Search

The present study was conducted to know the constraints perceived by the small scale goat farmers of Kamrup, Kamrup Metro and Morigaon districts of Assam. The data obtained on various constraints perceived by the goat farmers under the study were tabulated and analyzed statistically by using Garrett’s Ranking Technique. The study was conducted at Goat Research Station, Assam Agricultural University, Burnihat, Kamrup Metro, Assam during the years, 2020-21 and 2021-22. For the purpose the research station prepared a questionnaire for surveying and data collection about various constraints faced by the goat farmers and entrepreneurs of three districts viz. Kamrup, Kamrup Metro and Morigaon who visited the station during the period for seeking advises and taking training on Scientific goat rearing and management. The farmers were asked to identify the constraints he/ she and their fellow farmers of their villages faced with respect to rearing of goats in their locality and to rank the constraints from 1 to 13 according to the seriousness of the constraints faced by them. The higher incidence of diseases was the major constraints of goat farmers with mean score of 77.66 and ranked first among the constraints in goat rearing. Scarcity of feed and fodder (63.76), lack of knowledge on scientific goat farming (63.25) and inadequate veterinary facilities (61.07) were ranked second, third and fourth major constraints, respectively. Similarly, high rate of kid mortality, lack of grazing land and scarcity of breedable male goat (buck) were ranked fifth, sixth and seventh, respectively as constraints in goat rearing. Non-availability of nutrient rich fodder trees/grasses, inbreeding, recurrent flood and lower sale prices of goats were some other constraints for the goat farmers surveyed during the study. From the study, it can be concluded that the small scale goat farmers of the districts of Kamrup, Kamrup Metro and Morigaon have a lot of constraints in goat rearing, the major being the incidence of diseases and scarcity of feed and fodder.

With the rapid development of underground space and the metro system in an urban area, the interaction between superstructures, foundations, and excavations with existing tunnels has been increasing. Hence, to ensure the safety of the tunnel, it is necessary to predict the displacement and stresses in tunnel induced by construction activity in its vicinity. The objective of the present study is to analyse the effect of superstructure construction on the stability of underground metro tunnels. A 2D numerical model has been developed using finite element software OptumG2 to replicate the Delhi Metro Phase 3 tunnel project. An elastoplastic model of the tunnel at a standard depth of 18 m has been analysed. The behaviour of the tunnel at the crown, invert, and springer (spring line) has been reported. The shear force and bending moment developed in tunnel lining has also been observed. The study investigates the stresses and displacement in the surrounding soil. Two parametric studies based on tunnel depth and load position have been studied. The study found that the displacement in tunnel points decreases but the lining forces increase with an increase in tunnel depth. The tunnel became stable with an increase in load eccentricity. It is also found that the maximum displacement of soil is not affected significantly either with the depth of tunnel or with load position. However, the stability of soil around the tunnel increases with an increase in depth of the tunnel and superstructure load eccentricity.

Objective: To investigate the safety and effectiveness of direct oral anticoagulants (DOAC) versus vitamin K antagonists (VKA) after recent stroke in patients with atrial fibrillation (AF) aged ≥85 years. Methods: Individual patient data analysis from seven prospective stroke cohorts. We compared DOAC versus VKA treatment among patients with AF and recent stroke (

Background: An evaluation of the reproduction performance of Sahiwal heifers was carried out outside of their original habitat due to the unavailability of performance record in the north-eastern part of India as this region being different from others because of possessing high humidity. Methods: Eighteen numbers of Sahiwal heifers maintained at the Sahiwal Cattle Farm in College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati, Assam were utilized for a period from August 2017 to January 2020. The resultant mean for different reproduction traits were carried out with the help of simple analysis technique of mean. Conclusion: The results for different reproduction traits were found to be in the normal range. This study confirmed that the Sahiwal breed can thrive well in the high humid climatic region of Assam.

Aim: This study aimed to determine the genetic and non-genetic factors affecting pre-weaning body weight (BW) and morphometry in Assam Hill goat along with the genetic parameters. Materials and Methods: The detailed information in respect of BW and body measurements of 960 animals at birth and 3 months of age belonging to three different populations of Assam Hill goat maintained at field units, namely, Batabari, Nahira, and Tetelia under "All India Coordinated Research Project on Goat Improvement" were utilized in the present study. The data were analyzed using least squares technique. Results: The least squares means for BW, height at withers (HW), heart girth (HG), and body length (BL) were 1.166±0.008 kg, 26.198±0.070 cm, 26.695±0.096 cm, and 29.482±0.119 cm at birth and 4.590±0.083 kg, 36.850±0.105 cm, 40.741±0.115 cm, and 39.703±0.108 cm at 3 months of age, respectively. Location had a significant effect on BW, HW, and BL at both birth and 3 months and on HG at 3 months of age. Season of birth exerted significant effect only on BL at birth, whereas the significant effect of sex was observed on HG and BL at 3 months of age. The heritability estimates for BW and body measurements were moderate indicating the scope of selection. The phenotypic and genetic correlations among BWs and body measurements at birth and 3 months of age were positive in direction and high in magnitude. Conclusion: On the basis of the present findings, it could be concluded that the weaning weight of kids can be considered for the selection of parent stock to increase productivity and eventually the economic efficiency. Further, animals with higher body measurements at initial phases of growth will perform better with respect to even BW at later stages of growth. Keywords: Assam Hill goat, genetic parameters, morphometric traits, non-genetic factors, pre-weaning growth.

The present study was conducted to identify the polymorphism of estrogen receptor (ESR) gene and its biological association with litter traits (litter size at birth, litter size at weaning, litter weight at birth and litter weight at weaning) of Doom pigs native to Assam. A total of 50 adult pigs (12 males and 38 females) chosen randomly from three different herds (Herd I, Herd II, and Herd III) were utilized in the present study. Detection of polymorphism of ESR gene was done by means of PCR-RFLP method. The amplified PCR product was digested with Pvu II restriction enzyme. PCR-RFLP analysis of ESR gene revealed polymorphic banding pattern. Two genotypes viz. AA and AB were identified. AA genotype yielded one fragment (120 bp) and AB genotype yielded three fragments (120, 65, and 55 bp). BB genotype was not found in the population under study. The frequencies of A and B alleles were found to be 0.650 and 0.350, respectively, and the genotypic frequencies of ESR gene were found to be 0.300 and 0.700 for AA and AB genotypes, respectively. There was no significant (P > 0.05) effect of ESR genotype on litter traits and the population under study was not in Hardy-Weinberg Equilibrium for ESR gene. Clustal W Multiple alignment of partial sequence of ESR gene revealed single nucleotide changes at 33, 65, 70, 83, and 92nd nucleotide positions. The presence of Pvu II polymorphism and identification of single nucleotide variation of ESR gene opens interesting prospects for improvement of litter traits in Doom pig through selective breeding program, especially based on marker-assisted selection.

Introduction: Coronavirus disease 2019 (COVID-19) was first reported in the Houston city area in the first week of March 2020. Soon hospitals in the city were overrun with COVID-19 patients. By October, COVID-19 had resulted in 216,025 deaths in the US1. Older patients and Hispanic, American Indian/Alaskan Natives, Black, and Asian patients have experienced the highest excessive deaths1. The aim of our research was to study the factors associated with mortality among COVID-19 patients. Methods: The study was conducted on patients at a large university-affiliated multi-hospital system. The study used data from electronic medical records with an inpatient admission from March-October 2020 and a confirmed diagnosis of COVID-19. The data included demographic information, prescreening information, length of stay, discharge disposition, diagnoses and comorbidity, respiratory support, medications, and laboratory test results. The dependent variable in all analyses was defined as a discharge disposition of in-hospital death or hospice. Unadjusted logistic regression analyses were carried out on all variables, and a multivariable logistic regression model was built using variables that lowered the Akaike information criterion. Laboratory values missing at random were imputed by multiple imputations using chained equations. Results: There were 8,341 inpatients admissions, of whom 1,139 died or received hospice. The median age was 72 years among dead/hospice patients and 55 years among patients discharged alive (p

Objective Liver biopsy is still needed for fibrosis staging in many patients with non-alcoholic fatty liver disease. The aims of this study were to evaluate the individual diagnostic performance of liver stiffness measurement by vibration controlled transient elastography (LSM-VCTE), Fibrosis-4 Index (FIB-4) and NAFLD (non-alcoholic fatty liver disease) Fibrosis Score (NFS) and to derive diagnostic strategies that could reduce the need for liver biopsies. Design Individual patient data meta-analysis of studies evaluating LSM-VCTE against liver histology was conducted. FIB-4 and NFS were computed where possible. Sensitivity, specificity and area under the receiver operating curve (AUROC) were calculated. Biomarkers were assessed individually and in sequential combinations. Results Data were included from 37 primary studies (n=5735; 45% women; median age: 54 years; median body mass index: 30 kg/m2; 33% had type 2 diabetes; 30% had advanced fibrosis). AUROCs of individual LSM-VCTE, FIB-4 and NFS for advanced fibrosis were 0.85, 0.76 and 0.73. Sequential combination of FIB-4 cut-offs (

Background and Aims: Vibration-controlled transient elastography (VCTE), point shear wave elastography (pSWE), 2-dimensional shear wave elastography (2DSWE), magnetic resonance elastography (MRE), and magnetic resonance imaging (MRI) have been proposed as non-invasive tests for patients with non-alcoholic fatty liver disease (NAFLD). This study evaluated their diagnostic accuracy for liver fibrosis and non-alcoholic steatohepatitis (NASH). Methods: PubMED/MEDLINE, EMBASE and the Cochrane Library were searched for studies examining the diagnostic accuracy of these index tests, against histology as the reference standard, in adult patients with NAFLD. Two authors independently screened and assessed methodological quality of studies and extracted data. Summary estimates of sensitivity, specificity and area under the curve (sAUC) were calculated for fibrosis stages and NASH, using a random effects bivariate logit-normal model. Results: We included 82 studies (14,609 patients). Meta-analysis for diagnosing fibrosis stages was possible in 53 VCTE, 11 MRE, 12 pSWE and 4 2DSWE studies, and for diagnosing NASH in 4 MRE studies. sAUC for diagnosis of significant fibrosis were: 0.83 for VCTE, 0.91 for MRE, 0.86 for pSWE and 0.75 for 2DSWE. sAUC for diagnosis of advanced fibrosis were: 0.85 for VCTE, 0.92 for MRE, 0.89 for pSWE and 0.72 for 2DSWE. sAUC for diagnosis of cirrhosis were: 0.89 for VCTE, 0.90 for MRE, 0.90 for pSWE and 0.88 for 2DSWE. MRE had sAUC of 0.83 for diagnosis of NASH. Three (4%) studies reported intention-to-diagnose analyses and 15 (18%) studies reported diagnostic accuracy against pre-specified cut-offs. Conclusions: When elastography index tests are acquired successfully, they have acceptable diagnostic accuracy for advanced fibrosis and cirrhosis. The potential clinical impact of these index tests cannot be assessed fully as intention-to-diagnose analyses and validation of pre-specified thresholds are lacking. Lay summary: Non-invasive tests that measure liver stiffness or use magnetic resonance imaging (MRI) have been suggested as alternatives to liver biopsy for assessing the severity of liver scarring (fibrosis) and fatty inflammation (steatohepatitis) in patients with non-alcoholic fatty liver disease (NAFLD). In this study, we summarise the results of previously published studies on how accurately these non-invasive tests can diagnose liver fibrosis and inflammation, using liver biopsy as the reference. We found that some techniques that measure liver stiffness had a good performance for the diagnosis of severe liver scarring. © 2021 The Author(s)

The construction and development of different modes of energy storage has been increased with urbanization and development of smart cities. The advent of modern underground excavation techniques in developing nations like India has put on swing the construction of underground storage. Explicit study of underground structures for different field scenario has been mandatory due to changing geology, influence of local infrastructure, variation in groundwater table, etc. The development of infrastructure facilities on the surface above or near tunnels is an unavoidable situation. Hence, it must be dealt with intense care due to its ability of significantly affecting the stability of underground structures. Further, it may also stimulus the design-parameters of underground facilities. The load intensity of the superstructure is an important parameter for stability of these structures. The present study describes a three-dimensional mathematical modelling of an underground tunnel. Simulation has been performed by using Abaqus, which is based on a continuum finite element. The elastoplastic Mohr–Coulomb constitutive model of the soil has been incorporated in analysis. The number of storey of a superstructure has been varied to assess the consequence of the superstructure on the behaviour of an underground energy storage tunnel. The numerical model has been modelled, and the load changes in a stepwise manner, no load to 50-storey building. The results are compared in terms of displacement and stresses generated in soil, and it has been observed that the construction of a structure has significant influence on an existing underground structure.

Background: Sahiwal is an outstanding milch breed of cattle originated from the Sahiwal area, Montgomery district of Punjab in Pakistan. Performance evaluation of this breed in the high humid condition of north-east India is very much limited. Assam Agricultural University is maintaining a pure herd of Sahiwal cattle in the College of Veterinary Science, Khanapara since August 2017 to conserve, propagate and bring about genetic improvement of this breed.Methods: The study was carried out in Sahiwal cattle farm, College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati by utilizing 25 numbers of Sahiwal calves. Least squares analysis of variance technique (1975) was undertaken to analyze the body weights of calves at monthly intervals up to six months of age. Result: Overall mean for body weights of calves were found as 26.96 ± 0.27 kg, 32.03 ± 0.47 kg, 37.03 ± 0.62 kg, 42.91 ± 0.76 kg, 48.45 ± 0.77 kg, 55.22 ± 0.77 kg, and 62.08 ± 0.88 kg at the day of birth, 1st month, 2nd month, 3rd month, 4th month, 5th month and 6th month respectively. Analysis of variance revealed that the bodyweight of male calves was significantly heavier than that of the female calves ( less than 0.05).

Purpose/Objective(s) Surveillance after definitive radiotherapy for oropharyngeal squamous cell carcinoma (OPSCC) is critical to confirm clinical complete response, as a subset of patients develop locoregional recurrences (LRR). The Hopkins Criteria are a standardized qualitative system for assessing response using post-treatment PET/CT and are validated for overall (OS) and progression-free survival (PFS). We hypothesized that the Hopkins Criteria score is independently prognostic for LRR. Materials/Methods We conducted an institutional retrospective study of adult patients with newly-diagnosed node-positive non-metastatic OPSCC treated with definitive (chemo)radiotherapy. Patients were eligible if they completed a pre- and post-radiotherapy PET/CT within 24 weeks after treatment. The primary outcome was the cumulative incidence of locoregional recurrence/persistence. A single board-certified nuclear medicine physician assigned Hopkins scores, which were considered either positive (scores 4-5) or negative (scores 1-3). Results Between 2004-2018, 259 patients were included in this analysis, while an additional 221 were excluded, most commonly due to lack of post-treatment PET/CT [37%] or N0 disease [22%]. Most patients were men (90%), 47% had never smoked, 86% had p16+/HPV+ tumors, and 39% had T3-4 tumors. Nearly all (98%) received concurrent chemotherapy, while 11% received induction chemotherapy. Median clinical follow-up was 40 months. Following radiotherapy, the first post-treatment PET/CT was positive (score 4-5) at the primary site in 32 patients (12%), cervical lymph nodes in 26 patients (10%), and either the primary site or neck in 50 patients (19%). This PET/CT was performed at a median of 3.3 months [range, 1.6-6.0] after radiotherapy. Thirty-four (13%) LRRs were observed. The sensitivity, specificity, negative predictive value, and overall accuracy of the Hopkins score for LRR were 68%, 88%, 95%, and 85%. The 36-month cumulative incidence of LRR was greater among patients with Hopkins scores 4-5 (45% vs. 5%, multivariable-adjusted HR 14.16, P Conclusion There is a lack of consensus reporting standards for response assessment after definitive radiotherapy for OPSCC. The Hopkins Criteria are an easily-implemented standard that appear to offer high accuracy for recurrence and death. These data support an initial PET/CT at least three months after radiotherapy to limit unnecessary diagnostic procedures.

The present study was carried out to investigate the mutagenic and cytotoxic potential of n-hexane and aqueous-methanolic whole plant extracts of Alternanthera bettzickiana. Aqueous-methanolic and n-hexane extracts of Alternanthera bettzickiana extracts were assessed for the mutagenic potential with Salmonella tester strains TA-100 and TA-102 in the presence and absence of the rodent enzyme activation system and cytotoxic potential was assessed by MTT assay. Aqueous-methanolic extract showed the presence of saponins, tannins, terpenoids, flavonoids and glycosides. However n-hexane extract revealed the presence of tannins and terpenoids only. It was found that a concentration as low as 15mg/mL of both extracts was more mutagenic to the TA 102 tester strain than TA-100. Hexane whole plant extract of Altenanthera bettzickiana was more mutagenic than aqueous-methanolic extract considering revertant colonies of TA 100 strain. Aqueous-methanolic and n-hexane whole plant extracts of Altenanthera bettzickiana showed higher mutagenic potential in the presence of the enzyme activation system. Mutagenicity of aqueous-methanolic extract increased with an enzyme activation system in case of TA 100 whereas mutagenicity of n-hexane extract decreased in the presence of the enzyme activation system with TA 100 and TA 102 strains. Aqueous-methanolic and n-Hexane whole plant extracts of Alternanthera bettzickiana showed an IC-50 of 493 and 456 µg/mL in BHK-21 cells respectively. It can be concluded that Altenanthera bettzickiana exhibited mutagenic activity in a bacterial reverse mutation assay with and without enzyme activation systems. However, it showed limited cytotoxicity to BHK-21 cells.

The present work was conducted to evaluate the performance in respect of post-weaning growth and morphometric traits of Assam Hill goat. Data on 960 animals belonging to 3 populations of Assam Hill goat maintained at three field units viz., Batabari, Nahira and Tetelia under All India Coordinated Research Project on Goat Improvement were utilized. The least-squares means for body weight, height at withers, heart girth and body length were 7.557 ± 0.049 kg, 41.231 ± 0.121 cm, 44.621 ± 0.115 cm and 50.778 ± 0.172 cm at 6 months; 9.934 ± 0.044 kg, 43.902 ± 0.120 cm, 48.890 ± 0.099 cm and 55.552 ± 0.170 cm at 9 months and 12.549 ± 0.046 kg, 46.791 ± 0.112 cm, 52.765 ± 0.090 cm and 58.392 ± 0.207 cm at 12 months of age, respectively. Location had significant effect on body weight and height at withers at all age groups; on heart girth at 6, 9 and 12 months and on body length at 6 and 12 months of age. Season of birth exerted significant effect on body weight at 9 and 12 months; on height at withers at 12 months and on body length at 6, 9 and 12 months of age. Significant effect of sex was observed on body weight at 9 and 12 months, on height at withers at 6, 9 and 12 months and on heart girth and body length at 9 and 12 months of age. The heritability estimates for body weight and body measurements were moderate indicating scope of selection. The phenotypic and genetic correlation among body weights and body measurements at 6, 9 and 12 months of age were positive in direction and high in magnitude.

Background and Purpose-Bridging therapy with low-molecular-weight heparin reportedly leads to a worse outcome for acute cardioembolic stroke patients because of a higher incidence of intracerebral bleeding. However, this practice is common in clinical settings. This observational study aimed to compare (1) the clinical profiles of patients receiving and not receiving bridging therapy, (2) overall group outcomes, and (3) outcomes according to the type of anticoagulant prescribed. Methods-We analyzed data of patients from the prospective RAF and RAF-NOACs studies. The primary outcome was defined as the composite of ischemic stroke, transient ischemic attack, systemic embolism, symptomatic cerebral bleeding, and major extracerebral bleeding observed at 90 days after the acute stroke. Results-Of 1810 patients who initiated oral anticoagulant therapy, 371 (20%) underwent bridging therapy with full-dose low-molecular-weight heparin. Older age and the presence of leukoaraiosis were inversely correlated with the use of bridging therapy. Forty-two bridged patients (11.3%) reached the combined outcome versus 72 (5.0%) of the nonbridged patients (P=0.0001). At multivariable analysis, bridging therapy was associated with the composite end point (odds ratio, 2.3; 95% CI, 1.4-3.7; P

Background: The relationship between different patterns of atrial fibrillation and early recurrence after an acute ischaemic stroke is unclear. Purpose: In a prospective cohort study, we evaluated the rates of early ischaemic recurrence after an acute ischaemic stroke in patients with paroxysmal atrial fibrillation or sustained atrial fibrillation which included persistent and permanent atrial fibrillation. Methods: In patients with acute ischaemic stroke, atrial fibrillation was categorised as paroxysmal atrial fibrillation or sustained atrial fibrillation. Ischaemic recurrences were the composite of ischaemic stroke, transient ischaemic attack and symptomatic systemic embolism occurring within 90 days from acute index stroke. Results: A total of 2150 patients (1155 females, 53.7%) were enrolled: 930 (43.3%) had paroxysmal atrial fibrillation and 1220 (56.7%) sustained atrial fibrillation. During the 90-day follow-up, 111 ischaemic recurrences were observed in 107 patients: 31 in patients with paroxysmal atrial fibrillation (3.3%) and 76 with sustained atrial fibrillation (6.2%) (hazard ratio (HR) 1.86 (95% CI 1.24–2.81)). Patients with sustained atrial fibrillation were on average older, more likely to have diabetes mellitus, hypertension, history of stroke/ transient ischaemic attack, congestive heart failure, atrial enlargement, high baseline NIHSS-score and implanted pacemaker. After adjustment by Cox proportional hazard model, sustained atrial fibrillation was not associated with early ischaemic recurrences (adjusted HR 1.23 (95% CI 0.74–2.04)). Conclusions: After acute ischaemic stroke, patients with sustained atrial fibrillation had a higher rate of early ischaemic recurrence than patients with paroxysmal atrial fibrillation. After adjustment for relevant risk factors, sustained atrial fibrillation was not associated with a significantly higher risk of recurrence, thus suggesting that the risk profile associated with atrial fibrillation, rather than its pattern, is determinant for recurrence. © European Stroke Organisation 2018.

PURPOSE: Cardiac surgery continues to transform into areas of sub-specialization and expertise. With increasing complexity of cases and scrutiny of outcome-based reimbursement, it is imperative that these cases are performed with reduced variability and superior outcomes. This can be achieved by introducing sub-specialization in mechanical circulatory support (MCS) therapies, implementing clinical care pathways and using standardized protocols during various stages of patient care. We analyzed the impact of protocol and clinical pathway-driven sub-specialization on MCS outcomes. METHODS: A single center retrospective analysis was conducted of patients undergoing long term MCS device placement between 2002-2018. The analysis was conducted comparing management of patients before (Era 1: 2003-2011) vs. after (Era 2: 2012-2018) introduction of MCS sub-specialization. Since 2012, multiple initiatives were introduced in our program, namely recruitment of specialized MCS/transplant surgeons, multidisciplinary team rounds, establishment of a shock team, development of clinical care pathways, electronic medical record order sets and clinical practice guidelines. Quality metrics were analyzed every month, and process improvement projects were initiated during this era. RESULTS: During Era 1, five cardiac surgeons implanted LVADs in 181 patients, while in Era 2, three MCS/transplant trained surgeons implanted LVADs in 326 patients. Era 2 included higher number of INTERMACS 1 and 2 profile patients (66% vs. 85%) reflecting higher-acuity patient population. With implementation of the sub-specialization services, 1-year survival improved from 58% to 96%. Median ICU stay decreased from 13 to 8 days and percent of patients discharged to home increased from 62% to 95%. Standardized protocols for management of high LDH, GI bleeding, and blood pressure management resulted in significant reduction in overall hospital length of stay. With introduction of clinical care pathways, the average time for workup from admission to LVAD implant decreased from 27.6 days to 8.5 days. With improved outcomes in Era 2, the program grew 200%. CONCLUSION: Introduction of sub-specialization services, with use of clinical pathways and protocols in managing patients with LVADs can help improve survival, reduce variability in medical care, and reduce ICU length of stay.

Purpose Right heart failure (RVF) after an LVAD implantation is associated with poor outcomes and increased morbidity and mortality. Right ventricular assist devices (RVAD) support is becoming a standard practice for RVF. Aim of our study is to assess the outcomes in the ambulatory patients who received an RVAD. Methods Single center retrospective review of 16 patients who received an RVAD after an LVAD implantation were analyzed. Primary end point was 30-day survival. Patient's preoperative demographics, medical history, laboratory values, hemodynamics, echo and catheterization data were assessed to find out different variables associated with mortality in this group. Continuous variables are reported as mean ± standard deviation (SD), whereas categorical data are reported as percentages. Results Mean age was 49.29 ± 11.47 years. 62.5% (n=10) were male and 37.5% (n=6) were female. 62.5% (n=10) were African American patients. All 16 patients were in NYHA class 4 at time of implant. Pre-operative right heart catheterization and 2D Echo data findings were: mean RA pressure 16.83 ± 9.57 mm Hg, PAPI 2.47 ± 2.52, TAPSE 1.39 ± 0.63 and S-Prime 9.76 ± 3.84. Patients received an RVAD support (Protek-Duo, Tandem Life, Pittsburgh, PA) within first 48 hours of LVAD implantation. Survival at 30-days with an RVAD support was 62.5% (n=10) (Table 1). Post-operatively all patients were ambulating while supported with a RVAD and continued participating in physical therapy. Conclusion 30-day survival in temporary RVAD supported patients with Protek-Duo cannula is comparable to previously published literature with Impella-RP support device (Recover Right study). However, this strategy enabled our patients to be ambulatory and involve themselves with physical therapy providing all the additional benefits of early ambulation.

Purpose Overall survival in left ventricular device supported patients has improved due to advancement in device technology. Fully magnetically levitated continuous device (HM3), has shown better hemocompatibility profile. The aim of this study is to compare 1 year survival between patients who received HM3 during the Momentum 3 clinical trial vs. post approval commercial phase. Methods A single center retrospective review of 149 patients undergoing HM3 implant between Aug 2015 -Aug 2019 was carried out. Patients were divided into 2 groups (trial v/s commerical). Patients were compared on their preoperative demographics, medical history, laboratory values, hemodynamics, echo and catheterization records. The primary end point was survival at 1-year. Categorical variables are reported as percentages, whereas continuous variables are reported as mean ± standard deviation (SD), p-value was set at 0.05. Results We had 67 (44.97%) patients in the commercial arm vs. 82 (55.03%) in the trial arm. Patients in the commercial arm were younger in age when compared to the trial arm group (50.61 ± 12.81 vs. 55.39 ± 11.54 years, p-0.03). More patients in the commercial arm were implanted as destination therapy (DT) when compared to the trial patients [41 (61.19%) vs. 11 (13.41%), p Conclusion Even with higher degree of heart failure (INTERMACS 1 and 2) and comorbid conditions (greater percentage of DT) seen in commercial arm group (reflective of a more real world experience), 1 year survival was similar to a highly controlled trial cohort. Larger multi center studies are required to validate these findings.

While the literature on HIV and aging has grown significantly in the past decade, there has been little examination of the needs of older women living with HIV and their disability experiences.The purpose of this study was to uncover the experiences of aging with HIV from the perspective of older women.An interpretive qualitative study was undertaken using semistructured interviews to explore the experiences of 10 women who are HIV positive between the ages of 51 and 62 years. Interview transcripts were analyzed thematically.Data analysis revealed seven themes: varying levels of acceptance, battling stigma of disclosure, declining functionality, living with negative emotions, practising healthy lifestyles, seeking social supports, and maximizing support from community services.There is a need for women's peer support groups, education for women with HIV and their families, and enhanced support services. Suggestions are provided for how occupational therapists can enable participation.

Background—In patients with acute ischemic stroke and atrial fibrillation, early anticoagulation prevents ischemic recurrence but with the risk of hemorrhagic transformation (HT). The aims of this study were to evaluate in consecutive patients with acute stroke and atrial fibrillation (1) the incidence of early HT, (2) the time to initiation of anticoagulation in patients with HT, (3) the association of HT with ischemic recurrences, and (4) the association of HT with clinical outcome at 90 days. Methods and Results—HT was diagnosed by a second brain computed tomographic scan performed 24 to 72 hours after stroke onset. The incidence of ischemic recurrences as well as mortality or disability (modified Rankin Scale scores >2) were evaluated at 90 days. Ischemic recurrences were the composite of ischemic stroke, transient ischemic attack, or systemic embolism. Among the 2183 patients included in the study, 241 (11.0%) had HT. Patients with and without HT initiated anticoagulant therapy after a mean 23.3 and 11.6 days, respectively, from index stroke. At 90 days, 4.6% (95% confidence interval, 2.3-8.0) of the patients with HT had ischemic recurrences compared with 4.9% (95% confidence interval, 4.0-6.0) of those without HT; 53.1% of patients with HT were deceased or disabled compared with 35.8% of those without HT. On multivariable analysis, HT was associated with mortality or disability (odds ratio, 1.71; 95% confidence interval, 1.24-2.35). Conclusions—In patients with HT, anticoagulation was initiated about 12 days later than patients without HT. This delay was not associated with increased detection of ischemic recurrence. HT was associated with increased mortality or disability. © 2018 The Authors.

Purpose Left ventricular non-compaction (LVNC) can present with congestive heart failure and thromboembolic events. Thrombus formation in the left ventricle from LVNC is commonly seen and has resulted in a very cautionary approach for mechanical circulatory support (MCS) for heart failure presentation. Due to continued limitations in availability for donor heart options other than MCS therapy remain limited. The aim of this single center study is to assess freedom from pump thrombosis at 6 months in LVNC. Methods Retrospective analysis of 18 patients (out of 244) who met the diagnostic criteria for LVNC underwent an LVAD implantation. Primary endpoint for this study was freedom from pump thrombosis at 6 months. Secondary outcomes were to assess in-hospital mortality, 30-day mortality and incidence of right ventricular failure after LVAD implantation. Pre-operative variables including laboratory, 2-D Echo, and right heath catheterization findings were comparable (Table 1). Results 11 out of 18 patients (61.11%) were males and 11 (61.11 %) were African Americans. 1 (5.56%) patient had pump thrombosis and underwent a successful pump exchange. Freedom from pump thrombosis at 6 months was 94.44% (17/18). 30-day survival was 100 % and 6-month survival was 88.89 % (16/18). Right ventricular failure (RVF) was noted in 9 patients (50%), even though pre-operative RV function analyses did not identify these patients as high risk for RVF (PAPi 3.56 (CI 95% 2.22-4.89), TAPSE 2.01 (CI 95% 1.80-2.23), S-PRIME 10.35 (CI 95% 7.80-12.89)). RVF was defined as requirement of inotropic support for > 4 weeks or placement of a temporary right ventricular assist device. Conclusion LVAD therapy for patients with LVNC is a very safe option with low incidence of pump thrombosis, 30 days and in-hospital mortality; however, a much higher rate of RVF is observed in this cohort when compared with INTERMACS registry data for patients with other diagnosis of cardiomyopathies undergoing MCS therapy.

A new matrine-type alkaloid, 7alpha-hydroxysophoramine (1), was isolated from the aerial parts of Sophora alopecuroides together with eight known alkaloids, 12beta-hydroxysophocarpine (2), sophoramine (3), 14beta-hydroxymatrine, matrine, sophoridine, sophocarpine, adenocarpine, and baptifoline. The structures of compounds 1-3 were confirmed through single-crystal X-ray diffraction analysis.

Background and Purposes - This study was designed to derive and validate a score to predict early ischemic events and major bleedings after an acute ischemic stroke in patients with atrial fibrillation. Methods - The derivation cohort consisted of 854 patients with acute ischemic stroke and atrial fibrillation included in prospective series between January 2012 and March 2014. Older age (hazard ratio 1.06 for each additional year; 95% confidence interval, 1.00-1.11) and severe atrial enlargement (hazard ratio, 2.05; 95% confidence interval, 1.08-2.87) were predictors for ischemic outcome events (stroke, transient ischemic attack, and systemic embolism) at 90 days from acute stroke. Small lesions (≤1.5 cm) were inversely correlated with both major bleeding (hazard ratio, 0.39; P=0.03) and ischemic outcome events (hazard ratio, 0.55; 95% confidence interval, 0.30-1.00). We assigned to age ≥80 years 2 points and between 70 and 79 years 1 point; ischemic index lesion >1.5 cm, 1 point; severe atrial enlargement, 1 point (ALESSA score). A logistic regression with the receiver-operating characteristic graph procedure (C statistic) showed an area under the curve of 0.697 (0.632-0.763; P=0.0001) for ischemic outcome events and 0.585 (0.493-0.678; P=0.10) for major bleedings. Results - The validation cohort consisted of 994 patients included in prospective series between April 2014 and June 2016. Logistic regression with the receiver-operating characteristic graph procedure showed an area under the curve of 0.646 (0.529-0.763; P=0.009) for ischemic outcome events and 0.407 (0.275-0.540; P=0.14) for hemorrhagic outcome events. Conclusions - In acute stroke patients with atrial fibrillation, high ALESSA scores were associated with a high risk of ischemic events but not of major bleedings. © 2017 American Heart Association, Inc.

Background and Purpose The aim of this study was to investigate for a possible association between both prestroke CHA2DS2-VASc score and the severity of stroke at presentation, as well as disability and mortality at 90 days, in patients with acute stroke and atrial fibrillation (AF). Methods This prospective study enrolled consecutive patients with acute ischemic stroke, AF, and assessment of prestroke CHA2DS2-VASc score. Severity of stroke was assessed on admission using the National Institutes of Health Stroke Scale (NIHSS) score (severe stroke: NIHSS ≥10). Disability and mortality at 90 days were assessed by the modified Rankin Scale (mRS

Introduction: Atrial fibrillation is an independent risk factor of thromboembolism. Women with atrial fibrillation are at a higher overall risk for stroke compared to men with atrial fibrillation. The aim of this study was to evaluate for sex differences in patients with acute stroke and atrial fibrillation, regarding risk factors, treatments received and outcomes. Methods: Data were analyzed from the “Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and Atrial Fibrillation” (RAF-study), a prospective, multicenter, international study including only patients with acute stroke and atrial fibrillation. Patients were followed up for 90 days. Disability was measured by the modified Rankin Scale (0–2 favorable outcome, 3–6 unfavorable outcome). Results: Of the 1029 patients enrolled, 561 were women (54.5%) (p < 0.001) and younger (p < 0.001) compared to men. In patients with known atrial fibrillation, women were less likely to receive oral anticoagulants before index stroke (p = 0.026) and were less likely to receive anticoagulants after stroke (71.3% versus 78.4%, p = 0.01). There was no observed sex difference regarding the time of starting anticoagulant therapy between the two groups (6.4 ± 11.7 days for men versus 6.5 ± 12.4 days for women, p = 0.902). Men presented with more severe strokes at onset (mean NIHSS 9.2 ± 6.9 versus 8.1 ± 7.5, p < 0.001). Within 90 days, 46 (8.2%) recurrent ischemic events (stroke/TIA/systemic embolism) and 19 (3.4%) symptomatic cerebral bleedings were found in women compared to 30 (6.4%) and 18 (3.8%) in men (p = 0.28 and p = 0.74). At 90 days, 57.7% of women were disabled or deceased, compared to 41.1% of the men (p < 0.001). Multivariate analysis did not confirm this significance. Conclusions: Women with atrial fibrillation were less likely to receive oral anticoagulants prior to and after stroke compared to men with atrial fibrillation, and when stroke occurred, regardless of the fact that in our study women were younger and with less severe stroke, outcomes did not differ between the sexes. © 2016, © European Stroke Organisation 2016.

Purpose Right ventricular failure (RVF) after LVAD implantation leads to poor prognosis. Use of Right ventricular assist device (RVAD) has become a standard practice for RVF. Even with RV support mortality up to 40% is observed. Aim of this study is to identify predictors of mortality in patients supported with an RVAD. Methods Retrospective analysis of 16 patients who received an RVAD after an LVAD implantation were carried out. Primary end point was death. Patient's demographic, pre-op labs, echo findings, indications and INTERMACS profile were assessed for mortality association. For normally distributed variables student's t-test was used, and non-parametric variables had Wilcoxon-Mann-Whitney test applied. Results 10 (62.5%) were male and 10 (62.5%) were African Americans. 6 (40%) died within 30 days of RVAD support. At time of hospital admission, variables among the “Survivor” vs. “Non-Survivor” were similar including the MELD score (30.4 ± 6.52 vs. 22.44 ± 9.37, p-value 0.0859). During admission patients were optimized for heart failure with inotropes and IABP. Prior to going for surgical implant majority showed an improvement of MELD score when compared to admission MELD. LVAD implantation was performed utilizing standard techniques. All RVAD implants (Protek-Duo, Tandem Life, Pittsburgh.PA) performed within first 48 hrs of LVAD implant. Poor survival was observed in patients who did not show an improvement in MELD score since admission “Non-Survivor” [Median 30(22-32)], vs. “Survivor” [Median 11(10-13)], p-value 0.0029. Mortality was 100% in patients; with MELD >30, 66.67% with MELD 20-29, 50% with MELD 15-19 and 0% in-group with MELD ≤14. Conclusion Increased mortality is observed among patients who failed to show any significant improvement in MELD score with interventions prior to LVAD implantation. Our data suggests higher MELD score can predict mortality in patients supported with an RVAD after LVAD implantation. Large multi-institutional studies are needed to support these initial findings.

Anticoagulant therapy is recommended for the secondary prevention of stroke in patients with atrial fibrillation (AF). The identification of patients at high risk for early recurrence, which are potential candidates to prompt anticoagulation, is crucial to justify the risk of bleeding associated with early anticoagulant treatment. The aim of this study was to evaluate in patients with acute ischemic stroke and AF the association between findings at trans-thoracic echocardiography (TTE) and 90 days recurrence. In consecutive patients with acute ischemic stroke and AF, TTE was performed within 7 days from hospital admission. Study outcomes were recurrent ischemic cerebrovascular events (stroke or TIA) and systemic embolism. 854 patients (mean age 76.3 ± 9.5 years) underwent a TTE evaluation; 63 patients (7.4 %) had at least a study outcome event. Left atrial thrombosis was present in 11 patients (1.3 %) among whom 1 had recurrent ischemic event. Left atrial enlargement was present in 548 patients (64.2 %) among whom 51 (9.3 %) had recurrent ischemic events. The recurrence rate in the 197 patients with severe left atrial enlargement was 11.7 %. On multivariate analysis, the presence of atrial enlargement (OR 2.13; 95 % CI 1.06–4.29, p = 0.033) and CHA2DS2-VASc score (OR 1.22; 95 % CI 1.04–1.45, p = 0.018, for each point increase) were correlated with ischemic recurrences. In patients with AF-associated acute stroke, left atrial enlargement is an independent marker of recurrent stroke and systemic embolism. The risk of recurrence is accounted for by severe atrial enlargement. TTE-detected left atrial thrombosis is relatively uncommon. © 2015, Springer-Verlag Berlin Heidelberg.

Grafted rubber films were prepared by mixing various proportions of acrylamide with natural rubber latex (NRL) with varying proportions by gamma radiation from Co-60 source at room temperature. Tensile strength, tear strength, elongation at break, permanent set, and swelling ratio, gel content and degree of grafting were measured. Tensile strength, tear strength, gel content and degree of grafting were found increasing with absorbed dose, as well as the proportion of monomer concentration and the optimum dose was found 12 kGy from the results. Elongation at break, permanent set, and swelling ratio of grafted rubber decreases with increase in absorbed dose, as well as proportion of grafted rubber.