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According to the 2018 Fourth Universal Definition of Myocardial Infarction (UDMI), acute myocardial injury is represented by an acute rise and/or fall in cTn values, with at least 1 cTn value above the assay's 99th percentile upper reference limit (URL) (3). [...]the 99th percentile URLs for cTn assays are, by convention, derived from normal reference populations (4), but there is no consensus regarding the most appropriate inclusion and exclusion criteria to define the normal reference population, nor is there consensus regarding statistical methodology. Preliminary evidence supports, for example, a machine learning approach using age, sex, and paired hs-cTn values as superior to a standard 0/3-hour hs-cTn protocol using the 99th percentile URL (12). [...]strategies are validated and operationalized, the most sensible solution to the conundrum surrounding the 99th percentile URL for hs-cTn assays may be to de-emphasize the importance of rigid hs-cTn cutoffs in clinical decision-making while placing more emphasis on appropriate strategies for MI ruleout and on serial cTn changes for acute MI diagnosis. [...]we believe that the implications of their study go even further, raising questions as to whether even a carefully determined 99th percentile URL can be considered reliable.

Un examen des citations de Job chez des auteurs Syriens ayant vécu entre le IVe et le IXe siècle prouve qu'elles proviennent essentiellement de la Pešiṭta. Dans une vaste aire culturelle caractérisée par le bilinguisme, la Septante ne fut qu'un outil d'exégèse dans les écoles de théologie et resta dans l'ombre de la Pešiṭta, laquelle se montre ainsi avoir été le texte biblique de référence. An examination of the quotations of Job among the Syrian writers of between the IVth and IXth Centuries gives evidence that those quotations come globally from the Pešiṭta. In a large cultural area characterised by bilinguism, the Septuagint has only been a tool for exegesis in theological schools; it remained in the shadow of the Pešiṭta, which thus appears to have been the biblical text of reference.

Many First Nations homes lack adequate water and sanitation services. One way to address these conditions is to develop effective public engagement strategies. Thus, in this qualitative interview study, we explored how 22 non-Indigenous Canadians from one city interpreted this issue and their interest in it. We analyzed the transcribed data using thematic coding and constant comparison. Though most participants were aware of the issue and expressed sadness or anger, understandings were relatively shallow and rarely translated into active involvement. Barriers to engagement included racism and a lack of resources, capacity, and personal responsibility. Based on these findings and social psychological literature on social action, we provide recommendations for public advocacy strategies to engage non-Indigenous Canadians on the issue.

New methodologies are required to probe the sensitivity of parameters describing cloud droplet activation. This paper presents an inverse modeling-based method for exploring cloud-aerosol interactions via response surfaces. The objective function, containing the difference between the measured and model predicted cloud droplet size distribution is studied in a two-dimensional framework, and presented for pseudo-adiabatic cloud parcel model parameters that are pair-wise selected. From this response surface analysis it is shown that the susceptibility of cloud droplet size distribution to variations in different aerosol physiochemical parameters is highly dependent on the aerosol environment and meteorological conditions. In general the cloud droplet size distribution is most susceptible to changes in the updraft velocity. A shift towards an increase in the importance of chemistry for the cloud nucleating ability of particles is shown to exist somewhere between marine average and rural continental aerosol regimes. We also use these response surfaces to explore the feasibility of inverse modeling to determine cloud-aerosol interactions. It is shown that the \"cloud-aerosol\" inverse problem is particularly difficult to solve due to significant parameter interaction, presence of multiple regions of attraction, numerous local optima, and considerable parameter insensitivity. The identifiability of the model parameters will be dependent on the choice of the objective function. Sensitivity analysis is performed to investigate the location of the information content within the calibration data to confirm that our choice of objective function maximizes information retrieval from the cloud droplet size distribution. Cloud parcel models that employ a moving-centre based calculation of the cloud droplet size distribution pose additional difficulties when applying automatic search algorithms for studying cloud-aerosol interactions. To aid future studies, an increased resolution of the region of the size spectrum associated with droplet activation within cloud parcel models, or further development of fixed-sectional cloud models would be beneficial. Despite these improvements, it is demonstrated that powerful search algorithms remain necessary to efficiently explore the parameter space and successfully solve the cloud-aerosol inverse problem.

Indian cities are definitely growing at a blinding pace. The population and traffic in cities are spiralling and the infrastructure is not able to cope up with the demand. All said and done, ‘True India’ still resides in the lap of Indian villages. The flavours, the colours, the vibrancy, the rich variety, the innocence that the Indian villages offer is truly breathtaking. This is true even for the issues in rural transport and road safety, where photos will depict the contraptions for transport that Villages in India have got to offer. The issue of rural transport safety has been simmering for quite some time. Until now safety issues in the transport sector have overwhelmingly concentrated on roads, highways and motorised traffic. We are advocating for more attention to rural transport safety issues, beyond roads; particularly in relation to public transport and gender. The geographical and economic isolation of rural communities is often exacerbated by a lack of political commitment to local mobility issues. As for many developing countries, rural road development has proven insufficient, often because little attention is paid to rural transport services. Enforcing the laws through stricter regulations, would mean that poor people would be marginalised and isolated even more as they would no longer be able to use the public transport or would have to pay fines, or even bribes. The photo study looks to highlight these issues to improve safety for poor people while still ensuring their access to critical lifelines and market opportunities. We will touch on issues of road safety, personal/commuter safety, pedestrian safety, road conditions, transport services, modes of transport, road rage, injuries in accidents, deaths, etc. We are interested to explore these themes and this opportunity will help to make these important issues more visible for policy and decision-makers.

Self-directed violence is deliberate self-injury, self-abuse or suicidal behaviour including attempted or completed suicides. Fabricated, fictitious, forged or invented wounds may be self-inflicted or self-suffered. Such injury is a major problem of forensic experts. Minimal of literature is available pertaining to the study of the fabricated injuries and specifically, no authentic criterion is laid down to label, which injury should be declared as fabricated. Self-directed violence has a large number of underlying causes. Apart from demographic factors like age and sex; psychiatric, biological, social and environmental factors are important apart from the factors related to individuals life history. The overall suicide rate was 28.9 per 100 000 population; the highest burden was among men (89%). The age group 21–30 years was most prone to suicide, accounting for 46% suicidal deaths. Most people died through self-poisoning (64%), hanging (25%) or self-immolation (10%). A significant group of injuries hitherto unaccounted, were fabricated injuries where the intentional was some ultimate gain or harm to others. The cultural epidemiology of deliberate self-harm, it is argued, is critical to planning for suicide and injury prevention and promotion of safety. The present study was designed to investigate the different methods of self-destruction, age and gender susceptibility to suicide, the groups particularly affected and the underlying motivating factors for such an extreme step among north Indian people. Various suggestions relating to decreasing the tensions of modern life, proper use and storage of agrochemicals and financial improvement of farmers have been put forward.

The survival of clinical isolates of H pylori at two cultural ages (two and four days) at pH 2, in the presence of different buffers, with and without urea, was investigated. It was found that the morphological changes which occur with longer incubation of H pylori have an inverse correlation with its resistance to an acidic environment. The finding that the addition of urea almost reversed this phenomenon and prolonged survival of the cultures emphasises the role of urea in the survival of H pylori in acidic environments.