40 research outputs found

    A simple statistical model for prediction of acute coronary syndrome in chest pain patients in the emergency department

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    BACKGROUND: Several models for prediction of acute coronary syndrome (ACS) among chest pain patients in the emergency department (ED) have been presented, but many models predict only the likelihood of acute myocardial infarction, or include a large number of variables, which make them less than optimal for implementation at a busy ED. We report here a simple statistical model for ACS prediction that could be used in routine care at a busy ED. METHODS: Multivariable analysis and logistic regression were used on data from 634 ED visits for chest pain. Only data immediately available at patient presentation were used. To make ACS prediction stable and the model useful for personnel inexperienced in electrocardiogram (ECG) reading, simple ECG data suitable for computerized reading were included. RESULTS: Besides ECG, eight variables were found to be important for ACS prediction, and included in the model: age, chest discomfort at presentation, symptom duration and previous hypertension, angina pectoris, AMI, congestive heart failure or PCI/CABG. At an ACS prevalence of 21% and a set sensitivity of 95%, the negative predictive value of the model was 96%. CONCLUSION: The present prediction model, combined with the clinical judgment of ED personnel, could be useful for the early discharge of chest pain patients in populations with a low prevalence of ACS

    Three little pieces for computer and relativity

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    Numerical relativity has made big strides over the last decade. A number of problems that have plagued the field for years have now been mostly solved. This progress has transformed numerical relativity into a powerful tool to explore fundamental problems in physics and astrophysics, and I present here three representative examples. These "three little pieces" reflect a personal choice and describe work that I am particularly familiar with. However, many more examples could be made.Comment: 42 pages, 11 figures. Plenary talk at "Relativity and Gravitation: 100 Years after Einstein in Prague", June 25 - 29, 2012, Prague, Czech Republic. To appear in the Proceedings (Edition Open Access). Collects results appeared in journal articles [72,73, 122-124

    sFlt Multivalent Conjugates Inhibit Angiogenesis and Improve Half-Life In Vivo

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    We would like to thank Jonathan Winger and Xiao Zhu for guidance with the insect cell protein expression system and providing reagents. We would like to acknowledge Ann Fischer for help with expressing the sFlt protein in the Tissue Culture Facility at UC Berkeley and Dawn Spelke and Anusuya Ramasubramanian for help optimizing protein purification from insect cells. We are also grateful for the help from Leah Byrne and John Flannery at in the Helen Wills Neuroscience Institute at UC Berkeley for aiding us in the development of the rat intravitreal residence time model and for allowing us to use their facilities.Current anti-VEGF drugs for patients with diabetic retinopathy suffer from short residence time in the vitreous of the eye. In order to maintain biologically effective doses of drug for inhibiting retinal neovascularization, patients are required to receive regular monthly injections of drug, which often results in low patient compliance and progression of the disease. To improve the intravitreal residence time of anti-VEGF drugs, we have synthesized multivalent bioconjugates of an anti-VEGF protein, soluble fms-like tyrosine kinase-1 (sFlt) that is covalently grafted to chains of hyaluronic acid (HyA), conjugates that are termed mvsFlt. Using a mouse corneal angiogenesis assay, we demonstrate that covalent conjugation to HyA chains does not decrease the bioactivity of sFlt and that mvsFlt is equivalent to sFlt at inhibiting corneal angiogenesis. In a rat vitreous model, we observed that mvsFlt had significantly increased intravitreal residence time compared to the unconjugated sFlt after 2 days. The calculated intravitreal half-lives for sFlt and mvsFlt were 3.3 and 35 hours, respectively. Furthermore, we show that mvsFlt is more effective than the unconjugated form at inhibiting retinal neovascularization in an oxygen-induced retinopathy model, an effect that is most likely due to the longer half-life of mvsFlt in the vitreous. Taken together, our results indicate that conjugation of sFlt to HyA does not affect its affinity for VEGF and this conjugation significantly improves drug half-life. These in vivo results suggest that our strategy of multivalent conjugation could substantially improve upon drug half-life, and thus the efficacy of currently available drugs that are used in diseases such as diabetic retinopathy, thereby improving patient quality of life.Yeshttp://www.plosone.org/static/editorial#pee

    An integrated model for the design of air-cooled chiller plants for commercial buildings

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    Cooling load calculation is the first step in designing the air-conditioning system of a building. The calculated cooling capacity with appropriate buffer is then used to select the number and size of chillers in the system. Nþ 1 is a common formula used by designers to size the chiller plants in Hong Kong buildings, where N is the actual number of chillers required and 1 is a redundant chiller provided to ensure reliability. This paper reviews the problem of excess capacity and discusses the risk exposure of chiller systems without redundant chillers. The cooling load profiles of the chiller plants of four medium-sized commercial buildings inHong Kongare reviewed. The risk exposure of chiller systemswithout redundant chillers can be minimized byapplying risk-based preventive maintenance. The just-in-demand design reduces capital cost of the building and frees up funds for continuous energy measurement and improving the energy efficiency of chiller plant systems. This paper presents a model for designing chiller plants that improves the energy efficiency of the plant in a cost effective and thoughtful manner. It is designed with consideration of the life cycle of the plant and real-time continuous commissioning, monitoring, measurement, comparison and execution for better energy manageme

    Environmental evaluation of pump replacement period in water supply systems of buildings

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    202311 bckwAccepted ManuscriptRGCPublishedGreen (AAM

    Performance impact of indoor environmental policy implementation for airside systems in Hong Kong Grade A offices

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    2014-2015 > Academic research: refereed > Publication in refereed journalAccepted ManuscriptOthersThe Hong Kong Polytechnic University (GYX1Y, GYL19)Environment and conservation Fund (ECF) project 14/2013 from The HKSAR governmentPublishe

    Student learning performance and indoor environmental quality (IEQ) in air-conditioned university teaching rooms

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    2011-2012 > Academic research: refereed > Publication in refereed journalAccepted ManuscriptSelf-fundedPublishe
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