It is unclear to what extent the 2019 European Society of Cardiology (ESC), 2018 American College of Cardiology/ American Heart Association (ACC/AHA), 2016 US Preventive Services Task Force (USPSTF), and 2016 Canadian Cardiovascular Society (CCS) guidelines differ in assigning levels of evidence and classes of recommendations (LOE/class) to lipid-lowering treatment recommendations in primary prevention of cardiovascular disease (CVD). To compare LOE/class from four commonly used guidelines at population level. A total of 7262 participants, aged 45–75 years of age and without history of CVD, from the prospective population-based Rotterdam Study were included. Per guideline, proportions of the population recommended statin therapy by LOE/class, sensitivity and specificity, and numbers needed to treat at 10 years (NNT10y) were calculated. Mean age was 61.1 (SD 6.9) years, and 58.2% were women. ESC, ACC/AHA, USPSTF and CCS strongly recommended statin use for a respective 33.8%, 48.1%, and 40.2% and 73.0% of the eligible population based on high-quality evidence, while in an additional 55.3%, 7.1%, 8.4% and 9.2% of participants statins use could or should be considered based on varying LOE/class. The sensitivity for treatment recommendations supported with strong, high quality evidence was 61.6% for ESC (“IA”), 74.6% for ACC/AHA (“IA or IB”), 69.4% for USPSTF (“USPSTF-B”) and 92.5% for CCS (“strong”). Specificity was highest for the ACC/AHA at 46.8% and lowest for ESC at 11.4%. Estimated NNT10y for those with the strongest LOE/class were comparable across all guidelines, ranging from 18 to 26 for moderate-intensity statin use, and 11 to 16 for high-intensity statin use. NNT10y reflective of recommendations supported with moderate strength of LOE/class varied substantially among guidelines for both moderate-intensity and high-intensity statin use, ranging from 33 for ESC and USPSTF to 91 for CCS. Assigned LOE/class varied greatly among four clinical practice guidelines for primary prevention of CVD. Efforts for harmonized and comparable evidence grading system for clinical practice guidelines in primary prevention of CVD may reduce ambiguity, and reinforce updated evidence-based recommendations for appropriate treatment of populations for whom clear evidence for benefit of statin use is available. Type of funding source: None

Gate-tunable spin-dependent properties could be induced in graphene at room temperature through the magnetic proximity effect by placing it in contact with a metallic ferromagnet. Because strong chemical bonding with the metallic substrate makes gating ineffective, an intervening passivation layer is needed. Previously considered passivation layers result in a large shift of the Dirac point away from the Fermi level, so that unrealistically large gate fields are required to tune the spin polarization in graphene (Gr). We show that a monolayer of Au or Pt used as the passivation layer between Co and graphene brings the Dirac point closer to the Fermi level. In the $\text{Co}/\text{Pt}/\text{Gr}$ system the proximity-induced spin polarization in graphene and its gate control are strongly enhanced by the presence of a surface band near the Fermi level. Furthermore, the shift of the Dirac point could be eliminated entirely by selecting submonolayer coverage in the passivation layer. Our findings open a path towards experimental realization of an optimized two-dimensional system with gate-tunable spin-dependent properties.

The role of autonomous cooperative vehicles will undoubtedly be important in Intelligent Transportation Systems (ITS) to increase both the safety and the overall efficiency of a high traffic network system. An autonomous platooning provides one promising strategy for decreasing total fuel consumption of a fleet of vehicles and potential risk of accidents, especially during long-distance transportation. In this work, we provide a proof-of-concept for a simulation framework in which it is possible to simulate platoon and other multi-vehicle systems using realistic vehicle models within different traffic scenarios, which is based on ROS, Gazebo and SUMO. The framework enables an easy-to-use perception and control modules of the autonomous driving stack for a realistic vehicle models, while preserving a convenient setup of different high traffic platooning scenarios. Consequently, it provides a platooning design step for conducting reliable development analyses and a platform for comparisons of different platooning strategies. We illustrate the effectiveness of the proposed platooning framework through three typical scenarios using a distributed model predictive control scheme with a platoon consisted of Toyota Prius car models.

Controversies exist how to predict medium term mortality (Mt) in diabetics (DM) with 3 vessel (3VD) and/or left main (LM) disease undergoing myocardial revascularization ranging from Syntax Score II (SSII) where DM was not predicative variable up to FREEDOM formula which was derived, just from population with DM (without LM), having DM patients (Pts) requirement of insulin as one of predicative variable. To compare predicative power of SSII, FREEDOM and formula developed in our institution in Pts post first isolated CABG with 3VD and/or LM with DM. From our prospective data base of 2455 consecutive pts who had the first isolated CABG in the period 01/2012–12/2014 with complex Ischemic Heart Disease with 100% follow up of 4 years all-cause Mt we created by random sampling Training (1321; Mt:10.4%; DM 511; Mt:13.3%) and Validation (1134; Mt:10.0%; DM 414; Mt: 11.8%) sets. After deriving predicative formula (Cox regression) from training population we validated FREEDOM, SSII and Our Formula in 414 pts with DM from the Validation set. Characteristics of pts, our formula, predicating power by C Statistics, Calibration plots and Brier scores are presented in Picture 1. FREEDOM formula designed just for DM pts with complex Ischemic Heart Disease without LM had the smallest standard error in the estimate, but moderate C statistics as Syntax Score II and our formula which may be used for pts with and without DM and 3VD and/or LM. Picture 1 Type of funding source: Public grant(s) – National budget only. Main funding source(s): Ministry of education, science and technology development, Republic of Serbia

Two-dimensional (2-D) volumetric exercise stress echocardiography (ESE) provides an integrated view of preload reserve through end-diastolic volume (EDV) and left ventricular contractile reserve (LVCR) through end-systolic volume (ESV) changes. To assess the dependence of stroke volume (SV) and cardiac output (CO) upon LVCR EDV changes and heart rate (HR) during ESE. We prospectively performed semi-supine bicycle or treadmill ESE in 1,344 patients (age 59.8±11.4 years; 550 female; ejection fraction = 62.5±8%) referred for known or suspected coronary artery disease in 20 quality controlled laboratories of 16 countries from 2016 to 2019. SV was calculated at rest and peak stress from raw measurement of LV EDV and ESV by biplane Simpson rule, 2-D echo. LVCR was the stress-rest ratio of force (systolic blood pressure by cuff sphygmomanometer/ESV, abnormal values <2.0 identify a “weak” heart). Preload reserve was defined by an increase in LV EDV. Abnormal values (lack of EDV increase, peak EDV ≤ rest EDV) identify a “stiff” heart. Cardiac output was calculated as SV * HR (measured with standard EKG). HR reserve (stress/rest ratio) <1.85 identifies a “slow” heart with chronotropic incompetence. By selection, all patients had negative SE by wall motion criteria. Of the 1,344 patients included in the study, 448 belonged to the lowest tertile of CO increase. Of them 326 (73%) achieved HR reserve <1.85; 220 (49%) had a blunted LVCR and 374 (83%) a reduction of preload reserve, with 348 patients (78%) showing ≥2 abnormalities. The more the abnormal criteria, the worse the CO response, which was lowest in slow, stiff and weak hearts: see figure. Patients with normal CO reserve during exercise usually have a fast, compliant and strong heart. Abnormal CO reserve is associated with heterogeneous hemodynamic responses, with slow, stiff and/or weak hearts. The clarification of underlying hemodynamic heterogeneity is the prerequisite for a personalized treatment, and can be easily extracted from a standard 2-D volumetric SE. Hearts with normal CO are all alike; every heart with abnormal CO is abnormal in its own way. CO % changes in subsets (*p<0.001) Type of funding source: None

Freedom formula (FF) was derived very recently to assist in decision making by Heart Team in patients (Pts) with diabetes (DM) who are in need for myocardial revascularization (Percutaneous Coronary Intervention or Coronary artery bypass grafting (CABG)) due to complex ischemic Heart disease (but without left main steam disease (LM)). In external validation moderate C statistics values were obtained. To validate FF predictive value in Pts with DM and more complex patients (three vessel (3VD) and/or LM as well lower left ventricular ejection fraction (LVEF)) than in FREEDOM population. From our prospective data base of 2455 consecutive pts who had the first isolated CABG in the period 01/2012–12/2014 with 3VD and/or LM with 100% follow up of 4 years All-cause Mortality (Mt) we retrieved 925 pts with DM. DM was present in 925 Pts (Mt: 12.6%). On insulin were 318 (34.3%; Mt 14.5%). We analysed the predicative value of FF in the whole group (925) of pts with DM as well as in subgroups with LM (294) and without LM (631; most similar to original Freedom population), separately. Characteristics of pts, Freedom formula, predicating power by C Statistics, Calibration plots and Brier scores are presented in Picture 1. Our external validation of FF was almost identical as previous published one. Furthermore, the FF may be of value even in pts with LM disease and other vessels involved. Of note our pts as seen by combined LVEF, ClCr and LM were sicker than pts in FREEDOM. Picture 1 Type of funding source: Public grant(s) – National budget only. Main funding source(s): Ministry of education, science and technological development, Republic of Serbia

Abstract Development of critical systems nowadays is hardly achievable without reuse of previous knowledge. Design patterns have an important role in the design of such systems as they define and document common solutions to recurring design problems. However, critical systems such as those that are safety or security related, often require specific assurances that the system is adequate to operate in a given environment. Just as with any other reused knowledge in such systems, the reuse via application of design patterns needs to be assured every time. In this paper, we present a methodology for assuring the application of design patterns in critical domains. In particular, we enrich the design patterns template to support their further assurance. We define the aspects that should be tackled during the assurance of a design pattern application. We use the information specified in the design pattern template to guide the automated instantiation of the argumentation for each design pattern application in the system. We provide tool-support for our methodology in the context of the AMASS tool-platform and evaluate it in an automotive case study.

This research aims at examining how the use of DICT is part of school curriculum and teacher education by analysing and comparing the following documents: “BNCC de lingua portuguesa do Ensino Medio” (BRASIL, 2018) and “DCN para formacao inicial” (BRASIL, 2015). Besides considering the prescribed curriculum for primary and secondary education, teacher training cannot overlook the documents which change the organisation of education cycles, such as “Reforma do Ensino Medio” (BRASIL, 2017). This analysis has shown that BNCC aims at approaching DICT in its pedagogical proposal when suggesting multimodal discursive genres (ROJO, 2017), observing the new forms of sociability (SALOMAO, 2018). We intended to encourage discussions about the importance of considering teacher education through a new perspective, as well as about the need to articulate this to investments in public education, taking into account that BNCC implementation is something that teachers will have to be prepared for.

Objetivo: Descrever o papel do enfermeiro na garantia da saude do idoso no programa Hiperdia. Metodos: Trata-se de uma revisao integrativa, em que foram consultadas junto a Biblioteca Virtual de Saude (BVS) acessando as bases de dados: Literatura Latino-Americana e do Caribe em Ciencias da Saude (LILACS) e Scientific Eletronic Library Online (SciELO). Resultados: No total foram encontrados 13 artigos de atenderam aos criterios de inclusao deste trabalho. Desta forma, entende-se que os enfermeiros que atuam na Estrategia Saude da Familia (ESF) necessitam programar e implementar atividades de investigacao e acompanhamento dos idosos. De acordo com os dados coletados na pesquisa, pode notar que a hipertensao arterial sistemica e o diabetes mellitus e a primeira causa de hospitalizacoes no sistema publico de saude e sao os principais fatores de risco para as doencas cardiovasculares, dos quais cerca de 60 a 80% dos casos podem ser tratados na rede publica basica Consideracoes finais: Percebe-se que o enfermeiro tem exercido um papel muito importante priorizando o desenvolvimento das acoes basicas de saude, no acompanhamento dos idosos hipertensos e diabeticos.

Overweight and obesity are major public health issues worldwide. There is increased risk of obesity‐related morbidity due to accumulation of abdominal fat. Regulation of body weight depends on physical activity and diet. Young adulthood is very critical period due to a tendency to gain weight and adopt poor dietary and exercise habits. This study aimed to investigate the relationships of the anthropometrical parameters with physical activity domains in everyday life and sedentary behavior among students of sixth year of the Faculty of Medicine of Sarajevo University. A cross-sectional study was conducted during May 2020. The survey covered 56 students, aged 24, who responded online to questionnaire. A self-administered questionnaire composed of two blocks of questions. In the first block of the questionnaire, questions were related to sex, and anthropometric measures. The second block referred to the practice of physical activity (vigorous, moderate, and walking), and sitting during seven days. The data collected were processed by the descriptive statistical procedure. Overweight and obesity was found at 11(19.65%). In sample 46.43% performed vigorous intensity activities that meet with WHO criteria, 58.93 performed moderate intensity activities that meet with WHO criteria, and 39.29% performed walking activities that meet with WHO criteria. There were positive, statistically significant difference between indicators of abdominal obesity and the average time spent during 7 days in vigorous physical activity. Health and physical educators can utilize these findings to better understand that physical activity, trying to balance diet and activities.

Background and Study Aim. Hammer throwing is the most complex athletic throwing discipline with rotational trajectory and strong effect of several different forces that try to disable the projected throwing trajectory. Kinematic parameters are an important segment in the analysis of athletic disciplines, including hammer throw. They are an indicator of influence and often a difference between competitors of different or the same rank of the competition. The aim of the study was to determine the spatial and temporal differences of kinematic parameters between male and female elite hammers. Material and Methods. The study was conducted on sample of 16 Daegu World Championship finalists in 2011, to analyse differences in kinematic parameters between male and female throwers hammer. To obtain the required results, t-test for small independent samples was applied. Results. The data obtained in the study were given as Mean and Standard deviation. Statistically significant differences between male and female finalists were confirmed in the rate of ejection (t=3.684; p<0.004) and the speed of the fourth turn (t=4.396; p<0.002). The male finalists achieved an average ejection velocity of 27.91m/s and the female finalists 27.17m/s, with an average turn speed of 4.67m/s (male) and 4.03m/s (female). Conclusions. The research has shown that significant differences were made between male and female finalists in Daegu in 2011. The causes of differences can be found in length of training, different training process, technical mastery, competitor experience, morphological profile, motor and anatomical structures, movement technique and biomechanical parameters, which were not taken into the research.

Exponentially-growing next-generation sequencing data requires high-performance tools and algorithms. Nevertheless, the implementation of high-performance computational genomics software is inaccessible to many scientists because it requires extensive knowledge of low-level software optimization techniques, forcing scientists to resort to high-level software alternatives that are less efficient. Here, we introduce Seq—a Python-based optimization framework that combines the power and usability of high-level languages like Python with the performance of low-level languages like C or C++. Seq allows for shorter, simpler code, is readily usable by a novice programmer, and obtains significant performance improvements over existing languages and frameworks. We showcase and evaluate Seq by implementing seven standard, widely-used applications from all stages of the genomics analysis pipeline, including genome index construction, finding maximal exact matches, long-read alignment and haplotype phasing, and demonstrate its implementations are up to an order of magnitude faster than existing hand-optimized implementations, with just a fraction of the code. By enabling researchers of all backgrounds to easily implement high-performance analysis tools, Seq further opens the door to the democratization and scalability of computational genomics.