The management of patients with acute pulmonary embolism (aPE) depend on the risk stratification at hospital admission. It is unknown when normotensive aPE patients with some other risk factors deteriorate. Patients with objectively established acute PE diagnosis enrolled in the regional PE registry from January 2015 to December 2021, were studied in this investigation. According to European Society od Cardiology criteria patients were stratified during admission to hospital in four risk stratums. The timing for death and the main reason for death were recorded. PE-related death was defined if patient has died because of cardiac arrest or obstructive shock if there is no another possible reason for that. In the REPER registry. Among 1541 patients (514 low risk, 366 intermediate-low risk, 472 intermediate-high risk and 189 high risk) with aPE, 101 (6.6%) have died primary from aPE and 64 (4.2%) have died from other reasons during the 30-day follow-up. PE-related death across the mortality risk groups were 0.8%, 1.1%, 8.5% and 28.5% in low-risk, intermediate-low, intermediate-high and high risk PE, respectively. Median time from hospital admission to PE related death was significantly longer in intermediate-high than in high risk patients 4.5 (2.0–9.0) vs 1.0 (1.0–4.5) days, p=0.001. In the high risk group 50.9% of patients died during the first 24 hours, 9.0% in the next 24 hours and 83.0% of patients died during the first 5 days from admission. In the intermediate-high risk group 17.5% died in the first 24 hours, 12.5% died in the next 24 hours and next 25% died till the fifth day. There was no difference in timing of non PE-related death between intermediate-high and high risk patients 9.5 (6.0–18.5) vs 7.0 (3.0–23.5) days, p=0.631. There is significant delay in timing of death in intermediate-high compare to high risk PE patients, however, almost 50% of patients who died in the intermediate-high risk PE patients have died inside the first 5 days from hospital admission. Type of funding sources: None.
Objective: This study aimed to determine the intravitreal concentration of VEGF in eyes with PDR and to evaluate the effects of previous PRP on its level. Methods: It was a cross-sectional study performed at the Clinical Centre University. It included 90 eyes surgically treated with PPV, divided into three groups, group A - patients with PDR with previous PRP, group B - patients with PDR without previous PRP, and group C - PPV performed due to the indication unrelated to diabetes. A vitreous sample was obtained during PPV, and the VEGF concentration was determined using an Enzyme-linked immunosorbent assay test (ELISA). Shapiro-Wilk, nonparametric tests Kruskal-Wallis, Mann-Whithney U test, ANOVA and Spearman’s correlation test were used. Results: The highest vitreous VEGF concentration was in group B - 972.96 (743.33-1149.13) and was higher than in group A - 69.22 (37.33-225.15) and in group C - 19.93 (1.15-32.17) (p<0.001). There was a positive correlation between VEGF vitreous concentration and glucose level in group A patients (Rho=0.410; p=0.027). Conclusion: As a treatment before PPV surgery, PRP showed to be effective in the reduction of VEGF levels, which also highlighted a decrease in complications during and postoperatively. Abbreviations: DRS = Diabetic Retinopathy Study, PDR = proliferative diabetic retinopathy, VEGF = vascular endothelial growth factor, PRP = pan-retinal photocoagulation, PPV = pars plana vitrectomy, HbA1c = glycosylated hemoglobin, ETDRS = Early treatment diabetic retinopathy study, ESR = erythrocyte sedimentation rate, BCVA = best corrected visual acuity, OCT = optical coherent tomography, ILM = internal limiting membrane, PHACO = phacoemulsification, IOL = intraocular lens, ELISA = Enzyme-linked immunosorbent assay test, AUC = area under the curve, DME = diabetic macular oedema, TDR = tractional retinal detachment, VMT = vitreomacular traction
A big challenge of autonomous mobility is guaranteeing safety in all possible extreme and unexpected scenarios. For the last 25 years, the sector therefore focused on improving the automation functions. Nevertheless, autonomous mobility is still not part of daily life. The 5G-Blueprint project follows an alternative approach: direct control teleoperation. This concept relies on 5G connectivity to remove the physical coupling between the human driver or sailor and the controlled vehicle or vessel. This way, automation and teleoperation can be combined as complementary technologies, assigning them to different segments of a single trajectory, realizing driverless mobility in a safe, scalable, and cost-efficient manner. However, this mode of operation brings demanding connectivity requirements, such as high uplink bandwidth, low latency and ultra-reliability at the same time, for which the potential of 5G needs to be studied and explored. In this paper, we present our performance validation strategies to pursue 5G-enhanced teleoperation in real-life environment (e.g., public roads, busy sea ports), including some initial results that we collected during the in-country piloting phase.
5G Stand Alone (SA) networks are in the process of implementation, as the today's progress of the main business services to migrate to the 5G new services communication (enhanced Mobile Broadband - eMBB, Ultra Reliable Low Latency Communications - URLLC, massive Machine Type Communications - mMTC) is estimated to slowly increase. There have been identified some key aspects responsible for the novel 5G communication adoption process, such as the complexity of the services deployment and the clear understanding of the huge potential of the technology that can further support the 5G vertical's stakeholders. This paper is representing the work of the EU funded project VITAL-5G in deploying 5G Stand Alone 3GPP Rel.16 testbeds, with enhanced network and services capabilities and 5G resources available to be offered to industries vertical's customers. The 5G solution of the testbed design is covering several aspects of the future 5G network implementation, such as services management and orchestration, automation of resources allocation, 5G network slicing (Radio Access Network, Core and Transport) and user traffic prioritization according to the service slice needs, eMBB and URLLC. An important aspect is the availability of the entire 5G ecosystem to be offered to the 5G developers and 3 rd parties for advanced and extensive trials such as Innovative Network Application (N etApps) implementations. By abstracting the complexity of underlying 5G infrastructure, reducing the time of service creation and deployment and optimizing the 5G resource usage, N etApps is a key enabler of 5G adoption.
One of the major challenges in 5G-based Cooperative Connected and Automated Mobility is to ensure continuity of a service that is deployed on the network edge and used by a moving vehicle. We propose enablers for smart cellular edges, which support service continuity in cross-border scenarios by the timely preparation of a service instance in an anticipated topologically closer target edge, and by connecting the vehicle to such service instance before the cellular handover occurs. In this paper, we use the edge data centers of a German and Austrian mobile operator to showcase two main enabling pillars for edge service continuity, i.e., i) transparent edge bridging by means of a programmable data plane to serve a vehicle from the target edge before the vehicle performs handover to a different operator, and ii) smart applications, which apply data analytics to boost orchestration decisions for target edge preparation.
Premature ventricular contraction (PVC) is a frequent kind of arrhythmia that affects around 1% of the general population. While PVC most frequently impairs ventricular function in structurally normal heart, retrograde ventriculo‐atrial conduction can occur in people with PVC. These retrograde atrial activations may mimic pulmonary vein‐derived atrial ectopies. As a result, PVC may raise the risk of atrial fibrillation (AF) by retrograde ventriculo‐atrial conduction. The Four‐Dimensional Automated Left Atrial Quantification (4D Auto LAQ) tool is a left atrial analytical approach that utilizes three‐dimensional volume data to quantify the volume, as well as LA longitudinal and circumferential strains. The purpose of this study was to determine if clinical diagnosis of PVC is connected with abnormal LA function as determined by LA strain evaluation utilizing a 4D Auto LAQ compared to the healthy population.
Premature ventricular complex (PVC) is common in general population. The atrial conduction time (ACT) represents the interval between electrocardiographic P wave and atrial mechanical contraction, and the prolongation of ACT called atrial electromechanical delay (EMD). In the present study, we investigated atrial conduction parameters through echocardiography in patients with frequent PVC. The study involved 54 patients with PVC and 54 healthy volunteers as a control group. A comprehensive echocardiographic examination was done. The time difference between the onset of the p wave and septal Am wave was the PA septal, the time difference between the onset of the p wave and the lateral Am wave was the PA lateral, and the time difference between the onset of the p wave and the tricuspid annulus Am wave was the PA tricuspid. The interatrial EMD was the time difference between the PA lateral and the PA tricuspid, the left atrial (LA) intraatrial delay was the time difference between the PA lateral and the PA septal and the right atrial (RA) intraatrial delay was the time difference between the PA septal and the PA tricuspid. LA anterior-posterior dimension and LA maximum volume were significantly larger in the patient group. Left intraatrial EMD, right intraatrial EMD, and interatrial EMD were significantly longer in the patient group. PA lateral, PA septal, PA tricuspid durations were significantly prolonged in the patient group. Atrial conduction times were prolonged in patients with frequent PVC. Type of funding sources: None.
Abstract Background Analysis of years of life lost (YLL) due to premature deaths during the COVID-19 pandemic can direct decision-makers towards specific public health recommendations in order to improve health and lives of people. Our study aimed to examine the existence of age- and sex-specific patterns of the three most common causes of premature death in Belgrade during the first year of the COVID-19 epidemic. Methods Mortality data disaggregated by age, sex and cause of death, as well as the estimated number of inhabitants and remaining life-expectancy by age-groups for Belgrade was provided by the Statistical Office of the Republic of Serbia. YLLs were calculated using the methods of the Global Burden of Disease Study, without garbage code redistribution. Mortality rates were standardized according to the European Standard Population. We acknowledge the support from the COST Action 18218 - European Burden of Disease Network. Results In 2020 in Belgrade, according to the share in all-cause YLLs, cardiovascular diseases ranked first (36.2%), followed by neoplasms (25.7%) and COVID-19 (11.1%). However, on average, COVID-19 generated higher number of YLLs per death case (11.9) than cardiovascular diseases (9.2), but fewer than neoplasms (13.9). In total of 31,943 YLLs due to COVID-19, men had 1.7 times more YLLs than women. By age groups, the highest YLL share due to COVID-19 was among men aged 45-49 (16%) and 70-74 (16%) and among women aged 20-25 (33%) and 25-29. years (29%). In men, COVID-19 YLL rate was 2,488 per 100,000 and was higher after standardization (2,714). In women, COVID-19 YLL rate was 1346 per 100,000 and was lower after standardization (1,245). Conclusions In Belgrade, COVID-19 was the third cause of premature mortality in 2020. The difference between COVID-19 YLL rates in men and women were even more prominent after standardization. Future research is needed to determine the synergistic impact of COVID-19 and other causes of premature death. Key messages • In 2020, COVID-19 was among the top three causes of premature mortality among male and female contingents of the Belgrade population. • Assessing the causes of premature mortality is important for determining community health priorities.
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