Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

The using of leisure time of pupils at the secondary stage of the basic education in Příbram and its environs

This thesis provides an overview of spending leisure time by a pupil of a lower secondary school at the level of organized activities. In the theoretical part the important terms, such as leisure time, leisure time education, leisure time teacher, are defined. In this part, a pupil of a lower secondary school and a gifted pupil are characterized, the sense of leisure time activities at the level of organized activities is mentioned and finally the educational facilities for leisure education and leisure facilities used by pupils are listed. The empirical part provides a list of various leisure time institutions which the city of Příbram offers and it also presents an elaborated research survey, which is subsequently evaluated using statistical functions into tables and graphs. Among other things, as a part of my teaching specialization, in addition to other leisure activities, I incorporated in this work a part aimed at natural and technical leisure activities that are helpful in educating gifted pupils as a future generation and who are a real shortage in this area

Structure of physics classes at elementary school - analysis of video recordings of lessons

The aim of my bachelor thesis is a partial view on the current physics education on the second grade of primary school. This work compares and shows the results of different physics lessons in terms of different groups (students, qualified teachers, non-qualified teachers) in parameters monitored below. This work can serve as a preparation of future physics teachers of for example as a pattern for observation on physics lessons

Průběh a extremita povodně v červnu 2013 =The course and the extremity of the June 2013 floods

Během června 2013 se na našem území vyskytly tři srážkově velmi významné epizody. Z hlediska plošného rozsahu a extremity byla nejvýznamnější srážková epizoda 1.-2. června, při které došlo po vypadnutí regionálních a lokálních přívalových srážek na území Čech k rozvodnění jak menších, tak i větších vodních toků v povodí Labe. 24hodinový srážkový úhrn lokálně přesáhl 100 mm. V profilech několika vodoměrných stanic přesáhla doba opakování kulminačních průtoku 100 let, a to zejména na menších tocích s plochou povodí do 500 km2. Průběh povodně a její extremita byly značně ovlivněny předchozím silným nasycením území, které bylo zapříčiněno srážkově nadnormálním květnem. Povodeň z počátku června 2013 byla sice v porovnání s povodní v srpnu 2002 méně významná, ale nástup povodně byl vzhledem k charakteru srážek a zasaženého území na velkém množství vodních toků mnohem rychlejší.During June of 2013 three episodes with significant precipitation amounts were observed. The most important one was the first, from 1st June to 2nd June, when 24 hours rainfall totals exceeded locally 100 mm and the rain was in some places very intensive. The course of the consequent flood and its extremity were also strongly influenced by previous soil saturation caused by abnormally rainy May. The extent of affected area by precipitation and local heavy rain had an effect in flooding not only of main rivers but smaller streams as well. The return period of peak flows exceeded 100 years in several gauging stations, situated mainly on smaller streams with catchment area less than 500 km2. This flood was less significant in comparison with flood in August of 2002, but rising limbs of the hydrographs were steeper in many river sites.19720

Výzkum a implementace nových nástrojů pro předpovědi povodní a odtoku v rámci zabezpečení hlásné a předpovědní povodňové služby v ČR:Vývoj robustní metody odhadu odtoku z přívalových srážek. DÚ 4

Popis systému FFG-Z (Flash Food Guidance - CZech), jehož základním výstupem je operativní informace o pravděpodobném vzniku přívalové povodně na daném území (povodí). Testování systému procedur FFG-CZ na vybraných významných událostech přívalových povodní

Heart rate as an independent predictor of long term mortality of acute heart failure patients in sinus rhythm according to their ejection fraction: data from the AHEAD registry

International audienceBackground: Heart rate (HR) at admission in patients with acute heart failure (AHF) has been shown to be an important risk marker of in-hospital mortality. However, its relation with mid and long-term prognosis as well as the impact of Ejection Fraction (EF) is unknown. Our objective was to study the relationship between long-term survival and HR at admission depending on EF in a cohort of patients hospitalized for AHF.Methods: We analyzed the data of 2335 patients in sinus rhythm hospitalized for AHF from AHEAD registry. Patients with cardiogenic shock and AHF from surgical or non-cardiac etiology were excluded.Results: Survival rates at 6 and 12 months were 84.8% and 78% respectively. Increased age, decreased diastolic BP, lack of PCI during hospitalization, increased creatinine level and increased HR (with different cut-offs according to EF categories) were found as predictors whatever the EF at 6 and 12 months. Optimal prognostic cut-offs of heart rate were identified for Heart Failure with reduced EF at 100 bpm, for Heart Failure with mid-range EF at 90 bpm and for Heart Failure with preserved EF at 80 bpm for both 6 and 12 months.Conclusion: Our study suggests that HR at admission appears to be an independent prognostic parameter in AHF patients in sinus rhythm irrespective of EF and can be used to classify patients according to the severity of the disease