ASSOCIATION BETWEEN THE WEIGHT LOSS AND ANXIETY, DEPRESSION AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY: A NEED FOR PRE-DISCHARGED COUNSELING

Objectives: To see the association between weight loss and anxiety, depression after percutaneous transluminal coronary angioplasty (PTCA) for coronary artery disease patients. (1) To see the severity of anxiety and depression 1 month after PTCA, (2) to evaluate the relationship between the weight changes and major adverse cardiac events (MACE) in 1 month follow-up.Methods: A total 1001 patients who underwent PTCA for acute coronary syndrome and coronary heart disease were included. Data were collected at baseline and 1 month after PTCA. A validated Euro 5Q-5D-5L questionnaire was used to assess the level of anxiety and depression. Chi-square test was applied to find out the association between weight loss status and anxiety, depression.Results: There was a significant decrease in mean weight 1 month after coronary angioplasty (64.18±11.022 vs. 61.96±11.17, p<0.001). No association was observed between weight loss status and anxiety, depression in PTCA patients (p=0.5) and there is no significant association between weight changes and MACE 1 month after PTCA (p=0.92).Conclusion: Data show that anxiety and depression were observed in 64.9% of the study population after coronary angioplasty but anxiety and depression are not associated with weight loss after PTCA. Loss of weight may be due to the modified post angioplasty lifestyles such as adherent to Mediterranean diet, physical exercise, cessation of smoking, optimum control of blood pressure, blood sugar, and blood cholesterol along with prescribed medications. Anxiety and depression may turn into chronic stage if not treated wisely could lead to significant MACE. Proper pre-hospital discharge counseling is necessary for all post PTCA patients to sustain their quality of life

Doppler prediction of adverse perinatal outcome in intrauterine growth restriction

Background: Objective of current study was to determine and compare the diagnostic performance of Doppler ultrasonography of the fetal Middle Cerebral Artery (MCA) and Umbilical Artery (UA) for prediction of adverse perinatal outcome in suspected intrauterine growth restriction (IUGR).Methods: Fifty singleton pregnancies in third trimester of pregnancy with suspected intrauterine growth restriction were examined with Doppler ultrasonography of fetal MCA and UA.Results: Twenty patients of the fifty included patients had at least one major or minor adverse outcome. Major adverse outcome included perinatal deaths which included both intrauterine deaths and early neonatal deaths, hypoxic ischemic encephalopathy, intraventricular hemorrhage, periventricular leukomalacia, pulmonary hemorrhage, necrotizing enterocolitis and septicemia. Minor outcomes included cesarean section for fetal distress, Apgar score below 7 at 5 minutes and admission to Neonatal Intensive Care Unit (NICU) for treatment. MCA PI is the most sensitive(90%) index in predicting any adverse perinatal outcome i.e. including both major and minor outcomes, Positive Predictive Value (PPV) and specificity being greatest for MCA/UA PI (96.6%, 93.7%). For the major adverse outcome most sensitive (86.6%) most specific (91.4%) and with highest PPV (81.2%) and NPV (94.1%), is MCA/UA PI. Ratio of MCA/UAPI is more sensitive (90%) than PI of both the arteries alone for overall prediction of adverse perinatal outcome.Conclusions: Thus we conclude that the Doppler studies of the multiple vessels in the fetoplacental unit can help in the monitoring of the compromised fetus and can help us predicting neonatal morbidity. This may be helpful in determining the optimal time of deliveries in pregnancies complicated by IUGR

Substrate Based Ablation of Ventricular Tachycardia Through An Epicardial Approach

Ventricular tachycardia (VT) occurring late after myocardial infarction is often due to reentry circuit in the peri-infarct zone. The circuit is usually located in the sub-endocardium, though subepicardial substrates are known. Activation mapping during VT to identify target regions for ablation can be difficult if VT is non inducible or poorly tolerated. In the latter, a substrate based approach of mapping during sinus rhythm in conjunction with pace mapping helps to define the reentry circuit and select target sites for ablation in majority of patients with hemodynamically unstable VT. Percutaneous epicardial catheter ablation has been attempted as an approach where ablation by a conventional endocardial access has been unsuccessful. We report a case of post myocardial infarction scar VT which could be successfully ablated with a substrate based approach from the epicardial aspect

Public Health Communication Strategies: A Content Analysis of Social Media Campaigns

The rise and improvement of web-based entertainment has achieved a huge change in the field of general wellbeing. This change has opened up remarkable chances to actually spread data and draw in different crowds. To completely get it and look at the effect of web-based entertainment crusades inside general wellbeing systems, this study embraces an extensive investigation. By explicitly zeroing in on crusades that use stages like Facebook, Twitter, and Instagram, the examination investigates different elements of content, including printed messages, visuals, and intelligent highlights. To acquire complete comprehension, both quantitative and subjective techniques are utilized to break down the substance. The examination means to recognize examples, patterns, and the general viability of various systems utilized in advancing wellbeing, ways of behaving, and bringing issues to light. The review digs into looking for proof-based rehearsals in these missions, as well as the usage of narration, visual illustrations, and client-produced content. By utilizing these strategies, general wellbeing efforts endeavor to actually convey their messages and interface with their objective audiences. This study assesses commitment measurements like likes, offers, and remarks to check crowd inclusion and investment levels. Bits of knowledge from this assessment are expected to outfit significant comprehension for enhancing approaching general wellbeing correspondence via virtual entertainment. Grasping prosperous mission credits can teach experts, policymakers, and wellbeing communicators about beneficially exploiting virtual entertainment stages to reach and resound with different populations, eventually working on the effect of computerized time general wellbeing messages

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

Software-Hardware Co-design for Fast and Scalable Training of Deep Learning Recommendation Models

Deep learning recommendation models (DLRMs) are used across many business-critical services at Facebook and are the single largest AI application in terms of infrastructure demand in its data-centers. In this paper we discuss the SW/HW co-designed solution for high-performance distributed training of large-scale DLRMs. We introduce a high-performance scalable software stack based on PyTorch and pair it with the new evolution of Zion platform, namely ZionEX. We demonstrate the capability to train very large DLRMs with up to 12 Trillion parameters and show that we can attain 40X speedup in terms of time to solution over previous systems. We achieve this by (i) designing the ZionEX platform with dedicated scale-out network, provisioned with high bandwidth, optimal topology and efficient transport (ii) implementing an optimized PyTorch-based training stack supporting both model and data parallelism (iii) developing sharding algorithms capable of hierarchical partitioning of the embedding tables along row, column dimensions and load balancing them across multiple workers; (iv) adding high-performance core operators while retaining flexibility to support optimizers with fully deterministic updates (v) leveraging reduced precision communications, multi-level memory hierarchy (HBM+DDR+SSD) and pipelining. Furthermore, we develop and briefly comment on distributed data ingestion and other supporting services that are required for the robust and efficient end-to-end training in production environments

Análisis sistémico de las externalidades del mercado de bioetanol

Trabajo de investigaciónEn Colombia a partir de la resolución 40108 de 2018, se aumentó el porcentaje de mezcla del combustibles llegando a un 10% (90% combustibles fósiles 10% biocombustibles), actualmente para suplir esta demanda, las productoras de bioetanol requieren emplear al 100% su capacidad instalada, mejorar sus prácticas de cultivo de caña de azúcar y hacer uso de nuevas hectáreas, por tanto, el presente trabajo de grado tiene como objetivo realizar un análisis sistémico de las externalidades del mercado de bioetanol.INTRODUCCIÓN 1. Formulación del trabajo 2. Marco referencial 3. Diagrama propuesto 4. Conclusiones generales BibliografiaPregradoEconomist