 inoperable CTEPH [16].
CTED is characterised by similar symptoms and perfusion defects as CTEPH but without PH at rest, as defined by the sixth WSPH [17]. PEA results in haemodynamic and clinical improvements in CTED patients, as demonstrated by Guth et al. [18]. The selection of patients deemed eligible for PEA in the absence of PH must be made based on patients' expectations and their perioperative risk [16].
PVD is a growing field of special interest for respiratory scientists. The increasing number of available studies and development of new treatment guidelines go along with the increasing interest in this fascinating field. While areas of debate and controversy exist, there is consensus on risk stratification based on RV adaptation for the different PVD disorders. The recommendations from the sixth WSPH and the proposed new definitions for PH, as well as the new BTS guidelines for outpatient management of PE, were a few of the landmark publications during 2018.
Conflict of interest: R.J. Bernardo has nothing to disclose.
Conflict of interest: A. Bokan has nothing to disclose.
Conflict of interest: S. Ramjug has nothing to disclose.
Maddox TM, et al.
Association of borderline pulmonary hypertension with mortality and hospitalization in a large patient cohort: insights from the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program. Circulation 2016; 133: 1240–1248.
Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology. J Am Coll Cardiol 2013; 62: Suppl., D22–D33.
Risk stratification and medical therapy of pulmonary arterial hypertension. Eur Respir J 2019; 53: 1801889.
. Epidemiology of venous thromboembolism. Nat Rev Cardiol 2015; 12: 464–474.
Germeau B, et al.
Safety of the combination of PERC and YEARS rules in patients with low clinical probability of pulmonary embolism: a retrospective analysis of two large European cohorts. Acad Emerg Med 2019; 26: 23–30.
British Thoracic Society Guideline for the initial outpatient management of pulmonary embolism (PE). Thorax 2018; 73: Suppl. 2, ii1–ii29.
Verhamme P, et al.
Edoxaban for the treatment of cancer-associated venous thromboembolism. N Engl J Med 2018; 378: 615–624.
Thirlwall J, et al.
Comparison of an oral factor Xa inhibitor with low molecular weight heparin in patients with cancer with venous thromboembolism: results of a randomized trial (SELECT-D). J Clin Oncol 2018; 36: 2017–2023.
Lee AYY, et al.
Role of direct oral anticoagulants in the treatment of cancer-associated venous thromboembolism: guidance from the SSC of the ISTH. J Thromb Haemost 2018; 16: 1891–1894.
Chronic thromboembolic pulmonary hypertension (CTEPH): updated recommendations from the Cologne Consensus Conference 2018. Int J Cardiol 2018; 272: 69–78.
Rieth A, et al.
Exercise right heart catheterisation before and after pulmonary endarterectomy in patients with chronic thromboembolic disease. Eur Respir J 2018; 52: 1800458.
What can you expect here on my blog? You can expect some honest opinions that I have on just about any subject. Some humor, some just plain observations about life or people, a little bit of insight into my life dealing with a progressive auto-immune disease, Ankylosing Spondylitits (AS), views on the world, family and friends practical, humorous & serious as well as the way I see things and how they line up with the Bible and Jesus including “Christians”, “churches”, businesses, my own relationship with Jesus and the struggles as well as victories, a lot of political stories and videos with links to fact check for yourself. The latter is because I believe it is important for people to know how what is going on in the world today lines up with the Bible. The New World Order (NWO). As a Christian I feel it is my responsibility to expose the evil that is in power today and what they are up to. Revelation tells us of the signs to watch out for and through this blog my hope is to help people come to know the truth about our government, elitists, banking cartels, the Federal Reserve, etc. and their plans. Knowing the truth will help us fight and expose these criminals, but more importantly, when people realize how Revelation and the Bible foretold of these things and they are happening right now, then hopefully this knowledge will bring people to the saving knowledge & grace of Jesus Christ and they can live victoriously with the Hope of the Gospel and reach a decision to accept the gift of Salvation instead of living in fear that the world and the news media bring.
My hope is that I can bring truth, hope, knowledge, and insight and humor into people’s lives. We may disagree on some things, but please do it in a respectful manner.
Thanks & Be Blessed!
Jeff,
Looks good. I have a website I am trying to develope but haven’t sat down long enough to figure it out…lol.
Blog away my friend…..JM
Can’t wait to read it!<gh_stars>1-10
import { readFileSync } from 'fs';
import request from'supertest';
import '@globality/nodule-express';
import { getConfig, getContainer, Nodule } from '@globality/nodule-config';

import { signSymmetric, signPrivate } from 'index';

describe('Configuring the middleware', () => {
    const audience = 'audience';
    const domain = 'example';
    const publicKeyRootPath = __dirname;
    const secret ='secret';

    let app;

    beforeEach(async () => {
        await Nodule.testing().fromObject({
            middleware: {
                jwt: {
                    audience,
                    domain,
                    publicKeyRootPath,
                    secret,
                },
            },
        }).load();

        const { express, notFound } = getContainer('routes');
        const { jwt } = getContainer('middleware');

        app = express;
        app.use(jwt);
        app.use('/*', notFound);
    });

    it('returns 401 on failed authorization', async (done) => {
        const response = await request(app).get('/');

        expect(response.statusCode).toBe(401);
        expect(response.headers['www-authenticate']).not.toBeDefined();
        return done();
    });

    it('returns 401 and WWW-Authenticate on failed authorization', async (done) => {
        const jwt = getConfig('middleware.jwt');

        jwt.realm = 'test';
        const response = await request(app).get('/');
        delete jwt.realm;

        expect(response.statusCode).toBe(401);
        expect(response.headers['www-authenticate']).toEqual('Basic realm="test"');

        return done();
    });

    it('handles HS256 authorization', async (done) => {
        const email = '<EMAIL>';
        const token = signSymmetric({ email }, secret, audience);

        const response = await request(app)
           .get('/')
           .set('Authorization', `Bearer ${token}`);

        expect(response.statusCode).toBe(404);
        return done();
    });

    it('handles RS256 authorization', async (done) => {
        const email = '<EMAIL>';
        const key = readFileSync(`${__dirname}/example.key`, 'ascii');
        const token = signPrivate({ email }, key, audience);

        const response = await request(app)
           .get('/')
           .set('Authorization', `Bearer ${token}`);

        expect(response.statusCode).toBe(404);
        return done();
    });
});
Madeira Island is full of wonders, what stands out is it's sea and marine biodiversity. This trip will present you with a maritime universe where you can watch dolphins, whales and other, taking you in a relaxing trip along the south coast of Madeira, the discovery of some of the most beautiful corners of Madeira.
Come and discover the wonders of an endless ocean.
Venture into an unforgettable experience.
Feel the contact with nature.
Let yourself be charmed by unique scenery.
Our skippers are licensed professionals.
Heading towards one of its main attractions - the ocean and marine biodiversity - a trip cetacean watching in Madeira is an excellent option for those looking for boat excursions in Madeira to know the aquatic fauna in it's natural habitat. Its main objective is the observation of whales, dolphins and turtles, the trip, lasting three hours, will take you from the Bay of Funchal, one of the most wonderful boat trips in Madeira.
In the summer months, you can lie back on the net and delight in the magnitude of the landscape. If you are a diving lover, this is also an excellent opportunity to dive in the crystal clear waters of Cabo Girão and observe the seabed, since we have equipment