Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 37
Filtrar
1.
PLoS One ; 19(3): e0297915, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38489256

RESUMO

This study investigates the relationship between democracy and innovation across 61 developing countries from 2013 to 2020, utilizing data from Global Innovation Index. Employing the Freedom House Index and Polity2 indicators as proxies for democracy, research employs Ordinary Least Squares (OLS), Fixed Effects and SystemGMM techniques to analyze their impact on innovation. The findings of the study reveal no statistically significant relationships between democracy and innovation in developing nations within specified timeframe. Through empirical analysis, including various econometric approaches, it is observed that the level of democracy as measured by these indicators, does not appear to exert a discernable impact on the innovation landscape of these countries. These results carry important implications for public policy. While the promotion of democracy remains a crucial goal, especially for societal development and political stability, this study suggests that solely focusing on enhancing democratic institutions might not necessarily yield immediate direct improvements in the innovation capacities of developing nations. Policymakers and stakeholders involved in fostering innovation ecosystems in these regions may need to consider a more nuanced approach, encompassing factors beyond the scope of democratic governance to effectively spur innovation. Understanding the nuanced relationship between democracy and innovation in developing countries has significant implications for designing targeted policies aimed at enhancing innovation capacities, economic growth and overall societal development in these regions.


Assuntos
Democracia , Países em Desenvolvimento , Ecossistema , Desenvolvimento Econômico , Liberdade
2.
Transpl Immunol ; 84: 102039, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38513813

RESUMO

BACKGROUND: We aimed to investigate factors associated with cytomegalovirus (CMV) viremia and CMV disease and its impact on post-transplant outcomes including overall survival (OS) following allogeneic hematopoietic stem cell transplantation (Allo-SCT). METHODS: We conducted a single-center retrospective study including 452 Allo-SCT recipients (matched unrelated donor, MUD 61%; haploidentical, haplo 39%) from 2016 to 2021. Data were analyzed using SPSS v28. Descriptive (chi-square and t-test), Kaplan-Meier and regression analyses were conducted. RESULTS: The median age was 57 years. Sixty-one percent were males and 84.3% were Caucasians. CMV serostatus was positive in 59.1% of recipients. The median follow-up was 24.4 months. CMV viremia and CMV disease were observed in 181 (40%) and 32 (7%) patients, respectively. Among CMV seropositive recipients, 65% developed CMV viremia and 11% were noted to have CMV disease compared to 4% and 1% in seronegative recipients, respectively (p < 0.001). Patients with CMV disease had significantly lower OS than those without CMV disease (median 14.1 months vs. not reached, p = 0.024); however, OS was not associated with CMV viremia (median not reached in both groups, p = 0.640). Letermovir prophylaxis was used in 66% (n = 176/267) of CMV seropositive recipients, but no impact was observed on the incidence of CMV viremia or CMV disease and OS. CONCLUSIONS: CMV disease leads to significantly inferior survival after an allogeneic hematopoietic cell transplantation. Recipient CMV seropositive status was associated with the risk of CMV viremia and CMV disease, and this was not abrogated with the use of Letermovir prophylaxis.


Assuntos
Infecções por Citomegalovirus , Citomegalovirus , Transplante de Células-Tronco Hematopoéticas , Transplante Homólogo , Ativação Viral , Humanos , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Masculino , Pessoa de Meia-Idade , Feminino , Infecções por Citomegalovirus/mortalidade , Estudos Retrospectivos , Citomegalovirus/fisiologia , Adulto , Idoso , Seguimentos , Adulto Jovem , Viremia/epidemiologia , Adolescente , Fatores de Risco , Prognóstico
3.
Cureus ; 15(9): e45015, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37829975

RESUMO

Background Hemorrhoids refer to the abnormal enlargement of the anal cushions. They are a common anorectal problem with a prevalence of 5% in the general population aged greater than 40 years. The objective of this study was to compare Milligan-Morgan open hemorrhoidectomy with pedicle ligation with LigaSure (Medtronic, Dublin, Ireland) in terms of postoperative pain on day 1 and day 7. It is important to assess the technique that is associated with lower postoperative pain because both of these techniques are still practiced in the developing world. Methods It was a randomized controlled trial conducted in the Department of Surgery, Rawalpindi, Pakistan. A total of 100 patients were selected and were allotted into the two groups by lottery method. Patients aged from 15 to 60 years who presented with symptomatic third and fourth-degree hemorrhoids were included after taking informed consent. Patients who had a previous or concomitant anorectal disease, patients who had undergone previous surgery for hemorrhoids, and those who were anesthetically unfit for surgery (American Society of Anesthesiologists (ASA) class 3 or above) were excluded from the study. Pain was assessed using the Visual Analogue scale (VAS). Data was entered and analyzed using SPSS v. 23.0 (IBM Corp., Armonk, USA). Chi-square tests were applied. P-value <0.05 was taken as statistically significant. Results Out of 100 patients, 68 (68%) were males while 32 (32%) were females. The mean age was 40.56±9.24 years. Postoperative pain at day 1 was 9.24±0.51 in the Milligan-Morgan group while that in the LigaSure group was 8.44±0.64 (p<0.0001). Postoperative pain at day 7 was 5.00±0.85 in the Milligan-Morgan group while it was 3.04±1.08 in the LigaSure group (p<0.0001). Conclusion LigaSure is a newer technique that helps to reduce complications as compared to other traditional hemorrhoidectomy procedures. Many patients avoid hemorrhoidectomy as it is associated with painful postoperative recovery. Pedicle coagulation with LigaSure was better than conventional Milligan-Morgan hemorrhoidectomy in terms of reducing the mean postoperative pain on 1st day and 7th day. Reducing the postoperative pain helps in greater patient satisfaction and lesser requirement of analgesia among patients of 3rd and 4th-degree hemorrhoids undergoing hemorrhoidectomy.

4.
Heliyon ; 9(9): e19447, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37681176

RESUMO

Wireless devices have become extremely inexpensive and popular in recent years. The two most significant advantages of wireless devices over wired ones are convenience and flexibility. Considering this, a wireless mouse pad prototype for access has been developed in this study. A capacitive sensors-based mouse pad with basic operations and conventional features has been developed using sensing arrays on paper. A facile, do-it-yourself fabrication process was utilized to develop a cost-effective, thin, wearable, and cleanroom-free wireless mouse cursor control (MCC) pad. The ablation process was used to cut the traces of conductive tape and paste them onto the paper to develop the MCC pad. The pad was connected with Espressif Systems (ESP)32 to wirelessly control the cursor of mobile and laptop. The capacitive touch sensor array-based pad is easy to reproduce and recycle. This pad can contribute to future advancements in thin human-machine interfaces, soft robotics, and medical and healthcare applications.

5.
PLoS One ; 18(8): e0290511, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37651415

RESUMO

The optimum economic outcome of financial system development depends on its level of efficiency. The purpose of this study is to investigate the effect of institutional quality on financial system efficiency. For empirical analysis, we have used a panel dataset of 108 countries from 1996-2020 and employed fixed effect regression and two stages least squares (2SLS) regression methods. The empirical results show that institutional quality has a significant positive effect on financial system efficiency. Particularly all the constituting elements-voice and accountability, political stability and absence of violence, regulatory quality, government effectiveness, rule of law, and control of corruption-of institutional quality are found to have a significant positive impact on financial system efficiency. Moreover, we found that the effect of institutional quality is more pronounced in countries with low-income levels and strong institutional quality. These findings are robust across several robustness tests conducted using additional controls, alternative methodologies, an alternative measure of institutional quality, and financial system efficiency. The results of the study suggest that policy makers should prioritize both enhancing and sustaining institutional quality to promote the efficiency of the financial system, which is crucial for sustainable growth and development.


Assuntos
Pessoal Administrativo , Governo , Humanos , Instalações de Saúde , Pobreza , Responsabilidade Social
6.
Cureus ; 15(5): e39553, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37378095

RESUMO

Lupus erythematosus (LE) is an autoimmune disease that presents either as a systemic (SLE) or an isolated skin disease (CLE). Currently, there is no FDA-approved medication specifically for CLE, and is treated with the same approach as SLE. We present two refractory cases of SLE with severe cutaneous manifestations unresponsive to the first-line therapy treated with anifrolumab. First, a 39-year-old Caucasian female with a known history of SLE with severe subacute CLE presented to the clinic for her refractory cutaneous symptoms. Her current regimen was hydroxychloroquine (HCQ), mycophenolate mofetil (MMF), and s/c belimumab with no improvement. Belimumab was discontinued, and she was started on anifrolumab with significant improvement. Another, a 28-year-old female with no known medical history was referred to a rheumatology clinic for elevated anti-nuclear antibody (ANA) and ribonucleoprotein (RNP) titers. She was diagnosed with SLE, and was treated with HCQ, belimumab, and MMF but failed to produce a reasonably good outcome. Hence belimumab was discontinued and anifrolumab was added instead with significant cutaneous improvement. The treatment spectrum for SLE is wide, which includes antimalarial (HCQ), oral corticosteroids (OCS), and immunosuppressants (Methotrexate-MTX, MMF, azathioprine-AZT). Anifrolumab, a type 1 IFNα receptor subunit 1 (IFNAR1) inhibitor, has been recently approved by the FDA for moderate to severe SLE while on standard therapy in August 2021. Early use of anifrolumab in moderate to severe cutaneous manifestations of SLE or CLE may result in significant improvement in patients.

7.
Heart Fail Rev ; 28(5): 1163-1175, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37145271

RESUMO

The twenty-first century has revolutionized the management of congestive heart failure with the widespread use of left ventricular assist devices and other treatment modalities that improve morbidity and mortality after the failure of medical management. These novel devices come with significant side effects. One of the most common side effects of left ventricular assist devices is the increased frequency of lower gastrointestinal bleeding compared to heart failure patients without left ventricular assist devices. Multiple etiologies of recurrent gastrointestinal bleeding in such patients have been studied. The decreased amount of von Willebrand factor polymers is now recognized as one of the most common causes of increased incidence of gastrointestinal bleeding in patients with left ventricular assist devices alongside increased arteriovenous malformations. Multiple treatment modalities have been identified to prevent and treat gastrointestinal bleeding in these patients. Since the use of left ventricular assist devices is becoming more prevalent in patients with advanced heart failure, we decided to conduct this systematic review. The article summarizes the incidence, pathophysiology, and management of lower gastrointestinal bleeding in patients with left ventricular assist devices.


Assuntos
Insuficiência Cardíaca , Coração Auxiliar , Humanos , Coração Auxiliar/efeitos adversos , Hemorragia Gastrointestinal/epidemiologia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/terapia , Incidência
8.
Cureus ; 15(4): e38026, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37228539

RESUMO

Marijuana is considered as the most popular illicit drug around the world. It has numerous cardiovascular effects with myocardial infarction (MI) being a lethal one. The negative physiological effects of marijuana are well-studied, including tachycardia, nausea, memory impairment, anxiety, panic, and arrhythmia. We present a case of cardiac arrest following marijuana use in a patient who had a normal electrocardiogram (EKG) on presentation but diffuse coronary vasospasm on left heart catheterization (LHC) with no obstructive lesion. The patient had a transient episode of ST elevation on EKG following the procedure which resolved with an increased dose of nitroglycerine drip. Synthetic cannabinoids are more potent and not detected on a regular urine drug screen (UDS). In patients with low risk for cardiovascular events, particularly young adults, presenting with symptoms of MI/cardiac arrest, marijuana-induced MI should be suspected due to the severe adverse effects of its synthetic component.

9.
ACS Omega ; 8(19): 16842-16850, 2023 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-37214719

RESUMO

An eco-friendly, biodegradable, flexible, and facile fabricated interdigital electrode-based capacitive humidity sensor with applications in health and medicine has been reported here. Several sensors use copper tape as electrodes on the polyethylene terephthalate (PET) substrate, with non-woven paper as the sensing layer. Two different configurations of sensors were tested, i.e., with and without pores in the PET substrate. The sensing performance of both sensors has been tested for relative humidity ranging from 35 to 100% at temperatures ranging from 20 to 50 °C. The capacitance of the sensor varies linearly in response to the change in humidity. The sensor with pores shows a response from 28 to 630 pF as the humidity varied from 35 to 100%, whereas the sensor without pores responded from 22 to 430 pF. The response and recovery times of the fabricated sensor are observed as ∼2.4, and ∼1.8 s, respectively, and the sensitivity is 9.67 pF/% RH. The sensors are tested multiple times, and repeatable results are achieved each time with an accuracy of ±0.22%. Further, the sensor's response is also stable for different ranges of temperatures. Finally, to demonstrate an application of the proposed sensor, it has been utilized to monitor respiration through nose and mouth breathing. The low-cost, stable, repeatable, and highly sensitive response makes our fabricated sensor a promising candidate for practical field applications.

10.
Nanomaterials (Basel) ; 13(4)2023 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-36839148

RESUMO

Two-dimensional materials (2DMs) have been vastly studied for various electrochemical sensors. Among these, the sensors that are directly related to human life and health are extremely important. Owing to their exclusive properties, 2DMs are vastly studied for electrochemical sensing. Here we have provided a selective overview of 2DMs-based electrochemical sensors that directly affect human life and health. We have explored graphene and its derivatives, transition metal dichalcogenide and MXenes-based electrochemical sensors for applications such as glucose detection in human blood, detection of nitrates and nitrites, and sensing of pesticides. We believe that the areas discussed here are extremely important and we have summarized the prominent reports on these significant areas together. We believe that our work will be able to provide guidelines for the evolution of electrochemical sensors in the future.

11.
Cardiovasc Revasc Med ; 50: 54-58, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36737383

RESUMO

BACKGROUND: Comparison of the real-world cohort on the relative safety of alcohol septal ablation (ASA) vs. septal myectomy (SM) for the management of hypertrophic cardiomyopathy (HCM) has been lacking. METHODS: The National Inpatient Sample (NIS) (2012-2019) was used to select all cases of HCM. The safety of ASA vs. SM was compared using a one:many propensity score matched (PSM) analysis. Adjusted odds ratios (aOR) for mortality and other in-hospital complications were computed. RESULTS: A total of 6208 HCM patients (ASA 3106 vs. SM 3102) were included using a PSM analysis. Post-procedural bleeding (aOR 0.18, 95 % CI 0.11-0.32, p < 0.0001) and the need for an intra-aortic balloon pump (aOR 0.51, 95 % CI, 0.28-0.96, p = 0.037) were significantly lower while permanent pacemaker (PPM) implantation was significantly higher in ASA group as compared with SM group (aOR 1.72, 95 % CI, 1.43-2.06, p < 0.0001). The total in-hospital mean adjusted cost and length of stay were also significantly lower in the ASA group. However, there were no significant differences in adjusted odds of all-cause mortality (aOR 0.91, 95 % CI 0.62-1.33, p = 0.61), stroke (aOR 0.91, 95 % CI, 0.59-1.4, p = 0.66), and major bleeding (aOR 1.0, 95 % CI 7.8-1.29, p = 0.99) between the two comparison groups. CONCLUSION: In patients with hypertrophic cardiomyopathy, alcohol septal ablation appears to be an acceptable alternative to septal myectomy due to a lower risk of post-procedural bleeding and the need for an intra-aortic balloon pump. However, ASA confers a higher risk of PPM placement.


Assuntos
Cardiomiopatia Hipertrófica , Pacientes Internados , Humanos , Resultado do Tratamento , Septos Cardíacos/diagnóstico por imagem , Septos Cardíacos/cirurgia , Etanol/efeitos adversos , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Cardiomiopatia Hipertrófica/cirurgia
12.
Heliyon ; 9(2): e13586, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36846675

RESUMO

Nowadays, security is one of the living essentials, and there is a dire need for reliable, secure, and smarter locking systems. The stand-alone smart security systems are of great interest as they do not involve keys, cards, or unsecured communication in order to prevent carrying, loss, duplication, and hacking. Here, we report an invisible touch sensors-based smart door locking system (DLS). The passive transducer-based touch sensors are fabricated through a facile do-it-yourself (DIY) based fabrication process by pasting the hybrid geometry copper electrodes on cellulose paper. The employment of biodegradable, and non-toxic materials like paper and copper tape makes this configuration a good candidate for green electronics. For additional security, the keypad in the DLS is made invisible by covering it with paper and spray paint. One can only open the door by knowing the password as well as the location of each key on the sensor keypad. The system can efficiently recognize the exact pattern of passwords without any false values. Invisible touch sensors-based locking systems can easily contribute to the security applications in homes, banks, automobiles, apartments, lockers, and cabinets.

13.
Sensors (Basel) ; 22(21)2022 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-36365810

RESUMO

There is a great demand for human-machine interfaces (HMIs) in emerging electronics applications. However, commercially available plastic-based HMIs are primarily rigid, application-specific, and hard to recycle and dispose of due to their non-biodegradability. This results in electronic and plastic waste, potentially damaging the environment by ending up in landfills and water resources. This work presents a green, capacitive pressure-sensitive (CPS), touch sensor-based keypad as a disposable, wireless, and intelligent HMI to mitigate these problems. The CPS touch keypads were fabricated through a facile green fabrication process by direct writing of graphite-on-paper, using readily available materials such as paper and pencils, etc. The interdigitated capacitive (IDC) touch sensors were optimized by analyzing the number of electrode fingers, dimensions, and spacing between the electrode fingers. The CPS touch keypad was customized to wirelessly control a robotic arm's movements based on the touch input. A low-pressure touch allows slow-speed robotic arm movement for precision movements, and a high-pressure touch allows high-speed robotic arm movement to cover the large movements quickly. The green CPS touch keypad, as a disposable wireless HMI, has the potential to enforce a circular economy by mitigating electronic and plastic waste, which supports the vision of a sustainable and green world.


Assuntos
Grafite , Tato , Humanos , Eletrodos , Eletrônica , Plásticos
14.
Sensors (Basel) ; 22(20)2022 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-36298240

RESUMO

The role of humidity sensors in different industries and field applications, such as agriculture, food monitoring, biomedical equipment, heating, and ventilation, is well known. However, most commercially available humidity sensors are based on polymers or electronic materials that are not degradable and thus contribute to electronic waste. Here, we report a low-cost, flexible, easy-to-fabricate, and eco-friendly parallel-plate capacitive humidity sensor for field applications. The sensor is fabricated from copper tape and tissue paper, where copper tape is used to create the plates of the capacitor, and tissue paper is used as a dielectric sensing layer. Along with the low cost, the high sensitivity, better response and recovery times, stability, and repeatability make this sensor unique. The sensor was tested for relative humidity (RH), ranging from 40% to 99%, and the capacitance varied linearly with RH from 240 pF to 720 pF, as measured by an Arduino. The response time of the sensor is ~1.5 s, and the recovery time is ~2.2 s. The experiment was performed 4-5 times on the same sensor, and repeatable results were achieved with an accuracy of ±0.1%. Furthermore, the sensor exhibits a stable response when tested at different temperatures. Due to the above advantages, the presented sensor can find ready applications in different areas.


Assuntos
Cobre , Eletrônica , Umidade , Capacitância Elétrica , Polímeros
15.
Int J Surg Case Rep ; 100: 107733, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36252545

RESUMO

INTRODUCTION AND IMPORTANCE: Ovarian and fallopian tube indirect inguinal hernias are rare hernias encountered on surgical floor. Herein, we are reporting a rare happening of obstructed ovarian and fallopian tube indirect inguinal hernia in an unmarried female. PRESENTATION OF CASE: A 19 years old unmarried female presented to surgical emergency with complain of swelling in left inguinal region that was about 3 × 3 cm on visual inspection from last 4 days that was associated with menstruation. Abdominal ultrasound (USG) was showing left ovarian and fallopian tube indirect inguinal hernia with preserved internal follicles and intact vasculature. The diagnosis of obstructed ovarian and fallopian tube indirect inguinal hernia was made and diagnostic laparoscopy and left sided hernioplasty was performed. Ovary was retrieved back into abdominal cavity and stitched to lateral pelvic wall. DISCUSSION: Inguinal hernia itself is a rare happening in females and the presence of ovary and fallopian tube along with other hernial content can become a topic of discussion due to rarity of this case. It is of paramount significance to diagnose such cases with great expertise in order to avoid long term complications in terms of preserving fertility among females. Early utilization of radiological investigations like USG abdomen and laparoscopic retrieval of adnexal structures are standard approach in management of such cases. CONCLUSION: Presence of ovary and fallopian tube in indirect inguinal hernia is a rare happening that need to be diagnosed and treated at earliest to avoid infertility among females.

16.
Case Rep Endocrinol ; 2021: 8243471, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34804616

RESUMO

OBJECTIVE: This case involves a new-onset diabetes patient diagnosed during pregnancy with the congenital dysplastic right kidney. Case Report. Clinical presentation, biochemical features, imaging in a patient with diabetes diagnosed during pregnancy, and congenital dysplastic right kidney. Discussion. We present a case of a 22-year-old female with the congenital dysplastic right kidney diagnosed with gestational diabetes mellitus after failing a 1-hour oral glucose tolerance test, requiring insulin during pregnancy. Because of the family history of diabetes and morphologic renal abnormalities at young ages on the maternal side of the family, our patient was evaluated for maturity-onset diabetes of adult and was found to have HNF-1ß mutation. CONCLUSION: This case highlights the importance of considering the diagnosis of maturity-onset diabetes of young and particularly MODY-5 in individuals with extrapancreatic features. MODY-5 should also be considered in a patient undergoing renal transplant at young ages with a family history of morphologic renal abnormalities.

17.
Cureus ; 13(6): e16022, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34336511

RESUMO

Background Transcatheter aortic valve replacement (TAVR) is now a common procedure to treat and improve quality of life, clinical outcomes, and self-sufficiency in high-risk patients with aortic stenosis, and its use has been expanding rapidly in younger and low-risk populations. The aim of this study was to evaluate the outcomes, trends, and predictors of major bleeding in patients undergoing TAVR. Methodology We utilized the National Inpatient Sample (NIS) data from the year 2015 to 2018. International Classification of Disease 10 codes were utilized to extract data. Baseline characteristics were compared using Pearson's chi-square test for categorical variables and independent samples t-test for continuous variables. A multivariable logistic regression model was used to evaluate the predictors of major bleeding. Propensity matching was done for adjusted analysis to compare outcomes in TAVR with and without major bleeding. The outcomes of interest in this study were (1) predictors of major bleeding after TAVR; (2) in-hospital mortality; and (3) resource utilization in terms of cost and length of stay. Results A total of 34,752 weighted hospitalizations for TAVR were included in the analysis. Of the patients undergoing the procedure, 2,294 (6.6%) had a major bleed while 32,458 (93.3%) did not. At baseline, patients with coagulopathy (odds ratio [OR]: 2.03; 95% confidence interval [CI]: 1.82-2.27), congestive heart failure (OR: 1.26; 95% CI: 1.13-1.40), chronic obstructive pulmonary disease (OR: 1.41; 95% CI: 1.29-1.55), liver disease (OR: 1.96; 95% CI: 1.61-2.39), peripheral vascular disease (OR: 1.29; 95% CI: 1.17-1.43), cerebrovascular disease (OR: 1.22; 95% CI: 1.07-1.38), end-stage renal disease (ESRD) (OR: 2.17; 95% CI: 1.82-2.59), and coronary artery disease (OR: 1.17; 95% Cl: 1.06-1.30) had higher adjusted rates of odds of major bleeding. Patients who had major bleeding had a higher median cost of stay (US$60,326 vs. US$45490) and length of stay (seven vs. three days). Conclusions Mortality is higher in patients with major bleeding, and at baseline, coagulopathy and ESRD are significant predictors of a major bleed in patients undergoing TAVR.

18.
J Am Heart Assoc ; 10(14): e020906, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34259045

RESUMO

Background As transcatheter aortic valve replacement (TAVR) technology expands to healthy and lower-risk populations, the burden and predictors of procedure-related complications including the need for permanent pacemaker (PPM) implantation needs to be identified. Methods and Results Digital databases were systematically searched to identify studies reporting the incidence of PPM implantation after TAVR. A random- and fixed-effects model was used to calculate unadjusted odds ratios (OR) for all predictors. A total of 78 studies, recruiting 31 261 patients were included in the final analysis. Overall, 6212 patients required a PPM, with a mean of 18.9% PPM per study and net rate ranging from 0.16% to 51%. The pooled estimates on a random-effects model indicated significantly higher odds of post-TAVR PPM implantation for men (OR, 1.16; 95% CI, 1.04-1.28); for patients with baseline mobitz type-1 second-degree atrioventricular block (OR, 3.13; 95% CI, 1.64-5.93), left anterior hemiblock (OR, 1.43; 95% CI, 1.09-1.86), bifascicular block (OR, 2.59; 95% CI, 1.52-4.42), right bundle-branch block (OR, 2.48; 95% CI, 2.17-2.83), and for periprocedural atriorventricular block (OR, 4.17; 95% CI, 2.69-6.46). The mechanically expandable valves had 1.44 (95% CI, 1.18-1.76), while self-expandable valves had 1.93 (95% CI, 1.42-2.63) fold higher odds of PPM requirement compared with self-expandable and balloon-expandable valves, respectively. Conclusions Male sex, baseline atrioventricular conduction delays, intraprocedural atrioventricular block, and use of mechanically expandable and self-expanding prosthesis served as positive predictors of PPM implantation in patients undergoing TAVR.


Assuntos
Estenose da Valva Aórtica/cirurgia , Arritmias Cardíacas/prevenção & controle , Frequência Cardíaca/fisiologia , Marca-Passo Artificial , Substituição da Valva Aórtica Transcateter/efeitos adversos , Estenose da Valva Aórtica/fisiopatologia , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/fisiopatologia , Eletrocardiografia , Saúde Global , Humanos , Incidência
19.
Nanotechnology ; 32(21)2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33556924

RESUMO

The integration of electrical contact into 2D heterostructure is an essential approach to high-quality electronic nano-devices, especially field-effect transistors. However, high contact resistance with transition metal dichalcogenides such as molybdenum disulphide (MoS2)-based devices has been a significant fabrication impediment to their potential applications. Here, we have demonstrated the advantage of 1D indium metal contact with fully encapsulated MoS2within hexagonal boron nitride. The electrical measurements of the device exhibit ambipolar transport with an on/off ratio of102for holes and107for electrons. The device exhibits high field-effect mobility of40.7cm2V-1s-1at liquid nitrogen temperature. Furthermore, we have also analysed the charge-transport mechanism at the interface and have calculated the Schottky barrier height from the temperature-dependent measurement. These results are highly promising for the use of air-sensitive material heterostructure and large-scale design of trending flexible, transparent electronic wearable devices.

20.
Environ Sci Pollut Res Int ; 28(13): 16568-16588, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33387307

RESUMO

This study investigates the impact of globalization, financial development, and energy utilization on environmental sustainability in the Gulf Cooperation Council (GCC) countries. GCC countries are currently experiencing higher demand and utilization of energy resources, high global integration, and improvements in the financial sector that poses serious environmental sustainability challenges. We have employed a relatively comprehensive proxy, i.e., ecological footprint for environmental sustainability and more advanced and robust econometric strategies (second-generation) to examine the impact of globalization, financial development, and energy utilization on environmental sustainability in the GCC countries, which have a significant departure from the extant literature. The results of this study show that globalization, financial development, and energy utilization are significantly deteriorating the environmental quality in the GCC countries. Additionally, in order to account for the national heterogeneity, we have performed country-specific analysis and interestingly, results reveal that globalization, financial development, and energy utilization negatively influence the environmental sustainability in each sample country that is consistent with the findings of overall panel. Furthermore, the findings are robust to various robustness checks that we have performed for checking the reliability of our main findings. This study also offers some useful policy implications to the stakeholder in general and specifically concerning the GCC countries for promoting their environmental sustainability.


Assuntos
Desenvolvimento Econômico , Internacionalidade , Dióxido de Carbono , Políticas , Reprodutibilidade dos Testes
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA