273 research outputs found

    Формалізація основних принципів взаємодії інвестора (кредитора) та позичальника (господарюючого суб’єкта)

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    Здійснено аналіз питань пов’язаних з організацією раціонального інвестування як з точки зору позичальника (господарюючого суб’єкта) так і з точки зору інвестора (кредитора). Проблему узгодження інтересів інвестора та позичальника сформульовано як багатокритеріальну задачу математичного програмування. Запропонована формалізація взаємодії господарюючого суб’єкта та інвестора за допомогою дослідження дискретного Марковського процесу, стани якого задаються вектором інтегральних показників діяльності кредитора та позичальника.This work comprises the rational investment organizationrelated issues analysis from the borrower’s (managing entity), as well as from the investor’s (creditor’s) point of view. The borrower and investor’s interests’ coordination issue is formulated as a mathematical programming multicriterion problem. The borrower and investor cooperation formalization with help of discreet Markov’s process study is introduced. The Markov’s process’ states are determined by the investor and borrower’s integral activities’ rates vector

    Determinants and outcomes of stroke following percutaneous coronary intervention by indication

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    Background and Purpose—Stroke after percutaneous coronary intervention (PCI) is a serious complication, but its determinants and outcomes after PCI in different clinical settings are poorly documented. Methods—The British Cardiovascular Intervention Society (BCIS) database was used to study 560 439 patients who underwent PCI in England and Wales between 2006 and 2013. We examined procedural-type specific determinants of ischemic and hemorrhagic stroke and the likelihood of subsequent 30-day mortality and in-hospital major adverse cardiovascular events (a composite of in-hospital mortality, myocardial infarction or reinfarction, and repeat revascularization). Results—A total of 705 stroke cases were recorded (80% ischemic). Stroke after an elective PCI or PCI for acute coronary syndrome indications was associated with a higher risk of adverse outcomes compared with those without stroke; 30-day mortality and major adverse cardiovascular events outcomes in fully adjusted model were odds ratios 37.90 (21.43–67.05) and 21.05 (13.25–33.44) for elective and 5.00 (3.96–6.31) and 6.25 (5.03–7.77) for acute coronary syndrome, respectively. Comparison of odds of these outcomes between these 2 settings showed no differences; corresponding odds ratios were 1.24 (0.64–2.43) and 0.63 (0.35–1.15), respectively. Conclusions—Hemorrhagic and ischemic stroke complications are uncommon, but serious complications can occur after PCI and are independently associated with worse mortality and major adverse cardiovascular events outcomes in both the elective and acute coronary syndrome setting irrespective of stroke type. Our study provides a better understanding of the risk factors and prognosis of stroke after PCI by procedure type, allowing physicians to provide more informed advice around stroke risk after PCI and counsel patients and their families around outcomes if such neurological complications occur

    Tidal wetland restoration at Ketenisse polder (Schelde Estuary, Belgium): developments in the first year

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    Ketenisse polder is a former intertidal brackish marsh (30ha) situated in the mesohaline part of the Schelde Estuary. In the 19th century its central part was embanked as a polder. In the mid 1980’s the area was raised above intertidal level when it was used as a dumping site for the excavated soil from the Liefkenshoek tunnel. In 2002 the area was restored, it was levelled with a weak slope below mean high water level, creating the optimal starting conditions for the development of intertidal mudflats and marshes. Geomorphological changes, sediment characteristics and colonisation by phytobenthos, vegetation, zoobenthos, water birds and breeding birds at the restored site are monitored. The monitoring results of the first year after tidal restoration are presented. Sedimentation as well as erosion between 0 and 30cm was observed in the first year. Local changes in stream current patterns caused erosion on parts of the former mudflats; sheltered depressions filled up relatively fast. Median grain size showed large variation. Organic carbon content of the sediment varied between 0.5 and 15% and was closely related to sediment medium grain size. Chlorophyll a concentrations were negatively correlated with median grain size and tended to increase from the low water line to the shore. They were comparable to nearby intertidal areas and displayed similar seasonal variability with a maximum in spring. The large surface covered wtithVaucheria was indicator of initiated succession towards tidal marsh. Scirpus maritimus and transitional vegetations to Chenopodiaceae-vegetations established with increasing altitude. The Chenopodiaceae-vegetations were relicts of earlier vegetations before the tidal restoration, and will probably disappear. The macrobenthos community was dominated by Oligochaetes, which were present in 73% of all samples and attained an average density of about 40*103 ind. m-2. Other macrobenthos species found were nematods, copepods and Corophium. On the sheltered sampling stations macrobenthic densities were high compared to those on nearby intertidal areas. In the first season, 15 breeding bird species were recorded, the most common species being the Pied Avocet (Recurvirostra avosetta). The most common waterbirds were Common Shelduck (Tadorna tadorna), Greylag Goose (Anser anser), Pied Avocet (Recurvirostra avoset) and Lapwing (Vanellus vanellus), typical species for the mesohaline part of the estuary. The first year’s results suggest that Ketenisse polder has the potential to develop towards a varied and normal functional intertidal area

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    The effectiveness and cost-effectiveness of spinal cord stimulation for refractory angina (RASCAL study): study protocol for a pilot randomized controlled trial

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    This is the final version of the article. Available from the publisher via the DOI in this record.BACKGROUND: The RASCAL (Refractory Angina Spinal Cord stimulation and usuAL care) pilot study seeks to assess the feasibility of a definitive trial to assess if addition of spinal cord stimulation (SCS) to usual care is clinically superior and more cost-effective than usual care alone in patients with refractory angina. METHODS/DESIGN: This is an external pilot, patient-randomized controlled trial.The study will take place at three centers in the United Kingdom - South Tees Hospitals NHS Foundation Trust (The James Cook University Hospital), Dudley Group of Hospitals NHS Foundation Trust, and Basildon and Thurrock University Hospitals NHS Foundation Trust.The subjects will be 45 adults with refractory angina, that is, limiting angina despite optimal anti-angina therapy, Canadian Cardiovascular Society Functional Classification Class III and IV, angiographically documented coronary artery disease not suitable for revascularization, satisfactory multidisciplinary assessment and demonstrable ischemia on functional testing.The study will be stratified by center, age and Canadian Cardiovascular Society Functional Classification.Interventions will involve spinal cord stimulation plus usual care ('SCS group') or usual care alone ('UC group'). Usual care received by both groups will include consideration of an education session with a pain consultant, trial of a transcutaneous electrical neurostimulation, serial thoracic sympathectomy and oral/systemic analgesics.Expected outcomes will be recruitment and retention rates; reasons for agreeing/declining participation; variability in primary and secondary outcomes (to inform power calculations for a definitive trial); and completion rates of outcome measures. Trial patient-related outcomes include disease-specific and generic health-related quality of life, angina exercise capacity, intake of angina medications, frequency of angina attacks, complications and adverse events, and satisfaction. DISCUSSION: The RASCAL pilot trial seeks to determine the feasibility and design of a definitive randomized controlled trial comparing the addition of spinal cord stimulation to usual care versus usual care alone for patients with refractory angina.Fifteen patients have been recruited since recruitment opened in October 2011. The trial was originally scheduled to end in April 2013 but due to slow recruitment may have to be extended to late 2013. TRIAL REGISTRATION: ISRCTN65254102.This article presents independent research funded by the National Institute of Health. Research (NIHR) under its Research for Patient Benefit (RfPB) program (grant reference: PB-PG-1208-18031)
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