Search

The prognostic implications of phenotypes along the preshock to cardiogenic shock (CS) continuum remain uncertain.

Carbon dioxide removal (CDR) is necessary for reaching net zero emissions, with studies showing potential deployment at multi-GtCO2scale by 2050. However, excessive reliance on future CDR entails serious risks, including delayed emissions cuts, lock-in of fossil infrastructure, and threats to sustainability from increased resource competition. This study highlights an alternative pathway─prioritizing near-term non-CDR mitigation and minimizing CDR dependence. We impose a 1 GtCO2limit on global novel CDR deployment by 2050, forcing aggressive early emissions reductions compared to 8–22 GtCO2in higher CDR scenarios. Our results reveal that this low CDR pathway significantly decreases fossil fuel use, greenhouse gas (GHG) emissions, and air pollutants compared to higher CDR pathways. Driving rapid energy transitions eases pressures on land (including food cropland), water, and fertilizer resources required for energy and negative emissions. However, these sustainability gains come with higher mitigation costs from greater near-term low/zero-carbon technology deployment for decarbonization. Overall, this work provides strong evidence for maximizing non-CDR strategies such as renewables, electrification, carbon neutral/negative fuels, and efficiency now rather than betting on uncertain future CDR scaling. Ambitious near-term mitigation in this decade is essential to prevent lock-in and offer the best chance of successful deep decarbonization. Our constrained CDR scenario offers a robust pathway to achieving net zero emissions with limited sustainability impacts.

Graphical Abstract

Graphical Abstract

The appropriate use of pulmonary artery catheters (PACs) in critically ill cardiac patients remains debated.

Byline: DAVID KAMINSKI-MORROW Airframer will maintain low output for the foreseeable future as it moves to axe 15,000 jobs Airbus is not expecting to make substantial adjustments to its production [...]

Byline: DAVID KAMINSKI-MORROW Irkut has provided few details after an MC-21 prototype experienced an issue relating to its landing-gear during a 3 October test flight. The company's third flight-test airframe, [...]

Byline: Court ends XL Airways' turbulent story French carrier liquidated as rescue bids fail to materialise, ending uncertainty following late September flight suspension Last-ditch attempts to save XL Airways France [...]

Byline: DAVID KAMINSKI-MORROW Severe impact at Chennai not recorded in technical log and later uncovered by routine inspection, Indian inquiry finds Indian investigators have revealed that an Air India Airbus [...]

Byline: CAA brings Operation Matterhorn to conclusion Final flights for the Thomas Cook Group repatriation programme were completed on 7 October, 14 days after the leisure firm collapsed. The last [...]

Byline: DAVID KAMINSKI-MORROW Bankruptcy proceedings have begun against loss-making airline after it had to cease operating at end of last month Slovenian flag carrier Adria Airways' latest full-year figures have [...]

Byline: DAVID KAMINSKI-MORROW Inquiry voices 'long-standing concern' over deliberate departures from landing procedure after May 2017 tragedy US investigators probing a fatal landing accident involving a Shorts 330 freighter have [...]

Byline: DAVID KAMINSKI-MORROW Stage-one rotors on PW1500G low-pressure compressors broke as two London-bound A220s climbed to cruise altitude Operators of Airbus A220s are being instructed to conduct checks of the [...]

Background:The Society for Cardiovascular Angiography and Intervention (SCAI) Shock Classification can define shock severity. We evaluated the vasoactive-inotropic score (VIS) combined with the SCAI Shock Classification for mortality risk stratification. Methods:This was a single-center retrospective cohort analysis including Mayo Clinic cardiac intensive care unit patients from 2007 to 2015. The peak VIS was calculated at 1 and 24 h after cardiac intensive care unit admission. In-hospital mortality was evaluated using multivariable logistic regression. Results:Of 9,916 included patients, vasoactive drugs were used in 875 (8.8%) within 1 h and 2,196 (22.1%) within 24 h. A total of 888 patients (9.0%) died during hospitalization. Patients who required vasoactive drugs within 1 h had higher in-hospital mortality (adjusted odds ratio [OR], 1.30; 95% confidence interval [CI], 1.03–1.65; P= 0.03) and in-hospital mortality rose with the VIS during the first 1 h (adjusted OR per 10 units, 1.22; 95% CI, 1.12–1.33; P< 0.001). The increase in VIS from 1 to 24 h was associated with higher in-hospital mortality (adjusted OR per 10 units, 1.16; 95% CI, 1.10–1.21; P< 0.001). These results were consistent in the 1,067 patients (10.9%) with cardiogenic shock. A gradient of in-hospital mortality was observed according to the VIS at 1 h and the increase in VIS from 1 to 24 h. Conclusions:Higher vasoactive drug requirements portend a higher risk of mortality, particularly a high VIS early after admission. The VIS provides incremental prognostic information beyond the SCAI Shock Classification, emphasizing the continuum of risk that exists across the spectrum of shock severity.

IMPORTANCE: Dapagliflozin reduces the risk of hospitalizations for heart failure and the progression of chronic kidney disease in patients with and without type 2 diabetes (T2D), whereas the effects on reducing atherosclerotic events appear less clear. OBJECTIVE: To explore whether N-terminal pro–B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hsTnT) levels can identify a subset of patients with T2D at higher risk and who might benefit more from dapagliflozin with regard to atherosclerotic events. DESIGN, SETTING, AND PARTICIPANTS: This was a secondary analysis of the DECLARE-TIMI 58 trial, a randomized clinical trial of dapagliflozin in patients with T2D and either multiple risk factors for atherosclerotic cardiovascular disease (ASCVD; approximately 60%) or established ASCVD (approximately 40%). All patients with available blood samples at randomization were included in these analyses. Data were collected from May 2013 to September 2018, and data were analyzed from May 2019 to June 2022. INTERVENTIONS: Dapagliflozin vs placebo. MAIN OUTCOMES AND MEASURES: Major adverse cardiovascular events (MACE), the composite of myocardial infarction, ischemic stroke, or cardiovascular death, which was one of dual primary outcomes of the main trial. RESULTS: Of 14 565 included patients, 9143 (62.8%) were male, and the mean (SD) age was 63.9 (6.8) years. When tested individually in a multivariable model for MACE risk, NT-proBNP and hsTnT were each significantly associated with the risk of MACE (adjusted hazard ratio [aHR] per 1 SD in log-transformed biomarker: NT-proBNP, 1.62; 95% CI, 1.49-1.76; hsTnT: 1.59; 95% CI, 1.46-1.74). The magnitude of the association was similar in patients with ASCVD (NT-proBNP: aHR, 1.60; 95% CI, 1.45-1.77; hsTnT: aHR, 1.62; 95% CI, 1.45-1.81) and multiple risk factors for ASCVD (NT-proBNP: aHR, 1.62; 95% CI, 1.40-1.88; hsTnT: aHR, 1.51; 95% CI, 1.29-1.77). Moreover, both biomarkers remained independently associated with MACE when both were included in the multivariable model (NT-proBNP: aHR, 1.46; 95% CI, 1.34-1.60; hsTnT: aHR, 1.39; 95% CI, 1.26-1.53). Modeled as a continuous variable, baseline biomarker levels did not modify the relative treatment effect of dapagliflozin vs placebo with MACE. However, the relative risk reduction numerically grew with higher biomarker levels, as did the baseline risk. Thus, MACE event rates were nominally lower in dapagliflozin-treated vs placebo-treated patients with biomarker concentrations in the top quartile (NT-proBNP: HR, 0.83; 95% CI, 0.71-0.97; absolute risk reduction [ARR], 2.4%; hsTnT: HR, 0.85; 95% CI, 0.72-0.99; ARR, 2.7%), whereas there was no significant treatment effect in patients with biomarkers levels in quartiles 1 to 3 (NT-proBNP: HR, 1.02; 95% CI, 0.88-1.18; ARR, 0%; hsTnT: HR, 0.97; 95% CI, 0.84-1.13; ARR, 0.2%). CONCLUSIONS AND RELEVANCE: In this study, NT-proBNP and hsTnT levels were associated with the risk for future cardiovascular events in both primary and secondary prevention patients with T2D. Both cardiac biomarkers were helpful to identify patients at very high risk for atherosclerotic events that may derive reduction in risk of MACE with dapagliflozin. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01730534

Byline: airlinedavid kaminski-morrow london N/A Qatar Airways Group has turned in a huge full-year operating loss, exceeding $500 million, exacerbated by a heavy share of losses at its Air Italy [...]

Byline: developmentdavid kaminski-morrow london N/A Russian airframer Irkut is to install a high-density seating layout in its fourth flight-test MC-21-300 aircraft. Irkut says the all-economy cabin of aircraft 004 will [...]

Byline: analysisdavid kaminski-morrow london N/A Airbus is likely to take A320-family deliveries into five figures around the first quarter of 2021, after it handed over its 9,000th example to UK [...]

Byline: inquiryDavid Kaminski-Morrow london Global Air 737-200 stalled seconds after take-off as weight and balance miscalculations contributed to control issues Cuban investigators have detailed the gross errors in weight and [...]

Byline: orderdavid kaminski-morrow london Swiss business aviation services company Comlux has ordered another Airbus ACJ320neo, taking its orders for the re-engined narrowbody to four. The aircraft will be outfitted by [...]

Byline: SALEDAVID KAMINSKI-MORROW loNDON Scandinavian carrier Braathens Regional Airways is to put its entire BAE Systems Avro RJ fleet up for sale ahead of a replacement programme. The 10 aircraft [...]

Byline: commitmentsDavid Kaminski-Morrowlondon Long-haul budget carrier AirAsia X is ordering another 12 Airbus A330-900s, adding to the 66 it has already booked. It is also taking 30 of the newly-launched [...]

Byline: investigationDAVID KAMINSKI-MORROW london Narrowbody's fuselage damaged by runway impact as captain attempted go-around Investigators believe a Korean Air Boeing 737-900 suffered a tail-strike at Osaka's Kansai airport on 9 [...]

Byline: inspectionDAVID KAMINSKI-MORROWlondon Operators of Airbus A380s with Engine Alliance powerplants are being instructed to conduct independent inspections for damage during disassembly of the engine fan hub blade lock. The [...]

Byline: technologyDavid Kaminski-Morrow london Swedish battery-powered regional project receives interest from BRA, SAS and Wideroe Scandinavian operators BRA, SAS and Wideroe have shown tentative interest in an electric regional aircraft [...]

Byline: acquisitionDavid Kaminski-Morrow london Quebec judges rule Group Mach attempt to prevent deal is 'contrary to public interest' Canadian financial judges have intervened to block real estate firm Group Mach [...]

Byline: financialDavid Kaminski-Morrowlondon Tour operator TUI Group is expecting a [euro]300 million ($335 million) impact on full-year financial results as a consequence of the continuing suspension of Boeing 737 Max [...]

Byline: safetydavid kaminski-morrow london Russian investigators find several instances of abnormal propeller pitch movement on Khabarovsk Airlines turboprops The inquiry into the fatal crash of an Aircraft Industries Let L-410 [...]

Byline: resultsDavid Kaminski-Morrow london Widebody deliveries stabilise as engine supply issues are resolved, but single-aisle production remains problematic Airbus is confident that it has overcome the powerplant supply issues that [...]

Byline: programmeDavid Kaminski-Morrow london Position under new ownership indicates marketing strategy has worked, as sales show healthy rise post acquisition Airbus has potentially increased total A220 orders by more than [...]

Byline: manufacturingDavid Kaminski-Morrow london Russian state corporation Rostec's Technodinamika division is to produce wheels for the Irkut MC-21 twinjet under the country's import substitution strategy. Technodinamika's Kamensk-Uralsky Foundry is currently [...]

Byline: strategyDavid Kaminski-Morrow london German flag carrier Lufthansa is to use its increased fleet of Airbus A380s at Munich to operate services to Boston and San Francisco. The airline disclosed [...]

Byline: interiorDavid Kaminski-Morrowlondon Airbus is hinting strongly that a 10-abreast seating configuration for the A350 is a reasonable option to increase accommodation on the twinjet type. Chief commercial officer Christian [...]

Byline: safetyDavid Kaminski-Morrow london European Cockpit Association queries regulatory framework covering approval process European pilot representatives have expressed alarm at the direction of discussions aimed at returning the Boeing 737 [...]

Byline: strategydavid Kaminski-Morrow toulouse Threat from Boeing's proposed New Mid-market Airplane will be met through capital cost flexibility of mature products Airbus has indicated that leeway on pricing is a [...]

Byline: ResearchDavid Kaminski-morrow Toulouse Airport systems, renewable energy supply focal points of analyses, which will feature input from Nordic universities Scandinavian carrier SAS has signed a preliminary agreement with Airbus [...]

Byline: incidentDavid Kaminski-Morrow london Confused instructions to Eva Air flightcrew departing from Los Angeles placed twinjet within 0.3nm of high terrain Pilots received 'pull up' order lasting for 7s AirTeamImages [...]

Byline: air showdavid kaminski-morrow london Weekend programme axed from 2020 event as organiser focuses on trade exhibition and driving industry interest Organisers of the UK's Farnborough air show are axing [...]

Byline: employmentdavid kaminski-morrow london Manufacturer says its twinjet programmes could provide internal transfer oppo r tunities after cancelling superjumbo Airbus has commenced discussions on personnel restructuring following its decision to [...]

Byline: trialdavid kaminski-morrow london Long-range narrowbody variant can complement Scandinavian carrier's twin-aisle operation, indicates chief executive Scandinavia's SAS has outlined the strategic options for deploying its new long-range Airbus A321LRs, [...]

Byline: researchDavid Kaminski-Morrow loNDON Study reports similar impacts from 10h or shorter duties and recommends strategies going beyond scheduling Prescriptive flight-duty limits are not sufficient, by themselves, to prevent the [...]

Byline: marketingdavid kaminski-morrow london While British Airways predecessor BEA's aircraft featured distinctive all-red wing surfaces, technical considerations have prevented the same colour scheme being applied to the flag carrier's retro-livery [...]