Lumen (United Kingdom)

The prevalence and case fatality of ischemic heart disease in India has increased over the past 2 decades. ST-segment elevation myocardial infarction (STEMI) accounts for up to 60% of all myocardial infarctions in India, with only 25% to 40% of patients undergoing primary percutaneous coronary intervention (PPCI). A national access gap persists in India that needs to be bridged with the implementation of in-hospital processes and regional systems of collaborative care. The single-center, observational, retrospective Myocardial Infarction Delhi Primary Angioplasty Study (MIDAS) was conducted at Max Super Specialty Hospital (New Delhi, India) between January 1, 2015, and December 31, 2019. All patients presenting to the emergency department with ongoing chest discomfort suggestive of ischemia and ST elevation on electrocardiogram were included. PPCI, initiated by a "CODE STEMI" team activation call, was employed as a single reperfusion strategy to treat all patients and minimize system delays. Systematic data collection of door-to-balloon (D2B) time regular audit, feedback, and multidisciplinary team engagement was implemented to refine processes and improve efficiency. The consistency of the process in maintaining D2B time during day and night hours, as well as on weekends and holidays was evaluated. Data from the electronic health record were collected and summarized to evaluate the impact of processes on in-hospital patient outcomes. A total of 887 patients meeting eligibility criteria were included in the analysis, of whom 45.2% were admitted during off hours, weekends, or holidays, and 92.3% underwent PPCI, 2.8% underwent PPCI followed by CABG, 1.8% underwent CABG, and 2.6% required medical therapy. The median D2B was 51 minutes (interquartile range, 40-60 minutes), and on holidays the mean D2B was 55 minutes (interquartile range, 40-75 minutes). The overall mortality was 5.2%. This study demonstrates that implementing a team-based standardized protocol can achieve guideline-recommended D2B times in a diverse STEMI population presenting to a percutaneous coronary intervention-capable hospital. Protocols reduce variation in care and enable the delivery of equitable high-quality care consistently across diverse demographic groups.

The increasing complexity of cyber threats necessitates powerful and versatile vulnerability assessment tools. This study evaluates the performance and efficiency of leading open-source cybersecurity scanners - OpenVAS, ZAP, Nessus, Nikto, and Nmap - in various network environments, including sophisticated cloud infrastructures and more constrained local PC setups. Utilizing platforms such as AWS, Microsoft Azure, and Linode, the research provides insights into how different environments impact the effectiveness of these tools. A key finding is the significant influence of network resources on the efficacy of scanners, underscoring the critical need for cybersecurity practitioners to consider the specific characteristics of their network environment when selecting tools. Through data collection and analysis, the capabilities of each tool are illuminated, offering valuable guidance for more effective denlovment of these tools.

In this paper, to achieve higher robustness against atmospheric turbulence for high-capacity free-space optical (FSO) communications, an adaptive multi-modal FSO transceiver has been designed and experimentally demonstrated. We show that based on the dynamically estimated channel state information, modulation formats and power for different transmit modes can be adaptively allocated at the transmitter side. Meanwhile, at the receiver side, we show that the most suitable multi-input/multi-output decoder can be selected and employed to meet the requirement of forward error correction at the minimal expense of power consumption. By employing time-division multiplexed transmitter and receiver emulation and a spatial light modulator for turbulence emulation, an aggregate data rate of 590 Gbit/s/wavelength has been achieved when suffering from strong atmospheric turbulence, verifying the feasibility of the proposed adaptive transceiver over a turbulent FSO link. Moreover, to demonstrate practical applicability, all key devices such as transponder, multiplexer, and demultiplexer are commercially available in this work.

With student and staff wellbeing a growing concern, several authors have asked whether existing data might help institutions provide better support. By analogy with the established field of Learning Analytics, this might involve identifying causes of stress, improving access to information for those who need it, suggesting options, providing rapid feedback, even early warning of problems. But just investigating the possibility of such uses can create significant risks for individuals: feelings of creepiness or surveillance making wellbeing worse, inappropriate data visibility destroying trust, assessments or interventions becoming self-fulfilling prophecies. To help institutions decide whether and how to explore this area, and to reassure individuals that this is being done safely, we propose a Wellbeing Analytics Code of Practice. This starts from an existing Learning Analytics Code, confirms that its concerns and mitigations remain relevant, and adds additional safeguards and tools for the wellbeing context. These are derived from a detailed analysis of European and UK data protection law, extracting all rules and safeguards mentioned in relation to health data. We also develop context-specific tools for managing risk and evaluating data sources. Early feedback suggests that these documents will indeed increase confidence that this important area can be safely explored.

This paper is a book review of the volume Bărbatul și femeia. Imaginea unei polemici cu privire la echitatea de gen [The man and the woman. The image of a controversy over gender equity], authored by Iulian Apostu and Cristina Petrescu and published by Lumen Publishing House from Iași, Romania, in 2017. The book addresses issues like the psycho-social dynamic of the marital couple, the emancipation of women within the couple, solidarity and conflict between men and women, while placing the debates at the crossroads of modernity and postmodernity, as social paradigms marking the couple’s formation, evolution and separation.

Ethnic violence in Africa has a number of underlying causes but at root the author identifies a lack of subjectivity as the common denominator between them. Ethnic conflict is dependent upon the crowd mentality which gives rise to a fear of the other. The crowd may be understood as undifferentiated individuals, lacking a personal subjectivity and who seek identity by referring to group norms and values in an uncritical way. These norms demand the objectification of those who are outside the group, and it is this objectification which validates acts of violence against outsiders. In arguing that it is this lack of subjectivity that is at the root of the problem, the author has also proposed that the solution is informed by the insights regarding subjectivity offered by Kierkegaard. This solution offers an approach to education in the widest sense that permits the space for reflection and an encouragement to reflect subjectively with the aim of allowing the development of moral, independent, reflective individuals, who are free to exercise choice and unafraid to question and evaluate the worth of group social values and norms and to work for change where this is warranted

We report order-of-magnitude improvements in performance of field-deployable hollow-core fiber cables evidenced by a 38.4Tb/s (800Gb/s-x-48WDM-channels) 20.5km lab-trial using commercial terminal equipment and the demonstration of 1128km/126km reach in full-fill 400/800Gb/s WDM recirculating-loop experiments.