关键词： chronic kidney disease   lipoprotein a   PCSK-9 inhibitors   ST-elevation myocardial infarction  

摘要： BackgroundCoronary slow flow and no reflow significantly predict poor prognosis in acute myocardial infarction (AMI) patients, especially those with chronic kidney disease (CKD). Early identification of factors contributing to these conditions can mitigate ischemic events and improve *** study aimed to investigate the association between elevated lipoprotein (a) [Lp(a)] levels and proprotein convertase subtilisin/kexin Type 9 (PCSK-9) inhibitor therapy with coronary slow flow or no reflow after percutaneous coronary intervention (PCI) in AMI patients with *** total of 323 ST-elevation myocardial infarction (STEMI) patients who underwent PCI between October 2017 and June 2023 were included. Patients were divided into CKD (n = 132) and non-CKD (n = 191) groups. Lp(a) levels and the prevalence of coronary slow flow or no reflow after PCI were evaluated. STEMI patients with CKD were further categorized into elevated Lp(a) (n = 81) and normal Lp(a) (n = 51) subgroups. Logistic analysis identified risk factors for coronary slow flow/no reflow after PCI. The impact of PCSK-9 inhibitors on outcomes was also assessed in the elevated Lp(a) *** patients with CKD had significantly higher Lp(a) levels compared to those without CKD (median 36.75 vs. 15.90 mg/dL, p = 0.0001). CKD patients with elevated Lp(a) had a higher prevalence of coronary slow flow/no reflow after PCI than those with normal Lp(a) (38.3% vs. 13.7%, p = 0.002). Logistic regression analysis identified elevated Lp(a) as an independent risk factor for slow flow/no reflow after PCI in STEMI patients with CKD (OR = 2.985, p = 0.027). In CKD patients with elevated Lp(a), PCSK-9 inhibitors significantly improved post-PCI coronary flow and reduced composite cardiovascular events during 1-year follow-up (22.2% vs. 51.1%, p = 0.008).ConclusionsElevated Lp(a) is an independent risk factor for coronary slow flow or no reflow after PCI in STEMI patients with CKD. PCSK-9 inhibitors im

关键词： Global Navigation Satellite System (GNSS)   Ground Based Augmentation Systems (GBAS)   Gradient Ionosphere Index (GIX)   Sudden Ionospheric Disturbance Index (SIDX)   Rate of Total Electron Content index (ROTI)   St. Patrick's Day storm  

摘要： The disturbance in ionospheric conditions caused by geomagnetic storms leads to problems with the ground, satellite communication, and navigation technology. The Ionospheric perturbations affect the accomplishment of the Global Navigation Satellite System (GNSS), namely accuracy, continuity, availability, and integrity. During the ionosphere's disturbance level, the Precision and safety of GNSS applications are essential to obtain data about space weather conditions. Along different GNSS satellite receiver paths, GNSS receivers are particularly vulnerable to expeditious changes in Total Electron Content (TEC) and critical spatial variations. The ionospheric indices, namely the Gradient Ionosphere Index (GIX), Rate of TEC Index (ROTI), and the Sudden Ionospheric Disturbance Index (SIDX), are employed for monitoring ionospheric conditions. The ionospheric disturbances can be assessed using GIX and SIDX without prior data. These indices have been modeled and validated based on GNSS observations provided by the Indian region. This research work examines the effects of the ionosphere on the St. Patrick's Day geomagnetic storm (17th March 2015) by inspecting TEC variations from March 14 to 19, 2015, using spatial and temporal indices for GNSS stations at Trivandrum, Hyderabad, Mumbai, Kolkata, Bhopal, Delhi positioned in the Indian subcontinent. In low-latitude regions, the highest GIX, ROTI, and more negative SIDX values started recording from 1,200 h UT to 1,500 h UT on 17th March 2015. On 17th March 2015, during the storm's main phase, the selected stations showed GIX values ranging from 47.2 to 103.3 m TECU/km. On Recovery Day 19th March 2015, GIX readings range from 38.1 to 60 m TECU/km, this research plays a part in understanding ionospheric gradients in the equatorial and low latitudes, where it is applicable for improving Ground Based Augmentation Systems (GBAS) and GPS-aided GEO Augmented Navigation (GAGAN) effective for aircraft landing.

关键词： diagnosis   cardiac troponin   high sensitivity   cMyBP-C   acute coronary syndrome   emergency department  

摘要： (1) Background: Prompt acute coronary syndrome (ACS) recognition remains challenging. This study evaluated the diagnostic and prognostic performance of novel biomarkers for non-ST-elevation myocardial infarction (NSTEMI). (2) Methods: Patients with suspected ACS presenting to Heidelberg University Hospital’s Emergency Department between August 2014 and February 2023 were analyzed. The biomarker panel included high-sensitivity cardiac troponin T (hs-cTnT), cardiac myosin-binding protein C (cMyBP-C), pro-B-type natriuretic peptide (proBNP), total N-terminal pro-B-type natriuretic peptide (t-NtproBNP), Angiotensin II (Ang2), Bone morphogenetic protein 10 (BMP10), Endothelial cell-specific molecule 1 (ESM1), fatty acid-binding protein 3 (FABP3), Fibroblast growth factor 23 (FGF23), Growth differentiation factor 15 (GDF15), and Copeptin. Negative predictive values (NPVs), sensitivities, and area under the curve (AUC) values were calculated for NSTEMI discrimination. Effectiveness and prognostic performance were assessed based on cardiovascular events at 30 days and 1 year. (3) Results: Of 1765 patients, 212 (12%) were diagnosed with NSTEMI. The European Society of Cardiology (ESC) 0/1 h and 0/3 h algorithms achieved sensitivities of 100% and 96.8%, NPVs of 100% and 99.3%, and effectiveness values of 54.8% and 66.0%. Hs-cTnT (AUC: 0.922) and cMyBP-C (AUC: 0.917) exhibited the highest diagnostic accuracy, followed by FABP3 (AUC: 0.759) and Copeptin (AUC: 0.624). Other biomarkers had lower performance (AUC: 0.516–0.617). At 1 year, event rates ranged from 0.0% to 3.4%, with the ESC algorithms demonstrating superior prognostic performance (0.8%, 2.4%). (4) Conclusions: The ESC 0/1 h and 0/3 h algorithms remain the most effective NSTEMI diagnostic strategies, balancing high sensitivity, prognostic reliability, and effectiveness. Among novel biomarkers, only cMyBP-C demonstrated comparable accuracy to hs-cTnT, supporting its potential as an adjunct to troponin assays.

关键词： Brucellosis   phylogeny   pangenome   MSLT  

摘要： Brucella melitensis is a highly infectious zoonotic pathogen responsible for brucellosis, which significantly affects both human and livestock health worldwide. This study employed whole-genome sequencing (WGS) to analyze the genetic diversity of 24 B. melitensis isolates from India. Pangenome analysis revealed a highly conserved nature with the involved strains having very limited accessory genes. Multilocus Sequence Typing (MLST) identified sequence type ST8 as predominant among Indian strains. Analysis of virulence genes revealed a total of 43 virulence-related genes in all strains, emphasizing their critical role in the pathogenicity of B. melitensis. Unique gene profiles and distinct phylogenetic clusters suggest regional adaptations and evolutionary pressures. The comprehensive genomic insights from this study help to elucidate the geographic distribution and interspecies transmission of Indian strains, highlighting the importance of targeted brucellosis control measures in India. Additionally, the identification of conserved virulence genes involved in immune evasion and intracellular survival highlights their importance in the bacterium's pathogenicity. This research contributes to the global understanding of B. melitensis genomic diversity, providing valuable insights for broader epidemiological studies and brucellosis management strategies ***. melitensis is a significant cause of illness in both humans and animals, particularly in India, where the disease remains a major concern. This study highlights that only a few genetic types of the bacteria are circulating in the region, which means control efforts can be better focused on these specific types. By understanding the unique characteristics of Indian strains, and how these strains spread and adapt, this research offers valuable guidance for improving brucellosis prevention strategies. These insights can help in developing more effective diagnostic tools, enhancing vaccination efforts,

关键词： St Publius   miracles   cult   nationalism   Malta  

摘要： This study presents what Padre Pelagio Mifsud Gauci Piscopo (1708–1781) wrote about the origins of the cult of St Publius both in Rome and in Malta, followed by a list of the miracles performed through the Saint’s intercession during the period mentioned by Padre Pelagio in his writings about the saint. In so doing, we will try to show how Padre Pelagio’s writings on St Publius are an affirmation of those characteristics which, according to him, identify Malta as a distinct nation, with its own history, beliefs, traditions and language. In other words, Padre Pelagio’s writings on this Saint are related to ulterior motives, namely, the search for the roots of a national identity that includes, among others, the element of Christianity, bestowed by St Paul the Apostle, and transmitted from one generation to another in spite of the long Arabic domination.

关键词： artisanal fisheries   bivalves   coastal fisheries   fishery dynamics   shellfisheries  

摘要： Clams constitute an important socioeconomic and Indigenous resource in the southern Gulf of St. Lawrence (sGSL); however, detailed analyses of commercial clam fisheries are outdated. I provide a synthesis of sGSL clam landings from 2003 to 2022. Three species comprised >99% of landings: Mya arenaria , Mercenaria mercenaria , and Spisula solidissima . Annual landings mostly came from Prince Edward Island (75 ± 7%; mean ± standard deviation), followed by New Brunswick (23 ± 6%) and Nova Scotia (2 ± 2%). For the sGSL as a whole, the three species contributed equally to landings from 2003 to 2020, but Mya arenaria dominated landings from 2021 to 2022. This trend was not consistent for individual provinces: province-specific fluctuations in species composition and a contemporary shift from multi-species to single-species harvests were evident. Overall, landings and their associated value sharply declined by 80% and 74%, respectively, over the time series. The number of catch records (i.e., active licenses and Supplement B records) also declined by 80%, suggesting progressively fewer people entering clam fisheries. Annual catch records were a strong predictor of annual landings, and declines in landings per catch record (proxy of CPUE) were apparent. This analysis ultimately suggests a dwindling Canadian fishery. Understanding the proximate causes of fishery declines, how to address them, and determining whether such declines reflect population trends, should be prioritized.