“SOLET”, a self-organised learning environment for teachers about critical digital literacies : proposal and validation

Although digital technologies have generated innumerable opportunities to develop skills for future social, cultural and economic scenarios, their use is nowadays generating several concerns. Decades of research on the adoption of educational technologies have led to understanding that “techno-enthusiasm” might only lead to dead ends in the best of scenarios. In the worst of cases, and particularly in the COVID19 aftermath, several issues associated with the lack of ergonomics at home and technology overexposure, dependence, and burnout have been discussed in the light of critically reconsidering technology-enhanced pedagogies. Such a situation requires not only careful educational research and policymaking, but particularly, a change in the direction of teachers’ professional development. In this context, the EU Erasmus+ Project DETECT (https://www.detectproject.eu/) is a transnational effort aimed to raise awareness amongst educators and support them in understanding the critical digital literacies scenarios and requirements. The project started in 2019 and has already developed a framework including eight areas of critical digital literacy and has been validated. This paper aims at enhancing such a framework by offering the teachers activities and resources to develop their professional skills to implement critical digital literacies at school. Such a professional learning offer is denominated “SOLET” (Self-Organised Learning Environment for Teachers) and its aim is to promote problem-based activities addressing the integration of conceptual reflection with design-thinking. The ultimate goal is to prepare teachers to design for learning around several scenarios and cases requiring critical technology appraisal and usage. The course is based on heutagogy, offering resources and cases to interact with. Moreover, taking into account the concept of “comparators” developed by Nicol the learning architecture embraces automatic, self and peer-assessment as specific activities providing sources of comparison for the participants’ reflection on their own learning. Through this approach, it is expected to ease teachers' access to professional learning opportunities, with implications for the transference of complex concepts like the eight areas of the framework to practice. Ultimately, it is expected to support teachers with enhancing their own students’ opportunities to develop critical digital literacies. The SOLET environment is under development and two rounds of user testing have been already undertaken. The first has included 8 researchers from four universities and one training institution, collecting 161 reviews. The interrater agreement was calculated over the basis of double-blind evaluation of a sample of interactions, yielding a reasonable agreement (83.33%) on the type of technological and interaction issues requiring improvement. The second user test was carried out by five teachers in two collaborative sessions; 18 reviews were collected, yielding more concerns (75% of agreement) but convergence in the adjustments was apparent. These results are discussed in the light of the research relating to teachers’ self-paced professional learning. Finally, the presentation in the conference context might encompass a unique opportunity to collect feedback.Peer reviewe

Platelet inhibition with ticagrelor 60 mg versus 90 mg twice daily in the PEGASUS-TIMI 54 trial

Background The PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin–Thrombolysis In Myocardial Infarction 54) trial studied 2 doses of ticagrelor, 90 mg twice a day (bid) and 60 mg bid, for long-term prevention of ischemic events in patients with prior myocardial infarction. Both doses similarly reduced the rate of ischemic events versus placebo. The pharmacokinetics and pharmacodynamics of ticagrelor 60 mg bid have not been studied. Objectives In this study, the authors sought to study the pharmacokinetics and pharmacodynamics for ticagrelor 60 mg compared with 90 mg bid. Methods A total of 180 patients who received >4 weeks of study medication had blood sampling in the morning pre-maintenance dose and again 2 h post-dose. All patients received aspirin. Plasma levels of ticagrelor and its active metabolite AR-C124910XX were determined. P2Y12 inhibition was assessed by the VerifyNow P2Y12 assay (Accumetrics, Inc., San Diego, California) (P2Y12 reaction units [PRU]), light transmittance aggregometry (adenosine diphosphate 5 and 20 μmol/l and arachidonic acid), and vasodilator-stimulated phosphoprotein phosphorylation assays. VerifyNow Aspirin assays and serum thromboxane B2 measurements were performed. Results Mean pre- and post-dose plasma levels of ticagrelor were 35% and 38% lower, respectively, with 60 mg versus 90 mg. Both doses achieved high levels of platelet inhibition pre- and post-dose, with numerically slightly more variability with 60 mg: mean (SD) pre-dose PRU values were 59 ± 63 and 47 ± 43 for ticagrelor 60 and 90 mg, respectively (p = 0.34). High platelet reactivity, determined as PRU >208, was rare with the 60-mg pre-dose and was absent post-dose. Platelet reactivity pre- and post-dose, as measured by light transmittance aggregometry or vasodilator-stimulated phosphoprotein assays, was numerically but not significantly lower with 90 mg than with 60 mg. Aspirin response was not affected by either dose. Conclusions Ticagrelor 60 mg bid achieved high levels of peak and trough platelet inhibition in nearly all patients, similar to that with 90 mg bid, helping to explain the efficacy of the lower ticagrelor dose in PEGASUS-TIMI 54

Editor's Choice-2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)

Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS) Authors/Task Force Members (a), Victor Aboyans (*), Jean- Baptiste Ricco (*), Marie- Louise E. L. Bartelink, Martin Bjorck, Marianne Brodmann, Tina Cohnert, Jean-Philippe Collet, Martin Czerny, Marco De Carlo, Sebastian Debus, Christine Espinola-Klein, Thomas Kahan, Serge Kownator, Lucia Mazzolai, A. Ross Naylor, Marco Roffi, Joachim Rother, Muriel Sprynger, Michal Tendera, Gunnar Tepe, Maarit Venermo, Charalambos Vlachopoulos, Ileana Desormais Document Reviewers (b), Petr Widimsky, Philippe Kolh, Stefan Agewall, Hector Bueno, Antonio Coca, Gert J. De Borst, Victoria Delgado, Florian Dick, Cetin Erol, Marc Ferrini, Stavros Kakkos, Hugo A. Katus, Juhani Knuuti, Jes Lindholt, Heinrich Mattle, Piotr Pieniazek, Massimo Francesco Piepoli, Dierk Scheinert, Horst Sievert, Iain Simpson, Jakub Sulzenko, Juan Tamargo, Lale Tokgozoglu, Adam Torbicki, Nikolaos Tsakountakis, Jose Tunon, Melina Vega de Ceniga, Stephan Windecker, Jose Luis ZamoranoPeer reviewe

2019 ESC/EAS guidelines for the management of dyslipidaemias : Lipid modification to reduce cardiovascular risk

Correction: Volume: 292 Pages: 160-162 DOI: 10.1016/j.atherosclerosis.2019.11.020 Published: JAN 2020Peer reviewe

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC

2016 ESC on Acute and Chronic H

A novel machine learning-derived radiotranscriptomic signature of perivascular fat improves cardiac risk prediction using coronary CT angiography

Background: Coronary inflammation induces dynamic changes in the balance between water and lipid content in perivascular adipose tissue (PVAT), as captured by perivascular Fat Attenuation Index (FAI) in standard coronary CT angiography (CCTA). However, inflammation is not the only process involved in atherogenesis and we hypothesized that additional radiomic signatures of adverse fibrotic and microvascular PVAT remodelling, may further improve cardiac risk prediction. Methods and results: We present a new artificial intelligence-powered method to predict cardiac risk by analysing the radiomic profile of coronary PVAT, developed and validated in patient cohorts acquired in three different studies. In Study 1, adipose tissue biopsies were obtained from 167 patients undergoing cardiac surgery, and the expression of genes representing inflammation, fibrosis and vascularity was linked with the radiomic features extracted from tissue CT images. Adipose tissue wavelet-transformed mean attenuation (captured by FAI) was the most sensitive radiomic feature in describing tissue inflammation (TNFA expression), while features of radiomic texture were related to adipose tissue fibrosis (COL1A1 expression) and vascularity (CD31 expression). In Study 2, we analysed 1391 coronary PVAT radiomic features in 101 patients who experienced major adverse cardiac events (MACE) within 5 years of having a CCTA and 101 matched controls, training and validating a machine learning (random forest) algorithm (fat radiomic profile, FRP) to discriminate cases from controls (C-statistic 0.77 [95%CI: 0.62–0.93] in the external validation set). The coronary FRP signature was then tested in 1575 consecutive eligible participants in the SCOT-HEART trial, where it significantly improved MACE prediction beyond traditional risk stratification that included risk factors, coronary calcium score, coronary stenosis, and high-risk plaque features on CCTA (Δ[C-statistic] = 0.126, P  Conclusion: The CCTA-based radiomic profiling of coronary artery PVAT detects perivascular structural remodelling associated with coronary artery disease, beyond inflammation. A new artificial intelligence (AI)-powered imaging biomarker (FRP) leads to a striking improvement of cardiac risk prediction over and above the current state-of-the-art. </p

Recanalization of acute left internal mammary artery graft failure by percutaneous coronary intervention

Acute occlusion of the left internal mammary artery (LIMA) immediately following coronary artery bypass surgery (CABG) is a rare complication that is usually treated by repeat emergency surgery. We described the case of a 65-year-old man known for dyslipidemia and family history of coronary artery disease who was admitted for non-ST elevation myocardial infarction as a result of a severe stenosis of the left anterior descending (LAD) coronary artery. After the discussion within the Heart Team, the patient underwent CABG with LIMA to LAD. As intraoperative blood flow control by transit time flowmeter showed intermittent flow despite optimal anastomosis, immediate coronary angiogram was performed following CABG and an occlusion of the LIMA graft was documented. By contrast injection though a microcatheter advanced into the occluded LIMA it could be demonstrated that the anastomosis was patent and that flow was obstructed by a focal lesion, most likely due to a bend/torsion of the LIMA or a focal vessel wall hematoma. Following multidisciplinary discussion within the Heart Team, a percutaneous coronary intervention (PCI) with a drug eluting stent of LIMA was performed with a good angiographic result and normalization of the flow. The clinical course of the patient was uneventful. This case suggests that, in selected cases, emergent PCI may be an alternative to repeat-CABG in patients with acute perioperative LIMA occlusion