A model based on clinical parameters to identify myocardial late gadolinium enhancement by magnetic resonance in patients with aortic stenosis: An observational study

Objective With increasing age, the prevalence of aortic stenosis grows exponentially, increasing left heart pressures and potentially leading to myocardial hypertrophy, myocardial fibrosis and adverse outcomes. To identify patients who are at greatest risk, an outpatient model for risk stratification would be of value to better direct patient imaging, frequency of monitoring and expeditious management of aortic stenosis with possible earlier surgical intervention. In this study, a relatively simple model is proposed to identify myocardial fibrosis in patients with a diagnosis of moderate or severe aortic stenosis. Design Patients with moderate to severe aortic stenosis were enrolled into the study; patient characteristics, blood work, medications as well as transthoracic echocardiography and cardiovascular magnetic resonance were used to determine potential identifiers of myocardial fibrosis. Setting The Royal Brompton Hospital, London, UK Participants One hundred and thirteen patients in derivation cohort and 26 patients in validation cohort. Main outcome measures Identification of myocardial fibrosis. Results Three blood biomarkers (serum platelets, serum urea, N-terminal pro-B-type natriuretic peptide) and left ventricular ejection fraction were shown to be capable of identifying myocardial fibrosis. The model was validated in a separate cohort of 26 patients. Conclusions Although further external validation of the model is necessary prior to its use in clinical practice, the proposed clinical model may direct patient care with respect to earlier magnetic resonance imagining, frequency of monitoring and may help in risk stratification for surgical intervention for myocardial fibrosis in patients with aortic stenosis

High-sensitivity troponin I concentrations are a marker of an advanced hypertrophic response and adverse outcomes in patients with aortic stenosis

Aims: High-sensitivity cardiac troponin I (cTnI) assays hold promise in detecting the transition from hypertrophy to heart failure in aortic stenosis. We sought to investigate the mechanism for troponin release in patients with aortic stenosis and whether plasma cTnI concentrations are associated with long-term outcome. Methods and results: Plasma cTnI concentrations were measured in two patient cohorts using a high-sensitivity assay. First, in the Mechanism Cohort, 122 patients with aortic stenosis (median age 71, 67% male, aortic valve area 1.0 ± 0.4 cm2) underwent cardiovascular magnetic resonance and echocardiography to assess left ventricular (LV) myocardial mass, function, and fibrosis. The indexed LV mass and measures of replacement fibrosis (late gadolinium enhancement) were associated with cTnI concentrations independent of age, sex, coronary artery disease, aortic stenosis severity, and diastolic function. In the separate Outcome Cohort, 131 patients originally recruited into the Scottish Aortic Stenosis and Lipid Lowering Trial, Impact of REgression (SALTIRE) study, had long-term follow-up for the occurrence of aortic valve replacement (AVR) and cardiovascular deaths. Over a median follow-up of 10.6 years (1178 patient-years), 24 patients died from a cardiovascular cause and 60 patients had an AVR. Plasma cTnI concentrations were associated with AVR or cardiovascular death HR 1.77 (95% CI, 1.22 to 2.55) independent of age, sex, systolic ejection fraction, and aortic stenosis severity. Conclusions: In patients with aortic stenosis, plasma cTnI concentration is associated with advanced hypertrophy and replacement myocardial fibrosis as well as AVR or cardiovascular death

Academic achievement : the role of praise in motivating students

The motivation of students is an important issue in higher education, particularly in the context of the increasing diversity of student populations. A social-cognitive perspective assumes motivation to be dynamic, context-sensitive and changeable, thereby rendering it to be a much more differentiated construct than previously understood. This complexity may be perplexing to tutors who are keen to develop applications to improve academic achievement. One application that is within the control of the tutor, at least to some extent, is the use of praise. Using psychological literature the article argues that in motivating students, the tutor is not well served by relying on simplistic and common sense understandings of the construct of praise and that effective applications of praise are mediated by students' goal orientations, which of themselves may be either additive or interactive composites of different objectives and different contexts

Motivation in physical education across the primary-secondary school transition

The purpose of this study was to examine the temporal patterns of approach-avoidance achievement goals, implicit theories of ability and perceived competence in physical education across the transition from primary to secondary school. We also evaluated the predictive utility of implicit theories and perceived competence with regard to achievement goal adoption, and determined the moderating influence of gender on temporal patterns and antecedent–goal relationships. One hundred and forty pupils (mean age at start of study = 11.37 years, SD =.28) completed measures of entity and incremental beliefs, perceived competence and goals on four occasions during a 12-month period. Mastery-approach, performance-approach and perform-ance-avoidance goals, as well as entity and incremental beliefs, exhibited a linear decline over time. Mastery-avoidance goals showed no significant change. Girls exhibited a linear decline in perceived competence, whereas for boys the trajectory was curvilinear. Competence perceptions predicted initial scores, but not rate of change, on mastery-approach and both types of performance goals. Incrementa

'I would rather die': reasons given by 16-year-olds for not continuing their study of mathematics

Improving participation rates in specialist mathematics after the subject ceases to be compulsory at age 16 is part of government policy in England. This article provides independent and recent support for earlier findings concerning reasons for non- participation, based on free response and closed items in a questionnaire with a sample of over 1500 students in 17 schools, close to the moment of choice. The analysis supports findings that perceived difficulty and lack of confidence are important reasons for students not continuing with mathematics, and that perceived dislike and boredom, and lack of relevance, are also factors. There is a close relationship between reasons for non-participation and predicted grade, and a weaker relation to gender. An analysis of the effects of schools, demonstrates that enjoyment is the main factor differentiating schools with high and low participation indices. Building on discussion of these findings, ways of improving participation are briefly suggested

Perserverance measures and attainment in first year computing science students.

We investigate the link between concepts of perseverance such as conscientiousness and grit, and the academic attainment of first year computing students. We review the role that perseverance plays in learning models, as well as describing the trait of conscientiousness in the Five Factor Model of personality. We outline research that links this trait with academic success, before focussing on more recent, narrower conceptualisations of perseverance such as academic tenacity and grit. We describe one of the questionnaire tools that have been used to assess the construct of grit. We give details of an investigation that looked for correlations between student responses to Duckworth's Grit Survey, the Big Five Inventory (BFI) Personality Survey and summative attainment scores in a first year programming course. The results suggest a weak but significant correlation between conscientiousness, grit and programming achievement. We discuss these results as well as the limitations of the method used. Finally, we make some observations about the importance of these concepts in Computer Science education and outline further work in this area

Multimodality imaging:Bird's eye view from the European Society of Cardiology Congress 2019 Paris, August 31st-September 4th, 2019

At the European Society of Cardiology (ESC) congress of this year 2019, held in Paris from August 31st to September 4th, 4509 abstracts were presented. Of those, 414 (9%) belonged to an imaging category. Experts in echocardiography (VD), nuclear imaging (AS), cardiac computed tomography (CT) (MD) and cardiovascular magnetic resonance (CMR) (CBD), have selected the abstracts in their areas of expertise that were of most interest to them and are summarized in this bird's eye view from this ESC meeting. These abstracts were integrated by one of the Editors of the Journal (JB).Cardiolog

Qualitative and quantitative characterization of a coal power plant waste by TG/DSC/MS, XRF and XRD

SO2 removal from coal-fired power plant flue gases can be done by dry, semi-dry or wet desulphurization processes, using limestone or lime-containing products as sorbents. In a Brazilian coal power plant, there is a dry desulphurization unit to capture SO2 with hydrated lime from the combustion gases. A part of the flying ashes produced is mixed with the bottom coal ashes and the spent sulphated product generated after SO2 capture. This residual solid blend is then buried in a non-productive area, from which coal was already extracted and is studied in this work. According to the authors’ experience in the development and characterization of adsorbents for low temperature dry desulphurization processes and in thermogravimetric analysis, this paper shows and discusses a method which was developed to characterize qualitatively and quantitatively the chemical and mineral composition of this waste by using thermogravimetry coupled with mass spectrometry, X-ray fluorescence and X-ray diffraction, to preview new potential industrial applications for this waste.We are thankful to the University of Cantabria for the financial support under the Project: 51.VP61.64005, to the Brazilian Research Council, under the project CNPq no. 407005/2013-7, and to the Brazilian Education Council CAPES