Abstract-When deploying collaborative applications such as Instant Messaging in ubiquitous computing environments significant enhancements can be afforded by offering additional context information, such as location information. However, such environments exert key challenges such as increased diversity of ownership and ad hoc, intermittent network connectivity that suits more decentralized computing architectures. This paper examines how a migration to a more decentralized collaborative architecture can be achieved together with a decentralization of the management of collaborative activities.
No abstract
Patients were eligible if they presented within 24 hours of suspected acute myocardial infarction with no clear indications for, or contraindications to, the study treatments (although planned use of a few days of intravenous or oral nitrates was permitted). About 40% were within 6 hours of pain onset. 75% had ST elevation, 25% were aged 70% 15% had heart failure, and 2% had systolic blood pressure < 100 ramHgPatients were randomly allocated in a 2 x 2 x 2 factorial design between one month of oral captopril (6.25 mg initial dose, 12.5 rag 2 hours later, 25 mg 10-12 hours later and then 50 mg twice daily) versus placebo, one month of oral controlled-release isosorbide mouonitrate (lmdur: 30 mg initial dose, 30 mg 10-12 hours later and then 60 nag each morning) versus placebo, and 24 hours of intravenous magnesium sulphate (8 raraol initial bolus over 15 minutes followed by 72 mmcl)'versus open control. About 75% received fibrinolytic and almost all antiplatelet therapy.The main comparisons are to be of 5-week and longer-term mortality amongst all those allocated each active therapy versus all those allocated the corresponding control. Principal subsidiary comparisons involve subdivisun by planned nitrate at entry and by the other randomly allocated treatments. Mode of death and major morbidity results will also be considered. The decisions by a single cardiologist as to which of 308 consecutive patients to refer for angiography after treadmill testing were compared with their life expectancy gains from bypass surgery predicted by decision analysis. Neither patient age nor gender influenced the decision to perform angiography. The 94 patients sent for angiograms exercised for a significantly shorter time (p < 0.001 ), had more ST deviation (p < 0.001 ), more angina (p < 0.002) and were more likely to have had a prior myocardial infarction (p < 0.001) than the 214 patients not referred. The mean life expectancy gain predicted from bypass surgery was also greater (p < 0.001) in those referred (2.9 + 1.7 QALYs) than in those not referred for angiography (I.0 + 1,7 QALYs). However, 1~.3 patients not referred were predicted to gain up to 5.7 QALYs from bypass surgery. Consequently the overall predicted life expectancy gain from the cardiologist's 388 intuitive decisions was only 0. I + 2.5 QALYs per patient. Had the referral decision been solely directed by decision analysis the overall gain per patient would have been 1.9 4-1.6 QALYs, and 135 extra patients (229 in total) would have been sent for angiography. Use of decision analysis, therefore might help make referral for angiography more efficient and consistent. Persistent chest pain with normal cardiac investigations is not uncommon following treatment of coronary artery disease. Oesophageal problems are often suspected but to date evaluation has proved difficult. Eight patients who had previously undergone successful coronary artery bypass grafting or coronary angioplasty underwent 24hr ambulatory manoraetry, pH and ECG monitoring. Symptoms were correlated with ...
Several systematic reviews/meta‐analyses published within the last 10 years have examined the effects of Mediterranean style diets (MedSD) on cardiovascular disease (CVD) risk. However, these reports have not been evaluated for satisfying contemporary methodological quality standards. To assess compliance with current standards, we applied a modified version of the Assessment of Multiple Systematic Reviews (AMSTARMedSD) quality scale to systematic reviews/ meta‐analyses retrieved from electronic databases that had met our selection criteria: (1) used systematic or meta‐analytic procedures to review the literature; (2) examined MedSD trials; and (3) had MedSD interventions independently or combined with other interventions. Reviews completely satisfied from 8% to 75% of the AMSTARMedSD items (Mean=31.6%±19.6%), with those published in higher impact journals having greater quality scores. At a minimum 50% of the 20 reports did not disclose full search details or apply appropriate statistical methods to combine study findings. Only two of the reviews included participant or MedSD diet characteristics in their analyses. These data suggest that current meta‐analyses evaluating the effect of MedSD on CVD risk do not fully comply with contemporary methodological quality standards. As a result they have contributed less than ideally to our understanding of how MedSD impacts CVD risk, or how these effects may be moderated by the participant or MedSD characteristics. In order to clarify the effects of MedSD on CVD risk,future meta‐analyses need to adhere to contemporary methodological quality standards.FundingUSDA Hatch project 1000900, CONS000927
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.