403 research outputs found
An Analysis of the Structure of the Fante Verb With Special Reference to Tone and Glottalisation.
The tonal phonemes which occur in utterances containing only one sentence are (i) high tone, (ii) downstep between successive high tones, and (iii) a slight rise towards the end of a prepausal high tone. The phonemic status of the second and third of these is very largely accounted for by low tones becoming high in agreement with adjacent high tones; downstep is basically an automatic feature of the second of two high tones which are separated by one or more low tones, but if a low tone between two high tones becomes high in tonal aagreement with the preceding or following high the downstep remains, occurring between the agreeing high and the high with which it is not in agreement. The slight rise towards the end of a prepausal high tone is basically an automatic feature of a high tone which is in pause and is borne by a tone-bearing unit without a final glottal stop, but if a low tone becomes high in pause in agreement with the preceding high it does not have the slight rise. The remaining occurrences of downstep and non- occurrences of the slight rise can be accounted for by the postulation of zero tone-bearing units with low or high tone (which mostly turn out to correspond to non-zero tone-bearing units in other dialects or languages). The glottal stop is an accentual rather than a consonantal phoneme. It sometimes represents a separate morpheme which might reasonably be looked upon as a morpheme of intonation, but apart from that it is basically an automatic feature of a tone-bearing unit of the pattern consonant-vowel-consonant which is in pause
Economic evaluation of cystic fibrosis screening: A Review of the literature, CHERE Working Paper 2006/6
Objectives: To critically examine the economic evidence on Cystic Fibrosis (CF) screening and to understand issues relating to the transferability of findings to the Australian context for policy decisions. Methods: A systematic literature search identified 25 economic studies with empirical results on CF published between 1990 and 2005. These articles were then assessed against international benchmarks on conducting and reporting of economic evaluations, focusing on the transferability of the evidence to the local setting. Results: Six studies described only costs, 12 were cost-effectiveness studies, 6 were cost-benefit studies and one had a combined design (cost utility, cost benefit and cost effectiveness). Most of the cost-effectiveness studies compared screening versus ?no-screening? but the screening programs under consideration differed markedly. Four considered neonatal screening, three prenatal screening, three pre-conception and carrier screening, and one considered all types of screening programs. The outcome measures also varied considerably between studies. One study included a quality adjusted life year measure. Cost?benefit measures mostly included economic savings ? evaded lifetime medical costs of avoiding CF child birth. Conclusion: The variability in study design, model inputs and reporting of economic evaluations of CF carrier screening raises issues on the applicability and transferability of such evidence to the Australian context.Cystic fibrosis, economic evaluation
WEC: weighted ensemble of text classifiers.
Text classification is one of the most important tasks in the field of Natural Language Processing. There are many approaches that focus on two main aspects: generating an effective representation; and selecting and refining algorithms to build the classification model. Traditional machine learning methods represent documents in vector space using features such as term frequencies, which have limitations in handling the order and semantics of words. Meanwhile, although achieving many successes, deep learning classifiers require substantial resources in terms of labelled data and computational complexity. In this work, a weighted ensemble of classifiers (WEC) is introduced to address the text classification problem. Instead of using majority vote as the combining method, we propose to associate each classifierâs prediction with a different weight when combining classifiers. The optimal weights are obtained by minimising a loss function on the training data with the Particle Swarm Optimisation algorithm. We conducted experiments on 5 popular datasets and report classification performance of algorithms with classification accuracy and macro F1 score. WEC was run with several different combinations of traditional machine learning and deep learning classifiers to show its flexibility and robustness. Experimental results confirm the advantage of WEC, especially on smaller datasets
Rolofylline, an adenosine A1âreceptor antagonist, in acute heart failure
Background:
Worsening renal function, which is associated with adverse outcomes, often develops
in patients with acute heart failure. Experimental and clinical studies suggest that
counterregulatory responses mediated by adenosine may be involved. We tested the
hypothesis that the use of rolofylline, an adenosine A1âreceptor antagonist, would
improve dyspnea, reduce the risk of worsening renal function, and lead to a more
favorable clinical course in patients with acute heart failure.
Methods:
We conducted a multicenter, double-blind, placebo-controlled trial involving patients
hospitalized for acute heart failure with impaired renal function. Within 24 hours
after presentation, 2033 patients were randomly assigned, in a 2:1 ratio, to receive
daily intravenous rolofylline (30 mg) or placebo for up to 3 days. The primary end
point was treatment success, treatment failure, or no change in the patientâs clinical
condition; this end point was defined according to survival, heart-failure status,
and changes in renal function. Secondary end points were the post-treatment development
of persistent renal impairment and the 60-day rate of death or readmission
for cardiovascular or renal causes.
Results:
Rolofylline, as compared with placebo, did not provide a benefit with respect to the
primary end point (odds ratio, 0.92; 95% confidence interval, 0.78 to 1.09; P=0.35).
Persistent renal impairment developed in 15.0% of patients in the rolofylline group
and in 13.7% of patients in the placebo group (P=0.44). By 60 days, death or readmission
for cardiovascular or renal causes had occurred in similar proportions of patients
assigned to rolofylline and placebo (30.7% and 31.9%, respectively; P=0.86).
Adverse-event rates were similar overall; however, only patients in the rolofylline
group had seizures, a known potential adverse effect of A1-receptor antagonists.
Conclusions:
Rolofylline did not have a favorable effect with respect to the primary clinical composite
end point, nor did it improve renal function or 60-day outcomes. It does not
show promise in the treatment of acute heart failure with renal dysfunction. (Funded
by NovaCardia, a subsidiary of Merck; ClinicalTrials.gov numbers, NCT00328692
and NCT00354458.
The Irbesartan in Heart Failure With Preserved Systolic Function (I-PRESERVE) Trial: Rationale and Design
Background:
Although 40% to 50% of patients with chronic heart failure (HF) have relatively preserved systolic function (PSF), few trials have been conducted in this population and treatment guidelines do not include evidence-based recommendations.
Methods and Results:
The Irbesartan in Heart Failure with Preserved Systolic Function (I-PRESERVE) is enrolling 4100 subjects with HF-PSF to evaluate whether 300 mg irbesartan is superior to placebo in reducing mortality and prespecified categories of cardiovascular hospitalizations. The principal inclusion criteria are age â„60 years, heart failure symptoms, an ejection fraction â„45%, and either hospitalization for heart failure within 6 months or corroborative evidence of heart failure or the substrate for diastolic heart failure. Additional secondary end points include cardiovascular mortality, cause-specific mortality and morbidity, change in New York Heart Association functional class, quality of life, and N-terminal pro-BNP measurements. Follow-up will continue until 1440 patients experience a primary end point. Substudies will evaluate changes in echocardiographic measurements and serum collagen markers.
Conclusion:
I-PRESERVE is the largest trial in this understudied area and will provide crucial information on the characteristics and course of the syndrome, as well as the efficacy of the angiotensin receptor blocker irbesartan
The Irbesartan in Heart Failure With Preserved Systolic Function (I-PRESERVE) Trial: Rationale and Design
Background:
Although 40% to 50% of patients with chronic heart failure (HF) have relatively preserved systolic function (PSF), few trials have been conducted in this population and treatment guidelines do not include evidence-based recommendations.
Methods and Results:
The Irbesartan in Heart Failure with Preserved Systolic Function (I-PRESERVE) is enrolling 4100 subjects with HF-PSF to evaluate whether 300 mg irbesartan is superior to placebo in reducing mortality and prespecified categories of cardiovascular hospitalizations. The principal inclusion criteria are age â„60 years, heart failure symptoms, an ejection fraction â„45%, and either hospitalization for heart failure within 6 months or corroborative evidence of heart failure or the substrate for diastolic heart failure. Additional secondary end points include cardiovascular mortality, cause-specific mortality and morbidity, change in New York Heart Association functional class, quality of life, and N-terminal pro-BNP measurements. Follow-up will continue until 1440 patients experience a primary end point. Substudies will evaluate changes in echocardiographic measurements and serum collagen markers.
Conclusion:
I-PRESERVE is the largest trial in this understudied area and will provide crucial information on the characteristics and course of the syndrome, as well as the efficacy of the angiotensin receptor blocker irbesartan
Aliskiren, enalapril, or aliskiren and enalapril in heart failure
BACKGROUND
Among patients with chronic heart failure, angiotensin-convertingâenzyme (ACE)
inhibitors reduce mortality and hospitalization, but the role of a renin inhibitor in
such patients is unknown. We compared the ACE inhibitor enalapril with the renin
inhibitor aliskiren (to test superiority or at least noninferiority) and with the combination
of the two treatments (to test superiority) in patients with heart failure
and a reduced ejection fraction.
METHODS
After a single-blind run-in period, we assigned patients, in a double-blind fashion,
to one of three groups: 2336 patients were assigned to receive enalapril at a dose
of 5 or 10 mg twice daily, 2340 to receive aliskiren at a dose of 300 mg once
daily, and 2340 to receive both treatments (combination therapy). The primary
composite outcome was death from cardiovascular causes or hospitalization for
heart failure.
RESULTS
After a median follow-up of 36.6 months, the primary outcome occurred in 770
patients (32.9%) in the combination-therapy group and in 808 (34.6%) in the
enalapril group (hazard ratio, 0.93; 95% confidence interval [CI], 0.85 to 1.03). The
primary outcome occurred in 791 patients (33.8%) in the aliskiren group (hazard
ratio vs. enalapril, 0.99; 95% CI, 0.90 to 1.10); the prespecified test for noninferiority
was not met. There was a higher risk of hypotensive symptoms in the combination-therapy
group than in the enalapril group (13.8% vs. 11.0%, P=0.005), as
well as higher risks of an elevated serum creatinine level (4.1% vs. 2.7%, P=0.009)
and an elevated potassium level (17.1% vs. 12.5%, P<0.001).
CONCLUSIONS
In patients with chronic heart failure, the addition of aliskiren to enalapril led to
more adverse events without an increase in benefit. Noninferiority was not shown
for aliskiren as compared with enalapri
Importance of obesity, race and age to the cardiac structural and functional effects of hypertension
AbstractObjectives. The purpose of this study was to determine the effects of obesity and its interaction with age, race and the magnitude of blood pressure elevation in a large cohort of patients with mild to moderate hypertension and a high prevalence of left ventricular hypertrophy.Background. Obesity, race and age each have important effects on the incidence and severity of hypertension and may contribute to the effects of blood pressure elevation on the cardiac manifestations of hypertension.Methods. Left ventricular structure and function were assessed with two-dimensional targeted M-mode echocardiography in 692 men with mild to moderate hypertension (average blood pressure 153/100 mm Hg), and the data were compared in relation to obesity (determined from body mass index), age, race, blood pressure, physical activity, plasma renin activity, urinary sodium excretion, hematocrit, heart rate and serum lipids.Results. Left ventricular hypertrophy was common (630% with increased left ventricular mass, 22% with left ventricular hypertrophy on the electrocardiogram [ECG]). On multivariable regression analysis, body mass index was the strongest predictor of left ventricular mass and magnified the slope relation of blood pressure to left ventricular mass. Despite a greater prevalence of ECG left ventricular hypertrophy in blacks (31%) than in whites (10%), left ventricular mass and echocardiographic prevalence of left ventricular hypertrophy did not differ by race. However, septal, posterior left ventricular and relative wall thickness were greater in black than in white men.Conclusions. Obesity is the strongest clinical predictor of left ventricular mass and left ventricular hypertrophy la men, even in those with mild to moderate hypertension of sufficient severity to be associated with a high prevalence of left ventricular hypertrophy. Moreover, independent effects of systolic blood pressure on left ventricular mass an amplified by obesity. Although race does not affect left ventricular mass or the prevalence of left ventricular hypertrophy, black race is associated with greater relative wall thickness, itself a predictor of unfavorable cardiovascular outcome
The role of the chemical composition of monetite on the synthesis and properties of α-tricalcium phosphate
Peer reviewedPublisher PD
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