The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

The role of micronutrients and vitamins in the prevention and remote treatment of heart failure

The purpose of this study is to study the roleof vitamins and trace elements in the preventionof cardiovascular diseases (arrhythmias) inchildren. In 2015-2019, 300 children of the experimentalgroup, 141 girls and 159 boys with diseases associatedwith heart dysfunctions were examined. The average ageof children is 11.2±1.2 years, the interval is from 6 to 16years. The second, control group included 150 healthychildren, 81 boys and 69 girls, the average age of thechild in this group was 11.6±1.2 years. Children from thecontrol and experimental groups lived in the same city(Orenburg, Russia; Grozny, Russia), in identical climatic(environmental) conditions. The concentration of traceelements in the hair and the level of vitamin D, B9 andB12 in the blood was determined using the method ofatomic emission spectrometry and the immunochemicalmethod, respectively. A 1.4-fold higher frequency of occurrenceof vitamin D deficiency or deficiency was foundin the experimental group (p≤0.001). As for the deficiencyof vitamins from group B, it was detected exclusivelyin patients with impaired heart function. Calcium deficiencywas found in 267 children from the experimentalgroup (89%) with cardiac abnormalities compared with60 children from the control group (40%, at p≤0.001).A similar trend was recorded for magnesium: deficiencywas found in 270 children (90%) from the experimentalgroup with a deficiency of vitamin D compared with 51(34%) children from the control. (p≤0.001). The values ofPearson correlations (at p≤0.05) between the deficiencyof vitamin D and the low concentration of the chemicalelements, in particular, calcium (0.95), magnesium (0.92),manganese (0.89), phosphorus (0.87), zinc (0.84), wereobtained. For four elements, the dependences were obtainedbetween a low concentration of vitamin D and anincreased concentration of these elements: lead (0.89),strontium (0.83), nickel (0.84), and aluminum (0.79). Inchildren with cardiac abnormalities, the concentration ofvitamins is 1.5–2 times or more significantly lower comparedto the control group. For the risk of disturbances inthe heart, a concentration of vitamin D at a level of 21.8ng/ml is sufficient, which slightly exceeds the minimumpermissible concentration of this vitamin. Since most ofthe chemical elements we studied are somehow related tothe concentration of vitamin D, the determination of thecritical concentration of this vitamin seemed extremely important.Children with vitamins D, B9 and B12 deficiency,have heart problems more often than the healthy childrenof the same age and living in similar conditions. For a third(5 out of 18) of the studied chemical elements there isa direct correlation between their low concentration andlow concentration of vitamin D in the blood plasma. For 4elements, a high concentration was established in conditionsof a lack of vitamin D (lead, nickel, strontium, aluminum).A high risk of arrhythmia may be associated witha concentration of vitamin D not exceeding 21.8 ng/ml

The role of micronutrients and vitamins in the prevention and remote treatment of heart failure

The purpose of this study is to study the roleof vitamins and trace elements in the preventionof cardiovascular diseases (arrhythmias) inchildren. In 2015-2019, 300 children of the experimentalgroup, 141 girls and 159 boys with diseases associatedwith heart dysfunctions were examined. The average ageof children is 11.2±1.2 years, the interval is from 6 to 16years. The second, control group included 150 healthychildren, 81 boys and 69 girls, the average age of thechild in this group was 11.6±1.2 years. Children from thecontrol and experimental groups lived in the same city(Orenburg, Russia; Grozny, Russia), in identical climatic(environmental) conditions. The concentration of traceelements in the hair and the level of vitamin D, B9 andB12 in the blood was determined using the method ofatomic emission spectrometry and the immunochemicalmethod, respectively. A 1.4-fold higher frequency of occurrenceof vitamin D deficiency or deficiency was foundin the experimental group (p≤0.001). As for the deficiencyof vitamins from group B, it was detected exclusivelyin patients with impaired heart function. Calcium deficiencywas found in 267 children from the experimentalgroup (89%) with cardiac abnormalities compared with60 children from the control group (40%, at p≤0.001).A similar trend was recorded for magnesium: deficiencywas found in 270 children (90%) from the experimentalgroup with a deficiency of vitamin D compared with 51(34%) children from the control. (p≤0.001). The values ofPearson correlations (at p≤0.05) between the deficiencyof vitamin D and the low concentration of the chemicalelements, in particular, calcium (0.95), magnesium (0.92),manganese (0.89), phosphorus (0.87), zinc (0.84), wereobtained. For four elements, the dependences were obtainedbetween a low concentration of vitamin D and anincreased concentration of these elements: lead (0.89),strontium (0.83), nickel (0.84), and aluminum (0.79). Inchildren with cardiac abnormalities, the concentration ofvitamins is 1.5–2 times or more significantly lower comparedto the control group. For the risk of disturbances inthe heart, a concentration of vitamin D at a level of 21.8ng/ml is sufficient, which slightly exceeds the minimumpermissible concentration of this vitamin. Since most ofthe chemical elements we studied are somehow related tothe concentration of vitamin D, the determination of thecritical concentration of this vitamin seemed extremely important.Children with vitamins D, B9 and B12 deficiency,have heart problems more often than the healthy childrenof the same age and living in similar conditions. For a third(5 out of 18) of the studied chemical elements there isa direct correlation between their low concentration andlow concentration of vitamin D in the blood plasma. For 4elements, a high concentration was established in conditionsof a lack of vitamin D (lead, nickel, strontium, aluminum).A high risk of arrhythmia may be associated witha concentration of vitamin D not exceeding 21.8 ng/ml

УСОВЕРШЕНСТВОВАННАЯ ТЕХНОЛОГИЯ РЕМОНТА ЭЛЕКТРОГИДРАВЛИЧЕСКИХ ФОРСУНОК АВТОТРАКТОРНЫХ ДИЗЕЛЕЙ

The actual service life of electrohydraulic injectors of automotive diesel engines with a high-pressure battery system of the Common Rail type in operation is significantly lower than the claimed one, and its restoration by repair is relevant from a technical and economic point of view. One of the most wearable elements of electrohydraulic injectors is the contact surface of the ball valve seat. (Research purpose) The research purpose is in developing an improved technology for repairing electro-hydraulic injectors of automotive diesel engines with a vibration-rivet of the contact surface of the ball valve seat. (Materials and methods) The article presents the carried out theoretical substantiation of the process of vibration riveting of the ball valve seat of electrohydraulic injectors and its laboratory and bench studies using serial stands for testing electrohydraulic injectors, checking their elements and restoring the seat geometry by lapping, an electronic digital microscope. (Results and discussion) Authors confirmed the working hypothesis about the possibility of forming the ring contact surface of the ball valve of electrohydraulic injectors reinforced with a vibration riveting by creating certain hydraulic and electrical modes of its operation during the required time. For the model 0445110376 electrohydraulic injectors of the Cummins ISF 2.8 diesel engine, the total area of the hardened surface of the regular ring shape was 0.07 square millimeters, and the depth was about 0.003 millimeters with a process time of 45 minutes. The parameters of the experimental electrohydraulic injectors met the requirements of the test plan, and they are currently successfully undergoing operational tests. (Conclusions) The use of a valve seat vibration rivet will increase the life of repaired injectors at a low cost for its implementation.</jats:p

PTRM: Perceived Terrain Realism Metric

Terrains are visually prominent and commonly needed objects in many computer graphics applications. While there are many algorithms for synthetic terrain generation, it is rather difficult to assess the realism of a generated output. This article presents a first step toward the direction of perceptual evaluation for terrain models. We gathered and categorized several classes of real terrains, and we generated synthetic terrain models using computer graphics methods. The terrain geometries were rendered by using the same texturing, lighting, and camera position. Two studies on these image sets were conducted, ranking the terrains perceptually, and showing that the synthetic terrains are perceived as lacking realism compared to the real ones. We provide insight into the features that affect the perceived realism by a quantitative evaluation based on localized geomorphology-based landform features (geomorphons) that categorize terrain structures such as valleys, ridges, hollows, and so forth. We show that the presence or absence of certain features has a significant perceptual effect. The importance and presence of the terrain features were confirmed by using a generative deep neural network that transferred the features between the geometric models of the real terrains and the synthetic ones. The feature transfer was followed by another perceptual experiment that further showed their importance and effect on perceived realism. We then introduce Perceived Terrain Realism Metrics (PTRM), which estimates human-perceived realism of a terrain represented as a digital elevation map by relating the distribution of terrain features with their perceived realism. This metric can be used on a synthetic terrain, and it will output an estimated level of perceived realism. We validated the proposed metrics on real and synthetic data and compared them to the perceptual studies. </jats:p

PTRM: Perceived Terrain Realism Metric

International audienceTerrains are visually prominent and commonly needed objects in many computer graphics applications. While there are many algorithms for synthetic terrain generation, it is rather difficult to assess the realism of a generated output. This paper presents a first step towards the direction of perceptual evaluation for terrain models. We gathered and categorized several classes of real terrains, and we generated synthetic terrain models using computer graphics methods. The terrain geometries were rendered by using the same texturing, lighting, and camera position. Two studies on these image sets were conducted, ranking the terrains perceptually, and showing that the synthetic terrains are perceived as lacking realism compared to the real ones. We provide insight into the features that affect the perceived realism by a quantitative evaluation based on localized geomorphology-based landform features (geomorphons) that categorize terrain structures such as valleys, ridges, hollows, etc. We show that the presence or absence of certain features has a significant perceptual effect. The importance and presence of the terrain features were confirmed by using a generative deep neural network that transferred the features between the geometric models of the real terrains and the synthetic ones. The feature transfer was followed by another perceptual experiment that further showed their importance and effect on perceived realism. We then introduce Perceived Terrain Realism Metrics (PTRM) that estimates human perceived realism of a terrain represented as a digital elevation map by relating distribution of terrain features with their perceived realism. This metric can be used on a synthetic terrain, and it will output an estimated level of perceived realism. We validated the proposed metrics on real and synthetic data and compared them to the perceptual studies