A Randomized Trial of the Optimum Duration of Acoustic Pulse Thrombolysis Procedure in Acute Intermediate-Risk Pulmonary Embolism: The OPTALYSE PE Trial.

The aim of this study was to determine the lowest optimal tissue plasminogen activator (tPA) dose and delivery duration using ultrasound-facilitated catheter-directed thrombolysis (USCDT) for the treatment of acute intermediate-risk (submassive) pulmonary embolism.This article is freely available via Open Access. Click on the Additional Link above to access the full-text via the publisher's site

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

The Daring Adventures of Kit Carson and Fremont: Among Buffaloes, Grizzlies and Indians, Being a Spirited Diary of the Most Difficult and Wonderful Explorations Ever Made

This book presents a narrative of adventures and explorations in the United States lying between the Missouri River and the Rocky Mountains

Map of an exploring expedition to the Rocky Mountains in the year 1842 and to Oregon & north California in the years 1843-44 / by Brevet Capt. J[ames] C. Frémont

Relief shown by hachures. Originally published in report of the Exploring Expedition to the Rocky Mountains in the year 1842 and to Oregon and North California in the years 1843-44. By Brevet Captain F.C. Fremont, of the Topographical Engineers, under the Orders of color F.F. Abert, Chief of the Topographical Bureau. Printed by the order of the Senate of the United States. Washington. Gales and Seaton, Printers. 1845 (28th Cong., 2nd Sess., Sen. Ex. Doc. 174, Serial 461.). Cited in Carl I. Wheat's Mapping the Transmississippi West, 1540-1861 ; vol. 2, no. 497. Includes: Profile of the route from the mouth of the Kansas to the Pacific by Capt. J.C. Fremont in 1843. Penciled annotations by George Gibbs, based on information supplied by Jedediah Smith.The geographical knowledge of the mountain man Jedediah Smith (1798–1831) is recorded by George Gibbs on this map. Smith’s explorations played a significant role in the settlement of the American West. Smith was the first white man to cross the future states of Nevada and Utah, the first American to enter California by the overland route, and the first American to explore the Pacific coast from California to the banks of the Columbia River. Gibbs’s annotations, based on a manuscript map by Smith, detail such matters as the numbers of Native American warriors in certain places in 1830, the limits of the buffalo range, how far salmon could ascend the Salmon River, and where the mountains had perpetual snow cover. Gibbs was an American geologist and ethnologist who became known for his contribution to the study of the languages of indigenous peoples in the Washington Territory. From a distinguished New York family, he gained a law degree from Harvard University and worked for the American Ethnological Society in New York before moving west, where he hoped to profit from the California Gold Rush. He eventually settled in Astoria, Oregon, where he took up a position as a customs official. WDLGrayscale1:3,000,000. 1 in. = 47.35 mile

Western United States 1845

Relief shown by hachures. Originally published in report of the Exploring Expedition to the Rocky Mountains in the year 1842 and to Oregon and North California in the years 1843-44. By Brevet Captain F.C. Fremont, of the Topographical Engineers, under the Orders of color F.F. Abert, Chief of the Topographical Bureau. Printed by the order of the Senate of the United States. Washington. Gales and Seaton, Printers. 1845 (28th Cong., 2nd Sess., Sen. Ex. Doc. 174, Serial 461.). Includes: Profile of the route from the mouth of the Kansas to the Pacific by Capt. J.C. Fremont in 1843. Source of annotations unknown. This map has been conserved through the generosity of the Hoan Foundation, 2014.Grayscale1:3,000,000. 1 in. = 47.35 mile

Bird's-Eye View of the Army Occupation, Corpus Christi, Texas, Oct. 1845

Illustration of a field full of white tents and army personnel next to the Gulf of Mexico with ships on it

United States 198-?

Facsimile of 1848 edition. Relief indicated by hachures and spot heights ; Shows area of U.S. west of the Continental Divide ; Includes notes and "Profile of the travelling route from the South Pass of the Rocky Mountains to the Bay of San Francisco."Colo