scholarly journals Current use of NT-proBNP in elderly patients and the impact of the selected threshold value: lessons from a big data analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Meune ◽  
F.X Goudot ◽  
T Boukertouta ◽  
A Lazureanu ◽  
S Msadek ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Threshold Value ◽  
Private Company ◽  
Discriminative Ability ◽  
Measured Concentration ◽  
Funding Sources ◽  
Biological Tests ◽  
Roche Diagnostics ◽  
The Impact ◽  
Selection Of

Abstract Background Natriuretic peptides (NPs) are widely used in the diagnosis and risk stratification of heart failure (HF).NPs may have a reduced discriminative ability in the subgroup of elderly patients. Methods We examined all biological tests performed from February 2010 to August 2015 in two districts in the French Brittany. We report the “real-world” use of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in an elderly population and examine the measured concentration and potential impact of the cut-off value's selection. Results From a total of 3,606,432 tests ordered in 557,650 adult patients, 56,653 included at least one NT-proBNP measurement. NT-proBNP measurements gradually increased by 10-y age categories up to 80–90 y, and 39,828 (70.3%) of all measurements have been done in patients ≥75y. NT-proBNP concentrations increased with advanced age (Pearson's correlation coefficient: 0.2; p<10–5), with concentrations of 3,564±6,440 ng/L in patients ≥75y. NT-proBNP was inversely correlated with creatinine clearance (p<10–5). Respective proportions of NT-proBNP below the threshold value were 22.6% in patients aged 70 to 80y and less than 10% in those over 80 y when considering a single threshold value of 125 ng/L, and 31% and 33% in the same groups when considering a dual age-adjusted threshold value of 450 ng/L in patients >75y (p<0.001 for all comparisons). Conclusion Among a very large cohort, we observed that NT-proBNP is increasingly measured in elderly patients. NT-proBNP concentrations increase with age, and the selection of the threshold value markedly impacts the proportion of “low” versus “high” results. FUNDunding Acknowledgement Type of funding sources: Private company. Main funding source(s): Roche Diagnostics Proportion (in %) of low NT-proBNP

Credit Dynamics and Financial Globalisation

2013 ◽  
Vol 225 ◽  
pp. R14-R22 ◽  
Author(s):  
Philip R. Lane
Keyword(s):  
Financial Stability ◽  
Financial Integration ◽  
Central Feature ◽  
Policy Reforms ◽  
Funding Sources ◽  
International Financial Integration ◽  
Credit Cycle ◽  
The Impact ◽  
Selection Of ◽  
Financial Globalisation

This paper reviews the impact of financial globalisation on credit dynamics. In particular, it argues that financial globalisation fundamentally alters credit demand and credit supply, since borrowers and lenders have foreign options as well as domestic options in terms of the selection of projects and funding sources. The rapid accumulation of large cross-border debt positions was a central feature in the boom phase of the European credit cycle during 2003–8 and has influenced the nature of the post-2008 financial crisis. Finally, the paper considers the range of policy reforms needed to improve macro-financial stability under international financial integration.

scholarly journals The Impact of Intervention on Survival of Elderly Patients with Gastric Cancer at IV Stage: A SEER Population-Based Study.

2020 ◽  
Author(s):  
Bo Cao ◽  
Wenquan Liang ◽  
Wang Zhang ◽  
Chuang Wang ◽  
Yajiao Shi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Elderly Patients ◽  
Stage Iv ◽  
Population Based ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Kaplan Meier ◽  
Stage Iv Disease ◽  
The Impact ◽  
Selection Of

Abstract Background The selection of therapeutic regimens for elderly patients with gastric cancer (GC) has attracted much attention. However, few clinical trials have been conducted concerning the subpopulation of patients diagnosed with stage IV disease. In this study, cases from the Surveillance, Epidemiologic and End Results (SEER) database were collected to investigate the effects of surgery and chemotherapy (CT) on the survival benefit in elderly GC patients with stage IV disease. Methods GC patients aged >65 years diagnosed with stage IV disease between 1973 and 2014 in the SEER database were included in the study pool based on strict inclusion and exclusion criteria. Univariate and multivariate analyses were employed to determine prognostic factors for overall survival (OS) and cancer-specific survival (CSS). Kaplan-Meier survival analysis was conducted to investigate the effects of different intervention methods on OS and CSS. Results A total of 9,306 patients were selected from the SEER database. The results showed that patients who received both surgery and chemotherapy significantly obtained OS and CSS benefits (P < 0.0001). Compared with the no surgery and CT group, the CT alone group (P < 0.0001) and the surgery alone group (P < 0.0001) had prolonged survival time. Furthermore, age and grade stratifications served as important indicators for the selection of therapeutic regimens Conclusions Surgery combined with CT outperformed monotherapy or no therapy strategies for elderly patients with stage IV disease.

Methods for Restricting Maximum Exposure Rate in Computerized Adaptative Testing

Methodology ◽  
2007 ◽  
Vol 3 (1) ◽  
pp. 14-23 ◽  
Author(s):  
Juan Ramon Barrada ◽  
Julio Olea ◽  
Vicente Ponsoda
Keyword(s):  
Measurement Accuracy ◽  
Computerized Adaptive Testing ◽  
Computation Time ◽  
Adaptive Testing ◽  
Exposure Rate ◽  
Control Parameters ◽  
The Impact ◽  
Two Alternatives ◽  
Selection Of ◽  
Maximum Exposure

Abstract. The Sympson-Hetter (1985) method provides a means of controlling maximum exposure rate of items in Computerized Adaptive Testing. Through a series of simulations, control parameters are set that mark the probability of administration of an item on being selected. This method presents two main problems: it requires a long computation time for calculating the parameters and the maximum exposure rate is slightly above the fixed limit. Van der Linden (2003) presented two alternatives which appear to solve both of the problems. The impact of these methods in the measurement accuracy has not been tested yet. We show how these methods over-restrict the exposure of some highly discriminating items and, thus, the accuracy is decreased. It also shown that, when the desired maximum exposure rate is near the minimum possible value, these methods offer an empirical maximum exposure rate clearly above the goal. A new method, based on the initial estimation of the probability of administration and the probability of selection of the items with the restricted method ( Revuelta & Ponsoda, 1998 ), is presented in this paper. It can be used with the Sympson-Hetter method and with the two van der Linden's methods. This option, when used with Sympson-Hetter, speeds the convergence of the control parameters without decreasing the accuracy.

Harnessing Digital Technology to Strengthen the Culture of Reading at Public Libraries in South Africa

Mousaion ◽  
2020 ◽  
Vol 38 (3) ◽  
Author(s):  
Harry Ramothupi Matolong
Keyword(s):  
South Africa ◽  
Digital Technology ◽  
Public Libraries ◽  
Pilot Phase ◽  
Impact Measurement ◽  
Private Company ◽  
Line Survey ◽  
Gates Foundation ◽  
Formed Part ◽  
The Impact

Statistics and numerous authors have highlighted the reading crisis in South Africa. At the same instance, more people in South Africa are embracing the potential of digital technology to provide lifelong learning opportunities and also to strengthen the culture of reading. This study is framed against the backdrop and implementation of the Mzansi Libraries On-Line Project in South Africa – a project implemented in line with the Global Libraries Programme of the Bill & Melinda Gates Foundation. The study explored the potential of access to information of digital technology and the contribution of the project to inculcating a culture of reading at public libraries. A benchmark survey was conducted by an independent research company during the pilot phase of the project in 2015. This survey covered library users of the 27 libraries that formed part of the pilot phase, and a further 25 libraries from a representative sample across South Africa. An end-line survey was conducted through a private company towards the conclusion of the countrywide implementation in 2017, based on the Common Impact Measurement System which was customised for South Africa. The benchmark survey found that although ICT in libraries had been used by relatively few people in 2015, the impact of this technology tended to be positive and would be beneficial to the wider society by helping to redress societal imbalances, including education and the culture of reading. The end-line survey found increased benefits of library usage and library technical infrastructure to improve the lives of the communities involved.

Impact of removing ESBL designation from culture reports on the selection of antibiotics for the treatment of infections associated with ESBL-producing organisms

2020 ◽  
Vol 41 (5) ◽  
pp. 604-607 ◽  
Author(s):  
Mark D. Lesher ◽  
Cory M. Hale ◽  
Dona S. S. Wijetunge ◽  
Matt R. England ◽  
Debra S. Myers ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Antibiotic Prescribing ◽  
The Impact ◽  
Inhibitor Combination ◽  
Lactamase Inhibitor ◽  
Selection Of

AbstractWe characterized the impact of removal of the ESBL designation from microbiology reports on inpatient antibiotic prescribing. Definitive prescribing of carbapenems decreased from 48.4% to 16.1% (P = .01) and β-lactam–β-lactamase inhibitor combination increased from 19.4% to 61.3% (P = .002). Our findings confirm the importance of collaboration between microbiology and antimicrobial stewardship programs.

Projecting the long-term benefits of single pill combination therapy for patients with hypertension in five countries

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Borghi ◽  
J.G Wang ◽  
A.V Rodionov ◽  
M Rosas ◽  
I.S Sohn ◽  
...  
Keyword(s):  
Combination Therapy ◽  
South Korea ◽  
Health Outcomes ◽  
Clinical Outcomes ◽  
Funding Source ◽  
Combination Therapies ◽  
Private Company ◽  
Treatment Pathways ◽  
Single Pill ◽  
The Impact

Abstract Background It is well established that single pill combination (SPC) therapies have the potential to improve patient adherence versus multi-pill regimens, thereby improving blood pressure control and clinical outcomes in populations with hypertension. Purpose To develop a microsimulation model, capturing different treatment pathways, to project the impact on clinical outcomes of using single pill combination therapies for the management of hypertension in five countries (Italy, Russia, China, South Korea and Mexico). Methods The model was designed to project health outcomes between 2020 and 2030 for populations with hypertension managed according to four different treatment pathways: current treatment practices [CTP], single drug with dosage titration first then sequential addition of other agents [start low and go slow, SLGS], free choice combination with multiple pills [FCC] and combination therapy in the form of a single pill [SPC]. Model inputs were derived from Global Burden of Disease 2017 dataset, including demographics, health status/risk factors, transition probabilities and treatment attributes/healthcare utilization, and the model incorporated real-world challenges to healthcare delivery such as access to care, SBP measurement error, adherence and therapeutic inertia. Simulated outcomes of mortality, incidence of chronic kidney disease (CKD), stroke and ischemic heart disease (IHD), and disability-adjusted life years (DALYs) due to these conditions were estimated for population of 1,000,000 simulated patients for each treatment pathway and country. Results SPC therapy was projected to improve health outcomes over SLGS, FCC and CTP over 10 years in all five countries. SPC was forecast to reduce mortality by 5.4% (Italy), 4.9% (Russia), 4.5% (China), 2.3% (South Korea) and 3.6% (Mexico) versus CTP and showed greater projected reductions in mortality than SLGS and FCC. DALYs were projected to be reduced with SPC therapy by between 5.7% (Italy) and 2.2% (South Korea) compared with CTP and reductions in the incidence of clinical events were also projected with SPC therapy, with decreases in the range of 11.5% (Italy) to 4.9% (South Korea) versus CTP. Conclusions Ten-year projections of clinical outcomes associated with different anti-hypertensive treatment pathways in five countries indicated that both combination therapies (FCC and SPC) are likely to reduce the disease burden of hypertension compared with conventional management approaches, with SPC showing the greatest overall benefits due to improved adherence. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Sanofi, Gentilly, France

scholarly journals The Impact of Alkaloid-Producing Epichloë Endophyte on Forage Ryegrass Breeding: A New Zealand Perspective

Toxins ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 158
Author(s):  
Colin Eady
Keyword(s):  
Seed Production ◽  
Health Issues ◽  
Abiotic Stressors ◽  
Livestock Health ◽  
The Right ◽  
The Impact ◽  
The Relationship ◽  
And Storage ◽  
Selection Of ◽  
Epichloë Endophyte

For 30 years, forage ryegrass breeding has known that the germplasm may contain a maternally inherited symbiotic Epichloë endophyte. These endophytes produce a suite of secondary alkaloid compounds, dependent upon strain. Many produce ergot and other alkaloids, which are associated with both insect deterrence and livestock health issues. The levels of alkaloids and other endophyte characteristics are influenced by strain, host germplasm, and environmental conditions. Some strains in the right host germplasm can confer an advantage over biotic and abiotic stressors, thus acting as a maternally inherited desirable ‘trait’. Through seed production, these mutualistic endophytes do not transmit into 100% of the crop seed and are less vigorous than the grass seed itself. This causes stability and longevity issues for seed production and storage should the ‘trait’ be desired in the germplasm. This makes understanding the precise nature of the relationship vitally important to the plant breeder. These Epichloë endophytes cannot be ‘bred’ in the conventional sense, as they are asexual. Instead, the breeder may modulate endophyte characteristics through selection of host germplasm, a sort of breeding by proxy. This article explores, from a forage seed company perspective, the issues that endophyte characteristics and breeding them by proxy have on ryegrass breeding, and outlines the methods used to assess the ‘trait’, and the application of these through the breeding, production, and deployment processes. Finally, this article investigates opportunities for enhancing the utilisation of alkaloid-producing endophytes within pastures, with a focus on balancing alkaloid levels to further enhance pest deterrence and improving livestock outcomes.

scholarly journals An IoT-Based Participatory Antitheft System for Public Safety Enhancement in Smart Cities

Smart Cities ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. 919-937
Author(s):  
Nikos Papadakis ◽  
Nikos Koukoulas ◽  
Ioannis Christakis ◽  
Ilias Stavrakas ◽  
Dionisis Kandris
Keyword(s):  
Smart Cities ◽  
Low Cost ◽  
Negative Influence ◽  
Asset Tracking ◽  
Tracking Tasks ◽  
Tracking Process ◽  
The Impact ◽  
Operation Center ◽  
Safety Enhancement ◽  
Selection Of

The risk of theft of goods is certainly an important source of negative influence in human psychology. This article focuses on the development of a scheme that, despite its low cost, acts as a smart antitheft system that achieves small property detection. Specifically, an Internet of Things (IoT)-based participatory platform was developed in order to allow asset-tracking tasks to be crowd-sourced to a community. Stolen objects are traced by using a prototype Bluetooth Low Energy (BLE)-based system, which sends signals, thus becoming a beacon. Once such an item (e.g., a bicycle) is stolen, the owner informs the authorities, which, in turn, broadcast an alert signal to activate the BLE sensor. To trace the asset with the antitheft tag, participants use their GPS-enabled smart phones to scan BLE tags through a specific smartphone client application and report the location of the asset to an operation center so that owners can locate their assets. A stolen item tracking simulator was created to support and optimize the aforementioned tracking process and to produce the best possible outcome, evaluating the impact of different parameters and strategies regarding the selection of how many and which users to activate when searching for a stolen item within a given area.

Sign in / Sign up

Export Citation Format

Share Document