Transcatheter aortic valve implantation in patients with pre-existing chronic kidney disease

AbstractBackgroundWe investigated the effect of chronic kidney disease (CKD) on morbidity and mortality following transcatheter aortic valve implantation (TAVI) including patients on haemodialysis, often excluded from randomised trials.Methods and resultsWe performed a retrospective post hoc analysis of all patients undergoing TAVI at our centre between 2008 and 2012. 118 consecutive patients underwent TAVI; 63 were considered as having (CKD) and 55 not having (No-CKD) significant pre-existing CKD, (defined as estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2). Chronic haemodialysis patients (n=4) were excluded from acute kidney injury (AKI) analysis. Following TAVI, in CKD and No-CKD patients respectively, AKI occurred in 23.7% and 14.5% (p=0.455) and renal replacement therapy (RRT) was necessary in 8.5% and 3.6% (relative risk (RR) [95% CI]=2.33 [0.47–11.5], p=0.440); 30-day mortality rates were 6.3% and 1.8% (p=0.370); and 1-year mortality rates were 17.5% and 18.2% (p=0.919). Patients who developed AKI had a significantly increased risk of 30-day (12.5% vs. 1.1%, p=0.029) mortality. We found the presence of diabetes (odds ratio (OR) [95% CI]=4.58 [1.58–13.3], p=0.005) and elevated baseline serum creatinine (OR [95% CI]=1.02 [1.00–1.03], p=0.026) to independently predict AKI to statistical significance by multivariate analysis.ConclusionTAVI is a safe, acceptable treatment for patients with pre-existing CKD, however caution must be exercised, particularly in patients with pre-existing diabetes mellitus and elevated pre-operative serum creatinine levels as this confers a greater risk of AKI development, which is associated with increased short-term post-operative mortality

Differences in intention to use educational RSS feeds between Lebanese and British students: A multi‑group analysis based on the technology acceptance model

Really Simple Syndication (RSS) offers a means for university students to receive timely updates from virtual learning environments. However, despite its utility, only 21% of home students surveyed at a university in Lebanon claim to have ever used the technology. To investigate whether national culture could be an influence on intention to use RSS, the survey was extended to British students in the UK. Using the Technology Adoption Model (TAM) as a research framework, 437 students responded to a questionnaire containing four constructs: behavioral intention to use; attitude towards benefit; perceived usefulness; and perceived ease of use. Principle components analysis and structural equation modelling were used to explore the psychometric qualities and utility of TAM in both contexts. The results show that adoption was significantly higher, but also modest, in the British context at 36%. Configural and metric invariance were fully supported, while scalar and factorial invariance were partially supported. Further analysis shows significant differences between perceived usefulness and perceived ease of use across the two contexts studied. Therefore, it is recommended that faculty demonstrate to students how educational RSS feeds can be used effectively to increase awareness and emphasize usefulness in both contexts

Photo Synthesis: The Expatriate Family Album as Historiography

I want to look at the expatriate family album as a site of history-writing. Through an examination of three photographs from my childhood in West Asia, I try to think about the idea of historical space and time through the visual narratives available to me of my own family. This essay will be an exploration of the way in which nostalgia for a personal past gets imbricated within the shared experience of a bygone cultural moment. I am interested in how an encounter with visual material from private archives initiates memory work and how these traces from the past can be used to apprehend public history

Liability of Internet Service Providers Across Various Countries: An Overview

The role of I.S.P. or Intermediary is very important for effective utilization of information technology. The liability of Intermediary or I.S.P. has gain immense importance at international level. Various countries have defined the liability of I.S.P. either in the form of copyright infringement or for the infringement of information technology. Australia was the first country to enact the legislation relating to the liability aspect of I.S.P. in the form of Copyright Act, 1968 making I.S.P. liable to disable the access to online services hosted outside Australia. Some safe harbors were also provided for I.S.P. as part of the Australia - United States Free Trade Agreement. The US provides for the liability of ISP in the form of Communications Decency Act, 1996, Digital Millennium Copyright Act,1998. Title II of the D.M.C.A. specifically deals with the issue of I.S.P. liability and also provides for the penalties for unauthorized access to a copyright work. As regarding the legislations of Canada, it does not specifically defines the liability of I.S.P., instead it provides safe harbor for those ISP’s providing any means for Internet access. I.S.P.’s are also protected for copyright infringement in Canada. In Singapore the liability of I.S.P. is regulated by the Internet class license and Internet code of Practice which requires the I.S.P. to abide by the conditions of license. I.S.P.’s are also restricted to make public access of those websites which contain offensive content harmful to national interest. Japan’s Copyright Act, 1970, The Provider Liability Limitation Law 2002 protects the I.S.P. against any kind of liability for Copyright infringement. UK enacted two legislations in form of Copyright, Designs and Patents Act 1988 Digital Economy Act 2010 which imposes the obligations on ISP to notify the infringement to its subscribers, also liable to take technical measures to terminate the Internet services after reporting of infringement. The countries also make the provisions for the penalties for offences relating to the infringement of copyright or unauthorized access of information by various I.S.P.’s or Intermediaries. The quantum of punishment is differed in every country according to the nature of offence

An Efficient Approach to Secure Versatile Data File in Video using Forbidden Zone Data Hiding Technique

Video Steganography is a technique in which we can hide all types of files with any extension into a carrying Video file. In this dissertation, we are using two main terminology that is host file and carrier file where host file is a hidden file (any kind of file like text file, image file, and audio/video file) and carrier file must be a video file. The main motivation of this dissertation is to secure transferring of data by using steganography and cryptography technique. It is concerned with embedding information in an innocuous cover media in a secure and robust manner. In this dissertation we are using Forbidden Zone Data Hiding technique where no alteration is required in host signal range during data hiding process.To securely transferring the data file, we use video data hiding and making use of correction capacity of repeat accumulate code with superiority of forbidden zone data hiding. Using this approach we can also hide and transfer the large video file whose size is larger than cover file in secure manner. The main advantage of using video file in hiding information is the added security against of the third party or unintended receiver due to the relative complexity of video compared to image and audio file