The utility of SYNTAX score predictability by electrocardiogram parameters in patients with unstable angina

Background SYNTAX score is one of the risk assessment systems to predict cardiac events in acute coronary syndrome patients. Despite the large number of SYNTAX score benefits, invasive methods such as coronary angiography are necessary to perform the scoring. We hypothesized that ECG parameters could predict the SYNTAX score in unstable angina patients. Methods During the retrospective cohort study, a total number of 876 patients were diagnosed with unstable angina. After applying the exclusion criteria, 600 patients were divided into tertiles based on the SYNTAX scores as low (0–22), intermediate (23–32), and high (≥ 33). The association between ECG parameters and SYNTAX score was investigated. Results The study included 65% men and 35% women with a mean age of 62.4 ± 9.97 years. The delayed transition zone of QRS complex, ST-depression in inferior-lateral territories or/and in all three territories, and T-wave inversion in lateral territory were significant (p < 0.05) independent predictors of intermediate SYNTAX score. High SYNTAX score was predicted by the presence of prolonged P wave duration, ST-depression in lateral territory or/and anterior-lateral territories, ST-elevation in aVR–III leads or/and aVR–III–V1 leads. Among those, all three territories ST-depression (AUC: 0.611, sensitivity: 75%, specificity: 51%) and aVR + III ST-elevation (AUC: 0.672, sensitivity: 50.12%, specificity: 80.50%) were the most accurate parameters to predict intermediate and high SYNTAX scores, respectively. Conclusion The present study demonstrates that accompanying the STE in the right side leads (aVR, III, V1) with ST-depression in other leads indicates the patients with high SYNTAX score; meanwhile, diffuse ST-depression without ST-elevation is a marker for intermediate SYNTAX score in unstable angina patients and can be applied for early risk stratification and intervention.

COHERENCE OF PUBLIC POLICIES IN POLAND IN THE PERSPECTIVE OF THE PROCESS ON REACHING COMPLETED ADULTHOOD

The issue of transition into adulthood, treated as a complex, multi-dimensional and multi-stage social process, is not explicitly an object of interest to public policies, including social policy. The context of the life course policy mentioned in the analyzes is justified by the institutionalization of tasks related to functioning in society typical of completed adulthood: completing education, taking up employment, setting up your own household and family. The so-called delayed transition into adulthood means an increasingly later implementation of these tasks. The barriers to reaching completed adulthood discussed in the article mean that this process becomes a social problem that should be prevented by public activities. The article synthetically summarizes the results of the research “Public policies for full adulthood in Poland” (National Science Center No. 2014/15/B/HS5/03284). The aim of the considerations is to indicate the level of coherence and coordination in the creation and implementation of political and institutional instruments that would support young adult Poles in the process of reaching full adulthood in the above-mentioned dimensions. The conclusions from the research prove the need to separate the transition to adulthood regime in Polish social policy (public policies).

A Notch-dependent transcriptional mechanism controls expression of temporal patterning factors in Drosophila medulla

Temporal patterning is an important mechanism for generating a great diversity of neuron subtypes from a seemingly homogenous progenitor pool in both vertebrates and invertebrates. Drosophila neuroblasts have been shown to be temporally patterned by sequentially expressed Temporal Transcription Factors (TTFs). These TTFs are proposed to form a transcriptional cascade based on mutant phenotypes, although direct transcriptional regulation between TTFs has not been verified in most cases. Furthermore, it is not known how the temporal transitions are coupled with generation of the appropriate number of neurons at each stage. We use neuroblasts of the Drosophila optic lobe medulla to address these questions, and show that the expression of TTFs Sloppy-paired 1/ 2 (Slp1/2) is regulated at transcriptional level directly by two other TTFs and the cell-cycle dependent Notch signaling through two cis-regulatory elements. We also show that supplying transcriptional active Notch can rescue the delayed transition into the Slp stage in cell cycle arrested neuroblasts. Our findings reveal how an interplay between temporal patterning, the neuroblast cell cycle and key signaling pathways such as Notch achieves precise regulation of patterning transcription factor gene expression that is characteristic of these programs.

Influence of Shear-Thinning Blood Rheology on the Laminar-Turbulent Transition over a Backward Facing Step

Cardiovascular diseases are the leading cause of death globally and there is an unmet need for effective, safer blood-contacting devices, including valves, stents and artificial hearts. In these, recirculation regions promote thrombosis, triggering mechanical failure, neurological dysfunction and infarctions. Transitional flow over a backward facing step is an idealised model of these flow conditions; the aim was to understand the impact of non-Newtonian blood rheology on modelling this flow. Flow simulations of shear-thinning and Newtonian fluids were compared for Reynolds numbers ( R e ) covering the comprehensive range of laminar, transitional and turbulent flow for the first time. Both unsteady Reynolds Averaged Navier–Stokes ( k − ω SST) and Smagorinsky Large Eddy Simulations (LES) were assessed; only LES correctly predicted trends in the recirculation zone length for all R e . Turbulent-transition was assessed by several criteria, revealing a complex picture. Instantaneous turbulent parameters, such as velocity, indicated delayed transition: R e = 1600 versus R e = 2000, for Newtonian and shear-thinning transitions, respectively. Conversely, when using a Re defined on spatially averaged viscosity, the shear-thinning model transitioned below the Newtonian. However, recirculation zone length, a mean flow parameter, did not indicate any difference in the transitional Re between the two. This work shows a shear-thinning rheology can explain the delayed transition for whole blood seen in published experimental data, but this delay is not the full story. The results show that, to accurately model transitional blood flow, and so enable the design of advanced cardiovascular devices, it is essential to incorporate the shear-thinning rheology, and to explicitly model the turbulent eddies.

The Serbian economy ten years after the global economic crisis

The global financial crisis hit the Serbian economy severely in late 2008. The subsequent decade has been characterized by negative or very modest economic growth and Serbia is now just slightly above the development level of ten years ago. This paper analyses the most important economic milestones during this decade and investigates why only modest progress has been made, despite various measures implemented by the Serbian government. It examines the background to Serbia?s delayed transition and analyses the effects of the global economic crisis on the Serbian economy. It outlines the policy responses and their results, focusing on public finance, foreign trade, reindustrialisation, FDI, the labour market, and sources of growth. The paper sets out the key challenges to accelerating Serbia?s economic growth and identifies the main elements of a new long-term development strategy.

DEATH AND CAPITAL

In a life-cycle model with dynastic households, parents value the transfer of tangible assets to their offspring in the event of premature death. This raises the subjective reward from investing in them relative to intangible human capital and tilts investment choice away from the latter. These effects of mortality on human capital risk and relative investment can translate into divergent growth paths, delayed transition from physical to human capital accumulation, and a dampened response to mortality shock in developing countries.