Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: the ESCARVAL-RISK study

The potential impact of targeting different components of an adverse lipid profile in populations with multiple cardiovascular risk factors is not completely clear. This study aims to assess the association between different components of the standard lipid profile with all cause mortality and hospitalization due to cardiovascular events in a high-risk population. Methods This prospective registry included high risk adults over 30 years old free of cardiovascular disease (2008±2012). Diagnosis of hypertension, dyslipidemia or diabetes mellitus was inclusion criterion. Lipid biomarkers were evaluated. Primary endpoints were all-cause mortality and hospital admission due to coronary heart disease or stroke. We estimated adjusted rate ratios (aRR), absolute risk differences and population attributable risk associated with adverse lipid profiles. Results 51,462 subjects were included with a mean age of 62.6 years (47.6% men). During an average follow-up of 3.2 years, 919 deaths, 1666 hospitalizations for coronary heart disease and 1510 hospitalizations for stroke were recorded. The parameters that showed an increased rate for total mortality, coronary heart disease and stroke hospitalization were, respectively, low HDL-Cholesterol: aRR 1.25, 1.29 and 1.23; high Total/HDL-Cholesterol: aRR 1.22, 1.38 and 1.25; and high Triglycerides/HDL-Cholesterol: aRR 1.21, 1.30, 1.09. The parameters that showed highest population attributable risk (%) were, respectively, low HDL-Cholesterol: 7.70, 11.42, 8.40; high Total/HDL-Cholesterol: 6.55, 12.47, 8.73; and high Triglycerides/ HDL-Cholesterol: 8.94, 15.09, 6.92. Conclusions In a population with cardiovascular risk factors, HDL-cholesterol, Total/HDL-cholesterol and triglycerides/HDL-cholesterol ratios were associated with a higher population attributable risk for cardiovascular disease compared to other common biomarkers

Low Work-Function Tether Deorbit Kit

This work presents a system level analysis of a Deorbit Kit (DK) based on electrodynamic tether technology. The analysis is focused on two relevant scenarios for deorbiting space debris: (i) Earth Observation (EO) satellites with mass in the range of 700kg -1000kg and initial orbital altitude of 800km and 98\uba inclination, and (ii) Mega Constellation (MC) spacecraft in the order of 200kg and initial orbit at 1200 km of altitude and 90\uba of inclination. The scenarios have been selected considering the orbits that are already suffering from the space debris problem or will suffer in the next future. The DK implements a bare electrodynamic tether for capturing electrons passively from the ambient plasma while different methods are used for emitting the electrons back to the plasma to reach a steady electrical current on the tether. The three studied options to close the electrical circuit are: (a) a hollow cathode, which has a high maturity but needs expellant and a little of power, (b) a thermionic emitter, which does not involve expellant but needs power, and (c) a Low Work-function Tether (LWT) that does not need neither expellant nor power because it has a segment coated with a special material that emits electrons passively through the thermionic and photoelectric effects. In order to provide a fully autonomous operation even in case of critical failure of the mother spacecraft, the DK includes a deployment mechanism, a telemetry and telecommand system, a complete Attitude Determination and Control System with attitude sensors (GNSS, sun sensors, magnetometer) and actuators (magneto torquers), solar panels and batteries. Upon activation, the DK autonomously de-tumbles the satellite, deploys a tether and carries out the satellite\u2019s de-orbiting. The study presents DK architectures, mass budgets and simulation results for the two scenarios. It is shown that complete DK with mass below 6% the mass of the host spacecraft can complete the deorbit maneuver of EO satellites in about 1.5 years and 10 years for MC satellites. The importance of the development of the LWT concept to enhance the simplicity and reduce the mass, power and volume budget is highlighted

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease