Risk factor stratification of peripheral arterial disease in the United Kingdom

Objective: To document the patient characteristics, primary care and hospital management and QoL in patients with intermittent claudication in the United Kingdom. Also to determine the appropriate use of prophylactic therapy, to determine markers of high and low risk and to suggest approaches to optimise the management of peripheral arterial disease. Methods: 474 patients were recruited from 23 centres across the United Kingdom. Data was collected at baseline and at six months and risk factors profile was analysed. Results: Symptomatic disease is more prevalent in men and those above 60. A high proportion of patients were hypertensive and control of blood pressure was not optimal. Use of antiplatelet agents and lipid lowering therapy was less than satisfactory though it improved following hospital referral. Life style modification advice was patchy and not uniform and intensive support for such programmes was lacking. Majority of patients improved not only on clinical parameters but also their QoL over a six month period. 35% underwent peripheral imaging and 7.8% had an interventional procedure. 14% had a vascular event over six months. Low ABPI, high systolic pressure and prior CHD were significantly associated with development of all vascular events. Conclusions: Use of appropriate therapy to reduce the risk factor profile is less than optimal. There is a need for uniform national guidelines for appropriate management of peripheral arterial disease patients in the United Kingdom.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Pancreatic Involvement in Hermansky–Pudlak Syndrome- A Case Report

Hermansky-Pudlak Syndrome (HPS) is a rare autosomal recessive disorder that presents with oculocutaneous albinism, bleeding disorders, and immunodeficiency. Granulomatous colitis and pulmonary fibrosis are two major complications of this syndrome. On rare instances, HPS can involve the heart and lungs. This report discusses a 32-year-old man who presented with oculocutaneous albinism and immunodeficiency along with renal, pulmonary, and pancreatic complications. Pancreatic atrophy is a unique finding in our patient, which has not been reported in the literature. The purpose of our case report is to bring into light unusual complications of HPS so that timely action could be taken to avoid the progression of complications.&nbsp

A comprehensive analysis of healthcare big data management, analytics and scientific programming

Healthcare systems are transformed digitally with the help of medical technology, information systems, electronic medical records, wearable and smart devices, and handheld devices. The advancement in the medical big data, along with the availability of new computational models in the field of healthcare, has enabled the caretakers and researchers to extract relevant information and visualize the healthcare big data in a new spectrum. The role of medical big data becomes a challenging task in the form of storage, required information retrieval within a limited time, cost efficient solutions in terms care, and many others. Early decision making based healthcare system has massive potential for dropping the cost of care, refining quality of care, and reducing waste and error. Scientific programming play a significant role to overcome the existing issues and future problems involved in the management of large scale data in healthcare, such as by assisting in the processing of huge data volumes, complex system modelling, and sourcing derivations from healthcare data and simulations. Therefore, to address this problem efficiently a detailed study and analysis of the available literature work is required to facilitate the doctors and practitioners for making the decisions in identifying the disease and suggest treatment accordingly. The peer reviewed reputed journals are selected for the accumulated of published research work during the period ranges from 2015 - 2019 (a portion of 2020 is also included). A total of 127 relevant articles (conference papers, journal papers, book section, and survey papers) are selected for the assessment and analysis purposes. The proposed research work organizes and summarizes the existing published research work based on the research questions defined and keywords identified for the search process. This analysis on the existence research work will help the doctors and practitioners to make more authentic decisions, which ultimately will help to use the study as evidence for treating patients and suggest medicines accordingly

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Polyamide-6-based composites reinforced with pristine or functionalized multi-walled carbon nanotubes produced using melt extrusion technique

Polyamide-6-based composites with pristine or functionalized multi-walled carbon nanotubes were produced using melt extrusion technique. After chemical functionalization, defect formation and attachment of carboxylic (−COOH) or amine (−NH2) groups on carbon nanotubes was confirmed from high-resolution transmission electron microscope and Fourier transform infra-red spectroscope studies. Carbon nanotubes incorporation promoted growth of α-form crystals with enhanced thermal stability through increase in crystallization temperature from 162 to 192℃. Dynamic mechanical thermal analysis (DMTA) indirectly pointed out to a homogeneous, uniform dispersion of nanotubes with reduction in free volume of the polymer, exhibiting a slight increase in glass transition temperature and a significant drop in coefficient of thermal expansion value. Composites containing 0.5 wt% NH2-carbon nanotubes show increases in elastic modulus and tensile strength by ∼60 and 76%, respectively. Uniform dispersion and high interfacial strength was manifested by drop in strain to failure and lack of evidence of carbon nanotubes debonding from the matrix

Effect of weaning age and milk feeding volume on growth performance of Nili-Ravi buffalo calves

The objective of this study was to evaluate the growth performance of early or late weaned Nili-Ravi buffalo calves offered feeding regimes of low or high milk volumes. For this purpose, 48-day-old buffalo calves were randomly allocated to four treatments of twelve calves each. Calves were weaned either at day 56 (early weaned) or 84 (late weaned). Within each weaning age calves were offered milk at either 10% (low milk) or 15% (high milk) of their body weight. Early weaned calves were offered milk adjusted weekly until day 35; the calculated milk intake at day 35 was reduced by one-third in each of the last two weeks leading to the weaning of the calves at day 56. Late weaned calves were offered milk, adjusted weekly, until day 63 and weaned at day 84 by decreasing milk by one-third each week for the last two weeks. At week sixteen, late weaned calves had higher body weight and average daily gain than early weaned calves (p < .05). These same measurements were also higher in the high milk than the low milk fed calves (p < .05). Highest body weight and average daily gain was recorded in high milk late weaned calves and poorest in low milk early weaned calves. Early weaning or low milk volumes minimised the feeding costs, however, resulted in lower body weights and average daily gains. Thus, choices of pre-weaning feeding regimen should be made with feeding cost and performance of replacement calves kept in mind

Anonymity-preserving Reputation Management System for health sector

<div><p>In health sector, trust is considered important because it indirectly influences the quality of health care through patient satisfaction, adherence and the continuity of its relationship with health care professionals and the promotion of accurate and timely diagnoses. One of the important requirements of TRSs in the health sector is rating secrecy, which mandates that the identification information about the service consumer should be kept secret to prevent any privacy violation. Anonymity and trust are two imperative objectives, and no significant explicit efforts have been made to achieve both of them at the same time. In this paper, we present a framework for solving the problem of reconciling trust with anonymity in the health sector. Our solution comprises Anonymous <i>Reputation Management</i> (ARM) protocol and <i>Context-aware Trustworthiness Assessment</i> (CTA) protocol. ARM protocol ensures that only those service consumers who received a service from a specific service provider provide a recommendation score anonymously with in the specified time limit. The CTA protocol computes the reputation of a user as a service provider and as a recommender. To determine the correctness of the proposed ARM protocol, formal modelling and verification are performed using High Level Petri Nets (HLPN) and Z3 Solver. Our simulation results verify the accuracy of the proposed context-aware trust assessment scheme.</p></div

Deciphering Plantago ovata Forsk Leaf Extract Mediated Distinct Germination, Growth and Physio-Biochemical Improvements under Water Stress in Maize (Zea mays L.) at Early Growth Stage

Use of Plantago ovata Forsk leaf (also known as blond plantain or isabgol) extract is a novel approach for ameliorating water stress in various agronomic crops such as maize (Zea mays L.). To examine the potential roles of P. ovata extract (0, 20 and 40%) in increasing seed germination, plant growth, photosynthetic measurements, stomatal properties, oxidative stress and antioxidant response, ions uptake and the relationship between studied parameters, we investigated the impacts of its short-term seed priming on Z. mays L. elite cultivar “Cimmyt-Pak” under a control environment and a water deficit stress environment (induced by PEG). It was evident that water deficit stress conditions induced a negative impact on plant growth, stomatal properties and ion uptake in different organs of Z. mays. The decrease in growth-related attributes might be due to overproduction of oxidative stress biomarkers, i.e., malondialdehyde (MDA) contents, hydrogen peroxide (H2O2) initiation, and electrolyte leakage (%), which was also overcome by the enzymatic antioxidants, i.e., superoxidase dismutase (SOD), peroxidase (POD), catalase (CAT) and ascorbate peroxidase (APX) and non-enzymatic antioxidants, which increased under the water stress environment. However, seed priming with P. ovata extract positively increased germination rate and growth profile, and protected photosynthetic apparatus and stomatal properties by decreasing oxidative stress indicators and increasing activities of antioxidant compounds. Our results also depicted that the optimum concentration of P. ovata extract for Z. mays seedlings under water stress conditions was 20%, while a further increase in P. ovata extract (40%) induced a non-significant negative impact on growth and biomass of Z. mays seedling. In addition, the effect was more promising on Z. mays seedlings when grown under controlled conditions. Here, we concluded that the understanding of the role of seed priming with P. ovata extract in the increment of growth-related attributes, photosynthetic apparatus (Pn, Gs, Ts and Ci) and nutrient uptake (Ca2+, Fe2+, P and Mg2+) introduces new possibilities for their effective use in water deficit stress environments and shows a promising foundation for Z. mays tolerance against water deficit stress conditions

Filtering accuracy in terms of MCC (bad mouthing attack done in <i>t</i>_<i>r</i>).

<p>Filtering accuracy in terms of MCC (bad mouthing attack done in <i>t</i>_<i>r</i>).</p