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Development and course of heart failure after a myocardial infarction in younger and older people

Journal of Geriatric Cardiology 2014年第1期11卷 1-12页

作者： Azam Torabi john GF cleland Alan S Rigby Nasser Sherwi Department of Cardiology Castle Hill Hospital Hull York Medical School University of Hull Kingston upon Hull HU16 5JQ United Kingdom

Background Acute myocardial infarction （AMI） is a common cause of heart failure （HF）, which can develop soon after AMI and may persist or resolve or develop late. HF after an MI is a major source of mortality. The cumulative incidence, prevalence and resolution of HF after MI in different age groups are poorly described. This study describes the natural history of HF after AMI according to age. Methods Patients with AMI during 1998 were identified from hospital records. HF was defined as treatment of symptoms and signs of HF with loop diuretics and was considered to have resolved if loop diuretic therapy could be stopped without recurrence of symptoms. Patients were cate- gorised into those aged 〈 65 years, 65-75 years, and 〉 75 years. Results Of 896 patients, 311,297 and 288 were aged 〈 65, 65-75 and 〉75 years and of whom 24%, 57% and 82% had died respectively by December 2005. Of these deaths, 24 （8%）, 68 （23%） and 107 （37%） oc- curred during the index admission, many associated with acute HF. A further 37 （12%）, 63 （21%） and 82 （29%） developed HF that persisted until discharge, of whom 15, 44 and 62 subsequently died. After discharge, 53 （24%）, 55 （40%） and 37 （47%） patients developed I-IF for the first time, of whom 26%, 62% and 76% subsequently died. Death was preceded by the development of HF in 35 （70%）, 93 （91%） and 107 （85%） in aged 〈 65 years, 65-75 years and 〉75 years, respectively. Conclusions The risk of developing HF and of dying after an MI in- creases progressively with age. Regardless of age, most deaths after a MI are preceded by the development of HF.

关键词： Myocardial infarction Heart failure Age

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Diversity of Fertility Levels and Implications for the Future

Diversity of Fertility Levels and Implications for the Futur...

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文明的和谐与共同繁荣：人类文明的多元发展模式——北京论坛（2007）

作者： john G.cleland London School of Hygiene & Tropical Medicine

Human fertility has never been so *** some countries the average number of births per woman is close to one,only half the level required for long term stability of population *** other countries the average woman is having six to seven *** possible reasons for this diversity and the consequences are *** problems of excessively high fertility are probably more easily solved than those of very low *** experience has been gained over the past 40 years in how to reduce childbearing,mainly by high quality family planning programmes with accompanying publicity to legitimise the idea of small families and use of modern ***,successful experience at raising fertility is much less common and the future of very low fertility countries remains *** paper concludes that fertility in the range of 1.7 to 2.3 births,implying modest long term decline or increase in population is probably optimal.

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上海市产后妇女避孕方法选择的定性研究

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中国计划生育学杂志 2007年第10期15卷 603-606页

作者：车焱 john cleland 韩耀玲上海市计划生育科学研究所 200032

目的:了解上海市产后妇女避孕措施的选择及其影响因素,并了解妇幼保健和计划生育机构对产后避孕服务提供情况。方法:采用个人访谈和小组讨论的研究方法,对上海市分娩1年内的产妇以及参与产后家庭访视的妇幼保健和计划生育工作人员进行... 详细信息

目的:了解上海市产后妇女避孕措施的选择及其影响因素,并了解妇幼保健和计划生育机构对产后避孕服务提供情况。方法:采用个人访谈和小组讨论的研究方法,对上海市分娩1年内的产妇以及参与产后家庭访视的妇幼保健和计划生育工作人员进行访谈。结果:妇女产后早期倾向选择对身体康复和哺乳没有影响的避孕套和安全期避孕,一段时期之后倾向选择避孕效率更高的方法。选择避孕方法的种类受妇产科医生的建议和亲戚朋友避孕经验的影响较大。产妇避孕知识整体水平不高,普遍不了解哺乳避孕法以及口服避孕药、皮下埋植剂等避孕方法。由于产后访视员避孕知识的不足使得产后访视几乎未开展有效的避孕指导。结论:采取多种措施,提高产妇避孕知识,扩大产后避孕方法的选择,改善产后访视的避孕指导。

关键词：产后妇女产后访视避孕选择定性研究

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Sexual Conduct before Marriage and Subsequent Marital Happiness in Shanghai

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Journal of Reproduction and Contraception 2005年第1期16卷 47-56页

作者： Yan CHE john cleland Shanghai＇Institute of Planned Parenthood Research 2140 Xie Tu Road Shanghai 200032 China Centre for Population Studies London School of Hygiene ＆ Tropical Medicine 49-51 Bedford Square London WCIB 3DP UK

Objective To investigate the links between wives＇ marital happiness and premarital sex and related consequences in Shanghai during 1980s Methods About 8 000 newly married couples were followed up at the 3rd and 15th month after their marriage. Results About 12% of them reported premarital intercourse. This proportion was higher among less educated couples with blue-collar jobs. About 63% of the sexually active caused pregnant before marriage. Most pregnancies were legitimised by marriage but 1/4 ended in induced abortion. Over 3/4 （78%） of wives reported that they were happy with the marriage in general, while 72% of wives were happy with the sexual aspects of their marriage. Results showed a strong relationship between marital happiness and the occurrence of a premarital abortion. Less educated and latearring women were more likely to assess their marriage neutrally or negatively. Conclusion Unhappiness with marriage in general and with marital sexual life were significantly higher among women with premarital abortion, and among less educated and late-marrying women.

关键词： happiness induced abortion marriage premarital sex

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生育水平的多样性及其对未来的影响(英文)

生育水平的多样性及其对未来的影响(英文)

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北京论坛（2007）文明的和谐与共同繁荣——人类文明的多元发展模式

作者： john cleland Centre for Population Studies London School of Hygiene & Tropical Medicine

The level of human fertility is more varied by region and country today than at any other point in *** some African countries,the average woman still experiences seven births over her lifetime,while at the other extreme,the fertility level is not much above one birth per woman in some European *** paper outlines the implications of continuing high fertility in poor countries - with a particular focus on Africa - and discusses the prospects for future *** also outlines the implications of sustained low fertility in parts of Europe and East Asia and possible policy adjustments to ageing and low fertility situations.

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Heart‘omicsin’AGEing (HOMAGE):design,research objectives and characteristics of the common database

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The Journal of Biomedical Research 2014年第5期28卷 349-359页

作者： Lotte Jacobs Lutgarde Thijs Yu Jin Faiez Zannad Alexandre Mebazaa Philippe Rouet Florence Pinet Christophe Bauters Burkert Pieske Andreas Tomaschitz Mamas Mamas Javier Diez Kenneth McDonald john G F cleland Hans-Peter Brunner-La Rocca Stephane Heymans Roberto Latini Serge Masson Peter Sever Christian Delles Stuart Pocock Timothy Collier Tatiana Kuznetsova Jan A Staessen Studies Coordinating Centre Research Unit Hypertension and Cardiovascular EpidemiologyKU Leuven Department of Cardiovascular Sciences University of Leuven Centre d'Investigation Clinique Pierre Drouin and U 961 Hypertension and Heart Failure UnitInstitut Lourrain du Coeur etdes VaisseauxInsermNancyFrance Department of Anesthesiology and Critical Care Medicine InsermUMR-S942Hopital LariboisiereUniversite Paris Diderot Equipe obesite et insuffisance cardiaque Universite UPSInserm I2MCUMR 1048ToulouseFrance Inserm U744CHRULilleFrance Department of Cardiology Medical University Graz Cardiovascular Institute University of ManchesterManchesterUK Division of Cardiovascular Sciences Foundation for Applied Medical ResearchUniversity of Navarra Heart Failure Unit St Vincent's University Hospital University College Dublin Department of Cardiology University of HullUK Department of Cardiology Maastricht University Medical CentreNetherlands Center for Heart Failure Research Department of CardiologyMaastricht UniversityNetherlands Department of Cardiovascular Research IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri" International Center for Circulatory Health Imperial College Institute of Cardiovascular and Medical Sciences BHF Glasgow Cardiovascular Research CenterUniversity of Glasgow London School of Hygiene and Tropical Medicine

Heart failure is common in older people and its prevalence is *** Heart ＇omics＇ in AGEing（HOMAGE） project aims to provide a biomarker approach that will improve the early diagnosis of heart failure.A large clinical database,based on（1） prospective population studies or（2） cross-sectional,prospective studies or randomized controlled trials（RCTs） of patients at risk for or with overt cardiovascular disease will be constructed to determine most promising ＇omics＇-based biomarkers to identify the risk of developing heart failure and/or *** studies,patient cohorts and RCTs are eligible for inclusion in the common database,if they received ethical approval to obtain and share data and have baseline information on cardiovascular risk ***,the HOMAGE database includes 43,065 subjects,from 20 studies in eight European countries,including healthy subjects from three population studies in France,Belgium and Italy（n = 7,124）,patients with heart failure（n = 4,312） from four cohorts in the UK,Spain and Switzerland and patients at high risk for cardiovascular disease（n = 31,629） in 13 *** is anticipated that more partners will join the consortium and enlarge the pooled *** large merged database will be a useful resource with which to identify candidate biomarkers that play a role in the mechanism underlying the onset and progression of heart failure.

关键词： left ventricle heart failure heart failure with reduced ejection fraction heart failure with preserved ejection fraction population science morbidity mortality

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Issues in the Mining of Heart Failure Datasets

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International Journal of Automation and computing 2014年第2期11卷 162-179页

作者： Nongnuch Poolsawad Lisa Moore Chandrasekhar Kambhampati john G.F.cleland Intelligent Systems Research Group(IS Department of Computer Science) University of Hull Hull York Medical School Department of CardiologyUniversity of Hull

This paper investigates the characteristics of a clinical dataset using a combination of feature selection and classification methods to handle missing values and understand the underlying statistical characteristics of a typical clinical dataset. Typically, when a large clinical dataset is presented, it consists of challenges such as missing values, high dimensionality, and unbalanced classes. These pose an inherent problem when implementing feature selection and classification algorithms. With most clinical datasets, an initial exploration of the dataset is carried out, and those attributes with more than a certain percentage of missing values are eliminated from the dataset. Later, with the help of missing value imputation, feature selection and classification algorithms, prognostic and diagnostic models are developed. This paper has two main conclusions: 1) Despite the nature of clinical datasets, and their large size, methods for missing value imputation do not affect the final performance. What is crucial is that the dataset is an accurate representation of the clinical problem and those methods of imputing missing values are not critical for developing classifiers and prognostic/diagnostic models. 2) Supervised learning has proven to be more suitable for mining clinical data than unsupervised methods. It is also shown that non-parametric classifiers such as decision trees give better results when compared to parametric classifiers such as radial basis function networks(RBFNs).

关键词： Heart failure clinical dataset classification clustering missing values feature selection.

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Retrospective review of a tertiary adult burn centre's experience with modified Meek grafting

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Burns & Trauma 2016年第1期4卷 53-59页

作者： Namal Munasinghe Jason Wasiak Andrew Ives Heather cleland Cheng Hean Lo Victorian Adult Burns Service The Alfred55 Commercial RoadMelbourne3004Australia. Epworth Hospital 89 Bridge RoadRichmond 3121Australia. School of Public Health&Preventive Medicine Monash UniversityTheAlfred55 Commercial RoadMelbourne 3004Australia.

Background:Autologous split skin grafting is the gold standard in treating patients with massive ***,the limited availability of donor sites remains a *** aim of this study is to present our experience with the modified Meek technique of grafting,outcomes achieved and recommendations for optimized ***:We retrospectively reviewed patient records from our tertiary referral burn centre and the Bi-National Burns Registry to identify all patients who had modified Meek grafting between 2010 and *** records were reviewed individually and information regarding patient demographics,mechanism of injury and surgical management was *** measures including graft take rate,requirement for further surgery and complications were also ***:Eleven patients had modified Meek grafting *** average age of patients was 46 years old(range 23–64).The average total body surface area(TBSA)burnt was 56.75%(range 20–80%).On average,87%of the grafted areas healed well and did not require *** the regrafted areas,infection was the leading cause of graft ***:Modified Meek grafting is a useful method of skin *** to any other grafting technique,infection needs to be sought and treated *** is recommended for larger burns where donor sites are not adequate or where it is desirable to limit their extent.

关键词： Meek grafting Postage stamp grafting Micro-grafting Massive burns

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Acute heart failure (suspected or confirmed): Initial diagnosis and subsequent evaluation with traditional and novel technologies

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World Journal of Cardiovascular Diseases 2013年第3期3卷 290-300页

作者： Ahmad Shoaib Thato Mabote Mohamed Zuhair Xenophon Kassianides john G. F. cleland Department of Cardiology University of Hull Castle Hill Hospital Kingston upon Hull UK

Acute or worsening heart failure is a common reason for hospitalization which carries a high mortality. Prompt diagnosis or exclusion of HF and its cause and precipitating factors can improve the quality and efficiency of care, shorten hospital stay, reduce readmission and improve prognosis. While the clinician remains central to reaching a clinical diagnosis of heart failure, the use of traditional and novel diagnostic technologies will improve the specificity and sensitivity of the diagnosis of heart failure diagnosis and provide insights into its pathophysiogical profile and help tailor therapy to individual patient need. Chest X-rays and electrocardiograms are generally available;echocardiograms less so. Novel technologies include both invasive and non-invasive methods to detect increases in intrathoracic fluid, pulmonary congestion, left ventricular filling pressures, cardiac output and vascular function. However, few of these technologies have been subjected to randomised controlled trials investigating their ability to improve patient management.

关键词： Heart Failure (HF) Acute Heart Failure Syndrome AHFS Bio-Impedance Diagnosis Monitoring

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