10,085 research outputs found
Left ventricular mass and incident hypertension in individuals with initial optimal blood pressure: the strong heart study.
Prevalence and Prognostic Significance of Wall-Motion Abnormalities in Adults without Clinically Recognized Cardiovascilar Disease
Flux of Atmospheric Neutrinos
Atmospheric neutrinos produced by cosmic-ray interactions in the atmosphere
are of interest for several reasons. As a beam for studies of neutrino
oscillations they cover a range of parameter space hitherto unexplored by
accelerator neutrino beams. The atmospheric neutrinos also constitute an
important background and calibration beam for neutrino astronomy and for the
search for proton decay and other rare processes. Here we review the literature
on calculations of atmospheric neutrinos over the full range of energy, but
with particular attention to the aspects important for neutrino oscillations.
Our goal is to assess how well the properties of atmospheric neutrinos are
known at present.Comment: 68 pages, 26 figures. With permission from the Annual Review of
Nuclear & Particle Science. Final version of this material is scheduled to
appear in the Annual Review of Nuclear & Particle Science Vol. 52, to be
published in December 2002 by Annual Reviews (http://annualreviews.org
Prompt atmospheric neutrino fluxes: perturbative QCD models and nuclear effects
We evaluate the prompt atmospheric neutrino flux at high energies using three
different frameworks for calculating the heavy quark production cross section
in QCD: NLO perturbative QCD, factorization including low-
resummation, and the dipole model including parton saturation. We use QCD
parameters, the value for the charm quark mass and the range for the
factorization and renormalization scales that provide the best description of
the total charm cross section measured at fixed target experiments, at RHIC and
at LHC. Using these parameters we calculate differential cross sections for
charm and bottom production and compare with the latest data on forward charm
meson production from LHCb at TeV and at TeV, finding good agreement
with the data. In addition, we investigate the role of nuclear shadowing by
including nuclear parton distribution functions (PDF) for the target air
nucleus using two different nuclear PDF schemes. Depending on the scheme used,
we find the reduction of the flux due to nuclear effects varies from to
at the highest energies. Finally, we compare our results with the
IceCube limit on the prompt neutrino flux, which is already providing valuable
information about some of the QCD models.Comment: 61 pages, 25 figures, 11 table
A critical review of obesity in healthcare systems in brazil and portugal: Pathways, guidelines and strategies
Background: Obesity and its associated diseases in the 21st century has led to new public policies with international commitments. Objective: The objective of this review was to examine public initiatives and policies to tackle obesity in Brazil and Portugal over the past two decades, identifying frameworks, guidelines and strategic actions. Methods: Official documents Brazilian and Portuguese public health policies were analyzed for international guidelines from 1999 to 2019. The documents were organized and analyzed by date. Additionally, they were evaluated for frameworks and actions proposed for individuals, communities, and the population across all levels of healthcare. Conclusion: This study shows that Portugal and Brazil have taken different paths when it comes to the creation and implementation of their strategies to manage obesity. In Brazil, actions aimed at promoting healthy eating have been introduced to children and are implemented by many government agencies. Portugal, on the other hand, has provided greater access to individualized healthcare services and has involved different sectors in addressing these issues. (c) 2021 da Graça da Costa et al
Randomized phase III KEYNOTE-045 trial of pembrolizumab versus paclitaxel, docetaxel, or vinflunine in recurrent advanced urothelial cancer: results of >2 years of follow-up.
BackgroundNovel second-line treatments are needed for patients with advanced urothelial cancer (UC). Interim analysis of the phase III KEYNOTE-045 study showed a superior overall survival (OS) benefit of pembrolizumab, a programmed death 1 inhibitor, versus chemotherapy in patients with advanced UC that progressed on platinum-based chemotherapy. Here we report the long-term safety and efficacy outcomes of KEYNOTE-045.Patients and methodsAdult patients with histologically/cytologically confirmed UC whose disease progressed after first-line, platinum-containing chemotherapy were enrolled. Patients were randomly assigned 1 : 1 to receive pembrolizumab [200 mg every 3 weeks (Q3W)] or investigator's choice of paclitaxel (175 mg/m2 Q3W), docetaxel (75 mg/m2 Q3W), or vinflunine (320 mg/m2 Q3W). Primary end points were OS and progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1) by blinded independent central radiology review (BICR). A key secondary end point was objective response rate per RECIST v1.1 by BICR.ResultsA total of 542 patients were enrolled (pembrolizumab, n = 270; chemotherapy, n = 272). Median follow-up as of 26 October 2017 was 27.7 months. Median 1- and 2-year OS rates were higher with pembrolizumab (44.2% and 26.9%, respectively) than chemotherapy (29.8% and 14.3%, respectively). PFS rates did not differ between treatment arms; however, 1- and 2-year PFS rates were higher with pembrolizumab. The objective response rate was also higher with pembrolizumab (21.1% versus 11.0%). Median duration of response to pembrolizumab was not reached (range 1.6+ to 30.0+ months) versus chemotherapy (4.4 months; range 1.4+ to 29.9+ months). Pembrolizumab had lower rates of any grade (62.0% versus 90.6%) and grade ≥3 (16.5% versus 50.2%) treatment-related adverse events than chemotherapy.ConclusionsLong-term results (>2 years' follow-up) were consistent with those of previously reported analyses, demonstrating continued clinical benefit of pembrolizumab over chemotherapy for efficacy and safety for treatment of locally advanced/metastatic, platinum-refractory UC.Trial registrationClinicalTrials.gov: NCT02256436
Caractérisation hydrochimique des aquifères fissurés de la région de San- Pedro (Sud-Ouest de la Côte d’Ivoire)
La région de San-Pedro est située dans le Sud-Ouest de la Côte d’Ivoire. Son substratum est constitué de roches cristallines et métamorphiques fracturées. L’objectif de la présente étude est de mieux connaître lespropriétés hydrochimiques et les mécanismes d’acquisition de la minéralisation des eaux souterraines de la région de San-Pedro. La base de données comporte les données des analyses physico-chimiques des eaux souterraines des aquifères fissurés et des fiches techniques des forages. L’approche hydrochimique et l’Analyse en Composantes Principales Normées ont été utilisées pour le traitement de ces données. Les résultats de cette étude montrent que les eaux souterraines de San-Pedro sont caractérisées par une faible minéralisation. Elles se subdivisent en deux principaux hydrofaciès : les eaux bicarbonatées et les eaux chlorurées. D’après le système calco-carbonique, on distingue trois familles d’eau dans la zone d’étude en fonction des indices de saturation vis-à-vis des carbonates : les eaux à circulation très lente, les eaux à circulation lente et les eaux à circulation rapide. L’ACPN a permis de mettre en évidence trois phénomènes principaux gouvernant la minéralisation des eaux souterraines : le temps de séjour de l’eau dans la roche aquifère, les apports superficiels et l’hydrolyse acide. Les eaux souterraines de la région de San-Pedro sont potables pour la consommation des populations humaines d’une manière générale. Ces résultats concourent à une meilleure connaissance des propriétés hydrochimiques des ressources en eaux souterraines du socle cristallin de Côte d’Ivoire
Weaning from Mechanical Ventilation
For most patients who require mechanical ventilation weaning and extubation is simple. In these patients a variety of strategies can be successful. In addition, sim ple criteria may predict when the patient is ready for extubation. For the small group of patients who require prolonged mechanical ventilation, however, contro versy exists about how best to remove ventilator sup port by weaning, and available data are sparse. Much of the controversy has centered on T-piece weaning ver sus intermittent mandatory ventilation. To date no con trolled study has demonstrated the superiority of either intermittent mandatory ventilation or T-piece weaning in difficult-to-wean patients. In the evolution of this con troversy, concern has developed over the potential for increased inspiratory work and expiratory resistance that may be associated with certain intermittent manda tory ventilation systems. The possibility that significant inspiratory work may occur during assist-control venti lation has also been demonstrated. Respiratory muscle weakness and fatigue is likely important in failure to wean. Other possible causes are failure of the cardiovas cular system and impaired ability of the lung to carry out gas exchange. In this article we first examine criteria and techniques for weaning short-term ventilator pa tients. We then examine criteria to begin the weaning process in prolonged ventilation patients, potential causes of failure to wean, and techniques that can be used to remove ventilator support from patients who are difficult to wean. Much literature has been devoted to techniques and criteria for weaning and extubation of patients from mechanical ventilation. For most patients who require ventilatory support, weaning and extuba tion can be easily accomplished by a variety of tech niques [1-4]. At one referral center 77.2% of all surviving patients were weaned from the ventilator within 72 hours of the onset of mechanical ventila tion, and 91% were weaned within 7 days [1]. Less than 10% of ventilated patients potentially posed problems in weaning from mechanical ventilation. Similarly, at a community hospital, few surviving patients required prolonged ventilatory support [2]. In easy-to-wean patients, Sahn and Lakshminarayan [5] described simple criteria that are predictive of successful discontinuation of ventilator support. For the small group of patients who require pro longed mechanical ventilation, however, minimal data are available. In these patients criteria to deter mine weaning ability or which measurements to follow are not clearly defined. Furthermore, no controlled trials are available to compare the differ ent weaning techniques proposed. In this article we first address routine weaning of the patient who has not required prolonged ventilator support. We then examine the difficult-to-wean patient and dis cuss criteria to begin the weaning process, poten tial causes of failure to wean, and available weaning techniques.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68923/2/10.1177_088506668800300207.pd
Observation of interstellar lithium in the low-metallicity Small Magellanic Cloud
The primordial abundances of light elements produced in the standard theory
of Big Bang nucleosynthesis (BBN) depend only on the cosmic ratio of baryons to
photons, a quantity inferred from observations of the microwave background. The
predicted primordial 7Li abundance is four times that measured in the
atmospheres of Galactic halo stars. This discrepancy could be caused by
modification of surface lithium abundances during the stars' lifetimes or by
physics beyond the Standard Model that affects early nucleosynthesis. The
lithium abundance of low-metallicity gas provides an alternative constraint on
the primordial abundance and cosmic evolution of lithium that is not
susceptible to the in situ modifications that may affect stellar atmospheres.
Here we report observations of interstellar 7Li in the low-metallicity gas of
the Small Magellanic Cloud, a nearby galaxy with a quarter the Sun's
metallicity. The present-day 7Li abundance of the Small Magellanic Cloud is
nearly equal to the BBN predictions, severely constraining the amount of
possible subsequent enrichment of the gas by stellar and cosmic-ray
nucleosynthesis. Our measurements can be reconciled with standard BBN with an
extremely fine-tuned depletion of stellar Li with metallicity. They are also
consistent with non-standard BBN.Comment: Published in Nature. Includes main text and Supplementary
Information. Replaced with final title and abstrac
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Imparting gas selective and pressure dependent porosity into a non-porous solid: Via coordination flexibility
Using a simple hard-soft acid-base concept we have deliberately designed gas-specific and pressure dependent porosity into a non-porous solid via coordination flexibility. This creates distinct gate-openings wherein the CO2 molecule opens-up the framework pores by rotating the ligand about the weaker hard-soft bonds (hard-soft gate control). For this, we have studied the CO2 gating behaviour of M(4-PyC)2 (M = Mg, Mn and Cu), which represent metals of varying hardness. A combination of quantum chemical calculations, molecular dynamics and Grand canonical Monte Carlo simulations were performed to examine the gate opening of the isonicotinate ligands in Mg(4-PyC)2. The simulations show that interaction of the CO2 molecules with the isonicotinate ligands at different CO2 loadings can result in pressure-dependent gate opening. Furthermore, the simulated CO2 uptake values calculated using the partially gate-opened structures at different loadings showed good agreement with the experimental uptake values. This provides an effective strategy for designing highly-stable dynamic porous solids employing rigid frameworks
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