Features of secondary prevention in young STEMI patients

Among patients who underwent a myocardial infarction (MI), one in five patients has a second cardiovascular event (MI, acute cerebrovascular accident, arrhythmias, etc.) during the first year, even with optimal treatment and care. Young patients often do not take the prescribed treatment or do not take it for a long time after discharge from the hospital. The issue of secondary prevention among the population is well studied, while in the literature such data for young people are lacking. Methods The data of 160 STEMI young patients (18–46 years) who admitted and treated in the intensive care unit were evaluated. We studied the effect of the main groups of medicines on the course of AMI in young patients. The remote observation lasted 5 years after discharge from the hospital. The following cardiovascular events during 1 (365 days), 2 (730 days), 3 (1095 days), and 5 years (1800 days) of the FU were used as the endpoint: death from any cause, combined endpoint (cardiovascular death, myocardial infarction, stroke, revascularization (CABG, stenting). Results It was noted that taking one of the antithrombotic drugs (clopidogrel or ticagrelor) in young patients, after 2, 3, and 5 years of follow-up, significantly affected the development of the combined endpoint, reducing the number of events (p=0.013, p=0.004 and p=0.048, respectively). Statins had a better effect on the number of combined endpoints (reduced their number) in young patients during 2-year and 3-year follow-up (p=0.041) and (p=0.034), respectively. In young patients, ACEI or ARB tended to influence the development of a combined endpoint at 2, 3, and 5 years of follow-up (p=0.061, p=0.080, and p=0.067, respectively). In our study, we found that taking aspirin at a dose of 75–100 mg tends to reduce the development of death from any cause (p=0.054) within 5 years (1800 days) from discharge. Patients under 45 years after undergoing AMI were significantly less likely to take the minimum necessary medication, like aspirin, and statins than older patients (45–65 years) (24.2% vs. 42%, p<0.001, respectively). Conclusion Young patients after AMI for secondary prevention must take an antithrombotic drug (clopidogrel or ticagrelor), statins, and an ACEI or ARB. In order to increase compliance, it is recommended to take a combination drug. FUNDunding Acknowledgement Type of funding sources: None.

Developing a Digital Solution for Remote Assessment in Multiple Sclerosis: From Concept to Software as a Medical Device

There is increasing interest in the development and deployment of digital solutions to improve patient care and facilitate monitoring in medical practice, e.g., by remote observation of disease symptoms in the patients’ home environment. Digital health solutions today range from non-regulated wellness applications and research-grade exploratory instruments to regulated software as a medical device (SaMD). This paper discusses the considerations and complexities in developing innovative, effective, and validated SaMD for multiple sclerosis (MS). The development of SaMD requires a formalised approach (design control), inclusive of technical verification and analytical validation to ensure reliability. SaMD must be clinically evaluated, characterised for benefit and risk, and must conform to regulatory requirements associated with device classification. Cybersecurity and data privacy are also critical. Careful consideration of patient and provider needs throughout the design and testing process help developers overcome challenges of adoption in medical practice. Here, we explore the development pathway for SaMD in MS, leveraging experiences from the development of Floodlight™ MS, a continually evolving bundled solution of SaMD for remote functional assessment of MS. The development process will be charted while reflecting on common challenges in the digital space, with a view to providing insights for future developers.

Olivine-rich achondrites from Vesta and the missing mantle problem

Mantles of rocky planets are dominantly composed of olivine and its high-pressure polymorphs, according to seismic data of Earth’s interior, the mineralogy of natural samples, and modelling results. The missing mantle problem represents the paucity of olivine-rich material among meteorite samples and remote observation of asteroids, given how common differentiated planetesimals were in the early Solar System. Here we report the discovery of new olivine-rich meteorites that have asteroidal origins and are related to V-type asteroids or vestoids. Northwest Africa 12217, 12319, and 12562 are dunites and lherzolite cumulates that have siderophile element abundances consistent with origins on highly differentiated asteroidal bodies that experienced core formation, and with trace element and oxygen and chromium isotopic compositions associated with the howardite-eucrite-diogenite meteorites. These meteorites represent a step towards the end of the shortage of olivine-rich material, allowing for full examination of differentiation processes acting on planetesimals in the earliest epoch of the Solar System.

ON THE RESULTS OF REMOTE OBSERVATION OF PULSED ULTRA-LOW-FREQUENCY ELECTROMAGNETIC SIGNALS DETECTABLE MINUTES BEFORE AN EARTHQUAKE

Based on longterm observations at the latitudinally and longitudinally remote Borok and College geophysical observatories, the characteristics of electromagnetic ultralowfrequency (ULF) signals, detectable several minutes before a remote seismic event, are being analyzed. The diurnal and seasonal patterns in the frequency of these precursors’ occurrence at observatories, and their spatial distribution over the Earth’s surface, are investigated in this article. In the daily distribution, two maxima are distinguishable in the local evening and morning hours. In the seasonal course, there is a maximum in the spring period and an increase in the winter months. In the spatial distribution, the unevenness of the location of sources across the globe is noted; those are grouped into separate zones and segments, reflecting seismoelectromagnetic activity across specific regions. Examples are given to illustrate the appearance of precursors. It is noted that the dynamic spectra of signals from earthquakes occurring in different regions of the Earth were similar, repeated at different magnitudes and depths of the source, and were observed in the same time interval relative to the moment of the earthquake. The results of the analysis justify an assumption of the universality of the patterns governing the generation of impulse precursors preceding an earthquake, as well as the possibility of shortterm warning (within a few minutes) of an approaching earthquake.

Aqueous chemistry in the clouds of Venus

<p>Droplet chemistry in the clouds of Venus may play a role in regulating the depletion of sulfur dioxide and water vapor in and above the clouds. The specific nature of this chemistry is unknown. In this talk, I present three different scenarios for aqueous chemistry in the cloud droplets:</p><ul><li>Hydroxide salts</li> <li>Reduced sulfites</li> <li>Iron sulfates</li> </ul><p>I will discuss the effects of these three different aqueous chemistries, some of which may be accessible via remote observation. The iron sulfate chemistry in particular provides a candidate for the unknown UV absorber.</p>

Medical telepatronage as a health-saving technology in the management of patients with chronic non-communicable diseases

he article reviews the definition of medical telepatronage, its tasks, functions, efficiency and perspectives of implementation into the clinical practice. The main goals of telepatronage are therapeutic and preventive measures based on the remote interaction of health care practioner with a patient. Telepatronage includes remote observation of the patient, self-monitoring of the disease and prescrtiptions, patient motivation and education on the digital Web 2.0 platform, and the creation of a remote coordination center. The authors present their own experience in remote monitoring of patients with rheumatic diseases, which is planned to be expanded to create a medical telepatronage system.