1,067 research outputs found

    Evaluation of soluble ST2 as a novel cardiovascular biomarker in patients with acute myocardial infarction

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    Background: Soluble ST-2 has considerable prognostic value and is used as an aid for risk stratification in identifying patients who are at high risk of cardiovascular disease. The main objective of the study was to analyze the level of soluble ST-2 biomarker in patients with acute myocardial infarction and chronic stable angina patients and secondly to evaluate the cardiovascular outcomes after 30 days.Methods: A total of 71 patients were enrolled into the study, patients were divided into two groups of which 50 patients were in test group (AMI patients) and the remaining 21 patients were in the control group (chronic stable angina). Then, 5ml of blood was collected from the patients and plasma soluble ST-2 was estimated from the sample using ELISA technique. Patients were then followed up to 30 days to ascertain the development of major adverse cardiovascular outcomes.Results: The median concentration of soluble ST-2 in test group was found to be 213.46pg/ml and in control group was found to be 124.53 pg/ml. Soluble ST-2 correlated significantly with left ventricular ejection fraction (LVEF) between the two groups (P value=0.01). Measurement of soluble ST-2 early after MI assists in the prediction of adverse cardiovascular events. In this study, soluble ST-2 was found to be higher in patients with acute myocardial infarction and also in patients with poor ejection fraction.Conclusions: Soluble ST-2 is a novel cardiovascular biomarker that is elevated in patients with acute myocardial infarction

    Value of hospital antimicrobial stewardship programs [ASPs]:a systematic review

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    Abstract Background Hospital antimicrobial stewardship programs (ASPs) aim to promote judicious use of antimicrobials to combat antimicrobial resistance. For ASPs to be developed, adopted, and implemented, an economic value assessment is essential. Few studies demonstrate the cost-effectiveness of ASPs. This systematic review aimed to evaluate the economic and clinical impact of ASPs. Methods An update to the Dik et al. systematic review (2000–2014) was conducted on EMBASE and Medline using PRISMA guidelines. The updated search was limited to primary research studies in English (30 September 2014–31 December 2017) that evaluated patient and/or economic outcomes after implementation of hospital ASPs including length of stay (LOS), antimicrobial use, and total (including operational and implementation) costs. Results One hundred forty-six studies meeting inclusion criteria were included. The majority of these studies were conducted within the last 5 years in North America (49%), Europe (25%), and Asia (14%), with few studies conducted in Africa (3%), South America (3%), and Australia (3%). Most studies were conducted in hospitals with 500–1000 beds and evaluated LOS and change in antibiotic expenditure, the majority of which showed a decrease in LOS (85%) and antibiotic expenditure (92%). The mean cost-savings varied by hospital size and region after implementation of ASPs. Average cost savings in US studies were 732perpatient(range:732 per patient (range: 2.50 to $2640), with similar trends exhibited in European studies. The key driver of cost savings was from reduction in LOS. Savings were higher among hospitals with comprehensive ASPs which included therapy review and antibiotic restrictions. Conclusions Our data indicates that hospital ASPs have significant value with beneficial clinical and economic impacts. More robust published data is required in terms of implementation, LOS, and overall costs so that decision-makers can make a stronger case for investing in ASPs, considering competing priorities. Such data on ASPs in lower- and middle-income countries is limited and requires urgent attention

    Embedding CCSL into Dynamic Logic: A Logical Approach for the Verification of CCSL Specifications

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    International audienceThe Clock Constraint Specification Language (CCSL) is a clock-based specification language for capturing causal and chronometric constraints between events in Real-Time Embedded Systems (RTESs). Due to the limitations of the existing verification approaches, CCSL lacks a full verification support for 'unsafe CCSL specifications' and a unified proof framework. In this paper, we propose a novel verification approach based on theorem proving and SMT-checking. We firstly build a logic called CCSL Dynamic Logic (CDL), which extends the traditional dynamic logic with 'signals' and 'clock relations' as primitives, and with synchronous execution mechanism for modelling RTESs. Then we propose a sound and relatively complete proof system for CDL to provide the verification support. We show how CDL can be used to capture RTES and verify CCSL specifications by analyzing a simple case study

    SARS-CoV-2 variants, spike mutations and immune escape.

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    Although most mutations in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome are expected to be either deleterious and swiftly purged or relatively neutral, a small proportion will affect functional properties and may alter infectivity, disease severity or interactions with host immunity. The emergence of SARS-CoV-2 in late 2019 was followed by a period of relative evolutionary stasis lasting about 11 months. Since late 2020, however, SARS-CoV-2 evolution has been characterized by the emergence of sets of mutations, in the context of 'variants of concern', that impact virus characteristics, including transmissibility and antigenicity, probably in response to the changing immune profile of the human population. There is emerging evidence of reduced neutralization of some SARS-CoV-2 variants by postvaccination serum; however, a greater understanding of correlates of protection is required to evaluate how this may impact vaccine effectiveness. Nonetheless, manufacturers are preparing platforms for a possible update of vaccine sequences, and it is crucial that surveillance of genetic and antigenic changes in the global virus population is done alongside experiments to elucidate the phenotypic impacts of mutations. In this Review, we summarize the literature on mutations of the SARS-CoV-2 spike protein, the primary antigen, focusing on their impacts on antigenicity and contextualizing them in the protein structure, and discuss them in the context of observed mutation frequencies in global sequence datasets

    Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality

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    Background and purpose: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT

    Measurement of Energy Correlators inside Jets and Determination of the Strong Coupling Formula Presented

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    Energy correlators that describe energy-weighted distances between two or three particles in a hadronic jet are measured using an event sample of s\sqrt{s}=13 TeV proton-proton collisions collected by the CMS experiment and corresponding to an integrated luminosity of 36.3 fb1^{−1}. The measured distributions are consistent with the trends in the simulation that reveal two key features of the strong interaction: confinement and asymptotic freedom. By comparing the ratio of the measured three- and two-particle energy correlator distributions with theoretical calculations that resum collinear emissions at approximate next-to-next-to-leading-logarithmic accuracy matched to a next-to-leading-order calculation, the strong coupling is determined at the Z boson mass: αS_S (mZ_Z)=0.1229 0.00400.0050\frac{0.0040}{-0.0050} , the most precise αS_SmZ_Z value obtained using jet substructure observable

    Measurement of the Bs0 = μ+μ- decay properties and search for the B0 → μ+μ- decay in proton-proton collisions at √s=13 TeV

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    Measurements are presented of the B0s & RARR; & mu;+& mu;- branching fraction and effective lifetime, as well as results of a search for the B0 & RARR; & mu;+& mu;- decay in proton-proton collisions at & RADIC;s =13 TeV at the LHC. The analysis is based on data collected with the CMS detector in 2016-2018 corresponding to an integrated luminosity of 140 fb-1. The branching fraction of the B0s & RARR; & mu;+& mu;- decay and the effective B0s meson lifetime are the most precise single measurements to date. No evidence for the B0 & RARR; & mu;+& mu;- decay has been found. All results are found to be consistent with the standard model predictions and previous measurements. & COPY; 2023 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons .org /licenses /by /4 .0/). Funded by SCOAP3

    Search for a vector-like quark T′ → tH via the diphoton decay mode of the Higgs boson in proton-proton collisions at s \sqrt{s} = 13 TeV

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    A search for the electroweak production of a vector-like quark T′, decaying to a top quark and a Higgs boson is presented. The search is based on a sample of proton-proton collision events recorded at the LHC at = 13 TeV, corresponding to an integrated luminosity of 138 fb−1. This is the first T′ search that exploits the Higgs boson decay to a pair of photons. For narrow isospin singlet T′ states with masses up to 1.1 TeV, the excellent diphoton invariant mass resolution of 1–2% results in an increased sensitivity compared to previous searches based on the same production mechanism. The electroweak production of a T′ quark with mass up to 960 GeV is excluded at 95% confidence level, assuming a coupling strength κT = 0.25 and a relative decay width Γ/MT′ < 5%

    A portrait of the Higgs boson by the CMS experiment ten years after the discovery

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    In July 2012, the ATLAS and CMS collaborations at the CERN Large Hadron Collider announced the observation of a Higgs boson at a mass of around 125 gigaelectronvolts. Ten years later, and with the data corresponding to the production of a 30-times larger number of Higgs bosons, we have learnt much more about the properties of the Higgs boson. The CMS experiment has observed the Higgs boson in numerous fermionic and bosonic decay channels, established its spin–parity quantum numbers, determined its mass and measured its production cross-sections in various modes. Here the CMS Collaboration reports the most up-to-date combination of results on the properties of the Higgs boson, including the most stringent limit on the cross-section for the production of a pair of Higgs bosons, on the basis of data from proton–proton collisions at a centre-of-mass energy of 13 teraelectronvolts. Within the uncertainties, all these observations are compatible with the predictions of the standard model of elementary particle physics. Much evidence points to the fact that the standard model is a low-energy approximation of a more comprehensive theory. Several of the standard model issues originate in the sector of Higgs boson physics. An order of magnitude larger number of Higgs bosons, expected to be examined over the next 15 years, will help deepen our understanding of this crucial sector
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