In vitro metabolic drug interaction study of warfarin with sildenafil citrate

Master'sMASTER OF SCIENCE (PHARMACY

Autonomous Parallel Parking of a Car-Like Mobile Robot with Geometric Path Planning

With the advancement of technology making everything so convenient in these days and ages, autonomous system is very interesting area in the innovating technology. One of the advanced booming technologies for the improvement of human race is autonomous taxi mobile transportation system. It is working well in a district area but it still thrives on making more comfortable. This research will be one point of supporting roles for automobile in parallel parking. An autonomous parallel parking of a car-like mobile robot has been developed in this study. The ultrasonic range sensors are used to detect the working environments and design an s-shaped trajectory between two parallel parked vehicles. One trail maneuver system is used to be moving along the s-shaped trajectory parking path. The s-shaped trajectory is purely based on the geometric approach path planning method. The proposed method is not dependent on the initial pose of the robot but it must be parallel with the parking space. Sensor data are used as the main decision part to change the parking states instance of to find the parking space and adjust robot orientation. Fuzzy filter is applied to stabilize the sensor data and give a quick response input. The working environment is constrained by the wall and sensor arrangement. Visual studio 2013 is used for the user interface window. The effectiveness of the proposed method is demonstrated through some experimental results with a car-like mobile robot

Ceasefires and Post-War Democratisation: A Comparative Study of Two Conflict-Affected Ethnic Societies in Myanmar

Ending four decades of all-out civil war, Myanmar s military government during the early 1990s managed to institute ceasefires with most of the minority ethnic insurgent groups. Most scholars were critical of the ceasefires, arguing that the failure to reach more lasting political settlements obstructed more fundamental progress in the affected areas. Some even argued that the ceasefires undermined the pressure for democratisation and therefore were detrimental to the country s political broader development. To the contrary, it is the argument of this thesis that the ceasefires served as a catalyst for important social, political and economic change processes that in turn improved the uptake of democratic opportunities in the relevant areas after the start of the liberalisation process in 2011. This is confirmed by tracing and comparing developments in two conflict-affected minority ethnic regions of Myanmar from the early 1990s until the present day: Mon-populated areas which benefitted from the ceasefire agreement between the government and the New Mon State Party in 1995, and Karen populated-areas which continued to be affected by armed conflict between the government and the Karen National Union until 2012. The thesis is primarily based on primary data, including personal observations from the direct involvement of the author in Myanmar politics over the past three decades, as well as scores of semi-structured interviews with key informants in the two regions, mainly conducted during fieldwork in 2016-17

Unilateral Hemihyperhidrosis in a Stroke Patient and Literature Review on Its Clinicoanatomical Correlation Clinicoanatomical Correlation

Contralateral hyperhidrosis from the cardiovascular accident has been infrequently described in the stroke literature. The clinical significance and pathogenesis are yet well understood. This is a case of a 60-year-old man who developed excessive sweating of the paralyzed side with a pure division along the midline of the body secondary to a subcortical stroke, which region is supplied by branches of middle cerebral artery territory known as deep perforating lenticulostriate. To the best of our knowledge, a precise clinicoanatomic correlation between hyperhidrosis and subcortical stroke has not been widely reported. In this review, we summarize the existing literature of post-stroke hyperhidrosis to evaluate the correlation between clinical manifestation and its neuroanatomical location. According to the location of the infarction and clinical features, it can be concluded that both tracks en route through the ipsilateral internal capsule, after originating in the opercular cortex before crossing the brain stem and terminal connections with the contralateral thoracic spinal cord. Therefore, the phenomenon of hyperhidrosis in anterior circulation stroke might be postulated as due to the disruption of the sympathoinhibitory pathway that controls sweat glands, similarly like posterior circulation stroke

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe