Assessing compliance of cardiologists with the national cholesterol education program (NCEP) III guidelines in an ambulatory care setting

INTRODUCTION: The NCEP III -ATP guidelines provide clear clinical directives for lipid management especially statins therapy in appropriate patient groups. Compliance of primary care physicians with these guidelines especially in ambulatory care settings has been shown to be poor. The compliance of cardiologist to these guidelines is less documented. METHODS: A retrospective chart review of 386 patients managed in a large urban cardiology practice was undertaken. Patients with documented contraindications to use of statins were excluded from the study. Only patients with two or more years of follow-up in the practice were included. Demographic variables and medical history including CAD or its equivalent and its major risk factors were identified. The proportion of patients on statins and adequacy of statins therapy were recorded. The lipid profiles of all patients were also analyzed. RESULTS: Fifteen patients with documented contraindications to statins therapy including persistent/severe LFT abnormalities, allergies, and gastrointestinal intolerance were excluded. A total of 371 patients were included in the analysis. The mean age for patients in the study was 65 years (range: 42–84). 236 (64%) were males while 141 (36%) were females. 161 (43%) patients were on statins while 210 (57%) weren't. 88 (62%) of females were on stain compared to 116 (49%) of males (p = 0.001). 68% of patients below the age of 50 yrs were not on statins compared with 55% of those greater than 50 yrs (p = 0.01). 38% of patients on statins therapy had sub-optimal lipid profile despite greater than two years of therapy. No statistically significant differences in race and use of satins were noted. CONCLUSION: This study demonstrates a higher than expected prevalence of sub-optimal management of dyslipidemia among patients with established coronary heart disease without contraindications to statins managed by cardiologists. Cardiology and primary care practices require similar comprehensive routine lipid management program that is assiduously maintained and evaluated at both in-patient and out patient settings to ensure most patients receive optimal therapy with statins and other lipid lowering agents

Degrees of tenant isolation for cloud-hosted software services : a cross-case analysis

A challenge, when implementing multi-tenancy in a cloud-hosted software service, is how to ensure that the performance and resource consumption of one tenant does not adversely affect other tenants. Software designers and architects must achieve an optimal degree of tenant isolation for their chosen application requirements. The objective of this research is to reveal the trade-offs, commonalities, and differences to be considered when implementing the required degree of tenant isolation. This research uses a cross-case analysis of selected open source cloud-hosted software engineering tools to empirically evaluate varying degrees of isolation between tenants. Our research reveals five commonalities across the case studies: disk space reduction, use of locking, low cloud resource consumption, customization and use of plug-in architecture, and choice of multi-tenancy pattern. Two of these common factors compromise tenant isolation. The degree of isolation is reduced when there is no strategy to reduce disk space and customization and plug-in architecture is not adopted. In contrast, the degree of isolation improves when careful consideration is given to how to handle a high workload, locking of data and processes is used to prevent clashes between multiple tenants and selection of appropriate multi-tenancy pattern. The research also revealed five case study differences: size of generated data, cloud resource consumption, sensitivity to workload changes, the effect of the software process, client latency and bandwidth, and type of software process. The degree of isolation is impaired, in our results, by the large size of generated data, high resource consumption by certain software processes, high or fluctuating workload, low client latency, and bandwidth when transferring multiple files between repositories. Additionally, this research provides a novel explanatory framework for (i) mapping tenant isolation to different software development processes, cloud resources and layers of the cloud stack; and (ii) explaining the different trade-offs to consider affecting tenant isolation (i.e. resource sharing, the number of users/requests, customizability, the size of generated data, the scope of control of the cloud application stack and business constraints) when implementing multi-tenant cloud-hosted software services. This research suggests that software architects have to pay attention to the trade-offs, commonalities, and differences we identify to achieve their degree of tenant isolation requirements

A Stability analysis for a mathematical model for the determination of optimum drug for chemotherapy of HIV

We propose a system of ordinary differential equations modeling the interaction of HIV virus and the immune system of the human body. We propose an optimal amount of medicine for the chemotherapy for patients with human immunodeficiency virus (HIV) and we show that the endemic equilibrium is asymptotically stable.Keywords: Optimal control, HIV – infection dynamics, AVK method, therapy therapeutic period, asymptotically stableJournal of the Nigerian Association of Mathematical Physics, Volume 20 (March, 2012), pp 115 – 11

A Stability analysis for a mathematical model for the determination of optimum drug for chemotherapy of HIV

We propose a system of ordinary differential equations modeling the interaction of HIV virus and the immune system of the human body. We propose an optimal amount of medicine for the chemotherapy for patients with human immunodeficiency virus (HIV) and we show that the endemic equilibrium is asymptotically stable.Keywords: Optimal control, HIV – infection dynamics, AVK method, therapy therapeutic period, asymptotically stable

Physiological and molecular responses of pearl millet seedling to atrazine stress

Pearl millet has been recommended beneficial for several therapeutic purposes. However, little is known of the physiological responses to abiotic stressors, especially of atrazine. In order to elucidate the physiological and molecular responses of pearl millet to atrazine stress, we studied the response of various biomarkers under increasing herbicide concentrations (0, 5, 10, and 50 mg/kg). We also quantified the levels of malondialdehyde (MDA) and reactive oxygen species (ROS) (H₂O₂ and O₂•-) produced in the leaves to evaluate the extent of oxidative damage. Increasing atrazine concentrations significantly increased ROS and MDA production in the plant leaves. Ascorbate peroxidase (APX) and peroxidase (POD) activities increased, while catalase (CAT) and superoxide dismutase activities reduced with increasing atrazine concentrations. Generally, atrazine applied at 50 mg/kg suppressed chlorophyll contents, whereas, chlorophyll (a/b) ratio was increased. Atrazine applied at 50 mg/kg significantly suppressed antioxidant gene expressions to the lowest. The APX gene showed overall low response to the atrazine treatments. The chloroplastic psbA gene showed highest expression with 10 mg/kg atrazine, whereas atrazine at 50 mg/kg significantly suppressed the gene expression to its lowest. Pearl millet was able to suppress oxidative stress under low atrazine levels, but high atrazine concentration could induce more oxidative damage.Kehinde O. Erinle, Zhao Jiang, Bingbing Ma, Khalil Ur-Rehman, Andleeb Shahla, and Ying Zhan

Oxidative stress response induced in an atrazine phytoremediating plant: physiological responses of Pennisetum glaucum to high atrazine concentrations

This research presented here, for the first time, elucidates the responses of several antioxidants in Pennisetum leaves exposed to varying concentrations of atrazine (0 - 200 mg•kg-1). Pennisetum has been reported to be resistant to atrazine; however, its physiological response to high concentrations (≥ 50 mg•kg-1) of atrazine is not well documented. The contents of reduced (AsA) and oxidized (DHA) ascorbate increased significantly with increase in atrazine concentration and exposure time; but the increase was more evident under higher (50 and 100 mg•kg-1) atrazine concentrations. Increase in atrazine concentration to 200 mg•kg-1 significantly decreased AsA, but increased DHA content, throughout the experiment. Seedlings treated with 200 mg•kg-1 atrazine showed significantly lowest reduced glutathione (GSH) content; while oxidized glutathione (GSSG) was not significantly affected, after 68d. Seedlings treated with 100 mg•kg-1 atrazine showed increased Glutathione-S-Transferase (GST) activity after 48 d and 68 d; while treatment with 200 mg•kg-1 atrazine significantly increased Glutathione reductase (GR) after 58d. This result suggests that Pennisetum may tolerate lower atrazine concentrations; However, higher concentrations (≥50 mg•kg-1) which could have longer residency period in the soil, could induce more physiological damage to the plant.Kehinde Olajide Erinle, Zhao Jiang, Mengyuan Li, Guangxia Su, Bingbing Ma, Yuheng Ma and Ying Zhan

Exogenous calcium induces tolerance to atrazine stress in Pennisetum seedlings and promotes photosynthetic activity, antioxidant enzymes and psbA gene transcripts

Calcium (Ca) has been reported to lessen oxidative damages in plants by upregulating the activities of antioxidant enzymes. However, atrazine mediated reactive oxygen species (ROS) reduction by Ca is limited. This study therefore investigated the effect of exogenously applied Ca on ROS, antioxidants activity and gene transcripts, the D1 protein (psbA gene), and chlorophyll contents in Pennisetum seedlings pre-treated with atrazine. Atrazine toxicity increased ROS production and enzyme activities (ascorbate peroxidase APX, peroxidase POD, Superoxide dismutase SOD, glutathione-S-transferase GST); but decreased antioxidants (APX, POD, and Cu/Zn SOD) and psbA gene transcripts. Atrazine also decreased the chlorophyll contents, but increased chlorophyll (a/b) ratio. Contrarily, Ca application to atrazine pre-treated seedlings lowered the harmful effects of atrazine by reducing ROS levels, but enhancing the accumulation of total chlorophyll contents. Ca-protected seedlings in the presence of atrazine manifested reduced APX and POD activity, whereas SOD and GST activity was further increased with Ca application. Antioxidant gene transcripts that were down-regulated by atrazine toxicity were up-regulated with the application of Ca. Calcium application also resulted in up-regulation of the D1 protein. In conclusion, ability of calcium to reverse atrazine-induced oxidative damage and calcium regulatory role on GST in Pennisetum was presented.Kehinde Olajide Erinle, Zhao Jiang, Bingbing Ma, Jinmei Li, Yukun Chen, Khalil Ur-Rehman, Andleeb Shahla, Ying Zhan

A comprehensive review of the materials degradation phenomena in solid-liquid phase change materials for thermal energy storage

Phase Change Materials (PCMs) employ latent heat property for storage and management of thermal energy in various applications. In order to ensure efficient performances of PCMs, their compositional compatibility in terms of corrosiveness on container/encapsulation materials is as important as thermal characteristic. This compatibility is usually determined with respect to factors such as exposure time and temperature, flow and non-flow condition, and static and dynamic conditions. The basic understanding of how corrosion/degradation mechanisms proceed on PCMs’ container/encapsulation materials provides for extended serviceability of thermal management or storage systems. Therefore, this paper has reviewed the corrosion/degradation mechanisms of container/encapsulation materials subjected to organic, inorganic and metallic PCMs exposure under static-isothermal, static-thermal cycling, dynamic-isothermal conditions. Common materials for containers and encapsulation are Carbon Steels (CS), Copper (CP), Aluminium (AL) and Stainless Steels (SS) where CS and CP were mostly degraded due to PCMs’ corrosive attack. Aluminium is mostly faced with pitting based on galvanic effect of impurities contained while the challenge mostly encountered with stainless steels is alloying element depletion, especially chromium depletion which can change the thermal properties of the fluid. However, SS have shown to be the most resistant to corrosive attacks. Another material with potential for use as container material is SiC, a corrosion resistant material. Generally, degree of corrosion for these materials are in the order of SiC<SS<AL<CP<CS.  Overview of methods so far investigated for combating corrosive attacks of PCMs on container/encapsulation materials have been highlighted and recommendations on areas of further research are provided