55 research outputs found
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Fluid properties at high pressures and temperatures: Experimental and modelling challenges
Thermophysical properties impact many aspects of the chemical process industries. Here three example areas, primarily in the energy sector, are highlighted to provide context for the experimental and modelling challenges associated with obtaining fluid property data at high pressures and temperatures (HPHT). These three areas include the recovery of petroleum reserves in ultra-deep reservoirs, the use of lubricants to reduce frictional losses in the automotive industries, and the use of high-pressure, common rail diesel fuel delivery to reduce soot emissions for greener environments. The accurate knowledge of thermodynamic and transport properties in these three focused areas minimizes associated operating uncertainties and accelerates safe, reliable, and robust process and product development
Psychosocial and cognitive multimorbidity and health-related quality of life and symptom burden in older adults with atrial fibrillation: The systematic assessment of geriatric elements in atrial fibrillation (SAGE-AF) cohort study
BACKGROUND: Depression, anxiety, and cognitive impairments occur in up to 40 % of adults with AF and are associated with poorer health-related quality of life (HRQoL) and higher symptom burden. However, it is unknown how often these impairments co-occur, or multimorbidity, and how multimorbidity effects HRQoL and symptom burden.
METHODS: Patients with AF age \u3e /=65 years with a CHA2DS2VASC risk score \u3e /= 2 and eligible for oral anticoagulation therapy were recruited from five clinics in a prospective cohort study. Participants completed validated measures of depression (PHQ9) and anxiety (GAD7), cognitive impairment (MoCA), and HRQOL and AF symptom burden (AFEQT). Multinomial logistic regression was used.
RESULTS: Participants (N = 1244, 49 % female) were on average 76 +/- 7 years; 86 % were non-Hispanic white. Approximately 35 % of participants had 1 impairment, 17 % had 2 impairments and 8% had 3 impairments; 39 % had none of the 3 impairments examined. Compared to participants with no impairments, patients with 1, 2 and 3 impairments had higher odds of poor HRQoL (adjusted OR [AOR] = 1.77, 95 % CI 1.21, 2.60; AOR = 6.64, 95 % CI 4.43, 9.96; and AOR = 7.50, 95 % CI 4.40, 12.77, respectively) and those with 2 and 3 impairments had higher odds of high symptom burden (AOR = 3.69 95 % CI 2.22, 6.13; and AOR = 5.41 95 % CI 2.85, 10.26).
CONCLUSIONS: Psychosocial/cognitive multimorbidity is common among older adults with AF and is associated with poor HRQoL and high symptom burden. Clinicians might consider incorporating psychosocial and cognitive screens into routine care as this may identify a high-risk population
Development of an Improved Convolutional Neural Network for an Automated Face Based University Attendance System
Because of the flaws of the present university attendance system, which has always been time intensive, not accurate, and a hard process to follow. It, therefore, becomes imperative to eradicate or minimize the deficiencies identified in the archaic method. The identification of human face systems has evolved into a significant element in autonomous attendance-taking systems due to their ease of adoption and dependable and polite engagement. Face recognition technology has drastically altered the field of Convolution Neural Networks (CNN) however it has challenges of high computing costs for analyzing information and determining the best specifications (design) for each problem. Thus, this study aims to enhance CNN’s performance using Genetic Algorithm (GA) for an automated face-based University attendance system. The improved face recognition accuracy with CNN-GA got 96.49% while the face recognition accuracy with CNN got 92.54%
What is the failure rate in extending labour analgesia in patients with a body mass index ≥ 40 kg/m2compared with patients with a body mass index < 30 kg/m2? a retrospective pilot study
Predictors Of Prostate Cancer Screening Using Andersen’s Behavioral Model Of Health Services Use
Differences in Perceived and Predicted Bleeding Risk in Older Adults With Atrial Fibrillation: The SAGE-AF Study
Background
Little research has evaluated patient bleeding risk perceptions in comparison with calculated bleeding risk among oral anticoagulant users with atrial fibrillation. Our objective was to investigate underestimation of bleeding risk and to describe the characteristics and patient-reported outcomes associated with underestimation of bleeding risk.
Methods and Results
In the SAGE-AF (Systematic Assessment of Geriatric Elements in Atrial Fibrillation) study, a prospective cohort study of patients \u3e /=65 years with atrial fibrillation, a CHA2DS2-VASc risk score \u3e /=2 and who were on oral anticoagulant therapy, we compared patients\u27 self-reported bleeding risk with their predicted bleeding risk from their HAS-BLED score. Among the 754 participants (mean age 74.8 years, 48.3% women), 68.0% underestimated their bleeding risk. Participants who were Asian or Pacific Islander, Black, Native American or Alaskan Native, Mixed Race or Hispanic (non-White) (adjusted OR [AOR], 0.45; 95% CI, 0.24-0.82) and women (AOR, 0.62; 95% CI, 0.40-0.95) had significantly lower odds of underestimating their bleeding risk than respective comparison groups. Participants with a history of bleeding (AOR, 3.07; 95% CI, 1.73-5.44) and prior hypertension (AOR, 4.33; 95% CI, 2.43-7.72), stroke (AOR, 5.18; 95% CI, 1.87-14.40), or renal disease (AOR, 5.05; 95% CI, 2.98-8.57) had significantly higher odds of underestimating their bleeding risk.
Conclusions
We found that more than two-thirds of patients with atrial fibrillation on oral anticoagulant therapy underestimated their bleeding risk and that participants with a history of bleeding and several comorbid conditions were more likely to underestimate their bleeding risk whereas non-Whites and women were less likely to underestimate their bleeding risk. Clinicians should ensure that patients prescribed oral anticoagulant therapy have a thorough understanding of bleeding risk
A cross-sectional analysis of racial differences in accelerated aging and cognitive function among patients with atrial fibrillation: The SAGE-AF study: Forrester, Accelerated aging and cognitive function
Background: Non-Whites are more likely to suffer from cognitive impairment and complications of atrial fibrillation (AF) than Whites, though Whites are more likely to be diagnosed with AF. We examined whether non-Whites with AF are biologically older than Whites with AF and whether accelerated biological aging is associated with cognitive functioning.
Methods: We used baseline data from the ongoing Systematic Assessment of Geriatric Elements in Atrial Fibrillation prospective cohort study, collected 2016-2020 across ambulatory care practices in Massachusetts and Georgia. Of 1244 enrolled, 974 participants with full biological data were included in the present analysis. Accelerated aging (AccA) was calculated based on a combination of biomarkers associated with age and physiological wear and tear.
Findings: The main outcome was score on Montreal Cognitive Assessment (MoCA). Non-Whites had 2.9 years more AccA than Whites and higher AccA was associated with a lower MoCA score among both Whites (-0.06, 95% CI: -0.10, -0.03) and non-Whites (-0.14, 95% CI: -0.27, 0.02). This association was significantly greater among non-whites (-0.11, 95% CI: -0.20, -0.01).
Interpretation: Non-White AF patients are functionally older than their White counterparts and experience a stronger deleterious association between AccA and cognition. These findings underscore the importance of taking functional age into account when treating patients with AF, particularly non-White patients, to enhance treatment and improve AF outcomes
Phase Behavior and Densities of Propylene + Hexane Binary Mixtures to 585 K and 70 MPa
In this study, we
report phase behavior data for propylene + hexane
mixtures at temperatures of 295 to 468 K and pressures to 5.5 MPa
and high-pressure mixture density data at temperatures of 295 to 584
K and pressures to 70 MPa. Both the phase behavior and density data
are simultaneously determined using a variable volume, high-pressure
view cell that is coupled with a linear variable differential transformer.
The phase behavior and mixture density data are modeled with the Soave–Redlich–Kwong
(SRK), Peng–Robinson (PR), modified Sanchez–Lacombe
(MSL), and perturbed-chain statistical associating fluid theory (PC-SAFT)
equations of state (EoS). The PC-SAFT and MSL EoS provide the best
fit of the phase behavior data with a nonzero value of 0.028 for <i>k</i><sub><i>ij</i></sub>. Likewise, the PC-SAFT EoS
provides the best fit of the high-pressure mixture density data, though
the PC-SAFT equation slightly overpredicts the solution density and
the calculated densities are relatively insensitive to changes in <i>k</i><sub><i>ij</i></sub> from zero to 0.028
Self-reported risk of stroke and factors associated with underestimation of stroke risk among older adults with atrial fibrillation: the SAGE-AF study
Background: Though engaging patients with atrial fibrillation (AF) in understanding their stroke risk is encouraged by guidelines, little is known regarding AF patients\u27 perceived stroke risk or its relationship with oral anticoagulation (OAC) use. We aim to identify factors associated with underestimation of stroke risk among older patients with AF and relate this to OAC use.
Methods: Data are from the ongoing SAGE (Systematic Assessment of Geriatric Elements)-AF study, which included older patients ( \u3e 65 years) with non-valvular AF and a CHA2DS2-VASc score of \u3e /= 2. Participants reported their perceived risk of having a stroke without OAC. We compared the perceived risk to CHA2DS2-VASc predicted stroke risk and classified participants as over or under estimators, and identified factors associated with underestimation of risk using multiple logistic regression.
Results: The average CHA2DS2-VASc score of 915 participants (average age: 75 years, 47% female, 86% white) was 4.3 +/- 1.6, 43% of participants had discordant predicted and self-reported stroke risks. Among the 376 participants at highest risk (CHA2DS2-VASc score \u3e /= 5), 46% of participants underestimated their risk. Older participants ( \u3e /= 85 years) were more likely and OAC treated patients less likely to underestimate their risk of developing a future stroke than respective comparison groups.
Conclusions: A significant proportion of study participants misperceived their stroke risk, mostly by overestimating. Almost half of participants at high risk of stroke underestimated their risk, with older patients more likely to do so. Patients on OAC were less likely to underestimate their risk, suggesting that successful efforts to educate patients about their stroke risk may influence treatment choices
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