Evalution of patients' adherence to warfarin therapy among cardiovascular disease

Objectives: To evalution patients’ adherence about warfarin therapy and to find out the relationship between patients’ adherence and sociodemographic characteristics. Methodology: A descriptive study was carried out at Ibn Al-Bitar Specialized center for Cardiac Surgery for the period between between October 28, 2022.until May 28,2023. A non-probability sampling was used among (210) patients with cardiovascular disease. The study instrument used to collect data was composed of two parts namely: sociodemographic characteristics included (10) questions , patient's adherence regarding warfarin therapy consists of (11) questions,.Data were analyzed using IBM SPSS version 26. Descriptive and inferential data analysis were utilized to summarize the results. Results: The study indicated that patients had paritial adherence ((70%) about warfarin Therapy. Conclusions: There are significant relationship between patient's adherence and sociodemographic characteristics

Association of QT interval with mortality by kidney function: results from the National Health and Nutrition Examination Survey (NHANES)

A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Objective Prolonged QT interval predisposes to ventricular arrhythmias and sudden cardiac death. However, the association between QT interval and mortality by the level of pre-existing kidney function has not been investigated. Methods We followed 6565 participants from the National Health and Nutrition Examination Survey III for a median of 13.3 years. Sample divided according to corrected QT (QTc) interval was as follows: normal (QTc 60 mL/min/1.73 m2 ⇓; (2) CKD by eGFR only (eGFR 30 mg/g, eGFR >60 mL/min/1.73 m2) and ⇓(4) CKD by both. Cox proportional hazards models were used. Results CKD group had prolonged QTc than those without CKD (20.5%vs12.9%, p<0.0001). Both prolonged QTc and CKD are independently associated with increased risk of mortality. When combined, risk of mortality is higher in those with CKD by eGFR with prolonged QTc than normal QTc (HR 2.6 (1.7–3.9) and 3.1 (1.7–5.4) vs 1.4 (1.1–1.7) and 1.7 (1.3–2.1) for all-cause and CV mortality). There is no significant difference in risk in those with CKD by ACR when QTc is prolonged. There is significant improvement in risk prediction for all-cause and CV mortality when QTc is added to CKD beyond established CV risk factors (net reclassification index p<0.00001). Conclusion A screening ECG in those with CKD may help in finer risk stratification and may be considere

Impact of Body Mass Index on the Association of Ankle-Brachial Index With All-Cause and Cardiovascular Mortality Results from the National Health and Nutrition Examination Survey

A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Objective To assess the influence of body-mass index (BMI) on the association of ankle-brachial index (ABI) with mortality. Patients and Methods We conducted a prospective study of National Health and Nutrition Examination Survey participants enrolled from January 1, 1999 to December 31, 2002 with BMI and ABI data available. ABI categories were 1.3 (high). BMI categories were <30 kg/m2 (nonobese) and ≥30 kg/m2 (obese). Cardiovascular (CV) and all-cause mortality were assessed by National Death Index records. Cox proportional-hazards models and Kaplan-Meier survival estimates were used to compare groups. Results In total, 4614 subjects were included, with mean age 56±12 years and BMI 28±6 kg/m2. Median follow-up was 10.3 years (interquartile range [IQR]: 9.3 to 11.4 years). Low and high ABI were present in 7% and 8%, respectively. After adjustment, low ABI was associated with increased all-cause and CV mortality in nonobese (hazard ratio [HR] 1.5, 95% CI, 1.1-2.1 for all-cause and 3.0 [1.8-5.1] for CV mortality) and obese individuals (1.8 [1.2-2.7] and 2.5 [1.2-5.6], respectively) compared with reference. High ABI was associated with increased CV mortality in nonobese (2.2 [1.1-4.5]) but not obese patients; it was not associated with all-cause mortality overall or when stratified by BMI. Conclusion In a US cohort, weight influenced the prognostic significance of high ABI. This may be related to technical factors reducing compressibility of the calf arteries in obese persons compared with those who are nonobese.The University of Kansas (KU) One University Open Access Author Fund sponsored jointly by the KU ProvostKU Vice Chancellor for Research & Graduate StudiesKUMC Vice Chancellor for Research and managed jointly by the Libraries at the Medical Center and KU - Lawrence.KUMC Vice Chancellor for Research and managed jointly by the Libraries at the Medical Center and KU - Lawrenc

Effect of leading-edge erosion on the performance of offshore horizontal axis wind turbine using BEM method

publishedVersio

Study of Some Cytokines and Hormones in a Sample of Iraqi women with Polycystic ovarian syndrome and Their Relation to Obesity.

The present study aimed to measure serum vaspin and apelin levels in women with PCOS to show their rule in the pathogenesis of PCOS. Ninety eight women with PCOS, 51 non-obese [body mass index (BMI) less than 25 kg/m2] and 47 obese (BMI >25 kg/m2) were enrolled in the study. Each group is compared to apparently healthy women as a control group matched for age and BMI. Clinical history, anthropometric measurements and biochemical and hormonal analysis were determined. The mean serum level of vaspin and apelin showed statistically significant difference between PCOS patients (non-obese and obese) compared to control women (non-obese and obese) respectively. Also, the levels of both parameters (vaspin, apelin)showed significant differences between PCOS obese patients and non-obese ones. It is concluded that serum vaspin and apelin level increased in PCOS women particularly the obese. These data suggest their involvement in the pathogenesis of PCO

Macroscopic Traffic Flow Characterization for Stimuli Based on Driver Reaction

The design and management of infrastructure is a significant challenge for traffic engineers and planners. Accurate traffic characterization is necessary for effective infrastructure utilization. Thus, models are required that can characterize a variety of conditions and can be employed for homogeneous, heterogeneous, equilibrium and non-equilibrium traffic. The Lighthill-Whitham-Richards (LWR) model is widely used because of its simplicity. This model characterizes traffic behavior with small changes over a long idealized road and so is inadequate for typical traffic conditions. The extended LWR model considers driver types based on velocity to characterize traffic behavior in non lane discipline traffic but it ignores the stimuli for changes in velocity. In this paper, an improved model is presented which is based on driver reaction to forward traffic stimuli. This reaction occurs over the forward distance headway during which traffic aligns to the current conditions. The performance of the proposed, LWR and extended LWR models is evaluated using the first order upwind scheme (FOUS). The numerical stability of this scheme is guaranteed by employing the Courant, Friedrich and Lewy (CFL) condition. Results are presented which show that the proposed model can characterize both small and large changes in traffic more realistically. Doi: 10.28991/cej-2021-03091632 Full Text: PD

Qualitative investigation of wake composition in offshore wind turbines: a combined computational and statistical analysis of inner and outer blade sections

2023 7th International Conference on Renewable Energy and Environment (ICREE 2023), 22-24 September 2023, Eskişehir, TurkeyHigh-fidelity numerical simulations are used to thoroughly analyze the evolution of the wake behind a megawatt-scale offshore wind turbine. The wake features are classified in terms of wake dynamics composition and the associated turbulence characteristics originating from the inner and outer sections of the blades. Understanding the wake is essential for developing compact layouts for future wind farms. We employed a transient Sliding Mesh Interface (SMI) technique to analyze the fully dynamic wake evolution of the offshore NREL 5MW full turbine. Our high-fidelity results have been validated against previously published results in the literature. We thoroughly investigated the dominant structures of the wake using Proper Orthogonal Decomposition (POD) techniques, which we applied to transient simulations of fully developed flows after five wind turbine revolutions over the snapshot data. Our findings show that the inner section of the blades, which is composed of airfoils with larger cross-sections, is responsible for the dominant components of the wake, while the contribution of the wake from the outer section of the blade is significantly lower. Therefore, designing more aerodynamic sections for the blade’s inner section can help reduce the dominant wake components and thus decrease the inter-turbine distance in future wind farms

Mutational analysis of the spike protein of SARS-COV-2 isolates revealed atomistic features responsible for higher binding and infectivity

Introduction: The perpetual appearance of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2), and its new variants devastated the public health and social fabric around the world. Understanding the genomic patterns and connecting them to phenotypic attributes is of great interest to devise a treatment strategy to control this pandemic.Materials and Methods: In this regard, computational methods to understand the evolution, dynamics and mutational spectrum of SARS-CoV-2 and its new variants are significantly important. Thus, herein, we used computational methods to screen the genomes of SARS-CoV-2 isolated from Pakistan and connect them to the phenotypic attributes of spike protein; we used stability-function correlation methods, protein-protein docking, and molecular dynamics simulation.Results: Using the Global initiative on sharing all influenza data (GISAID) a total of 21 unique mutations were identified, among which five were reported as stabilizing while 16 were destabilizing revealed through mCSM, DynaMut 2.0, and I-Mutant servers. Protein-protein docking with Angiotensin-converting enzyme 2 (ACE2) and monoclonal antibody (4A8) revealed that mutation G446V in the receptor-binding domain; R102S and G181V in the N-terminal domain (NTD) significantly affected the binding and thus increased the infectivity. The interaction pattern also revealed significant variations in the hydrogen bonding, salt bridges and non-bonded contact networks. The structural-dynamic features of these mutations revealed the global dynamic trend and the finding energy calculation further established that the G446V mutation increases the binding affinity towards ACE2 while R102S and G181V help in evading the host immune response. The other mutations reported supplement these processes indirectly. The binding free energy results revealed that wild type-RBD has a TBE of −60.55 kcal/mol while G446V-RBD reported a TBE of −73.49 kcal/mol. On the other hand, wild type-NTD reported −67.77 kcal/mol of TBE, R102S-NTD reported −51.25 kcal/mol of TBE while G181V-NTD reported a TBE of −63.68 kcal/mol.Conclusions: In conclusion, the current findings revealed basis for higher infectivity and immune evasion associated with the aforementioned mutations and structure-based drug discovery against such variants