Inflammatory Markers in Bicuspid Transcatheter Aortic Valve Replacement

Background Aortic stenosis (AS) has a prevalence of 2%. Valve replacement is the definitive treatment for AS, with transcatheter aortic valve replacement (TAVR) offering a minimally invasive alternative to surgery. Bicuspid aortic valve (BAV) is the most common congenital cardiac abnormality. BAV patients are predisposed to AS, and comprise a distinct, younger TAVR patient population. Given limited prior work on inflammatory markers for TAVR risk assessment, this study sought to investigate if white blood cell count (WBC) correlates with BAV TAVR patient severity and post-TAVR outcomes. Methods A single-center retrospective analysis was performed on patients with BAV who underwent TAVR from 2014 to 2018 (N=37). Patient demographics, symptomatic severity (NYHA class) and anatomic severity: aortic valve area (AVA) and indexed aortic valve area (AVAI) were collected. WBC prior to TAVR and post-TAVR complications/readmissions were also collected. Correlations between WBC, patient severity, and adverse outcomes were assessed using the Pearson and Spearman correlation tests, two-sample t-tests, and the Wilcoxon rank sum test. Results A statistically significant correlation (p = .041) was found between elevated pre-procedure WBC and patient NYHA class. No association was found between pre-procedure WBC and AVA (p = .723), AVAI (p = .961), or adverse outcomes/readmission post-procedure (p = .116). Conclusions A statistically significant correlation between pre-procedure WBC and NYHA class demonstrates that WBC is an accurate predictor of BAV patient’s functional symptom severity and could thus serve as a readily-accessible metric to stratify BAV TAVR patients in pre-procedure planning. No correlation existed between WBC and anatomic valve severity

Structural Stability and Renormalization Group for Propagating Fronts

A solution to a given equation is structurally stable if it suffers only an infinitesimal change when the equation (not the solution) is perturbed infinitesimally. We have found that structural stability can be used as a velocity selection principle for propagating fronts. We give examples, using numerical and renormalization group methods.Comment: 14 pages, uiucmac.tex, no figure

The Changing Landscape of the Philippine Retail Food Industry

The retail industry, growing at a significant rate, has contributed much to the economy of the country as highlighted in its increasing share in the personal consumption expenditure (PCE), gross domestic product (GDP), and employment. This study examines the importance of the retail industry, discussing its pattern of spread, the supply and demand conditions that affect the industry, the change in the procurement system of the retail formats, as well as the actions taken by some stakeholders to address the negative impact of such changes. The major players in the industry that are based locally have resorted to importation, modernization, and expansion to other areas to maintain their position. These activities gave the retailers a competitive edge over the others, even over the foreign retailers. Moreover, initial findings suggest that the changes in the food retail structure influenced the way the supermarkets source their fresh produce from their suppliers. This procurement system determines which actors are included in the structure. Only those suppliers who can respond to the stringent standards set by the supermarkets can continuously serve them

The Effects of Anthropogenic Sensory Pollution on Arthropod Diversity and Pollinator Behavior

Pollinators provide a key ecological function in terrestrial ecosystems, yet in recent years, they have encountered unprecedented declines, likely due to anthropogenic change. Light and noise pollution, which can interfere with the visual and auditory systems of animals that regulate daily behaviors, are important factors to consider when communities are encroached by human development. While many researchers have looked at how vertebrate species behaviorally react to human caused habitat degradation and sensory pollution, little is known about how invertebrates, including arthropod pollinators, are affected, and whether there is a negative cascading effect on the plants that they pollinate. This research investigates threats to arthropod biodiversity and pollination services from light pollution and noise pollution with field observations and experiments. This research is unique and is an important first step to understanding why arthropods and arthropod pollinators are in decline and will inform land managers in important conservation action

Teen Drinking and Education Attainment: Evidence From Two-Sample Instrumental Variables (TSIV) Estimates

Recent research has suggested that one of the important consequences of teen drinking is reduced scholastic achievement and that state excise taxes on beer and minimum legal drinking ages (MLDA) as policy instruments can have a positive impact on educational attainment. But there is reason to ask whether the results are empirically sound. Prior research as assumed the decision to drink is made independently of schooling decisions and estimations that have recognized potential simultaneity in these decisions may be poorly identified since they rely only on the cross-state variation in beer taxes and MLDA as exogenous determinants of teen drinking. A more convincing strategy would rely on the within-state variation in alcohol availability over time. We use the increases in the state MLDA during the late 70's and 80's as an exogenous source of variation in teen drinking. Using data from the 1977-92 Monitoring the Future (MTF) surveys, we show that teens with an MLDA of 18 were more likely to drink than teens with a higher drinking age. If teen drinking did reduce educational attainment then it should have risen within a state after the MLDA was increased. Using data from over 1.3 million respondents from the 1960-1969 birth cohorts in the 1990 Public-Use Microdata Sample (PUMS) we find that changes in the MLDA had small effects on educational attainment measured by high school completion, college entrance and completion. A new method developed by Angrist and Krueger (1992, 1995) lets us tie these results together. Using matched cohorts from the MTF and PUMS data sets, we report two-sample instrumental variables (TSIV) estimates of the effect of teen drinking on educational attainment. These estimates are smaller than corresponding single-equation probit estimates, indicating that teen drinking does not have an independent effect on educational attainment.

A simple nutrition screening tool for hemodialysis nurses

Objective : To assess the reliability of a nurse-performed nutrition screening tool (NST) for hemodialysis (HD) patients to identify nutritionally at-risk patients.Design : Tool reliability assessment.Setting and Participants : The setting was nine non-hospital private (n = 3) and public (n = 6) HD units in Australia (two rural and seven metropolitan). Participants were 112 HD patients.Results : A total of 112 HD patients (male = 65, female = 47) from 9 non-hospital HD units in Australia (seven metropolitan and two rural) were screened with the NST and the outcome of dietitian referral compared with Standard Dietitians Assessment. The mean age of patients was 57.6 years. Overall, the NST showed a sensitivity of 0.84 (range, 0.71 to 0.94; P &lt; .05) and a specificity of 0.9 (range, 0.82 to 0.98; P &lt; .05). The NST was more sensitive (sensitivity, 0.93 [range, 0.87 to 0.99; P &lt; .05]) and was more specific for men (specificity, 0.92 [range, 0.85 to 0.99; P &lt; .05]). Specificity was very strong in metropolitan patients (specificity, 0.94 [range, 0.87 to 1.01; P &lt; .05]).Conclusions : The tool was more sensitive and specific than the NST previously reported by the same investigators. The tool is particularly specific in that it screens those patients not requiring dietitian intervention. The use of this tool may benefit HD units that do not have on-site or regular dietetic support to prioritize patients needing dietitian intervention.<br /

Multiple Front Propagation Into Unstable States

The dynamics of transient patterns formed by front propagation in extended nonequilibrium systems is considered. Under certain circumstances, the state left behind a front propagating into an unstable homogeneous state can be an unstable periodic pattern. It is found by a numerical solution of a model of the Fr\'eedericksz transition in nematic liquid crystals that the mechanism of decay of such periodic unstable states is the propagation of a second front which replaces the unstable pattern by a another unstable periodic state with larger wavelength. The speed of this second front and the periodicity of the new state are analytically calculated with a generalization of the marginal stability formalism suited to the study of front propagation into periodic unstable states. PACS: 47.20.Ky, 03.40.Kf, 47.54.+rComment: 12 page