Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Validation of edge turbulence codes against the TCV-X21 diverted L-mode reference case

Self-consistent full-size turbulent-transport simulations of the divertor and scrape-off-layer (SOL) of existing tokamaks have recently become feasible. This enables the direct comparison of turbulence simulations against experimental measurements. In this work, we perform a series of diverted ohmic L-mode discharges on the tokamak à configuration variable (TCV) tokamak, building a first-of-a-kind dataset for the validation of edge turbulence models. This dataset, referred to as TCV-X21, contains measurements from five diagnostic systems from the outboard midplane (OMP) to the divertor targets - giving a total of 45 one- and two-dimensional comparison observables in two toroidal magnetic field directions. The experimental dataset is used to validate three flux-driven 3D fluid-turbulence models - GBS, GRILLIX and TOKAM3X. With each model, we perform simulations of the TCV-X21 scenario, individually tuning the particle and power source rates to achieve a reasonable match of the upstream separatrix value of density and electron temperature. We find that the simulations match the experimental profiles for most observables at the OMP - both in terms of profile shape and absolute magnitude - while a comparatively poorer agreement is found towards the divertor targets. The match between simulation and experiment is seen to be sensitive to the value of the resistivity, the heat conductivities, the power injection rate and the choice of sheath boundary conditions. Additionally, despite targeting a sheath-limited regime, the discrepancy between simulations and experiment also suggests that the neutral dynamics should be included. The results of this validation show that turbulence models are able to perform simulations of existing devices and achieve reasonable agreement with experimental measurements. Where disagreement is found, the validation helps to identify how the models can be improved. By publicly releasing the experimental dataset and validation analysis, this work should help to guide and accelerate the development of predictive turbulence simulations of the edge and SOL

Development and validation of a dissolution method using HPLC for diclofenac potassium in oral suspension

The present study describes the development and validation of an in vitro dissolution method for evaluation to release diclofenac potassium in oral suspension. The dissolution test was developed and validated according to international guidelines. Parameters like linearity, specificity, precision and accuracy were evaluated, as well as the influence of rotation speed and surfactant concentration on the medium. After selecting the best conditions, the method was validated using apparatus 2 (paddle), 50-rpm rotation speed, 900 mL of water with 0.3% sodium lauryl sulfate (SLS) as dissolution medium at 37.0 ± 0.5°C. Samples were analyzed using the HPLC-UV (PDA) method. The results obtained were satisfactory for the parameters evaluated. The method developed may be useful in routine quality control for pharmaceutical industries that produce oral suspensions containing diclofenac potassium

High-pressure lubricity at the meso- and nanoscale

The increase of sliding friction upon increasing load is a classic in the macroscopic world. Here we discuss the possibility that friction rise might sometimes turn into a drop when, at the mesoscale and nanoscale, a confined lubricant film separating crystalline sliders undergoes strong layering and solidification. Under pressure, transitions from N to N-1 layers may imply a change of lateral periodicity of the crystallized lubricant sufficient to alter the matching of crystal structures, influencing the ensuing friction jump. A pressure-induced friction drop may occur as the shear gradient maximum switches from the lubricant middle, marked by strong stick-slip with or without shear melting, to the crystalline slider-lubricant interface, characterized by smooth superlubric sliding. We present high pressure sliding simulations to display examples of frictional drops, suggesting their possible relevance to the local behavior in boundary lubrication

The GBS code for the self-consistent simulation of plasma turbulence and kinetic neutral dynamics in the tokamak boundary

A new version of GBS (Ricci et al. (2012) [27]; Halpern et al. J. Comput. Phys. 315 (2016) 388-408; Paruta et al. (2018) [11]) is described. GBS is a three-dimensional, fluxdriven, global, two-fluid turbulence code developed for the self-consistent simulation of plasma turbulence and kinetic neutral dynamics in the tokamak boundary. In the new version presented here, the simulation domain is extended to encompass the whole plasma volume, avoiding an artificial boundary with the core, hence retaining the core-edgeSOL interplay. A toroidal coordinate system is introduced to increase the code flexibility, allowing for the simulation of arbitrary magnetic configurations (e.g. single-null, doublenull and snowflake configurations), which can also be the result of the equilibrium reconstruction of an experimental discharge. The implementation of a new iterative solver for the Poisson and Ampere equations is presented, leading to a remarkable speed-up of the code with respect to the use of direct solvers, therefore allowing for efficient electromagnetic simulations that avoid the use of the Boussinesq approximation. The selfconsistent kinetic neutral model, initially developed for limited configurations, is ported to the magnetic configurations considered by the present version of GBS and carefully optimized. A new MPI parallelisation is implemented to evolve the plasma and neutral models in parallel, thus improving the code scalability. The numerical implementation of the plasma and neutral models is verified by means of the method of manufactured solutions. As an example of the simulation capabilities of the new version of GBS, a simulation of a TCV tokamak discharge is presented. (c) 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).SP