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Search Results: 1 - 10 of 463067 matches for " Alfred A. Bove "
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Elevated Cardiac Troponin in Acute Stroke without Acute Coronary Syndrome Predicts Long-Term Adverse Cardiovascular Outcomes
Farhan Raza,Mohamad Alkhouli,Paul Sandhu,Reema Bhatt,Alfred A. Bove
Stroke Research and Treatment , 2014, DOI: 10.1155/2014/621650
Abstract: Background. Elevated cardiac troponin in acute stroke in absence of acute coronary syndrome (ACS) has unclear long-term outcomes. Methods. Retrospective analysis of 566 patients admitted to Temple University Hospital from 2008 to 2010 for acute stroke was performed. Patients were included if cardiac troponin I was measured and had no evidence of ACS and an echocardiogram was performed. Of 200 patients who met the criteria, baseline characteristics, electrocardiograms, and major adverse cardiovascular events (MACE) were reviewed. Patients were characterized into two groups with normal and elevated troponins. Primary end point was nonfatal myocardial infarction during follow-up period after discharge. The secondary end points were MACE and death from any cause. Results. For 200 patients, 17 patients had positive troponins. Baseline characteristics were as follows: age , 64% African Americans, 78% with hypertension, and 22% with previous CVA. During mean follow-up of 20.1 months, 7 patients (41.2%) in elevated troponin and 6 (3.3%) patients in normal troponin group had nonfatal myocardial infarction (). MACE (41.2% versus 14.2%, ) and death from any cause (41.2% versus 14.5%, ) were significant in the positive troponin group. Conclusions. Elevated cardiac troponin in patients with acute stroke and no evidence of ACS is strong predictor of long-term cardiac outcomes. 1. Background The relationship between acute stroke and coronary artery disease is complex, and they are related to each other in multiple ways. Acute stroke confers a significant increase in adverse cardiac outcomes during short- and long-term follow-up [1]. A subset of patients with stroke might be at higher risk of long-term adverse cardiovascular outcomes. Identifying these patients, ideally with a simple test or biomarker, can help to reduce their long-term risk of adverse events. Troponin is a highly sensitive and specific marker for myocardial necrosis that is used in the diagnosis and prognosis of patients with acute coronary syndrome. However, troponin elevation has been documented in multiple clinical settings in the absence of ACS [2, 3]. Increase in troponin has been documented in all types of stroke including ischemic stroke and subarachnoid hemorrhage [4]. In a meta-analysis of 15 studies involving 2,901 patients, elevated troponins were documented in 18.1% patients with stroke that included patients with EKG changes suggestive of myocardial ischemia [3]. Troponin elevation has also been documented in acute stroke without any evidence of acute coronary syndrome [5]. While some
A Study of Dog Coprolite from Late Neolithic Pile-Dwelling Site in Slovenia  [PDF]
Tja?a Tolar, Alfred Galik
Archaeological Discovery (AD) , 2019, DOI: 10.4236/ad.2019.71002
Abstract: More than 5000 years old dog’s coprolite was found during rescue excavation at Črnelnik pile-dwelling site in Slovenia. Although human and dog diets may overlap considerably, the content of the consumed and digested food, consisting of plant and/or animal remains biologically diverse. While the investigated fossil excrement contained many fish head bones, scales and teeth of Cyprinidae family, we believe that we are dealing with an individual that had only eaten fish heads, that is why it was suggested to be of dog. Beside the origin and the daily diet of the individual together with the nutritional habits of the dog in the Late Neolithic, the analyses of coprolite provide more important information, for example: the time of year of the deposit, the environmental conditions there, the size and the health of the animal as well as care (or the status) of domesticated animal for humans. The discovery confirms again that animal dung should be an important part of archaeological investigations, specially at waterlogged sites.
Clinical significance of troponin elevations in acute decompensated diabetes without clinical acute coronary syndrome
Anthony Eubanks, Farhan Raza, Mohamad Alkhouli, April N Glenn, Carol Homko, Abul Kashem, Alfred Bove
Cardiovascular Diabetology , 2012, DOI: 10.1186/1475-2840-11-154
Abstract: We performed a retrospective analysis of 872 patients admitted to Temple University Hospital from 2004–2009 with DKA or HHS. Patients were included if they had cardiac troponin I (cTnI) measured within 24 hours of hospital admission, had no evidence of acute coronary syndrome and had a follow up period of at least 18 months. Of the 264 patients who met the criteria, we reviewed the baseline patient characteristics, admission labs, EKGs and major adverse cardiovascular events during the follow up period. Patients were categorized into two groups with normal and elevated levels of cardiac enzymes. The composite end point of the study was the occurrence of a major cardiovascular event (MACE) during the follow up period and was compared between the two groups.Of 264 patients, 24 patients were found to have elevated cTnI. Compared to patients with normal cardiac enzymes, there was a significant increase in incidence of MACE in patients with elevated cTnI. In a regression analysis, which included prior history of CAD, HTN and ESRD, the only variable that independently predicted MACE was an elevation in cTnI (p?=?0.044). Patients with elevated CK-MB had increased lengths of hospitalization compared to the other group (p?<?0.001).Elevated cardiac troponin I in patients admitted with decompensated diabetes and without evidence of acute coronary syndrome, strongly correlate with a later major cardiovascular event. Thus, elevated troponin I during metabolic abnormalities identify a group of patients at an increased risk for poor long-term outcomes. Whether these patients may benefit from early detection, risk stratification and preventive interventions remains to be investigated.Elevated cardiac biomarkers in decompensated diabetes in the absence of an acute coronary syndrome (ACS) have been described in several case reports [1-5]. While non-ACS related cardiac biomarkers have been studied in various acute and chronic medical conditions, acute decompensated diabetes has receiv
HIV/STIs and Pregnancy Prevention, Using a Cervical Barrier and Microbicide  [PDF]
Alfred A. Shihata, Steven A. Brody
World Journal of AIDS (WJA) , 2011, DOI: 10.4236/wja.2011.14018
Abstract: Objectives: (A) HIV prevention, using a mechanical cervical barrier in combination with microbicide. (B) Prevention of pregnancy. (C) Shield the cervix to prevent sperm penetration and Gonorrhea, Chlamydia and HIV virus invasion. Methods: We investigated a new FDA approved cervical barrier FemCap (Figure 1). The FemCap is a contraceptive device that is designed with a unique delivery system for microbicides on its cervical and vaginal sides (Figure 4) to ensure better coverage, and retention of gel on the cervix and vagina. We also compared the acceptability and adherence with the FemCap, and retention of a stained vaginal lubricant when delivered with the FemCap versus the vaginal lubricant when delivered using a traditional vaginal applicator (Figure 2). We used the same vaginal applicator utilized in the CAPRISA 0041 study, to deliver Tenofovir microbicide. Thirty women compared the use of a vaginal applicator to deliver a high viscosity stained vaginal lubricant before and after intercourse, versus the FemCap to deliver the same lubricant once before intercourse. The acceptability and efficacy of this delivery system was evaluated. Results: Forty percent (12) women missed the application of the lubricant with the vaginal applicator before intercourse and 10% missed it after intercourse. Amongst FemCap users (3) women (10%) missed application of the vaginal lubricant before intercourse and all of them inserted it after intercourse. The stained gel was better retained over the cervix (Figure 5) by single application with the FemCap versus two applications with the traditional applicator (Figure 2). Conclusions: Women in this study preferred the FemCap due to elimination of leakage and the single application, method versus two applications with the traditional vaginal applicator. The use of the FemCap, can prevent pregnancy, HIV mother-to-child transmission, enhance compliance and retention of gel over the cervix and vagina that may potentially prevent STIs and increase the efficacy of Tenofovir.
Application of Tikhonov Regularization Technique to the Kinetic Data of an Autocatalytic Reaction: Pyrolysis of N-Eicosane  [PDF]
Sunday C. Omowunmi, Alfred A. Susu
Engineering (ENG) , 2011, DOI: 10.4236/eng.2011.312145
Abstract: A new technique based on Tikhonov regularization, for converting time-concentration data into concentration-reaction rate data, was applied to a novel pyrolysis investigation carried out by Susu and Kunugi [1]. The reaction which involves the thermal decomposition of n-eicosane using synthesis gas for K2CO3-catalyzed shift reaction was reported to be autocatalytic. This result was confirmed by applying Tikhonov regularization to the experimental data (conversion vs. time) presented by Susu and Kunugi [1]. Due to the ill-posed nature of the problem of obtaining reaction rates from experimental data, conventional methods will lead to noise amplification of the experimental data. Hence, Tikhonov regularization is preferably employed because it is entirely independent of reaction rate model and it also manages to keep noise amplification under control, thus, leading to more reliable results. This is shown by the agreement of the kinetic parameters obtained using the resulting conversion-reaction rate profile, with the Ostwald-type process for autocatalysis suggested by Susu and Kunugi [1].
Application of Artificial Neural Networks Based Monte Carlo Simulation in the Expert System Design and Control of Crude Oil Distillation Column of a Nigerian Refinery  [PDF]
Lekan T. Popoola, Alfred A. Susu
Advances in Chemical Engineering and Science (ACES) , 2014, DOI: 10.4236/aces.2014.42030

This research work investigated comparative studies of expert system design and control of crude oil distillation column (CODC) using artificial neural networks based Monte Carlo (ANNBMC) simulation of random processes and artificial neural networks (ANN) model which were validated using experimental data obtained from functioning crude oil distillation column of Port-Harcourt Refinery, Nigeria by MATLAB computer program. Ninety percent (90%) of the experimental data sets were used for training while ten percent (10%) were used for testing the networks. The maximum relative errors between the experimental and calculated data obtained from the output variables of the neural network for CODC design were 1.98 error % and 0.57 error % when ANN only and ANNBMC were used respectively while their respective values for the maximum relative error were 0.346 error % and 0.124 error % when they were used for the controller prediction. Larger number of iteration steps of below 2500 and 5000 were required to achieve convergence of less than 10-7 for the training error using ANNBMC for both the design of the CODC and controller respectively while less than 400 and 700 iteration steps were needed to achieve convergence of 10-4 using ANN only. The linear regression analysis performed revealed the minimum and maximum prediction accuracies to be 80.65% and 98.79%; and 98.38% and 99.98% when ANN and ANNBMC were used for the CODC design respectively. Also, the minimum and maximum prediction accuracies were 92.83% and 99.34%; and 98.89% and 99.71% when ANN and ANNBMC were used for the CODC controller respectively as both methodologies have excellent predictions. Hence, artificial neural networks based Monte Carlo simulation is an effective and better tool for the design and control of crude oil distillation column.

Case control study of the geographic variability of exposure to disinfectant byproducts and risk for rectal cancer
Gerald E Bove, Peter A Rogerson, John E Vena
International Journal of Health Geographics , 2007, DOI: 10.1186/1476-072x-6-18
Abstract: Trihalomethane levels varied spatially within the county; although risk for rectal cancer did not increase with total level of trihalomethanes, increasing levels of the component bromoform (measured in ug/day) did correspond with an increase in odds ratios (OR = 1.85; 95% CI = 1.25 – 2.74) for rectal cancer. The highest quartiles of estimated consumption of bromoform (1.69–15.43 ug/day) led to increased risk for rectal cancer (OR = 2.32; 95% CI = 1.22–4.39). Two other THMs were marginally associated with an increase in risk – chlorodibromomethane (OR = 1.78, 95% CI = 1.00–3.19) and bromodichloromethane (OR = 1.15; 95% CI = 1.00–1.32).Levels of THMs in the water distribution system exhibited spatial variation that was partially due to variation in water age. We also observed a geographic pattern of increased risk of rectal cancer in areas with the highest levels of bromoform in the county.At a global scale there are geographic differences in the prevalence of rectal cancer, and the highest rates generally occur in economically developed areas (e.g., Australia, Japan, New Zealand, and North America) compared with less developed areas (e.g., Africa and China). This is most often explained by environmental factors related to diet [1]. There are also geographic disparities within the United States; for example, Devesa et al. [2] summarized geographic patterns of urinary bladder and rectal cancers in the U.S. for the period 1950–94 and noted that throughout the period, high rates clustered in the northeastern United States. Other potential risk factors for rectal cancer include tobacco consumption [3,4], alcohol consumption [5,6], genetic disposition [7,8], occupational exposures [9,10], diet [5,11-13], and disinfectant by-products (DBPs), the focus of the present study.DBPs in water supplies are formed from the interaction of organic material in raw water and an introduced disinfectant. DBPs are particularly problematic in surface water supplies since they generally cont
Eleocharis R.Br. (Cyperaceae) no Estado do Rio de Janeiro, Brasil
Gil, André dos Santos Bragan?a;Bove, Claudia Petean;
Biota Neotropica , 2007, DOI: 10.1590/S1676-06032007000100020
Abstract: a floristic inventory of the species of eleocharis (cyperaceae) from rio de janeiro state - brazil was made. this research included material from most important herbaria of rio de janeiro (fcab, gua, hb, huni, r, rb, rbr, rfa, rusu) as well as plants collected during expeditions to aquatic ecosystems of rio de janeiro, between november 1998 and september 2003. the genus eleocharis is represented in the area by 19 species: eleocharis acutangula (roxb.) schult., e. debilis kunth, e. elongata chapm., e. equisetoides (elliott) torr., e. filiculmis kunth, e. flavescens (poir.) urb., e. geniculata (l.) roem. & schult., e. interstincta (vahl) roem. & schult., e. maculosa (vahl) roem. & schult., e. minarum boeck.*, e. minima kunth, e. montana (kunth) roem. & schult., e. mutata (l.) roem. & schult., e. nana kunth, e. pachystyla (c. wright) c. b. clarke*, e. radicans (poir.) kunth*, e. sellowiana kunth, e. squamigera svenson, and e. subarticulata (nees) boeck. (*species rare in rio de janeiro state). a key of identification, descriptions of species, illustrations, and notes on ecological features and geographical distribution are presented.
A tool for evaluating the potential for cost-effective outcomes measurement
Somasekhar MM,Bove A,Rausch C,Degnan J
International Journal of General Medicine , 2012,
Abstract: Melinda M Somasekhar1, Alfred Bove2, Chris Rausch1, James Degnan3, Cathy T King1, Arnold Meyer11The Albert J Finestone, MD, Office for Continuing Medical Education, 2Section of Cardiology, Temple University School of Medicine, Philadelphia, PA, USA; 3Measurement and Research Center, Temple University, Philadelphia, PA, USAAbstract: Cost related to higher-level outcomes measurement is often very high. However, the cost burden is felt even more by smaller, less well-funded continuing medical education (CME) programs. It is possible to overcome financial and participant-related barriers to measuring Level 6 outcomes, which are patient health outcomes. The Temple University School of Medicine’s Office for Continuing Medical Education developed a sequential tool for attaining cost-effective outcomes measurement for determining the likelihood of a CME intervention to produce significant changes in physician performance. The appropriate selection of the CME topic and specific practice change indictors drive this tool. This tool walks providers through a simple YES or NO decision-making list that guides them toward an accurate prediction of potential programmatic outcomes. Factors considered during the decision-making process include whether: (a) the intended change(s) will have a substantial impact on current practice; (b) the intended practice change(s) are well supported by clinical data, specialty organization/government recommendations, expert opinion, etc; (c) the potential change(s) affects a large population; (d) external factors, such as system pressures, media pressures, financial pressures, patient pressures, safety pressures, etc, are driving this intended change in performance; (e) there is a strong motivation on the part of physicians to implement the intended change(s); and (f) the intended change(s) is relatively easy to implement within any system of practice. If each of these questions can be responded to positively, there is a higher likelihood that the intended practice-related change(s) will occur. Such change can be measured using a simpler and less costly methodology.Keywords: outcomes, outcomes measurement, cost-effective, evaluation tool, continuing medical education
Mathematical Modeling and Software Application of Blood Flow for Therapeutic Management of Stroke  [PDF]
Babagana Gutti, Alfred A. Susu, Olufemi A. Fasanmade
Engineering (ENG) , 2012, DOI: 10.4236/eng.2012.44030
Abstract: People in the rural areas do not have access to specialist medical care, and when they have complications of stroke, they do not have specialists to look at them and they cannot afford to travel to the cities. The primary health care centers are not equipped with sophisticated equipments. Medicine is about medication, treatment and management. In rural areas treatment is not available either because of accessibility or affordability. Even the few doctors that are available are not in primary health care centres. Well conserved one-dimensional non-linear equations of blood flow describing blood flow in distensible blood vessels were used to develop software. This model could describe discontinuities and disruption in blood flow. The computer software can be used for detecting artherosclerosis, stenosis and differentiation of haemorrhagic and ischaemic strokes for stroke management from simple measurements. The software developed is capable of computing the Siriraj and the Allen clinical scores. These scores have been proposed to help clinicians in making decisions while waiting for results of computerized tomography, hence clinicians can start anti-thrombotic treatment while waiting for the scan results. It is capable of simulating stenosis at different position and depth of flow along the arterial length, and can be used for diagnosis. The medical emphasis is on avoiding possible occurrence, every individual can know his status by inputting the required data such as flow and geometry of their arteries into the developed interface and such measurements can be obtained from simple Doppler measurements.
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