Q wave and non-Q wave myocardial infarction: a multivariate analysis of survival experience and clinical outcome after first diagnosis at a tertiary care hospital

Introduction: Myocardial infarction (MI) is a well-recognized clinical entity with a worldwide distribution. In the United States alone, 1.5 million cases of MI occur per year. This study compares the in-hospital mortality, 1 year mortality and time to death following a first Q-wave or non Q-wave myocardial infarction (MI).Methods: One thousand five hundred and ninety-six patients were admitted at the Aga Khan University Hospital with a diagnosis of MI over a period of four years of whom 420 patients met our inclusion criteria. Data was collected from the patients\u27 medical records and on telephone using a pretested questionnaire. Logistic regression and Cox proportional hazard models were used to analyze the data.Results: The mean age +/- sd of the patients was 59 +/- 10 years. Of the total patients, 151(36%) and 269(64%) suffered non-Q wave and Q-wave MI respectively. A higher in hospital mortality was observed in patients with Q-wave MI (n = 64, 23.8%) than those with non-Q wave MI [n = 16 (10.6%); adjusted OR = 2.76, 95% CI: 1.5-5.01]. Similarly, patients having Q-wave MI experienced increased 1 year mortality (n = 77, 28.6%) compared to patients suffering non-Q wave MI [n = 26 (17.2%); adjusted OR = 2.04, 95% CI: 1.21-3.43].CONCLUSION: Patients with Q-wave MI had a worse prognosis compared with patients with non-Q-wave MI and therefore warrant a closer follow up. Further prospective studies are needed to evaluate the efficacy of early aggressive interventions in modifying the natural history of this disease

The shape of equality: discourses around the Section 28 repeal in Scotland

This article focuses on conceptualizations of equality in the discourses deployed in the campaign to repeal Section 28 in Scotland. I use the parliamentary debates and two newspapers: the Daily Record, which supported the campaign to Keep the Clause, and The Guardian, which supported repeal, to exemplify the different discursive articulations around equality and citizenship. I suggest that the Scottish example provides further evidence of the ways in which liberalism naturalizes heterosexuality as the standard for citizenship and thus bequeaths a hierarchy of 'equality' and citizenship in the realm of sexuality, wherein lesbian and gay citizenship is either rendered invalid or characterized as 'special rights'. However, within the narrow confines of the parliamentary debates, more expansive and differentiated notions of citizenship and equality are evident. Whilst I conclude that the 'shape' of equality achieved through the repeal has been moulded to support institutionalized heterosexuality - with Section 28 replaced by statutory guidelines on sex education which advocate marriage - I also suggest equality is contested, both through the recognition of transformations in heterosexual family forms and the appeal to non-discrimination as a democratic principle. It is possible, therefore, that current destabilizations of the heterosexual social order simultaneously destabilize the precepts of liberal democracy

Yield sensing technologies for perennial and annual horticultural crops: a review

Yield maps provide a detailed account of crop production and potential revenue of a farm. This level of details enables a range of possibilities from improving input management, conducting on-farm experimentation, or generating profitability map, thus creating value for farmers. While this technology is widely available for field crops such as maize, soybean and grain, few yield sensing systems exist for horticultural crops such as berries, field vegetable or orchards. Nevertheless, a wide range of techniques and technologies have been investigated as potential means of sensing crop yield for horticultural crops. This paper reviews yield monitoring approaches that can be divided into proximal, either direct or indirect, and remote measurement principles. It reviews remote sensing as a way to estimate and forecast yield prior to harvest. For each approach, basic principles are explained as well as examples of application in horticultural crops and success rate. The different approaches provide whether a deterministic (direct measurement of weight for instance) or an empirical (capacitance measurements correlated to weight for instance) result, which may impact transferability. The discussion also covers the level of precision required for different tasks and the trend and future perspectives. This review demonstrated the need for more commercial solutions to map yield of horticultural crops. It also showed that several approaches have demonstrated high success rate and that combining technologies may be the best way to provide enough accuracy and robustness for future commercial systems

Thermodynamic properties and structural stability of thorium dioxide

Using density functional theory (DFT) calculations, we have systematically investigated the thermodynamic properties and structural stabilities of thorium dioxide (ThO$_2$). Based on the calculated phonon dispersion curves, we calculate the thermal expansion coefficient, bulk modulus, and heat capacities at different temperatures for ThO$_2$ under the quasi-harmonic approximation. All the results are in good agreement with corresponding experiments proving the validity of our methods. Our theoretical studies can help people more clearly understand the thermodynamic behaviors of ThO$_2$ at different temperatures. In addition, we have also studied possible defect formations and diffusion behaviors of helium in ThO$_2$, to discuss its structural stability. It is found that in intrinsic ThO$_2$ without any Fermi energy shifts, the interstitial Th$_i^{4+}$ defect other than oxygen or thorium vacancies, interstitial oxygen, and any kinds of Frenkel pairs, is most probable to form with an energy release of 1.74 eV. However, after upshifting the Fermi energy, the formation of the other defects also becomes possible. For helium diffusion, we find that only through the thorium vacancy can it happen with the small energy barrier of 0.52 eV. Otherwise, helium atoms can hardly incorporate or diffuse in ThO$_2$. Our results indicate that people should prevent upshifts of the Fermi energy of ThO$_2$ to avoid the formation of thorium vacancies and so as to prevent helium caused damages.Comment: 11 pages, 11 figure

Lysyl Hydroxylase 2 Is Secreted by Tumor Cells and Can Modify Collagen in the Extracellular Space

Lysyl hydroxylase 2 (LH2) catalyzes the hydroxylation of lysine residues in the telopeptides of fibrillar collagens, which leads to the formation of stable collagen cross-links. Recently we reported that LH2 enhances the metastatic propensity of lung cancer by increasing the amount of stable hydroxylysine aldehyde-derived collagen cross-links (HLCCs), which generate a stiffer tumor stroma (Chen, Y., et al. (2015) J. Clin. Invest. 125, 125, 1147–1162). It is generally accepted that LH2 modifies procollagen α chains on the endoplasmic reticulum before the formation of triple helical procollagen molecules. Herein, we report that LH2 is also secreted and modifies collagen in the extracellular space. Analyses of lung cancer cell lines demonstrated that LH2 is present in the cell lysates and the conditioned media in a dimeric, active form in both compartments. LH2 co-localized with collagen fibrils in the extracellular space in human lung cancer specimens and in orthotopic lung tumors generated by injection of a LH2-expressing human lung cancer cell line into nude mice. LH2 depletion in MC3T3 osteoblastic cells impaired the formation of HLCCs, resulting in an increase in the unmodified lysine aldehyde-derived collagen cross-link (LCC), and the addition of recombinant LH2 to the media of LH2-deficient MC3T3 cells was sufficient to rescue HLCC formation in the extracellular matrix. The finding that LH2 modifies collagen in the extracellular space challenges the current view that LH2 functions solely on the endoplasmic reticulum and could also have important implications for cancer biology

A Poincar\'e-Birkhoff theorem for tight Reeb flows on S3S^3

We consider Reeb flows on the tight $3$-sphere admitting a pair of closed orbits forming a Hopf link. If the rotation numbers associated to the transverse linearized dynamics at these orbits fail to satisfy a certain resonance condition then there exist infinitely many periodic trajectories distinguished by their linking numbers with the components of the link. This result admits a natural comparison to the Poincar\'e-Birkhoff theorem on area-preserving annulus homeomorphisms. An analogous theorem holds on $SO(3)$ and applies to geodesic flows of Finsler metrics on $S^2$.Comment: 67 pages. To appear in Inventiones Mathematica

Single port/incision laparoscopic surgery compared with standard three-port laparoscopic surgery for appendicectomy : a randomised controlled trial

PMID: 23111090 [PubMed - indexed for MEDLINE] PMCID: PMC3543288 Free PMC ArticlePeer reviewedPublisher PD

The Impact of the COVID-19 Pandemic on Racial Disparities in Patients Undergoing Total Shoulder Arthroplasty in the United States

INTRODUCTION: The purpose of this study was to assess racial disparities in total shoulder arthroplasty (TSA) in the US and to determine whether these disparities were affected by the COVID-19 pandemic. METHODS: Centers for Medicare and Medicaid Services (CMS) 100% sample was used to examine primary TSA volume from April-December from 2019-2020. Utilization was assessed for White/Black/Hispanic/Asian populations to determine if COVID-19 affected these groups differently. A regression model adjusted for age/sex/CMS-Hierarchical Condition Categories (HCC) score, dual enrollment (proxy for socioeconomic status), time fixed effects, and Core-based Statistical Area (CBSA) fixed effects was used to study difference across groups. RESULTS: In 2019, TSA volume/1000 beneficiaries was 1.51 for White and 0.57 for non-White, a 2.6-fold difference. In 2020, the rate of TSA in White patients (1.30/1000) was 2.9 times higher than non-White (0.45/1000) during the COVID-19 pandemic (P\u3c0.01). There was an overall 14% decrease in TSA volume/1000 Medicare beneficiaries in 2020; non-White patients had a larger percentage decrease in TSA volume than White (21% vs. 14%, estimated difference;8.7%,p = 0.02). Black patients experienced the most pronounced disparity with estimated difference of 10.1%,p = 0.05, compared with White patients. Similar disparities were observed when categorizing procedures into anatomic and reverse TSA, but not proximal humerus fracture. CONCLUSIONS: During the COVID-19 pandemic, overall TSA utilization decreased by 14% with White patients experiencing a decrease of 14%, and non-White patients experiencing a decrease of 21%. This trend was observed for elective TSA while disparities were less apparent for proximal humerus fracture