The Multi-center Evaluation of the Accuracy of the Contrast MEdium INduced Pd/Pa RaTiO in Predicting FFR (MEMENTO-FFR) Study.

AIMS: Adenosine administration is needed for the achievement of maximal hyperaemia fractional flow reserve (FFR) assessment. The objective was to test the accuracy of Pd/Pa ratio registered during submaximal hyperaemia induced by non-ionic contrast medium (contrast FFR [cFFR]) in predicting FFR and comparing it to the performance of resting Pd/Pa in a collaborative registry of 926 patients enrolled in 10 hospitals from four European countries (Italy, Spain, France and Portugal). METHODS AND RESULTS: Resting Pd/Pa, cFFR and FFR were measured in 1,026 coronary stenoses functionally evaluated using commercially available pressure wires. cFFR was obtained after intracoronary injection of contrast medium, while FFR was measured after administration of adenosine. Resting Pd/Pa and cFFR were significantly higher than FFR (0.93±0.05 vs. 0.87±0.08 vs. 0.84±0.08, p<0.001). A strong correlation and a close agreement at Bland-Altman analysis between cFFR and FFR were observed (r=0.90, p<0.001 and 95% CI of disagreement: from -0.042 to 0.11). ROC curve analysis showed an excellent accuracy (89%) of the cFFR cut-off of ≤0.85 in predicting an FFR value ≤0.80 (AUC 0.95 [95% CI: 0.94-0.96]), significantly better than that observed using resting Pd/Pa (AUC: 0.90, 95% CI: 0.88-0.91; p<0.001). A cFFR/FFR hybrid approach showed a significantly lower number of lesions requiring adenosine than a resting Pd/Pa/FFR hybrid approach (22% vs. 44%, p<0.0001). CONCLUSIONS: cFFR is accurate in predicting the functional significance of coronary stenosis. This could allow limiting the use of adenosine to obtain FFR to a minority of stenoses with considerable savings of time and costs.info:eu-repo/semantics/publishedVersio

Thirty-Day Mortality in COVID-19 Positive Patients With Hip Fractures: A Case-Series and Literature Review

Introduction: The novel coronavirus has spread rapidly around the world with particularly high mortality in the elderly. Care and nursing homes have become the sites of greatest concentration of cases. We intended to review 30-day mortality of COVID-19 patients with hip fractures. This is relevant given the disease impact in this age group.Methods: Medline and Embase databases were searched for relevant studies linked to mortality and morbidity in COVID-19 patients who have undergone non-elective hip surgeries using the keywords "COVID-19"OR "SARS-cov-2"OR "Coronavirus Infections"; AND "Surgery"OR "Hip"OR "Fracture"OR "Orthopedics." We included all patients with hip fractures, but excluded pathological fractures and other non-traumatic hip pathologies. Four-hundred and eighty-one articles were identified for screening, in addition to an unpublished case-series of 67 patients that have 3 cases turned positive for COVID 19, yielding a total of 50patients for the final review.Results: The study included 4 articles published until May 9th 2020 and a case-series: 26(52%) patients were females; the median age was 86years; hypertension(53.6%), diabetes mellitus type II(28.6%), and coronary artery heart disease(25%) were the most common comorbidities; 34(68%) patients had intertrochanteric hip fracture and 16(32%) patients had femoral neck fractures; 22(59.5%) patients underwent cephalomedullary nail fixation, 12(32.4%) patients had hemiarthroplasty, and for 3(8.1%) patients, the type of surgery was not documented; 20(40%) patients died(12patients died before the surgery and 8died after surgery at a median time of 3days), 29(76.3%) patients had an unremarkable course throughout hospitalization and were discharged including 1(2.6%) patient managed non-operatively, and 1(2.6%) patient was admitted to the ICU after the surgery but eventually discharged.Conclusion: COVID-19 infected elderly patients have a higher 30-days mortality rate compared to non-COVID-19 infected cases. Further studies are warranted to look at the morbidity and mortality rates in COVID-19 positive patients with hip fractures and to investigate how these outcomes can be improved.Level of evidence: Level IV

The optical potential of 6^{6}He in the eikonal approximation

The new data of the elastic scattering of $^{6}$He+$^{12}$C at about 40 MeV/nucleon are analyzed in the eikonal approximation. The $^{6}$He+$^{12}$C phase-shift function is evaluated completely without any {\it ad hoc} assumption by a Monte Carlo integration, which makes it possible to use a realistic 6-nucleon wave function for a halo nucleus $^{6}$He. The effect of the breakup of $^6$He on the elastic differential cross sections as well as the optical potential is studied at different energies from 40 to 800 MeV/nucleon. PACS number(s): 24.10.-i; 21.60.Ka; 25.60.Bx; 25.10.+s Keywords: Eikonal; Glauber; Monte Carlo; Halo; BreakupComment: 13 pages, 9 figure

Residues located inside the Escherichia coli FepE protein oligomer are essential for lipopolysaccharide O-antigen modal chain length regulation

The Escherichia coli O157 : H7 FepE protein regulates lipopolysaccharide (LPS) O-antigen (Oag) chain length to confer a very long modal chain length of >80 Oag repeat units (RUs). The mechanism by which FepE regulates Oag modal chain length and the regions within it that are important for its function remain unclear. Studies on the structure of FepE show that the protein oligomerizes. However, the exact size of the oligomer is in dispute, further hampering our understanding of its mechanism. Guided by information previously obtained for regions known to be important for Oag modal chain length determination in the homologous Shigella flexneri WzzBSF protein, a set of FepE mutant constructs with single amino acid substitutions was created. Analysis of the resulting LPS conferred by these mutant His6-FepE proteins showed that amino acid substitutions of leucine 168 (L168) and aspartic acid 268 (D268) resulted in LPS with consistently shortened Oag chain lengths of <80 Oag RUs. Substitution of FepE’s transmembrane cysteine residues did not affect function. Chemical cross-linking experiments on mutant FepE proteins showed no consistent correlation between oligomer size and functional activity, and MS analysis of FepE oligomers indicated that the in vivo size of FepE is consistent with a maximum size of a hexamer. Our findings suggest that different FepE residues, mainly located within the internal cavity of the oligomer, contribute to Oag modal chain length determination but not the oligomeric state of the protein.Elizabeth Ngoc Hoa Tran and Renato Moron

A regulation-based classification system for marine protected areas: A response to Dudley et al. [9]

Dudley et al. [9] commented on our paper [11], arguing that the current IUCN objective-based categorization of protected areas, which is also used in marine protected areas (MPAs), should not be abandoned and replaced by the new regulation-based classification system [11]. Here we clarify that we do not advocate replacing the current IUCN categories, but highlight the benefits of using both the objective-based IUCN categories and the new regulation-based classification when applied to MPAs. With an increasing number of MPA types being implemented, most of them multiple-use areas zoned for various purposes, assessing ecological and socio-economic benefits is key for advancing conservation targets and policy objectives. Although the IUCN categories can be used both in terrestrial and marine systems, they were not designed to follow a gradient of impacts and there is often a mismatch between stated objectives and implemented regulations. The new regulation-based classification system addresses these problems by linking impacts of activities in marine systems with MPA and zone classes in a simple and globally applicable way. Applying both the IUCN categories and the regulation based classes will increase transparency when assessing marine conservation goals.ERA-Net BiodivERsA project "BUFFER Partially protected areas as buffers to increase the linked social ecological resilience"; national funders ANR (France); FCT (Portugal); FOR-MAS (Sweden); SEPA (Sweden); RCN (Norway); project BUFFER; Fernand Braudel IFER fellowship (Fondation Maison des Sciences de l'Homme); Fundacao para a Ciencia e a Tecnologia (FCT) [UID/MAR/04292/2013

Brane Tilings and M2 Branes

Brane tilings are efficient mnemonics for Lagrangians of N=2 Chern-Simons-matter theories. Such theories are conjectured to arise on M2-branes probing singular toric Calabi-Yau fourfolds. In this paper, a simple modification of the Kasteleyn technique is described which is conjectured to compute the three dimensional toric diagram of the non-compact moduli space of a single probe. The Hilbert Series is used to compute the spectrum of non-trivial scaling dimensions for a selected set of examples.Comment: 47 pages, 23 figure

Mitología nórdica e imagen: Un acercamiento a la representación mitológica

Como objetivo de este trabajo de investigación nos proponemos abordar la mitología nórdica haciendo hincapié en la relevancia del proceso de creación de su representación gráfica, centrándonos específicamente en el grabado y el concept-art, comprometiéndonos a aportar diversas materializaciones basadas en dichos ámbitos artísticos y así sacar conclusiones que deriven en esclarecer el método de trabajo empleado en contraste con el tema mitológico.Universidad de Sevilla. Grado en Bellas Arte

Monte Carlo integration in Glauber model analysis of reactions of halo nuclei

Reaction and elastic differential cross sections are calculated for light nuclei in the framework of the Glauber theory. The optical phase-shift function is evaluated by Monte Carlo integration. This enables us to use the most accurate wave functions and calculate the phase-shift functions without approximation. Examples of proton nucleus (e.g. p-$^6$He, p-$^6$Li) and nucleus-nucleus (e.g. $^6$He$-^{12}$C) scatterings illustrate the effectiveness of the method. This approach gives us a possibility of a more stringent analysis of the high-energy reactions of halo nuclei.Comment: 20 pages, 8 figure

Impact of one or two visits strategy on hypertension burden estimation in HYDY, a population-based cross-sectional study: implications for healthcare resource allocation decision making.

CONTEXT: The prevalence of hypertension in developing countries is coming closer to values found in developed countries. However, surveys usually rely on readings taken at a single visit, the option to implement the diagnosis on readings taken at multiple visits, being limited by costs. OBJECTIVE: To estimate more accurately the magnitude and extent of the resource that should be allocated to the prevention of hypertension. DESIGN: Population-based cross-sectional survey with triplicate blood pressure (BP) readings taken on two separate home-visits. SETTING: Rural and urban locations in three areas of Yemen (capital, inland and coast). PARTICIPANTS: A nationally representative sample of the Yemen population aged 15–69 years (5063 men and 5179 women), with an overall response rate of 92% in urban and 94% in rural locations. MAIN OUTCOME MEASURE: Hypertension diagnosed as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or self-reported use of antihypertensive drugs. RESULTS: Hypertension prevalence (age-standardised to the WHO world population 2001) based on fulfilling the same criteria on both visits (11.3%; 95% Cl 10.7% to 11.9%), was 35% lower than estimation based on the first visit (17.3%; 16.5% to 18.0%). Advanced age, blood glucose ≥7 mmol/l or proteinuria ≥1+ at dipstick test at visit one were significant predictors of confirmation at visit 2. The 959 participants found to be hypertensive at visit 1 or at visit 2 only and thus excluded from the final diagnosis had a rate of proteinuria (5.0%; 3.8% to 6.5%) comparable to rates of the general population (6.1%; 5.6% to 6.6%), and of subjects normotensive at both visits (5.6%; 5.1% to 6.2%). Only 1.9% of Yemen population classified at high or very high cardiovascular (CV) risk at visit 1 moved to average, low or moderate CV risk categories after two visits. CONCLUSIONS: Hypertension prevalence based on readings obtained after two visits is 35% lower than estimation based on the first visit, subjects were excluded from final diagnosis belonging to low CV risk classes