548 research outputs found

    Advanced Detection of Rotor Electrical Faults in Induction Motors at Start-up

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    Comparative effectiveness, safety, and costs of rivaroxaban and warfarin among morbidly obese patients with atrial fibrillation.

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    BACKGROUND: There are limited data regarding clinical outcomes and healthcare resource utilization of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) who are morbidly obese (body mass index \u3e40 kg/m METHODS: Using data from 2 US healthcare claims databases, we identified patients initiating rivaroxaban or warfarin who had ≥1 medical claim with an AF diagnosis, a diagnostic code for morbid obesity (ICD-9: 278.01, V85.4%; ICD-10: E66.01%, E66.2%, Z68.4%), and a minimum continuous enrollment of 12 months before and 3 months after treatment initiation. Patients were excluded if they had mitral stenosis, a mechanical heart valve procedure, an organ/tissue transplant, or an oral anticoagulant prescription prior to the index date. Rivaroxaban and warfarin patients were 1:1 propensity score matched. Conditional logistic regression was used to compare ischemic stroke/systemic embolism and major bleeding risk. Generalized linear models were used to compare healthcare resource utilization and costs. RESULTS: A total of 3563 matched pairs of morbidly obese AF patients treated with rivaroxaban or warfarin were identified. The majority (81.4%) of patients in the rivaroxaban cohort were receiving the 20 mg dose. The rivaroxaban and warfarin cohorts were well balanced after propensity score matching. The risks of ischemic stroke/systemic embolism and major bleeding were similar for rivaroxaban and warfarin users (stroke/systemic embolism: 1.5% vs 1.7%; odds ratio [OR]: 0.88; 95% confidence interval [CI]: 0.60, 1.28; P = .5028; major bleeding: 2.2% vs 2.7%; OR: 0.80; 95% CI: 0.59, 1.08; P = .1447). Total healthcare costs including medication costs per patient per year (PPPY) were significantly lower with rivaroxaban versus warfarin (48,552vs48,552 vs 52,418; P = .0025), which was primarily driven by lower hospitalization rate (50.2% vs 54.1%; P = .0008), shorter length of stay (7.5 vs 9.1 days; P = .0010), and less outpatient service utilization (86 vs 115 visits PPPY; P \u3c .0001). CONCLUSIONS: Morbidly obese AF patients treated with rivaroxaban had comparable risk of ischemic stroke/systemic embolism and major bleeding as those treated with warfarin, but lower healthcare resource utilization and costs

    Rivaroxaban versus warfarin treatment among morbidly obese patients with venous thromboembolism: Comparative effectiveness, safety, and costs.

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    INTRODUCTION: Limited data exist on direct-acting oral anticoagulants in morbidly obese patients with venous thromboembolism (VTE). We compared clinical and health/economic outcomes with rivaroxaban versus warfarin for VTE treatment in morbidly obese patients. MATERIALS AND METHODS: This retrospective 1:1 propensity score matched cohort study analyzed data from 2 US claims databases. VTE patients initiating rivaroxaban or warfarin were identified who had diagnosis codes for morbid obesity (ICD-9:278.01,V85.4; ICD-10:E66.01,E66.2,Z68.4) 12 months pre- or 3 months post-initiation and followed ≥3 months. Intent-to-treat (ITT) and on-treatment (OT) analyses were conducted using conditional logistic regression and generalized linear models to compare recurrent VTE and major bleeding risks, healthcare resource utilization (HRU), and per patient per year (PPPY) costs. RESULTS: In total, 2890 matched pairs of morbidly obese VTE patients initiating rivaroxaban or warfarin were identified. Risks of recurrent VTE (ITT: OR: 0.99; 95% CI: 0.85-1.14) and major bleeding (OT: OR: 0.75; 95% CI: 0.47-1.19) were similar for cohorts. Anti-Factor Xa laboratory measurement was performed on CONCLUSIONS: Morbidly obese VTE patients receiving rivaroxaban had similar risks of recurrent VTE and major bleeding versus warfarin. Rivaroxaban treatment yielded significantly less HRU and total medical costs, with similar total healthcare costs between groups

    PLEISTOCENE PALAEOCLIMATIC EVOLUTION FROM AGIOS GEORGIOS CAVE SPELEOTHEM (KILKIS, N. GREECE)

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    Palaeoclimatic reconstruction in N. Greece has been investigated in this study, using stable isotope analyses and U/Th dating of a speleothem (stalactite) from the cave of Agios Georgios (Kilkis). Sampling sequence was followed in detail in order to obtain high resolution analysis of the proxy. Speleothem δ18O entirely depends on two factors: changes in the δ18O of the percolation waters (a proxy for local rainfall δ18O) and the temperature of water-calcite fractionation inside the cave (a proxy for outside air temperatures). During periods of relatively stable temperatures, δ13C shifts are caused principally by variations in soil CO2 input and physico-chemical processes inside the cave. More important processes affect the δ13C signal of speleothem inside the cave are length of flow path and rates of CO2 degassing.The lower δ13C calcite values indicate greater respiratory activity of soils under wetter conditions. The stalagmite layers were dated through U/Th geochronological method, which places the carbonate precipitation in Middle Pleistocene (630-300ka BP). The isotopic composition of the layers was used in combination with the dating results to reconstruct the evolution of the area of Kilkis. Correlation with global climatic records shows that major climatic transitions that influenced northern hemisphere seem to have also affected the region of N. Greece

    PLEISTOCENE PALAEOCLIMATIC EVOLUTION FROM AGIOS GEORGIOS CAVE SPELEOTHEM (KILKIS, N. GREECE)

    Get PDF
    Palaeoclimatic reconstruction in N. Greece has been investigated in this study, using stable isotope analyses and U/Th dating of a speleothem (stalactite) from the cave of Agios Georgios (Kilkis). Sampling sequence was followed in detail in order to obtain high resolution analysis of the proxy. Speleothem δ18O entirely depends on two factors: changes in the δ18O of the percolation waters (a proxy for local rainfall δ18O) and the temperature of water-calcite fractionation inside the cave (a proxy for outside air temperatures). During periods of relatively stable temperatures, δ13C shifts are caused principally by variations in soil CO2 input and physico-chemical processes inside the cave. More important processes affect the δ13C signal of speleothem inside the cave are length of flow path and rates of CO2 degassing.The lower δ13C calcite values indicate greater respiratory activity of soils under wetter conditions. The stalagmite layers were dated through U/Th geochronological method, which places the carbonate precipitation in Middle Pleistocene (630-300ka BP). The isotopic composition of the layers was used in combination with the dating results to reconstruct the evolution of the area of Kilkis. Correlation with global climatic records shows that major climatic transitions that influenced northern hemisphere seem to have also affected the region of N. Greece
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