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This paper presents the application of hydraulic modelling for the prediction of pipe bursts in a water distribution system (WDS). As a case study, more than 1430 km of pipelines within 29 water pressure zones (PZs) in Bendigo and Castlemaine WDSs, located in Victoria, Australia, were modelled and calibrated using an InfoWorks WS hydraulic model. A pressure index (PI) was defined to quantify the intensity of high pressures in the WDS pipes. The PIs for all the PZs were calculated using hydraulic model simulations. Ten years of actual pipe burst data (2007–2017) in the studied WDSs were used in the research. A burst index (BI) was used to measure the burst rate for the length of pipe network within the study area. A mathematical relationship between PI and BI was proposed based on the first eight years (2007–2015) of burst data and the results of the hydraulic modelling in the same period. The number of pipe bursts for the last two years (2016–2017) in each PZ was then predicted according to the proposed mathematical relationship. The predicted number of bursts fitted well with the actual recorded pipe burst data, with a coefficient of determination of 0.98.

We focus on forecasting the probability that euro-area inflation will fall into one of three intervals by employing an ordered multinomial model augmented with macroeconomic variables. We directly forecast the probability that the expected euro area HICP price index inflation rate (12-month percent changes) over the next 12 and 24 months will be less than 1.5 percent, exceed 2 percent, or be between these two values. The model includes many predictors, and deal with dimensionality issues by an approach which mixes factor models with Bayesian shrinkage. Our results show that macroeconomic variables’ inclusion improves the model’s forecast quality, especially at the longer horizon considered. The Deflationary Pressure Index coincides with the probability that inflation is below 1.5 percent on average in the next 24 months, and it is useful as a policy monitoring tool.

Channeling between injectors and producers leads to bypassed oil left in the reservoir, which is one of most common reasons that wells in mature oil fields experience high water cut after long-term waterflooding. Identification and evaluation of the higher permeable channels (thief zones) are the key to effectively plug these thief zones and improve the conformance of water flood. This study applies three different methods to identify and evaluate the thief zones of a water injection project in North Buzazi Oilfield, a thick-bedded unconsolidated sandstone heavy oil reservoir in Manghestau, Kazakhstan. The thief zones, which evolve as a result of formation erosion and sand production, are identified and classified with respect to four different levels of significance using fuzzy comprehensive evaluation, production/injection profile method and pressure index (PI) methods. Good consistency is observed among the identification results using these methods. Finally, we present two ways to quantitatively evaluate the characteristics of the thief zones using water–oil-ratio as the input, which can be readily applied for future field development design.

The Exchange Market Pressure Index (EMPI) is an indicator of pressure on a currency. Because of the presence of serial correlation, financial time series may not be normally distributed even for la...

This study investigates the effects of the financial stress index (FSI) of developed countries on the exchange market pressure index (EMPI) of Brazil, China, Mexico, Russia and South Korea using nonlinear vector autoregression (VAR) model and quantile-based analysis. It was found by the nonlinear VAR that increases/decreases in the FSI of developed countries will increase/decrease the EMPI in each emerging country; on the other hand, allowing the role of regime changes, quantile regression model revealed that a raise in the FSI of developed countries may cause an increase in the EMPI of Brazil, China, Mexico, Russia and South Korea during their high-EMP periods. The effects of FSI depletion on the EMPI were found for lower EMP regimes, and it was suggested that Mexico and South Korea would be affected positively by the fall in the FSI of developed countries. The quantile slope equality test also verified that the effects of the FSI on the EMPI will vary under low/medium/high-EMP regimes and will be asymmetric.

Poaching is one of the greatest immediate threats and a serious conservation challenge facing wildlife in Borneo. Medium- to large-sized mammals, while charismatic, are hunted for consumption and sale. This study focuses on wildlife hunting and utilization of selected communities in a remote area in Sarawak, conducted using interview surveys within communities who hunt wildlife in Ulu Baleh. The calculated hunting pressure index in Ulu Baleh (2.24) is considered low compared to other parts of Sarawak. Local communities are dependent on wildlife protein and medicine. Even though the common hunting offtake included the bearded pig and deer species, for the hunter’s own consumption, hunters were opportunistic in taking non-target species and selling surplus meat. Lack of awareness of the implications of unsustainable hunting and difficulty in monitoring by the relevant authorities appear to be the main challenges to wildlife conservation in the area. This paper highlights the lack of research documenting wildlife utilization in the Ulu Baleh region and the implication of these results are particularly important for future adaptive wildlife management, especially for species of conservation importance in Sarawak.

Purpose The purpose of this study was to explore average time to heal for patients with venous leg ulcers (VLUs) receiving standard of care that included compression and advanced wound dressings. Design Secondary analysis of an existing electronic database. Subject and settings A convenience sample consisting of 1323 patients with VLUs from various community care sectors (homecare and clinics) across Canada. Methods The Wound Studies database used in the analysis consisted of data from 6 studies conducted prospectively between 1999 and 2009 in which the treatment and delivery of care for all lower leg ulcers (venous, arterial, and mixed) in Canada was examined. From these studies, only patients with VLUs, with an ankle-brachial pressure index of greater than 0.8, and surface area measurements of the ulcers at baseline, 3 months, and 6 months were included. Descriptive statistics were used to determine the proportion of patients who achieved closure at 3 and 6 months and explore the weekly and monthly healing rates for those who did and did not achieve closure. Logistic regression analysis was performed to identify predictive factors for healing. Results A total of 777 patients (mean age 69 years) met inclusion criteria. The proportion of patients who achieved closure at 3 and 6 months was 42.2% and 48.6%, respectively. Of the participants who achieved wound closure, monthly mean healing rate, measured by percentage of reduction in surface area, was 33.4% (0.56 cm, SD 1.4 [median 0.15 cm]) through month 3, and 31.0% (0.70 cm, SD 1.6 [median 0.08 cm]) through month 6. The overall monthly surface area reduction was 30%. Conclusion Study findings suggest a monthly surface area reduction of 30% provides a baseline healing rate for VLUs managed with compression therapy and advanced dressings. Findings also suggest standard of care is not sufficient for healing in over 50% of the population, as the proportion of those who achieved closure at 3 and 6 months was 42.2% and 48.6%, respectively.

The goal of this paper is to present quantitative tools to manage competition policy analysis in two‐sided platforms, based on a common framework for transaction and non‐transaction platforms. We explore tools for relevant market definition [Critical Loss Analysis and a small but significant non‐transitory increase in price (SSNIP) test], unilateral effects indicators [Upward Pricing Pressure (UPP) and Gross Upward Pricing Pressure Index (GUPPI)] and tests for exclusionary practices. We review dispersed results in the literature and fill the gaps where appropriate. We highlight the required changes from the usual one‐sided market framework and tools. While discussions of antitrust tools can be found in specialized forums devoted to advances in competition policy analysis, we organize the material in an integrated framework.

Peripheral artery disease of the lower limbs is a chronically progressive disorder characterised by the presence of occlusive lesions in the medium and large arteries that result in symptoms secondary to insufficient blood flow to the lower extremities. It is both a manifestation of systemic atherosclerosis and a marker of increased cardiovascular morbidity and mortality. Because of its highly heterogenous clinical picture, a detailed history and physical assessment, a high degree of suspicion for peripheral artery disease and the use of the ankle–brachial pressure index is essential to identify patients with peripheral artery disease. This will allow early administration of basic pharmacotherapy and lifestyle changes to reduce cardiovascular events, minimise claudication symptoms and enable optimal revascularisation to prevent loss of limb function.

An absolute definition union has not been achieved yet among economists about the concept of exchange rate crisis. However, general description in the literature can be expressed as deviation of an index value which is created by variables such as nominal exchange rate, real exchange rate, foreign exchange reserves, interest and inflation from a threshold determined regarding past trend. In this study, a comparative analysis by the scope of the definition of currency crisis has been conducted and currency crisis definition which is specific to Turkey's economy has been proposed. In addition, 10 different currency crisis occurences are contained examining the Exchange Market Pressure Index: EMPI data which considers successful and unsuccessful speculative currency attacks and using data of Turkey for 2006Q1-2018Q4 period and by calculation of 10 different EMPI index. According to the findings of the analysis 4 currency crisis are contained which includes at least 1 of 10 different currency crisis definition for Turkey regarding 2006Q1-2018Q4 period which comprises 54 quarterly data. The currency crisis which suits all 10 different currency crisis definitions occurred in 2018Q3.

We herein report a case of leg malperfusion caused by dynamic obstruction after aortic dissection diagnosed by the exercise ankle brachial pressure index test that could not be diagnosed solely by examining the symptoms and investigations at rest. This case suggests that exercise can be a key factor in the diagnosis of this complication. Furthermore, blood pressure elevation can be an exacerbating factor in dynamic obstruction. We recommend conducting an aggressive evaluation of the symptoms and medical examinations not only at rest but also under stress.

A 64-year-old woman came to our hospital because of intermittent claudication of her left leg. She had undergone meniscectomy of the left knee in her 30s. The ankle-brachial pressure index of the left leg was 0.70. Imaging examinations showed occlusion of the popliteal artery compressed by an enlarged sesamoid bone with osteophytes. No anatomic abnormalities of vessels and muscles were seen. A particular type of popliteal entrapment syndrome was diagnosed. After resection of the sesamoid bone, thromboendarterectomy and patch plasty were performed. After the operation, the claudication was improved, and the ankle-brachial pressure index of the left leg increased to 0.91. Keywords: Popliteal artery, Entrapment, PES, Limb ischemia, Sesamoid

Background: Right ventricular stroke work index is a useful but invasively measured parameter that can be used to predict right heart failure following continuous-flow left ventricular assist device implantation. Right ventricular contraction pressure index is a novel parameter that was developed to measure right ventricular stroke work index with echocardiography. We aimed to investigate the clinical usefulness of right ventricular contraction pressure index to predict short-term mortality and right heart failure in patients who underwent continuous-flow left ventricular assist device implantation. Methods: A total of 49 patients who participated in institutional advanced heart failure registry and underwent continuous-flow left ventricular assist device implantation with a bridge-to-candidacy indication were analyzed retrospectively. Right ventricular contraction pressure index was calculated using offline measurements. Demographic, clinical and outcome data were obtained from the registry data. Patients were grouped according to right ventricular contraction pressure index quartiles. Results: Patients within the lowest right ventricular contraction pressure index quartile had a trend toward higher short-term mortality (46.2%, p = 0.056) and combined short-term mortality and definitive right heart failure (53.8%, p = 0.054) at 15th day postoperatively. Similarly, short-term survival or survival free of definite right heart failure were significantly lower in the lowest right ventricular contraction pressure index quartile (log-rank p = 0.045 and log-rank p = 0.03, respectively). In a proportional hazards model that included echocardiographic parameters, right ventricular contraction pressure index was an independent predictor for short-term mortality (odds ratio: 6.777, 95% confidence interval: 1.118–41.098, p = 0.037), but not for combined short-term mortality and definite right heart failure. No such associations were found for long-term mortality. Right ventricular contraction pressure index had a statistically significant correlation with invasively measured pulmonary capillary wedge pressure, pulmonary vascular resistance, mean pulmonary pressure, and right ventricular stroke work index. Conclusion: Right ventricular contraction pressure index was found as a useful parameter for determining short-term postoperative mortality in patients undergoing continuous-flow left ventricular assist device implantation.

Objective. To study the impact of sulodexide on the healing process of trophic ulcers of the mixed genesis in the lower extremities. Materials and methods. Analysis of the medical cards data was done for 105 patients, who in 2015 - 2019 yrs have had treated the trophic ulcers of the mixed genesis of the ankles in Department of Vascular Surgery of the Poltava Regional Clinical Hospital. The causes of development of trophic ulcers were confirmed by data of ultrasonographic color angioscanning of the lower extremities and pelvis with measurement of the ankle-brachial pressure index and arteriography. All the patients did not accepted the proposal for performing of correcting and restoration surgical treatment on the lower extremities vessels. Depending on the treatment prescribed the patients were divided into two groups. Into the Group I (comparative) 53 (50.5%) patients were included, who obtained a casual conservative treatment, directed to improvement of the lower extremities blood supply, as well as the blood rheological properties, which included venotonic, analgesic, antibacterial preparations and local treatment, depending on the wound process stage. Into the Group II (the main) 52 (49.5%) patients were included, who on the background of typical treatment have obtained sulodexide in a dose 600 LU (lipoproteidlipase units) on 200 ml of physiological solution of sodium chloride up to 15 days long with subsequent therapy in the dose of 1 capsule twice a day (500 LU) during up to 60 days. In the Group I there were 32 (60.4%) men and 21 (39.6%) women, and in the Group II – 30 (57.7%) men and 22 (42.3%) women. Average age of patients in the Group I have constituted (65.8 ± 4.38), and in the Group II – (66.2 ± 5.04) yrs old. The pain intensity in accordance to the ten-point numerical rating scale was checked before the treatment beginning, in 7 and 14 - 15 days, the trophic ulcers square was measured, local temperature of the patient’s body, pН-metry and cytological investigations of the wounds exudate were done in all the patients before the treatment. Besides this, 38 (71.7%) patients of the comparison group and 40 (76.9%) patients of the main group were followed during 90 - 120 days after leaving a stationary. Results. In the patients, who have obtained sulodexide additionally, reparative processes in the trophic ulcers regions of the lower extremities have become accelerated, the pain syndrome have been lowered rapidly, the water index normalized, the blood supply improved, the ankle-brachial index enhanced, a local temperature raised, cytological picture of the wound exudate improved, what promoted more rapid healing of ulcers and reduction of the stationary stay duration. During the planned visits of the patients in 90 - 120 days a complete healing of trophic ulcers of the lower extremities in 31 (77.5%) patients of the main group and in 24 (63.2%) patients of the comparison group was proved. Conclusion. Application of sulodexide in the treatment dosage is expedient to include into complex of treatment for trophic ulcers of the mixed origin in the lower extremities.

The main drawback of the existing methods of identification of banking crises is their dependence on subjective expert judgments, in connection with which, databases on crises have differences in the date and duration of crisis episodes. However, there is a more objective way to do it — the use of the money market pressure index (MPI), based on the indicators provided by the statistical authorities. In his work, the author explored the von Hagen & Ho (2007) index method and Laeven & Valencia (2012) method, which includes evaluative judgment. The aim of our work was, on the example of the banking sector ofRussiafor 1998–2016, the identification of the most accurate and sensitive methodology for assessment of banking crises. This study was carried out in stages. First, it was supplemented Laeven &Valenciathe database on the crises inRussiafrom 2011 to 2016. Second, it was built the money market pressure index (MPI) for the Russian banking sector for the period 1998–2016. At the final stage, the author compared the crisis episodes, identified using these two methods, which simultaneously identify the crises of 1998 and 2009. However, the crisis of 2014–2016 was identified only by the Laeven & Valencia criteria. This discrepancy can be explained by the shortcomings of the index methodology, which does not take into account hidden guarantees and direct support from the state. Moreover, the hypothesis that the banking crisis took place in 2014–2016 was confirmed by the Demirgüç-Kunt & Detragiache criteria (2005), as well as the financial stress index proposed by ACRA (ACRA FSI RU). Thus, it can be concluded that it is most acceptable to use the Laeven & Valencia methods when identifying banking crises.

Psoriasis is a systemic inflammatory disease known to affect survival in the presence of cerebral or cardiovascular comorbidities. However, no clear guidelines have been defined regarding the extent of vascular lesion testing that should be performed in patients with psoriasis. We therefore performed coronary computed tomography angiography (CCTA) in 88 Japanese patients with psoriasis who visited Kansai Medical University Hospital between 2015 and 2019 and determined the ankle–brachial pressure index (ABI) for 44 of these patients. CCTA abnormalities were found in 39 of the 88 patients, and a need for treatment was identified in 14 patients. The prevalence of cardiovascular lesions in these patients was 15.9%, significantly higher than that in the healthy Japanese population (6.38% according to the Suita Study). In the 44 patients with results for both ABI and CCTA, the rates of CCTA vascular lesions were significantly higher in cases with ABIs indicating hard vessels or above than in cases with supple, normal, or slightly stiff vessels. This is the first report to show a correlation between CCTA and ABI in psoriasis patients. ABI was considered useful as a preliminary test before CCTA. The univariate analysis of the abnormal and normal CCTA groups showed that the prevalence differed significantly among patients with psoriatic arthritis, erythrodermic psoriasis, older age, pre-existing conditions, drinking, and hypertension. The multivariate analysis showed correlations with arthritic or erythrodermic psoriasis.

When products are differentiated, applying the standard critical loss formula to assess whether it is profitable for a hypothetical monopolist to impose a common price increase can lead to delineating an antitrust market that is too broad by setting a critical loss threshold that is too low. This error is particularly likely to occur when the products exhibit very different per-unit profits, own price elasticities, and cross price elasticities. In particular, different per-unit profits are a necessary condition for this error to occur and this difference is more likely to be driven by an asymmetry in prices than by an asymmetry in costs when own price elasticities are moderate in magnitude. In contrast, differences in the quantity sold of each product do not tend to lead to errors in market definition. Given the issues associated with the standard critical loss analysis, critical loss analysis with asymmetric price increases and the gross upward pricing pressure index are practical alternative approaches for conducting market definition analysis when products in a candidate market are differentiated.

In response to the complex social, environmental and economic situation caused by the "Terra dei Fuochi" phenomenon, the IZSM collaborated closely with the Terra dei Fuochi working group, carrying out additional monitoring surveys both on food (QR Code Campania project[30]), and on the environment (Campania Trasparente project[31]). This model was developed in the context of the experience accumulated in the field of environmental and food monitoring, and represents an innovative tool aimed at increasing knowledge of the environmental context of the Campania Region through an objective, integrated and organic synthesis of complex environmental phe-nomena and territorial dynamics. The model proposed here is useful for the global and synthetic assessment of environmental pressure on a municipal basis. As shown, it can also be applied to aggregations of municipalities. Furthermore, it can be used in the context of institutional actions for the planning and monitoring of improvements on a local or regional scale. Finally, the pro-posed municipality-based environmental pressure index represents the basis for geo-stratification of the sample in the context of population biomonitoring studies on a regional scale, as in the described biomonitoring study design applicable to the Campania Region.

We located rural communities with pet parrots and used these locations to predict the probability of illegal parrot ownership across coastal Ecuador, using variables related to demand for pets, parrot availability, and trapping accessibility. In 12 pet keeping communities, we carried out in-depth interviews with 106 people, to quantify ownership, trapping, and interviewees’ attitudes towards these behaviours. We combined these data to calculate a trapping pressure index for four key roosting, feeding and nesting sites for the Critically Endangered Lilacine or Ecuadorian Amazon Parrot Amazona lilacina. We found that 66% of all communities had pet parrots and 31% had pet Lilacines. Our predictive models showed that pet parrot ownership occurs throughout coastal Ecuador, but ownership of Lilacines by rural communities, is more likely to occur within the natural distribution of the species. The number of people per community who had owned Lilacines in the last three years varied from 0–50%, as did the number of people who had trapped them—from 0–26%. We interviewed 10 people who had captured the species in the last three years who reported motives of either to sell or keep birds as pets. Attitudes towards pet keeping and trapping differed among the 12 communities: 20–52% believed it was acceptable to keep pet parrots, and for 32–74%, it was acceptable to catch parrots to sell. This being said, most people believed that wild parrots were important for nature and that local people had a responsibility to protect them. We conclude that trapping pressure is greatest in the southern part of the Lilacine’s range, and urgent conservation measures such as nest and roost protection, and local community engagement are needed.

Family Health Nursing focuses its action on the user and family and, due to its centrality and proximity, it is the main responsible for monitoring chronic diseases, where leg ulcers stand out. Given the complications that they represent in the user and family, it is essential that the Family Nurse masters their characteristics, to distinguish their etiology, as well as the different treatments available, adapting them to the particularities and background of the user. Compressive therapy is a good alternative to apply to venous ulcers, if the essential criteria for its application are met. It is up to the Nurse to evaluate them and, when properly instructed, their application, to enhance health gains and cost adequacy info:eu-repo/semantics/publishedVersion

In this research communication we address the hypothesis that a single intramammary infusion of casein hydrolyzate (CH) would have a similar effect to three intramammary infusions of CH for drying-off quarters with chronic mastitis (CM) during lactation. Sixty cows with CM were selected and randomly distributed into two treatment groups: (a) three intramammary CH infusions (100 mg, 50 ml per infusion, with 24-h intervals) or (b) single intramammary CH infusion (300 mg, 50 ml). Milk samples from the treated and untreated quarters were collected for microbiological culture and somatic cell count (SCC) before and after CH infusions. Milk yield was recorded and a manual pressure index measurement was used to evaluate cessation of lactation. Of the 60 quarters selected, 43 (71.67%) had positive microbiological culture. The quarters treated with three intramammary CH infusions had higher udder pressure index than those treated with single CH infusion. However, the average milk yield and composite SCC of three functional quarters were not different among treatments. Therefore, a single infusion of CH has the potential to be used as an alternative method for drying-off mammary quarters with CM during lactation.

Pressure analysis is concerned with the study of systematic variations of reservoir pore pressure with depth. The most common interpretation for pressure analysis is pressure-depth plot analysis, but other techniques that magnify understated pressure differences are also available. The measurement of formation pressure is of immense value in quantitative evaluation and prospect risk. Once the pressure data has been acquired, we need to understand how to interpret the data received because reservoir pressure data has numerous applications and misinterpreting it could make the results misleading. At equilibrium state (i.e. there are no net forces and no acceleration), a fluid in the system is called hydrostatic equilibrium. Hydrostatic pressure increases with depth measured from the surface due to the increasing weight of fluid exerting downward force from above. The traditional pressure evaluation is usually done in conventional unit such as psi, kPa, psi/feet, psi/m, kPa/m, ppg. The current work will introduce the concepts and definitions of formation pressure evaluation using Pressure Index (PI) with the unit g/cc. For better understanding of the application of PI, some reservoir studies are also discussed in this paper.

Background In patients with significant tricuspid regurgitation (TR) the conventional markers for the assessment of right ventricular (RV) systolic function may be less accurate. Tricuspid annular plane systolic excursion (TAPSE) indexed to systolic pulmonary artery pressure (SPAP) (TAPSE/SPAP) may be prognostically useful in pulmonary hypertension and right ventricular (RV) dysfunction. Objective Our aim was to explore the prognostic value of TAPSE/SPAP index in patients with moderate or severe TR. Methods A total of 209 patients (72±14 years, 56% women) with moderate (n=123) or severe (n=86) TR (primary in 6% and secondary in 94%) were followed up for a median of 80 months (mean 70±33 months). The clinical correlates of TAPSE/SPAP ratio and association with all-cause mortality were assessed. Results The TAPSE/SPAP index was inversely correlated with all-cause mortality with an optimal threshold of 0.49 mm/mmHg. A low index was found in 139 (68%) patients and was associated with reduced survival (Figure). In a multivariate Cox regression analysis adjusted for age, smoking, coronary artery disease, left ventricular ejection fraction, right atrium area and mitral valve replacement, low TAPSE/SPAP index was associated with significantly higher hazard ratio of all-cause mortality (HR: 2.0; 95% CI 1.27–3.14, p=0.003). Age, coronary artery disease, left ventricular ejection fraction and right atrium area were other independent predictors of all-cause mortality. Conclusions The TAPSE/SPAP index, reflecting RV systolic function in the longitudinal axis corrected for force generating by the RV is a powerful predictor of all-cause mortality in patients with moderate or severe TR. Figure 1 Funding Acknowledgement Type of funding source: None

The aim of this study was to investigate if compression therapy (CT) can be safely applied in diabetic patients with Venous Leg Ulcers (VLU), even when a moderate arterial impairment (defined by an Ankle-Brachial Pressure Index 0.5&ndash, 0.8) occurs as in mixed leg ulcers (MLU). Materials and methods: in one of our previous publications we compared the outcomes of two groups of patients with recalcitrant leg ulcers. Seventy-one patients were affected by mixed venous and arterial impairment and 109 by isolated venous disease. Both groups were treated by tailored inelastic CT (with compression pressure &lt, 40 mm Hg in patients with MLU and &gt, 60 mm Hg in patients with VLU) and ultrasound guided foam sclerotherapy (UGFS) of the superficial incompetent veins with the reflux directed to the ulcer bed. In the present sub analysis of the same patients we compared the healing time of 107 non-diabetic patients (NDP), 69 with VLU and 38 with MLU) with the healing time of 73 diabetic patients (DP), 40 with VLU and 33 with MLU. Results: Twenty-five patients were lost at follow up. The results refer to 155 patients who completed the treatment protocol. In the VLU group median healing time was 25 weeks for NDP and 28 weeks in DP (p = 0.09). In the MLU group median healing time was 27 weeks for NDP and 29 weeks for DP (p = &minus, 0.19). Conclusions: when providing leg ulcer treatment by means of tailored compression regimen and foam sclerotherapy for superficial venous refluxes, diabetes has only a minor or no effect on the healing time of recalcitrant VLU or MLU.

Background Recommendations for screening patients with lower-extremity arterial disease (LEAD) to detect asymptomatic carotid stenosis (ACS) are conflicting. Prediction models might identify patients at high risk of ACS, possibly allowing targeted screening to improve preventive therapy and compliance. Methods A systematic search for prediction models for at least 50 per cent ACS in patients with LEAD was conducted. A prediction model in screened patients from the USA with an ankle : brachial pressure index of 0.9 or less was subsequently developed, and assessed for discrimination and calibration. External validation was performed in two independent cohorts, from the UK and the Netherlands. Results After screening 4907 studies, no previously published prediction models were found. For development of a new model, data for 112 117 patients were used, of whom 6354 (5.7 per cent) had at least 50 per cent ACS and 2801 (2.5 per cent) had at least 70 per cent ACS. Age, sex, smoking status, history of hypercholesterolaemia, stroke/transient ischaemic attack, coronary heart disease and measured systolic BP were predictors of ACS. The model discrimination had an area under the receiver operating characteristic (AUROC) curve of 0.71 (95 per cent c.i. 0.71 to 0.72) for at least 50 per cent ACS and 0.73 (0.72 to 0.73) for at least 70 per cent ACS. Screening the 20 per cent of patients at greatest risk detected 12.4 per cent with at least 50 per cent ACS (number needed to screen (NNS) 8] and 5.8 per cent with at least 70 per cent ACS (NNS 17). This yielded 44.2 and 46.9 per cent of patients with at least 50 and 70 per cent ACS respectively. External validation showed reliable discrimination and adequate calibration. Conclusion The present risk score can predict significant ACS in patients with LEAD. This approach may inform targeted screening of high-risk individuals to enhance the detection of ACS.

In this study, an attempt is made to predict the outcome of Twenty20 cricket matches applying predictive discriminant analysis on pressure index. The classification functions of discriminant analys...

Background: Studies have shown that carotid intima-media thickness (CIMT) and ankle–brachial pressure index (ABI) can be used as surrogate markers of coronary artery disease (CAD). However, whether studying the ratio of ABI and CIMT has any added value in predicting CAD when compared to either of them alone, has not been studied. Aims: The aim of the study is to compare CIMT and ABI as surrogate markers for the presence and extent of CAD and to investigate whether studying the ratio of ABI and CIMT has any incremental value in predicting CAD than either of them. Methods: We prospectively enrolled 235 stable, non-ACS patients who underwent CIMT and ABI measurements followed by diagnostic coronary angiography. Results: The mean age of the study population was 56.32 ± 10.14 years. CIMT was significantly higher in the CAD group compared to non-CAD group (0.91 ± 0.22 vs. 0.66 ± 0.15, P ≤ 0.0001). ABI was significantly lower in the CAD group compared to non-CAD group (1.07 ± 0.19 vs. 1.18 ± 0.14, P ≤ 0.0001). At an optimal cutoff value of ≥0.75 mm, CIMT showed better predictive values (sensitivity and specificity –72.3% and 79%, respectively) compared to ABI ≤0.9 (sensitivity and specificity – 21.53% and 96.19%, respectively). CIMT was the strongest independent predictor of CAD (P < 0.0001) followed by ABI (P = 0.006) by multiple regression. ABI/CIMT ratio of ≤1.55 had better predictive value (sensitivity and specificity –75.4% and 78.1%, respectively) and stronger correlation with CAD severity (R = 0.42), than either of them. Conclusion: CIMT is a better surrogate marker of CAD compared to ABI. Studying ABI/CIMT ratio has an incremental value in predicting CAD.

Screening program in lower extremity atherosclerotic disease (LEAD) has not been widely implemented from health systems. The aim of this study was to assess the incidence of LEAD in Greece though a pilot LEAD screening program.Males60 years old without known diagnosis of LEAD or chronic renal disease were invited through public primary health care institutions to participate in a pilot screening program in Central Greece. Demographics, atherosclerotic risk factors and other comorbidities were recorded. LEAD was defined as ankle-brachial pressure index (ABPI) of0.9 or1.4.Among a total of 1152 individuals (invitation acceptance 70%; 1152/1638) LEAD was detected in 13% (148); including 7% with ABPI0.9 and 6% with ABPI1.4. Comparing the groups with ABPI0.9 vs. normal ABPI, abnormal ABPI was associated with older age (P=0.001), hypertension (HT) (P=0.037), smoking (P=0.002), duration of smoking (P=0.01), packs/year (P=0.002), coronary artery disease (P=0.02), chronic obstructive pulmonary disease (P=0.028) and cerebrovascular disease (P=0.001). After multivariate analysis, increased age (0.94, CI: 0.026-5.2; P=0.022), history of HT (2.4, CI: 0.44- 3.7; P=0.05) and longer duration of smoking (0.9, CI: 0.01-6.1; 0.013) were associated with ABPI0.9. Abnormally higher ABPI (1.4) was not associated with any factor. Among those without known CAD or CVD (96/148), 37.5% (36/96) were on statins and 21% (20/96) on antiplatelets.Incidence of LEAD was 13% in a male60 years-old population of central Greece; these individuals maybe undertreated. ABPI0.9 was diagnosed in 7% and was associated with older age, HT and duration of smoking.

Leg ulceration is a debilitating condition in which various factors play a role in determining patients' quality of life (QoL), and compression therapy has been shown to improve QoL. The 3M Coban 2 Lite Compression System provides reduced compression (25–30 mmHg) ideal for patients with painful venous leg ulcers (VLU) who are unable to tolerate high-strength compression or those with mixed-aetiology leg ulcers (MLU) who have an ankle-brachial pressure index (ABPI)≥0.5. This non-comparative evaluation aims to report the initial clinical experiences with 3M Coban 2 Lite and evaluate the performance of this two-layer reduced compression bandage system in treating chronic VLUs and MLUs. In total, 30 patients (12 men (40%); mean age=68.5 years) were enroled for evaluation. The duration of the chronic wounds was 28 months (range=1.5–144 months); 16 patients had VLUs, while 14 had MLUs. Complete healing was achieved in 6 (20%) patients, and an overall mean reduction in wound surface area (4.11 cm2) was observed between the baseline and study endpoint (16 weeks). Thus, 3M Coban 2 Lite seems safe and effective for treating painful VLUs and MLUs in patients unable to tolerate high-strength compression.

The present invention relates to a solid propellant used for propulsion machinery such as a rocket or a shell and, more specifically, to a solid propellant composition having a feature of a low pressure index value in a section where erosive combustion occurs rapidly by including 10-95 wt% of an oxidant, 0.1-20 wt% of a binder, 0.1-20 wt% of a hardener, 0.1-30 wt% of a plasticizer, 0.1-10 wt% of a binding agent, and 0.01-10 wt% of yellow iron oxide (FeOOH) as a combustion catalyst.