Prevalence of pre-hypertension and hypertension and its related risk factors among undergraduate students in a Tertiary institution, Ghana

Objectives: This study sought to provide information about pre-hypertension and hypertension status among undergraduate students at the Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.Methods: This cross-sectional study was conducted among a total of 540 students. Participants were interviewed using questionnaires and their blood pressures (BP), height, weight were measured and Body Mass Index ‘BMI’ and Waist-to-Height Ratio (WHtR) were calculated. Repeated measurements were obtained on two successive times in students with persistently elevated BP. Data obtained was entered and analyzed using SPSS version 23. Final prevalence was adjusted for loss-to- follow up on participants with first elevated BP from the reading and logistic regression used to evaluate risk factors. P-value less than .05 was considered statistically significant.Results: Twelve (2.2%) of the students were hypertensive, whilst pre-hypertension was prevalent in 26.1% of the student. Family history of hypertension [OR = 1.68(0.73–1.68)], kidney failure [OR = 1.38(0.34– 5.60)], stroke [OR = 1.10(0.64–1.91)] and heart failure [OR = 1.03(0.27–3.94)] were associated with increased risk of developing pre-hypertension; however no significant association was observed (p > .05). WHtR and BMI were independent positively correlated with blood pressure status after controlling for gender and age (p < .05). Further analysis revealed that, obesity detected by WHtR [OR = 3.67 (1.13–11.94), p = .031] and BMI [OR = 6.89(0.71–66.48), p = .0005] were significant predictors of hypertension using logistic regression analysis.Conclusion: The study revealed considerable prevalence rates of pre-hypertension and hypertension among undergraduate students, with significant risk factors such as obesity detected by BMI and WHtR. Gender as male was also significant for pre-hypertension and hypertension. Sound prevention and control programmes of hypertension should be devised among students, to improve their knowledge and lifestyle practices early in life.Keywords: Hypertension, Pre-hypertension, Obesity, Tertiary students, Ghan

High‐Sensitivity Cardiac Troponin T and Recurrent Vascular Events After First Ischemic Stroke

Background: Recent evidence suggests cardiac troponin levels to be a marker of increased vascular risk. We aimed to assess whether levels of high-sensitivity cardiac troponin T (hs-cTnT) are associated with recurrent vascular events and death in patients with first-ever, mild to moderate ischemic stroke. Methods and Results: We used data from the PROSCIS-B (Prospective Cohort With Incident Stroke Berlin) study. We computed Cox proportional hazards regression analyses to assess the association between hs-cTnT levels upon study entry (Roche Elecsys, upper reference limit, 14 ng/L) and the primary outcome (composite of recurrent stroke, myocardial infarction, and all-cause death). A total of 562 patients were analyzed (mean age, 67 years [SD 13]; 38.6% women; median National Institutes of Health Stroke Scale=2; hs-cTnT above upper reference limit, 39.2%). During a mean follow-up of 3 years, the primary outcome occurred in 89 patients (15.8%), including 40 (7.1%) recurrent strokes, 4 (0.7%) myocardial infarctions, and 51 (9.1%) events of all-cause death. The primary outcome occurred more often in patients with hs-cTnT above the upper reference limit (27.3% versus 10.2%; adjusted hazard ratio, 2.0; 95% CI, 1.3-3.3), with a dose-response relationship when the highest and lowest hs-cTnT quartiles were compared (15.2 versus 1.8 events per 100 person-years; adjusted hazard ratio, 4.8; 95% CI, 1.9-11.8). This association remained consistent in sensitivity analyses, which included age matching and stratification for sex. Conclusions: Hs-cTnT is dose-dependently associated with an increased risk of recurrent vascular events and death within 3 years after first-ever, mild to moderate ischemic stroke. These findings support further studies of the utility of hs-cTnT for individualized risk stratification after stroke. Registration URL: ; Unique identifier: NCT01363856

Comparison of three analytical platforms for quantification of the neurofilament light chain in blood samples: ELISA, electrochemiluminescence immunoassay and Simoa

AbstractBackground: Neuronal damage is the morphological substrate of persisting neurological disability. Neurofilaments (Nf) are specific cytoskeletal proteins of neurons and their quantification has shown encouraging results as a biomarker for axonal injury. Methods: We aimed at comparing a widely used conventional ELISA for Nf light chain (NfL) with an electrochemiluminescence-based method (ECL assay) and a newly developed single-molecule array (Simoa) method in clinically relevant cerebrospinal fluid (CSF) and serum samples. Results: Analytical sensitivity was 0.62 pg/mL for Simoa, 15.6 pg/mL for the ECL assay, and 78.0 pg/mL for the ELISA. Correlations between paired CSF and serum samples were strongest for Simoa (r=0.88, p<0.001) and the ECL assay (r=0.78, p<0.001) and weaker for ELISA measurements (r=0.38, p=0.030). CSF NfL measurements between the platforms were highly correlated (r=1.0, p<0.001). Serum NfL levels were highly related between ECL assay and Simoa (r=0.86, p<0.001), and this was less visible between ELISA-ECL assay (r=0.41, p=0.018) and ELISA-Simoa (r=0.43, p=0.013). Multiple sclerosis (MS) patients had significantly higher serum NfL levels than controls when measured with Simoa (p=0.001) but not with the other platforms. Conclusions: We found Simoa to be more sensitive than ELISA or the ECL assay. Our results support the feasibility of quantifying NfL in serum; the results correlate with the more-established CSF NfL test. The highly sensitive Simoa technology deserves further studies in larger patient cohorts to clarify whether serum NfL could be used in the future to measure disease severity and determine prognosis or response to treatment interventions in neurological diseases

EndoVAscular treatment and ThRombolysis for Ischemic Stroke Patients (EVA-TRISP) registry: basis and methodology of a pan-European prospective ischaemic stroke revascularisation treatment registry.

PURPOSE The Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration was a concerted effort initiated in 2010 with the purpose to address relevant research questions about the effectiveness and safety of intravenous thrombolysis (IVT). The collaboration also aims to prospectively collect data on patients undergoing endovascular treatment (EVT) and hence the name of the collaboration was changed from TRISP to EVA-TRISP. The methodology of the former TRISP registry for patients treated with IVT has already been published. This paper focuses on describing the EVT part of the registry. PARTICIPANTS All centres committed to collecting predefined variables on consecutive patients prospectively. We aim for accuracy and completeness of the data and to adapt local databases to investigate novel research questions. Herein, we introduce the methodology of a recently constructed academic investigator-initiated open collaboration EVT registry built as an extension of an existing IVT registry in patients with acute ischaemic stroke (AIS). FINDINGS TO DATE Currently, the EVA-TRISP network includes 20 stroke centres with considerable expertise in EVT and maintenance of high-quality hospital-based registries. Following several successful randomised controlled trials (RCTs), many important clinical questions remain unanswered in the (EVT) field and some of them will unlikely be investigated in future RCTs. Prospective registries with high-quality data on EVT-treated patients may help answering some of these unanswered issues, especially on safety and efficacy of EVT in specific patient subgroups. FUTURE PLANS This collaborative effort aims at addressing clinically important questions on safety and efficacy of EVT in conditions not covered by RCTs. The TRISP registry generated substantial novel data supporting stroke physicians in their daily decision making considering IVT candidate patients. While providing observational data on EVT in daily clinical practice, our future findings may likewise be hypothesis generating for future research as well as for quality improvement (on EVT). The collaboration welcomes participation of further centres willing to fulfill the commitment and the outlined requirements

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Stroke genetics informs drug discovery and risk prediction across ancestries

Previous genome-wide association studies (GWASs) of stroke — the second leading cause of death worldwide — were conducted predominantly in populations of European ancestry1,2. Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis3, and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach4, we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry5. Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries

Stroke genetics informs drug discovery and risk prediction across ancestries

Previous genome-wide association studies (GWASs) of stroke - the second leading cause of death worldwide - were conducted predominantly in populations of European ancestry(1,2). Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis(3), and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach(4), we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry(5). Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries.</p

Implementation of potentials of unbalanced complex kinetics model with particle filter in detecting critical transition in financial market time series

As a complex system, a real financial market consists of many interacting agents that can be differentiated into buyers, sellers, and brokers. Each of them drives the market with their strategies, which are affected by various factors. However, sometimes these agents’ behavior may lead to an uncontrollable market price movement, which eventually leads to financial bubbles or crashes. These events, which can be regarded as a critical transition in analogy to statistical physics, may damage the economy, which has led researchers to develop techniques to quantify the financial risk and detect these abnormal market states. In 2006, Takayasu et al. introduced the Potentials of Unbalanced Complex Kinetics (PUCK) model, which is understood as a simple modification to the random walk theory by adding a potential force term that varies over time. This potential function reflects the state of the market participants, and its functional form can be estimated from the data. However, with the conventional PUCK model, we require at least 1,000 latest data points to obtain a reasonable estimate for the model parameters, which is too long for a real-time application. Hence, to achieve a more rapid estimation, the particle filter version of PUCK model was introduced by Yura et al., where Monte Carlo simulation is incorporated to the estimation. We observe that the particle filter simulation can detect the critical transition within roughly 50 time steps with an appropriate choice of simulation parameters. We also find out that the PUCK model replicates the actual situation in the market fairly well, especially at the times of financial bubbles and crashes, compared to a normal random walk model that has been used by analysts over the last century.Bachelor of Science in Physic

Prarencana pabrik stretch film biodegradabel untuk mesin (for machine used) kapasitas 41360 ton stretch film/tahun

Plastik Stretch Film sangat banyak digunakan dalarn packaging ekspedisi pengiriman barang. Setelah dipakai hanya sebentar saja, plastik yang tidak dapat didaur ulang ini menumpuk menjadi sarnpah yang tentu saja tidak dapat didaur ulang. Oleh karena itu, plastik biodegradabel dirasa cukup untuk mengatasi permasalahan tersebut. Pada prarencana pabrik ini, akan dibuat produk plastik stretch film biodegradabel dengan penambahan filler serbuk tongkol jagung. Pembuatan stretch film biodegradabel ini dengan menggunakan cara mixing atau pencampuran, yaitu mencampurkan plastik (LLDPE) dengan selulosa (serbuk tongkol jagung). Alasan pemilihan proses mixing ini karena prosesnya sederhana, tidak membutuhkan waktu yang lama serta biaya produksmya relatif murah. Prarencana pabrik stretch film biodegradabel ini memiliki rincian sebagai berikut: • Bahan baku utama • LLDPE (5170 kg/jam), tongkol jagung (678,3967 kg/jam), dan silan (5,6876 kg/jam) • Kapasitas produksi .41.360 ton /tahun • Utilitas : Air : 35,486 m³/hari Listrik : 9.4557,9 kW/hari Solar : 1.255 kg/ bulan Udara panas. 8.942,4531 kg/jam • Jumlah tenaga kerja .119 orang • Lokasi pabrik • Lamongan, Jawa Timur • Luas Tanah • 11.200 m² Analisa ekonomi: Modal tetap (FCI) • Rp. 33.450.638.301 Modal kerja (WCI) • Rp. 30.207.301.262 BiayaProduksi Total (TPC) • Rp. 201.286.919.121,59 Penjualan per tahun • Rp. 236.499,750,000 Metode Discounted Cash Flow Rate of Return Investment sebelum pajak .30% Rate of Return Investment sesudah pajak .22% Pay Out Time sebelum pajak • 3 tahun 8 bulan Pay Out Time sesudah pajak • 4 tahun 5 bulan Titik impas (BEP) .30,93% Kelayakan pabrik stretch film biodegradabel ini dapat ditinjau dari berbagai segi yaitu dari segi proses, peralatan, lokasi, dan ekonomi, Dengan melihat dari berbagai segi terutama untuk segi ekonomi, dimana persen Rate of Return Investment (ROR) lebih besar dari suku bunga bank di Indonesia yang hanya 7%, mengindikasikan bahwa dengan menginvestasikan modal pada pendirian pabrik stretch film biodegradabel ini, akan diperoleh pendapatan yang lebih banyak daripada menginvestasikan modal di bank