On verbal agreement variation in European Portuguese: syntactic conditions for the 3SG/3PL alternation

In this paper we scrutinize a case of concord variation in European Portuguese (EP) concerning third plural vs. third singular verbal agreement in the co-presence of an overt plural argument, which in the standard variety agrees with the in! ected verb. " e paper is focused on the linguistic factors that correlate with singular concord in this context. Going beyond previous proposals that emphasize the correlation between agreement variation and particular morphological and phonological factors, it is shown that the incidence of non-standard singulars in EP may be straightforwardly explained within a syntactic account. " e empirical basis for this investigation is CORDIAL-SIN, a dialect corpus of EP (600,000 words). " e evidence from this corpus leads us to discuss and reconsider the role that di# erent linguistic factors play in the manifestation of non-standard singulars. It is shown that this case of third singular agreement occurs in the investigated EP varieties in correlation with particular syntactic conditions, mainly in unaccusative-like con- $gurations. Furthermore, it is suggested that this kind of agreement variation may be ultimately ascribed to lexical variation concerning the availability and feature speci$ cation of (null) expletives.info:eu-repo/semantics/publishedVersio

Post-discharge prognosis of patients admitted to hospital for heart failure by world region, and national level of income and income disparity (REPORT-HF): a cohort study

Background: Heart failure is a global public health problem, affecting a large number of individuals from low-income and middle-income countries. REPORT-HF is, to our knowledge, the first prospective global registry collecting information on patient characteristics, management, and prognosis of acute heart failure using a single protocol. The aim of this study was to investigate differences in 1-year post-discharge mortality according to region, country income, and income inequality. Methods: Patients were enrolled during hospitalisation for acute heart failure from 358 centres in 44 countries on six continents. We stratified countries according to a modified WHO regional classification (Latin America, North America, western Europe, eastern Europe, eastern Mediterranean and Africa, southeast Asia, and western Pacific), country income (low, middle, high) and income inequality (according to tertiles of Gini index). Risk factors were identified on the basis of expert opinion and knowledge of the literature. Findings: Of 18 102 patients discharged, 3461 (20%) died within 1 year. Important predictors of 1-year mortality were old age, anaemia, chronic kidney disease, presence of valvular heart disease, left ventricular ejection fraction phenotype (heart failure with reduced ejection fraction [HFrEF] vs preserved ejection fraction [HFpEF]), and being on guideline-directed medical treatment (GDMT) at discharge (p<0·0001 for all). Patients from eastern Europe had the lowest 1-year mortality (16%) and patients from eastern Mediterranean and Africa (22%) and Latin America (22%) the highest. Patients from lower-income countries (ie, ≤US$3955 per capita; hazard ratio 1·58, 95$12 235 per capita) or lower income inequality (ie, from the lowest Gini tertile). Compared with patients with HFrEF, patients with HFpEF had a lower 1-year mortality with little variation by income level (pinteraction for HFrEF vs HFpEF <0·0001). Interpretation: Acute heart failure is associated with a high post-discharge mortality, particularly in patients with HFrEF from low-income regions with high income inequality. Regional differences exist in the proportion of eligible patients discharged on GDMT, which was strongly associated with mortality and might reflect lack of access to post-discharge care and prescribing of GDMT. Funding: Novartis Pharma

International REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure (REPORT-HF): Rationale for and design of a global registry

Aims. The clinical characteristics, initial presentation, management, and outcomes of patients hospitalized with new-onset (first diagnosis) heart failure (HF) or decompensation of chronic HF are poorly understood worldwide. REPORT-HF (International REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure) is a global, prospective, and observational study designed to characterize patient trajectories longitudinally during and following an index hospitalization for HF. Methods. Data collection for the registry will be conducted at ∼300 sites located in ∼40 countries. Comprehensive data including demographics, clinical presentation, co-morbidities, treatment patterns, quality of life, in-hospital and post-discharge outcomes, and health utilization and costs will be collected. Enrolment of ∼20 000 adult patients hospitalized with new-onset (first diagnosis) HF or decompensation of chronic HF over a 3-year period is planned with subsequent 3 years follow-up. Perspective. The REPORT-HF registry will explore the clinical characteristics, management, and outcomes of HF worldwide. This global research programme may have implications for the formulation of public health policy and the design and conduct of international clinical trials

Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE):rationale and study design

Background. Patients with type 2 diabetes are at increased risk of macro- and microvascular disease, and the presence of albuminuria and/or reduced kidney function further enhances macrovascular risk. Angiotensin-converting-enzyme inhibitors reduce both macro- and microvascular events, yet the residual renal and cardiovascular risk still remains high. Aliskiren a novel oral direct renin inhibitor that unlike ACEi and ARBs, lowers plasma renin activity, angiotensin I and angiotensin II levels, may thereby provide greater benefit compared to ACEi or ARB alone. Methods. The primary objective of the ALTITUDE trial is to determine whether aliskiren 300 mg once daily, reduces cardiovascular and renal morbidity and mortality compared with placebo when added to conventional treatment (including ACEi or ARB). ALTITUDE is an international, randomized, double-blind, placebo-controlled, parallel-group study, which will include three categories of high-risk patients with type 2 diabetes (aged >= 35 years): those with either urinary albumin/creatinine ratio (UACR) >= 200 mg/g; microalbuminuria (UACR) >= 20 = 30 = 30 <60 mL/min/1.73 m(2) with or without microalbuminuria. ALTITUDE is an event driven trial that aims to randomize 8600 patients with a planned follow-up time of 48 months. The primary outcome measure is time to first event for the composite endpoint of cardiovascular death, resuscitated death, myocardial infarction, stroke, unplanned hospitalization for heart failure, onset of end-stage renal disease or doubling of baseline serum creatinine concentration. Secondary endpoints include a composite CV endpoint and a composite renal endpoint. Conclusion. ALTITUDE will determine whether dual RAAS blockade with the direct renin inhibitor aliskiren in combination with an ACEi or ARB will reduce major morbidity and mortality in a broad range of high-risk patients with type 2 diabetes

Association of time‐to‐IV ‐furosemide with mortality in acute heart failure: data from REPORT‐HF

Background: Acute heart failure (AHF) can be a life-threatening medical condition. Delaying administration of intravenous furosemide (time-to-diuretics) has been postulated to increase mortality, but prior reports have been inconclusive. Objective: To evaluate the association between time-to-diuretics and mortality in the international REPORT-HF registry. Methods: We assessed the association of time-to-diuretics within the first 24-hours with in-hospital and 30-day post-discharge mortality in 15,078 patients from 7 world-regions in the REPORT-HF registry. We further tested for effect modification by baseline mortality risk (ADHERE risk-score), left ventricular ejection fraction (LVEF) and region. Results: The median time-to-diuretics was 67 (25th-75th percentiles 17-190) minutes. Women, patients with more signs and symptoms of heart failure, and patients from Eastern Europe or Southeast Asia had shorter time-to-diuretics. There was no significant association between time-to-diuretics and in-hospital mortality (P&gt;0.1). The 30-day mortality risk increased linearly with longer time-to-diuretics (administered between hospital arrival and 8-hours post- hospital arrival) (P=0.016). This increase was more significant in patients with a higher ADHERE risk score (Pinteraction=0.008), and not modified by LVEF or geographic region (Pinteraction &gt;0.1 for both). Conclusion: In REPORT-HF, longer time-to-diuretics was not associated with higher in-hospital mortality. However, we did found an association with increased 30-day mortality, particularly in high-risk patients, and irrespective of LVEF or geographic region

A global perspective of racial differences and outcomes in patients presenting with acute heart failure

Important racial differences in characteristics, treatment, and outcomes of patient with acute heart failure (AHF) have been described. The objective of this analysis of the International REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure (REPORT-HF) registry was to estimate racial differences in patients with AHF according to country income level