Correlations between the elliptic or triangular flow coefficients vm (m=2 or 3) and other flow harmonics vn (n=2 to 5) are measured using √sNN=2.76 TeV Pb+Pb collision data collected in 2010 by the ...ATLAS experiment at the LHC, corresponding to an integrated luminosity of 7 μb-1. The vm-vn correlations are measured in midrapidity as a function of centrality, and, for events within the same centrality interval, as a function of event ellipticity or triangularity defined in a forward rapidity region. For events within the same centrality interval, v3 is found to be anticorrelated with v2 and this anticorrelation is consistent with similar anticorrelations between the corresponding eccentricities, ε2 and ε3. However, it is observed that v4 increases strongly with v2, and v5 increases strongly with both v2 and v3. The trend and strength of the vm-vn correlations for n=4 and 5 are found to disagree with εm-εn correlations predicted by initial-geometry models. Instead, these correlations are found to be consistent with the combined effects of a linear contribution to vn and a nonlinear term that is a function of v22 or of v2v3, as predicted by hydrodynamic models. A simple two-component fit is used to separate these two contributions. The extracted linear and nonlinear contributions to v4 and v5 are found to be consistent with previously measured event-plane correlations.
The COVID-19 pandemic has hit Spain particularly hard, despite being a country with a developed economy and being praised for the robustness of its national health system. In order to understand what ...happened and to identify how to improve the response, we believe that an independent multi-disciplinary evaluation of the health, political and socio-economic spheres is essential. In this piece we propose objectives, principles, methodology and dimensions to be evaluated, as well as outlining the type of results and conclusions expected. Inspired by the requirements formulated by the WHO Independent Panel for Pandemic Preparedness and Response and by experiences in other countries, we detail the multidimensional aspects to be evaluated. The goal is to understand key aspects in the studied areas and their scope for improvement in terms of preparedness, governance, regulatory framework, national health system structures (primary care, hospital, and public health), education sector, social protection schemes, minimization of economic impact, and labour framework and reforms for a more resilient society. We seek to ensure that this exercise serves not only at present, but also that in the future we are better prepared and more agile in terms of our ability to recover from any pandemic threats that may arise.
Abstract
Introduction
Exercise echocardiography is a useful diagnostic test for the evaluation of coronary artery disease. Supine bicycle exercise echocardiography has the advantage of continuous ...monitoring of wall motion during exercise. On the contrary, the heart rate and workload is usually lower compared to treadmill exercise, especially between patients not used to cycling as is the case of many old adults. The aim of this study is to compare both exercise modalities.
Methods
A group of consecutive patients with chest pain underwent supine bicycle exercise echocardiography under a protocol adapted to the individual requirements. The operator chose between three protocols: light (5 watts every minute), medium (5 watts every 30 seconds) or intensive (10 watts every 30 seconds) according to age, sex and physical condition. The other group underwent treadmill exercise echocardiography using the Ball State University/Bruce Ramp protocol.
Results
A total of 902 patients were included. Of them, 258 patients underwent supine bicycle exercise echocardiography and 644 patients underwent treadmill exercise echocardiography. Mean age was 62.1 years (SD=13.4) and 48.5% of patients were women. Baseline characteristics were comparable in both groups, without significant differences regarding age, sex, body mass index, pre-test probability or image quality. There were no significant differences in the percentage of positive tests (5.0 vs. 5.3%, p = 0.883). However, the percentage of patients that achieved at least 85% of the predicted workload was significantly higher in the group of treadmill exercise echocardiography (91.3 vs. 45.0%, p < 0.001). The percentage of patients that achieved at least 85% of the age-predicted maximum heart rate was also significantly higher in the group of treadmill exercise echocardiography (76.7 vs. 44.2%, p < 0.001).
Conclusions
This study suggests that in a population not used to cycling, the use of supine bicycle exercise echocardiography, as opposed to the use of treadmill, hinders the achievement of an adequate maximum heart rate and workload, which can lead to inconclusive results. This should be considered while selecting the ischemic test to use.
Abstract
Background
Significant aortic regurgitation (AR) leads to left ventricular (LV) remodelling and poor outcomes if untreated; however, data on sex-differences in the setting of significant AR ...is scare.
Purpose
To examine contemporary clinical and echocardiographic differences between men and women with significant chronic AR.
Methods and results
Consecutive patients with significant AR evaluated in a heart valve clinic following a comprehensive clinical and imaging protocol were included. Comparison was performed between genders. A total of 206 patients with significant AR were included (130 grade III, 76 grade IV AR) (mean age 69 years, 49% women). Mean follow-up was 3.7 years. Women showed similar comorbidities, but were older (66.5 vs 71.4, p=0.017), and more symptomatic. Women were smaller in terms of height, weight and surface area, showing significantly smaller volumes and diameters (LVEDD 52 ± 6.2 mm men vs 47.0 ±6.7 mm women, p<0.001). However, when diameters were normalized, no significant differences were seen between men and women. Hospital admissions due to heart failure and number of surgeries were not significantly different between genders.
Conclusion
In patients with significant AR, indication for intervention in guidelines is based on the same values for both men and women. However, women were more symptomatic and showed significantly smaller volumes and diameters. Indexed values should be considered in decision making taking into account differences in gender.
Resumen: La pandemia de COVID-19 ha afectado de manera particularmente intensa a España, pese a su nivel de desarrollo y la elogiada solidez de su Sistema Nacional de Salud. Para comprender qué ha ...pasado e identificar cómo mejorar la respuesta creemos imprescindible una evaluación independiente multidisciplinaria de la esfera sanitaria, política y socioeconómica. En este trabajo proponemos objetivos, principios, metodología y dimensiones a evaluar, además de esbozar el tipo de resultados y conclusiones esperadas. Nos inspiramos en los requerimientos formulados por el panel independiente de la Organización Mundial de la Salud y en las experiencias evaluativas en otros países, y detallamos la propuesta de aspectos multidimensionales que deben valorarse. La idea es comprender aspectos clave en los ámbitos estudiados y su margen de mejora en lo relativo a preparación, gobernanza, marco normativo, estructuras del Sistema Nacional de Salud (atención primaria, hospitalaria y de salud pública), sector de educación, esquemas de protección social, minimización del impacto económico, y marco y reformas en el ámbito laboral para una sociedad más resiliente. En definitiva, buscamos que este ejercicio sirva no solo para el presente, sino también para que en el futuro estemos mejor preparados y con más ágil capacidad de recuperación ante las amenazas pandémicas que puedan surgir. Abstract: The COVID-19 pandemic has hit Spain particularly hard, despite being a country with a developed economy and being praised for the robustness of its national health system. In order to understand what happened and to identify how to improve the response, we believe that an independent multi-disciplinary evaluation of the health, political and socio-economic spheres is essential. In this piece we propose objectives, principles, methodology and dimensions to be evaluated, as well as outlining the type of results and conclusions expected. Inspired by the requirements formulated by the WHO Independent Panel for Pandemic Preparedness and Response and by experiences in other countries, we detail the multidimensional aspects to be evaluated. The goal is to understand key aspects in the studied areas and their scope for improvement in terms of preparedness, governance, regulatory framework, national health system structures (primary care, hospital, and public health), education sector, social protection schemes, minimization of economic impact, and labour framework and reforms for a more resilient society. We seek to ensure that this exercise serves not only at present, but also that in the future we are better prepared and more agile in terms of our ability to recover from any pandemic threats that may arise.
La pandemia de COVID-19ha afectado de manera particularmente intensa a España, pese a su nivel de desarrollo y la elogiada solidez de su Sistema Nacional de Salud. Para comprender qué ha pasado e ...identificar cómo mejorar la respuesta creemos imprescindible una evaluación independiente multidisciplinaria de la esfera sanitaria, política y socioeconómica. En este trabajo proponemos objetivos, principios, metodología y dimensiones a evaluar, además de esbozar el tipo de resultados y conclusiones esperadas. Nos inspiramos en los requerimientos formulados por el panel independiente de la Organización Mundial de la Salud y en las experiencias evaluativas en otros países, y detallamos la propuesta de aspectos multidimensionales que deben valorarse. La idea es comprender aspectos clave en los ámbitos estudiados y su margen de mejora en lo relativo a preparación, gobernanza, marco normativo, estructuras del Sistema Nacional de Salud (atención primaria, hospitalaria y de salud pública), sector de educación, esquemas de protección social, minimización del impacto económico, y marco y reformas en el ámbito laboral para una sociedad más resiliente. En definitiva, buscamos que este ejercicio sirva no solo para el presente, sino también para que en el futuro estemos mejor preparados y con más ágil capacidad de recuperación ante las amenazas pandémicas que puedan surgir.
The COVID-19 pandemic has hit Spain particularly hard, despite being a country with a developed economy and being praised for the robustness of its national health system. In order to understand what happened and to identify how to improve the response, we believe that an independent multi-disciplinary evaluation of the health, political and socio-economic spheres is essential. In this piece we propose objectives, principles, methodology and dimensions to be evaluated, as well as outlining the type of results and conclusions expected. Inspired by the requirements formulated by the WHO Independent Panel for Pandemic Preparedness and Response and by experiences in other countries, we detail the multidimensional aspects to be evaluated. The goal is to understand key aspects in the studied areas and their scope for improvement in terms of preparedness, governance, regulatory framework, national health system structures (primary care, hospital, and public health), education sector, social protection schemes, minimization of economic impact, and labour framework and reforms for a more resilient society. We seek to ensure that this exercise serves not only at present, but also that in the future we are better prepared and more agile in terms of our ability to recover from any pandemic threats that may arise.
To analyze the association between Scadding radiological stages of sarcoidosis at diagnosis and the disease phenotype (epidemiology, clinical presentation and extrathoracic involvement) in one of the ...largest cohorts of patients with sarcoidosis reported from southern Europe.
The SARCOGEAS-Study Group includes a multicenter database of consecutive patients diagnosed with sarcoidosis according to the WASOG 1999 criteria. Extrathoracic disease at diagnosis was defined according to the 2014 instrument and the clusters proposed by Schupp et al.
We analyzed 1230 patients (712 female, mean age 47 yrs.) who showed the following Scadding radiologic stages at diagnosis: stage 0 (n = 98), stage I (n = 395), stage II (n = 500), stage III (n = 195) and stage IV (n = 42). Women were overrepresented in patients presenting with extrathoracic/extrapulmonary disease, while the diagnosis was made at younger ages in patients presenting with BHL, and at older ages in those presenting with pulmonary fibrosis (q values <0.05). Multivariable adjusted analysis showed that patients presenting with pulmonary involvement (especially those with stages II and III) had a lower frequency of concomitant systemic involvement in some specific extrathoracic clusters (cutaneous-adenopathic/musculoskeletal, ENT and neuro-ocular/OCCC) but a higher frequency for others (hepatosplenic), in comparison with patients with extrapulmonary involvement (stages 0 and I). The presence of either BHL or fibrotic lesions did not influence the systemic phenotype of patients with pulmonary involvement.
The key determinant associated with a differentiated systemic phenotype of sarcoidosis at diagnosis was interstitial pulmonary involvement rather than the individual Scadding radiological stage.
•Sarcoidosis at diagnosis was limited to extrathoracic organs in 8% of patients.•Skin and neurological involvements were the most common isolated extrathoracic presentations.•Patients with Scadding stage I (isolated BHL) represented one third of patients.•The presence or absence of BHL played a weak role in driving significant phenotypic differences.•Stage IV (radiological evidence of lung fibrosis, 3% of patients) was associated with older age.
Measurements of inclusive jet production are performed in pp and Pb + Pb collisions at root SNN = 2.76 TeV with the ATLAS detector at the LHC, corresponding to integrated luminosities of 4.0 and 0.14 ...nb(-1), respectively. The jets are identified with the anti-k(t) algorithm with R = 0.4, and the spectra are measured over the kinematic range of jet transverse momentum 32 < pT < 500 GeV and absolute rapidity |y| < 2.1 and as a function of collision centrality. The nuclear modification factor R-AA is evaluated, and jets are found to be suppressed by approximately a factor of 2 in central collisions compared to pp collisions. The RAA shows a slight increase with pT and no significant variation with rapidity.
A
bstract
A summary is presented of ATLAS searches for gluinos and first- and second-generation squarks in final states containing jets and missing transverse momentum, with or without leptons or
b
...-jets, in the
s
=
8
TeV data set collected at the Large Hadron Collider in 2012. This paper reports the results of new interpretations and statistical combinations of previously published analyses, as well as a new analysis. Since no significant excess of events over the Standard Model expectation is observed, the data are used to set limits in a variety of models. In all the considered simplified models that assume R-parity conservation, the limit on the gluino mass exceeds 1150 GeV at 95% confidence level, for an LSP mass smaller than 100 GeV. Furthermore, exclusion limits are set for left-handed squarks in a phenomenological MSSM model, a minimal Supergravity/Constrained MSSM model, R-parity-violation scenarios, a minimal gauge-mediated supersymmetry breaking model, a natural gauge mediation model, a non-universal Higgs mass model with gaugino mediation and a minimal model of universal extra dimensions.
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