Class Lc Research Articles

Ethnic and geographic variations in multimorbidty: Evidence from three large cohorts

A common characteristic of patients seen at the Veterans Health Administration (VHA) is a high number of concurrent comorbidities (i.e. multimorbidity). This study (i) examines the magnitude and patterns of multimorbidity by race/ethnicity and geography; (ii) compares the level of variation explained by these factors in three multimorbidity measures across three large cohorts. We created three national cohorts for Veterans with chronic kidney disease (CKD:n = 2,190,564), traumatic brain injury (TBI:n = 167,954) and diabetes-mellitus (DM:n = 1,263,906). Multimorbidity was measured by Charlson-Deyo, Elixhauser and Walraven-Elixhauser scores. Multimorbidity differences by race/ethnicity and geography were compared using generalized linear models (GLM). Latent class analysis (LCA) was used to identify groups of conditions that are highly associated with race/ethnic groups. Differences in age (CKD,74.5, TBI,49.7, DM, 66.9 years), race (CKD,80.9%, TBI,76.4%, DM, 63.8% NHW) and geography (CKD,64.4%, TBI,70%, DM, 70.9% urban) were observed among the three cohorts. Accounting for these differences, GLM results showed that risk of multimorbidity in non-Hispanic blacks (NHB) with CKD were 1.16 times higher in urban areas and 1.10 times higher in rural areas compared to non-Hispanic whites (NHW) with CKD. DM and TBI showed similar results with risk for NHB, 1.05 higher in urban areas and 0.97 lower in rural areas for both diseases. Overall, our results show that (i) multimorbidity risk was higher for NHB in urban areas compared to rural areas in all three cohorts; (ii) multimorbidity risk was higher for Hispanics in urban areas compared to rural areas in the DM and CKD cohorts; and (iii) the highest overall multimorbidity risk of any race group or location exists for Hispanics in insular islands for all three disease cohorts. These findings are consistent among the three multimorbidity measures. In fact, our LCA also showed that a three class LC model based on Elixhauser or Charlson provides good discrimination by type and extent of multimorbidity.

Fire-Resistant Structures for Tunnels Using Light Concrete II

The subject of the article is to inform the experts about results of a set of fire resistance tests of light concretes designed for traffic and tunnel structures. In addition to commonly used recipe C 30/37 FX4, corresponding version of light concrete class LC 35/38/XF 4 was tested. One of the goals of the tests was verification of behaviour of “road” (XF4) concretes under the most demanding conditions of fire, especially in road tunnels. In addition to standard curve, the hydrocarbon and Eureka curves were used for the fire tests. The loading curves differ from normally used standard curve especially in the temperature rise speed (temperatures over 1,000°C are reached within a couple of minutes). In this case, real concrete moisture and possibility to remove water steams from a component are substantially important for the fire safety (integrity).

AUSGeoid09: a more direct and more accurate model for converting ellipsoidal heights to AHD heights

In an absolute sense, AUSGeoid09 is an order of magnitude more accurate than AUSGeoid98 at converting ellipsoidal heights to Australian Height Datum (AHD) heights and vice versa. Results of this study show AUSGeoid09 can be used to compute AHD heights from Global Navigation Satellite System (GNSS) ellipsoidal heights with an uncertainty of less than ±0.03 m (one sigma). The improvement is largely due to the inclusion of a geometric component in AUSGeoid09 that accounts for the spatially varying offset between a gravimetric quasigeoid model and the AHD. This geometric component was calculated using least squares collocation in cross validation mode and then added to the gravimetric quasigeoid. Although previous AUSGeoid models were used to convert GNSS ellipsoidal heights to the AHD and vice versa, none until now have accounted for the gravimetric quasigeoid to AHD offsets. This offset is a consequence of how the AHD was realised and has commonly resulted in misfits of ∼0.5 m or more. When used with GNSS technology, AUSGeoid09 can replace the need for traditional third-order levelling (Class LC; 12) in many situations. Relative tests of AUSGeoid09 over a continent-wide set of over 20 million baselines showed that it can deliver better than Class LC tolerances in 99 percent of cases. The model accepts a user's GDA94 latitude, longitude and ellipsoidal height and returns an AHD height and deviations of the vertical. AUSGeoid09 is now available free-of-charge on the Geoscience Australia website (http://www.ga.gov.au/geodesy/ausgeoid/nvalcomp.jsp).

Error propagation for three common height-system corrections to differential levelling

This paper investigates the propagation of input data errors through the application of Helmert orthometric, normal and normal-orthometric height corrections to differential levelling observations, these being the three principal height systems in practical use around the world. Height corrections are required to remove the systematic error resulting from the geometric non-parallelism of the Earth's equipotential surfaces, but different height systems propagate errors differently. These systematic errors are thus present within levelling networks and subsequently in local vertical datums. Here, we show that the Helmert orthometric correction is sensitive to errors in the mean value of gravity along the plumbline, particularly for heights above 1000 m. The normal correction is much less sensitive due to the use of normal gravity along the normal plumbline. The normal-orthometric correction of Rapp (1961) is largely insensitive to such errors, but it does not properly correct for the non-parallelism of the Earth's equipotential surfaces. Information showing the circumstances under which survey practitioners should apply height corrections to levelling lines is provided, demonstrating that normal-orthometric corrections only need be applied to class LC levelling lines that are to be used for large levelling networks extending in the north-south direction, particularly at high elevations.

ICH Guidance in Practice: Validated Reversed-Phase HPLC Method for the Determination of Active Mangiferin from Extracts of Mangifera indica Linn

This study presents the development and validation of a reversed-phase liquid chromatographic method for the determination of mangiferin (MGN) in alcoholic extracts of mangifera indica. A Lichrospher 100 C(18)-ODS (250 x 4.6 mm, 5 microm size) (Merck, Whitehouse Station, NJ) prepacked column and a mobile phase of potassium dihydrogen orthophosphate (0.01M) pH 2.7 +/- 0.2-acetonitrile (15:85, v/v) with the flow rate of 1 mL/min was used. MGN detection was achieved at a wavelength monitored at 254 nm with SPD-M 10A vp PDA detector or SPD 10AD vp UV detector in combination with class LC 10A software. The proposed method was validated as prescribed by International Conference on Harmonization (ICH) with respect to linearity, specificity, accuracy, precision, stability, and quantification. The method validation was realized using alcoholic extracts and raw materials of leaves and barks. All the validation parameters were within the acceptable limits, and the developed analytical method can successfully be applied for MGN determination.

Estimates for interval probabilities of the sums of random variables with locally subexponential distributions

Let {i} i=1 be a sequence of independent identically distributed nonnegative random variables, S n = ξ1 + ⋯ +ξn. Let Δ = (0, T] and x + Δ = (x, x + T]. We study the ratios of the probabilities P(S n e x + Δ)/P(ξ 1 e x + Δ) for all n and x. The estimates uniform in x for these ratios are known for the so-called Δ-subexponential distributions. Here we improve these estimates for two subclasses of Δ-subexponential distributions; one of them is a generalization of the well-known class LC to the case of the interval (0, T] with an arbitrary T ≤ ∞. Also, a characterization of the class LC is given.

On the Coefficients of Some Subclasses of Univalent Functions

In this paper we consider the class L c *(α,β,γ) consisting of analytic and univlent functions with negative coefficients and with fixed second coefficient. The object of the present paper is to show coefficient estimates, convex linear combinations, some distortion theoems and radii of starlikeness and convexity for f(z) in the class L c *(α,β,γ). The results are generalized to families with finitely many fixed coefficients.

Existentially closed locally cofinite groups

Let be a class of finite groups. Then a c-group shall be a topological group which has a fundamental system of open neighbourhoods of the identity consisting of normal subgroups with -factor groups and trivial intersection. In this note we study groups which are existentially closed (e.c.) with respect to the class Lc of all direct limits of c-groups (where satisfies certain closure properties). We show that the so-called locally closed normal subgroups of an e.c. Lc-group are totally ordered via inclusion. Moreover it turns out that every ∀2-sentence, which is true for countable e.c. L-groups, also holds for e.c. Lc-groups. This allows it to transfer many known properties from e.c. L-groups to e.c. Lc-groups.

Treatment and prevention of ventricular fibrillation: Are there better agents?

Ventricular fibrillation occurs in diverse clinical settings and differing pathogenic mechanisms make it unlikely that a single drug treatment will be universally effective. Drugs may be used as an adjunct to electrical defibrillation in circulatory collapse, to prevent recurrence after successful resuscitation or as a prophylactic treatment in high-risk patients. Various drugs are available for intravenous administration in the acute management of ventricular fibrillation and the choice among them will depend on several factors: proven efficacy, comparative efficacy and their safety including haemodynamic effects. Although several drugs have been shown to suppress ventricular ectopic beats and ventricular tachycardia, ventricular fibrillation and sudden death can occur despite abolition of these less serious ventricular arrhythmias [ 11. Animal studies have suggested the concept of separate ‘antiarrhythmic’ and ‘antilibrillatory’ action of drugs. Drugs with antifibrillatory properties increase the energy threshold for production of ventricular fibrillation while many conventional antiarrhythmic drugs have no effect [2,3]. However, an effect on fibrillation threshold does not necessarily indicate a reduction in energy requirements for successful electrical defibrillation. The major criticism of such models is that the substrate for generation of ventricular fibrillation is usually different in clinical ventricular fibrillation. Lignocaine and bretylium are the current standard drugs for management of acute ventricular fibrillation. This review examines the claims of other antiarrhythmic drugs to supplant or supplement these agents (Table I). Figure 1 shows a representation of the normal cardiac action potential. Initial depolarisation (phase 0) is achieved by rapid influx of sodium ions which is slowed by agents which belong to class 1 of the Vaughan Williams and Singh classification. These compounds are subdivided by their effect on the duration of the action potential: Class la drugs lengthen it, Class lb shorten it, while Class lc have no effect. Class II drugs are the beta blockers which have no direct effect on the action potential but antagonise myocardial stimulation by catecholamines. The Class III agents delay phase 3 repolarisation and prolong the duration of the action potential. Class IV drugs are calcium channel blockers which reduce the influx of calcium into cells, in particular reducing the spontaneous depolarisation of phase 4 in the atrio-

A jump class of noncappable degrees

Friedberg [3] showed that every degree of unsolvability above 0′ is the jump of some degree, and Sacks [9] showed that the degrees above 0′ which are recursively enumerable (r.e.) in 0′ are the jumps of the r.e. degrees.In this paper we examine the extent to which the Sacks jump theorem can be combined with the minimal pair theorem of Lachlan [4] and Yates [13]. We prove below that there is a degree c > 0′ which is r.e. in 0′ but which is not the jump of half a minimal pair of r.e. degrees.This extends Yates' result [13] proving the existence of noncappable degrees (that is, r.e. degrees a < 0′ for which there is no corresponding r.e. b > 0 with a ∩ b = 0).It also throws more light on the class PS of promptly simple degrees. It was shown by Ambos-Spies, Jockusch, Shore and Soare [1] that PS coincides with the class NC of noncappable degrees, and with the class LC of all low-cuppable degrees, and (using earlier work of Maass, Shore and Stob [5]) that PS splits every class Hn or Ln, n ≥ 0, in the high-low hierarchy of r.e. degrees.If c > 0′, with c r.e. in 0′, letand call c−1 the jump class for c. It is easy to see that every jump class contains members of PS (= NC = LC). By Sacks [8] there exists a low a ∈ LC, where of course [a, 0′] (= {br.e. ∣a ≤ b ≤ 0′}) ⊆ LC = PS. But by Robinson [7] [a, 0′] intersects with every jump class.

General pharmacology of diprafenone, a new class lc antiarrhythmic agent, and 5‐hydroxydiprafenone, an active metabolite

AbstractThis study compareo the effects of diprafenone, a new class lc antiarrhythmic agent, and 5‐hydroxydiprafenone (5‐OHDP), an active metabolite of diprafenone, to standard class l antiarrhythmic agents (propafenone, flecainide, or lidocaine), in several pharmacologic models, to ascertain the potential for side effects relative to the currently available class l antiarrhythmic agents. Diprafenone and propafenone decreased blood pressure and heart rate in anesthetized rabbits at 3 and 7 mg/kg, i.v., respectively. Neuromuscular transmission in rabbit gastrocnemius muscle was partially (38%) inhibited after 3 mg/kg of diprafenone and 7 mg/kg of propafenone. Diprafenone and 5‐OHDP (10−4M), but not lidocaine, inhibited aggregation of human platelets evoked by sodium arachidonate and adenosine diphosphate. Diprafenone, fleoainide, and 5‐OHDP (10−4M) inhibited the contractile responses of guinea pig vas deferens to norepinephrine and spontaneous and bradykinin‐evoked contractions of the guinea pig uteri. Diprafenone and 5‐OHDP, but not flecainide, relaxed rabbit bronchial smooth muscle contracted by acetylcholine. Diprafenone, 5‐OHDP and propafenone (10−5M and 10−4M) also depressed the contractile responses of canine mesenteric arteries to transmural nerve stimulation. Thus, high concentrations of diprafenone (10−5M and 10−4M) depress smooth muscle and neural function. The depressant effects occur with 4ndash;40 times the antiarrhythmic concentration of diprafenone and are shared by propafenone and, in part, by 5‐OHDP and flecainide. It is unlikely that major peripheral side effects will occur with therapeutic doses of diprafenone in man.