survival after surgery for PAD and AAA is similar. However, overall life expectancy is significantly worse among PAD patients. The contribution of cardiovascular disease towards mortality in PAD patients warrants more aggressive secondary prevention to reduce cardiovascular mortality and improve longevity
Severe hypocalcaemia and hypomagnesemia presenting with severe neurologic and gastro-intestinal symptoms:a case report and review of literature
Coronary Revascularization Induces a Shift From Cardiac Toward Noncardiac Mortality Without Improving Survival in Vascular Surgery Patient
OBJECTIVE: Although evidence has shown that ischemic heart disease (IHD) in vascular surgery patients has a negative impact on the prognosis after surgery, it is unclear whether directed treatment of IHD may influence cause-specific and overall mortality. The objective of this study was to determine the prognostic implication of coronary revascularization (CR) on overall and cause-specific mortality in vascular surgery patients.
METHODS:
Patients undergoing surgery for abdominal aortic aneurysm, carotid artery stenosis, or peripheral artery disease in a university hospital in The Netherlands between January 2003 and December 2011 were retrospectively included. Survival estimates were obtained by Kaplan-Meier and Cox regression analysis.
RESULTS:
A total of 1104 patients were included. Adjusted survival analyses showed that IHD significantly increased the risk of overall mortality (hazard ratio [HR], 1.50; 95% confidence interval, 1.21-1.87) and cardiovascular death (HR, 1.93; 95% confidence interval, 1.35-2.76). Compared with those without CR, patients previously undergoing CR had similar overall mortality (HR, 1.38 vs 1.62; P = .274) and cardiovascular mortality (HR, 1.83 vs 2.02; P = .656). Nonrevascularized IHD patients were more likely to die of IHD (6.9% vs 35.7%), whereas revascularized IHD patients more frequently died of cardiovascular causes unrelated to IHD (39.1% vs 64.3%; P = .018).
CONCLUSIONS:
This study confirms the significance of IHD for postoperative survival of vascular surgery patients. CR was associated with lower IHD-related death rates. However, it failed to provide an overall survival benefit because of an increased rate of cardiovascular mortality unrelated to IHD. Intensification of secondary prevention regimens may be required to prevent this shift toward non-IHD-related death and thereby improve life expectancy
Individualized Angiotensin‐Converting Enzyme (ACE)‐Inhibitor Therapy in Stable Coronary Artery Disease Based on Clinical and Pharmacogenetic Determinants: The PERindopril GENEtic (PERGENE) Risk Model
Patients with stable coronary artery disease (CAD) constitute a heterogeneous group in which the treatment benefits by angiotensin-converting enzyme (ACE)-inhibitor therapy vary between individuals. Our objective was to integrate clinical and pharmacogenetic determinants in an ultimate combined risk prediction model.Clinical, genetic, and outcomes data were used from 8726 stable CAD patients participating in the EUROPA/PERGENE trial of perindopril versus placebo. Multivariable analysis of phenotype data resulted in a clinical risk score (range, 0-21 points). Three single-nucleotide polymorphisms (rs275651 and rs5182 in the angiotensin-II type I-receptor gene and rs12050217 in the bradykinin type I-receptor gene) were used to construct a pharmacogenetic risk score (PGXscore; range, 0-6 points). Seven hundred eighty-five patients (9.0%) experienced the primary endpoint of cardiovascular mortality, nonfatal myocardial infarction or resuscitated cardiac arrest, during 4.2 years of follow-up. Absolute risk reductions ranged from 1.2% to 7.5% in the 73.5% of patients with PGXscore of 0 to 2. As a consequence, estimated annual numbers needed to treat ranged from as low as 29 (clinical risk score ≥10 and PGXscore of 0) to 521 (clinical risk score ≤6 and PGXscore of 2). Furthermore, our data suggest that long-term perindopril prescription in patients with a PGXscore of 0 to 2 is cost-effective.Both baseline clinical phenotype, as well as genotype determine the efficacy of widely prescribed ACE inhibition in stable CAD. Integration of clinical and pharmacogenetic determinants in a combined risk prediction model demonstrated a very wide range of gradients of absolute treatment benefit
Anti-oxidized LDL antibodies and coronary artery disease: a systematic review
Antibodies to oxidized LDL (oxLDL) may be associated with improved outcomes in cardiovascular disease. However, analysis is restricted by heterogenous study design and endpoints. Our objective was to conduct a comprehensive systematic review assessing anti-oxLDL antibodies in relation to coronary artery disease (CAD). Through a systematic literature search, we identified all studies assessing the relationship of either, IgG or IgM ox-LDL/ copper-oxLDL/ malondialdehyde-LDL, with coronary atherosclerosis or cardiovascular events in populations with, and without, established CAD. Systematic review best practices were adhered to and study quality was assessed. An initial electronic database search identified 2059 records, which was subsequently followed by abstract and full-text review. Finally, we included 18 studies with over 1811 patients with CAD. The studies varied according to populations studied, conventional cardiovascular risk factors and interventional modalities used to assess CAD. IgM anti-oxLDL antibodies were found to indicate protection from more severe CAD and possibly cardiovascular events, whilst the relationship with IgG is more complex and difficult to elucidate, with studies reporting divergent results. In this systematic review, there is evidence that suggests a relationship between anti-oxLDL antibodies and CAD, especially for the IgM subclass. However, further studies, with well-characterized prospective cohorts, will be important to clarify these associations
Double Neutron Star Systems and Natal Neutron Star Kicks
We study the four double neutron star systems found in the Galactic disk in
terms of the orbital characteristics of their immediate progenitors and the
natal kicks imparted to neutron stars. Analysis of the effect of the second
supernova explosion on the orbital dynamics, combined with recent results from
simulations of rapid accretion onto neutron stars lead us to conclude that the
observed systems could not have been formed had the explosion been symmetric.
Their formation becomes possible if kicks are imparted to the radio-pulsar
companions at birth. We identify the constraints imposed on the immediate
progenitors of the observed double neutron stars and calculate the ranges
within which their binary characteristics (orbital separations and masses of
the exploding stars) are restricted. We also study the dependence of these
limits on the magnitude of the kick velocity and the time elapsed since the
second explosion. For each of the double neutron stars, we derive a minimum
kick magnitude required for their formation, and for the two systems in close
orbits we find it to exceed 200km/s. Lower limits are also set to the
center-of-mass velocities of double neutron stars, and we find them to be
consistent with the current proper motion observations.Comment: 25 pages, 6 figs (9 parts), 4 tables, AASTeX, Accepted in Ap
Оценка эффективности управления деятельностью предприятия
Целью исследования является оценка эффективности управления деятельностью предприятия как интегрального показателя, то есть управления совокупностью деятельностей, таких как производственная, инвестиционная, инновационная, маркетинговая и финансовая
The Galactic Population of Low- and Intermediate-Mass X-ray Binaries
(abridged) We present the first study that combines binary population
synthesis in the Galactic disk and detailed evolutionary calculations of low-
and intermediate-mass X-ray binaries (L/IMXBs). We show that the formation
probability of IMXBs with initial donor masses of 1.5--4 Msun is typically >~5
times higher than that of standard LMXBs, and suggest that the majority of the
observed systems may have descended from IMXBs. Distributions at the current
epoch of the orbital periods, donor masses, and mass accretion rates have been
computed, as have orbital-period distributions of BMPs. Several significant
discrepancies between the theoretical and observed distributions are discussed.
The orbital-period distribution of observed BMPs strongly favors cases where
the envelope of the neutron-star progenitor is more easily ejected during the
common-envelope phase. However, this leads to a >~100-fold overproduction of
the theoretical number of luminous X-ray sources relative to the total observed
number of LMXBs. X-ray irradiation of the donor star may result in a dramatic
reduction in the X-ray active lifetime of L/IMXBs, thus possibly resolving the
overproduction problem, as well as the long-standing BMP/LMXB birthrate
problem.Comment: 12 pages, emulateapj, submitted to Ap
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