The Relevance of Implementing the Systematic Screening of Perioperative Myocardial Injury in Noncardiac Surgery Patients

Noncardiac surgery; Perioperative myocardial injury; ScreeningCirugía no cardíaca; Lesión miocárdica perioperatoria; CribadoCirurgia no cardíaca; Lesió miocàrdica perioperatòria; CribratgePerioperative myocardial injury (PMI) is a common cardiac complication. Recent guidelines recommend its systematic screening using high-sensitivity cardiac troponin (hs-cTn). However, there is limited evidence of local screening programs. We conducted a prospective, single-center study aimed at assessing the feasibility and outcomes of implementing systematic PMI screening. Hs-cTn concentrations were measured before and after surgery. PMI was defined as a postoperative hs-cTnT of ≥14 ng/L, exceeding the preoperative value by 50%. All patients were followed-up during the hospitalization, at one month and one year after surgery. The primary outcome was the incidence of death and major cardiovascular and cerebrovascular events (MACCE). The secondary outcomes focused on the individual components of MACCE. We included two-thirds of all eligible high-risk patients and achieved almost complete compliance with follow-ups. The prevalence of PMI was 15.7%, suggesting a higher presence of cardiovascular (CV) antecedents, increased perioperative CV complications, and higher preoperative hs-cTnT values. The all-cause death rate was 1.7% in the first month, increasing up to 11.2% at one year. The incidence of MACCE was 9.5% and 8.6% at the same time points. Given the observed elevated frequencies of PMI and MACCE, implementing systematic PMI screening is recommendable, particularly in patients with increased cardiovascular risk. However, it is important to acknowledge that achieving optimal screening implementation comes with various challenges and complexities.This study was supported by a research grant from Fundació La Marató de TV3 (20150110)

Search for a Light Charged Higgs Boson Decaying to a W Boson and a CP-Odd Higgs Boson in Final States with eμμ or μμμ in Proton-Proton Collisions at √s=13 TeV

A search for a light charged Higgs boson (H+) decaying to a W boson and a CP-odd Higgs boson (A) in final states with eμμ or μμμ is performed using data from pp collisions at √s=13  TeV, recorded by the CMS detector at the LHC and corresponding to an integrated luminosity of 35.9  fb−1. In this search, it is assumed that the H+ boson is produced in decays of top quarks, and the A boson decays to two oppositely charged muons. The presence of signals for H+ boson masses between 100 and 160 GeV and A boson masses between 15 and 75 GeV is investigated. No evidence for the production of the H+ boson is found. Upper limits at 95% confidence level are obtained on the combined branching fraction for the decay chain, t→bH+→bW+A→bW+μ+μ−, of 1.9×10−6 to 8.6×10−6, depending on the masses of the H+ and A bosons. These are the first limits for these decay modes of the H+ and A bosons.Peer reviewe

Growth differentiation factor 15 as mortality predictor in heart failure patients with non-reduced ejection fraction

Altres ajuts: This study was supported by Fundació d'Investigació Sant Pau (G-60136934).The prognostic value of biomarkers in patients with heart failure (HF) and mid-range (HFmrEF) or preserved ejection fraction (HFpEF) has not been widely addressed. The aim of this study was to assess whether the prognostic value of growth differentiation factor 15 (GDF-15) is superior to that of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with HFmrEF or HFpEF. Heart failure patients with either HFpEF or HFmrEF were included in the study. During their first visit to the HF unit, serum samples were obtained and stored for later assessment of GDF-15 and NT-proBNP concentrations. Patients were followed up by the HF unit. The main endpoint was all-cause mortality. A total of 311 patients, 90 (29%) HFmrEF and 221 (71%) HFpEF, were included. Mean age was 72 ± 13 years, and 136 (44%) were women. No differences were found in GDF-15 or NT-proBNP concentrations between both HF groups. During a median follow-up of 15 months (Q1-Q3: 9-30 months), 98 patients (32%) died, most (71%) of cardiovascular causes. Patients who died had higher median concentrations of GDF-15 (4085 vs. 2270 ng/L, P 65 years (P 4330 ng/L), and survival curves were evaluated using the Kaplan-Meier technique. Patients in the highest tertile had the poorest 5 year survival, at 16%, whereas the lowest tertile had the best survival, of 78% (P < 0.001). Growth differentiation factor 15 was superior to NT-proBNP for assessing prognosis in patients with HFpEF and HFmrEF. GDF-15 emerges as a strong, independent biomarker for identifying HFmrEF and HFpEF patients with worse prognosis

Search for MSSM Higgs bosons decaying to μ+μ−\mu^+\mu^- in proton-proton collisions at s=\sqrt{s}= 13 TeV

A search is performed for neutral non-standard-model Higgs bosons decaying to two muons in the context of the minimal supersymmetric standard model (MSSM). Proton-proton collision data recorded by the CMS experiment at the CERN Large Hadron Collider at a center-of-mass energy of 13 TeV were used, corresponding to an integrated luminosity of 35.9 fb$^{-1}$. The search is sensitive to neutral Higgs bosons produced via the gluon fusion process or in association with a $\mathrm{b\overline{b}}$ quark pair. No significant deviations from the standard model expectation are observed. Upper limits at 95% confidence level are set in the context of the $m_\mathrm{h}^{\text{mod+}}$ and phenomenological MSSM scenarios on the parameter $\tan\beta$ as a function of the mass of the pseudoscalar A boson, in the range from 130 to 600 GeV. The results are also used to set a model-independent limit on the product of the branching fraction for the decay into a muon pair and the cross section for the production of a scalar neutral boson, either via gluon fusion, or in association with b quarks, in the mass range from 130 to 1000 GeV

Combination of CMS searches for heavy resonances decaying to pairs of bosons or leptons

A statistical combination of searches for heavy resonances decaying to pairs of bosons or leptons is presented. The data correspond to an integrated luminosity of 35.9 fb$^{-1}$ collected during 2016 by the CMS experiment at the LHC in proton-proton collisions at a center-of-mass energy of 13 TeV. The data are found to be consistent with expectations from the standard model background. Exclusion limits are set in the context of models of spin-1 heavy vector triplets and of spin-2 bulk gravitons. For mass-degenerate W' and Z' resonances that predominantly couple to the standard model gauge bosons, the mass exclusion at 95% confidence level of heavy vector bosons is extended to 4.5 TeV as compared to 3.8 TeV determined from the best individual channel. This excluded mass increases to 5.0 TeV if the resonances couple predominantly to fermions

Measurement of the average very forward energy as a function of the track multiplicity at central pseudorapidities in proton-proton collisions at s=\sqrt{s}= 13 tev

Este artículo tiene por objetivo abordar el tema de la presencia de las mujeres indígenas en los procesos de reivindicaciones de sus territorios tradicionales. Hace hincapié en que las demandas indígenas y las movilizaciones por sus derechos no son nuevas. A lo largo del siglo XX, han protagonizado sucesivas demandas en defensa de sus tierras y particularmente desde 1980, pusieron en marcha un poderoso proceso de rearticulación social y político, con el fin de obtener el reconocimiento como pueblos étnicamente diferenciados. La entrada de las mujeres indígenas en la arena política, aunque implica importantes avances, es un proceso complejo, pues ha dependido entre otros factores de la dicotomía entre tradición y modernidad y, por otro lado, de las políticas indigenistas. Utilizamos como caso de estudio el proceso en el que viven las mujeres guaraní kaiowá del Estado de Mato Grosso del Sur, Brasil

Elinkeino-, liikenne- ja ympäristökeskuksen sekä KEHA-keskuksen palvelutyytyväistutkimus 2017 : Yhteenvetoraportti

Asiakkaat ovat pääosin tyytyväisiä ELY-keskusten ja KEHA-keskuksen tarjoamaan palveluun ja annettuja arvosanoja voidaan pitää hyvinä. ELY-keskusten ja KEHA-keskuksen asiakkailta saamien ”palvelu kokonaisuudessaan” tyytyväisyysarvosanojen valtakunnallinen keskiarvo on kaikkien palveluiden osalta 4,11 eli tyytyväisyys o noussut jonkin verran vuoden 2016 tuloksista (4,03). Asiakkaat ovat antaneet korkeimmat tyytyväisyysarvosanat ”ystävällisyydestä” sekä ”asiantuntemuksesta” ja ”päätöksen perusteluista”. Muita tekijöitä alhaisemmat arvosanat on annettu ”asian käsittelynopeudelle”. Vuoden 2017 palvelutyytyväisyystutkimuksessa olivat mukana ELY-keskusten rahoitus-, maksatus-, lupa- ja valvontapalvelut. Lisäksi mukana oli toista kertaa KEHA-keskuksen maksatuspalvelut ja yritysten kehittämispalvelut (analyysi-, konsultointi- sekä koulutuspalvelut). Tutkimukseen osallistuivat kaikki ELY-keskukset ja KEHA-keskuksen maksatuspalvelut ja vastauksia tutkimukseen saatiin yhteensä noin 5700 kappaletta. Rahoituspalveluiden osalta kokonaisarvosana (4,21) on noussut jonkin verran ja arvioiden parantumista oli palvelun kaikissa osatekijöissä. Maksatuspalveluiden osalta kokonaisarvosana (4,01) nousi hieman ja kokonaistyytyväisyys vaihtelee palveluittain 4,50-3,76. Lupapalveluiden osalta kokonaisarvosanassa (4,43) oli huomattavaa nousua, tosin vastaajamäärässä on ollut alenemista. Valvontapalveluiden osalta kokonaisarvosana 4,20 on noussut ollen edellisvuonna 4,11. Yritysten kehittämispalveluissa kokonaistyytyväisyys pysyi hyvällä tasolla 4,30. Yli 90 % analyysi-, konsultointi- ja koulutuspalvelua arvioineista vastaajista oli sitä mieltä, että palvelua voi suositella myös muille yrityksille. Koulutuspalveluissa kouluttajien ammattitaito sekä yhteistyö kouluttajien kanssa koettiin hyviksi ja positiivisia kommentteja saivat mm. koulutusten sisältöjen käytännönläheisyys ja yrityskohtaisuus. Lisätietoja raportista saa Jukka Lyytiselta KEHA-keskuksesta. Julkaisu on saavutettava

Search for Low-Mass Quark-Antiquark Resonances Produced in Association with a Photon at s =13 TeV

A search for narrow low-mass resonances decaying to quark-antiquark pairs is presented. The search is based on proton-proton collision events collected at 13 TeV by the CMS detector at the CERN LHC. The data sample corresponds to an integrated luminosity of 35.9 fb-1, recorded in 2016. The search considers the case where the resonance has high transverse momentum due to initial-state radiation of a hard photon. To study this process, the decay products of the resonance are reconstructed as a single large-radius jet with two-pronged substructure. The signal would be identified as a localized excess in the jet invariant mass spectrum. No evidence for such a resonance is observed in the mass range 10 to 125 GeV. Upper limits at the 95% confidence level are set on the coupling strength of resonances decaying to quark pairs. The results obtained with this photon trigger strategy provide the first direct constraints on quark-antiquark resonance masses below 50 GeV obtained at a hadron collider.STFC (United Kingdom); The Marie-Curie programme; The European Research Council; Horizon 2020 Gran