Cost evaluation and comparison of three decision strategies for cardiac revascularization : results of the suspected CAD protocol of the European CMR registry

Background: The public health burden of coronary artery disease (CAD) is important. Perfusion cardiac magnetic resonance (CMR) is generally accepted to detect and monitor CAD. Few studies have so far addressed its costs and costeffectiveness. Objectives: To compare in a large CMR registry the costs of a CMR-guided strategy vs two hypothetical invasive strategies for the diagnosis and the treatment of patients with suspected CAD. Methods: In 3'647 patients with suspected CAD included prospectively in the EuroCMR Registry (59 centers; 18 countries) costs were calculated for diagnostic examinations, revascularizations as well as for complication management over a 1-year follow-up. Patients with ischemia-positive CMR underwent an invasive X-ray coronary angiography (CXA) and revascularization at the discretion of the treating physician (=CMR+CXA strategy). Ischemia was found in 20.9% of patients and 17.4% of them were revascularized. In ischemia-negative patients by CMR, cardiac death and non-fatal myocardial infarctions occurred in 0.38%/y. In a hypothetical invasive arm the costs were calculated for an initial CXA followed by FFR testing in vessels with ≥50% diameter stenoses (=CXA+FFR strategy). To model this hypothetical arm, the same proportion of ischemic patients and outcome was assumed as for the CMR+CXA strategy. The coronary stenosis - FFR relationship reported in the literature was used to derive the proportion of patients with ≥50% diameter stenoses (Psten) in the study cohort. The costs of a CXA-only strategy were also calculated. Calculations were performed from a third payer perspective for the German, UK, Swiss, and US healthcare systems.

Systematics, Germplasm evaluation and pattern of distribution and abundance of freshwater fishes of Kerala (lndia)

The overall focus of the thesis involves the systematics,germplasm evaluation and pattern of distribution and abundance of freshwater fishes of kerala (india).Biodiversity is the measure of variety of Life.With the signing on the convention on biodiversity, the countries become privileged with absolute rights and responsibility to conserve and utilize their diverse resources for the betterment of mankind in a sustainable way. South-east Asia along with Africa and South America were considered to be the most biodiversity rich areas in the world .The tremendous potential associated with the sustainable utilization of fish germplasm resources of various river systems of Kerala for food, aquaculture and ornamental purposes have to be fully tapped for economic upliftment of fisherman community and also for equitable sharing of benefits among the mankind without compromising the conservation of the rare and unique fish germplasm resources for the future generations.The study was carried during April 2000 to December 2004. 25 major river systems of Kerala were surveyed for fish fauna for delineating the pattern of distribution and abundance of fishes both seasonally and geographically.The results of germplasm inventory and evaluation of fish species were presented both for the state and also river wise. The results of evaluation of fish species for their commercial utilization revealed that, of the 145, 76 are ornamental, 47 food and 22 cultivable. 21 species are strictly endemic to Kerala rivers. The revalidation on biodiversity status of the fishes assessed based on IUCN is so alarming that a high percentage of fishes (59spp.) belong to threatened category which is inclusive of 8 critically ndangered (CR), 36 endangered and 15 species under vulnerable (VU) category.The river wise fish germplasm inventory surveys were conducted in 25 major river systems of Kerala.The results of the present study is indicative of existence of several new fish species in the streams and rivulets located in remote areas of the forests and therefore, new exclusive surveys are required to surface fish species new to science, new distributional records etc, for the river systems.The results of fish germplasm evaluation revealed that there exist many potential endemic ornamental and cultivable fishes in Kerala. It is found imperative to utilize these species sustainably for improving the aquaculture production and aquarium trade of the country which would definitely fetch more income and generate employment.

Biostatistical evaluation and Management of sciaenid fishery with particular reference to Otolithes ruber (Schneider, 1801) andJohnieops sina (Cuvier, 1830) of Konkan coast

Fish, a natural resource, has received great attention from all over the world. since it provides a cheap protein, employment and income to the millions of people for centuries. So fishermen, industrialist and multinationals are trying to exploit the marine resources to their maximum benefit by using modern craft, advance fishing equipments and efficient gear. Fishery resources in the open system particularly in oceans, were considered to be unlimited. However, recent developments in the innovation of efficient craft and gear using well tested material fitted with modern equipments that have greatly enhanced the mobility of craft, agility of gear and the ability of equipments to locate fishery resources have proved otherwise. Hence as the exploitation increases with more effort entering the fishery, the catch per unit of fishing effort starts to decline due to the limitness of the resources. The heavy fishing pressure in the recent past led to commercial extinction of a number of stocks such as. the North Sea herring, California sardine, Japanese Sardine and Peruvian anchovy (FAO. 1968: Gulland, 1974). In India, seer fish from Palk-Bay declined due to uncontrolled fishing (Devaraj 1983).

The Development and Promotion of ETDs in Kerala

Electronic Theses and Dissertations (ETD) have become an important component of library service in all countries. Many Indian higher education institutions are actively engaged in the process of introducing ETDs. This study describes the development of ETD projects in Kerala. This paper examines the ETD project of Cochin University of Science and Technology (CUSAT) and Mahatma Gandhi University (MGU)

Evaluation and early detection of problematic Internet use in adolescents

Resumen tomado de la publicación

Improvement of strategies for the management of fire blight (Erwinia amylovora). Evaluation and optimization of physical and chemical control methods, and use of decision support systems

El foc bacterià és una malaltia que afecta a plantes de la família de la rosàcies, causada pel bacteri Erwinia amylovora. El seu rang d'hostes inclou arbres fruiters, com la perera, la pomera o el codonyer, i plantes ornamentals de gran interès comercial i econòmic. Actualment, la malaltia s'ha dispersat i es troba àmpliament distribuïda en totes les zones de clima temperat del món. A Espanya, on la malaltia no és endèmica, el foc bacterià es va detectar per primer cop al 1995 al nord del país (Euskadi) i posteriorment, han aparegut varis focus en altres localitzacions, que han estat convenientment eradicats. El control del foc bacterià, és molt poc efectiu en plantes afectades per la malaltia, de manera que es basa en mesures encaminades a evitar la dispersió del patogen, i la introducció de la malaltia en regions no endèmiques. En aquest treball, la termoteràpia ha estat avaluada com a mètode d'eradicació d'E. amylovora de material vegetal de propagació asimptomàtic. S'ha demostrat que la termoteràpia és un mètode viable d'eradicar E. amylovora de material de propagació. Gairebé totes les espècies i varietats de rosàcies mantingudes en condicions d'humitat sobrevivien 7 hores a 45 ºC i més de 3 hores a 50 ºC, mentre que més d'1 hora d'exposició a 50 ºC amb calor seca produïa danys en el material vegetal i reduïa la brotació. Tractaments de 60 min a 45 ºC o 30 min a 50 ºC van ser suficients per reduir la població epífita d'E. amylovora a nivells no detectables (5 x 102 ufc g-1 p.f.) en branques de perera. Els derivats dels fosfonats i el benzotiadiazol són efectius en el control del foc bacterià en perera i pomera, tant en condicions de laboratori, com d'hivernacle i camp. Els inductors de defensa de les plantes redueixen els nivells de malaltia fins al 40-60%. Els intervals de temps mínims per aconseguir el millor control de la malaltia van ser 5 dies pel fosetil-Al, i 7 dies per l'etefon i el benzotiadiazol, i les dosis òptimes pel fosetil-Al i el benzotiadiazol van ser 3.72 g HPO32- L-1 i 150 mg i.a. L-1, respectivament. Es millora l'eficàcia del fosetil-Al i del benzotiadiazol en el control del foc bacterià, quan es combinen amb els antibiòtics a la meitat de la dosi d'aquests últims. Tot i que l'estratègia de barrejar productes és més pràctica i fàcil de dur a terme a camp, que l'estratègia de combinar productes, el millor nivell de control de la malaltia s'aconsegueix amb l'estratègia de combinar productes. Es va analitzar a nivell histològic i ultrastructural l'efecte del benzotiadiazol i dels fosfonats en la interacció Erwinia amylovora-perera. Ni el benzotiadiazol, ni el fosetil-Al, ni l'etefon van induir canvis estructurals en els teixits de perera 7 dies després de la seva aplicació. No obstant, després de la inoculació d'E. amylovora es va observar en plantes tractades amb fosetil-Al i etefon una desorganització estructural cel·lular, mentre que en les plantes tractades amb benzotiadiazol aquestes alteracions tissulars van ser retardades. S'han avaluat dos models (Maryblyt, Cougarblight) en un camp a Espanya afectat per la malaltia, per determinar la precisió de les prediccions. Es van utilitzar dos models per elaborar el mapa de risc, el BRS-Powell combinat i el BIS95 modificat. Els resultats van mostrar dos zones amb elevat i baix risc de la malaltia. Maryblyt i Cougarblight són dos models de fàcil ús, tot i que la seva implementació en programes de maneig de la malaltia requereix que siguin avaluats i validats per un període de temps més llarg i en àrees on la malaltia hi estigui present.

Speech and the hearing-impaired child: evaluation and revision of the CID Speech Skills Worksheet

The purpose of this study was to evaluate the current use of the Central Institute for the Deaf’s Speech Skills Worksheet by teacher of the deaf and speech-language pathologists, review the current literature on speech development in hearing-impaired children, and apply the findings to develop a more comprehensive Speech Skills Worksheet.