Here in this ppt we are showing how we are using machine learning to predict cardio d functionalities or diseases in a patient before he is diagnosed with the disease or in the later stages.
This study evaluated shock index (SI), defined as heart rate divided by systolic blood pressure, as a predictor of morbidity and mortality in pediatric trauma patients. The study used data from the 2010 National Trauma Data Bank and found that an elevated age-adjusted SI was strongly associated with mortality, need for blood transfusion, ventilation, procedures, and ICU stay. Compared to hypotension alone, elevated SI had improved sensitivity for predicting negative outcomes while maintaining high specificity. The findings support using SI as a simple tool to identify pediatric trauma patients at risk of shock-related complications.
1) This study investigated whether using 64-slice MDCT as part of the initial diagnostic strategy for patients presenting with acute chest pain could reduce emergency department and hospital length of stay, admissions, and 30-day major adverse cardiac events.
2) 267 patients were randomized to either a conventional diagnostic strategy or a MDCT-based strategy. The MDCT-based strategy reduced unnecessary admissions in patients at intermediate risk and decreased hospital length of stay overall and in high-risk patients specifically.
3) Emergency department length of stay was not different between the strategies. No patients in the MDCT group experienced events at the one-month follow-up.
Copyright 2016 American Medical Association. All rights reserv.docxmelvinjrobinson2199
Copyright 2016 American Medical Association. All rights reserved.
Intensive vs Standard Blood Pressure Control
and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years
A Randomized Clinical Trial
Jeff D. Williamson, MD, MHS; Mark A. Supiano, MD; William B. Applegate, MD, MPH; Dan R. Berlowitz, MD; Ruth C. Campbell, MD, MSPH;
Glenn M. Chertow, MD; Larry J. Fine, MD; William E. Haley, MD; Amret T. Hawfield, MD; Joachim H. Ix, MD, MAS; Dalane W. Kitzman, MD;
John B. Kostis, MD; Marie A. Krousel-Wood, MD; Lenore J. Launer, PhD; Suzanne Oparil, MD; Carlos J. Rodriguez, MD, MPH;
Christianne L. Roumie, MD, MPH; Ronald I. Shorr, MD, MS; Kaycee M. Sink, MD, MAS; Virginia G. Wadley, PhD; Paul K. Whelton, MD;
Jeffrey Whittle, MD; Nancy F. Woolard; Jackson T. Wright Jr, MD, PhD; Nicholas M. Pajewski, PhD; for the SPRINT Research Group
IMPORTANCE The appropriate treatment target for systolic blood pressure (SBP) in older
patients with hypertension remains uncertain.
OBJECTIVE To evaluate the effects of intensive (<120 mm Hg) compared with standard
(<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension
but without diabetes.
DESIGN, SETTING, AND PARTICIPANTS A multicenter, randomized clinical trial of patients aged
75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT).
Recruitment began on October 20, 2010, and follow-up ended on August 20, 2015.
INTERVENTIONS Participants were randomized to an SBP target of less than 120 mm Hg
(intensive treatment group, n = 1317) or an SBP target of less than 140 mm Hg (standard
treatment group, n = 1319).
MAIN OUTCOMES AND MEASURES The primary cardiovascular disease outcome was a
composite of nonfatal myocardial infarction, acute coronary syndrome not resulting in a
myocardial infarction, nonfatal stroke, nonfatal acute decompensated heart failure, and death
from cardiovascular causes. All-cause mortality was a secondary outcome.
RESULTS Among 2636 participants (mean age, 79.9 years; 37.9% women), 2510 (95.2%)
provided complete follow-up data. At a median follow-up of 3.14 years, there was a
significantly lower rate of the primary composite outcome (102 events in the intensive
treatment group vs 148 events in the standard treatment group; hazard ratio [HR], 0.66
[95% CI, 0.51-0.85]) and all-cause mortality (73 deaths vs 107 deaths, respectively; HR, 0.67
[95% CI, 0.49-0.91]). The overall rate of serious adverse events was not different between
treatment groups (48.4% in the intensive treatment group vs 48.3% in the standard
treatment group; HR, 0.99 [95% CI, 0.89-1.11]). Absolute rates of hypotension were 2.4% in
the intensive treatment group vs 1.4% in the standard treatment group (HR, 1.71 [95% CI,
0.97-3.09]), 3.0% vs 2.4%, respectively, for syncope (HR, 1.23 [95% CI, 0.76-2.00]), 4.0% vs
2.7% for electrolyte abnormalities (HR, 1.51 [95% CI, 0.99-2.33]), 5.5% vs 4.0% for acute
kidney injury (HR, 1.41 [95% CI, 0.98-2.04]), and 4.9% vs 5.5% for inj.
Copyright 2016 American Medical Association. All rights reserv.docxbobbywlane695641
Copyright 2016 American Medical Association. All rights reserved.
Intensive vs Standard Blood Pressure Control
and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years
A Randomized Clinical Trial
Jeff D. Williamson, MD, MHS; Mark A. Supiano, MD; William B. Applegate, MD, MPH; Dan R. Berlowitz, MD; Ruth C. Campbell, MD, MSPH;
Glenn M. Chertow, MD; Larry J. Fine, MD; William E. Haley, MD; Amret T. Hawfield, MD; Joachim H. Ix, MD, MAS; Dalane W. Kitzman, MD;
John B. Kostis, MD; Marie A. Krousel-Wood, MD; Lenore J. Launer, PhD; Suzanne Oparil, MD; Carlos J. Rodriguez, MD, MPH;
Christianne L. Roumie, MD, MPH; Ronald I. Shorr, MD, MS; Kaycee M. Sink, MD, MAS; Virginia G. Wadley, PhD; Paul K. Whelton, MD;
Jeffrey Whittle, MD; Nancy F. Woolard; Jackson T. Wright Jr, MD, PhD; Nicholas M. Pajewski, PhD; for the SPRINT Research Group
IMPORTANCE The appropriate treatment target for systolic blood pressure (SBP) in older
patients with hypertension remains uncertain.
OBJECTIVE To evaluate the effects of intensive (<120 mm Hg) compared with standard
(<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension
but without diabetes.
DESIGN, SETTING, AND PARTICIPANTS A multicenter, randomized clinical trial of patients aged
75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT).
Recruitment began on October 20, 2010, and follow-up ended on August 20, 2015.
INTERVENTIONS Participants were randomized to an SBP target of less than 120 mm Hg
(intensive treatment group, n = 1317) or an SBP target of less than 140 mm Hg (standard
treatment group, n = 1319).
MAIN OUTCOMES AND MEASURES The primary cardiovascular disease outcome was a
composite of nonfatal myocardial infarction, acute coronary syndrome not resulting in a
myocardial infarction, nonfatal stroke, nonfatal acute decompensated heart failure, and death
from cardiovascular causes. All-cause mortality was a secondary outcome.
RESULTS Among 2636 participants (mean age, 79.9 years; 37.9% women), 2510 (95.2%)
provided complete follow-up data. At a median follow-up of 3.14 years, there was a
significantly lower rate of the primary composite outcome (102 events in the intensive
treatment group vs 148 events in the standard treatment group; hazard ratio [HR], 0.66
[95% CI, 0.51-0.85]) and all-cause mortality (73 deaths vs 107 deaths, respectively; HR, 0.67
[95% CI, 0.49-0.91]). The overall rate of serious adverse events was not different between
treatment groups (48.4% in the intensive treatment group vs 48.3% in the standard
treatment group; HR, 0.99 [95% CI, 0.89-1.11]). Absolute rates of hypotension were 2.4% in
the intensive treatment group vs 1.4% in the standard treatment group (HR, 1.71 [95% CI,
0.97-3.09]), 3.0% vs 2.4%, respectively, for syncope (HR, 1.23 [95% CI, 0.76-2.00]), 4.0% vs
2.7% for electrolyte abnormalities (HR, 1.51 [95% CI, 0.99-2.33]), 5.5% vs 4.0% for acute
kidney injury (HR, 1.41 [95% CI, 0.98-2.04]), and 4.9% vs 5.5% for inj.
Among 19,114 healthy elderly patients without cardiovascular disease who were randomized to low-dose aspirin or placebo, aspirin did not reduce the primary composite outcome of death, dementia or persistent physical disability compared to placebo after a median follow-up of 4.7 years. Aspirin was associated with a higher risk of major hemorrhage. Similar recent trials found no benefit of aspirin for primary prevention in diabetic patients or those at moderate cardiovascular risk without increasing bleeding risk. Guidelines do not recommend routine aspirin use for primary prevention in adults over 70 years old due to lack of benefit and risk of bleeding.
This study reviewed outcomes for patients receiving implantable cardioverter-defibrillators (ICDs) for primary or secondary prevention of sudden cardiac death. Among 3628 patients who received ICDs, 162 (4.5%) had end-stage renal disease (ESRD) requiring dialysis. For patients without dialysis, survival at a mean follow-up of 27.1 months was 86.5% for primary prevention and 82.0% for secondary prevention, with no significant difference. However, patients with ESRD had significantly worse survival for both primary (68.4%) and secondary (74.7%) prevention compared to non-dialysis patients. While one-year survival in ESRD patients was
This study evaluated the usefulness of the EGSYS score in predicting cardiac causes of syncope in an outpatient setting. The researchers retrospectively analyzed 224 patients seen in a syncope clinic, calculating the EGSYS score for each. Of 163 patients confirmed to have syncope, 27 (16.6%) had a cardiac cause and 136 (83.4%) a non-cardiac cause. A score ≥3 had a sensitivity of 48.2% and specificity of 77.9% for predicting cardiac syncope. The authors concluded the EGSYS score has limited usefulness in an outpatient setting, but may help reassure low-risk patients due to its high specificity and negative predictive value.
This study evaluated D-dimer levels in 220 patients with suspected acute aortic dissection over 24 hours. D-dimer levels were significantly higher in patients with acute aortic dissection compared to other conditions. Using a cutoff of 500 ng/mL, D-dimer had high sensitivity of 96.6% and moderate specificity of 46.6% for diagnosing acute aortic dissection within 24 hours. D-dimer performed best within the first 6 hours, with an area under the curve of 0.94 for diagnosing acute aortic dissection, suggesting it may help rule out aortic dissection early in presentation.
This study evaluated shock index (SI), defined as heart rate divided by systolic blood pressure, as a predictor of morbidity and mortality in pediatric trauma patients. The study used data from the 2010 National Trauma Data Bank and found that an elevated age-adjusted SI was strongly associated with mortality, need for blood transfusion, ventilation, procedures, and ICU stay. Compared to hypotension alone, elevated SI had improved sensitivity for predicting negative outcomes while maintaining high specificity. The findings support using SI as a simple tool to identify pediatric trauma patients at risk of shock-related complications.
1) This study investigated whether using 64-slice MDCT as part of the initial diagnostic strategy for patients presenting with acute chest pain could reduce emergency department and hospital length of stay, admissions, and 30-day major adverse cardiac events.
2) 267 patients were randomized to either a conventional diagnostic strategy or a MDCT-based strategy. The MDCT-based strategy reduced unnecessary admissions in patients at intermediate risk and decreased hospital length of stay overall and in high-risk patients specifically.
3) Emergency department length of stay was not different between the strategies. No patients in the MDCT group experienced events at the one-month follow-up.
Copyright 2016 American Medical Association. All rights reserv.docxmelvinjrobinson2199
Copyright 2016 American Medical Association. All rights reserved.
Intensive vs Standard Blood Pressure Control
and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years
A Randomized Clinical Trial
Jeff D. Williamson, MD, MHS; Mark A. Supiano, MD; William B. Applegate, MD, MPH; Dan R. Berlowitz, MD; Ruth C. Campbell, MD, MSPH;
Glenn M. Chertow, MD; Larry J. Fine, MD; William E. Haley, MD; Amret T. Hawfield, MD; Joachim H. Ix, MD, MAS; Dalane W. Kitzman, MD;
John B. Kostis, MD; Marie A. Krousel-Wood, MD; Lenore J. Launer, PhD; Suzanne Oparil, MD; Carlos J. Rodriguez, MD, MPH;
Christianne L. Roumie, MD, MPH; Ronald I. Shorr, MD, MS; Kaycee M. Sink, MD, MAS; Virginia G. Wadley, PhD; Paul K. Whelton, MD;
Jeffrey Whittle, MD; Nancy F. Woolard; Jackson T. Wright Jr, MD, PhD; Nicholas M. Pajewski, PhD; for the SPRINT Research Group
IMPORTANCE The appropriate treatment target for systolic blood pressure (SBP) in older
patients with hypertension remains uncertain.
OBJECTIVE To evaluate the effects of intensive (<120 mm Hg) compared with standard
(<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension
but without diabetes.
DESIGN, SETTING, AND PARTICIPANTS A multicenter, randomized clinical trial of patients aged
75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT).
Recruitment began on October 20, 2010, and follow-up ended on August 20, 2015.
INTERVENTIONS Participants were randomized to an SBP target of less than 120 mm Hg
(intensive treatment group, n = 1317) or an SBP target of less than 140 mm Hg (standard
treatment group, n = 1319).
MAIN OUTCOMES AND MEASURES The primary cardiovascular disease outcome was a
composite of nonfatal myocardial infarction, acute coronary syndrome not resulting in a
myocardial infarction, nonfatal stroke, nonfatal acute decompensated heart failure, and death
from cardiovascular causes. All-cause mortality was a secondary outcome.
RESULTS Among 2636 participants (mean age, 79.9 years; 37.9% women), 2510 (95.2%)
provided complete follow-up data. At a median follow-up of 3.14 years, there was a
significantly lower rate of the primary composite outcome (102 events in the intensive
treatment group vs 148 events in the standard treatment group; hazard ratio [HR], 0.66
[95% CI, 0.51-0.85]) and all-cause mortality (73 deaths vs 107 deaths, respectively; HR, 0.67
[95% CI, 0.49-0.91]). The overall rate of serious adverse events was not different between
treatment groups (48.4% in the intensive treatment group vs 48.3% in the standard
treatment group; HR, 0.99 [95% CI, 0.89-1.11]). Absolute rates of hypotension were 2.4% in
the intensive treatment group vs 1.4% in the standard treatment group (HR, 1.71 [95% CI,
0.97-3.09]), 3.0% vs 2.4%, respectively, for syncope (HR, 1.23 [95% CI, 0.76-2.00]), 4.0% vs
2.7% for electrolyte abnormalities (HR, 1.51 [95% CI, 0.99-2.33]), 5.5% vs 4.0% for acute
kidney injury (HR, 1.41 [95% CI, 0.98-2.04]), and 4.9% vs 5.5% for inj.
Copyright 2016 American Medical Association. All rights reserv.docxbobbywlane695641
Copyright 2016 American Medical Association. All rights reserved.
Intensive vs Standard Blood Pressure Control
and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years
A Randomized Clinical Trial
Jeff D. Williamson, MD, MHS; Mark A. Supiano, MD; William B. Applegate, MD, MPH; Dan R. Berlowitz, MD; Ruth C. Campbell, MD, MSPH;
Glenn M. Chertow, MD; Larry J. Fine, MD; William E. Haley, MD; Amret T. Hawfield, MD; Joachim H. Ix, MD, MAS; Dalane W. Kitzman, MD;
John B. Kostis, MD; Marie A. Krousel-Wood, MD; Lenore J. Launer, PhD; Suzanne Oparil, MD; Carlos J. Rodriguez, MD, MPH;
Christianne L. Roumie, MD, MPH; Ronald I. Shorr, MD, MS; Kaycee M. Sink, MD, MAS; Virginia G. Wadley, PhD; Paul K. Whelton, MD;
Jeffrey Whittle, MD; Nancy F. Woolard; Jackson T. Wright Jr, MD, PhD; Nicholas M. Pajewski, PhD; for the SPRINT Research Group
IMPORTANCE The appropriate treatment target for systolic blood pressure (SBP) in older
patients with hypertension remains uncertain.
OBJECTIVE To evaluate the effects of intensive (<120 mm Hg) compared with standard
(<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension
but without diabetes.
DESIGN, SETTING, AND PARTICIPANTS A multicenter, randomized clinical trial of patients aged
75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT).
Recruitment began on October 20, 2010, and follow-up ended on August 20, 2015.
INTERVENTIONS Participants were randomized to an SBP target of less than 120 mm Hg
(intensive treatment group, n = 1317) or an SBP target of less than 140 mm Hg (standard
treatment group, n = 1319).
MAIN OUTCOMES AND MEASURES The primary cardiovascular disease outcome was a
composite of nonfatal myocardial infarction, acute coronary syndrome not resulting in a
myocardial infarction, nonfatal stroke, nonfatal acute decompensated heart failure, and death
from cardiovascular causes. All-cause mortality was a secondary outcome.
RESULTS Among 2636 participants (mean age, 79.9 years; 37.9% women), 2510 (95.2%)
provided complete follow-up data. At a median follow-up of 3.14 years, there was a
significantly lower rate of the primary composite outcome (102 events in the intensive
treatment group vs 148 events in the standard treatment group; hazard ratio [HR], 0.66
[95% CI, 0.51-0.85]) and all-cause mortality (73 deaths vs 107 deaths, respectively; HR, 0.67
[95% CI, 0.49-0.91]). The overall rate of serious adverse events was not different between
treatment groups (48.4% in the intensive treatment group vs 48.3% in the standard
treatment group; HR, 0.99 [95% CI, 0.89-1.11]). Absolute rates of hypotension were 2.4% in
the intensive treatment group vs 1.4% in the standard treatment group (HR, 1.71 [95% CI,
0.97-3.09]), 3.0% vs 2.4%, respectively, for syncope (HR, 1.23 [95% CI, 0.76-2.00]), 4.0% vs
2.7% for electrolyte abnormalities (HR, 1.51 [95% CI, 0.99-2.33]), 5.5% vs 4.0% for acute
kidney injury (HR, 1.41 [95% CI, 0.98-2.04]), and 4.9% vs 5.5% for inj.
Among 19,114 healthy elderly patients without cardiovascular disease who were randomized to low-dose aspirin or placebo, aspirin did not reduce the primary composite outcome of death, dementia or persistent physical disability compared to placebo after a median follow-up of 4.7 years. Aspirin was associated with a higher risk of major hemorrhage. Similar recent trials found no benefit of aspirin for primary prevention in diabetic patients or those at moderate cardiovascular risk without increasing bleeding risk. Guidelines do not recommend routine aspirin use for primary prevention in adults over 70 years old due to lack of benefit and risk of bleeding.
This study reviewed outcomes for patients receiving implantable cardioverter-defibrillators (ICDs) for primary or secondary prevention of sudden cardiac death. Among 3628 patients who received ICDs, 162 (4.5%) had end-stage renal disease (ESRD) requiring dialysis. For patients without dialysis, survival at a mean follow-up of 27.1 months was 86.5% for primary prevention and 82.0% for secondary prevention, with no significant difference. However, patients with ESRD had significantly worse survival for both primary (68.4%) and secondary (74.7%) prevention compared to non-dialysis patients. While one-year survival in ESRD patients was
This study evaluated the usefulness of the EGSYS score in predicting cardiac causes of syncope in an outpatient setting. The researchers retrospectively analyzed 224 patients seen in a syncope clinic, calculating the EGSYS score for each. Of 163 patients confirmed to have syncope, 27 (16.6%) had a cardiac cause and 136 (83.4%) a non-cardiac cause. A score ≥3 had a sensitivity of 48.2% and specificity of 77.9% for predicting cardiac syncope. The authors concluded the EGSYS score has limited usefulness in an outpatient setting, but may help reassure low-risk patients due to its high specificity and negative predictive value.
This study evaluated D-dimer levels in 220 patients with suspected acute aortic dissection over 24 hours. D-dimer levels were significantly higher in patients with acute aortic dissection compared to other conditions. Using a cutoff of 500 ng/mL, D-dimer had high sensitivity of 96.6% and moderate specificity of 46.6% for diagnosing acute aortic dissection within 24 hours. D-dimer performed best within the first 6 hours, with an area under the curve of 0.94 for diagnosing acute aortic dissection, suggesting it may help rule out aortic dissection early in presentation.
approach to stemi in non pci centre.pptxShivani Rao
This document discusses strategies to improve care for ST-elevation myocardial infarction (STEMI) in India. It notes that STEMI is common in India, with patients often experiencing delays in receiving medical treatment. While international guidelines recommend primary percutaneous coronary intervention (PCI) for STEMI, this is often not available in India due to lack of infrastructure. As such, thrombolysis remains the main reperfusion strategy used in India. The document advocates for developing protocols and infrastructure to expedite diagnosis of STEMI and administration of reperfusion therapy. This includes training emergency responders to perform pre-hospital ECGs, transmit results to hospitals, and potentially administer drugs like aspirin and thrombolysis en route. The goal is to shorten
This document reviews recent advances in the management of pulmonary embolism (PE). Risk-adapted treatment and follow-up has led to more favorable outcomes for PE patients. Age-adjusted D-dimer cutoff levels can decrease overuse of imaging tests by increasing the specificity of D-dimer. New oral anticoagulants are effective alternatives to standard treatments. However, areas that require more research include the implications of subsegmental PE, diagnosing PE in pregnant patients, and the efficacy of new oral anticoagulants in cancer patients. Improving guideline implementation will further optimize PE management.
Predictive value of exercise myocardial perfusion imaging in the Medicare population: the impact of the ability to exercise
Authors: Deborah H. Kwon, Venu Menon, Penny Houghtaling, Elizabeth Lieber, Richard C. Brunken, Manuel D. Cerqueira, Wael A. Jaber
This study compared the cost-effectiveness of carotid artery stent placement (CAS) versus carotid endarterectomy (CEA) in high-risk patients based on data from the SAPPHIRE trial. The mean cost per quality-adjusted life year (QALY) gained was higher for CAS ($16,223) than for CEA ($12,745). The incremental cost-effectiveness ratio estimated CAS to be $67,891 more expensive per QALY gained than CEA, with a wide range. Although CAS was not inferior to CEA for outcomes, its higher cost offsets the marginal benefit for high-risk patients.
1) The study assessed the relationship between sudden sensorineural hearing loss (SSNHL) and white matter lesions visible on brain MRI, known as cerebral small vessel disease (CSVD).
2) Results showed that individuals with SSNHL aged 48-60 years have a 26% higher probability of having a Fazekas score indicating CSVD compared to the general population. Those under 28 years showed a statistically significant negative correlation.
3) Higher Fazekas scores, indicating more severe CSVD, were related to a decreased probability of hearing recovery in patients with SSNHL. The probability of recovery decreased from 80% in those under 48 with no lesions, to 14% in those with the most
La Hipertensión, es una de las mayores enfermedades que sufren los Hispanohablantes en el planeta . Es grato poder colocar este documento al público y haber podido hacer parte del equipo , ojalá sirvan a muchos las implementaciones. idioma más hablado según el foro Económico mundial - Me refiero al español ó castellano según sea -
segundo idioma y haber podido hacer parte de este equipo. Genuinamente, espero que se curen la mayor cantidad de personas con . Espero genuinamente puedan hacer algúna donación a este esfuerzo grupal. Espero Compartamos este "Paper" así como compartimos memes - En el sentido literal de la significancia-
** Refierase a Wikipedia sino tiene un diccionario a mano.
This study examined 2,112 patients admitted to the National Institute of Cardiovascular Diseases in Dhaka with heart failure. The average age was 46 years old, most were male. Common presenting symptoms were shortness of breath, leg edema, and orthopnea. Hypertension and diabetes were common comorbidities. The leading causes of heart failure were ischemic cardiomyopathy and chronic ischemic heart disease. The study aims to identify clinical presentations of heart failure patients to help determine best treatment approaches.
This study compared the long-term (18-month) outcomes of supervised exercise (SE), stent revascularization (ST), and optimal medical therapy (OMT) for patients with claudication due to aortoiliac peripheral artery disease. 79 patients completed the 18-month follow-up assessment. The study found that both SE and ST resulted in significantly greater improvements in peak walking time and claudication onset time compared to OMT. SE and ST also provided durable improvements in quality of life measures up to 18 months. Both SE and ST had better long-term outcomes than OMT alone for treating claudication, demonstrating the durability of exercise interventions for peripheral artery disease.
This study evaluated the cardiac event rate in 428 patients with known coronary artery disease (CAD) who had a normal stress myocardial perfusion scan (SPECT MPI). During a median follow-up of 3.1 years, all-cause mortality occurred in 60 patients (14%) and 41 patients (10%) died from cardiac causes. Non-fatal myocardial infarction (MI) occurred in 77 patients (18%). The annualized cardiac mortality and non-fatal MI rates were 2% and 3.6%, respectively. Smoking, congestive heart failure, and failure to achieve 85% of the age-predicted maximum heart rate were predictors of all-cause and cardiac mortality. Diabetes, dyslipidemia, smoking, and limited
This presentation by Gavin Giovannoni looks at the new treatment paradigm for MS. It includes: arguments for early treatment in multiple sclerosis, the effect of MS on quality of life and whether highly-effective treatments stabilise MS.
It was presented at the MS Trust Annual Conference in November 2013.
This document summarizes the key points from a lipidology conference presentation. It discusses recent guidelines and studies on cholesterol treatment, including more aggressive LDL lowering to under 70mg/dl for patients with cardiovascular disease. New tools for general cardiovascular risk prediction were presented. Treatment with high-dose statins was found to significantly reduce stroke recurrence and other outcomes for patients who had a stroke or TIA within the past 1-6 months. Immediate withdrawal of statins after acute stroke was associated with increased risks.
1) The study examined predictors of ischemia and outcomes in 169 Egyptian patients with diabetes referred for nuclear perfusion imaging over 2 years of follow up.
2) Significant relationships were found between higher summed stress scores and outcomes of sudden cardiac death, myocardial infarction, and heart failure. Higher summed rest scores also significantly predicted several adverse outcomes.
3) Degree of typical chest pain, transient left ventricular dilation, lung uptake on imaging, and extent of ischemia (summed difference score) were independent predictors of myocardial infarction. Transient left ventricular dilation was the strongest predictor of sudden cardiac death.
Central Adiposity and Mortality after First-Ever Acute Ischemic StrokeErwin Chiquete, MD, PhD
Erwin Chiquete a José L. Ruiz-Sandoval c Luis Murillo-Bonilla e
Carolina León-Jiménez g Bertha Ruiz-Madrigal d, f Erika Martínez-López d, f
Sonia Román d, f Arturo Panduro d, f Alma Ramos b Carlos Cantú-Brito
Background: The waist-to-height ratio (WHtR) may be a better
adiposity measure than the body mass index (BMI). We
evaluated the prognostic performance of WHtR in patients
with acute ischemic stroke (AIS). Methods: First, we compared
WHtR and BMI as adiposity measures in 712 healthy
adults by tetrapolar bioimpedance analysis. Thereafter,
baseline WHtR was analyzed as predictor of 12-month allcause
mortality in 821 Mexican mestizo adults with first-ever
AIS by a Cox proportional hazards model adjusted for baseline
predictors. Results: In healthy individuals, WHtR correlated
higher than BMI with total fat mass and showed a higher
accuracy in identifying a high percentage of body fat (p <
0.01). In AIS patients a U-shaped relationship was observed
between baseline WHtR and mortality (fatality rate 29.1%).
On multivariate analysis, baseline WHtR ≤ 0.300 or >0.800 independently
predicted 12-month all-cause mortality (h
Coronary heart disease is best addressed by a comprehensive approach aimed at halting atherosclerotic disease and reducing the risk of thrombosis. Unfortunately, our success in optimal risk factor modification in patients with stable CHD remains poor: only 41% of patients achieved all basic goals in the recent ISCHEMIA trial, with success rates likely even lower outside the rigorous clinical trial context. A greater focus on achieving prevention goals in patients with CHD will have a substantial impact on patient outcome and rates of hospitalization and more resources and incentives should be allocated for improved secondary prevention.
The ISCHEMIA trial suggests that even selected, high-risk patients with extensive ischemic burden do not benefit from revascularization barring unacceptable angina despite OMT. As ISCHEMIA excluded patients with unacceptable angina, advanced heart failure, and those with unprotected left main disease, our evaluation may be geared to identify such patients for consideration of revascularization alongside an initial strategy of OMT.
Atherosclerosis is a systemic disease of the arterial circulation, with focal areas of more severe manifestation. From an imaging standpoint, the paradigm of ischemia testing may have come to an end. Recent evidence from COURAGE, PROMISE, SCOT-HEART, and ISCHEMIA has demonstrated that functional testing for inducible myocardial ischemia is inferior to anatomic assessment for risk stratifying and managing patients with suspected or known CHD. Consistent with a large body of evidence, risk from CHD is mediated by the extent of atherosclerotic disease burden and not by the extent of inducible ischemia. Given that 55% of patients had nonobstructive CHD by CT in PROMISE, which was associated with 77% of cardiovascular deaths and myocardial infarctions at follow-up, there is immense opportunity to impact the disease at an earlier stage in a very large population of patients with occult CHD.
Los fármacos recomendados para iniciar el tratamiento antihipertensivo en este paciente son:
- Candesartán: por su demostrada capacidad para disminuir la hipertrofia ventricular izquierda y reducir la proteinuria, lo que es importante dado que el paciente presenta diabetes e hipertrofia ventricular.
- Telmisartán: al igual que el candesartán, ha demostrado reducir la proteinuria en pacientes diabéticos. Además, posee efecto antioxidante y antiaterogénico que son beneficiosos en este tipo de pacientes.
- V
This document discusses population health management and how it can help address health needs. It begins by defining population health management as improving systems and policies that affect healthcare quality, access, and outcomes to ultimately improve the health of an entire population. It then provides examples of individual-focused patient care policies and population-focused policies. Population-focused policies aim to improve access to services, overcome non-medical barriers to maximize health outcomes, coordinate care, provide meaningful integration, and monitor and address health disparities. The document concludes by describing a case study of a stroke risk screening program developed in North Carolina to identify modifiable stroke risks in high-risk communities.
Case Study 2The approach should include a combination of nutriti.docxwendolynhalbert
Case Study 2
The approach should include a combination of nutritional therapy as well as medication and other treatments. The home-based care program consisted of weekly home visits by a physician and a nurse. During visit, they have to assess the condition of patient, review of medications and made any necessary changes. Along with that, the needed laboratory tests were examined and the intravenous diuretics were administered. The patient compliance with the dosage regimen should also be determined on the basis of pill count which is followed by assessment of patient’s physical status. Since, the patients had poor knowledge about the regimen or poor compliance he must need the additional intervention. Moreover, the information derived from the home visit must be provided to the patient’s primary physicians. During initial visit, the nurse must educate and counsel the patients on the management and on behavioral techniques to enhance the compliance. It must be followed by telephone calls every week for 6 weeks with continued counseling so that he must be adhered to the diet and drug regimen plan as well as the self-monitoring of symptoms (Grady, et al., 2000).
The treatment plan should include the airway management as it is the critical first step. It is required since the elderly with heart failure can promptly fatigue and may require the emergent intubation. The diuretics such as Furosemide should be used to decrease the venous congestion however, the use must be regulated as in the elderly, there is age-related decline in the renal function as well as the decreased circulating volume (Emergency Physicians Monthly). For pulmonary edema, the morphine and IV nitrates should be used. Moreover, the symptoms caused by fluid retention may be treated with diuretic followed by the weight monitoring. Additional treatments include the use of ACE inhibitor according to the tolerability, β-blockers, digoxin or spironolactone. The angiotensin antagonists are also used in patients in whom ACE inhibition is contraindicated (Gillespie, 2005).
The education and counseling of heart failure patient are the essential part of patient care. It may reduce the re-admission of these patients along with cost of care. The education can be provided through mailing the personalized educational materials in which main emphasis was done on self-care and the recommended health behaviors were promoted (Serxner, Miyaji, & Jeffords, 1998). The wife can be educated about the risk of contracting the disease. Along with that, the history of the wife should also be assessed to determine her risk of contracting the disease due to hypertension. Moreover, the overviews of associated symptoms, activity and exercise, dietary recommendations, and medications are taught to patient and his wife. The written materials and videotapes can also be used as the additional resource for patient education (Quaglietti, Atwood, Ackerman, & Froelicher, 2000).
The teaching plan may involve the foll ...
There was a time when Man was the son of nature, interacting and part of the whole process of life. Then, as his fate, man progressed, invented, produced, flourished and finally prevailed on earth. He created artificial systems in which he lived, and at times seemed so close to being protected and safe from any natural phenomenal impact. Then he realized that his own creation, byproducts, beside his aggression against his own kind were being his enemy. In recent years, disasters increased in frequency, where grade 4 or more, hurricanes attacked the southern parts of the USA, as well in Asia. Large ice bergs cracked in Greenland, North and South poles, dissolving in the sea. There is an increase or rise of the Sea level, although it is few cms a year but it became a reality
https://crimsonpublishers.com/eaes/fulltext/EAES.000501.php
For more open access journals in Crimson Publishers
Please click on link: https://crimsonpublishers.com
For More Articles on Environmental Analysis & Ecology Studies
Please click on: https://crimsonpublishers.com/eaes/
This document provides biographical information on Dr. Subodh K. Agrawal, an interventional cardiologist. It lists his medical education, specializations, and interests. It also includes brief summaries of statistics on atrial fibrillation prevalence, costs, and treatment guidelines. Graphs show results from an analysis of 337 patients with non-valvular atrial fibrillation, including their risk levels, current antithrombotic therapy patterns, and documentation of therapy or lack thereof. The document emphasizes the importance of following guidelines for atrial fibrillation treatment and anticoagulation.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
approach to stemi in non pci centre.pptxShivani Rao
This document discusses strategies to improve care for ST-elevation myocardial infarction (STEMI) in India. It notes that STEMI is common in India, with patients often experiencing delays in receiving medical treatment. While international guidelines recommend primary percutaneous coronary intervention (PCI) for STEMI, this is often not available in India due to lack of infrastructure. As such, thrombolysis remains the main reperfusion strategy used in India. The document advocates for developing protocols and infrastructure to expedite diagnosis of STEMI and administration of reperfusion therapy. This includes training emergency responders to perform pre-hospital ECGs, transmit results to hospitals, and potentially administer drugs like aspirin and thrombolysis en route. The goal is to shorten
This document reviews recent advances in the management of pulmonary embolism (PE). Risk-adapted treatment and follow-up has led to more favorable outcomes for PE patients. Age-adjusted D-dimer cutoff levels can decrease overuse of imaging tests by increasing the specificity of D-dimer. New oral anticoagulants are effective alternatives to standard treatments. However, areas that require more research include the implications of subsegmental PE, diagnosing PE in pregnant patients, and the efficacy of new oral anticoagulants in cancer patients. Improving guideline implementation will further optimize PE management.
Predictive value of exercise myocardial perfusion imaging in the Medicare population: the impact of the ability to exercise
Authors: Deborah H. Kwon, Venu Menon, Penny Houghtaling, Elizabeth Lieber, Richard C. Brunken, Manuel D. Cerqueira, Wael A. Jaber
This study compared the cost-effectiveness of carotid artery stent placement (CAS) versus carotid endarterectomy (CEA) in high-risk patients based on data from the SAPPHIRE trial. The mean cost per quality-adjusted life year (QALY) gained was higher for CAS ($16,223) than for CEA ($12,745). The incremental cost-effectiveness ratio estimated CAS to be $67,891 more expensive per QALY gained than CEA, with a wide range. Although CAS was not inferior to CEA for outcomes, its higher cost offsets the marginal benefit for high-risk patients.
1) The study assessed the relationship between sudden sensorineural hearing loss (SSNHL) and white matter lesions visible on brain MRI, known as cerebral small vessel disease (CSVD).
2) Results showed that individuals with SSNHL aged 48-60 years have a 26% higher probability of having a Fazekas score indicating CSVD compared to the general population. Those under 28 years showed a statistically significant negative correlation.
3) Higher Fazekas scores, indicating more severe CSVD, were related to a decreased probability of hearing recovery in patients with SSNHL. The probability of recovery decreased from 80% in those under 48 with no lesions, to 14% in those with the most
La Hipertensión, es una de las mayores enfermedades que sufren los Hispanohablantes en el planeta . Es grato poder colocar este documento al público y haber podido hacer parte del equipo , ojalá sirvan a muchos las implementaciones. idioma más hablado según el foro Económico mundial - Me refiero al español ó castellano según sea -
segundo idioma y haber podido hacer parte de este equipo. Genuinamente, espero que se curen la mayor cantidad de personas con . Espero genuinamente puedan hacer algúna donación a este esfuerzo grupal. Espero Compartamos este "Paper" así como compartimos memes - En el sentido literal de la significancia-
** Refierase a Wikipedia sino tiene un diccionario a mano.
This study examined 2,112 patients admitted to the National Institute of Cardiovascular Diseases in Dhaka with heart failure. The average age was 46 years old, most were male. Common presenting symptoms were shortness of breath, leg edema, and orthopnea. Hypertension and diabetes were common comorbidities. The leading causes of heart failure were ischemic cardiomyopathy and chronic ischemic heart disease. The study aims to identify clinical presentations of heart failure patients to help determine best treatment approaches.
This study compared the long-term (18-month) outcomes of supervised exercise (SE), stent revascularization (ST), and optimal medical therapy (OMT) for patients with claudication due to aortoiliac peripheral artery disease. 79 patients completed the 18-month follow-up assessment. The study found that both SE and ST resulted in significantly greater improvements in peak walking time and claudication onset time compared to OMT. SE and ST also provided durable improvements in quality of life measures up to 18 months. Both SE and ST had better long-term outcomes than OMT alone for treating claudication, demonstrating the durability of exercise interventions for peripheral artery disease.
This study evaluated the cardiac event rate in 428 patients with known coronary artery disease (CAD) who had a normal stress myocardial perfusion scan (SPECT MPI). During a median follow-up of 3.1 years, all-cause mortality occurred in 60 patients (14%) and 41 patients (10%) died from cardiac causes. Non-fatal myocardial infarction (MI) occurred in 77 patients (18%). The annualized cardiac mortality and non-fatal MI rates were 2% and 3.6%, respectively. Smoking, congestive heart failure, and failure to achieve 85% of the age-predicted maximum heart rate were predictors of all-cause and cardiac mortality. Diabetes, dyslipidemia, smoking, and limited
This presentation by Gavin Giovannoni looks at the new treatment paradigm for MS. It includes: arguments for early treatment in multiple sclerosis, the effect of MS on quality of life and whether highly-effective treatments stabilise MS.
It was presented at the MS Trust Annual Conference in November 2013.
This document summarizes the key points from a lipidology conference presentation. It discusses recent guidelines and studies on cholesterol treatment, including more aggressive LDL lowering to under 70mg/dl for patients with cardiovascular disease. New tools for general cardiovascular risk prediction were presented. Treatment with high-dose statins was found to significantly reduce stroke recurrence and other outcomes for patients who had a stroke or TIA within the past 1-6 months. Immediate withdrawal of statins after acute stroke was associated with increased risks.
1) The study examined predictors of ischemia and outcomes in 169 Egyptian patients with diabetes referred for nuclear perfusion imaging over 2 years of follow up.
2) Significant relationships were found between higher summed stress scores and outcomes of sudden cardiac death, myocardial infarction, and heart failure. Higher summed rest scores also significantly predicted several adverse outcomes.
3) Degree of typical chest pain, transient left ventricular dilation, lung uptake on imaging, and extent of ischemia (summed difference score) were independent predictors of myocardial infarction. Transient left ventricular dilation was the strongest predictor of sudden cardiac death.
Central Adiposity and Mortality after First-Ever Acute Ischemic StrokeErwin Chiquete, MD, PhD
Erwin Chiquete a José L. Ruiz-Sandoval c Luis Murillo-Bonilla e
Carolina León-Jiménez g Bertha Ruiz-Madrigal d, f Erika Martínez-López d, f
Sonia Román d, f Arturo Panduro d, f Alma Ramos b Carlos Cantú-Brito
Background: The waist-to-height ratio (WHtR) may be a better
adiposity measure than the body mass index (BMI). We
evaluated the prognostic performance of WHtR in patients
with acute ischemic stroke (AIS). Methods: First, we compared
WHtR and BMI as adiposity measures in 712 healthy
adults by tetrapolar bioimpedance analysis. Thereafter,
baseline WHtR was analyzed as predictor of 12-month allcause
mortality in 821 Mexican mestizo adults with first-ever
AIS by a Cox proportional hazards model adjusted for baseline
predictors. Results: In healthy individuals, WHtR correlated
higher than BMI with total fat mass and showed a higher
accuracy in identifying a high percentage of body fat (p <
0.01). In AIS patients a U-shaped relationship was observed
between baseline WHtR and mortality (fatality rate 29.1%).
On multivariate analysis, baseline WHtR ≤ 0.300 or >0.800 independently
predicted 12-month all-cause mortality (h
Coronary heart disease is best addressed by a comprehensive approach aimed at halting atherosclerotic disease and reducing the risk of thrombosis. Unfortunately, our success in optimal risk factor modification in patients with stable CHD remains poor: only 41% of patients achieved all basic goals in the recent ISCHEMIA trial, with success rates likely even lower outside the rigorous clinical trial context. A greater focus on achieving prevention goals in patients with CHD will have a substantial impact on patient outcome and rates of hospitalization and more resources and incentives should be allocated for improved secondary prevention.
The ISCHEMIA trial suggests that even selected, high-risk patients with extensive ischemic burden do not benefit from revascularization barring unacceptable angina despite OMT. As ISCHEMIA excluded patients with unacceptable angina, advanced heart failure, and those with unprotected left main disease, our evaluation may be geared to identify such patients for consideration of revascularization alongside an initial strategy of OMT.
Atherosclerosis is a systemic disease of the arterial circulation, with focal areas of more severe manifestation. From an imaging standpoint, the paradigm of ischemia testing may have come to an end. Recent evidence from COURAGE, PROMISE, SCOT-HEART, and ISCHEMIA has demonstrated that functional testing for inducible myocardial ischemia is inferior to anatomic assessment for risk stratifying and managing patients with suspected or known CHD. Consistent with a large body of evidence, risk from CHD is mediated by the extent of atherosclerotic disease burden and not by the extent of inducible ischemia. Given that 55% of patients had nonobstructive CHD by CT in PROMISE, which was associated with 77% of cardiovascular deaths and myocardial infarctions at follow-up, there is immense opportunity to impact the disease at an earlier stage in a very large population of patients with occult CHD.
Los fármacos recomendados para iniciar el tratamiento antihipertensivo en este paciente son:
- Candesartán: por su demostrada capacidad para disminuir la hipertrofia ventricular izquierda y reducir la proteinuria, lo que es importante dado que el paciente presenta diabetes e hipertrofia ventricular.
- Telmisartán: al igual que el candesartán, ha demostrado reducir la proteinuria en pacientes diabéticos. Además, posee efecto antioxidante y antiaterogénico que son beneficiosos en este tipo de pacientes.
- V
This document discusses population health management and how it can help address health needs. It begins by defining population health management as improving systems and policies that affect healthcare quality, access, and outcomes to ultimately improve the health of an entire population. It then provides examples of individual-focused patient care policies and population-focused policies. Population-focused policies aim to improve access to services, overcome non-medical barriers to maximize health outcomes, coordinate care, provide meaningful integration, and monitor and address health disparities. The document concludes by describing a case study of a stroke risk screening program developed in North Carolina to identify modifiable stroke risks in high-risk communities.
Case Study 2The approach should include a combination of nutriti.docxwendolynhalbert
Case Study 2
The approach should include a combination of nutritional therapy as well as medication and other treatments. The home-based care program consisted of weekly home visits by a physician and a nurse. During visit, they have to assess the condition of patient, review of medications and made any necessary changes. Along with that, the needed laboratory tests were examined and the intravenous diuretics were administered. The patient compliance with the dosage regimen should also be determined on the basis of pill count which is followed by assessment of patient’s physical status. Since, the patients had poor knowledge about the regimen or poor compliance he must need the additional intervention. Moreover, the information derived from the home visit must be provided to the patient’s primary physicians. During initial visit, the nurse must educate and counsel the patients on the management and on behavioral techniques to enhance the compliance. It must be followed by telephone calls every week for 6 weeks with continued counseling so that he must be adhered to the diet and drug regimen plan as well as the self-monitoring of symptoms (Grady, et al., 2000).
The treatment plan should include the airway management as it is the critical first step. It is required since the elderly with heart failure can promptly fatigue and may require the emergent intubation. The diuretics such as Furosemide should be used to decrease the venous congestion however, the use must be regulated as in the elderly, there is age-related decline in the renal function as well as the decreased circulating volume (Emergency Physicians Monthly). For pulmonary edema, the morphine and IV nitrates should be used. Moreover, the symptoms caused by fluid retention may be treated with diuretic followed by the weight monitoring. Additional treatments include the use of ACE inhibitor according to the tolerability, β-blockers, digoxin or spironolactone. The angiotensin antagonists are also used in patients in whom ACE inhibition is contraindicated (Gillespie, 2005).
The education and counseling of heart failure patient are the essential part of patient care. It may reduce the re-admission of these patients along with cost of care. The education can be provided through mailing the personalized educational materials in which main emphasis was done on self-care and the recommended health behaviors were promoted (Serxner, Miyaji, & Jeffords, 1998). The wife can be educated about the risk of contracting the disease. Along with that, the history of the wife should also be assessed to determine her risk of contracting the disease due to hypertension. Moreover, the overviews of associated symptoms, activity and exercise, dietary recommendations, and medications are taught to patient and his wife. The written materials and videotapes can also be used as the additional resource for patient education (Quaglietti, Atwood, Ackerman, & Froelicher, 2000).
The teaching plan may involve the foll ...
There was a time when Man was the son of nature, interacting and part of the whole process of life. Then, as his fate, man progressed, invented, produced, flourished and finally prevailed on earth. He created artificial systems in which he lived, and at times seemed so close to being protected and safe from any natural phenomenal impact. Then he realized that his own creation, byproducts, beside his aggression against his own kind were being his enemy. In recent years, disasters increased in frequency, where grade 4 or more, hurricanes attacked the southern parts of the USA, as well in Asia. Large ice bergs cracked in Greenland, North and South poles, dissolving in the sea. There is an increase or rise of the Sea level, although it is few cms a year but it became a reality
https://crimsonpublishers.com/eaes/fulltext/EAES.000501.php
For more open access journals in Crimson Publishers
Please click on link: https://crimsonpublishers.com
For More Articles on Environmental Analysis & Ecology Studies
Please click on: https://crimsonpublishers.com/eaes/
This document provides biographical information on Dr. Subodh K. Agrawal, an interventional cardiologist. It lists his medical education, specializations, and interests. It also includes brief summaries of statistics on atrial fibrillation prevalence, costs, and treatment guidelines. Graphs show results from an analysis of 337 patients with non-valvular atrial fibrillation, including their risk levels, current antithrombotic therapy patterns, and documentation of therapy or lack thereof. The document emphasizes the importance of following guidelines for atrial fibrillation treatment and anticoagulation.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
Reimagining Your Library Space: How to Increase the Vibes in Your Library No ...Diana Rendina
Librarians are leading the way in creating future-ready citizens – now we need to update our spaces to match. In this session, attendees will get inspiration for transforming their library spaces. You’ll learn how to survey students and patrons, create a focus group, and use design thinking to brainstorm ideas for your space. We’ll discuss budget friendly ways to change your space as well as how to find funding. No matter where you’re at, you’ll find ideas for reimagining your space in this session.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
3. PROBLEM STATEMENT
INTRODUCTION
Heart diseases are the primary reason of deaths in adults.
In the last 10 years, from 2012 to 2021, there had been
a 54 per cent increase in heart attack deaths. Last year,
70 per cent of heart attack deaths occurred in the 30-60
age group. A total of 19,744 people aged 30 to 60 years
died due to heart attacks in 2021. Thus we need to find a
Method to predict any possibilities of CVDs.
NEXT
4. OBJECTIVE
Objective of this project is to check whether the patient
is likely to be diagnosed with any CVDs based on their
age, sex, chest pain, blood pressure, cholesterol.... Etc,
Using a classification model and enhancing its frequency.
INDEX
5. BACKGROUND
DATASET
S.No Attribute Name Description Range of values
1. Age Age of the person in years 28 to 77
2. Sex Gender of the person M, F
3. Chest Pain Type Typical Angina ,Atypical
Angina
,Non-angina pain,
Asymptomatic
4. RestingBP Blood Pressure in mm Hg 80 to 200
5. Cholestrol Serum cholesterol in mg/dl 0 to 603
6. FastingBS Fasting Blood Sugar in
mg/dl(1: >1200: < 120)
0, 1
7. RestingECG Electrocardiographic Results N, ST, LVH
8. Max HR Maximum Heart Rate Achieved 60 to 202
9 Exercise angina Exercise Induced Angina Y, N
10. Oldpeak ST depression induced by
exercise relative to res
-2.6 to 6.2
11. ST_Slope Slope of the Peak Exercise ST
segment
Up, Flat, Down
NEXT
6. RELATED WORK
• Robert Detrano, Andras Janosi, Walter Steinbrunn, Matthias Pfisterer, Johann-Jakob Schmid,
Sarbjit Sandhu, Kern H. Guppy, Stella Lee and Victor Froelicher in 1989 used the logistic
regression algorithm and predicted the dataset with 77% accuracy.
• In 2001 used multiple algorithms to predict the heart disease and came up with the accuracy of
81.48% using the Naïve Bayes algorithm.
• Polat, K., Sahan, S., Kodaz, H., Günes, S in 2005 used the AIS algorithm and came up with the
accuracy of 84.5%.
• Polat, K., S. Sahan, and S. Gunes in 2007 used Fuzzy-AIRS-KNN 8 algorithm and increased
het accuracy of model BY 87.0% .
• Lamia Abed Noor Muhammed in 2012 used the CLIP4 ensemble to increase the accuracy of
the model by 90.4% .
INDEX
7. Feature Extraction
Patient data and
health records
Medical Dataset
Machine Learning
Techniques
Linear Regression
Random Tree
Naïve Bayes
Discriminant Analysis
Ensemble
Performance Evaluation
Training Dataset
Testing Dataset
Selecting Best Model
Cardiovascular Prediction
FRAMEWORK
NEXT
8. RANDOM FOREST CLASSIFIER
● Random forests or random decision forests is a learning
method for classification.
● Like its name implies, it consists of a large number of
individual decision trees that operate as an group.
● Each individual tree in the random forest spits out a
class prediction and the class with the most votes
becomes our model’s prediction
INDEX
9. RESULT
MODEL ACCURACY
rf Random Forest Classifier 91.20 %
gbc Gradiant Boosting Classifier 89.97%
lightgbm Light Gradiant Boosting
Classifier
89.56%
Following pie chart shows that from the given data there were 42.14%
people diagnosed negative and 57.86% people diagnosed positive
with heart disease.Other pie chart shows, from the given data there
were 42.43% people predicted negative and 58.57% people predicted
positive with heart disease.
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10. • It is found that the group between 50 and 65 had the highest frequency/occurance
in the given dataset.
• It was found that out of total positive cases of heart disease, 77% of the cases
showed no symptom of any chest pain i.e., they were asymptomatic.
INDEX
11. FUTURE SCOPE
It should be recognized that, although prevention will delay or even
prevent the
onset of CVD and the cost of cardiovascular treatment, patients will
need
medical care longer and the lifetime cost of care may not be reduced
as patients
live longer. Thus, prevention strategies should not be evaluated
solely on their
ability to reduce cost of care, but instead they should be valued
based on a
combination of cost and impact on patient well being, including the
length and
quality of life.
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