9 research outputs found
A MODEST review
We present an account of the state of the art in the fields explored by the
research community invested in 'Modeling and Observing DEnse STellar systems'.
For this purpose, we take as a basis the activities of the MODEST-17
conference, which was held at Charles University, Prague, in September 2017.
Reviewed topics include recent advances in fundamental stellar dynamics,
numerical methods for the solution of the gravitational N-body problem,
formation and evolution of young and old star clusters and galactic nuclei,
their elusive stellar populations, planetary systems, and exotic compact
objects, with timely attention to black holes of different classes of mass and
their role as sources of gravitational waves.
Such a breadth of topics reflects the growing role played by collisional
stellar dynamics in numerous areas of modern astrophysics. Indeed, in the next
decade, many revolutionary instruments will enable the derivation of positions
and velocities of individual stars in the Milky Way and its satellites and will
detect signals from a range of astrophysical sources in different portions of
the electromagnetic and gravitational spectrum, with an unprecedented
sensitivity. On the one hand, this wealth of data will allow us to address a
number of long-standing open questions in star cluster studies; on the other
hand, many unexpected properties of these systems will come to light,
stimulating further progress of our understanding of their formation and
evolution.Comment: 42 pages; accepted for publication in 'Computational Astrophysics and
Cosmology'. We are much grateful to the organisers of the MODEST-17
conference (Charles University, Prague, September 2017). We acknowledge the
input provided by all MODEST-17 participants, and, more generally, by the
members of the MODEST communit
Use of the adjustable trans-obturator male sling system for the treatment of male incontinence. An initial experience
Objective: To evaluate the safety and efficacy of the “Adjustable Trans-Obturator Male Sling System (ATOMS)” as a new surgical technique for the treatment of different types of male urinary incontinence.
Subjects and methods: Between March 2012 and December 2013, 9 patients with a mean age of 56 (range 15–74) years were operated for urinary incontinence using the ATOMS system. Incontinence had developed following bladder exstrophy repair in 2, after radical cystectomy with construction of an orthotopic neobladder in 3, after transvesical open prostatectomy in one and after radical prostatectomy in 3 patients. Preoperative evaluation included a detailed medical history, physical examination, 24-h pad tests, urodynamic assessment and sonography.
Results: The mean number of pads used preoperatively was 4.6 (range 3–6). The mean operative time was 45 (range 36–50) min. No intraoperative complications were encountered. The mean hospital stay was 3.8 (range 3–6) days. Transient perineal/scrotal pain was observed in 6 patients (66.7%) and controlled with non-opioid analgesics. There were no perineal infections; however, two port infections occurred (22.2%) and repositioning of the port was done in these cases. At a mean follow-up of 9 (range 6–12) months, the overall success rate was 100% with 77.8% of the patients being completely dry (0 pads per 24 h) and 22.2% using less than 2 pads per 24 h.
Conclusions: Our early experience demonstrated that the ATOMS system may be a safe and effective procedure for the treatment of male urinary incontinence. It has the advantage of being feasible any time after an operation when necessary. However, long-term follow-up on a large number of cases is required to ensure its long-term efficacy and safety
Physicians' guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry
Background: Physicians' adherence to guideline-recommended therapy is associated with short-term clinical outcomes in heart failure (HF) with reduced ejection fraction (HFrEF). However, its impact on longer-term outcomes is poorly documented. Here, we present results from the 18-month follow-up of the QUALIFY registry. Methods and results: Data at 18 months were available for 6118 ambulatory HFrEF patients from this international prospective observational survey. Adherence was measured as a continuous variable, ranging from 0 to 1, and was assessed for five classes of recommended HF medications and dosages. Most deaths were cardiovascular (CV) (228/394) and HF-related (191/394) and the same was true for unplanned hospitalizations (1175 CV and 861 HF-related hospitalizations, out of a total of 1541). According to univariable analysis, CV and HF deaths were significantly associated with physician adherence to guidelines. In multivariable analysis, HF death was associated with adherence level [subdistribution hazard ratio (SHR) 0.93, 95% confidence interval (CI) 0.87–0.99 per 0.1 unit adherence level increase; P = 0.034] as was composite of HF hospitalization or CV death (SHR 0.97, 95% CI 0.94–0.99 per 0.1 unit adherence level increase; P = 0.043), whereas unplanned all-cause, CV or HF hospitalizations were not (all-cause: SHR 0.99, 95% CI 0.9–1.02; CV: SHR 0.98, 95% CI 0.96–1.01; and HF: SHR 0.99, 95% CI 0.96–1.02 per 0.1 unit change in adherence score; P = 0.52, P = 0.2, and P = 0.4, respectively). Conclusion: These results suggest that physicians' adherence to guideline-recommended HF therapies is associated with improved outcomes in HFrEF. Practical strategies should be established to improve physicians' adherence to guidelines. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiolog