Production processes depend on fragmented and interdependent value chains; nowadays, a single product often includes components produced in dozens of countries. Many public health measures being ...implemented to prevent the spread of COVID-19 have dampened economic activity of 'non-essential' sectors. The decreased production affects other industries and countries that supply parts, machinery, and services via global value chains. Using the World Input-Output Database, we show how a hypothetical decline in the worldwide consumption of a set of non-essential sectors affects the global distribution of GDP and employment. While richer countries consume relatively more non-essential goods and services, we find, by considering the interdependencies among developed and developing economies, that low-income countries are likely to suffer steeper declines in their GDP and employment. Specifically, for each 1% decline in the demand for non-essential products, the GINI index across nations is expected to rise by 0.3%. That is, global inequality is likely to rise, contradicting some earlier findings. Finally, we show that economies with less-diverse sets of industries are more vulnerable to such global shocks. This study highlights the role of value chains in analyzing the spatial spread of the impacts and their contribution to amplifying world imbalances.
► Parking is a central topic in urban transportation and traffic management. ► Parking facilities at the UC campus are overcrowded and underpriced. ► Commuters are willing to pay to have access to ...conditional parking. ► Commuters are willing to accept a compensation to revise private car mode option. ► Integrated parking management (with public transport) might have positive impacts.
This study underscores the importance of adopting integrated parking management policies that ensure not only more rational use of the available parking spaces, evenly balancing supply and demand and bringing in revenues to cover the parking facilities costs, but also the improved attractiveness of alternative transportation modes. Parking supply and demand flows within the UC campus are estimated. The results indicate that the parking facility is underpriced and that there is overcrowding. To reflect critically on these issues and identify research areas to address their socioeconomic implications, a survey regarding the characterization of campus commuters and their travel options is presented. Logistic regression modelling is applied to determine the relative importance of UC campus commuters’ attributes in their level of willingness to pay to have reserved parking on the campus. Finally, some policy proposals are discussed.
Renewable Energy Communities (REC) can play a crucial role in enhancing citizen participation in the energy transition. Current European Union legislation enshrines energy communities and mandates ...Member States to encourage these organizations, promoting adequate conditions for their establishment. Nevertheless, uptake has been slow, and more research is needed to optimize the associated energy sharing. Using a Portuguese case study (REC Telheiras, Lisbon), this research aims to match local generation through four photovoltaic systems (totalizing 156.5 kWp of installed capacity) with household electricity consumption while cross evaluating the Portuguese legislation for energy sharing. The latter aim compares two scenarios: (a) current legislation (generated energy must be locally self-consumed before shared) and (b) equal share for members with a fixed coefficient. The evaluation is performed according to two indexes of self-consumption (SCI) and self-sufficiency (SSI), related to the simulation of four photovoltaic systems in public buildings, their associated consumption profiles, and an average household consumption profile of community members. The results show that, while maximizing self-consumption for the same values of generation and consumption, the number of participants is considerably lower for Scenario A (SCI = 100% is achieved with at least 491 residential members in Scenario A and 583 in Scenario B), implying that legislative changes enabling energy communities to better tailor sharing schemes may be necessary for them to become more attractive. The methods and results of this research can also be applied to other types of facilities, e.g., industrial and commercial consumers, if they are members of a REC and have smart meters in their installations.
Aims
Women with heart failure (HF) are under‐represented in individual randomized clinical trials (RCTs). Little is known about sex‐specific treatment effects in HF medications. We evaluated sex ...differences in the response to mineralocorticoid receptor antagonists (MRAs) in major HF MRA trials, including a broad spectrum of left ventricular ejection fraction (LVEF).
Methods and results
Individual patient data fixed‐effect meta‐analysis was performed using 6167 patients (31.4% were women) recruited in three placebo‐controlled RCTs: Randomized Aldactone Evaluation Study (RALES), Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS‐HF) and Spironolactone for Heart Failure with Preserved Ejection Fraction (TOPCAT)‐Americas. Compared to men, women were older, had higher body mass index and lower glomerular filtration rate. They also had higher LVEF and poorer New York Heart Association functional class and were less likely to be taking angiotensin‐converting enzyme inhibitors/angiotensin II receptor blockers. Placebo‐arm event rates were lower for women compared with men (15.4 vs. 22.1 per 100 person‐year; P = 0.002). MRAs reduced consistently, in men and women, the relative risk for cardiovascular death or HF hospitalization (P for interaction = 0.83), cardiovascular death (P for interaction = 0.44) and all‐cause death (P for interaction = 0.19). These findings remained consistent after adjustment for potential confounders, regardless of LVEF. There was no sex‐specific impact of MRA on the rate of hyperkalaemia and worsening renal function during the median 22 months of follow‐up.
Conclusion
In three large MRA RCTs, women were substantially different from men with regard to their clinical features and event rates. Nonetheless, this meta‐analysis supports a consistent and beneficial MRA effect regardless of sex.
Introduction
The optimal combination of amyloid‐β/tau/neurodegeneration (A/T/N) biomarker profiles for the diagnosis of Alzheimer's disease (AD) dementia is unclear.
Methods
We examined the ...discriminative accuracy of A/T/N combinations assessed with neuroimaging biomarkers for the differentiation of AD from cognitively unimpaired (CU) elderly and non‐AD neurodegenerative diseases in the TRIAD, BioFINDER‐1 and BioFINDER‐2 cohorts (total n = 832) using area under the receiver operating characteristic curves (AUC).
Results
For the diagnosis of AD dementia (vs. CU elderly), T biomarkers performed as well as the complete A/T/N system (AUC range: 0.90–0.99). A and T biomarkers in isolation performed as well as the complete A/T/N system in differentiating AD dementia from non‐AD neurodegenerative diseases (AUC range; A biomarker: 0.84–1; T biomarker: 0.83–1).
Discussion
In diagnostic settings, the use of A or T neuroimaging biomarkers alone can reduce patient burden and medical costs compared with using their combination, without significantly compromising accuracy.
The Internet-of-Things (IoT) has created a complex environment where hardware and software interact in complex ways. Despite being a prime candidate for applying well-established software engineering ...practices, IoT has not seen the same level of adoption as other areas, such as cloud development. This discrepancy is even more evident in the case of edge devices, where programming and managing applications can be challenging due to their heterogeneous nature and dependence on specific toolchains and languages. However, the emergence of WebAssembly as a viable solution for running high-level languages on some devices presents an opportunity to streamline development practices, such as DevOps. In this paper, we present WASMICO — a firmware and command-line utility that allows for the execution and management of application lifecycles in microcontrollers. Our solution has been benchmarked against other state-of-the-art tools, demonstrating its feasibility, novel features, and empirical evidence that it outperforms some of the most widely used solutions for running high-level code on these devices. Overall, our work aims to promote the use of well-established software engineering practices in the IoT domain, helping to bridge the gap between cloud and edge development.
•WASMICO simplifies IoT application continuous deployment without system resets.•WASMICO allows the management and operation of multi-applications in IoT devices.•Benchmark tests show WASMICO improves the execution of high-level code in devices.•WASMICO reduces the gap that inhibits the adoption of DevOps practices in IoT.
The clinical associations and prognostic implications of the 6-minute walk test (6MWT) distance in patients with rheumatoid arthritis (RA) is yet to be explored. To identify the clinical features and ...prognostic implications associated with the 6MWT in patients with RA. Cohort study including 387 RA patients who underwent 6MWT. Regression models (linear and logistic) were built to identify independent predictors of shorter 6MWT distance. Cox proportional models were used to study the association of 6MWT distance with cardiovascular outcomes. Patients were subdivided according to 6MWT tertiles: 126 patients walked > 405 m, 129 walked 345-405 m, and 132 walked < 345 m. Older age (> 55 years), elevated waist circumference, NT-pro BNP > 125 pg/mL, anemia, C-reactive protein ≥ 3 mg/dL, and troponin T ≥ 14 pg/mL were independent predictors of walking shorter distances. Patients walking less than 345 m had higher risk of a subsequent cardiovascular hospitalization or cardiovascular death compared with patients walking 345 m or more (adjusted HR: 2.98, 95%CI: 1.37-6.51, p = 0.006). Older age, abdominal obesity, anemia, cardiac dysfunction, and inflammation were associated with walking shorter distances in patients with RA. Walking less than 345 m in the 6MWT was associated with a poor cardiovascular prognosis. The 6MWT is simple, reproducible, and inexpensive, easily performed in routine practice, and provides important information regarding the patients´ status and outcomes, enabling the monitorization of the therapeutic optimization of the various domains of the RA.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) binds low-density lipoprotein receptor (LDLR), preventing its recycling. PCSK9 is a risk predictor and a biotarget in atherosclerosis ...progression.
The aim of this study was to determine whether the PCSK9-LDLR axis could predict risk in patients with heart failure (HF).
The BIOSTAT-CHF (Biology Study to Tailored Treatment in Chronic Heart Failure) is a multicenter, multinational, prospective, observational study that included patients with worsening HF signs and/or symptoms. The primary endpoints were all-cause mortality and the composite of mortality or unscheduled hospitalizations for HF. We implemented Cox proportional hazard regression to determine the simultaneously adjusted effect of PCSK9 and LDLR on both outcomes when added to the previously validated BIOSTAT-CHF risk scores.
This study included 2,174 patients (mean age: 68 ± 12 years; 53.2% had a history of ischemic heart disease). Median (interquartile range) PCSK9 and LDLR levels were 1.81 U/ml (1.45 to 2.18) and 2.98 U/ml (2.45 to 3.53), respectively. During follow-up, 569 deaths (26.2%) and 896 (41.2%) composite endpoints were ascertained. A multivariable analysis, which included BIOSTAT-CHF risk scores, LDLR, and statin treatment as covariates, revealed a positive linear association between PCSK9 levels and the risk of mortality (hazard ratio HR: 1.24; 95% confidence interval CI: 1.04 to 1.49; p = 0.020) and the composite endpoint (HR: 1.21; 95% CI: 1.05 to 1.40; p = 0.010). A similar analysis for LDLR revealed a negative association with mortality (HR: 0.86; 95% CI: 0.76 to 0.98; p = 0.025) and the composite endpoint (HR: 0.92; 95% CI: 0.83 to 1.01; p = 0.087). Including PCSK9 and LDLR improved risk score performance.
The PCSK9-LDLR axis was associated with outcomes in patients with HF. Future studies must assess whether PCSK9 inhibition will result in better outcomes in HF.
Sol-gel production of hybrid materials has, to some extent, revolutionised materials' engineering and the way science and technology perceive the creation of new materials. Despite that, the method ...presents some limitations that are circumvented by radiation processing. Electron beam irradiation was used to promote synthesis of hybrid structures while using silanol-terminated PDMS, TEOS and TPOZ as precursors. Evaluation of the method's performance was executed by gel fraction determination, WDXRF and FTIR-ATR. Results showed that, although there is some pre-irradiation reactivity between precursors, radiolysis induces scission on multiple sites of precursor's structures, which induces hybrid network formation to a greater extent. Characterisation allowed determining electron beam irradiation to be effective in the creation of Si-O-Zr bonds, resulting in the production of a Class II hybrid material.
Serum potassium in the PARADIGM‐HF trial Ferreira, João Pedro; Mogensen, Ulrik M.; Jhund, Pardeep S. ...
European journal of heart failure,
November 2020, Volume:
22, Issue:
11
Journal Article
Peer reviewed
Open access
Aims
The associations between potassium level and outcomes, the effect of sacubitril–valsartan on potassium level, and whether potassium level modified the effect of sacubitril–valsartan in patients ...with heart failure and a reduced ejection fraction were studied in PARADIGM‐HF. Several outcomes, including cardiovascular death, sudden death, pump failure death, non‐cardiovascular death and heart failure hospitalization, were examined.
Methods and results
A total of 8399 patients were randomized to either enalapril or sacubitril–valsartan. Potassium level at randomization and follow‐up was examined as a continuous and categorical variable (≤3.5, 3.6–4.0, 4.1–4.9, 5.0–5.4 and ≥5.5 mmol/L) in various statistical models. Hyperkalaemia was defined as K+ ≥5.5 mmol/L and hypokalaemia as K+ ≤3.5 mmol/L. Compared with potassium 4.1–4.9 mmol/L, both hypokalaemia hazard ratio (HR) 2.40, 95% confidence interval (CI) 1.84–3.14 and hyperkalaemia (HR 1.42, 95% CI 1.10–1.83) were associated with a higher risk for cardiovascular death. However, potassium abnormalities were similarly associated with sudden death and pump failure death, as well as non‐cardiovascular death and heart failure hospitalization. Sacubitril–valsartan had no effect on potassium overall. The benefit of sacubitril–valsartan over enalapril was consistent across the range of baseline potassium levels.
Conclusions
Although both higher and lower potassium levels were independent predictors of cardiovascular death, potassium abnormalities may mainly be markers rather than mediators of risk for death.
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