BACKGROUND Management of chronic total occlusions(CTO)in diabetics is challenging,with a recent trend towards early revascularization[ER:Percutaneous coronary intervention(PCI)and bypass grafting]instead of optimal me...BACKGROUND Management of chronic total occlusions(CTO)in diabetics is challenging,with a recent trend towards early revascularization[ER:Percutaneous coronary intervention(PCI)and bypass grafting]instead of optimal medical therapy(OMT).We hypothesize that ER improves morbidity and mortality outcomes in diabetic patients with CTOs as compared to OMT.AIM To determine the long term clinical outcomes and to compare morbidity and mortality between OMT and ER in diabetic patients with CTOs.METHODS Potentially relevant published clinical trials were identified in Medline,Embase,chemical abstracts and Biosis(from start of the databases till date)and pooled hazard ratios(HR)computed using a random effects model,with significant P value<0.05.Primary outcome of interest was all-cause death.Secondary outcomes included cardiac death,prompt revascularization(ER)or repeat myocardial infarction(MI).Due to scarcity of data,both Randomized control trials and observational studies were included.4 eligible articles,containing 2248 patients were identified(1252 in OMT and 1196 in ER).Mean follow-up was 45-60 mo.RESULTS OMT was associated with a higher all-cause mortality[HR:1.70,95%confidence interval(CI):0.80-3.26,P=0.11]and cardiac mortality(HR:1.68,95%CI:0.96-2.96,P=0.07).Results were close to significance.The risk of repeat MI was almost the same in both groups(HR:0.97,95%CI:0.61-1.54,P=0.90).Similarly,patients assigned to OMT had a higher risk of repeat revascularization(HR:1.62,95%CI:1.36-1.94,P<0.00001).Sub-group analysis of OMT vs PCI demonstrated higher all-cause(HR:1.98,95%CI:1.36-2.87,P=0.0003)and cardiac mortality(HR:1.87,95%CI:0.96-3.62,P=0.06)in the OMT group.The risk of repeat MI was low in the OMT group vs PCI(HR:0.53,95%CI:0.31-0.91,P=0.02).Data on repeat revascularization revealed no difference between the two(HR:1.00,95%CI:0.52-1.93,P=1.00).CONCLUSION In diabetic patients with CTO,there was a trend for improved outcomes with ER regarding all-cause and cardiac death as compared to OMT.These findings were reinforced with statistical significance on subgroup analysis of OMT vs PCI.展开更多
Contaminated or infected patients present a risk of cross-contamination for emergency responders, attending medical personnel and medical facilities as they enter a treatment facility. The controlled conditions of an ...Contaminated or infected patients present a risk of cross-contamination for emergency responders, attending medical personnel and medical facilities as they enter a treatment facility. The controlled conditions of an aerosol test chamber are required to examine factors of contamination, decontamination, and cross-contamination. This study presents the design, construction, and a method for characterizing an aerosol test chamber for a full-sized manikin on a standard North Atlantic Treaty Organization litter. The methodology combined air velocity measurements, aerosol particle counts and size distributions, and computational fluid dynamics modeling to describe the chamber’s performance in three dimensions. This detailed characterization facilitates future experimental design by predicting chamber performance for a variety of patient-focused research.展开更多
Pavement deterioration creates conditions that undermine their performances, which gives rise to the need for maintenance and rehabilitation. This paper develops a mathematical multi-linear regression analysis （MLRA...Pavement deterioration creates conditions that undermine their performances, which gives rise to the need for maintenance and rehabilitation. This paper develops a mathematical multi-linear regression analysis （MLRA） model to determine a pavement sustainability index （PSTI） as dependent variable for flexible pavements in Maryland. Four categories of pavement performance evaluation indicators are subdivided into seven pavement condition indices and analyzed as independent variables for each section of pavement. Data are collected from five different roadways using field evaluations and existing database. Results indicate that coefficient of determination （R^2） is correlated and significant, R^2 = 0.959. Of the seven independent variables, present serviceability index （PSI） is the most significant with a coefficient value of 0.032, present serviceability rating （PSR） coefficient value=0.028, and international roughness index （IRI） coefficient value = -0.001. Increasing each unit value of coefficients for PSI and PSR would increase the value of PSTI; thereby providing a more sustainable pavement infrastructure; which explains the significance of the model and why IR/ will most likely impact environmental, economic and social values.展开更多
Holographic imaging offers a reliable and fast method to capture the complete three-dimensional （3D） information of the scene from a single perspective. We review our recently proposed single-channel optical system ...Holographic imaging offers a reliable and fast method to capture the complete three-dimensional （3D） information of the scene from a single perspective. We review our recently proposed single-channel optical system for generating digital Fresnel holograms of 3D real-existing objects illuminated by incoherent light. In this motionless holographic technique, light is reflected, or emitted from a 3D object, propagates through a spatial light modulator （SLM）, and is recorded by a digital camera. The SLM is used as a beamsplitter of the single-channel incoherent interferometer, such that each spherical beam originated from each object point is split into two spherical beams with two different curve radii. Incoherent sum of the entire interferences between all the couples of spherical beams creates the Fresnel hologram of the observed 3D object. When this hologram is reconstructed in the computer, the 3D properties of the object are revealed.展开更多
文摘BACKGROUND Management of chronic total occlusions(CTO)in diabetics is challenging,with a recent trend towards early revascularization[ER:Percutaneous coronary intervention(PCI)and bypass grafting]instead of optimal medical therapy(OMT).We hypothesize that ER improves morbidity and mortality outcomes in diabetic patients with CTOs as compared to OMT.AIM To determine the long term clinical outcomes and to compare morbidity and mortality between OMT and ER in diabetic patients with CTOs.METHODS Potentially relevant published clinical trials were identified in Medline,Embase,chemical abstracts and Biosis(from start of the databases till date)and pooled hazard ratios(HR)computed using a random effects model,with significant P value<0.05.Primary outcome of interest was all-cause death.Secondary outcomes included cardiac death,prompt revascularization(ER)or repeat myocardial infarction(MI).Due to scarcity of data,both Randomized control trials and observational studies were included.4 eligible articles,containing 2248 patients were identified(1252 in OMT and 1196 in ER).Mean follow-up was 45-60 mo.RESULTS OMT was associated with a higher all-cause mortality[HR:1.70,95%confidence interval(CI):0.80-3.26,P=0.11]and cardiac mortality(HR:1.68,95%CI:0.96-2.96,P=0.07).Results were close to significance.The risk of repeat MI was almost the same in both groups(HR:0.97,95%CI:0.61-1.54,P=0.90).Similarly,patients assigned to OMT had a higher risk of repeat revascularization(HR:1.62,95%CI:1.36-1.94,P<0.00001).Sub-group analysis of OMT vs PCI demonstrated higher all-cause(HR:1.98,95%CI:1.36-2.87,P=0.0003)and cardiac mortality(HR:1.87,95%CI:0.96-3.62,P=0.06)in the OMT group.The risk of repeat MI was low in the OMT group vs PCI(HR:0.53,95%CI:0.31-0.91,P=0.02).Data on repeat revascularization revealed no difference between the two(HR:1.00,95%CI:0.52-1.93,P=1.00).CONCLUSION In diabetic patients with CTO,there was a trend for improved outcomes with ER regarding all-cause and cardiac death as compared to OMT.These findings were reinforced with statistical significance on subgroup analysis of OMT vs PCI.
文摘Contaminated or infected patients present a risk of cross-contamination for emergency responders, attending medical personnel and medical facilities as they enter a treatment facility. The controlled conditions of an aerosol test chamber are required to examine factors of contamination, decontamination, and cross-contamination. This study presents the design, construction, and a method for characterizing an aerosol test chamber for a full-sized manikin on a standard North Atlantic Treaty Organization litter. The methodology combined air velocity measurements, aerosol particle counts and size distributions, and computational fluid dynamics modeling to describe the chamber’s performance in three dimensions. This detailed characterization facilitates future experimental design by predicting chamber performance for a variety of patient-focused research.
文摘Pavement deterioration creates conditions that undermine their performances, which gives rise to the need for maintenance and rehabilitation. This paper develops a mathematical multi-linear regression analysis （MLRA） model to determine a pavement sustainability index （PSTI） as dependent variable for flexible pavements in Maryland. Four categories of pavement performance evaluation indicators are subdivided into seven pavement condition indices and analyzed as independent variables for each section of pavement. Data are collected from five different roadways using field evaluations and existing database. Results indicate that coefficient of determination （R^2） is correlated and significant, R^2 = 0.959. Of the seven independent variables, present serviceability index （PSI） is the most significant with a coefficient value of 0.032, present serviceability rating （PSR） coefficient value=0.028, and international roughness index （IRI） coefficient value = -0.001. Increasing each unit value of coefficients for PSI and PSR would increase the value of PSTI; thereby providing a more sustainable pavement infrastructure; which explains the significance of the model and why IR/ will most likely impact environmental, economic and social values.
文摘Holographic imaging offers a reliable and fast method to capture the complete three-dimensional （3D） information of the scene from a single perspective. We review our recently proposed single-channel optical system for generating digital Fresnel holograms of 3D real-existing objects illuminated by incoherent light. In this motionless holographic technique, light is reflected, or emitted from a 3D object, propagates through a spatial light modulator （SLM）, and is recorded by a digital camera. The SLM is used as a beamsplitter of the single-channel incoherent interferometer, such that each spherical beam originated from each object point is split into two spherical beams with two different curve radii. Incoherent sum of the entire interferences between all the couples of spherical beams creates the Fresnel hologram of the observed 3D object. When this hologram is reconstructed in the computer, the 3D properties of the object are revealed.
