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Background: Rates and predictors of major bleeding in patients with peripheral artery disease (PAD) treated with antiplatelets have not been well studied. This post hoc analysis of EUCLID aimed to determine the incidence of major/minor bleeding, predictors of major bleeding, and risk of major adverse cardiovascular events (MACE) following major bleeding events.Methods: EUCLID, a multicenter randomized controlled trial of 13,885 patients with symptomatic PAD, compared ticagrelor with clopidogrel for the prevention of MACE. The primary safety end point was Thrombolysis in Myocardial Infarction (TIMI) major bleeding. Baseline characteristics were used to develop a multivariable model to determine factors associated with TIMI major bleeding. The occurrence and timing of MACE relative to a first major bleeding event were determined.Results: TIMI major bleeding occurred in 2.3% of participants overall (0.94 event/100 patient-years). There was no significant difference in major bleeding rates by treatment assignment. Factors associated with TIMI major bleeding included older age, geographic region, Rutherford class, and β-blocker use. Patients with TIMI major bleeding postrandomization had an increased risk of MACE (hazard ratio [HR] 4.46; 95% CI 3.40-5.84; P < .0001) compared with those without major bleeding; the association was strongest within 30 days after a bleeding event.Conclusions: In patients with symptomatic PAD, 0.94 major bleeding event/100 patient-years was observed and associated with older age, residing in North America, disease severity, and β-blocker use. Patients who had a major bleeding event were significantly more likely to experience MACE, especially within the first 30 days, when compared with patients who did not have major bleeding. [ABSTRACT FROM AUTHOR]

Assessment plays a crucial role in student learning in higher education. Until rather recently, the role of assessment in relation to inclusion has been unexplored. In this study, we conduct a research synthesis of 42 studies published between 2010 and 2022, including 868 student participants, to map the assessment experiences of students with disabilities in higher education. Specifically, we conduct a meta-ethnographic review to synthesise qualitative studies and capture the participants' lived experiences of assessment. Our analysis considers how these experiences reflect both inclusion and exclusion. We theorise these elusive terms through the ideas of access and participation. Most of the studies considered the students' imminent physical, perceptual and social access to assessment, such as in the cases of inaccessible examination halls or digital assessment systems. A smaller subset of the studies considered inclusion/exclusion as a matter of students' social participation as fully accepted members of academia. In these studies, assessment was described as providing the students with opportunities to belong to academia, whereas experiences of exclusion portrayed assessment as a mechanism for social segregation and discrimination. Overall, our review shows that assessment is a primary barrier to the inclusion of students with disabilities in higher education. We propose that the predominant discourse of inclusion in assessment needs to widen from considering immediate access to assessment into considering how assessment regulates the full participation of diverse students in higher education. We discuss the implications of inaccessible assessment for all students and suggest that, ultimately, both access and participation are matters of student identity. Our review has important practical implications for the design of inclusive assessment in the current higher education contexts in which student cohorts are becoming increasingly diverse. • We synthesise the assessment experiences of higher education students with disabilities. • 42 empirical, qualitative studies are analysed in our meta-ethnographic review. • The students largely reported experiences of exclusion in assessment. • We emphasise assessment not only as a matter of learning, but as a matter of inclusion. • In mass higher education, assessment must be designed with student diversity in mind. [ABSTRACT FROM AUTHOR]

Many survivors of COVID-19 experience persistent symptoms, continuing beyond three months from the onset of infection. In this study, authors investigate the effect of remdesivir on recovery and long-COVID-19 symptoms, as well as quality of life and other symptom outcomes, in the 1-year follow-up of a randomised trial.

In an effort to strengthen health care professionals' ability to anticipate and address multiple trauma patients' needs, this study aims to explore the experience of suffering from multiple trauma. This is a qualitative descriptive study. Nine interviews were analysed using content analysis. The study included patients who had been registered in the Swedish Intensive Care registry [SIR] due to suffering multiple trauma. The analysis revealed one theme, A detour in life, based on three sub-themes: (a) Feeling lost and not knowing what to expect, (b) Striving to get life back on track and (c) Dealing with 'dead ends' during rehabilitation. The theme showed that those who suffered multiple trauma did not know what to expect of their recovery and they expressed experiencing a lack of understanding and guidance from healthcare professionals. As it was important to focus on the present and find ways to move on in life, they sought for other ways to find direction in matters of rehabilitation and care. A shared understanding is essential in order to define a person's needs. By setting short-term goals and improving documentation, healthcare professionals across the trauma recovery continuum could more easily gain insight of their patients' needs and address them with supportive guidance. [ABSTRACT FROM AUTHOR]

Scedosporium species are fungal opportunistic pathogens frequently seen in chronic lung diseases such as in cystic fibrosis (CF). They can cause a wide spectrum of diseases mainly in immunodeficient patients. Invasive, disseminated infections with poor prognosis have been described after lung transplantation. We present a CF-patient with disseminated Scedosporium apiospermum infection after lung transplantation. The patient had skin, surgical wound, spinal cord, and brain involvements. She recovered fully after prolonged course of voriconazole treatment. [ABSTRACT FROM AUTHOR]

Highlights • Births before arrival are rare, and stressful for the ambulance nurses. • BBA arouses mixed feelings of fright and exhilaration among ambulance nurses. • Ambulance nurses need more education and scenario training about BBA. • The prehospital care environment imposes challenges regarding safety and security. Abstract Background Working as an ambulance nurse means interacting with and caring for acutely ill and injured patients. It can even involve births before arrival to the hospital (BBA), which are rare but increasing due to the centralization of maternity wards. Aim This study describes the experiences of specialist ambulance nurses with BBA. Method A qualitative study was conducted, and nine specialist ambulance nurses who had assisted with one or more prehospital births were interviewed. Data were analysed with thematic content analysis. Findings The analysis revealed three categories that were compiled into a theme of feeling fright and exhilaration. The findings showed that BBA causes feelings of anxiety and stress. The experience is also associated with joy and relief when the baby is born. Childbirth is a situation for which specialist ambulance nurses feel less prepared, lack of knowledge, and wish for more education. Conclusion Specialist ambulance nurses face challenges in the pre-hospital care environment during BBA, with long distances, a lack of equipment aboard the ambulance, and no assistance from midwives. To feel secure in the complex role that is required when assisting with a BBA, specialist ambulance nurses should be given the opportunity to receive scenario training. [ABSTRACT FROM AUTHOR]

Abstract Background The significant morbidity caused by COVID-19 necessitates further understanding of long-term recovery. Our aim was to evaluate long-term lung function, exercise capacity, and radiological findings in patients after critical COVID-19. Methods Patients who received treatment in ICU for COVID-19 between March 2020 and January 2021 underwent pulmonary function tests, a 6MWD and CXR 6 months after hospital discharge. Results A restrictive ventilatory defect was found in 35% (23/65) and an impaired diffusing capacity in 52% (32/62) at 6 months. The 6-minute walk distance was reduced in 33% (18/55), and 7% (4/55) of the patients had reduced exercise capacity. Chest X-ray was abnormal in 78% (52/67) at 6 months after hospital discharge. Conclusion A significant number of patients had persisting lung function impairment and radiological abnormalities at 6 months after critical COVID-19. Reduced exercise capacity was rare.

Performance of meso-scale numerical weather prediction model HARMONIE-AROME was assessed for a summer-time heatwave in a high-latitude coastal city of Turku in SW Finland. Representativeness of the model's ECOCLIMAP-SG based physiographic land cover specification with a resolution of 750 m was assessed against the 20 m resolution CORINE Land Cover (CLC) dataset. Moreover, the modelled 2 m air temperatures were compared with temperature observations recorded at 74 sites of the local climate observation network. Correlation analysis between the model's physiographic data (PGD) and CLC shows a statistically significant (p ≤ 0.01) match between the datasets in 76% of the land cover types, indicating mainly a good representativeness of the HARMONIE-AROME's land cover parameterization in the study area. The cases of mismatch are mostly related to the differences in ECOCLIMAP-SG and CLC classification principles and/or resolution, and thus can not be considered to indicate poor representativeness of the ECOCLIMAP-SG classification in the area. The HARMONIE-AROME modelled temperatures were on average slightly higher than the observed temperatures, and the difference was largest for daily minimum temperatures. Heterogeneity of land cover and topography inside a 750 m grid cell was related to larger difference between the modelled and observed temperature. • The T modelled by HARMONIE-AROME was accurate; only 0.8 °C warmer than the observed T. • The largest site-specific differences were 2.1 °C / 0.4 °C (same/opposite direction). • Diurnally, the difference between the modelled and observed T was largest at night. • ECOCLIMAP-SG reflects well the land cover (CLC) in the study area. • The best correspondence between ECOCLIMAP-SG and CLC was on natural uninhabited areas. [ABSTRACT FROM AUTHOR]

• Noise is an important image quality feature in computed tomography. • Deep learning can be used for noise mapping from clinical images. • Image quality control using clinical data instead of phantom scans is desirable. • Our model was trained with phantom data and tested with clinical data. • The developed tool allows objective and tissue-specific protocol optimization. This study aimed to develop a deep learning (DL) method for noise quantification for clinical chest computed tomography (CT) images without the need for repeated scanning or homogeneous tissue regions. A comprehensive phantom CT dataset (three dose levels, six reconstruction methods, amounting to 9240 slices) was acquired and used to train a convolutional neural network (CNN) to output an estimate of local image noise standard deviations (SD) from a single CT scan input. The CNN model consisting of seven convolutional layers was trained on the phantom image dataset representing a range of scan parameters and was tested with phantom images acquired in a variety of different scan conditions, as well as publicly available chest CT images to produce clinical noise SD maps. Noise SD maps predicted by the CNN agreed well with the ground truth both visually and numerically in the phantom dataset (errors of < 5 HU for most scan parameter combinations). In addition, the noise SD estimates obtained from clinical chest CT images were similar to running-average based reference estimates in areas without prominent tissue interfaces. Predicting local noise magnitudes without the need for repeated scans is feasible using DL. Our implementation trained with phantom data was successfully applied to open-source clinical data with heterogeneous tissue borders and textures. We suggest that automatic DL noise mapping from clinical patient images could be used as a tool for objective CT image quality estimation and protocol optimization. [ABSTRACT FROM AUTHOR]

The wearable industry is growing and diverse. However, despite the variety in device producers and served purposes, many wearables include biosensors that can measure health parameters, such as heart rate. This makes them potentially useful or even disruptive for healthcare; particularly, for its remote delivery mode that is referred to as telehealth. Wearables and consumer technologies can bring changes to the current value network of telehealth industry by creating new business roles and attracting new stakeholders. However, traditionally regulated telehealth industry may be reluctant to accept unregulated non-medical devices. Furthermore, apart from the potential impact of wearables, the future of the industry is affected by other factors, which need to be understood. This article analyzes a potential evolution of the telehealth value network. For that, we first identified the current trends in the evolution of telehealth technologies and products based on the quantitative analysis and review of three different types of literature – scientific publications, patents, and press releases. Furthermore, we discussed the actors that can drive the future telehealth industry by taking a key role in its value network. The study indicates that technologies and products brought by consumer companies will be used in telehealth for the self-management of chronic diseases and wellness. To facilitate the interaction of the previously separated unregulated consumer and regulated medical domains of telehealth, a new health data aggregation role may emerge and take a central position in the value network. While several candidates for this role can be identified, currently, none of them has the full required expertise. [ABSTRACT FROM AUTHOR]

The I tragedy i of art education was, for him, that while art educators have been eager to hold others accountable for their failed attempts to secure the position of art in American schools for good, the precariousness of their profession has never been entirely someone else's fault: art educators themselves are also to blame for their Sisyphean struggle for recognition. Drawing from Tyson [14] conceptualization of Agambenian educational thought, rather than asking what art educators ought to I learn i from the past, this approach asks art educators to I study i it. Our custom of not explicitly acknowledging, connecting to, and building upon the work of other art education scholars, particularly those from the more-than-recent-decade past, results in a fragmented, incoherent disciplinary knowledge base - a condition that ultimately may slow the deepening of our collective insight and deter substantive refinements to the field's evolving theories and practices of art teaching and learning. [Extracted from the article]

Abstract Background Substantial variation in health care costs for malignant pleural mesothelioma (MPM) has previously been identified. Materials and Methods We analyzed the changes in health care costs in MPM in Finland during 2002–2012. Finland has low‐threshold public health care and a mandatory Workers' Compensation scheme that covers all occupational‐related disease expenses. The costs include treatment costs for inpatients, hospice care, medication costs, rehabilitation costs, and travel costs. All costs are expressed in 2012 prices, adjusted using the consumer price index. Results A total of 907 MPM patients were included in the study. Mean duration of inpatient episodes increased 7% per year from 2002 to 2012, correlating with total costs (R2 = 0.861, p

Abstract Malignant pleural mesothelioma (MPM) has a rich stromal component containing mesenchymal fibroblasts. However, the properties and interplay of MPM tumor cells and their surrounding stromal fibroblasts are poorly characterized. Our objective was to spatially profile known mesenchymal markers in both tumor cells and associated fibroblasts and correlate their expression with patient survival. The primary study cohort consisted of 74 MPM patients, including 16 patients who survived at least 60 months. We analyzed location‐specific tissue expression of seven fibroblast markers in clinical samples using multiplexed fluorescence immunohistochemistry (mfIHC) and digital image analysis. Effect on survival was assessed using Cox regression analyses. The outcome measurement was all‐cause mortality. Univariate analysis revealed that high expression of secreted protein acidic and cysteine rich (SPARC) and fibroblast activation protein in stromal cells was associated with shorter survival. Importantly, high expression of platelet‐derived growth factor receptor beta (PDGFRB) in tumor cells, but not in stromal cells, was associated with shorter survival (hazard ratio [HR] = 1.02, p

BackgroundPleural mesothelioma (MPM) is an aggressive malignancy with an average patient survival of only 10 months. Interestingly, about 5%–10% of the patients survive remarkably longer. Prior studies have suggested that the tumor immune microenvironment (TIME) has potential prognostic value in MPM. We hypothesized that high-resolution single-cell spatial profiling of the TIME would make it possible to identify subpopulations of patients with long survival and identify immunophenotypes for the development of novel treatment strategies.MethodsWe used multiplexed fluorescence immunohistochemistry (mfIHC) and cell-based image analysis to define spatial TIME immunophenotypes in 69 patients with epithelioid MPM (20 patients surviving ≥ 36 months). Five mfIHC panels (altogether 21 antibodies) were used to classify tumor-associated stromal cells and different immune cell populations. Prognostic associations were evaluated using univariate and multivariable Cox regression, as well as combination risk models with area under receiver operating characteristic curve (AUROC) analyses.ResultsWe observed that type M2 pro-tumorigenic macrophages (CD163+pSTAT1−HLA-DRA1−) were independently associated with shorter survival, whereas granzyme B+ cells and CD11c+ cells were independently associated with longer survival. CD11c+ cells were the only immunophenotype increasing the AUROC (from 0.67 to 0.84) when added to clinical factors (age, gender, clinical stage, and grade).ConclusionHigh-resolution, deep profiling of TIME in MPM defined subgroups associated with both poor (M2 macrophages) and favorable (granzyme B/CD11c positivity) patient survival. CD11c positivity stood out as the most potential prognostic cell subtype adding prediction power to the clinical factors. These findings help to understand the critical determinants of TIME for risk and therapeutic stratification purposes in MPM.

Objectives Critical limb ischaemia (CLI) implies an increased risk of cardiovascular morbidity and mortality, and the optimal antithrombotic treatment is not established. Design, Materials, Methods The EUCLID trial investigated the effect of monotherapy with ticagrelor versus clopidogrel in 13,885 patients with peripheral artery disease (PAD); the primary endpoint was cardiovascular death, myocardial infarction, or ischaemic stroke. Patients planned for revascularisation or amputation within 3 months, were excluded. This analysis focuses on the subgroup with CLI, defined by rest pain (58.8%), major (9.0%) or minor (32.2%) tissue loss. Results In EUCLID, 643 patients (4.6%) had CLI at baseline. Diabetes mellitus was more common in the CLI group, while coronary disease, carotid disease, and hypertension were more common in the non-CLI group. A majority of CLI patients (62.1%) had only lower extremity PAD. In patients enrolled on the ankle brachial index (ABI) criteria, ABI was 0.55 ± 0.21 (mean ± SD) for those with CLI versus 0.63 ± 0.15 for those without CLI. The primary efficacy endpoint significantly increased among patients with CLI compared with those without CLI with a rate of 8.85 versus 4.28/100 patient years (adjusted for baseline characteristics hazard ratio [HR] 1.43 [95% CI 1.16–1.76]; p = 0.0009). When acute limb ischaemia requiring hospitalisation was added to the model, significant differences remained (adjusted HR 1.38, [95% CI 1.13–1.69]; p = 0.0016). The 1 year mortality was 8.9%. A trend towards increased lower limb revascularisation among those with CLI was observed. Bleeding (TIMI major, fatal, intracranial) did not differ between those with and without CLI. Conclusions Nearly 5% of patients enrolled in EUCLID had CLI at baseline. Milder forms of CLI dominated, a result of the trial design. Patients with CLI had a significantly higher rate of cardiovascular mortality and morbidity versus those without CLI. Further efforts are required to reduce the risk of cardiovascular events in PAD, especially in patients with CLI. ClinicalTrials.gov NCT01732822 . [ABSTRACT FROM AUTHOR]

Objectives: To investigate the independent and combined associations of objectively measured moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) with reading and arithmetic skills.Design: Cross-sectional/prospective.Methods: Participants were 89 boys and 69 girls aged 6-8 years. MVPA and ST were measured using a combined heart rate and movement sensor and body fat percentage by dual-energy X-ray absorptiometry in Grade 1. Reading fluency, reading comprehension, and arithmetic skills were assessed using standardized tests in Grades 1-3. The data were analyzed using linear regression analyses and analyses of covariance with repeated measures.Results: In boys, MVPA was directly and ST inversely associated with reading fluency in Grades 1-3 and arithmetic skills in Grade 1 (P<0.05). Higher levels of MVPA were also related to better reading comprehension in Grade 1 (P<0.05). Most of the associations of MVPA and ST with reading and arithmetic skills attenuated after mutual adjustment for MVPA or ST. Furthermore, boys with a combination of lower levels of MVPA and higher levels of ST had consistently poorer reading fluency (P=0.002) and reading comprehension (P=0.027) across Grades 1-3 than other boys. In girls, ST was directly associated with arithmetic skills in Grade 2 (P<0.05). However, this relationship of ST with arithmetic skills was no longer significant after adjustment for body fat percentage.Conclusions: Lower levels of MVPA and higher levels of ST and particularly their combination were related to poorer reading skills in boys. In girls, higher levels of ST were related to better arithmetic skills. [ABSTRACT FROM AUTHOR]

Introduction When emergency medical services (EMS) are needed, the choice of transport depends on several factors. These may include the patient’s medical condition, transport accessibility to the accident site and the receiving hospital’s resources. Emergency care research is advancing, but little is known about the patient’s perspective of helicopter emergency medical services (HEMS). Aim The aim of this study was to describe trauma patients’ experiences of HEMS. Method Thirteen persons (ages 21–76) were interviewed using an interview guide. Data were analyzed using qualitative content analysis. Findings The analysis resulted in three themes: Being distraught and dazed by the event – patients experienced shock and tension, as well as feelings of curiosity and excitement. Being comforted by the caregivers – as the caregivers were present and attentive, they had no need for relatives in the helicopter. Being safe in a restricted environment – the participants’ injuries were taken seriously and the caregivers displayed effective teamwork. Conclusion For trauma patients to be taken seriously and treated as ‘worst cases’ enables them to trust their caregivers and ‘hand themselves over’ to their care. HEMS provide additional advantageous circumstances, such as being the sole patient and having proximity to a small, professional team. [ABSTRACT FROM AUTHOR]

Objective: This retrospective study evaluated all trauma patients who were admitted to intensive care unit in Turku University Central Hospital, Finland in 2000-2004. Methods: We reviewed details of demographic factors, injury mechanism, treatment details, and the overall recovery of patients after the hospital episode. Results: A total of 427 trauma patients were identified, 66% of these were severely injured (ISS > 15). 79% of patients were men. The median age of 44 years. The most frequent injury type was road traffic accidents, leisure-time accidents and injury mechanism a high-energy blunt trauma. Head injuries were the most frequently diagnosed severe injury and 59% of the patients were multiple traumatized. Conclusions: Current results suggest that the overall survival of these patients is satisfactory, although, the head and cervical spine injuries are still often related to compromised prognosis. Despite the improvements in morbidity and mortality of these patients during last decades, still almost every tenth of trauma patient treated in the ICU dies to the complications of the injury. [ABSTRACT FROM AUTHOR]

In the article, the author discusses creative destruction and its application in education. Other topics include the integration of art, education, and economics in art education in the U.S., the views of former U.S. education official William Torrey Harris on the societal mission of art education, and how ancient Greece was a model of societal order and harmony in the late 19th and early 20th centuries.

Settings and objectives: A midsize hospital in the north of Sweden with a high-tech intensive care unit and space for up to 10 patients, with an attached postoperative ward for up to 15 patients. The wards are manned by critical care nurses who are also responsible for carrying a trauma pager. When the alarm goes off, the critical care nurse leaves her/his duties and joins a trauma team. The aim of the study was to describe critical care nurse's experiences of nursing patients suffering from trauma. Method: A qualitative descriptive design was used. Data were collected through four focus group discussions with 15 critical care nurses analysed using qualitative content analysis. Findings: One theme: Preparing for the unexpected with four subthemes: (1) Feeling competent, but sometimes inadequate; (2) Feeling unsatisfied with the care environment; (3) Feeling satisfied with well-functioning communication; and (4) Feeling a need to reflect when affected. Conclusions: Nursing trauma patients require critical care nurses to be prepared for the unexpected. Two aspects of trauma care must be improved in order to fully address the challenges it poses: First, formal preparation and adequate resources must be invested to ensure delivery of quality trauma care. Secondly, follow-ups are needed to evaluate care measures and to give members of the trauma team the opportunity to address feelings of distress or concern. [ABSTRACT FROM AUTHOR]

Unlabelled: We investigated the cross-sectional associations of sedentary behavior, physical activity, cardiorespiratory fitness, and body fat content with pain conditions in prepubertal children. The participants were a population sample of 439 children aged 6 to 8 years. Sedentary behavior, physical activity, and pain conditions were assessed using questionnaires, cardiorespiratory fitness using maximal cycle ergometer test, and body fat percentage using dual-energy X-ray absorptiometry. The associations of sedentary behavior, physical activity, cardiorespiratory fitness, and body fat percentage with the risk of pain conditions were analyzed using multivariate logistic regression. Children in the highest sex-specific third of sedentary behavior had 1.95 (95% confidence interval [CI], 1.20-3.17; P = .007 for trend across thirds) times higher odds of any pain than children in the lowest third. Children in the highest sex-specific third of cardiorespiratory fitness had 46% (odds ratio [OR] = .54; 95% CI, .32-.91; P = .019) lower odds of any pain and 50% (OR = .50; 95% CI, .28-.87; P = .015) lower odds of headache than children in the lowest third. Children in the highest sex-specific third of body fat percentage had 44% (OR = .56; 95% CI, .34-.93; P = .023) lower odds of any pain, 49% (OR = .51; 95% CI, .30-.86; P = .011) lower risk of multiple pain, and 48% (OR = .52; 95% CI, .31-.86; P = .010) lower odds of lower limb pain than children in the lowest third. Physical activity was not associated with pain conditions. These findings suggest that prepubertal children with high levels of sedentary behavior, low levels of cardiorespiratory fitness, and low body fat content have increased likelihood of various pain conditions. This information could be used to develop strategies to prevent chronic pain in childhood.Perspective: Our findings suggest that low cardiorespiratory fitness, high levels of sedentary behavior, and low body fat content are associated with increased likelihood of various pain conditions among prepubertal children. This information could be used to develop strategies to prevent chronic pain in childhood. [ABSTRACT FROM AUTHOR]

There is a historical tendency in art education to envision both art and education as integral parts of the development and sustainment of individual human life and a just society. While this conception has enabled art educators to tackle various societal issues in their profession, it reduces the societal presence of art education into a predetermined narrative of completion and conservative politics where everything eventually finds its allegedly right place and function. In this article, I historicize this argument by examining how human life and its development have been tied to the goals of public art education in the United States in the early decades of the 20th century and reflect on what kind of tradition of political thought have they upheld. In order to eventually offer an alternative approach to politics of art education, I end this article by sketching an impossible relation between art, education, and human life that would not consider human agency and its development as given categories but as modalities of being that have radical potentialities beyond predetermined actualizations. [ABSTRACT FROM AUTHOR]

Background: Despite overwhelming data demonstrating the efficacy of antiplatelet therapy in heart disease and stroke, data in peripheral artery disease (PAD) are less compelling. Aspirin has modest evidence supporting a reduction in cardiovascular events in patients with PAD, whereas clopidogrel monotherapy may be more effective in PAD. Ticagrelor, a potent, reversibly binding P2Y12 receptor antagonist, is beneficial in patients with acute coronary syndrome and prior myocardial infarction. The EUCLID trial is designed to address the need for effective antiplatelet therapy in PAD to decrease the risk of cardiovascular events.Study Design: EUCLID is a randomized, double-blind, parallel-group, multinational clinical trial designed to evaluate the efficacy and safety of ticagrelor compared with clopidogrel for the prevention of major adverse cardiovascular events in subjects with symptomatic PAD. Subjects with established PAD will be randomized in a 1:1 fashion to ticagrelor 90 mg twice daily or clopidogrel 75 mg daily. The primary end point is a composite of cardiovascular death, myocardial infarction, or ischemic stroke. Other end points address limb events including acute leg ischemia, need for revascularization, disease progression by ankle-brachial index, and quality of life. The primary safety objective is Thrombolysis in Myocardial Infarction-defined major bleeding. Recruitment began in December 2012 and was completed in March 2014; 13,887 patients were randomized. The trial will continue until at least 1,364 adjudicated primary end points occur.Conclusions: The EUCLID study is investigating whether treatment with ticagrelor versus clopidogrel, given as antiplatelet monotherapy, will reduce the incidence of cardiovascular and limb-specific events in patients with symptomatic PAD. [ABSTRACT FROM AUTHOR]

Modeling the sales and replacements of technology products is typically carried out at the aggregate product category level. However, with maturing markets and especially with high-technology products, the ever-increasing variety of differentiating product features calls for more detailed analysis. This article presents evidence on the effect of price, popularity, and technological sophistication on unit replacement and lifetimes of mobile handsets. The analysis is conducted with a unique device model specific dataset from the Finnish market, with monthly mobile handset unit sales from 2003 to 2009 and annual installed bases from 2005 to 2012. The results show that median unit lifetimes decreased during the second half of the study period, indicating a structural change in the mobile handset market. Furthermore, handset models with higher technological sophistication were shown to have explanatory power on unit lifetimes. During the first half of the study period, more popular handset models were also associated with longer unit lifetimes and models with complex flip design with shorter lifetimes. [ABSTRACT FROM AUTHOR]