Left ventricular systolic dysfunction, heart failure, and the risk of stroke and systemic embolism in patients with atrial fibrillation : insights from the ARISTOTLE trial

We examined the risk of stroke or systemic embolism (SSE) conferred by heart failure (HF) and left ventricular systolic dysfunction (LVSD) in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation Trial (ARISTOTLE), as well as the effect of apixaban versus warfarin

JWST Near-Infrared Detector Degradation: Finding the Problem, Fixing the Problem, and Moving Forward

The James Webb Space Telescope (JWST) is the successor to the Hubble Space Telescope. JWST will be an infrared optimized telescope, with an approximately 6.5 m diameter primary mirror, that is located at the Sun-Earth L2 Lagrange point. Three of JWST's four science instruments use Teledyne HgCdTe HAWAII-2RG (H2RG) near infrared detector arrays. During 2010, the JWST Project noticed that a few of its 5 micron cutoff H2RG detectors were degrading during room temperature storage, and NASA chartered a "Detector Degradation Failure Review Board" (DD-FRB) to investigate. The DD-FRB determined that the root cause was a design flaw that allowed indium to interdiffuse with the gold contacts and migrate into the HgCdTe detector layer. Fortunately, Teledyne already had an improved design that eliminated this degradation mechanism. During early 2012, the improved H2RG design was qualified for flight and JWST began making additional H2RGs. In this article we present the two public DD-FRB "Executiye Summaries" that: (1) determined the root cause of the detector degradation and (2) defined tests to determine whether the existing detectors are qualified for flight. We supplement these with a brief introduction to H2RG detector arrays, and a discussion of how the JWST Project is using cryogenic storage to retard the degradation rate of the existing flight spare H2RGs

Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics

Trial enrichment using gut microbiota derived biomarkers by high-risk individuals can improve the feasibility of randomized controlled trials for prevention of Clostridioides difficile infection (CDI). Here, we report in a prospective observational cohort study the incidence of CDI and assess potential clinical characteristics and biomarkers to predict CDI in 1,007 patients ≥ 50 years receiving newly initiated antibiotic treatment with penicillins plus a beta- lactamase inhibitor, 3rd/4th generation cephalosporins, carbapenems, fluoroquinolones or clindamycin from 34 European hospitals. The estimated 90-day cumulative incidences of a first CDI episode is 1.9% (95% CI 1.1-3.0). Carbapenem treatment (Hazard Ratio (95% CI): 5.3 (1.7-16.6)), toxigenic C. difficile rectal carriage (10.3 (3.2-33.1)), high intestinal abundance of Enterococcus spp. relative to Ruminococcus spp. (5.4 (2.1-18.7)), and low Shannon alpha diversity index as determined by 16 S rRNA gene profiling (9.7 (3.2-29.7)), but not nor- malized urinary 3-indoxyl sulfate levels, predicts an increased CDI risk

Para a noção de transformação curricular

Neste artigo é evidenciada a relação entre currículo e conhecimento, abordando-se o conhecimento escolar na sua seleção, organização e transformação, a partir de uma revisão do conceito de transposição didática e da proposição dos conceitos de transformação curricular e transformação didática. Qualquer debate sobre o currículo exige a dilucidação do conhecimento e uma reflexão sobre os seus diversos significados, sobretudo quando a educação se torna num projeto amplo de questionamento da realidade social. Para além de várias questões colocadas acerca do conhecimento escolar e do modo como a sua organização pode ser realizada, procura-se centrar o debate numa reflexão sobre as fronteiras entre conhecimentos e esclarecer que, sobre essa temática, jamais poderão existir respostas fechadas.This article highlights the link between curriculum and knowledge, the approach of school knowledge’s selection, organization and transformation is based on a revision of the concept of didactic transposition and on the proposal of the concepts of curriculum and didactic transformation. Debates on curriculum demand an explanation and a reflection on the multiple meanings of knowledge mainly when education aims to be a broad project to contest social reality. It aims to focus the discussion on a reflection regarding the borders between knowledges and to show that in this subject there are never closed answers.Dans cet article est mis en évidence le rapport entre le curriculum et la connaissance, en abordant la connaissance scolaire dans sa sélection, son organisation et sa transformation à partir d’une révision du concept de transposition didactique et de la proposition des concepts de transformation du curriculum et de transformation didactique. Toute discussion sur le curriculum exige la dilucidation de la connaissance et une réflexion sur ses plusieurs signifiés, surtout quand l’éducation devient un projet plus large de mise en question de la réalité sociale. Au delà des plusieurs questions posées autour de la connaissance scolaire et de la manière comme son organisation peut être réalisée, on cherche á fixer le débat dans une réflexion sur les frontières entre connaissances et éclaircir que, sur cette thématique jamais ne pourront exister des réponses absolues.En este trabajo se pone en evidencia la relación entre el currículum y el conocimiento, abordándose el conocimiento escolar en su selección, organización y transformación desde una revisión del concepto de transposición didáctica y de la proposición de los conceptos de transformación curricular y transformación didáctica. Cualquier discusión sobre el currículum requiere la aclaración del conocimiento y una reflexión sobre sus diversos significados, especialmente cuando la educación se convierte en un proyecto más amplio de cuestionamiento de la realidad social. Además de varias preguntas sobre el conocimiento escolar y el modo en el que su organización puede tener lugar, se intenta centrar el debate en una reflexión sobre las fronteras entre conocimientos y aclarar que en esta temática jamás podrán existir respuestas cerradas.(undefined

Clinical Outcomes in 3343 Children and Adults with Rheumatic Heart Disease from 14 Low and Middle Income Countries: 2-Year Follow-up of the Global Rheumatic Heart Disease Registry (the REMEDY study)

Background: There are few contemporary data on the mortality and morbidity associated with rheumatic heart disease or information on their predictors. We report the 2-year follow-up of individuals with rheumatic heart disease from 14 low- and middle-income countries in Africa and Asia. Methods: Between January 2010 and November 2012, we enrolled 3343 patients from 25 centers in 14 countries and followed them for 2 years to assess mortality, congestive heart failure, stroke or transient ischemic attack, recurrent acute rheumatic fever, and infective endocarditis. Results: Vital status at 24 months was known for 2960 (88.5%) patients. Two-thirds were female. Although patients were young (median age, 28 years; interquartile range, 18–40), the 2-year case fatality rate was high (500 deaths, 16.9%). Mortality rate was 116.3/1000 patient-years in the first year and 65.4/1000 patient-years in the second year. Median age at death was 28.7 years. Independent predictors of death were severe valve disease (hazard ratio [HR], 2.36; 95% confidence interval [CI], 1.80–3.11), congestive heart failure (HR, 2.16; 95% CI, 1.70–2.72), New York Heart Association functional class III/IV (HR, 1.67; 95% CI, 1.32–2.10), atrial fibrillation (HR, 1.40; 95% CI, 1.10–1.78), and older age (HR, 1.02; 95% CI, 1.01–1.02 per year increase) at enrollment. Postprimary education (HR, 0.67; 95% CI, 0.54–0.85) and female sex (HR, 0.65; 95% CI, 0.52–0.80) were associated with lower risk of death. Two hundred and four (6.9%) patients had new congestive heart failure (incidence, 38.42/1000 patient-years), 46 (1.6%) had a stroke or transient ischemic attack (8.45/1000 patient-years), 19 (0.6%) had recurrent acute rheumatic fever (3.49/1000 patient-years), and 20 (0.7%) had infective endocarditis (3.65/1000 patient-years). Previous stroke and older age were independent predictors of stroke/transient ischemic attack or systemic embolism. Patients from low- and lower-middle–income countries had significantly higher age- and sex-adjusted mortality than patients from upper-middle–income countries. Valve surgery was significantly more common in upper-middle–income than in lower-middle– or low-income countries. Conclusions: Patients with clinical rheumatic heart disease have high mortality and morbidity despite being young; those from low- and lower-middle–income countries had a poorer prognosis associated with advanced disease and low education. Programs focused on early detection and the treatment of clinical rheumatic heart disease are required to improve outcomes. </jats:sec

Об управлении непрофильными активами в структуре капиталов организаций

Материалы XX Междунар. науч.-техн. конф. студентов, аспирантов и молодых ученых, Гомель, 23–24 апр. 2020 г

A systematic approach to biomarker discovery; Preamble to "the iSBTc-FDA taskforce on immunotherapy biomarkers"

The International Society for the Biological Therapy of Cancer (iSBTc) has initiated in collaboration with the United States Food and Drug Administration (FDA) a programmatic look at innovative avenues for the identification of relevant parameters to assist clinical and basic scientists who study the natural course of host/tumor interactions or their response to immune manipulation. The task force has two primary goals: 1) identify best practices of standardized and validated immune monitoring procedures and assays to promote inter-trial comparisons and 2) develop strategies for the identification of novel biomarkers that may enhance our understating of principles governing human cancer immune biology and, consequently, implement their clinical application. Two working groups were created that will report the developed best practices at an NCI/FDA/iSBTc sponsored workshop tied to the annual meeting of the iSBTc to be held in Washington DC in the Fall of 2009. This foreword provides an overview of the task force and invites feedback from readers that might be incorporated in the discussions and in the final document

EFFECT OF LOCALISED ELECTRON CYCLOTRON HEATING ON ENERGY CONFINEMENT AND MHD IN TCV

Within the range of plasma shapes and plasma currents investigated, the electron confinement time, tau_Ee, increases with safety factor, density and negative triangularity similar to the Ohmic heating case. There is little dependence of tau_Ee on the heating location provided power deposition occurs inside the q=1 surface; as power deposition moves out of the inversion surface, tau_Ee decreases. The power-induced energy confinement degradation exponent (tau_Ee~PaP) is as usual: alpha_P ~-0.5. As a general trend, central relaxations decrease in amplitude with increasing qa, P_EC, or negative delta, in a situation where the confinement time increases

2019 ESC/EAS guidelines for the management of dyslipidaemias : Lipid modification to reduce cardiovascular risk

Correction: Volume: 292 Pages: 160-162 DOI: 10.1016/j.atherosclerosis.2019.11.020 Published: JAN 2020Peer reviewe