Progressive skin fibrosis is associated with a decline in lung function and worse survival in patients with diffuse cutaneous systemic sclerosis in the European Scleroderma Trials and Research (EUSTAR) cohort.

Objectives To determine whether progressive skin fibrosis is associated with visceral organ progression and mortality during follow-up in patients with diffuse cutaneous systemic sclerosis (dcSSc). Methods We evaluated patients from the European Scleroderma Trials and Research database with dcSSc, baseline modified Rodnan skin score (mRSS) ≥7, valid mRSS at 12±3 months after baseline and ≥1 annual follow-up visit. Progressive skin fibrosis was defined as an increase in mRSS >5 and ≥25% from baseline to 12±3 months. Outcomes were pulmonary, cardiovascular and renal progression, and all-cause death. Associations between skin progression and outcomes were evaluated by Kaplan-Meier survival analysis and multivariable Cox regression. Results Of 1021 included patients, 78 (7.6%) had progressive skin fibrosis (skin progressors). Median follow-up was 3.4 years. Survival analyses indicated that skin progressors had a significantly higher probability of FVC decline ≥10% (53.6% vs 34.4%; p<0.001) and all-cause death (15.4% vs 7.3%; p=0.003) than non-progressors. These significant associations were also found in subgroup analyses of patients with either low baseline mRSS (≤22/51) or short disease duration (≤15 months). In multivariable analyses, skin progression within 1 year was independently associated with FVC decline ≥10% (HR 1.79, 95% CI 1.20 to 2.65) and all-cause death (HR 2.58, 95% CI 1.31 to 5.09). Conclusions Progressive skin fibrosis within 1 year is associated with decline in lung function and worse survival in dcSSc during follow-up. These results confirm mRSS as a surrogate marker in dcSSc, which will be helpful for cohort enrichment in future trials and risk stratification in clinical practice

The Belle II Physics Book

We present the physics program of the Belle II experiment, located on the intensity frontier SuperKEKB $e^+e^-$ collider. Belle II collected its first collisions in 2018, and is expected to operate for the next decade. It is anticipated to collect 50/ab of collision data over its lifetime. This book is the outcome of a joint effort of Belle II collaborators and theorists through the Belle II theory interface platform (B2TiP), an effort that commenced in 2014. The aim of B2TiP was to elucidate the potential impacts of the Belle II program, which includes a wide scope of physics topics: B physics, charm, tau, quarkonium, electroweak precision measurements and dark sector searches. It is composed of nine working groups (WGs), which are coordinated by teams of theorist and experimentalists conveners: Semileptonic and leptonic B decays, Radiative and Electroweak penguins, phi_1 and phi_2 (time-dependent CP violation) measurements, phi_3 measurements, Charmless hadronic B decay, Charm, Quarkonium(like), tau and low-multiplicity processes, new physics and global fit analyses. This book highlights "golden- and silver-channels", i.e. those that would have the highest potential impact in the field. Theorists scrutinised the role of those measurements and estimated the respective theoretical uncertainties, achievable now as well as prospects for the future. Experimentalists investigated the expected improvements with the large dataset expected from Belle II, taking into account improved performance from the upgraded detector.Comment: 689 page

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

ISBN: 978-3-941663-08-4Three Views of Two Degrees

ECF initiates and performs high-class research on climate change in close interaction with stakeholders. We provide a pluralistic communication platform in the emerging global field of researchers, governments, local authorities, businesses, and social movements. This field lies beyond the traditional linkage between academic institutions and the nation state hosting them. It requires a capability to learn from each other in situations where consensus is impossible, perhaps not even desirable. As a key requisite for addressing the climate challenge in this spirit, ECF contributes to a new economic theory that will enhance our capability to manage climate risks. European Climate Forum e.V