Prior events predict cerebrovascular and coronary outcomes in the PROGRESS trial

<p><b>Background and Purpose:</b> The relationship between baseline and recurrent vascular events may be important in the targeting of secondary prevention strategies. We examined the relationship between initial event and various types of further vascular outcomes and associated effects of blood pressure (BP)–lowering.</p> <p><b>Methods:</b> Subsidiary analyses of the Perindopril Protection Against Recurrent Stroke Study (PROGRESS) trial, a randomized, placebo-controlled trial that established the benefits of BP–lowering in 6105 patients (mean age 64 years, 30% female) with cerebrovascular disease, randomly assigned to either active treatment (perindopril for all, plus indapamide in those with neither an indication for, nor a contraindication to, a diuretic) or placebo(s).</p> <p><b>Results:</b> Stroke subtypes and coronary events were associated with 1.5- to 6.6-fold greater risk of recurrence of the same event (hazard ratios, 1.51 to 6.64; P=0.1 for large artery infarction, P<0.0001 for other events). However, 46% to 92% of further vascular outcomes were not of the same type. Active treatment produced comparable reductions in the risk of vascular outcomes among patients with a broad range of vascular events at entry (relative risk reduction, 25%; P<0.0001 for ischemic stroke; 42%, P=0.0006 for hemorrhagic stroke; 17%, P=0.3 for coronary events; P homogeneity=0.4).</p> <p><b>Conclusions:</b> Patients with previous vascular events are at high risk of recurrences of the same event. However, because they are also at risk of other vascular outcomes, a broad range of secondary prevention strategies is necessary for their treatment. BP–lowering is likely to be one of the most effective and generalizable strategies across a variety of major vascular events including stroke and myocardial infarction.</p&gt

Ultrafast carrier relaxation in GaN, In_(0.05)Ga_(0.95)N and an In_(0.05)Ga_(0.95)/In_(0.15)Ga_(0.85)N Multiple Quantum Well

Room temperature, wavelength non-degenerate ultrafast pump/probe measurements were performed on GaN and InGaN epilayers and an InGaN multiple quantum well structure. Carrier relaxation dynamics were investigated as a function of excitation wavelength and intensity. Spectrally-resolved sub-picosecond relaxation due to carrier redistribution and QW capture was found to depend sensitively on the wavelength of pump excitation. Moreover, for pump intensities above a threshold of 100 microJ/cm2, all samples demonstrated an additional emission feature arising from stimulated emission (SE). SE is evidenced as accelerated relaxation (< 10 ps) in the pump-probe data, fundamentally altering the re-distribution of carriers. Once SE and carrier redistribution is completed, a slower relaxation of up to 1 ns for GaN and InGaN epilayers, and 660 ps for the MQW sample, indicates carrier recombination through spontaneous emission.Comment: submitted to Phys. Rev.

Rothamsted carbon model reveals technical options to maintain soil organic carbon under semi-arid climate

Soil organic matter in the Sahel is severely reduced by continuous cultivation. Reductions of soil organic matter decrease in turn soil productivity. Nonetheless, reports show that organic matter application in the Sahel improves crop yield. However, long-term effects of organic matter application on soil fertility have not been fully studied. In particular, it is essential to get information on organic matter decomposition and annual carbon requirement. Model simulation is suitable for evaluating long-term sustainability. The Rothamsted carbon model is convenient and has been recently validated for use in Sahelian conditions. Here, we studied the annual carbon requirement for sustainable soil organic carbon management in the Sahelian zone using datasets of short-term trials conducted in the Sahel. We estimated the long-term effect of various agricultural managements on soil organic carbon dynamics as one of the soil fertility indices. The 10-year soil organic carbon value changes were predicted by the Rothamsted carbon model for 59 treatments. Results show that, contrary to previous short-term experiments that indicated crop yield enhancement, these technical options also cause a decline in soil organic carbon if enough organic resource is not applied. Soil productivity should therefore decrease. The annual carbon requirement to maintain the soil organic carbon level is approximately 0.8 tons of carbon per hectar

Validation of soil organic carbon dynamics model in the semi-arid tropics in Niger, West Africa

The fertility of sandy soils in the Sahelian zone (SZ) is extremely low. This poor soil fertility is one of the limiting factors of crop production in the SZ. Therefore, it is imperative to improve or to maintain soil fertility through various agricultural management methods. Further, it is well known that soil organic matter plays an important role in improving the physicochemical properties of these sandy infertile soils. Therefore, it is essential to develop a suitable tool for the appropriate evaluation of soil organic carbon (SOC) dynamics in the SZ. Therefore, the Rothamsted carbon model (Roth-C) was verified in 32 treatments of two long-term field experiments with and without crop residue application. These experiments were performed by ICRISAT. The performance of the model was evaluated by statistical methods using four indices (RMSE: root mean square error, LOFIT: lack of fit, r: correlation coefficient, and M: mean difference). As a result, the predicted SOC values in the casewithout crop residue management decreased with time in approximately 10 cultivated years. In contrast, in the case with crop residue application, the predicted SOC remained roughly equal to the initial SOC value during the term observed. Mostly, the Roth-C-modelled values agreed well with the actual value. RMSE and LOFIT, the statistical indicators of agreement between predicted and observed values, showed a significant conformity between the predicted and observed SOC values in all the 32 treatments. This fact means that Roth-C can estimate long-term SOC dynamics of several technical options that developed with short-term trials. Moreover the annual carbon requirement for SOC maintaining can be calculate if enough number of cases was estimated. And also analysis of regional carbon dynamics was made possible with using Roth-C model. It will contribute to show the sustainable development in SZ against global warming and other climatic changes

Predicting procedure duration of colorectal endoscopic submucosal dissection at Western endoscopy centers

Background and study aims Overcoming logistical obstacles for the implementation of colorectal endoscopic submucosal dissection (ESD) requires accurate prediction of procedure times. We aimed to evaluate existing and new prediction models for ESD duration.Patients and methods Records of all consecutive patients who underwent single, non-hybrid colorectal ESDs before 2020 at three Dutch centers were reviewed. The performance of an Eastern prediction model [GIE 2021;94(1):133–144] was assessed in the Dutch cohort. A prediction model for procedure duration was built using multivariable linear regression. The model’s performance was validated using internal validation by bootstrap resampling, internal-external cross-validation and external validation in an independent Swedish ESD cohort.Results A total of 435 colorectal ESDs were analyzed (92% en bloc resections, mean duration 139 minutes, mean tumor size 39 mm). The performance of current unstandardized time scheduling practice was suboptimal (explained variance: R2=27%). We successfully validated the Eastern prediction model for colorectal ESD duration &lt;60 minutes (c-statistic 0.70, 95% CI 0.62–0.77), but this model was limited due to dichotomization of the outcome and a relatively low frequency (14%) of ESDs completed &lt;60 minutes in the Dutch centers. The model was more useful with a dichotomization cut-off of 120 minutes (c-statistic: 0.75; 88% and 17% of “easy” and “very difficult” ESDs completed &lt;120 minutes, respectively). To predict ESD duration as continuous outcome, we developed and validated the six-variable cESD-TIME formula (https://cesdtimeformula.shinyapps.io/calculator/; optimism-corrected R2=61%; R2=66% after recalibration of the slope).Conclusions We provided two useful tools for predicting colorectal ESD duration at Western centers. Further improvements and validations are encouraged with potential local adaptation to optimize time planning