117 results on '"McQuillan, B"'
Search Results
2. The Diagnostic Yield and Clinical Utility of CMR in Myocardial Infarction With Non-Obstructed Coronary Arteries
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Giudicatti, L., Telyuk, P., Pasupathy, S., Chieng, D., McQuillan, B., Austin, D., Maredia, N., Hillis, G., Beltrame, J., Dwivedi, G., and Rajwani, A.
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- 2023
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3. Pooled Safety and Efficacy of Inclisiran in Patients With Statin Intolerance (ORION-10 and ORION-11)
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McQuillan, B., Wright, R., Kallend, D., Raal, F., Stoekenbroek, R., Koenig, W., Leiter, L., Landmesser, U., Schwartz, G., Wijngaard, P., Kastelein, J., and Ray, K.
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- 2023
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4. Variability of Antiplatelet and Statin Prescription In Australia for Myocardial Infarction With Non-Obstructed Coronary Arteries
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Giudicatti, L., Pasupathy, S., Chieng, D., McQuillan, B., Hillis, G., Beltrame, J., Dwivedi, G., and Rajwani, A.
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- 2023
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5. Circulating adiponectin levels associate with inflammatory markers, insulin resistance and metabolic syndrome independent of obesity
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Hung, J, McQuillan, B M, Thompson, P L, and Beilby, J P
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- 2008
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6. The C-480T hepatic lipase polymorphism is associated with HDL-C but not with risk of coronary heart disease
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McCaskie, P A, Cadby, G, Hung, J, McQuillan, B M, Chapman, C M L, Carter, K W, Thompson, P L, Palmer, L J, and Beilby, J P
- Published
- 2006
7. Impact of Pre-Hospital Activation of ST-segment Elevation Myocardial Infarction on Rate of False Positive Activation and Door to Balloon Time
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Shoaib, M., Woollard, E., Huish, W., Aguila, J., and McQuillan, B.
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- 2021
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8. Factors Influencing Delay in Door to Balloon Time in Inter-Hospital Transfer STEMI Patients
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Shoaib, M., Wollard, E., Huish, W., Aguila, J., and McQuillan, B.
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- 2021
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9. Sodium-glucose Co-transporter 2 Inhibitor use and Barriers to Prescription in a Tertiary Cardiology Department
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Ng, D. and McQuillan, B.
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- 2021
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10. 230 Machine Learning Models for Predicting Ischemic Stroke and Major Bleeding Risk in Patients with Atrial Fibrillation
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Lu, J., Dwivedi, G., Sanfilippo, F., Bennamoun, M., Hung, J., Briffa, T., Sohel, F., Hutchens, R., Stewart, J., Chow, B., and McQuillan, B.
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- 2020
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11. The reaction of hf with polyacetylene
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McQuillan, B., Street, G. B., and Clarke, T. C.
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- 1982
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12. A Positive Score for Depressive Symptoms Using the Patient Health Questionnaire-9: To What Extent is This Information Used to Inform Care in the Community?
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Crittenden, J., Collins, S., and McQuillan, B.
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- 2018
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13. Ischaemic Stroke and the Echo ‘Bubble Study’: Are we Screening the Right Patients? A Multicentre Experience from Western Australia
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Maggiore, P., Bellinge, J., Chieng, D., White, D., Lan, N., Jaltotage, B., Ali, U., Gordon, M., Chung, K., Stobie, P., Ng, J., Hankey, G., and McQuillan, B.
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- 2018
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14. Factors Associated with Escalating Hospitalisations for Non–Valvular Atrial Fibrillation in Western Australia Between 2000 and 2013
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Weber, C., Hung, J., Hickling, S., McQuillan, B., Li, I., and Briffa, T.
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- 2018
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15. Appropriate Selection of Oral Anticoagulant (OAC) Therapy for Stroke Prevention Among Older Subjects with Atrial Fibrillation (AF) Has Improved Over Time but an Evidence Treatment Gap Persists
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Hutchens, R., McQuillan, B., Briffa, T., and Hung, J.
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- 2017
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16. Underutilisation of Oral Anticoagulation (OAC) Therapy for Stroke Prevention in Non-Valvular Atrial Fibrillation (AF) Management Among Women
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Hutchens, R., McQuillan, B., Briffa, T., and Hung, J.
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- 2017
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17. Translating the Evidence in Atrial Fibrillation Management. Can We Improve Appropriate Use of Anticoagulation Through the Use of an Electronic Clinical Decision Support Tool?
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Hutchens, R., McQuillan, B., Briffa, T., and Hung, J.
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- 2017
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18. Familial Hypercholesterolaemia and Lipoprotein(a) Phenotypes in a Community-Based Cohort: Associations with Carotid Intima-Media Thickness, Focal Plaque and Cardiovascular Outcomes
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Ellis, K., Ooi, E., Barrett, H., Chan, D., Hung, J., Thompson, P., Beilby, J., Watts, G., and McQuillan, B.
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- 2017
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19. Management of Suspected Acute Coronary Syndromes in a Regional Australian Hospital: An Audit of Adherence with Guidelines.
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Quartermaine, T. and McQuillan, B.
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- 2017
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20. Contemporary Management of Acute Coronary Syndrome in a Large Urban Tertiary Referral Centre
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Naing, P., Chung, K., Htwe, S., Pattani, S., De Varona, G., Stobie, P., Bhullar, D., Yeow, W., and McQuillan, B.
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- 2017
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21. Echocardiographic Pulmonary Left Atrial Ratio (ePLAR): Is it a Clinically Useful, Noninvasive Measure to Help Identify Patients with Left-Heart Causes of Pulmonary Hypertension?
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Ng, P. and McQuillan, B.
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- 2016
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22. Assessment of management for heart failure with preserved ejection fraction
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Lee, F., Bachmann, D., and McQuillan, B.
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- 2015
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23. Trends in incidence and prevalence of hospitalisation for atrial fibrillation and associated mortality in Western Australia, 1995–2010
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Briffa, T., Hung, J., Knuiman, M., McQuillan, B., Chew, D., Eikelboom, J., Hankey, G., Nedkoff, L., Weerasooriya, R., Liu, A., and Stobie, P.
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- 2015
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24. Developing a commercial production process for 500 000 targets per day: A key challenge for inertial fusion energy.
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Goodin, D. T., Alexander, N. B., Besenbruch, G. E., Bozek, A. S., Brown, L. C., Carlson, L. C., Flint, G. W., Goodman, P., Kilkenny, J. D., Maksaereekul, W., McQuillan, B. W., Nikroo, A., Paguio, R. R., Petzoldt, R. W., Raffray, R., Schroen, D. G., Sheliak, J. D., Spalding, J., Streit, J. E., and Tillack, M. S.
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INERTIAL confinement fusion ,POWER plants ,LOW temperature engineering ,ELECTRIC power production ,CRYOELECTRONICS ,POWER resources ,FUEL - Abstract
As is true for current-day commercial power plants, a reliable and economic fuel supply is essential for the viability of future Inertial Fusion Energy (IFE) [Energy From Inertial Fusion, edited by W. J. Hogan (International Atomic Energy Agency, Vienna, 1995)] power plants. While IFE power plants will utilize deuterium-tritium (DT) bred in-house as the fusion fuel, the “target” is the vehicle by which the fuel is delivered to the reaction chamber. Thus the cost of the target becomes a critical issue in regard to fuel cost. Typically six targets per second, or about 500 000/day are required for a nominal 1000 MW(e) power plant. The electricity value within a typical target is about $3, allocating 10% for fuel cost gives only 30 cents per target as-delivered to the chamber center. Complicating this economic goal, the target supply has many significant technical challenges—fabricating the precision fuel-containing capsule, filling it with DT, cooling it to cryogenic temperatures, layering the DT into a uniform layer, characterizing the finished product, accelerating it to high velocity for injection into the chamber, and tracking the target to steer the driver beams to meet it with micron-precision at the chamber center. [ABSTRACT FROM AUTHOR]
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- 2006
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25. Serum ferritin and C282Y mutation of the hemochromatosis gene as predictors of asymptomatic carotid atherosclerosis in a community population.
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Rossi, E, McQuillan, B M, Hung, J, Thompson, P L, Kuek, C, and Beilby, J P
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- 2000
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26. LoDoCo: LOw DOse COlchicine in Stable Coronary Artery Disease and the Effect on hs-CRP and Brachial Flow Mediated Dilation
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Judkins, C., Thompson, P., Nidorf, M., and McQuillan, B.
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- 2011
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27. False Positive Rates in Patients Undergoing Emergency Coronary Angiography for Suspected STEMI is Not Increased with Emergency Physician Activation of The Cardiac Catheterisation Laboratory
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Willson, A., Mountain, D., Jeffers, J., Blanton, C., McQuillan, B., Hung, J., Muhlman, M., and Nguyen, M.
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- 2010
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28. Cardiology verses Emergency Physician Activation of the Cardiac Catheterisation Laboratory in ST Elevation Myocardial Infarction: Effect on Door to Balloon Times
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Willson, A., Mountain, D., Jeffers, J., Blanton, C., McQuillan, B., Hung, J., Muhlman, M., and Nguyen, M.
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- 2010
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29. An Integrated Approach to Predicting Response to Cardiac Reysnchronisation Therapy (CRT)
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Ng, J., Jenkins, G., McQuillan, B., Stobie, P., Cooke, P., Paul, V., and Stoyanov, N.
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- 2010
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30. The chemistry of polyacetylene doping.
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Clarke, T. C., Mcquillan, B. W., Rabolt, J. F., Scott, J. C., and Street, G. B.
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- 1983
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31. Determining the optimal level of compliance with evidence-based treatment in acute coronary syndromes
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Thomson, D., McQuillan, B., Hung, J., and Bloomer, S.
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- 2009
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32. The Different Patterns of Myocardial Velocity Curves as Assessed by Colour Tissue Velocity Imaging
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Ng, J., Jenkins, G., Turnbull, A., Lansdown, L., and McQuillan, B.
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- 2009
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33. Abnormal Glucose Regulation in Patients with Acute Coronary Syndromes
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Chih, S., McQuillan, B., Kaye, J., Wilson, D., Beilby, J., and Hung, J.
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- 2007
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34. Novel salts of graphite and a boron nitride salt.
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Bartlett, Neil, Biagioni, R. N., McQuillan, B. W., Robertson, A. S., and Thompson, A. C.
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- 1978
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35. 4P-1083 Interrelationship of inflammatory markers with cardiovascular and lifestyle risk factors in a community population
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Hung, J., McQuillan, B., Chapman, C., Thompson, P., and Beilby, J.
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- 2003
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36. The synthesis of the first stage graphite salt C 8+AsF 6− and its relationship to the first stage graphite/AsF 5 intercalate
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Bartlett, N, McQuillan, B, and Robertson, A.S
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- 1978
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37. Differences in cardiovascular risk factors and carotid IMT in Australian Indians and Caucasians with type-2 diabetes mellitus; an ethnic predisposition to atherosclerosis?
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Harmer, J., Chow, C., McQuillan, B., and Celermajer, D.
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CARDIOVASCULAR diseases risk factors , *INFORMATION manipulation theory , *CAUCASIAN race , *TYPE 2 diabetes , *DISEASE susceptibility , *ATHEROSCLEROSIS ,CAROTID artery abnormalities - Published
- 2015
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38. 4P-1078 Monocyte cell count as an inflammatory marker for carotid plaque
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Chapman, C., Beilby, J., McQuillan, B., Thompson, P., and Hung, J.
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- 2003
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39. Children's emotional and behavioral disorders: attributions of parental responsibility by professionals.
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Johnson, Harriette C., Cournoyer, David E., Johnson, H C, Cournoyer, D E, Fisher, G A, McQuillan, B E, Moriarty, S, Richert, A L, Stanek, E J, Stockford, C L, and Yirigian, B R
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MENTAL health personnel , *MENTAL illness , *PARENTING , *ATTITUDE (Psychology) , *MEDICAL personnel , *BEHAVIOR disorders in children , *CHILD psychiatry , *ALEXITHYMIA , *CHILD psychology , *SOCIAL responsibility , *SOCIAL case work , *PSYCHOLOGICAL factors - Abstract
In the wake of the neurobiological "revolution," do mental health professionals still assign etiological responsibility for emotional and behavioral disorders to deficient or harmful parenting? This study investigated differences in attributions of causality by theoretical orientation, professional discipline, areas of practice, familiarity with parent support groups, and demographic characteristics. Implications for policy, research, and practice are discussed. [ABSTRACT FROM AUTHOR]
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- 2000
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40. Lack of association between seropositivity to Chlamydia pneumoniae and carotid atherosclerosis.
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Coles, Katie A., Plant, Aileen J., Coles, K A, Plant, A J, Riley, T V, Smith, D W, McQuillan, B M, and Thompson, P L
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HIV infections , *CHLAMYDOPHILA pneumoniae , *ATHEROSCLEROSIS - Abstract
Since the Chlamydia pneumoniae (C. pneumoniae)-specific antibody was shown to be associated with acute myocardial infarction and chronic coronary heart disease, the role of C. pneumoniae in the etiology of cardiovascular disease has been studied by a number of groups. We investigated the association between the C. pneumoniae-specific antibody, measured by microimmunofluorescence, risk factors for cardiovascular disease, and atherosclerosis in a randomly selected urban population. Overall, immunoglobulin-G (IgG) seroprevalence to C. pneumoniae in this sample of 1,034 subjects was 58%, whereas IgA seroprevalence was 32%. There was a decline in seropositivity with age for IgG but not IgA. Men were more likely than women to be IgG (66% vs 51%, chi-square p = 0.001) and IgA seropositive (36% vs 28%, chi-square p = 0.005). Current smokers had higher IgA seropositivity than nonsmokers (43% vs 30%). Those patients with a family history of cerebrovascular disease were more likely to have IgG antibody than those without (75% vs 57%, chi-square p= 0.007). Neither IgG nor IgA seropositivity was associated with the standard risk factors of hypertension, hyperlipidemia, or family history of ischemic heart disease, nor was seropositivity associated with carotid intima medial thickening (IMT) or atherosclerotic plaque as measured by carotid B-mode ultrasound. There was no difference between those participants who were IgG or IgA seropositive and seronegative in measurements of mean IMT, prevalence of abnormal IMT, and percentage with atherosclerotic plaque. In conclusion, although C. pneumoniae was associated with several risk factors for cardiovascular disease in a large cross-sectional population, we found no independent association between seroprevalence to C. pneumoniae and carotid atherosclerosis as measured by carotid IMT. [ABSTRACT FROM AUTHOR]
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- 1999
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41. Online sexual abuse and exploitation of children in the Philippines: An exploratory study of outcomes after reintegration into the community.
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Scroger M, Draper RS, and McQuillan B
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- Humans, Philippines, Female, Male, Adolescent, Child, Survivors psychology, Internet, Psychosocial Functioning, Child Abuse, Sexual psychology
- Abstract
Background: This study examined psychosocial outcomes for Filipino survivors of online sexual abuse and exploitation of children (OSAEC)., Objective: This study aimed to identify relationships between demographic variables, self-reported and caregiver-reported trauma symptoms, and psychosocial functioning among Filipino youth who have experienced OSAEC., Participants and Setting: This study utilized inclusion criteria of survivors of OSAEC between ages 12 and 18 who received residential care and were reintegrated into the community for at least one year (N = 48). Participants were in care at shelters associated with Project PAVE in the Philippines., Methods: As measured by three assessment tools, relationships between demographic variables and psychosocial functioning were explored for risk and protective factors of trauma symptoms and psychosocial functioning to better understand this population's needs post-integration., Results: Results suggest survivors continue to experience psychosocial symptoms after reintegration. Caregivers reported survivors reintegrated outside the home had significantly higher externalizing symptoms (MR = 6.67; H(3) = 14.85, p = .002, η
2 = 0.27) compared to survivors reintegrated within the home and survivors who trafficked themselves to have higher internalizing symptoms (MR = 16.79; H(3) = 11.80; p = .008, η2 = 0.20) than survivors trafficked by a relative. Caregivers reported survivors who resided in the shelter for one month or less to have higher internalizing symptoms (MR = 20.12; H(2) = 11.06; p = .004; η2 = 0.20) than survivors who resided in the shelter for six months or longer., Conclusion: This study highlights the importance of further research to better understand the needs of this vulnerable population in order to guide the most effective intervention, aftercare, and reintegration programs to support survivors and their caregivers., (Copyright © 2024 Elsevier Ltd. All rights reserved.)- Published
- 2024
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42. Predicting multifaceted risks using machine learning in atrial fibrillation: insights from GLORIA-AF study.
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Lu J, Bisson A, Bennamoun M, Zheng Y, Sanfilippo FM, Hung J, Briffa T, McQuillan B, Stewart J, Figtree G, Huisman MV, Dwivedi G, and Lip GYH
- Abstract
Aims: Patients with atrial fibrillation (AF) have a higher risk of ischaemic stroke and death. While anticoagulants are effective at reducing these risks, they increase the risk of bleeding. Current clinical risk scores only perform modestly in predicting adverse outcomes, especially for the outcome of death. We aimed to test the multi-label gradient boosting decision tree (ML-GBDT) model in predicting risks for adverse outcomes in a prospective global AF registry., Methods and Results: We studied patients from phase II/III of the Global Registry on Long-Term Oral Anti-Thrombotic Treatment in Patients with Atrial Fibrillation registry between 2011 and 2020. The outcomes were all-cause death, ischaemic stroke, and major bleeding within 1 year following the AF. We trained the ML-GBDT model and compared its discrimination with the clinical scores in predicting patient outcomes. A total of 25 656 patients were included [mean age 70.3 years (SD 10.3); 44.8% female]. Within 1 year after AF, ischaemic stroke occurred in 215 (0.8%), major bleeding in 405 (1.6%), and death in 897 (3.5%) patients. Our model achieved an optimized area under the curve in predicting death (0.785, 95% CI: 0.757-0.813) compared with the Charlson Comorbidity Index (0.747, P = 0.007), ischaemic stroke (0.691, 0.626-0.756) compared with CHA
2 DS2 -VASc (0.613, P = 0.028), and major bleeding (0.698, 0.651-0.745) as opposed to HAS-BLED (0.607, P = 0.002), with improvement in net reclassification index (10.0, 12.5, and 23.6%, respectively)., Conclusion: The ML-GBDT model outperformed clinical risk scores in predicting the risks in patients with AF. This approach could be used as a single multifaceted holistic tool to optimize patient risk assessment and mitigate adverse outcomes when managing AF., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)- Published
- 2024
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43. Achievement of Target Gain Larger than Unity in an Inertial Fusion Experiment.
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Abu-Shawareb H, Acree R, Adams P, Adams J, Addis B, Aden R, Adrian P, Afeyan BB, Aggleton M, Aghaian L, Aguirre A, Aikens D, Akre J, Albert F, Albrecht M, Albright BJ, Albritton J, Alcala J, Alday C, Alessi DA, Alexander N, Alfonso J, Alfonso N, Alger E, Ali SJ, Ali ZA, Allen A, Alley WE, Amala P, Amendt PA, Amick P, Ammula S, Amorin C, Ampleford DJ, Anderson RW, Anklam T, Antipa N, Appelbe B, Aracne-Ruddle C, Araya E, Archuleta TN, Arend M, Arnold P, Arnold T, Arsenlis A, Asay J, Atherton LJ, Atkinson D, Atkinson R, Auerbach JM, Austin B, Auyang L, Awwal AAS, Aybar N, Ayers J, Ayers S, Ayers T, Azevedo S, Bachmann B, Back CA, Bae J, Bailey DS, Bailey J, Baisden T, Baker KL, Baldis H, Barber D, Barberis M, Barker D, Barnes A, Barnes CW, Barrios MA, Barty C, Bass I, Batha SH, Baxamusa SH, Bazan G, Beagle JK, Beale R, Beck BR, Beck JB, Bedzyk M, Beeler RG, Beeler RG, Behrendt W, Belk L, Bell P, Belyaev M, Benage JF, Bennett G, Benedetti LR, Benedict LX, Berger RL, Bernat T, Bernstein LA, Berry B, Bertolini L, Besenbruch G, Betcher J, Bettenhausen R, Betti R, Bezzerides B, Bhandarkar SD, Bickel R, Biener J, Biesiada T, Bigelow K, Bigelow-Granillo J, Bigman V, Bionta RM, Birge NW, Bitter M, Black AC, Bleile R, Bleuel DL, Bliss E, Bliss E, Blue B, Boehly T, Boehm K, Boley CD, Bonanno R, Bond EJ, Bond T, Bonino MJ, Borden M, Bourgade JL, Bousquet J, Bowers J, Bowers M, Boyd R, Boyle D, Bozek A, Bradley DK, Bradley KS, Bradley PA, Bradley L, Brannon L, Brantley PS, Braun D, Braun T, Brienza-Larsen K, Briggs R, Briggs TM, Britten J, Brooks ED, Browning D, Bruhn MW, Brunner TA, Bruns H, Brunton G, Bryant B, Buczek T, Bude J, Buitano L, Burkhart S, Burmark J, Burnham A, Burr R, Busby LE, Butlin B, Cabeltis R, Cable M, Cabot WH, Cagadas B, Caggiano J, Cahayag R, Caldwell SE, Calkins S, Callahan DA, Calleja-Aguirre J, Camara L, Camp D, Campbell EM, Campbell JH, Carey B, Carey R, Carlisle K, Carlson L, Carman L, Carmichael J, Carpenter A, Carr C, Carrera JA, Casavant D, Casey A, Casey DT, Castillo A, Castillo E, Castor JI, Castro C, Caughey W, Cavitt R, Celeste J, Celliers PM, Cerjan C, Chandler G, Chang B, Chang C, Chang J, Chang L, Chapman R, Chapman TD, Chase L, Chen H, Chen H, Chen K, Chen LY, Cheng B, Chittenden J, Choate C, Chou J, Chrien RE, Chrisp M, Christensen K, Christensen M, Christiansen NS, Christopherson AR, Chung M, Church JA, Clark A, Clark DS, Clark K, Clark R, Claus L, Cline B, Cline JA, Cobble JA, Cochrane K, Cohen B, Cohen S, Collette MR, Collins GW, Collins LA, Collins TJB, Conder A, Conrad B, Conyers M, Cook AW, Cook D, Cook R, Cooley JC, Cooper G, Cope T, Copeland SR, Coppari F, Cortez J, Cox J, Crandall DH, Crane J, Craxton RS, Cray M, Crilly A, Crippen JW, Cross D, Cuneo M, Cuotts G, Czajka CE, Czechowicz D, Daly T, Danforth P, Danly C, Darbee R, Darlington B, Datte P, Dauffy L, Davalos G, Davidovits S, Davis P, Davis J, Dawson S, Day RD, Day TH, Dayton M, Deck C, Decker C, Deeney C, DeFriend KA, Deis G, Delamater ND, Delettrez JA, Demaret R, Demos S, Dempsey SM, Desjardin R, Desjardins T, Desjarlais MP, Dewald EL, DeYoreo J, Diaz S, Dimonte G, Dittrich TR, Divol L, Dixit SN, Dixon J, Do A, Dodd ES, Dolan D, Donovan A, Donovan M, Döppner T, Dorrer C, Dorsano N, Douglas MR, Dow D, Downie J, Downing E, Dozieres M, Draggoo V, Drake D, Drake RP, Drake T, Dreifuerst G, Drury O, DuBois DF, DuBois PF, Dunham G, Durocher M, Dylla-Spears R, Dymoke-Bradshaw AKL, Dzenitis B, Ebbers C, Eckart M, Eddinger S, Eder D, Edgell D, Edwards MJ, Efthimion P, Eggert JH, Ehrlich B, Ehrmann P, Elhadj S, Ellerbee C, Elliott NS, Ellison CL, Elsner F, Emerich M, Engelhorn K, England T, English E, Epperson P, Epstein R, Erbert G, Erickson MA, Erskine DJ, Erlandson A, Espinosa RJ, Estes C, Estabrook KG, Evans S, Fabyan A, Fair J, Fallejo R, Farmer N, Farmer WA, Farrell M, Fatherley VE, Fedorov M, Feigenbaum E, Fehrenbach T, Feit M, Felker B, Ferguson W, Fernandez JC, Fernandez-Panella A, Fess S, Field JE, Filip CV, Fincke JR, Finn T, Finnegan SM, Finucane RG, Fischer M, Fisher A, Fisher J, Fishler B, Fittinghoff D, Fitzsimmons P, Flegel M, Flippo KA, Florio J, Folta J, Folta P, Foreman LR, Forrest C, Forsman A, Fooks J, Foord M, Fortner R, Fournier K, Fratanduono DE, Frazier N, Frazier T, Frederick C, Freeman MS, Frenje J, Frey D, Frieders G, Friedrich S, Froula DH, Fry J, Fuller T, Gaffney J, Gales S, Le Galloudec B, Le Galloudec KK, Gambhir A, Gao L, Garbett WJ, Garcia A, Gates C, Gaut E, Gauthier P, Gavin Z, Gaylord J, Geddes CGR, Geissel M, Génin F, Georgeson J, Geppert-Kleinrath H, Geppert-Kleinrath V, Gharibyan N, Gibson J, Gibson C, Giraldez E, Glebov V, Glendinning SG, Glenn S, Glenzer SH, Goade S, Gobby PL, Goldman SR, Golick B, Gomez M, Goncharov V, Goodin D, Grabowski P, Grafil E, Graham P, Grandy J, Grasz E, Graziani FR, Greenman G, Greenough JA, Greenwood A, Gregori G, Green T, Griego JR, Grim GP, Grondalski J, Gross S, Guckian J, Guler N, Gunney B, Guss G, Haan S, Hackbarth J, Hackel L, Hackel R, Haefner C, Hagmann C, Hahn KD, Hahn S, Haid BJ, Haines BM, Hall BM, Hall C, Hall GN, Hamamoto M, Hamel S, Hamilton CE, Hammel BA, Hammer JH, Hampton G, Hamza A, Handler A, Hansen S, Hanson D, Haque R, Harding D, Harding E, Hares JD, Harris DB, Harte JA, Hartouni EP, Hatarik R, Hatchett S, Hauer AA, Havre M, Hawley R, Hayes J, Hayes J, Hayes S, Hayes-Sterbenz A, Haynam CA, Haynes DA, Headley D, Heal A, Heebner JE, Heerey S, Heestand GM, Heeter R, Hein N, Heinbockel C, Hendricks C, Henesian M, Heninger J, Henrikson J, Henry EA, Herbold EB, Hermann MR, Hermes G, Hernandez JE, Hernandez VJ, Herrmann MC, Herrmann HW, Herrera OD, Hewett D, Hibbard R, Hicks DG, Higginson DP, Hill D, Hill K, Hilsabeck T, Hinkel DE, Ho DD, Ho VK, Hoffer JK, Hoffman NM, Hohenberger M, Hohensee M, Hoke W, Holdener D, Holdener F, Holder JP, Holko B, Holunga D, Holzrichter JF, Honig J, Hoover D, Hopkins D, Berzak Hopkins LF, Hoppe M, Hoppe ML, Horner J, Hornung R, Horsfield CJ, Horvath J, Hotaling D, House R, 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- Abstract
On December 5, 2022, an indirect drive fusion implosion on the National Ignition Facility (NIF) achieved a target gain G_{target} of 1.5. This is the first laboratory demonstration of exceeding "scientific breakeven" (or G_{target}>1) where 2.05 MJ of 351 nm laser light produced 3.1 MJ of total fusion yield, a result which significantly exceeds the Lawson criterion for fusion ignition as reported in a previous NIF implosion [H. Abu-Shawareb et al. (Indirect Drive ICF Collaboration), Phys. Rev. Lett. 129, 075001 (2022)PRLTAO0031-900710.1103/PhysRevLett.129.075001]. This achievement is the culmination of more than five decades of research and gives proof that laboratory fusion, based on fundamental physics principles, is possible. This Letter reports on the target, laser, design, and experimental advancements that led to this result.
- Published
- 2024
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44. Performance of multilabel machine learning models and risk stratification schemas for predicting stroke and bleeding risk in patients with non-valvular atrial fibrillation.
- Author
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Lu J, Hutchens R, Hung J, Bennamoun M, McQuillan B, Briffa T, Sohel F, Murray K, Stewart J, Chow B, Sanfilippo F, and Dwivedi G
- Subjects
- Humans, Female, Aged, Male, Retrospective Studies, Risk Assessment, Hemorrhage, Anticoagulants adverse effects, Risk Factors, Atrial Fibrillation complications, Atrial Fibrillation drug therapy, Stroke drug therapy
- Abstract
Background: Appropriate anticoagulant therapy for patients with atrial fibrillation (AF) requires assessment of stroke and bleeding risks. However, risk stratification schemas such as CHA
2 DS2 -VASc and HAS-BLED have modest predictive capacity for patients with AF. Multilabel machine learning (ML) techniques may improve predictive performance and support decision-making for anticoagulant therapy. We compared the performance of multilabel ML models with the currently used risk scores for predicting outcomes in AF patients., Methods: This was a retrospective cohort study of 9670 patients, mean age 76.9 years, 46% women, who were hospitalized with non-valvular AF, and had 1-year follow-up. The outcomes were ischemic stroke (167), major bleeding (430) admissions, all-cause death (1912) and event-free survival (7387). Discrimination and calibration of ML models were compared with clinical risk scores by area under the curve (AUC). Risk stratification was assessed using net reclassification index (NRI)., Results: Multilabel gradient boosting classifier chain provided the best AUCs for stroke (0.685 95% CI 0.676, 0.694), major bleeding (0.709 95% CI 0.703, 0.716) and death (0.765 95% CI 0.763, 0.768) compared to multi-layer neural networks and classifier chain using support vector machine. It provided modest performance improvement for stroke compared to AUC of CHA2 DS2 -VASc (0.652, NRI = 3.2%, p-value = 0.1), but significantly improved major bleeding prediction compared to AUC of HAS-BLED (0.522, NRI = 22.8%, p-value < 0.05). It also achieved greater discriminant power for death compared with AUC of CHA2 DS2 -VASc (0.606, p-value < 0.05). ML models identified additional risk features such as hemoglobin level, renal function., Conclusions: Multilabel ML models can outperform clinical risk stratification scores for predicting the risk of major bleeding and death in non-valvular AF patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)- Published
- 2022
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45. Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment.
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Kritcher AL, Krieger E, Kroll JJ, Kruer WL, Kruse MKG, Kucheyev S, Kumbera M, Kumpan S, Kunimune J, Kustowski B, Kwan TJT, Kyrala GA, Laffite S, Lafon M, LaFortune K, Lahmann B, Lairson B, Landen OL, Langenbrunner J, Lagin L, Land T, Lane M, Laney D, Langdon AB, Langer SH, Langro A, Lanier NE, Lanier TE, Larson D, Lasinski BF, Lassle D, LaTray D, Lau G, Lau N, Laumann C, Laurence A, Laurence TA, Lawson J, Le HP, Leach RR, Leal L, Leatherland A, LeChien K, Lechleiter B, Lee A, Lee M, Lee T, Leeper RJ, Lefebvre E, Leidinger JP, LeMire B, Lemke RW, Lemos NC, Le Pape S, Lerche R, Lerner S, Letts S, Levedahl K, Lewis T, Li CK, Li H, Li J, Liao W, Liao ZM, Liedahl D, Liebman J, Lindford G, Lindman EL, Lindl JD, Loey H, London RA, Long F, Loomis EN, Lopez FE, Lopez H, Losbanos E, Loucks S, Lowe-Webb R, Lundgren E, Ludwigsen AP, Luo R, Lusk J, Lyons R, Ma T, Macallop Y, MacDonald MJ, MacGowan BJ, Mack JM, Mackinnon AJ, MacLaren SA, MacPhee AG, Magelssen GR, Magoon J, Malone RM, Malsbury T, Managan R, Mancini R, Manes K, Maney D, Manha D, Mannion OM, Manuel AM, Mapoles E, Mara G, Marcotte T, Marin E, Marinak MM, Mariscal C, Mariscal DA, Mariscal EF, Marley EV, Marozas JA, Marquez R, Marshall CD, Marshall FJ, Marshall M, Marshall S, Marticorena J, Martinez D, Maslennikov I, Mason D, Mason RJ, Masse L, Massey W, Masson-Laborde PE, Masters ND, Mathisen D, Mathison E, Matone J, Matthews MJ, Mattoon C, Mattsson TR, Matzen K, Mauche CW, Mauldin M, McAbee T, McBurney M, Mccarville T, McCrory RL, McEvoy AM, McGuffey C, Mcinnis M, McKenty P, McKinley MS, McLeod JB, McPherson A, Mcquillan B, Meamber M, Meaney KD, Meezan NB, Meissner R, Mehlhorn TA, Mehta NC, Menapace J, Merrill FE, Merritt BT, Merritt EC, Meyerhofer DD, Mezyk S, Mich RJ, Michel PA, Milam D, Miller C, Miller D, Miller DS, Miller E, Miller EK, Miller J, Miller M, Miller PE, Miller T, Miller W, Miller-Kamm V, Millot M, Milovich JL, Minner P, Miquel JL, Mitchell S, Molvig K, Montesanti RC, Montgomery DS, Monticelli M, 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Person S, Petersen D, Petersen T, Peterson DL, Peterson EB, Peterson JE, Peterson JL, Peterson K, Peterson RR, Petrasso RD, Philippe F, Phipps TJ, Piceno E, Ping Y, Pickworth L, Pino J, Plummer R, Pollack GD, Pollaine SM, Pollock BB, Ponce D, Ponce J, Pontelandolfo J, Porter JL, Post J, Poujade O, Powell C, Powell H, Power G, Pozulp M, Prantil M, Prasad M, Pratuch S, Price S, Primdahl K, Prisbrey S, Procassini R, Pruyne A, Pudliner B, Qiu SR, Quan K, Quinn M, Quintenz J, Radha PB, Rainer F, Ralph JE, Raman KS, Raman R, Rambo P, Rana S, Randewich A, Rardin D, Ratledge M, Ravelo N, Ravizza F, Rayce M, Raymond A, Raymond B, Reed B, Reed C, Regan S, Reichelt B, Reis V, Reisdorf S, Rekow V, Remington BA, Rendon A, Requieron W, Rever M, Reynolds H, Reynolds J, Rhodes J, Rhodes M, Richardson MC, Rice B, Rice NG, Rieben R, Rigatti A, Riggs S, Rinderknecht HG, Ring K, Riordan B, Riquier R, Rivers C, Roberts D, Roberts V, Robertson G, Robey HF, Robles J, Rocha P, Rochau G, Rodriguez J, Rodriguez S, Rosen M, Rosenberg M, Ross G, Ross JS, Ross P, Rouse J, Rovang D, Rubenchik AM, Rubery MS, Ruiz CL, Rushford M, Russ B, Rygg JR, Ryujin BS, Sacks RA, Sacks RF, Saito K, Salmon T, Salmonson JD, Sanchez J, Samuelson S, Sanchez M, Sangster C, Saroyan A, Sater J, Satsangi A, Sauers S, Saunders R, Sauppe JP, Sawicki R, Sayre D, Scanlan M, Schaffers K, Schappert GT, Schiaffino S, Schlossberg DJ, Schmidt DW, Schmitt MJ, Schneider DHG, Schneider MB, Schneider R, Schoff M, Schollmeier M, Schölmerich M, Schroeder CR, Schrauth SE, Scott HA, Scott I, Scott JM, Scott RHH, Scullard CR, Sedillo T, Seguin FH, Seka W, Senecal J, Sepke SM, Seppala L, Sequoia K, Severyn J, Sevier JM, Sewell N, Seznec S, Shah RC, Shamlian J, Shaughnessy D, Shaw M, Shaw R, Shearer C, Shelton R, Shen N, Sherlock MW, Shestakov AI, Shi EL, Shin SJ, Shingleton N, Shmayda W, Shor M, Shoup M, Shuldberg C, Siegel L, Silva FJ, Simakov AN, Sims BT, Sinars D, Singh P, Sio H, Skulina K, Skupsky S, Slutz S, Sluyter M, Smalyuk VA, 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RE, Ulitsky M, Upadhye R, Vaher JL, VanArsdall P, VanBlarcom D, Vandenboomgaerde M, VanQuinlan R, Van Wonterghem BM, Varnum WS, Velikovich AL, Vella A, Verdon CP, Vermillion B, Vernon S, Vesey R, Vickers J, Vignes RM, Visosky M, Vocke J, Volegov PL, Vonhof S, Von Rotz R, Vu HX, Vu M, Wall D, Wall J, Wallace R, Wallin B, Walmer D, Walsh CA, Walters CF, Waltz C, Wan A, Wang A, Wang Y, Wark JS, Warner BE, Watson J, Watt RG, Watts P, Weaver J, Weaver RP, Weaver S, Weber CR, Weber P, Weber SV, Wegner P, Welday B, Welser-Sherrill L, Weiss K, Widmann K, Wheeler GF, Whistler W, White RK, Whitley HD, Whitman P, Wickett ME, Widmayer C, Wiedwald J, Wilcox R, Wilcox S, Wild C, Wilde BH, Wilde CH, Wilhelmsen K, Wilke MD, Wilkens H, Wilkins P, Wilks SC, Williams EA, Williams GJ, Williams W, Williams WH, Wilson DC, Wilson B, Wilson E, Wilson R, Winters S, Wisoff J, Wittman M, Wolfe J, Wong A, Wong KW, Wong L, Wong N, Wood R, Woodhouse D, Woodruff J, Woods DT, Woods S, Woodworth BN, Wooten E, Wootton A, Work K, Workman JB, Wright J, Wu M, Wuest C, Wysocki FJ, Xu H, Yamaguchi M, Yang B, Yang ST, Yatabe J, Yeamans CB, Yee BC, Yi SA, Yin L, Young B, Young CS, Young CV, Young P, Youngblood K, Zacharias R, Zagaris G, Zaitseva N, Zaka F, Ze F, Zeiger B, Zika M, Zimmerman GB, Zobrist T, Zuegel JD, and Zylstra AB
- Abstract
For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.
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- 2022
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46. Impact of Pre-Hospital Activation of STEMI on False Positive Activation Rate and Door to Balloon Time.
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Shoaib M, Huish W, Woollard EL, Aguila J, Coxall D, Alexander M, Hicks D, and McQuillan B
- Subjects
- Emergency Service, Hospital, Hospitals, Humans, Retrospective Studies, Time Factors, Percutaneous Coronary Intervention methods, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction etiology, ST Elevation Myocardial Infarction surgery
- Abstract
Background: Pre-hospital identification of ST-segment elevation myocardial infarction (STEMI) by paramedical staff reduces reperfusion time. However, the impact of this approach on the rate of unnecessary activation of coronary catheterisation lab (CCL) remains unclear., Methods: The study reviewed consecutive STEMI patients over 3 years (July 2015 to June 2018) from all primary percutaneous coronary intervention (PPCI) centres and inter-hospital transfers (IHT) from non-PPCI capable centres in Western Australia. Out-of-hospital cardiac arrests (OOHCA) and STEMI calls for in-patients receiving treatment for other medical reasons were excluded., Results: During the 3 years study period, 1,736 STEMI cases were recorded. Pre-hospital (PH) activation occurred in 799 (46%) cases. Median door to balloon time (D2BT) was 68 minutes (IQR 63 mins). D2BT for PH activation (40 min [IQR 25 min]) was significantly lower than both the PPCI centre emergency department (ED) activation (86 min [IQR 55 min]) and IHT activation groups (108 min [IQR 55 min]), p-value <0.00001. In PH activation group 98% patients received primary PCI in less than 90 minutes compared to 54% and 26% patients in the ED and the IHT activation groups, respectively. False positive STEMI activation rate was lower in the PH activation group (2.75%) compared to ED activation (5.4%) and IHT group (6%), p-value 0.0115. The false positive rate did not vary significantly between working hours and out-of-hour calls (5% vs 4%, p-value=0.304). Pericarditis, coronary artery disease other than STEMI, atypical chest pain, and stress induced cardiomyopathy were the common diagnoses in false positive activations., Conclusion: Pre-hospital activation of STEMI leads to reduced door to balloon times without a significant increase in inappropriate procedures, though false positive activation rates are unclear. The majority of STEMI patients transferred from non-PPCI centres failed to receive reperfusion therapy within 90 minutes of initial hospital presentation. Further studies are required to assess the benefits of thrombolysis in selected patients in inter-hospital transfer group., (Crown Copyright © 2021. Published by Elsevier B.V. All rights reserved.)
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- 2022
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47. Alcohol Consumption and Cardiovascular Outcomes in Patients With Nonalcoholic Fatty Liver Disease: A Population-Based Cohort Study.
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Janjua M, Knuiman M, Divitini M, McQuillan B, Olynyk JK, Jeffrey GP, and Adams LA
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- Alcohol Drinking adverse effects, Australia epidemiology, Cohort Studies, Female, Humans, Male, Cardiovascular Diseases epidemiology, Non-alcoholic Fatty Liver Disease epidemiology
- Abstract
Low-level alcohol consumption is associated with reduced cardiovascular disease (CVD) in the general population. It is unclear whether this association is seen in patients with nonalcoholic fatty liver disease (NAFLD) who have an increased risk of CVD. We examined the association between alcohol consumption and CVD-related outcomes in subjects with NAFLD from a general population cohort. Subjects participating in the 1994-1995 Busselton Health survey underwent clinical and biochemical assessment. NAFLD was identified using the Fatty Liver Index of >60, and alcohol consumption quantified using a validated questionnaire. CVD hospitalizations and death during the ensuing 20 years were ascertained using the Western Australian data linkage system. A total of 659 of 4,843 patients were diagnosed with NAFLD. The average standard drinks per week was 8.0 for men and 4.0 for women. Men consuming 8-21 drinks per week had a 38% (hazard ratio [HR] 0.62, 95% confidence interval [CI] 0.43-0.90) lower risk of CVD hospitalization as compared with men consuming 1-7 drinks per week. With both men and women combined, consumption of 8-21 drinks per week was associated with a 32% (HR 0.68, 95% CI 0.49-0.93) reduction in CVD hospitalization in minimally adjusted and 29% (HR 0.71, 95% CI 0.51-0.99) in fully adjusted models. No protective association was observed with binge drinking. There was no association between alcohol consumption and CVD death. Conclusion: Low to moderate alcohol consumption is associated with fewer CVD hospitalizations but not CVD death in subjects with NAFLD., (© 2021 The Authors. Hepatology Communications published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.)
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- 2022
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48. Prehospital continuous positive airway pressure (CPAP) for acute respiratory distress: a randomised controlled trial.
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Finn JC, Brink D, Mckenzie N, Garcia A, Tohira H, Perkins GD, Arendts G, Fatovich DM, Hendrie D, McQuillan B, Summers Q, Celenza A, Mukherjee A, Smedley B, Pereira G, Ball S, Williams T, and Bailey P
- Subjects
- Continuous Positive Airway Pressure, Humans, Emergency Medical Services, Respiratory Distress Syndrome therapy
- Abstract
Objective: To compare the efficacy of continuous positive airway pressure (CPAP) versus usual care for prehospital patients with severe respiratory distress., Methods: We conducted a parallel group, individual patient, non-blinded randomised controlled trial in Western Australia between March 2016 and December 2018. Eligible patients were aged ≥40 years with acute severe respiratory distress of non-traumatic origin and unresponsive to initial treatments by emergency medical service (EMS) paramedics. Patients were randomised (1:1) to usual care or usual care plus CPAP. The primary outcomes were change in dyspnoea score and change in RR at ED arrival, and hospital length of stay., Results: 708 patients were randomly assigned (opaque sealed envelope) to usual care (n=346) or CPAP (n=362). Compared with usual care, patients randomised to CPAP had a greater reduction in dyspnoea scores (usual care -1.0, IQR -3.0 to 0.0 vs CPAP -3.5, IQR -5.2 to -2.0), median difference -2.0 (95% CI -2.5 to -1.6); and RR (usual care -4.0, IQR -9.0 to 0.0 min
-1 vs CPAP -8.0, IQR -14.0 to -4.0 min-1 ), median difference -4.0 (95% CI -5.0 to -4.0) min-1 . There was no difference in hospital length of stay (usual care 4.2, IQR 2.1 to 7.8 days vs CPAP 4.8, IQR 2.5 to 7.9 days) for the n=624 cases admitted to hospital, median difference 0.36 (95% CI -0.17 to 0.90)., Conclusions: The use of prehospital CPAP by EMS paramedics reduced dyspnoea and tachypnoea in patients with acute respiratory distress but did not impact hospital length of stay., Trial Registration Number: ACTRN12615001180505., Competing Interests: Competing interests: Several of the authors are affiliated with St John Western Australia, as follows: DB, AG, PB (employees); JF, SB (adjunct research positions); JF (research funding)., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)- Published
- 2022
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49. Association of hypertension with mortality in patients hospitalised with COVID-19.
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Bhatia KS, Sritharan HP, Ciofani J, Chia J, Allahwala UK, Chui K, Nour D, Vasanthakumar S, Khandadai D, Jayadeva P, Bhagwandeen R, Brieger D, Choong C, Delaney A, Dwivedi G, Harris B, Hillis G, Hudson B, Javorski G, Jepson N, Kanagaratnam L, Kotsiou G, Lee A, Lo ST, MacIsaac AI, McQuillan B, Ranasinghe I, Walton A, Weaver J, Wilson W, Yong ASC, Zhu J, Van Gaal W, Kritharides L, Chow CK, and Bhindi R
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- Adult, Aged, Aged, 80 and over, Angiotensin Receptor Antagonists therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Antihypertensive Agents therapeutic use, Australia epidemiology, COVID-19 diagnosis, COVID-19 therapy, Comorbidity, Female, Humans, Hypertension diagnosis, Hypertension drug therapy, Male, Middle Aged, Prevalence, Prognosis, Registries, Risk Assessment, Risk Factors, Time Factors, COVID-19 mortality, Hospital Mortality, Hospitalization, Hypertension mortality
- Abstract
Objective: To assess whether hypertension is an independent risk factor for mortality among patients hospitalised with COVID-19, and to evaluate the impact of ACE inhibitor and angiotensin receptor blocker (ARB) use on mortality in patients with a background of hypertension., Method: This observational cohort study included all index hospitalisations with laboratory-proven COVID-19 aged ≥18 years across 21 Australian hospitals. Patients with suspected, but not laboratory-proven COVID-19, were excluded. Registry data were analysed for in-hospital mortality in patients with comorbidities including hypertension, and baseline treatment with ACE inhibitors or ARBs., Results: 546 consecutive patients (62.9±19.8 years old, 51.8% male) hospitalised with COVID-19 were enrolled. In the multivariable model, significant predictors of mortality were age (adjusted OR (aOR) 1.09, 95% CI 1.07 to 1.12, p<0.001), heart failure or cardiomyopathy (aOR 2.71, 95% CI 1.13 to 6.53, p=0.026), chronic kidney disease (aOR 2.33, 95% CI 1.02 to 5.32, p=0.044) and chronic obstructive pulmonary disease (aOR 2.27, 95% CI 1.06 to 4.85, p=0.035). Hypertension was the most prevalent comorbidity (49.5%) but was not independently associated with increased mortality (aOR 0.92, 95% CI 0.48 to 1.77, p=0.81). Among patients with hypertension, ACE inhibitor (aOR 1.37, 95% CI 0.61 to 3.08, p=0.61) and ARB (aOR 0.64, 95% CI 0.27 to 1.49, p=0.30) use was not associated with mortality., Conclusions: In patients hospitalised with COVID-19, pre-existing hypertension was the most prevalent comorbidity but was not independently associated with mortality. Similarly, the baseline use of ACE inhibitors or ARBs had no independent association with in-hospital mortality., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2021
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50. Antithrombotic Therapy in Atrial Fibrillation Management in Western Australia: Temporal Trends and Evidence-Treatment Gaps.
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Hutchens R, Hung J, Briffa T, and McQuillan B
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- Administration, Oral, Adult, Aged, Anticoagulants therapeutic use, Female, Fibrinolytic Agents therapeutic use, Humans, Male, Retrospective Studies, Risk Factors, Western Australia epidemiology, Atrial Fibrillation complications, Atrial Fibrillation drug therapy, Atrial Fibrillation epidemiology, Stroke epidemiology, Stroke etiology, Stroke prevention & control
- Abstract
Objective: To describe temporal trends in appropriate antithrombotic therapy use in hospitalised atrial fibrillation (AF) patients and identify evidence-treatment gaps in clinical practice., Design: Retrospective cohort study from January 2009-March 2016., Setting: Tertiary and secondary teaching hospitals in Perth, Western Australia., Participants: Hospitalised adults with non-valvular AF., Results: We identified 11,294 index AF admissions, with a mean age of 76.9 years, 45.8% women and 86.3% at high risk of stroke (CHA
2 DS2 -VASc score ≥2 in men and ≥3 in women). In high risk subjects use of appropriate antithrombotic therapy improved over time with increasing oral anticoagulant (OAC) use and declining sole antiplatelet use (both trend p<0.001). However, by study end only 45.3% of high-risk patients were receiving OAC therapy. In low risk patients, receipt of OAC therapy was steady throughout the study at 40.5% (trend p=0.10). The gender gap in OAC use narrowed over time, with no significant difference between high risk men and women by study end. Use of OAC therapy in elderly patients (age ≥75 years) remained lower than younger patients (age <65 years) over the entire period, with only 31% of elderly patients receiving OAC therapy at study end. From 2012 onwards use of non-vitamin K oral anticoagulants (NOACs) doubled each year with declining warfarin use (both trend p<0.001)., Conclusion: Despite substantial uptake of NOACs, OAC therapy in AF patients at high risk of stroke remains under-utilised in Western Australia and over-utilised in low risk patients. Further work is required to reduce treatment-risk mismatch for stroke prevention in AF patients., (Copyright © 2021. Published by Elsevier B.V.)- Published
- 2021
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