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Introduction: Stroke outcomes in patients with LDL levels Method: The study includes patients admitted for stroke and LDL Result: Among 469 patients admitted for the stroke, 119(25%) patients had LDL 14) respectively vs 57.4%, 24.6% and 18% in group A. Mortality was higher in group B in patients admitted with moderate (33.3% vs 13.3%) and severe NIHSS score(18.2% vs 6.7%). Within group B, patients who were started on statin during admission had a lower modified Rankin Scale (mRS) on discharge, compared to patients who were not started on statin(mRS 0 36.6% vs 0%, mRS 4-17.1% vs 29.4%, mRS 5- 9.8% vs 17.6%). Also, mortality was higher in patients not started on statin. Conclusion: Patients who were not on statins had higher incidence of hemorrhagic stroke, worse functional status on discharge, and higher mortality than those who were already on statin. Patients who were started on statin during index admission had better functional status on discharge and lower mortality than patients who were never started on statin. Our study highlights the better outcomes at discharge with statin use in stroke patients with LDL

Ever since Kalat rulers gave away the rule of their Kalat state comprising Balochistan, in the hands of Pakistan in 1948, the people of Balochistan have been demanding freedom and to declare it as an independent nation. Their demand slowly converted into a violent struggle and separatists resorted to insurgency, commonly known as ‘Baloch Insurgency’. Pakistan too resorted to counter insurgency, commonly known as ‘Pak Counter Insurgency.’ Pakistan adopted enforced disappearances as a major tool to suppress the violent struggle, by forcibly abducting family members of the suspect. The menace of enforced disappearance has now engulfed entire Balochistan province and no day goes without such acts of kidnapping, abduction, sexual assaults, killings and enforced disappearances, at some place or in some area of Balochistan. There is no end to such atrocities and genocide. There are severe violations of the human rights in the province. In the context, enforced disappearances of the people are a major human rights issue in Balochistan.

Background: Maize (Zea mays L.) is one of the important cereal crops of world. Its multiple uses in food industry made it most demanded crop, but the productivity in India is still low. Inclusion of legumes in the cropping system can help in restoring soil fertility in incredible ways hence, enhancing the crop productivity. Methods: A field experiment was conducted at B. A. College of Agriculture, AAU, Anand during summer-kharif seasons of years 2017 and 2018 to examine the impact of legume crop residue and nitrogen levels on maize crop. Experiment comprised of three legume crops grown in summer season viz., green gram, groundnut and cluster bean, two residue management treatments viz., residue removal and incorporation and three nitrogen levels in kharif maize viz., 100%, 75% and 50% recommended dose of nitrogen. Result: Cluster bean-maize cropping system followed by groundnut-maize cropping system observed for the highest improvement in growth parameters, yield attribute and grain and straw yield. Residue incorporation of summer legumes and full dose of nitrogen in maize was found significant for increasing growth and yield parameters and grain yield of maize. Study indicate that residue incorporation had positive effects on maize growth and yield, however incorporation was not able to reduce the nitrogen requirement through chemical means.

This qualitative study is part of Smart Indigenous Youth, a digital health community trial involving rural schools in Saskatchewan, Canada. Secondary school administrators and educators were engaged as citizen scientists in rural Indigenous communities to understand rapid decision-making processes for preserving school health during the COVID-19 pandemic, and to inform evidence-based safe school policies and practices. After COVID-19 restrictions were implemented, key informant interviews and focus groups were conducted with school administrators and educators, respectively, to understand the impact of school responses and decision-making processes. Two independent reviewers conducted thematic analyses and compared themes to reach consensus on a final shortlist. Four main themes emerged from the administrator interviews, and six main themes were identified from the educator focus group discussions which revealed a pressing need for mental health supports for students and educators. The study findings highlight the challenges faced by schools in rural and remote areas during the COVID-19 pandemic, including school closures, students' reactions to closures, measures taken by schools to preserve health during the pandemic, and different approaches to implement for future closures. Citizen scientists developed a set of recommendations, including the need for structured communication, reflection meetings, adequate funding, and external monitoring and evaluation to guide evidence-based safe school policies and practices during the pandemic.

Contains fulltext : 244566.pdf (Publisher’s version ) (Closed access) BACKGROUND AND AIMS: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as 3 L/day. RESULTS: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.

Most diagnostic testing for West Nile virus (WNV) disease is accomplished using serologic testing, which is subject to cross-reactivity, may require cumbersome confirmatory testing, and may fail to detect infection in specimens collected early in the course of illness. The objective of this project was to determine whether a combination of molecular and serologic testing would increase detection of WNV disease cases in acute serum samples. A total of 380 serum specimens collected ≤7 days after onset of symptoms and submitted to four state public health laboratories for WNV diagnostic testing in 2014 and 2015 were tested. WNV immunoglobulin M (IgM) antibody and RT-PCR tests were performed on specimens collected ≤3 days after symptom onset. WNV IgM antibody testing was performed on specimens collected 4–7 days after onset and RT-PCR was performed on IgM-positive specimens. A patient was considered to have laboratory evidence of WNV infection if they had detectable WNV IgM antibodies or WNV RNA in the submitted serum specimen. Of specimens collected ≤3 days after symptom onset, 19/158 (12%) had laboratory evidence of WNV infection, including 16 positive for only WNV IgM antibodies, 1 positive for only WNV RNA, and 2 positive for both. Of specimens collected 4–7 days after onset, 21/222 (9%) were positive for WNV IgM antibodies; none had detectable WNV RNA. These findings suggest that routinely performing WNV RT-PCR on acute serum specimens submitted for WNV diagnostic testing is unlikely to identify a substantial number of additional cases beyond IgM antibody testing alone.

PURPOSE: To validate an algorithm for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) episodes derived in an electronic health record (EHR) database, against AECOPD episodes collected in a randomized clinical trial using an electronic case report form (eCRF).METHODS: We analyzed two data sources from the Salford Lung Study in COPD: trial eCRF and the Salford Integrated Record, a linked primary-secondary routine care EHR database of all patients in Salford. For trial participants, AECOPD episodes reported in eCRF were compared with algorithmically derived moderate/severe AECOPD episodes identified in EHR. Episode characteristics (frequency, duration), sensitivity, and positive predictive value (PPV) were calculated. A match between eCRF and EHR episodes was defined as at least 1-day overlap.RESULTS: In the primary effectiveness analysis population (n = 2269), 3791 EHR episodes (mean [SD] length: 15.1 [3.59] days; range: 14-54) and 4403 moderate/severe AECOPD eCRF episodes (mean length: 13.8 [16.20] days; range: 1-372) were identified. eCRF episodes exceeding 28 days were usually broken up into shorter episodes in the EHR. Sensitivity was 63.6% and PPV 71.1%, where concordance was defined as at least 1-day overlap.CONCLUSIONS: The EHR algorithm performance was acceptable, indicating that EHR-derived AECOPD episodes may provide an efficient, valid method of data collection. Comparing EHR-derived AECOPD episodes with those collected by eCRF resulted in slightly fewer episodes, and eCRF episodes of extreme lengths were poorly captured in EHR. Analysis of routinely collected EHR data may be reasonable when relative, rather than absolute, rates of AECOPD are relevant for stakeholders' decision making.

Background To facilitate deployment of point-of-care testing for severe acute respiratory syndrome coronavirus 2, we evaluated the Access Bio CareStart COVID-19 Antigen test in a high-throughput, drive-through, free community testing site using anterior nasal (AN) swab reverse-transcription polymerase chain reaction (RT-PCR) for clinical testing. Methods Consenting symptomatic and asymptomatic children (≤18 years) and adults received dual AN swabs. CareStart testing was performed with temperature/humidity monitoring. All tests had 2 independent reads to assess interoperator agreement. Patients with positive CareStart results were called and instructed to isolate pending RT-PCR results. The paired RT-PCR result was the reference for sensitivity and specificity calculations. Results Of 1603 participants, 1245 adults and 253 children had paired RT-PCR/CareStart results and complete symptom data. Eighty-three percent of adults and 87% of children were asymptomatic. CareStart sensitivity/specificity were 84.8% (95% confidence interval [CI], 71.1–93.7)/97.2% (95% CI, 92.0–99.4) and 85.7% (95% CI, 42.1–99.6)/89.5% (95% CI, 66.9–98.7) in adults and children, respectively, within 5 days of symptoms. Sensitivity/specificity were 50.0% (95% CI, 41.0–59.0)/99.1% (95% CI, 98.3–99.6) in asymptomatic adults and 51.4% (95% CI, 34.4–68.1)/97.8% (95% CI, 94.5–99.4) in asymptomatic children. Sensitivity in all 234 RT-PCR-positive people was 96.3% with cycle threshold (Ct) ≤25, 79.6% with Ct ≤30, and 61.4% with Ct ≤35. All 21 false-positive CareStart tests had faint but normal bands. Interoperator agreement was 99.5%. Operational challenges included identification of faint test bands and inconsistent swab elution volumes. Conclusions CareStart had high sensitivity in people with Ct ≤25 and moderate sensitivity in symptomatic people overall. Specificity was unexpectedly lower in symptomatic versus asymptomatic people. Excellent interoperator agreement was observed, but operational challenges indicate that operator training is warranted., We evaluated the CareStart COVID-19 Antigen test in a high-throughput community testing site. We observed 50.0%–85.7% sensitivity and 89.5%–99.1% specificity in asymptomatic and symptomatic children/adults, with 96.3% or 79.6% sensitivity, respectively. Interoperator agreement was 99.5%.

Rapid diagnostic tests (RDTs) for SARS-CoV-2 antigens (Ag) that can be performed at point of care (POC) can supplement molecular testing and help mitigate the COVID-19 pandemic. Deployment of an Ag RDT requires an understanding of its operational and performance characteristics under real-world conditions and in relevant subpopulations. We evaluated the Abbott BinaxNOW COVID-19 Ag card in a high-throughput, drive-through, free community testing site in Massachusetts using anterior nasal (AN) swab reverse transcriptase PCR (RT-PCR) for clinical testing. Individuals presenting for molecular testing in two of seven lanes were offered the opportunity to also receive BinaxNOW testing. Dual AN swabs were collected from symptomatic and asymptomatic children (≤18 years of age) and adults. BinaxNOW testing was performed in a testing pod with temperature/humidity monitoring. One individual performed testing and official result reporting for each test, but most tests had a second independent reading to assess interoperator agreement. Positive BinaxNOW results were scored as faint, medium, or strong. Positive BinaxNOW results were reported to patients by phone, and they were instructed to isolate pending RT-PCR results. The paired RT-PCR result was the reference for sensitivity and specificity calculations. Of 2,482 participants, 1,380 adults and 928 children had paired RT-PCR/BinaxNOW results and complete symptom data. In this study, 974/1,380 (71%) adults and 829/928 (89%) children were asymptomatic. BinaxNOW had 96.5% (95% confidence interval [CI], 90.0 to 99.3) sensitivity and 100% (95% CI, 98.6 to 100.0) specificity in adults within 7 days of symptoms and 84.6% (95% CI, 65.1 to 95.6) sensitivity and 100% (95% CI, 94.5 to 100.0) specificity in children within 7 days of symptoms. Sensitivity and specificity in asymptomatic adults were 70.2% (95% CI, 56.6 to 81.6) and 99.6% (95% CI, 98.9 to 99.9), respectively, and in asymptomatic children, they were 65.4% (95% CI, 55.6 to 74.4) and 99.0% (95% CI, 98.0 to 99.6), respectively. By cycle threshold (C(T)) value cutoff, sensitivity in all subgroups combined (n = 292 RT-PCR-positive individuals) was 99.3% with C(T) values of ≤25, 95.8% with C(T) values of ≤30, and 81.2% with C(T) values of ≤35. Twelve false-positive BinaxNOW results (out of 2,308 tests) were observed; in all 12, the test bands were faint but otherwise normal and were noted by both readers. One invalid BinaxNOW result was identified. Interoperator agreement (positive versus negative BinaxNOW result) was 100% (n = 2,230/2,230 double reads). Each operator was able to process 20 RDTs per hour. In a separate set of 30 specimens (from individuals with symptoms ≤7 days) run at temperatures below the manufacturer’s recommended range (46 to 58.5°F), sensitivity was 66.7% and specificity 95.2%. BinaxNOW had very high specificity in both adults and children and very high sensitivity in newly symptomatic adults. Overall, 95.8% sensitivity was observed with C(T) values of ≤30. These data support public health recommendations for use of the BinaxNOW test in adults with symptoms for ≤7 days without RT-PCR confirmation. Excellent interoperator agreement indicates that an individual can perform and read the BinaxNOW test alone. A skilled laboratorian can perform and read 20 tests per hour. Careful attention to temperature is critical.

Diet and nutrition play an important and essential role in everyone's life. It helps build a healthy body and a strong mind. We know that food rich in nutrients can remove toxins from the body, make an excellent immune system, curb hunger, and prevent obesity. Obesity is one of the most concerning, alarming, and fastest-growing pandemics. It affects not only adults but also adolescents and children. The disease's early-onset calls for prompt attention to control the physical, psychological, financial, and social burden it creates. Children with autism and autism spectrum disorders (ASDs) are commonly affected by eating disorders. Their preference for energy-dense food with low nutrition can alter their metabolism, leading to the accumulation of oxidative radicals, causing them to deteriorate mentally and physically. Although dieting and losing weight are now commonly seen in the general population, it has become hard to bring awareness to children with special needs about diet, nutrition, and obesity. Despite efforts, parents of such children usually cannot help control the eating because tantrums and behavioral problems are common. It is now imperative for doctors and parents to work alongside nutritionists and dieticians to help these children eat healthy to be fit and improve the quality of life.

BackgroundRapid diagnostic tests (RDTs) for SARS-CoV-2 antigens (Ag) that can be performed at point-of-care (POC) can supplement molecular testing and help mitigate the COVID-19 pandemic. Deployment of an Ag RDT requires an understanding of its operational and performance characteristics under real-world conditions and in relevant subpopulations. We evaluated the Abbott BinaxNOW™ COVID-19 Ag Card in a high-throughput, drive-through, free community testing site in Massachusetts (MA) using anterior nasal (AN) swab RT-PCR for clinical testing.MethodsIndividuals presenting for molecular testing in two of seven lanes were offered the opportunity to also receive BinaxNOW testing. Dual AN swabs were collected from symptomatic and asymptomatic children (≤ 18 years) and adults. BinaxNOW testing was performed in a testing pod with temperature/humidity monitoring. One individual performed testing and official result reporting for each test, but most tests had a second independent reading to assess inter-operator agreement. Positive BinaxNOW results were scored as faint, medium, or strong. Positive BinaxNOW results were reported to patients by phone and they were instructed to isolate pending RT-PCR results. The paired RT-PCR result was the reference for sensitivity and specificity calculations.ResultsOf 2482 participants, 1380 adults and 928 children had paired RT-PCR/BinaxNOW results and complete symptom data. 974/1380 (71%) adults and 829/928 (89%) children were asymptomatic. BinaxNOW had 96.5% (95% confidence interval [CI] 90.0-99.3) sensitivity and 100% (98.6-100.0) specificity in adults within 7 days of symptoms, and 84.6% (65.1-95.6) sensitivity and 100% (94.5-100.0) specificity in children within 7 days of symptoms. Sensitivity and specificity in asymptomatic adults were 70.2% (56.6-81.6) and 99.6% (98.9-99.9), respectively, and in asymptomatic children were 65.4% (55.6-74.4) and 99.0% (98.0-99.6), respectively. By cycle threshold (Ct) value cutoff, sensitivity in all subgroups combined (n=292 RT-PCR-positive individuals) was 99.3% with Ct ≤25, 95.8% with ≤30, and 81.2% with ≤35. Twelve false positive BinaxNOW results (out of 2308 tests) were observed; in all twelve, the test bands were faint but otherwise normal, and were noted by both readers. One invalid BinaxNOW result was identified. Inter-operator agreement (positive versus negative BinaxNOW result) was 100% (n = 2230/2230 double reads). Each operator was able to process 20 RDTs per hour. In a separate set of 30 specimens (from individuals with symptoms ≤7 days) run at temperatures below the manufacturer’s recommended range (46-58.5°F), sensitivity was 66.7% and specificity 95.2%.ConclusionsBinaxNOW had very high specificity in both adults and children and very high sensitivity in newly symptomatic adults. Overall, 95.8% sensitivity was observed with Ct ≤ 30. These data support public health recommendations for use of the BinaxNOW test in adults with symptoms for ≤7 days without RT-PCR confirmation. Excellent inter-operator agreement indicates that an individual can perform and read the BinaxNOW test alone. A skilled laboratorian can perform and read 20 tests per hour. Careful attention to temperature is critical.

Obesity in children is becoming a worldwide epidemic that requires immediate attention. Despite all the efforts directed towards controlling this issue, its prevalence is increasing overtime both in developed and developing countries. With an increasing prevalence in the younger age groups, it is emerging as a public health crisis. A rise in body mass index (BMI) results in an increased risk of developing a variety of metabolic and cardiovascular diseases, particularly coronary artery disease (CAD). The early onset of the disease affects the peak productivity years in young individuals leading to disability at a later age. It makes it essential that we understand the contributory factors towards the development of obesity as a risk factor for CAD and develop strategies that hinder the progression towards adverse outcomes. There is an urgent need to screen these children at a younger age and educate them to change their lifestyle to decrease the BMI within the normal range to promote cardiovascular health. It requires a multidisciplinary approach involving dietary, physical, and behavioral-centered strategies. Failure to control this epidemic timely may cause widespread consequences for the quality of life and longevity.

The authors report 3.5 GHz bulk acoustic wave resonators with an observed k 2 eff in the range of 14.2 to 16%, which the authors believe to be amongst the highest reported for a Sc mole fraction of 28%. The measured Qp is as high as 951 at 3.5 GHz, which is 3.8 times higher than recently reported for resonators at comparable Sc mole fractions. A high Qmax of 1070 combined with the high k 2 eff achieves the highest reported FOM at 158 for a Sc mole fraction of 28%. Furthermore, randomly selected 3.5 GHz devices mounted on evaluation PCB boards were power tested and damaged at CW power levels between +40 dBm and +41.5 dBm, indicating high power performance capability.

This is the first systematic review to comprehensively capture Global Positioning Systems’ (GPS) utilization in active living research by investigating the influence of physical contexts and social environment on all intensities of physical activity and sedentary behavior among all age groups. An extensive search of peer-reviewed literature was conducted using six databases. Out of 2026 articles identified, 129 studies met the inclusion criteria. After describing the evolution of GPS use across four themes (study designs and methods, physical contexts and social environment, active transportation, and behaviors), evidence-based recommendations for active living research, policy, and practice were generated.

Urbanization is one of the main drivers in the conversion of natural habitats into different land use and land cover types (LULC) which threaten the local as well as global biodiversity. This impact is particularly alarming in tropical countries like India, where ~18% of the world's population live, and its ever-growing economy (i.e., industrial development) expanded urban areas by several folds. We undertook this study to examine the impacts of urbanization (i.e., LULC) on terrestrial vertebrates (mammals, birds, reptiles, and amphibians) in the Mumbai Metropolitan Region (MMR), Western Ghats, India. We sampled different habitats ranged from highly disturbed urban areas to less disturbed forested areas. Multiple sampling methods such as quadrat sampling, line transect, point count, and camera trapping were used to quantify the target taxa. We used multi-species occupancy modeling in the Bayesian framework to estimate detection probability and occupancy and to assess the effect of various LULC on different species. All four groups showed a significant negative impact of increasing anthropogenic habitat cover on occupancy. Out of 213 species detected in this study, 96% of mammals, 85% of birds, 93.75% of amphibians, and 69.43% of reptiles showed a negative effect of anthropogenic habitat cover. Evidence suggests that historical and recent human disturbances could have played an important role in transforming this area from semi-evergreen and moist deciduous forest to open, scrubby, dry deciduous, and fire-prone landscape. This might be the reason for the high occupancy of open and degraded forest habitat preferring species in our study area. We recommend species-rich areas in the MMR, e.g., Karnala Bird Sanctuary (KBS) and Prabalgad-Matheran-Malanggad Hill Range (PMMHR), must be conserved through habitat restoration, ecotourism, public awareness, and policymaking.

5.66 GHz bulk acoustic wave filters, utilizing doped aluminum nitride (AlN), are reported. The filters exhibit high -3 dB bandwidth of 452 MHz (8% fractional bandwidth), a minimum insertion loss of 1.79 dB, rejection greater than 50 dB and power handling performance (near the upper band edge) up to 32.5 dBm. Resonators show k2eff of 10.24%, Qmax of 1479, and FOM of 151.

Supplemental Material, CRD-18-0043_Feldman_et_al_supplement_09Oct18 for Correct use and ease of use of a placebo dry powder inhaler in subjects with asthma and chronic obstructive pulmonary disease by Gregory J Feldman, Dmitry V Galkin, Pinal Patel, Kathryn A Collison, and Raj Sharma in Chronic Respiratory Disease

This randomised, open-label, cross-over, placebo-containing inhaler study assessed patient preference indicators for ELLIPTA and HandiHaler dry powder inhalers in patients with COPD (NCT02786927; GSK identifier: 204983). The primary objective of this study was to assess patient preference between ELLIPTA and HandiHaler based on the number of steps needed to use the inhaler. Eligible patients ≥40 years of age with COPD were randomised 1:1 to receive their current COPD medication plus a placebo-containing ELLIPTA or HandiHaler inhaler once daily for 7 ± 2 days (treatment period 1); this was followed by a 7 ± 2-day placebo treatment with the alternative inhaler. A 5-item questionnaire assessed inhaler-related patient preferences. A total of 212 patients (mean age, 65.1 years) were enrolled at 22 US sites; 73% had a COPD duration ≥5 years. Median (range) exposure was 8 ( 5 , 13 ) days for ELLIPTA and 8 ( 1 , 16) days for HandiHaler. Significantly more patients preferred ELLIPTA to HandiHaler in terms of the number of steps to use and all secondary attributes (size, comfort of the mouthpiece, remaining doses, and ease of use of the two inhalers; all p0.001). Similar results were observed irrespective of the order of inhaler use. Eighteen patients (8%) reported at least one AE and two (1%) patients reported four non-fatal SAEs; none were related to the study treatment. Patient attitude toward a particular inhaler and their experiences in using it can affect adherence to therapy, which can in turn strongly influence effectiveness of inhaled medications. This study uses a robust methodology to assess patient preference.

5.24GHz bulk acoustic wave filters, utilizing undoped single crystal aluminum nitride, are reported. The filters had an absolute 4dB bandwidth of 151 MHz, a minimum insertion loss of 2.82 dB and rejection >38 dB. Resonators show k2 eff of 6.32%, Q rnax of 1523, and FOM of 96.

Aim: Study HZA106837 demonstrated a reduced risk of asthma exacerbations with FF/VI vs FF, measured by time-to-first severe asthma exacerbation over a ≥24–78 week treatment period (Bateman et al; Thorax 2014). This post-hoc analysis investigated whether asthma exacerbation prevalence varied across seasons. Methods: Patients aged ≥12 years with asthma for ≥1 year, receiving an ICS or ICS/LABA and with ≥1 exacerbation requiring systemic corticosteroids and/or hospital visit in the previous year, were randomised to receive FF/VI 100/25µg or FF 100µg. Exacerbation prevalence rate during the study was analysed by season; seasonal data were also analysed by hemisphere of study centre country (Northern: Germany, Japan, Mexico, Poland, Romania, Russian Federation, Ukraine, United States; Southern: Argentina, Australia). Data from the Philippines has been excluded from this analysis, but will be presented separately. Results: 1865 patients were included (FF/VI: N=933; FF: N=932), with 444 exacerbations recorded during the study period. Exacerbation prevalence by treatment and season are shown . Findings were consistent when seasonal data were analysed by hemisphere. Conclusion: Asthma exacerbation rates were highest in autumn and winter with both FF/VI and FF; however, FF/VI reduced this seasonal increase in exacerbations vs FF. Funding: GSK (study HZA106837/NCT01086384).

Bulk acoustic wave (BAW) filters operating at center frequency of 3.7GHz, comprising of BAW resonators utilizing single crystal aluminum nitride (AlN) piezoelectric films epitaxially grown on silicon carbide (SiC) substrates, are reported. Metal-organic chemical vapor deposition (MOCVD) growth was used to obtain single crystal AlN films on 150-mm diameter c-plane semi-insulating SiC substrates with (0004) X-ray diffraction (XRD) rocking curve full-width half-maximum (FWHM) of 0.025°. The fabricated filters (1.25×0.9 sq.mm) had a center frequency of 3.71GHz and a 3dB bandwidth of 100MHz, an insertion loss of 2.0dB and narrow band rejection of 40dB and out-of-band rejection in excess of 37dB to 8GHz. Individual resonators on the same wafer show an electro-mechanical coupling as high as 7.63% and maximum quality-factors up to 1572. Insertion loss of 5ohm resonators configured as individual 2-port devices changed by 0.15dB after high power survival test at 10W. This is the first demonstration of single crystal AlN-on-SiC based BAW resonator and filter technology at 3.7GHz and illustrates the potential of a single crystal AlN-on-SiC based BAW technology platform enabling compact, high power and high performance filter solutions for high frequency mobile, Wi-Fi and infrastructure applications.

Correct use and ease of use of a placebo dry powder inhaler was evaluated in two single-arm, United States-multicenter, phase-IV studies in adults with asthma ( n = 259) or chronic obstructive pulmonary disease (COPD; n = 278) who were receiving maintenance inhaler therapy. Subjects demonstrating correct placebo inhaler use within three attempts at screening were instructed to take once-daily inhalations from the inhaler for 28 ± 2 days (continuing usual maintenance), followed by randomization to complete one of two versions of an ease-of-use questionnaire and reassessment for correct inhaler use. At study end, 96% asthma/93% COPD subjects rated the placebo inhaler as “easy” or “very easy” to use while demonstrating correct use. Furthermore, 99% asthma/99% COPD subjects indicated it was “easy” or “very easy” to determine number of doses remaining, and 81%/84%, respectively, indicated they would be “likely” or “very likely” to request their current medication in the inhaler, if available. Adverse event (AE) rates were 12% asthma/15% COPD, most frequently headache (3%/3%). Treatment-related AEs were reported in one subject with asthma (cough) and four subjects with COPD (cough, n = 3; back pain, n = 1). At study end, most subjects with asthma or COPD operated the placebo inhaler correctly and found it easy to use.

Search engine process millions of query and collect data of user interaction every day. These huge amount of data contains valuable information through which web search engine can be optimized. Search engine mostly relies on explicit judgement received from domain experts. To survive the competition search engine must understand user’s information needs very well. Search logs provide implicit data about user’s interaction with search engine. Search logs are noisy, they contain data of both successful search and unsuccessful search. The challenge is to accurately interpret user’s feedback to search engine and learning the user access patterns, such that search engine will better be able to cater the user’s information needs. User feedback can be used to re-rank the search result, query suggestion and URL recommendation.

In recent years, film bulk acoustic resonators (FBARs) have become important in the mobile handset market for their small size compared to surface acoustic wave resonators, their compatibility with existing integrated circuit processes, and their usage in synthesizing components such as filters and duplexers. In this work, we demonstrate through finite element simulation using COMSOL MultiPhysics and experimental data, that single crystal FBARs outperform current polycrystalline devices with their higher mechanical coupling efficiency and quality factor. We also present elasticity coefficients extracted from experimental data on fabricated devices.

Objective: The rhizomes part of Acorus calamus (AC) having the calcium inhibitory effect and diuretic activity which may potentiate Na+ excretion in hypertension induced by occlusion of renal artery. Therefore this study was aimed to investigate the effect of AC on experimentally induced hypertension. Methods: Hypertension in rats was induced by clamping the left renal artery for 4h by arterial clamp (2K1C). At the end of experiment animal were anesthetized with ketamine (50 mg/kg). Carotid artery was cannulated which was connected to pressure transducer for estimation of blood pressure. Results: Ethyl acetate extract of Acorus calamus rhizomes (EAAC) treated rats that underwent hypertension, demonstrated significant (P < 0.01) lower systolic blood pressure and diastolic blood pressure when compared with 2K1C rats indicated blood pressure lowering activity. Plasma renin activity was significantly (P < 0.05) decreased in EAAC treated rats compared to 2K1C rats. EAAC treated rats that underwent hypertension demonstrated significant (P < 0.01) lower mean blood urea nitrogen and creatinine when compared with 2K1C rats. Lipid peroxidation was significantly (P < 0.001) decreased, where as nitric oxide level in tissue was significantly elevated in EAAC treated rats. Antioxidant enzymes like glutathione, superoxide dismutase and catalase were significantly (P < 0.05, P < 0.01, P < 0.001) increased in EAAC treated rats when compared to 2K1C rats. Conclusions: In conclusions, EAAC treatment attenuated renal artery occlusion induced hypertension via nitric oxide generation and decreases the plasma renin activity.

This paper describes the approach used by ezDI at the SemEval 2015 Task-14: ”Analysis of Clinical Text”. The task was divided into two embedded tasks. Task-1 required determining disorder boundaries (including the discontiguous ones) from a given set of clinical notes and normalizing the disorders by assigning a unique CUI from the UMLS/SNOMEDCT 1 . Task-2 was about finding different type of modifiers for given disorder mention. Task-2 was divided further into two subtasks. In subtask-2a, gold set of disorder was already provided and system needed to just fill modifier types into the pre-specified slots. Subtask 2b did not provide any gold set of disorders and both the disorders and its related modifiers are to be identified by the system itself. In Task-1 our system was ranked first with F-score of 0.757 for strict evaluation and 0.788 for relaxed evaluation. In both Task-2a and 2b our system was placed second with weighted F-score of 0.88 and 0.795 respectively.

The mitochondrial metabolism of β cells is thought to be highly specialized. Its direct comparison with other cells using isolated mitochondria is limited by the availability of islets/β cells in sufficient quantity. In this study, we have compared mitochondrial metabolism of INS1E/β cells with other cells in intact and permeabilized states. To selectively permeabilize the plasma membrane, we have evaluated the use of perfringolysin-O (PFO) in conjunction with microplate-based respirometry. PFO is a protein that binds membranes based on a threshold level of active cholesterol. Therefore, unless active cholesterol reaches a threshold level in mitochondria, they are expected to remain untouched by PFO. Cytochrome c sensitivity tests showed that in PFO-permeabilized cells, the mitochondrial integrity was completely preserved. Our data show that a time-dependent decline of the oligomycin-insensitive respiration observed in INS1E cells was due to a limitation in substrate supply to the respiratory chain. We predict that it is linked with the β cell-specific metabolism involving metabolites shuttling between the cytoplasm and mitochondria. In permeabilized β cells, the Complex l-dependent respiration was either transient or absent because of the inefficient TCA cycle. The TCA cycle insufficiency was confirmed by analysis of the CO2 evolution. This may be linked with lower levels of NAD+, which is required as a co-factor for CO2 producing reactions of the TCA cycle. β cells showed comparable OxPhos and respiratory capacities that were not affected by the inorganic phosphate (Pi) levels in the respiration medium. They showed lower ADP-stimulation of the respiration on different substrates. We believe that this study will significantly enhance our understanding of the β cell mitochondrial metabolism.

This paper describes the system used in Task-7 (Analysis of Clinical Text) of SemEval-2014 for detecting disorder mentions and associating them with their related CUI of UMLS 1 . For Task-A, a CRF based sequencing algorithm was used to find different medical entities and a binary SVM classifier was used to find relationship between entities. For Task-B, a dictionary look-up algorithm on a customized UMLS-2012 dictionary was used to find relative CUI for a given disorder mention. The system achieved F-score of 0.714 for Task A & accuracy of 0.599 for Task B when trained only on training data set, and it achieved F-score of 0.755 for Task A & accuracy of 0.646 for Task B when trained on both training as well as development data set. Our system was placed 3rd for both task A and B.

• Clostridium difficile infection (CDI) is a growing concern in many health care facilities.

In today’s era one of the most preferred ways for advertisement is the live telecast programs. The innovative idea is to use background for advertisement in dynamic way. It needs real time video processing, as it is required to mix the two signals, i.e. actual video programs and advertisement. For example, logos of the companies (Sponsor) can be shown on the ground, ball and on player’s T-Shirts without interfering the program, which makes great impact and remembrance on the mind of people through visualization of dynamically changing for advertisement. This paper presents the use of Modified Hough Transform to perform Ball Detection in football videos, in which the football is replaced with Sponsor’s Logo (Coca-Cola). To overcome some disadvantages of Hough Transform the proposed algorithm utilized only 8 edge points to detect the ball. For real time application, the algorithm is designed with simulink model. The design presented here is first verified in with MATLAB Version 7.3 and Simulink model Version 6.5. The corresponding results are verified. The algorithm works 80 % efficiently for videos.

Autotitrating continuous positive airway pressure (auto-CPAP) devices now have a smart card (a pocket-sized card with embedded integrated circuits which records data from the CPAP machine such as CPAP usage, CPAP pressure, large leak, etc.) which can estimate the Apnea–Hypopnea Index (AHI) on therapy. The aim of this study was to determine the accuracy of auto-CPAP in estimating the residual AHI in patients with obstructive sleep apnea (OSA) who were treated with auto-CPAP without a CPAP titration study. We studied 99 patients with OSA from April 2005 to May 2007 who underwent a repeat sleep study using auto-CPAP. The estimated AHI from auto-CPAP was compared with the AHI from an overnight polysomnogram (PSG) on auto-CPAP using Bland–Altman plot and likelihood ratio analyses. A PSG AHI cutoff of five events per hour was used to differentiate patients optimally treated with auto-CPAP from those with residual OSA on therapy. Bland and Altman analysis showed good agreement between auto-CPAP AHI and PSG AHI. There was no significant bias when smart card estimates of AHI at home were compared to smart card estimates obtained in the sleep laboratory. An auto-CPAP cutoff for the AHI of six events per hour was shown to be optimal for differentiating patients with and without residual OSA with a sensitivity of 0.92 (95% confidence interval (CI) 0.76 to 0.98) and specificity of 0.90 (95% CI 0.82 to 0.95) with a positive likelihood ratio (LR) of 9.6 (95% CI 5.1 to 21.5) and a negative likelihood ratio of 0.085 (95% CI 0.02 to 0.25). Auto-CPAP AHI of eight events per hour yielded the optimal sensitivity (0.94, 95% CI 0.73 to 0.99) and specificity (0.90, 95% CI 0.82 to 0.95) with a positive LR of 9.6 (95% CI 5.23 to 20.31) and a negative LR of 0.065 (95% CI 0.004 to 0.279) to identify patients with a PSG AHI of ≥ 10 events per hour. Auto-CPAP estimate of AHI may be used to estimate residual AHI in patients with OSA of varying severity treated with auto-CPAP.

Concerns about the availability and use of conventional nonrenewable energy sources have led to an increasing interest in renewable energy. Because renewable energy sources tend to be dilute and intermittent, solar power satellites have been proposed as a means of supplying large amounts of power continuously. Space solar power (SSP) will not be competitive for commercial-scale baseload power without some combination of greatly reduced launch and non-recurring engineering costs as well as space resource utilization. However, SSP may be competitive in the near term for niche markets where the fully burdened cost of delivery of conventional fuel is much higher than that for commercial markets. A model under development provides a tool to assess masses and costs of solar power satellites at a variety of power levels, orbits, and power transmission frequencies.