AFSC/RACE/MACE: Results of 2012 acoustic trawl survey Shelikof DY1203

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Scientists from the Midwater Assessment and Conservation Engineering (MACE) Program of the Alaska Fisheries Science Center (AFSC) Resource Assessment and...

AFSC/RACE/MACE: Results of 2014 acoustic trawl survey Bogoslof DY1402

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Scientists from the Midwater Assessment and Conservation Engineering (MACE) Program of the Alaska Fisheries Science Center (AFSC) regularly conduct acoustic-trawl...

Parallax adjustment algorithm based on Susan-Zernike moments

Science.gov (United States)

Deng, Yan; Zhang, Kun; Shen, Xiaoqin; Zhang, Huiyun

2018-02-01

Precise parallax detection through definition evaluation and the adjustment of the assembly position of the objective lens or the reticle are important means of eliminating the parallax of the telescope system, so that the imaging screen and the reticle are clearly focused at the same time. An adaptive definition evaluation function based on Susan-Zernike moments is proposed. First, the image is preprocessed by the Susan operator to find the potential boundary edge. Then, the Zernike moments operator is used to determine the exact region of the reticle line with sub-pixel accuracy. The image definition is evaluated only in this related area. The evaluation function consists of the gradient difference calculated by the Zernike moments operator. By adjusting the assembly position of the objective lens, the imaging screen and the reticle will be simultaneously in the state of maximum definition, so the parallax can be eliminated. The experimental results show that the definition evaluation function proposed in this paper has the advantages of good focusing performance, strong anti-interference ability compared with the other commonly used definition evaluation functions.

AFSC/RACE/MACE: Results of 2014 Pollock Acoustic-Trawl Survey Shelikof- DY1403

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National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) Program of the Alaska Fisheries Science Center's (AFSC) Resource Assessment and Conservation Engineering...

AFSC/RACE/MACE: Results of 2016 acoustic trawl survey Shumagins/Sanak DY1602

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National Oceanic and Atmospheric Administration, Department of Commerce — Scientists from the Midwater Assessment and Conservation Engineering (MACE) Program of the Alaska Fisheries Science Center's (AFSC) Resource Assessment and...

AFSC/RACE/MACE: Results of 2008 pollock acoustic trawl survey Shelikof DY0803

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Scientists from the Midwater Assessment and Conservation Engineering (MACE) Program of the Alaska Fisheries Science Center's (AFSC) Resource Assessment and...

Binding in the Lazy Susan of the 1 MW TRIGA at the Centro Nuclear de Mexico

Energy Technology Data Exchange (ETDEWEB)

Sanchez, J; Mulas, P; Mariano, G; Hernandez, R [Instituto Nacional de Energia Nuclear (Mexico)

1974-07-01

Problems with the original Lazy Susan were reported in a previous conference, where the procedure followed for its removal was described. A new Lazy Susan was supplied by the fabricant and it was judged convenient to perform an out-of-core test of the dispositive. A rig was built to produce temperature gradients similar to the ones encountered in the operation at high power levels. After a temperature difference (estimated between 130{sup o}C and 170{sup o}C) between the rotating part and the outside surface was established, the Lazy Susan started to bind. This was reported to the fabricant and it was concluded that a new design was needed and since it would take at least two years before the new unit could be acquired, it was decided to install the Lazy Susan recently supplied. The unit now rotates for approximately 20 minutes when the reactor is operating at 1 MW and then binds. At lower power levels it is operative for longer periods of time. (author)

Binding in the Lazy Susan of the 1 MW TRIGA at the Centro Nuclear de Mexico

International Nuclear Information System (INIS)

Sanchez, J.; Mulas, P.; Mariano, G.; Hernandez, R.

1974-01-01

Problems with the original Lazy Susan were reported in a previous conference, where the procedure followed for its removal was described. A new Lazy Susan was supplied by the fabricant and it was judged convenient to perform an out-of-core test of the dispositive. A rig was built to produce temperature gradients similar to the ones encountered in the operation at high power levels. After a temperature difference (estimated between 130 o C and 170 o C) between the rotating part and the outside surface was established, the Lazy Susan started to bind. This was reported to the fabricant and it was concluded that a new design was needed and since it would take at least two years before the new unit could be acquired, it was decided to install the Lazy Susan recently supplied. The unit now rotates for approximately 20 minutes when the reactor is operating at 1 MW and then binds. At lower power levels it is operative for longer periods of time. (author)

International Literacy Crusader: An Interview with Susan Mandel Glazer

Science.gov (United States)

Ambrose, Valerie K.

2011-01-01

This article presents an interview with Susan Mandel Glazer, past president of both the International Reading Association and the College Reading Association. Dr. Glazer received her doctorate in education from the University of Pennsylvania and her master of arts from New York University. Her most recent books are "Beyond the Looking Glass:…

Detection algorithm of infrared small target based on improved SUSAN operator

Science.gov (United States)

Liu, Xingmiao; Wang, Shicheng; Zhao, Jing

2010-10-01

The methods of detecting small moving targets in infrared image sequences that contain moving nuisance objects and background noise is analyzed in this paper. A novel infrared small target detection algorithm based on improved SUSAN operator is put forward. The algorithm selects double templates for the infrared small target detection: one size is greater than the small target point size and another size is equal to the small target point size. First, the algorithm uses the big template to calculate the USAN of each pixel in the image and detect the small target, the edge of the image and isolated noise pixels; Then the algorithm uses the another template to calculate the USAN of pixels detected in the first step and improves the principles of SUSAN algorithm based on the characteristics of the small target so that the algorithm can only detect small targets and don't sensitive to the edge pixels of the image and isolated noise pixels. So the interference of the edge of the image and isolate noise points are removed and the candidate target points can be identified; At last, the target is detected by utilizing the continuity and consistency of target movement. The experimental results indicate that the improved SUSAN detection algorithm can quickly and effectively detect the infrared small targets.

AFSC/RACE/MACE: Results of 2013 acoustic trawl survey Gulf of Alaska DY1307

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National Oceanic and Atmospheric Administration, Department of Commerce — Scientists from the Midwater Assessment and Conservation Engineering (MACE) Program of the Alaska Fisheries Science Center (AFSC) Resource Assessment and...

AFSC/RACE/MACE: Results of 2011 acoustic trawl survey Gulf of Alaska DY1103

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Scientists from the Midwater Assessment and Conservation Engineering (MACE) Program of the Alaska Fisheries Science Center (AFSC) Resource Assessment and...

Cross-cultural adaptation of the Maltreatment and Abuse Chronology of Exposure (MACE scale to Brazilian Portuguese

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Bruno Kluwe-Schiavon

2016-03-01

Full Text Available Introduction : There is strong evidence to indicate that childhood maltreatment can negatively affect both physical and mental health and there is increasing interest in understanding the occurrence and consequences of such experiences. While several tools have been developed to retrospectively investigate childhood maltreatment experiences, most of them do not investigate the experience of witnessing family violence during childhood or bullying exposure. Moreover, the majority of scales do not identify when these experiences may have occurred, who was involved or the feelings evoked, such as helplessness or terror. The Maltreatment and Abuse Chronology of Exposure (MACE scale was developed to overcome these limitations. Objective : In view of the improvements over previous self-report instruments that this new tool offers and of the small number of self-report questionnaires for childhood maltreatment assessment available in Brazil, this study was conducted to conduct cross-cultural adaptation of the MACE scale for Brazilian Portuguese. Method : The following steps were performed: translation, back-translation, committee review for semantic and conceptual evaluation, and acceptability trial for equivalence. Results : Semantic and structural changes were made to the interview to adapt it for the Brazilian culture and all 75 of the items that comprise the longer version of MACE were translated. The results of the acceptability trial suggest that the items are comprehensible. Conclusion : The MACE scales may be useful tools for investigation of childhood maltreatment and make a valuable contribution to research in Brazil. Future studies should consider testing the availability and reliability of the three versions of the instrument translated into Brazilian Portuguese.

AFSC/RACE/MACE: Results of 2006 Pollock Acoustic-Trawl Survey Bering Sea- DY0606

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National Oceanic and Atmospheric Administration, Department of Commerce — Scientists from the Alaska Fisheries Science Center’s (AFSC) Midwater Assessment and Conservation Engineering (MACE) Program conduct biennial echo...

APhoRISM FP7 project: the Multi-platform volcanic Ash Cloud Estimation (MACE) infrastructure

Science.gov (United States)

Merucci, Luca; Corradini, Stefano; Bignami, Christian; Stramondo, Salvatore

2014-05-01

APHORISM is an FP7 project that aims to develop innovative products to support the management and mitigation of the volcanic and the seismic crisis. Satellite and ground measurements will be managed in a novel manner to provide new and improved products in terms of accuracy and quality of information. The Multi-platform volcanic Ash Cloud Estimation (MACE) infrastructure will exploit the complementarity between geostationary, and polar satellite sensors and ground measurements to improve the ash detection and retrieval and to fully characterize the volcanic ash clouds from source to the atmosphere. The basic idea behind the proposed method consists to manage in a novel manner, the volcanic ash retrievals at the space-time scale of typical geostationary observations using both the polar satellite estimations and in-situ measurements. The typical ash thermal infrared (TIR) retrieval will be integrated by using a wider spectral range from visible (VIS) to microwave (MW) and the ash detection will be extended also in case of cloudy atmosphere or steam plumes. All the MACE ash products will be tested on three recent eruptions representative of different eruption styles in different clear or cloudy atmospheric conditions: Eyjafjallajokull (Iceland) 2010, Grimsvotn (Iceland) 2011 and Etna (Italy) 2011-2012. The MACE infrastructure will be suitable to be implemented in the next generation of ESA Sentinels satellite missions.

Risk prediction models for major adverse cardiac event (MACE) following percutaneous coronary intervention (PCI): A review

Science.gov (United States)

Manan, Norhafizah A.; Abidin, Basir

2015-02-01

Five percent of patients who went through Percutaneous Coronary Intervention (PCI) experienced Major Adverse Cardiac Events (MACE) after PCI procedure. Risk prediction of MACE following a PCI procedure therefore is helpful. This work describes a review of such prediction models currently in use. Literature search was done on PubMed and SCOPUS database. Thirty literatures were found but only 4 studies were chosen based on the data used, design, and outcome of the study. Particular emphasis was given and commented on the study design, population, sample size, modeling method, predictors, outcomes, discrimination and calibration of the model. All the models had acceptable discrimination ability (C-statistics >0.7) and good calibration (Hosmer-Lameshow P-value >0.05). Most common model used was multivariate logistic regression and most popular predictor was age.

Vascular risk levels affect the predictive value of platelet reactivity for the occurrence of MACE in patients on clopidogrel. Systematic review and meta-analysis of individual patient data.

Science.gov (United States)

Reny, Jean-Luc; Fontana, Pierre; Hochholzer, Willibald; Neumann, Franz Josef; Ten Berg, Jurriën; Janssen, Paul W; Geisler, Tobias; Gawaz, Meinrad; Marcucci, Rossella; Gori, Anna-Maria; Cuisset, Thomas; Alessi, Marie-Christine; Berdagué, Philippe; Gurbel, Paul A; Yong, Gerald; Angiolillo, Dominick J; Aradi, Dániel; Beigel, Roy; Campo, Gianluca; Combescure, Christophe

2016-04-01

Prior studies have shown an association between high on-clopidogrel platelet reactivity (PR) and the risk of major adverse cardiovascular events (MACE). However, large intervention trials on PR-tailored treatments have been neutral. The role and usefulness of PR with regard to levels of cardiovascular risk are unclear. We undertook a systematic review and meta-analysis of individual patient data on MACE outcomes (acute coronary syndromes (ACS), ischaemic strokes, and vascular deaths) in relation to PR and its interaction with cardiovascular risk levels. PR was determined using ADP-induced light transmission aggregometry with a primary concentration of 20 µM ADP. Thirteen prospective studies totaled 6,478 clopidogrel-treated patients who experienced 421 MACE (6.5 %) during a median follow-up of 12 months. The strength of the association between the risk of MACE and PR increased significantly (p=0.04) with the number of risk factors present (age> 75 years, ACS at inclusion, diabetes, and hypertension). No association was detected in patients with no risk factor (p=0.48). In patients presenting one risk factor, only high-PR was associated with an increased risk of MACE (HR 3.2, p=0.001). In patients presenting ≥ 2 risk factors, the increase of risk started from medium-PR (medium-PR: HR=2.9, p=0.0004; high-PR: HR=3.7, p=0.0003). PR allowed the reclassification of 44 % of the total population to a different risk level for the outcome of MACE, mostly in intermediate or high risk patients. In conclusion, the magnitude of the association between PR and MACE risk is strongly dependent on the level of cardiovascular risk faced by patients on clopidogrel.

Teaching Students About Stereotypes, Prejudice, and Discrimination: An Interview with Susan Fiske

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Hackney, Amy

2005-01-01

Susan T. Fiske is professor of psychology, Princeton University (PhD, Harvard University; honorary doctorate, Universite Catholique de Louvain-la-Neuve, Belgium). She wrote Social Cognition (with Taylor) on how people make sense of each other. Currently, she investigates emotional prejudices (pity, contempt, envy, and pride) at cultural,…

A five year record of high-frequency in situ measurements of non-methane hydrocarbons at Mace Head, Ireland

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A. Grant

2011-05-01

Full Text Available Continuous high-frequency in situ measurements of a range of non-methane hydrocarbons have been made at Mace Head since January 2005. Mace Head is a background Northern Hemispheric site situated on the eastern edge of the Atlantic. Five year measurements (2005–2009 of six C₂–C₅ non-methane hydrocarbons have been separated into baseline Northern Hemispheric and European polluted air masses, among other sectors. Seasonal cycles in baseline Northern Hemispheric air masses and European polluted air masses arriving at Mace Head have been studied. Baseline air masses show a broad summer minima between June and September for shorter lived species, longer lived species show summer minima in July/August. All species displayed a winter maxima in February. European air masses showed baseline elevated mole fractions for all non-methane hydrocarbons. Largest elevations (of up to 360 ppt for ethane maxima from baseline data were observed in winter maxima, with smaller elevations observed during the summer. Analysis of temporal trends using the Mann-Kendall test showed small (<6 % yr⁻¹ but statistically significant decreases in the butanes and i-pentane between 2005 and 2009 in European air. No significant trends were found for any species in baseline air.

Resurrecting Absence: Iconic Ghosts in the Poetry of Susan Howe

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Jessica Wilkinson

2011-04-01

Full Text Available The article focuses on the opinions of Susan Howe in her book A Bibliography of the King's Book, Or Eikon Basilike. It cites that Howe's work reflects her evocative visual and verbal landscapes as well as her enthusiasm of leading readers to the obscurities of textual and historical respresentation. It also discusses the strange tyrannical martyrdom of King Charles the First and his publication as well as her understanding of Edward Almack's bibliographical project.

Comparisons of continuous atmospheric CH4, CO2 and N2O measurements - results from a travelling instrument campaign at Mace Head

International Nuclear Information System (INIS)

Vardag, S.N.; Hammer, S.; Levin, I.; O'Doherty, S.; Spain, T.G.; Wastine, B.; Jordan, A.

2014-01-01

A 2-month measurement campaign with a Fourier transform infrared analyser as a travelling comparison instrument (TCI) was performed at the Advanced Global Atmospheric Gases Experiment (AGAGE) and World Meteorological Organization (WMO) Global Atmosphere Watch (GAW) station at Mace Head, Ireland. The aim was to evaluate the compatibility of atmospheric methane (CH 4 ), carbon dioxide (CO 2 ) and nitrous oxide (N 2 O) measurements of the routine station instrumentation, consisting of a gas chromatograph (GC) for CH 4 and N 2 O as well as a cavity ring-down spectroscopy (CRDS) system for CH 4 and CO 2 . The advantage of a TCI approach for quality control is that the comparison covers the entire ambient air measurement system, including the sample intake system and the data evaluation process. For initial quality and performance control, the TCI was run in parallel with the Heidelberg GC before and after the measurement campaign at Mace Head. Median differences between the Heidelberg GC and the TCI were well within the WMO inter-laboratory compatibility target for all three greenhouse gases. At Mace Head, the median difference between the station GC and the TCI were -0.04 nmol mol -1 for CH 4 and -0.37 nmol mol -1 for N 2 O (GC-TCI). For N 2 O, a similar difference (-0.40 nmol mol -1 ) was found when measuring surveillance or working gas cylinders with both instruments. This suggests that the difference observed in ambient air originates from a calibration offset that could partly be due to a difference between the WMON2O X2006a reference scale used for the TCI and the Scripps Institution of Oceanography (SIO-1998) scale used at Mace Head and in the whole AGAGE network. Median differences between the CRDS G1301 and the TCI at Mace Head were 0.12 nmol mol -1 for CH 4 and 0.14 μmol mol -1 for CO 2 (CRDS G1301 - TCI). The difference between both instruments for CO 2 could not be explained, as direct measurements of calibration gases show no such difference. The CH 4

Re-Establishing Social Studies as a Core Subject: An Interview with Susan Griffin

Science.gov (United States)

Griffin, Susan

2014-01-01

NCSS Executive Director Susan Griffin was chair of the Task Force of Professional Organizations that worked with the Social Studies Assessment, Curriculum, and Instruction Collaborative (SSACI) of the Council of Chief State School Officers to initiate and guide the development of the "College, Career and Civic Life (C3) Framework for Social…

Impact of glycemic variability on the occurrence of periprocedural myocardial infarction and major adverse cardiovascular events (MACE) after coronary intervention in patients with stable angina pectoris at 6months follow-up.

Science.gov (United States)

Xia, Jinggang; Xu, Ji; Hu, Shaodong; Hao, Hengjian; Yin, Chunlin; Xu, Dong

2017-08-01

We explored the impact of glycemic variability on the occurrence of periprocedural myocardial infarction and major adverse cardiovascular events (MACE) after coronary intervention in patients with stable angina pectoris (SAP) at 6months follow-up. From May 2015 to April 2016, a total of 746 patients with SAP were divided to high glycemic variability group (H group) (n=261) and low glycemic variability group (L group) (n=485). The primary end point was incidence of periprocedural myocardial infarction and MACE at 6months follow-up. The occurrence of periprocedural myocardial infarction occurred in 18.8% of patients in H group and in 12.4% in L group (P=0.03). The incidence of MACE at 6months follow-up was 9.6% in H group and 4.5% in L group (P=0.01). Multivariable analysis suggested that high glycemic variability conferred a 53% risk increment of 6months follow-up MACE (odds ratio 2.13, 95% confidence interval 1.85-5.38; P=0.01). The trial shows that higher blood glucose variability was correlated with higher incidence of periprocedural myocardial infarction and MACE at 6months follow-up. Copyright © 2017. Published by Elsevier B.V.

Carbon monoxide measurements at Mace Head, Ireland

Science.gov (United States)

Doddridge, Bruce G.; Dickerson, Russell R.; Spain, T. Gerard; Oltmans, Samuel J.; Novelli, Paul C.

1994-01-01

The North Atlantic Ocean is bordered by continents which may each, under the influence of seasonal weather patterns, act as sources of natural and anthropogenic trace gas and particulate species. Photochemically active species such as carbon monoxide (CO) react to form ozone (O3), a species of critical importance in global climate change. CO is sparingly soluble in water, and the relatively long lifetime of CO in the troposphere makes this species an ideal tracer of air masses with origin over land. We have measured CO using a nondispersive infrared gas filter correlation analyzer at Mace Head on the west coast of Ireland nearly continuously since August 9, 1991. Measurements of CO were acquired at 20-sec resolution and recorded as 60-sec averages. Daily, monthly, and diurnal variation data characteristics of CO mixing ratios observed at this site are reported. Depending on source regions of air parcels passing over this site, 60-min concentrations of CO range from clean air values of approximately 90 ppbv to values in excess of 300 ppbv. Data characterizing the correlation between 60-min CO and O3 mixing ratio data observed at this site are reported also.

Practitioner Profile: An Interview with Susan Bross, AFC®

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Susan Bross

2011-04-01

Full Text Available

Susan Bross is a nationally accredited financial counselor who established her private practice in 1992. She currently lives in San Rafael, California. She brings a multi-faceted background and a combination of skills to her work. As a financial counselor, she works with individuals, couples, and entrepreneurs throughout the nation to help clients develop a practical and emotionally healthy relationship with money. When asked, she will tell you that she is passionate about her work because it mirrors her own hard-won path with money. Readers of the Journal will find Ms. Bross’s approach to financial therapy inspiring. She teaches simple tools for effortless and sustainable cash flow and money management. She also guides her clients to balanced attitudes and beliefs about money and success.

AFSC/RACE/MACE: Results of 2009 ACOUSTIC-TRAWL SURVEYS OF THE SHUMAGINS, SANAK TROUGH & WESTERN GULF OF ALASKA SHELFBREAK DY0901

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National Oceanic and Atmospheric Administration, Department of Commerce — Scientists from the Midwater Assessment and Conservation Engineering (MACE) Program of the Alaska Fisheries Science Center's (AFSC) Resource Assessment and...

Psychoanalytic Interpretation of Blueberries by Susan Gibb

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Maya Zalbidea Paniagua

2014-06-01

Full Text Available Blueberries (2009 by Susan Gibb, published in the ELO (Electronic Literature Organization, invites the reader to travel inside the protagonist’s mind to discover real and imaginary experiences examining notions of gender, sex, body and identity of a traumatised woman. This article explores the verbal and visual modes in this digital short fiction following semiotic patterns as well as interpreting the psychological states that are expressed through poetical and technological components. A comparative study of the consequences of trauma in the protagonist will be developed including psychoanalytic theories by Sigmund Freud, Jacques Lacan and the feminist psychoanalysts: Melanie Klein and Bracha Ettinger. The reactions of the protagonist will be studied: loss of reality, hallucinations and Electra Complex, as well as the rise of defence mechanisms and her use of the artistic creativity as a healing therapy. The interactivity of the hypermedia, multiple paths and endings will be analyzed as a literary strategy that increases the reader’s capacity of empathizing with the speaker.

78 FR 75676 - Mark W. Dobronski and Susan K. Dobronski-Acquisition of Control Exemption-Adrian & Blissfield...

Science.gov (United States)

2013-12-12

... Ferrovia, L.L.C. (Ferrovia), also a noncarrier and a limited liability company, which, until very recently... and Susan K. Dobronski--Acquisition of Control Exemption--Adrian & Blissfield Rail Road Company, Charlotte Southern Railroad Company, Detroit Connecting Railroad Company, Lapeer Industrial Railroad Company...

Susan Sontag — A Forgotten Mother?

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Kludia Ziewiec

2013-01-01

Full Text Available The article discusses new and republished translations of Susan Sontag’s work, recently launched by the Karakter publishing house: Regarding the Pan of Others, On Photography, and Against Interpretation and Other Essays. The article focuses on the elements of Sontag’s thought that make her a forgotten mother of feminist and gender theoreticians, as well as such influential critics as Michel Foucault and Roland Barthes. The article points out to continuations of Sontag’s thought in contemporary theoretical and social projects, and to the pertinence of her critical observations on theories based on metaphysics of presence: psychoanalysis, Marxism, or hermeneutics. The article also touches upon history of war photography and related war journalism, and upon the ambivalent quality of imaging of the misery of war. It also present historical and cultural circumstances of the development of Sontag’s thought in the intellectual milieu of New York in the 1960s. The discussion recapitulates the main statements of Sontag’s essays, relating them to a wider theoretical context, which is aimed at a reappraisal of the forgotten intelectual in the history of literature.

Susan Magoffin’s Santa Fe Days in 1846: The Value of Testimony Les journées de Santa Fé en 1846 de Susan Magoffin : la valeur du témoignage

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Susanne Berthier-Foglar

2009-11-01

Full Text Available Susan Magoffin, la jeune épouse d’un commerçant de la piste de Santa Fe, accompagna son mari en 1846 pour un voyage où la caravane suivait de près l’Armée de l’Ouest et pendant lequel elle tint un journal. Cet article traite des 37 jours que dura la pause de la caravane à Santa Fe et aborde plus spécifiquement la façon dont l’auteur appréhendait l’altérité dans un environnement inhabituel et parfois dangereux. Pour apprécier la valeur du témoignage, je combine une analyse du discours avec une évaluation statistique du contenu. La description, parfois naïve, de Santa Fe sous l’occupation américaine illustre les raisons de la guerre contre le Mexique. En tant qu’agent de la destinée manifeste, Susan Magoffin admirait le général Kearny en lui attribuant des qualités surhumaines et en participant à ses efforts de propagande. Alors qu’elle était enracinée dans sa classe et sa culture, elle voyait la population mexicaine et les Amérindiens avec un esprit ouvert bien que ses motifs pour apprendre l’espagnol, ainsi que le métier de commerçante, avaient une fonction plus prosaïque.

A New Approach: The Feminist Musicology Studies of Susan McClary and Marcia J. Citron

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Kimberly Reitsma

2014-06-01

Full Text Available One of the currently prevalent analytic approaches in academia is feminist theory and criticism. Its combination with musicology has influenced the field for the past four decades. The goal of the new approach, loosely termed “feminist musicology,” has been to discover, analyze, discuss, and promote the representation of women and the “feminine” essence in various disciplines of music. Today, feminist musicology is highly researched, published in books and journals, and presented as scholarly papers at various musicological conferences around the world. This new approach introduces the ideologies of feminism to the study of music. Susan McClary and Marcia J. Citron are two musicologists who were influenced by these ideologies and have guided the musicological world in this direction of feminist musicology. Both have made serious contributions to the emerging field of feminist musicology. Both researched the ideas of gender musical construction within musical narratives, music as a gendered discourse, and historical and social factors that affected women in music. Although they have met with considerable resistance, Susan McClary and Marcia J. Citron have significantly expanded the scope of musicology through their application of feminist theory.

[The Durkheim Test. Remarks on Susan Leigh Star's Boundary Objects].

Science.gov (United States)

Gießmann, Sebastian

2015-09-01

The article reconstructs Susan Leigh Star's conceptual work on the notion of 'boundary objects'. It traces the emergence of the concept, beginning with her PhD thesis and its publication as Regions of the Mind in 1989. 'Boundary objects' attempt to represent the distributed, multifold nature of scientific work and its mediations between different 'social worlds'. Being addressed to several 'communities of practice', the term responded to questions from Distributed Artificial Intelligence in Computer Science, Workplace Studies and Computer Supported Cooperative Work (CSCW), and microhistorical approaches inside the growing Science and Technology Studies. Yet the interdisciplinary character and interpretive flexibility of Star’s invention has rarely been noticed as a conceptual tool for media theory. I therefore propose to reconsider Star's 'Durkheim test' for sociotechnical media practices.

An Interview with Susan Conners: An Educator's Observations about Living with and Educating Others about Tourette's Syndrome.

Science.gov (United States)

Chamberlain, Steven P.

2003-01-01

In this interview with Susan Conners, a middle school French teacher who has lived with Tourette syndrome (TS) since age 6, she discusses her lack of diagnosis until age 36, difficulties in school, why TS should be listed under "Other Health Impaired" in federal legislation, characteristics of TS, and interventions. (Contains…

Lesson Plans for "Not for Ourselves Alone: The Story of Elizabeth Cady Stanton and Susan B. Anthony."

Science.gov (United States)

Prososki, Lisa; Krouse, Judith; Harper, Judith E.

These lesson plans for high school students were developed to accompany the documentary film by Ken Burns and Paul Barnes which tells the story of Elizabeth Cady Stanton and Susan B. Anthony and their lifelong fight for women's rights. In the lessons students write editorials about women's rights around the world today, interview senior citizens…

Intermittent large amplitude internal waves observed in Port Susan, Puget Sound

Science.gov (United States)

Harris, J. C.; Decker, L.

2017-07-01

A previously unreported internal tidal bore, which evolves into solitary internal wave packets, was observed in Port Susan, Puget Sound, and the timing, speed, and amplitude of the waves were measured by CTD and visual observation. Acoustic Doppler current profiler (ADCP) measurements were attempted, but unsuccessful. The waves appear to be generated with the ebb flow along the tidal flats of the Stillaguamish River, and the speed and width of the resulting waves can be predicted from second-order KdV theory. Their eventual dissipation may contribute significantly to surface mixing locally, particularly in comparison with the local dissipation due to the tides. Visually the waves appear in fair weather as a strong foam front, which is less visible the farther they propagate.

"I Am Not a Fairy Tale": Contextualizing Sioux Spirituality and Story Traditions in Susan Power's "The Grass Dancer"

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Diana, Vanessa Holford

2009-01-01

Standing Rock Sioux writer Susan Power's best-selling novel "The Grass Dancer" (1994) includes depictions of the supernatural and spiritual that do not conform to the Judeo-Christian or, in some cases, the atheist or rationalist worldviews of many readers. Power writes of ghost characters and haunted places, communication between the living and…

Bárbara Mujica, ed., Shakespeare and the Spanish «Comedia». Translation, Interpretation, Performance. Essays in Honor of Susan L. Fischer

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Alejandro García-Reidy

2016-01-01

Full Text Available Reseña de Bárbara Mujica, ed., Shakespeare and the Spanish «Comedia». Translation, Interpretation, Performance. Essays in Honor of Susan L. Fischer, Bucknell University Press, Lewisburg, 2013, 298 pp. ISBN 9781611485172.

Susan Loucks-Horsley learning model in light pollution theme: based on a new taxonomy for science education

Science.gov (United States)

Liliawati, W.; Utama, J. A.; Fauziah, H.

2016-08-01

The curriculum in Indonesia recommended that science teachers in the elementary and intermediate schools should have interdisciplinary ability in science. However, integrated learning still has not been implemented optimally. This research is designing and applying integrated learning with Susan Loucks-Horsley model in light pollution theme. It can be showed how the student's achievements based on new taxonomy of science education with five domains: knowing & understanding, science process skill, creativity, attitudinal and connecting & applying. This research use mixed methods with concurrent embedded design. The subject is grade 8 of junior high school students in Bandung as many as 27 students. The Instrument have been employed has 28 questions test mastery of concepts, observations sheet and moral dilemma test. The result shows that integrated learning with model Susan Loucks-Horsley is able to increase student's achievement and positive characters on light pollution theme. As the results are the average normalized gain of knowing and understanding domain reach in lower category, the average percentage of science process skill domain reach in good category, the average percentage of creativity and connecting domain reach respectively in good category and attitudinal domain the average percentage is over 75% in moral knowing and moral feeling.

Susan Loucks-Horsley learning model in light pollution theme: based on a new taxonomy for science education

International Nuclear Information System (INIS)

Liliawati, W; Utama, J A; Fauziah, H

2016-01-01

The curriculum in Indonesia recommended that science teachers in the elementary and intermediate schools should have interdisciplinary ability in science. However, integrated learning still has not been implemented optimally. This research is designing and applying integrated learning with Susan Loucks-Horsley model in light pollution theme. It can be showed how the student's achievements based on new taxonomy of science education with five domains: knowing and understanding, science process skill, creativity, attitudinal and connecting and applying. This research use mixed methods with concurrent embedded design. The subject is grade 8 of junior high school students in Bandung as many as 27 students. The Instrument have been employed has 28 questions test mastery of concepts, observations sheet and moral dilemma test. The result shows that integrated learning with model Susan Loucks-Horsley is able to increase student's achievement and positive characters on light pollution theme. As the results are the average normalized gain of knowing and understanding domain reach in lower category, the average percentage of science process skill domain reach in good category, the average percentage of creativity and connecting domain reach respectively in good category and attitudinal domain the average percentage is over 75% in moral knowing and moral feeling. (paper)

Quantitative trace analysis of polyfluorinated alkyl substances (PFAS) in ambient air samples from Mace Head (Ireland): A method intercomparison

Science.gov (United States)

Jahnke, Annika; Barber, Jonathan L.; Jones, Kevin C.; Temme, Christian

A method intercomparison study of analytical methods for the determination of neutral, volatile polyfluorinated alkyl substances (PFAS) was carried out in March, 2006. Environmental air samples were collected in triplicate at the European background site Mace Head on the west coast of Ireland, a site dominated by 'clean' westerly winds coming across the Atlantic. Extraction and analysis were performed at two laboratories active in PFAS research using their in-house methods. Airborne polyfluorinated telomer alcohols (FTOHs), fluorooctane sulfonamides and sulfonamidoethanols (FOSAs/FOSEs) as well as additional polyfluorinated compounds were investigated. Different native and isotope-labelled internal standards (IS) were applied at various steps in the analytical procedure to evaluate the different quantification strategies. Field blanks revealed no major blank problems. European background concentrations observed at Mace Head were found to be in a similar range to Arctic data reported in the literature. Due to trace-levels at the remote site, only FTOH data sets were complete and could therefore be compared between the laboratories. Additionally, FOSEs could partly be included. Data comparison revealed that despite the challenges inherent in analysis of airborne PFAS and the low concentrations, all methods applied in this study obtained similar results. However, application of isotope-labelled IS early in the analytical procedure leads to more precise results and is therefore recommended.

(REREADING INDEX CARDS: THE ARCHIVIST AS INTERPRETER IN SUSAN PUI SAN LOK'S 'NEWS'

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Sandra Camacho

2018-01-01

Full Text Available Looking at susan pui san lok's projects News (2005 and RoCH (2013, this paper contemplates the notions put forward by Michel-Rolph Trouillot and Jacques Derrida on the power of archivists, not solely as guardians of documents but also as their interpreters. Taking into consideration that photographic and moving image archives present unique difficulties in their cataloguing processes, I examine silences that might be generated by a thematic classification that is not impervious to archivists' biases. Moreover, I consider if the silences created by manual processes of classification and retrieval might be surpassed through digital technologies, or if it is possible that new technologies simply create different types of silencing.

A conversation with Susan Band Horwitz.

Science.gov (United States)

Horwitz, Susan Band; Goldman, I David

2015-01-01

Susan Band Horwitz is a Distinguished Professor and holds the Falkenstein Chair in Cancer Research at Albert Einstein College of Medicine in New York. She is co-chair of the Department of Molecular Pharmacology and associate director for therapeutics at the Albert Einstein Cancer Center. After graduating from Bryn Mawr College, Dr. Horwitz received her PhD in biochemistry from Brandeis University. She has had a continuing interest in natural products as a source of new drugs for the treatment of cancer. Her most seminal research contribution has been in the development of Taxol(®). Dr. Horwitz and her colleagues made the discovery that Taxol had a unique mechanism of action and suggested that it was a prototype for a new class of antitumor drugs. Although Taxol was an antimitotic agent blocking cells in the metaphase stage of the cell cycle, Dr. Horwitz recognized that Taxol was blocking mitosis in a way different from that of other known agents. Her group demonstrated that the binding site for Taxol was on the β-tubulin subunit. The interaction of Taxol with the β-tubulin subunit resulted in stabilized microtubules, essentially paralyzing the cytoskeleton, thereby preventing cell division. Dr. Horwitz served as president (2002-2003) of the American Association for Cancer Research (AACR). She is a member of the National Academy of Sciences, the Institute of Medicine, the American Academy of Arts and Sciences, and the American Philosophical Society. She has received numerous honors and awards, including the C. Chester Stock Award from Memorial Sloan Kettering Cancer Center, the Warren Alpert Foundation Prize from Harvard Medical School, the Bristol-Myers Squibb Award for Distinguished Achievement in Cancer Research, the American Cancer Society's Medal of Honor, and the AACR Award for Lifetime Achievement in Cancer Research. The following interview was conducted on January 23, 2014.

Results of MACE tests M0 and M1

International Nuclear Information System (INIS)

Spencer, B.W.; Farmer, M.T.; Armstrong, D.R.; Kilsdonk, D.J.; Aeschlimann, R.W.; Fischer, M.

1992-01-01

This document discusses the Melt Attack and Coolability Experiment (MACE) Program underway at Argonne National Laboratory under ACE/EPRI sponsorship. The program addresses the efficacy of water to terminate an accident situation if melt progression were to result in a molten core/concrete interaction (MCCI) in the reactor containment. Large-scale experiments are being conducted in parallel with related modeling efforts, involving the addition of water to an MCI already underway. The experiments utilize UO 2 /ZrO 2 /Zr corium mixtures, direct electrical heating for simulation of decay heating, and various types of concrete basemats. Currently the tests involve 430 kg corium mass, 25 cm depth, in a 50 cm square test section. Test MO was a successful scoping test, but the first full size test, Ml, failed to achieve melt-water contact owing to existence of a preexisting bridge crust of corium charge. A heat flux of 3.5 MW/m 2 was measured in MO which removed energy from the corium pool equivalent to its entire heat of solidification prior to abatement by formation of an interfacial crust. The crust subsequently limited heat extraction to 600 kW/m 2 and less. Both tests MO and Ml revealed physical evidence of large pool swelling events which resulted in extrusion (and ejection) of melt into water above the crust, significantly increasing the overall quench and reducing the remaining melt in contact with the concrete. Furthermore, test Ml provided evidence of occasional ''burst mode'' ablation events and one additional important benefit of overlying water -- aerosol capture

Peristeen anal irrigation as a substitute for the MACE procedure in children who are in need of reconstructive bladder surgery

Science.gov (United States)

Alenezi, Husain; Alhazmi, Hamdan; Trbay, Mahmoud; Khattab, Amna; Neel, Khalid Fouda

2014-01-01

Introduction: We evaluate the efficacy of the Peristeen (Coloplast A/S, Kokkedal, Denmark) transanal irrigation (TAI) system, as a stool cleansing mechanism, to gain stool continence in children who need reconstructive bladder surgery and have fecal incontinence. Methods: We prospectively evaluated children with neuropathic bladder and bowel dysfunction who were intended for reconstructive bladder surgery and the Malone antegrade continence enema (MACE) procedure. All patients were started on the Peristeen TAI system at least 3 months before surgery to assess their response. Each patient’s bowel function, frequency of using the system, satisfaction (and that of their parents) and diaper independency were evaluated before and after reconstructive surgery. Results: We included 18 patients (11 female, 7 male) who were evaluated from April 2006 to the present. The mean age of the group was 7.6 years (range: 4–15). Fifteen patients (83.3%) showed complete dryness from stools. Of the 15 patients, 8 (53.3%) were able to be diaper-free, while 6 continued wearing diapers due to fear of soiling and 1 due to urinary incontinence. The patients underwent reconstructive bladder surgery and continued to use the Peristeen TAI system with the same results postoperatively. The main limitation of this study is the small number of patients included, although this is a very specific patient group. Conclusion: Our initial results suggest that the Peristeen TAI system is a successful conservative substitute for the MACE procedure in children who require reconstructive bladder surgery. PMID:24454594

A Journey, the Pain of Others, and Historical Experience: Susan Silas

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Sendyka, Roma

2014-12-01

Full Text Available The author interprets Susan Silas' Helmbrechts walk (1998-2003, a unique series of forty-five photographs and supplementing visual and textual materials collected during the walk along the route of two hundred and twenty-five miles. The walk repeats the route which in 1945 had to undertake women prisoners from the concentration camp in Helmbrechts near Flossenbürg in their death march to Prachatice in Czech Republic. The pictures Silas takes, the people she meets, and finally the trees, the very materiality of the road become the factors of creating her own, individual memory of the event from the past. Silas selects an object from "the margins of the Holocaust" – a forgotten event that she re-presents by reacting to contemporary objects placed along the route of the event. Silas' work offers an opportunity to critically review the concept of memory landscapes (where is memory located in a landscape? and the phenomenon of dark tourism (is following in the footsteps of the prisoners a kind of pilgrimage, tourism, or therapy?. Silas problematises the question of memory, as well as examines different kinds of non-memory. Her camera is directed at locations that can be termed "the non-sites of memory."

The haunting of Susan Lay: servants and mistresses in seventeenth-century England.

Science.gov (United States)

Gowing, Laura

2002-01-01

At Easter 1650, Susan Lay, a servant in an Essex alehouse, saw the ghost of her mistress, who had been buried three days before. This article explores the history that lay behind her experience: of sexual relationships with both her master and his son, the births and deaths of two bastard children, and beneath it all, a relationship of antagonism, competition, and intimacy with her mistress. It uses this and other legal records to examine the relationship between women in early modern households, arguing that, while antagonisms between women are typically part of effective patriarchies, the domestic life and social structures of mid seventeenth-century England bound servants and mistresses peculiarly tightly together, giving servants licence to dream of replacing their mistresses and mistresses cause to feel threatened by their servants, and making the competitive relations between women functional to patriarchal order. It suggests, finally, that at this moment in time and in this context, seeing a ghost was the best, perhaps the only, way this servant had to tell a suppressed story and stake a claim to a household that had excluded her.

The phase-in and phase-out of European emissions of HCFC-141b and HCFC-142b under the Montreal Protocol: Evidence from observations at Mace Head, Ireland and Jungfraujoch, Switzerland from 1994 to 2004

Science.gov (United States)

Derwent, R. G.; Simmonds, P. G.; Greally, B. R.; O'doherty, S.; McCulloch, A.; Manning, A.; Reimann, S.; Folini, D.; Vollmer, M. K.

The mixing ratios of HCFC-141b (1,1-dichlorofluoroethane) and HCFC-142b (1-chloro-1,1-difluoroethane) have been rising steadily in baseline air at Mace Head, Ireland over the 10-year period from 1994 to 2004. These HCFCs are widely used replacements for the chlorofluorocarbons phased out under the Montreal Protocol and its subsequent amendments. Analysis of the HCFC content of regionally-polluted air arriving at Mace Head from the European continent shows that European emissions reached a peak during 2000-2001 and have declined subsequently, following the phase-out in their usage. European emissions of HCFC-141b have been further constrained by observations at the High-Alpine Jungfraujoch site. The reductions are consistent with the phase-out of HCFC production and use from the year 2001 onwards mandated by European regulations designed to exceed the requirements of the Montreal Protocol.

Podróż, cudze cierpienie i doświadczenie historyczne: Susan Silas

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Sendyka, Roma

2014-12-01

Full Text Available Autorka interpretuje pracę Susan Silas Helmbrechts walk (1998-2003, szczególny cykl czterdziestu pięciu zdjęć i dołączonych do nich materiałów wizualnych oraz tekstowych zbudowany podczas przejścia trasy dwustu dwudziestu pięciu mil, które w 1945 roku musiały przebyć kobiety pędzone w marszu śmierci z Helmbrecht koło Flossenbürga do czeskich Prachatic. Wykonywane zdjęcia, napotykani ludzie, w końcu – drzewa, sama materialność drogi stają się czynnikami wytwarzania własnej, indywidualnej pamięci wydarzenia sprzed lat. Silas wybiera szczególny obiekt "z marginesów Zagłady" – zapomniane zdarzenie, które przedstawia obserwując współczesne obiekty położone wzdłuż trasy tego zdarzenia. Praca Silas pozwala przyjrzeć się krytycznie koncepcji memory landscapes (gdzie w krajobrazie umiejscawia się pamięć? i zjawisku dark tourism (czy podążanie śladami więźniarek to pielgrzymka, turystyka czy terapia?. Silas problematyzuje nie tylko kwestię pamięci, bada również rodzaje nie-pamiętania. Jej kamera zostaje zwrócona ku lokalizacjom, które można nazwać "nie-miejscami pamięci".

'Speaking Kleinian': Susan Isaacs as Ursula Wise and the Inter-War Popularisation of Psychoanalysis.

Science.gov (United States)

Shapira, Michal

2017-10-01

How did the complex concepts of psychoanalysis become popular in early twentieth-century Britain? This article examines the contribution of educator and psychoanalyst Susan Isaacs (1885-1948) to this process, as well as her role as a female expert in the intellectual and medical history of this period. Isaacs was one of the most influential British psychologists of the inter-war era, yet historical research on her work is still limited. The article focuses on her writing as 'Ursula Wise', answering the questions of parents and nursery nurses in the popular journal Nursery World, from 1929 to 1936. Researched in depth for the first time, Isaacs' important magazine columns reveal that her writing was instrumental in disseminating the work of psychoanalyst Melanie Klein in Britain. Moreover, Isaacs' powerful rebuttals to behaviourist, disciplinarian parenting methods helped shift the focus of caregivers to the child's perspective, encouraging them to acknowledge children as independent subjects and future democratic citizens. Like other early psychoanalysts, Isaacs was not an elitist; she was in fact committed to disseminating her ideas as broadly as possible. Isaacs taught British parents and child caregivers to 'speak Kleinian', translating Klein's intellectual ideas into ordinary language and thus enabling their swift integration into popular discourse.

Chemical and physical characteristics of aerosol particles at a remote coastal location, Mace Head, Ireland, during NAMBLEX

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H. Coe

2006-01-01

Full Text Available A suite of aerosol physical and chemical measurements were made at the Mace Head Atmospheric Research Station, Co. Galway, Ireland, a coastal site on the eastern seaboard of the north Atlantic Ocean during NAMBLEX. The data have been used in this paper to show that over a wide range of aerosol sizes there is no impact of the inter-tidal zone or the surf zone on measurements made at 7 m above ground level or higher. During the measurement period a range of air mass types were observed. During anticyclonic periods and conditions of continental outflow Aitken and accumulation mode were enhanced by a factor of 5 compared to the marine sector, whilst coarse mode particles were enhanced during westerly conditions. Baseline marine conditions were rarely met at Mace Head during NAMBLEX and high wind speeds were observed for brief periods only. The NAMBLEX experiment focussed on a detailed assessment of photochemistry in the marine environment, investigating the linkage between the HOx and the halogen radical cycles. Heterogeneous losses are important in both these cycles. In this paper loss rates of gaseous species to aerosol surfaces were calculated for a range of uptake coefficients. Even when the accommodation coefficient is unity, lifetimes due to heterogeneous loss of less than 10 s were never observed and rarely were they less than 500 s. Diffusional limitation to mass transfer is important in most conditions as the coarse mode is always significant. We calculate a minimum overestimate of 50% in the loss rate if this is neglected and so it should always be considered when calculating loss rates of gaseous species to particle surfaces. HO2 and HOI have accommodation coefficients of around 0.03 and hence we calculate lifetimes due to loss to particle surfaces of 2000 s or greater under the conditions experienced during NAMBLEX. Aerosol composition data collected during this experiment provide representative information on the input aerosol

‘Speaking Kleinian’: Susan Isaacs as Ursula Wise and the Inter-War Popularisation of Psychoanalysis

Science.gov (United States)

Shapira, Michal

2017-01-01

How did the complex concepts of psychoanalysis become popular in early twentieth-century Britain? This article examines the contribution of educator and psychoanalyst Susan Isaacs (1885–1948) to this process, as well as her role as a female expert in the intellectual and medical history of this period. Isaacs was one of the most influential British psychologists of the inter-war era, yet historical research on her work is still limited. The article focuses on her writing as ‘Ursula Wise’, answering the questions of parents and nursery nurses in the popular journal Nursery World, from 1929 to 1936. Researched in depth for the first time, Isaacs’ important magazine columns reveal that her writing was instrumental in disseminating the work of psychoanalyst Melanie Klein in Britain. Moreover, Isaacs’ powerful rebuttals to behaviourist, disciplinarian parenting methods helped shift the focus of caregivers to the child’s perspective, encouraging them to acknowledge children as independent subjects and future democratic citizens. Like other early psychoanalysts, Isaacs was not an elitist; she was in fact committed to disseminating her ideas as broadly as possible. Isaacs taught British parents and child caregivers to ‘speak Kleinian’, translating Klein’s intellectual ideas into ordinary language and thus enabling their swift integration into popular discourse. PMID:28901872

Fabrication of porous silicon nanowires by MACE method in HF/H2O2/AgNO3 system at room temperature

Science.gov (United States)

2014-01-01

In this paper, the moderately and lightly doped porous silicon nanowires (PSiNWs) were fabricated by the ‘one-pot procedure’ metal-assisted chemical etching (MACE) method in the HF/H2O2/AgNO3 system at room temperature. The effects of H2O2 concentration on the nanostructure of silicon nanowires (SiNWs) were investigated. The experimental results indicate that porous structure can be introduced by the addition of H2O2 and the pore structure could be controlled by adjusting the concentration of H2O2. The H2O2 species replaces Ag+ as the oxidant and the Ag nanoparticles work as catalyst during the etching. And the concentration of H2O2 influences the nucleation and motility of Ag particles, which leads to formation of different porous structure within the nanowires. A mechanism based on the lateral etching which is catalyzed by Ag particles under the motivation by H2O2 reduction is proposed to explain the PSiNWs formation. PMID:24910568

Treasure Your Exceptions: An Interview with 2017 George Beadle Award Recipient Susan A. Gerbi.

Science.gov (United States)

Gerbi, Susan A

2017-12-01

THE Genetics Society of America's (GSA) George W. Beadle Award honors individuals who have made outstanding contributions to the community of genetics researchers and who exemplify the qualities of its namesake. The 2017 recipient is Susan A. Gerbi, who has been a prominent leader and advocate for the scientific community. In the course of her research on DNA replication, Gerbi helped develop the method of Replication Initiation Point (RIP) mapping to map replication origins at the nucleotide level, improving resolution by two orders of magnitude. RIP mapping also provides the basis for the now popular use of λ-exonuclease to enrich nascent DNA to map replication origins genome-wide. Gerbi's second area of research on ribosomal RNA revealed a conserved core secondary structure, as well as conserved nucleotide elements (CNEs). Some CNEs are universally conserved, while other CNEs are conserved in all eukaryotes but not in archaea or bacteria, suggesting a eukaryotic function. Intriguingly, the majority of the eukaryotic-specific CNEs line the tunnel of the large ribosomal subunit through which the nascent polypeptide exits. Gerbi has promoted the fly Sciara coprophila as a model organism ever since she used its enormous polytene chromosomes to help develop the method of in situ hybridization during her Ph.D. research in Joe Gall's laboratory. The Gerbi laboratory maintains the Sciara International Stock Center and manages its future, actively spreading Sciara stocks to other laboratories. Gerbi has also served in many leadership roles, working on issues of science policy, women in science, scientific training, and career preparation. This is an abridged version of the interview. The full interview is available on the Genes to Genomes blog, at genestogenomes.org/gerbi. Copyright © 2017 by the Genetics Society of America.

The effectiveness of using WebCT in distance learning programmes in MACE, the University of Manchester

Science.gov (United States)

Ahmad, Rosman

The World Wide Web impacted the educational model and became part of distance education early in this century. There were many changes taking place in higher education for political, economic and educational reasons." New goals and educational objectives were being set within educational institutions. There were particular emphases to produce a more effective delivery of learning methods for distance learning students. The use of Internet was seen as an important issue in the development of an understanding of the complex process of instilling knowledge to post graduates students. Well-established universities were re-examining their missions and looking for different ways of providing lifelong education. The School of Mechanical, Aerospace and Civil Engineering (MACE) was particularly keen to increase the use of web-based learning in its courses, which will increase the amount of students enrolled into these programmes and help them learn in a flexible and workable manner. This approach was reinforced by responses from a survey of MSc. degree students which suggested that the current distance learning programme were not being operated efficiently and did not develop adequate personal skills in relation to the requirements of prospective employers. One way of improving these programmes was to make use of the Virtual Learning Environment (VLE). A study was made and WebCT was found to be suitable. Five WebCT units were initially produced. The experience of designing and running the units was very useful in determining the effective use of the WebCT. From the analysis of students and staff surveys it has been demonstrated that these WebCT units are much more effective in achieving the project objectives in a wide number of areas which relate to students satisfaction, skills development and enhancing their interest into learning experience. The success of the WebCT units has stimulated interest in overseas establishments. It is hope that the success will follow in the

Fidelity, Adaptation, and Meta-commentary: The Case of Susan Orlean’s The Orchid Thief and Spike Jonze’s Adaptation

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Victoria de Zwaan

2017-12-01

Full Text Available Abstract Susan Orlean’s The Orchid Thief has raised and defied questions about genre since its appearance in 1998. Though “research” and “facts” are at the foreground of the book, critics have described it by such terms as literary non-fiction, faction, personal journalism, and non-fiction novel because of its strong “literary,” that is narrative, characterological, thematic, and even philosophical, qualities. Struggling to make a faithful adaptation of this “simple” and “beautiful” book “about flowers” for film, Charlie Kaufman, the neurotic and anxious protagonist/screenwriter of Adaptation (2002, a fictionalized avatar of the real-life Charlie Kaufman, works through the wide range of possible generic and narrative adaptive possibilities that the book invites. The series of apparent false starts eventually get resolved, in a desperate attempt at creating closure, by way of the “Hollywood ending” that the screenwriter ostensibly despises and insists he will avoid. This paper engages the complex relationships between these two objects – The Orchid Thief and Adaptation – first, by providing some interpretive analysis of Orlean’s book and its potential adaptive possibilities, and second, by examining what happens to those possibilities in Adaptation. On my argument, the film refracts the book’s concerns into a meditation on the processes of reading, storytelling, and interpretation in the realm of explicit adaptation by way of metafiction, metalepsis, and other techniques associated with experimental narrative.

A Combined Comparative Transcriptomic, Metabolomic, and Anatomical Analyses of Two Key Domestication Traits: Pod Dehiscence and Seed Dormancy in Pea (Pisum sp.

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Petr Smýkal

2017-04-01

Full Text Available The origin of the agriculture was one of the turning points in human history, and a central part of this was the evolution of new plant forms, domesticated crops. Seed dispersal and germination are two key traits which have been selected to facilitate cultivation and harvesting of crops. The objective of this study was to analyze anatomical structure of seed coat and pod, identify metabolic compounds associated with water-impermeable seed coat and differentially expressed genes involved in pea seed dormancy and pod dehiscence. Comparative anatomical, metabolomics, and transcriptomic analyses were carried out on wild dormant, dehiscent Pisum elatius (JI64, VIR320 and cultivated, indehiscent Pisum sativum non-dormant (JI92, Cameor and recombinant inbred lines (RILs. Considerable differences were found in texture of testa surface, length of macrosclereids, and seed coat thickness. Histochemical and biochemical analyses indicated genotype related variation in composition and heterogeneity of seed coat cell walls within macrosclereids. Liquid chromatography–electrospray ionization/mass spectrometry and Laser desorption/ionization–mass spectrometry of separated seed coats revealed significantly higher contents of proanthocyanidins (dimer and trimer of gallocatechin, quercetin, and myricetin rhamnosides and hydroxylated fatty acids in dormant compared to non-dormant genotypes. Bulk Segregant Analysis coupled to high throughput RNA sequencing resulted in identification of 770 and 148 differentially expressed genes between dormant and non-dormant seeds or dehiscent and indehiscent pods, respectively. The expression of 14 selected dormancy-related genes was studied by qRT-PCR. Of these, expression pattern of four genes: porin (MACE-S082, peroxisomal membrane PEX14-like protein (MACE-S108, 4-coumarate CoA ligase (MACE-S131, and UDP-glucosyl transferase (MACE-S139 was in agreement in all four genotypes with Massive analysis of cDNA Ends (MACE data. In

Peroxy radical chemistry and the control of ozone photochemistry at Mace Head, Ireland during the summer of 2002

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Z. L. Fleming

2006-01-01

Full Text Available Peroxy radical (HO2+ΣRO2 measurements, using the PEroxy Radical Chemical Amplification (PERCA technique at the North Atlantic Marine Boundary Layer EXperiment (NAMBLEX at Mace Head in summer 2002, are presented and put into the context of marine, boundary-layer chemistry. A suite of other chemical parameters (NO, NO2, NO3, CO, CH4, O3, VOCs, peroxides, photolysis frequencies and meteorological measurements, are used to present a detailed analysis of the role of peroxy radicals in tropospheric oxidation cycles and ozone formation. Under the range of conditions encountered the peroxy radical daily maxima varied from 10 to 40 pptv. The diurnal cycles showed an asymmetric shape typically shifted to the afternoon. Using a box model based on the master chemical mechanism the average model measurement agreement was 2.5 across the campaign. The addition of halogen oxides to the model increases the level of model/measurement agreement, apparently by respeciation of HOx. A good correlation exists between j(HCHO.[HCHO] and the peroxy radicals indicative of the importance of HCHO in the remote atmosphere as a HOx source, particularly in the afternoon. The peroxy radicals showed a strong dependence on [NO2] with a break point at 0.1 ppbv, where the radicals increased concomitantly with the reactive VOC loading, this is a lower value than seen at representative urban campaigns. The HO2/(HO2+ΣRO2 ratios are dependent on [NOx] ranging between 0.2 and 0.6, with the ratio increasing linearly with NOx. Significant night-time levels of peroxy radicals were measured up to 25 pptv. The contribution of ozone-alkenes and NO3-alkene chemistry to night-time peroxy radical production was shown to be on average 59 and 41%. The campaign mean net ozone production rate was 0.11±0.3 ppbv h-1. The ozone production rate was strongly dependent on [NO] having linear sensitivity (dln(P(O3/dln(NO=1.0. The results imply that the N(O3 (the in-situ net photochemical rate of ozone

Association between influenza vaccination and reduced risks of major adverse cardiovascular events in elderly patients.

Science.gov (United States)

Chiang, Ming-Hsien; Wu, Hau-Hsin; Shih, Chia-Jen; Chen, Yung-Tai; Kuo, Shu-Chen; Chen, Te-Li

2017-11-01

This study was conducted to determine the protective effect of influenza vaccine against primary major adverse cardiovascular events (MACEs) in elderly patients, especially those with influenza-like illness (ILI). This retrospective, population-based case-control study of an elderly population (age≥65 years) was conducted using Taiwan's National Health Insurance Research Database (2000-2013). One control was selected for each MACE case (n=80,363 each), matched according to age, year of study entry, and predisposing factors for MACEs. ILI and MACEs (myocardial infarction [MI] and ischemic stroke) were defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification. Odds ratios (ORs) were calculated for the association between MACEs and vaccination. Influenza vaccination received in the previous year was associated with reduced risks of primary MACEs overall (adjusted OR [aOR] 0.80, 95% CI 0.78-0.82, Prisks of MACEs (aOR 1.24, 95% CI 1.18-1.29, PVaccination attenuated the heightened risks associated with ILI (MACEs: aOR 0.99, 95% CI 0.92-1.07, P=.834; MI: aOR 1.05, 95% CI 0.92-1.21, P=.440; ischemic stroke: aOR 0.96, 95% CI 0.89-1.05, P=.398). Results of this study suggest that influenza vaccination is associated with reduced primary MACE risks in the elderly population, including those with ILI. Copyright © 2017 Elsevier Inc. All rights reserved.

SU-E-T-540: Volumetric Modulated Total Body Irradiation Using a Rotational Lazy Susan-Like Immobilization System

International Nuclear Information System (INIS)

Gu, X; Hrycushko, B; Lee, H; Lamphier, R; Jiang, S; Abdulrahman, R; Timmerman, R

2014-01-01

Purpose: Traditional extended SSD total body irradiation (TBI) techniques can be problematic in terms of patient comfort and/or dose uniformity. This work aims to develop a comfortable TBI technique that achieves a uniform dose distribution to the total body while reducing the dose to organs at risk for complications. Methods: To maximize patient comfort, a lazy Susan-like couch top immobilization system which rotates about a pivot point was developed. During CT simulation, a patient is immobilized by a Vac-Lok bag within the body frame. The patient is scanned head-first and then feet-first following 180° rotation of the frame. The two scans are imported into the Pinnacle treatment planning system and concatenated to give a full-body CT dataset. Treatment planning matches multiple isocenter volumetric modulated arc (VMAT) fields of the upper body and multiple isocenter parallel-opposed fields of the lower body. VMAT fields of the torso are optimized to satisfy lung dose constraints while achieving a therapeutic dose to the torso. The multiple isocenter VMAT fields are delivered with an indexed couch, followed by body frame rotation about the pivot point to treat the lower body isocenters. The treatment workflow was simulated with a Rando phantom, and the plan was mapped to a solid water slab phantom for point- and film-dose measurements at multiple locations. Results: The treatment plan of 12Gy over 8 fractions achieved 80.2% coverage of the total body volume within ±10% of the prescription dose. The mean lung dose was 8.1 Gy. All ion chamber measurements were within ±1.7% compared to the calculated point doses. All relative film dosimetry showed at least a 98.0% gamma passing rate using a 3mm/3% passing criteria. Conclusion: The proposed patient comfort-oriented TBI technique provides for a uniform dose distribution within the total body while reducing the dose to the lungs

Role of Low Endothelial Shear Stress and Plaque Characteristics in the Prediction of Nonculprit Major Adverse Cardiac Events: The PROSPECT Study.

Science.gov (United States)

Stone, Peter H; Maehara, Akiko; Coskun, Ahmet Umit; Maynard, Charles C; Zaromytidou, Marina; Siasos, Gerasimos; Andreou, Ioannis; Fotiadis, Dimitris; Stefanou, Kostas; Papafaklis, Michail; Michalis, Lampros; Lansky, Alexandra J; Mintz, Gary S; Serruys, Patrick W; Feldman, Charles L; Stone, Gregg W

2018-03-01

This study sought to determine whether low endothelial shear stress (ESS) adds independent prognostication for future major adverse cardiac events (MACE) in coronary lesions in patients with high-risk acute coronary syndrome (ACS) from the United States and Europe. Low ESS is a proinflammatory, proatherogenic stimulus associated with coronary plaque development, progression, and destabilization in human-like animal models and in humans. Previous natural history studies including baseline ESS characterization investigated low-risk patients. In the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study, 697 patients with ACS underwent 3-vessel intracoronary imaging. Independent predictors of MACE attributable to untreated nonculprit (nc) coronary lesions during 3.4-year follow-up were large plaque burden (PB), small minimum lumen area (MLA), and thin-cap fibroatheroma (TCFA) morphology. In this analysis, baseline ESS of nc lesions leading to new MACE (nc-MACE lesions) and randomly selected control nc lesions without MACE (nc-non-MACE lesions) were calculated. A propensity score for ESS was constructed for each lesion, and the relationship between ESS and subsequent nc-MACE was examined. A total of 145 lesions were analyzed in 97 patients: 23 nc-MACE lesions (13 TCFAs, 10 thick-cap fibroatheromas [ThCFAs]), and 122 nc-non-MACE lesions (63 TCFAs, 59 ThCFAs). Low local ESS (<1.3 Pa) was strongly associated with subsequent nc-MACE compared with physiological/high ESS (≥1.3 Pa) (23 of 101 [22.8%]) versus (0 of 44 [0%]). In propensity-adjusted Cox regression, low ESS was strongly associated with MACE (hazard ratio: 4.34; 95% confidence interval: 1.89 to 10.00; p < 0.001). Categorizing plaques by anatomic risk (high risk: ≥2 high-risk characteristics PB ≥70%, MLA ≤4 mm 2 , or TCFA), high anatomic risk, and low ESS were prognostically synergistic: 3-year nc-MACE rates were 52.1% versus 14.4% versus 0.0% in high

Mace-like hierarchical MoS2/NiCo2S4 composites supported by carbon fiber paper: An efficient electrocatalyst for the hydrogen evolution reaction

Science.gov (United States)

Sun, Lan; Wang, Tao; Zhang, Long; Sun, Yunjin; Xu, Kewei; Dai, Zhengfei; Ma, Fei

2018-02-01

The rational design and preparation of earth-abundant, stable and efficient electrocatalysts for hydrogen production is currently the subject in extensive scientific and technological researches toward the future of a clean-energy society. Herein, a mace-like MoS2/NiCo2S4 hierarchical structure is designed and synthesized on carbon fiber paper via a facile hydrothermal method, and evaluated as electrocatalyst for hydrogen evolution reaction. In the MoS2/NiCo2S4/carbon fiber paper hierarchical structures, MoS2 nanosheets are dispersively distributed on the surface of NiCo2S4 nanowires, which provides an enlarged surface area, abundant interfaces and catalytic active sites. As for hydrogen evolution reaction, such MoS2/NiCo2S4/carbon fiber paper heterostructures give rise to a hydrogen evolution reaction catalytic current density of 10 mA cm-2 with a lower overpotential of 139 mV and a smaller Tafel slope of 37 mV·dec-1 than those of MoS2/carbon fiber paper and NiCo2S4/carbon fiber paper counterparts, exhibiting a prominent electrocatalytic performance. Moreover, the electrocatalytic properties change little after 5000 CV cycles and continual electrolysis for 12 h without obvious decay, respectively, demonstrating high durability and stability. The excellent hydrogen evolution reaction performances endow the hierarchical configuration MoS2/NiCo2S4/carbon fiber paper with promising alternative in HER and other related renewable energy fields.

Cardiovascular disease: Risk factors and applicability of a risk model in a Greek cohort of renal transplant recipients.

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Anastasopoulos, Nikolaos-Andreas; Dounousi, Evangelia; Papachristou, Evangelos; Pappas, Charalampos; Leontaridou, Eleni; Savvidaki, Eirini; Goumenos, Dimitrios; Mitsis, Michael

2017-02-24

To investigate the incidence and the determinants of cardiovascular morbidity in Greek renal transplant recipients (RTRs) expressed as major advance cardiac event (MACE) rate. Two hundred and forty-two adult patients with a functioning graft for at least three months and available data that were followed up on the August 31, 2015 at two transplant centers of Western Greece were included in this study. Baseline recipients' data elements included demographics, clinical characteristics, history of comorbid conditions and laboratory parameters. Follow-up data regarding MACE occurrence were collected retrospectively from the patients' records and MACE risk score was calculated for each patient. The mean age was 53 years (63.6% males) and 47 patients (19.4%) had a pre-existing cardiovascular disease (CVD) before transplantation. The mean estimated glomerular filtration rate was 52 ± 17 mL/min per 1.73 m 2 . During follow-up 36 patients (14.9%) suffered a MACE with a median time to MACE 5 years (interquartile range: 2.2-10 years). Recipients with a MACE compared to recipients without a MACE had a significantly higher mean age (59 years vs 52 years, P Greek database of RTRs was good with an area under the receiver operating characteristics curve of 0.68 (95%CI: 0.58-0.78). In this Greek cohort of RTRs, MACE occurred in 14.9% of the patients, pre-existing CVD was the main risk factor, while MACE risk model was proved a dependable utility in predicting CVD post RT.

Hemorheological and Glycemic Parameters and HDL Cholesterol for the Prediction of Cardiovascular Events

International Nuclear Information System (INIS)

Cho, Sung Woo; Kim, Byung Gyu; Kim, Byung Ok; Byun, Young Sup; Goh, Choong Won; Rhee, Kun Joo; Kwon, Hyuck Moon; Lee, Byoung Kwon

2016-01-01

Hemorheological and glycemic parameters and high density lipoprotein (HDL) cholesterol are used as biomarkers of atherosclerosis and thrombosis. To investigate the association and clinical relevance of erythrocyte sedimentation rate (ESR), fibrinogen, fasting glucose, glycated hemoglobin (HbA1c), and HDL cholesterol in the prediction of major adverse cardiovascular events (MACE) and coronary heart disease (CHD) in an outpatient population. 708 stable patients who visited the outpatient department were enrolled and followed for a mean period of 28.5 months. Patients were divided into two groups, patients without MACE and patients with MACE, which included cardiac death, acute myocardial infarction, newly diagnosed CHD, and cerebral vascular accident. We compared hemorheological and glycemic parameters and lipid profiles between the groups. Patients with MACE had significantly higher ESR, fibrinogen, fasting glucose, and HbA1c, while lower HDL cholesterol compared with patients without MACE. High ESR and fibrinogen and low HDL cholesterol significantly increased the risk of MACE in multivariate regression analysis. In patients with MACE, high fibrinogen and HbA1c levels increased the risk of multivessel CHD. Furthermore, ESR and fibrinogen were significantly positively correlated with HbA1c and negatively correlated with HDL cholesterol, however not correlated with fasting glucose. Hemorheological abnormalities, poor glycemic control, and low HDL cholesterol are correlated with each other and could serve as simple and useful surrogate markers and predictors for MACE and CHD in outpatients

Hemorheological and Glycemic Parameters and HDL Cholesterol for the Prediction of Cardiovascular Events

Energy Technology Data Exchange (ETDEWEB)

Cho, Sung Woo [Division of Cardiology - Department of Internal Medicine - Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Division of Cardiology - Department of Medicine - Samsung Medical Center, Seoul (Korea, Republic of); Kim, Byung Gyu; Kim, Byung Ok; Byun, Young Sup; Goh, Choong Won; Rhee, Kun Joo [Division of Cardiology - Department of Internal Medicine - Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Kwon, Hyuck Moon; Lee, Byoung Kwon, E-mail: cardiobk@yuhs.ac [Division of Cardiology - Department of Internal Medicine - Gangnam Severance Hospital - Yonsei University College of Medicine, Seoul (Korea, Republic of)

2016-01-15

Hemorheological and glycemic parameters and high density lipoprotein (HDL) cholesterol are used as biomarkers of atherosclerosis and thrombosis. To investigate the association and clinical relevance of erythrocyte sedimentation rate (ESR), fibrinogen, fasting glucose, glycated hemoglobin (HbA1c), and HDL cholesterol in the prediction of major adverse cardiovascular events (MACE) and coronary heart disease (CHD) in an outpatient population. 708 stable patients who visited the outpatient department were enrolled and followed for a mean period of 28.5 months. Patients were divided into two groups, patients without MACE and patients with MACE, which included cardiac death, acute myocardial infarction, newly diagnosed CHD, and cerebral vascular accident. We compared hemorheological and glycemic parameters and lipid profiles between the groups. Patients with MACE had significantly higher ESR, fibrinogen, fasting glucose, and HbA1c, while lower HDL cholesterol compared with patients without MACE. High ESR and fibrinogen and low HDL cholesterol significantly increased the risk of MACE in multivariate regression analysis. In patients with MACE, high fibrinogen and HbA1c levels increased the risk of multivessel CHD. Furthermore, ESR and fibrinogen were significantly positively correlated with HbA1c and negatively correlated with HDL cholesterol, however not correlated with fasting glucose. Hemorheological abnormalities, poor glycemic control, and low HDL cholesterol are correlated with each other and could serve as simple and useful surrogate markers and predictors for MACE and CHD in outpatients.

Increased long-term risk of major adverse cardiovascular events in patients with carbon monoxide poisoning: A population-based study in Taiwan.

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Chung-Shun Wong

Full Text Available Carbon monoxide (CO poisoning may cause toxicity to the cardiovascular system. However, the association between CO poisoning and the risk of major adverse cardiovascular events (MACE remains unestablished. We investigated the incidence of MACE after CO poisoning in Taiwan and evaluated whether CO-poisoned individuals had a higher risk of MACE than did the general population.Using Taiwan's National Health Insurance Research Database (NHIRD during 2005-2013, a nationwide population-based cohort study was conducted among patients who experienced CO poisoning between 2005 and 2013. CO poisoning was defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. The study cohort comprised patients with CO poisoning between 2005 and 2010 (N = 13,939. Each patient was matched according to age, sex and index date with four randomly selected controls from the comparison cohort (N = 55,756. All patients were followed from the study date until MACE development, death, or the end of 2013. The hazard ratios for MACE were compared between the two cohorts by using Cox proportional hazards regressions analyses.Incident cases of MACE were identified from the NHIRD. After adjustment for potential confounders, the study cohort was independently associated with a higher MACE risk (adjusted hazard ratio, 2.00; 95% confidence interval, 1.83-2.18.This population-based cohort study indicated that patients with CO poisoning have a higher risk of MACE than do individuals without CO poisoning.

The Utility of the Mini-Addenbrooke's Cognitive Examination as a Screen for Cognitive Impairment in Elderly Patients with Chronic Kidney Disease and Diabetes.

Science.gov (United States)

Hobson, Peter; Rohoma, Kamel H; Wong, Stephen P; Kumwenda, Mick J

2016-01-01

We tested the utility of the Mini-Addenbrooke's Cognitive Examination (M-ACE) in a cohort of older adults with chronic kidney disease (CKD) and diabetes. The M-ACE was administered to 112 CKD and diabetes patients attending a nephrology clinic. Cognitive impairment was based upon patient, informant, and case review, neuropsychological assessment, and application of criteria for mild cognitive impairment (MCI) and the Diagnostic and Statistical Manual of Mental Disorders, fifth edition for dementia. The M-ACE was also compared to the Mini-Mental State Examination (MMSE). Upon assessment, 52 patients had normal cognitive function, 33 had MCI, and 27 had dementia. The area under the receiver operating curve for the M-ACE was 0.96 (95% CI 0.95-1.00). The sensitivity and specificity for a dementia diagnosis were 0.96 and 0.84 at the cut point <25 and 0.70 and 1.00 at the cut point <21. Mean M-ACE scores differed significantly between normal, demented, and MCI groups ( p < 0.001), and compared to the MMSE, the M-ACE did not suffer from ceiling effects. The M-ACE is an easily administered test with good sensitivity and specificity to capture and assist in the diagnosis of MCI or dementia in patients with CKD and diabetes.

Resting heart rate associates with one-year risk of major adverse cardiovascular events in patients with acute coronary syndrome after percutaneous coronary intervention.

Science.gov (United States)

Wang, Shao-Li; Wang, Cheng-Long; Wang, Pei-Li; Xu, Hao; Du, Jian-Peng; Zhang, Da-Wu; Gao, Zhu-Ye; Zhang, Lei; Fu, Chang-Geng; Chen, Ke-Ji; Shi, Da-Zhuo

2016-03-01

The study was to access the association between resting heart rate (RHR) and one-year risk of major adverse cardiovascular events (MACE) in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). Patients with ACS after PCI (n = 808) were prospectively followed-up for MACE. RHR was obtained from electrocardiogram. MACE was defined as a composite of cardiac death, nonfatal recurrent myocardial infarction, ischemic-driven revascularization, and ischemic stroke. The association between RHR and one-year risk of MACE was assessed using Cox proportional hazards regression model. Compared with patients with RHR >76 bpm, the adjusted hazard ratio (AHR) was 0.51 (95% confidence intervals [CI]: 0.23-1.14; P = 0.100) for patients with RHR 76 bpm were at higher risk of MACE during one-year follow-up compared with patients with RHR 61-76 bpm. An elevated RHR ≥ 61 bpm was associated with increased risk of one-year MACE in ACS patients. © 2015 by the Society for Experimental Biology and Medicine.

Long-term major adverse cardiovascular events and quality of life after coronary angiography in elderly patients with acute coronary syndrome.

Science.gov (United States)

Sigurjonsdottir, R; Barywani, S; Albertsson, P; Fu, M

2016-11-01

Although the elderly comprise the majority of acute coronary syndrome (ACS) patients, limited data exist on major adverse cardiovascular events (MACEs) and quality of life (QoL). To study MACEs and QoL prospectively in ACS patients >70years referred for coronary angiography. A prospective observational study that included ACS patients >70years undergoing coronary angiography. The outcomes were MACEs and QoL 3years after inclusion. MACEs were defined as death, recurrent ACS, new-onset of heart failure and repeated revascularization by coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). A QoL questionnaire was completed by the patients along with a physical examination and a personal interview at the 3-year follow-up. Multivariate analysis was performed to identify the predictors for MACEs. In total, 138 patients (mean age 78.8±3.8years) with ACS were included in the study. Mean follow-up was 1196±296days. In all, 42% of the patients had MACEs and 25% had post-ACS heart failure. The mortality rate was 11%. After adjusting for significant cardiovascular risk factors, the following factors were significantly associated with MACEs: Age, high-sensitive troponin T (hsTNT), use of diuretics and reduced left ventricular ejection fraction (LVEF). Furthermore, the QoL evaluated with SF-36 in survivors from ACS at the end of study was similar to the QoL in an age-matched healthy Swedish population. In this prospective study on elderly ACS patients MACEs still occurred in 42% of the cases (despite low mortality and good QoL), with post-ACS heart failure as the most important event. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A 9-Year-Old Girl Discovers That Her Mother Was Murdered.

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Schonfeld, David J; Shekunov, Julia; Jellinek, Michael; Stein, Martin T

Susan was a 9-year-old girl living with her mother; she had never met her father. Her mother returned one evening from her job as a cocktail waitress and Susan met her at the apartment door to let her know they had run out of cat food. Her mother said she would go and buy some the next morning because it was late and she was tired, but Susan insisted she go out that evening because the cat had not eaten all day. Her mother was fatally shot in the parking lot of the convenience store shortly thereafter; since there was no robbery involved, the police suspected it was someone that she knew. Susan's extended family had her move out of the apartment that evening and relocate to live with her aunt and uncle out-of-state. The transition happened quickly. Susan was unable to return to her apartment to pick up any additional belongings and never returned to say goodbye to her friends. The family decided she was too young to attend the funeral.Susan had trouble fitting in with her aunt and uncle's family; they had 2 children who were 8 and 6 years old, and Susan felt she was being treated like a baby. She resented having a bedtime (her mother allowed her to stay up as late as she wished), and she complained that the work at school was boring and her classmates were childish. When the family went to a festival in town, she left abruptly without telling them, which frightened Susan's aunt and uncle. They wanted to be supportive but felt that she needed more structure than her mother had provided her. Susan's aunt and uncle sought bereavement support for Susan from her pediatrician and parenting advice for themselves.

Impact of TCFA on Unanticipated Ischemic Events in Medically Treated Diabetes Mellitus: Insights From the PROSPECT Study.

Science.gov (United States)

Kedhi, Elvin; Kennedy, Mark W; Maehara, Akiko; Lansky, Alexandra J; McAndrew, Thomas C; Marso, Steven P; De Bruyne, Bernard; Serruys, Patrick W; Stone, Gregg W

2017-04-01

This study sought to investigate the relationship between thin-cap fibroatheromas (TCFAs) on major adverse cardiac events (MACEs) arising from medically treated nonculprit lesions (NCLs) in patients with acute coronary syndromes (ACS) with and without diabetes mellitus (DM). MACEs occur frequently in patients with DM and ACS. The impact of plaque composition on subsequent MACEs in DM patients with ACS is unknown. In the PROSPECT (Providing Regional Observations Study Predictors of Events in the Coronary Tree) study, using 3-vessel radiofrequency intravascular ultrasound, we analyzed the incidence of NCL-MACE in 2 propensity-matched groups according to the presence of DM and TCFA. Among 697 patients, 119 (17.7%) had DM. The 3-year total MACE rate (29.4% vs. 18.8%; p = 0.01) was significantly higher in patients with versus without DM, driven by a higher rate of NCL-MACE in DM (18.7% vs. 10.4%; p = 0.02). Propensity score matching generated 2 balanced groups with and without DM of 82 patients each. Among DM patients, the presence of ≥1 TCFA was associated with higher NCL-MACE at 3 years (27.8% vs. 8.9% in patients without a TCFA, hazard ratio: 3.56; 95% confidence interval: 0.98 to 12.96; p = 0.04). DM patients without a TCFA had a similar 3-year rate of NCL-MACE as patients without DM (8.9% vs. 8.9%; hazard ratio: 1.09; 95% confidence interval: 0.27 to 4.41; p = 0.90). ACS patients with DM and ≥1 TCFA have a high rate of NCL-MACE at 3 years. In contrast, the prognosis of ACS patients with DM but no TCFAs is favorable and similar to patients without DM. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Plaque Structural Stress Estimations Improve Prediction of Future Major Adverse Cardiovascular Events After Intracoronary Imaging.

Science.gov (United States)

Brown, Adam J; Teng, Zhongzhao; Calvert, Patrick A; Rajani, Nikil K; Hennessy, Orla; Nerlekar, Nitesh; Obaid, Daniel R; Costopoulos, Charis; Huang, Yuan; Hoole, Stephen P; Goddard, Martin; West, Nick E J; Gillard, Jonathan H; Bennett, Martin R

2016-06-01

Although plaque rupture is responsible for most myocardial infarctions, few high-risk plaques identified by intracoronary imaging actually result in future major adverse cardiovascular events (MACE). Nonimaging markers of individual plaque behavior are therefore required. Rupture occurs when plaque structural stress (PSS) exceeds material strength. We therefore assessed whether PSS could predict future MACE in high-risk nonculprit lesions identified on virtual-histology intravascular ultrasound. Baseline nonculprit lesion features associated with MACE during long-term follow-up (median: 1115 days) were determined in 170 patients undergoing 3-vessel virtual-histology intravascular ultrasound. MACE was associated with plaque burden ≥70% (hazard ratio: 8.6; 95% confidence interval, 2.5-30.6; P<0.001) and minimal luminal area ≤4 mm(2) (hazard ratio: 6.6; 95% confidence interval, 2.1-20.1; P=0.036), although absolute event rates for high-risk lesions remained <10%. PSS derived from virtual-histology intravascular ultrasound was subsequently estimated in nonculprit lesions responsible for MACE (n=22) versus matched control lesions (n=22). PSS showed marked heterogeneity across and between similar lesions but was significantly increased in MACE lesions at high-risk regions, including plaque burden ≥70% (13.9±11.5 versus 10.2±4.7; P<0.001) and thin-cap fibroatheroma (14.0±8.9 versus 11.6±4.5; P=0.02). Furthermore, PSS improved the ability of virtual-histology intravascular ultrasound to predict MACE in plaques with plaque burden ≥70% (adjusted log-rank, P=0.003) and minimal luminal area ≤4 mm(2) (P=0.002). Plaques responsible for MACE had larger superficial calcium inclusions, which acted to increase PSS (P<0.05). Baseline PSS is increased in plaques responsible for MACE and improves the ability of intracoronary imaging to predict events. Biomechanical modeling may complement plaque imaging for risk stratification of coronary nonculprit lesions. © 2016

Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population.

Science.gov (United States)

Stone, Melvin E; Safadjou, Saman; Farber, Benjamin; Velazco, Nerissa; Man, Jianliang; Reddy, Srinivas H; Todor, Roxanne; Teperman, Sheldon

2015-07-01

Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. Diagnostic study, level II.

Prognostic value of CT-derived left atrial and left ventricular measures in patients with acute chest pain

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Takx, Richard A.P. [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, University Medical Center Utrecht (Netherlands); Vliegenthart, Rozemarijn [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); University of Groningen/University Medical Center Groningen, Center for Medical Imaging − North East Netherlands, Department of Radiology, Groningen (Netherlands); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States); Nance, John W. [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Bamberg, Fabian [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen (Germany); Abro, Joseph A. [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Carr, Christine M. [Division of Emergency Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States); Litwin, Sheldon E. [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States); and others

2017-01-15

Highlights: • LV mass and LA diameter are independent prognostic factor for composite MACE. • LV mass and LA diameter were not significant prognostic factors for MACE in African Americans. • Assessment of LV mass by CT may have a role in the management of patients. - Abstract: Purpose: To determine which left atrial (LA) and left ventricular (LV) parameters are associated with future major adverse cardiac event (MACE) and whether these measurements have independent prognostic value beyond risk factors and computed tomography (CT)-derived coronary artery disease measures. Materials and methods: This retrospective analysis was performed under an IRB waiver and in HIPAA compliance. Subjects underwent coronary CT angiography (CCTA) using a dual-source CT system for acute chest pain evaluation. LV mass, LV ejection fraction (EF), LV end-systolic volume (ESV) and LV end-diastolic volume (EDV), LA ESV and LA diameter, septal wall thickness and cardiac chamber diameters were measured. MACE was defined as cardiac death, non-fatal myocardial infarction, unstable angina, or late revascularization. The association between cardiac CT measures and the occurrence of MACE was quantified using Cox proportional hazard analysis. Results: 225 subjects (age, 56.2 ± 11.2; 140 males) were analyzed, of whom 42 (18.7%) experienced a MACE during a median follow-up of 13 months. LA diameter (HR:1.07, 95%CI:1.01–1.13 per mm) and LV mass (HR:1.05, 95%CI:1.00–1.10 per g) remained significant prognostic factor of MACE after controlling for Framingham risk score. LA diameter and LV mass were also found to have prognostic value independent of each other. The other morphologic and functional cardiac measures were no significant prognostic factors for MACE. Conclusion: CT-derived LA diameter and LV mass are associated with future MACE in patients undergoing evaluation for chest pain, and portend independent prognostic value beyond traditional risk factors, coronary calcium score, and

Reliability of the CARE rule and the HEART score to rule out an acute coronary syndrome in non-traumatic chest pain patients.

Science.gov (United States)

Moumneh, Thomas; Richard-Jourjon, Vanessa; Friou, Emilie; Prunier, Fabrice; Soulie-Chavignon, Caroline; Choukroun, Jacques; Mazet-Guilaumé, Betty; Riou, Jérémie; Penaloza, Andréa; Roy, Pierre-Marie

2018-03-02

In patients consulting in the Emergency Department for chest pain, a HEART score ≤ 3 has been shown to rule out an acute coronary syndrome (ACS) with a low risk of major adverse cardiac event (MACE) occurrence. A negative CARE rule (≤ 1) that stands for the first four elements of the HEART score may have similar rule-out reliability without troponin assay requirement. We aim to prospectively assess the performance of the CARE rule and of the HEART score to predict MACE in a chest pain population. Prospective two-center non-interventional study. Patients admitted to the ED for non-traumatic chest pain were included, and followed-up at 6 weeks. The main study endpoint was the 6-week rate of MACE (myocardial infarction, coronary angioplasty, coronary bypass, and sudden unexplained death). 641 patients were included, of whom 9.5% presented a MACE at 6 weeks. The CARE rule was negative for 31.2% of patients, and none presented a MACE during follow-up [0, 95% confidence interval: (0.0-1.9)]. The HEART score was ≤ 3 for 63.0% of patients, and none presented a MACE during follow-up [0% (0.0-0.9)]. With an incidence below 2% in the negative group, the CARE rule seemed able to safely rule out a MACE without any biological test for one-third of patients with chest pain and the HEART score for another third with a single troponin assay.

Reducing the porosity and reflection loss of silicon nanowires by a sticky tape

International Nuclear Information System (INIS)

Liu, Junjun; Huang, Zhifeng

2015-01-01

Engineering the porosity of silicon nanowires (SiNWs) is of fundamental importance, and this work introduces a new method for doing so. Metal-assisted chemical etching (MACE) of heavily doped Si(100) creates mesoporous silicon nanowires (mp-SiNWs). mp-SiNWs are transferred from the MACE-treated wafer to a sticky tape, leaving residues composed of broken mp-SiNWs and a mesoporous Si layer on the wafer. Then the taped wafer is re-treated by MACE, without changing the etching conditions. The second MACE treatment generates mp-SiNWs that are less porous and longer than those generated by the first MACE treatment, which can be attributed to the difference in the surface topography at the beginning of the etching process. Less porous mp-SiNWs reduce optical scattering from the porous Si skeletons, and vertically protrude on the wafer without aggregation to facilitate optical trapping. Consequently, less porous mp-SiNWs effectively reduce ultraviolet-visible reflection loss. (paper)

Left ventricular long axis function assessed during cine-cardiovascular magnetic resonance is an independent predictor of adverse cardiac events.

Science.gov (United States)

Rangarajan, Vibhav; Chacko, Satish Jacob; Romano, Simone; Jue, Jennifer; Jariwala, Nikhil; Chung, Jaehoon; Farzaneh-Far, Afshin

2016-06-07

Left ventricular pump function requires a complex interplay involving myocardial fibers orientated in the longitudinal, oblique and circumferential directions. Long axis dysfunction appears to be an early marker for a number of pathological states. We hypothesized that mitral annular plane systolic excursion (MAPSE) measured during cine-cardiovascular magnetic resonance (CMR) reflects changes in long axis function and may be an early marker for adverse cardiovascular outcomes. The aims of this study were therefore: 1) To assess the feasibility and reproducibility of MAPSE measurements during routine cine-CMR; and 2) To assess whether MAPSE, as a surrogate for long axis function, is a predictor of major adverse cardiovascular events (MACE). Four hundred consecutive patients undergoing CMR were prospectively enrolled. MAPSE was measured in the 4-chamber cine view. Patients were prospectively followed for major adverse cardiac events (MACE) - death, non-fatal myocardial infarction, hospitalization for heart failure or unstable angina, and late revascularization. Cox proportional hazards regression modeling was used to identify factors independently associated with MACE. Net reclassification improvement (NRI) was calculated to assess whether addition of MAPSE resulted in improved risk reclassification of MACE. Seventy-two MACE occurred during a median follow-up of 14.5 months. By Kaplan-Meier analysis, patients with lateral MAPSE cine-CMR is an independent predictor of MACE.

The anxious heart in whose mind? A systematic review and meta-regression of factors associated with anxiety disorder diagnosis, treatment and morbidity risk in coronary heart disease.

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Tully, Phillip J; Cosh, Suzanne M; Baumeister, Harald

2014-12-01

To (1) report the prognostic association between anxiety disorder subtypes and major adverse cardiac events (MACE), (2) report anxiety disorder prevalence in coronary heart disease (CHD), and (3) report the efficacy of anxiety disorder treatments in CHD. A comprehensive electronic database search was performed in November 2013 for studies reporting anxiety disorder prevalence according to structured interview in CHD samples or MACE, and randomized controlled trials (RCTs) comparing anxiety disorder treatment with placebo or usual care. From 4041 articles 42 samples were selected for extraction (8 for MACE prognosis, 39 for prevalence, no RCTs were eligible). Five generalized anxiety disorder (GAD) studies reported 883 MACE events (combined n=2851). There was a non-significant association between GAD and MACE (risk ratio=1.20, 95% CI .86-1.68, P=.28) however the effect size was highly significant in outpatient samples (adjusted hazard ratio=1.94, 95% CI 1.45-2.60, Pversus DSM-IV taxonomies. The paucity of extant anxiety disorder RCTs, alongside MACE risk for GAD outpatients, should stimulate further anxiety disorder intervention in CHD populations. Research should focus on depression and anxiety, thereby unraveling disorder specific and more generic pathways. Copyright © 2014 Elsevier Inc. All rights reserved.

Differences in coronary artery disease by CT angiography between patients developing unstable angina pectoris vs. major adverse cardiac events

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Schlett, Christopher L. [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg (Germany); Nance, John W. Jr. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); O’Brien, Terrence X. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); The Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC (United States); Ebersberger, Ullrich [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Centre Munich-Bogenhausen, Munich (Germany); Headden, Gary F. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); Hoffmann, Udo [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Bamberg, Fabian [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Radiology, University of Munich, Grosshadern Campus, and Munich Heart Alliance, Munich (Germany); Department of Radiology, University of Tuebingen (Germany)

2014-07-15

Highlights: • Patients developing UAP had overall more atherosclerosis as patients without any events. • Patients developing MACE had only more mixed plaque as those developing UAP. • Different atherosclerotic plaque components by CTA carry different prognostic value. - Abstract: Objective: CT angiography (CTA) has prognostic value in patients. But it is unknown whether differences in atherosclerosis by CTA predict the development of unstable angina pectoris (UAP) vs. major adverse cardiac events (MACE). Methods: We followed patients undergoing CTA as part of their acute chest pain work-up. Primary outcome was the development of UAP or MACE (cardiac death, myocardial infarction, revascularization) during a minimum follow-up of 12-months. CTAs were assessed for extent and composition of coronary plaque and stenosis. Ordinal regression with a 3-level outcome (no events, UAP, MACE) was applied. Results: Among 315 patients, 22 developed UAP and 31 MACE. While UAP patients had higher atherosclerosis burden with respect to all assessed features compared to patients with no events (p ≤ 0.02), only mixed plaque extent was significantly different between UAP and MACE patients (p = 0.02). The odds ratio was 4.55 for being in a higher disease-level comparing patients with low extent to those with no mixed plaque, and 3.02 comparing patients with high to those with low. These findings remained after adjustments for potential confounders. Conclusion: The extent of mixed coronary plaque is different between patients who develop UAP vs. MACE, supporting the hypothesis that it is a more culprit morphology.

Metabolic syndrome definitions and components in predicting major adverse cardiovascular events after kidney transplantation.

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Prasad, G V Ramesh; Huang, Michael; Silver, Samuel A; Al-Lawati, Ali I; Rapi, Lindita; Nash, Michelle M; Zaltzman, Jeffrey S

2015-01-01

Metabolic syndrome (MetS) associates with cardiovascular risk post-kidney transplantation, but its ambiguity impairs understanding of its diagnostic utility relative to components. We compared five MetS definitions and the predictive value of constituent components of significant definitions for major adverse cardiovascular events (MACE) in a cohort of 1182 kidney transplant recipients. MetS definitions were adjusted for noncomponent traditional Framingham risk factors and relevant transplant-related variables. Kaplan-Meier, logistic regression, and Cox proportional hazards analysis were utilized. There were 143 MACE over 7447 patient-years of follow-up. Only the World Health Organization (WHO) 1998 definition predicted MACE (25.3 vs 15.5 events/1000 patient-years, P = 0.019). Time-to-MACE was 5.5 ± 3.5 years with MetS and 6.8 ± 3.9 years without MetS (P < 0.0001). MetS was independent of pertinent MACE risk factors except age and previous cardiac disease. Among MetS components, dysglycemia provided greatest hazard ratio (HR) for MACE (1.814 [95% confidence interval 1.26-2.60]), increased successively by microalbuminuria (HR 1.946 [1.37-2.75]), dyslipidemia (3.284 [1.72-6.26]), hypertension (4.127 [2.16-7.86]), and central obesity (4.282 [2.09-8.76]). MetS did not affect graft survival. In summary, although the WHO 1998 definition provides greatest predictive value for post-transplant MACE, most of this is conferred by dysglycemia and is overshadowed by age and previous cardiac disease. © 2014 Steunstichting ESOT.

"If you thought this story sour, sweeten it with your own telling" - a feminist poetics of rewriting in Susan Price's Ghost dance

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Sanna Lehtonen

2010-01-01

Full Text Available The attempts to challenge conventional gendered discourses in children's fantasy have often resulted in feminist rewritings of earlier stories. Ghost dance (1994 by the English author Susan Price is a novel that reflects a specific feminist poetics of rewriting: metafictional passages highlight the constructedness of the narrative and at the end readers are invited to tell their own versions of the story. Moreover, the rewriting freely combines and recontextualises elements from different source texts and reformulates them to create a narrative that challenges conventional discourses of gender. While this poetics has an appeal from a feminist perspective, the play with cross-cultural intertexts and gender becomes more complex when the novel is examined in a postcolonialist framework in relation to ethnicity and the issue of cultural appropriation. Ghost dance is situated in a setting that has a real-world equivalent (Russia, involves characters that are identified with names of real-world ethnic groups (Lapps (Sámi, Russian, and mixes elements from Russian wonder tales, Nordic mythology and an Ojibwe legend. The novel does not aim at historical accuracy in its representations nor is it a direct retelling of any of the pre-texts but combines motifs, themes, names, characters and settings freely from each source. In this textual melting pot, the protagonist Shingebiss is, on one level, a revision of the witch Baba Yaga, but also described as a Lappish shaman with an Ojibwe name. To rewrite gendered discourses, certain elements from the pretexts are chosen and others left out – the question is, then, what effects does this recontextualisation have on the representation of ethnicity? Or, are the feminist rewriting strategies actually a form of cultural appropriation?

Cardiovascular safety of liraglutide assessed in a patient-level pooled analysis of phase 2: 3 liraglutide clinical development studies.

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Marso, Steven P; Lindsey, Jason B; Stolker, Joshua M; House, John A; Martinez Ravn, Gabriela; Kennedy, Kevin F; Jensen, Troels M; Buse, John B

2011-07-01

We assessed the cardiovascular safety of liraglutide, a glucagon-like peptide-1 receptor agonist, using existing clinical data. Patient-level results from all completed phase 2 and 3 studies from the liraglutide clinical development programme were pooled to determine rates of major adverse cardiovascular events (MACE): cardiovascular death, myocardial infarction, stroke. MACE were identified by querying the study database using Medical Dictionary for Regulatory Activities (MedDRA) terms combined with serious adverse events recorded by study investigators. Broad, narrow, and custom groups of MedDRA queries were used. Candidate events from each query were independently adjudicated post hoc. In 15 studies (6638 patients; 4257 liraglutide treated), there were 114 patients with MACE identified using the broad MedDRA query. Of these, 44 were classified as serious adverse events and 39 were adjudicated as MACE. The incidence ratio for adjudicated broad/serious MACE associated with liraglutide was 0.73 (95% CI 0.38-1.41) versus all comparator drugs (metformin, glimepiride, rosiglitazone, insulin glargine, placebo), within cardiovascular safety limits defined by the United States Food & Drug Administration for diabetes therapies under current investigation.

Anatomical criteria of malignancy by computed tomography angiography in patients with anomalous coronary arteries with an interarterial course

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Ashrafpoor, Golmehr [Assistance Publique-Hopitaux de Paris, Hopital Europeen Georges Pompidou, Universite Paris Descartes, Department of Radiology, Cardiovascular Imaging Unit, Paris (France); Danchin, Nicolas [Assistance Publique-Hopitaux de Paris, Hopital Europeen Georges Pompidou, Universite Paris Descartes, Department of Cardiology, Paris (France); Houyel, Lucile; Belli, Emre [Centre Chirurgical Marie-Lannelongue, Department of Congenital Cardiac Surgery, Le Plessis-Robinson (France); Ramadan, Ramzi [Centre Chirurgical Marie-Lannelongue, Department of Cardiac Surgery, Le Plessis-Robinson (France); Paul, Jean-Francois [Institut Mutualiste Montsouris, Department of Radiology, Paris (France)

2014-10-11

We sought to determine the relation between major adverse cardiac events (MACE) and anatomical criteria assessed by coronary computed tomography angiography (CCTA) in patients with an anomalous coronary artery with an interarterial course (ACAIAC). We selected CCTA studies of patients with an ACAIAC from a database of 4,160 examinations and studied anatomical criteria according to the presence of prior MACE, defined as syncope, unstable angina, myocardial infarction and resuscitated sudden cardiac death. There were 19 patients (18 males) with an ACAIAC during the study period (incidence 0.46 %). Seven patients with prior MACE were younger (26 years vs 59 years, p < 0.001), had a smaller minimal lumen area (3.6 mm{sup 2} vs 9.0 mm{sup 2}, p = 0.001), a higher degree of area stenosis (57 % vs 24 %, p = 0.001), a longer interarterial course (14.7 vs 8.6 mm, p = 0.003) and a smaller proximal segment width (1.6 mm vs 2.5 mm, p = 0.02) compared with the 12 patients without prior MACE. All patients with MACE had the following concomitant anatomical characteristics: minimum lumen area ≤4 mm{sup 2}, an area stenosis ≥50 % and intra-arterial length >10 mm Prior MACE is associated with specific anatomical CCTA characteristics among patients with ACAIAC. CCTA may therefore contribute to distinguish patients at risk of adverse events. (orig.)

Drug-eluting stents appear superior to bare metal stents for vein-graft PCI in vessels up to a stent diameter of 4 mm

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Oliver P. Guttmann

2016-05-01

Full Text Available BackgroundResearch trials have shown improved short-term outcome with drug-eluting stents (DES over bare metal stents (BMS in saphenous vein graft (SVG percutaneous coronary intervention (PCI, primarily by reducing target vessel revascularization (TVR for in-stent restenosis. We compared the outcomes in patients undergoing SVG stent implantation treated with DES or BMS. In exploratory analyses we investigated the influence of stent generation and diameter.MethodsData were obtained from a prospective database of 657 patients who underwent PCI for SVG lesions between 2003 and 2011. A total of 344 patients had PCI with BMS and 313 with DES. Propensity scores were developed based on 15 observed baseline covariates in a logistic regression model with stent type as the dependent variable. The nearest-neighbour-matching algorithm with Greedy 5-1 Digit Matching was used to produce two patient cohorts of 313 patients each. We assessed major adverse cardiac events (MACE out to a median of 3.3 years (interquartile range: 2.1-4.1. MACE was defined as all-cause mortality, myocardial infarction (MI, TVR and stroke.ResultsThere was a significant difference in MACE between the two groups in favour of DES (17.9% DES vs. 31.2% BMS group; p = 0.0017 over the 5-year follow-up period. MACE was driven by increased TVR in the BMS group. There was no difference in death, MI or stroke. Adjusted Cox analysis confirmed a decreased risk of MACE for DES compared with BMS 0.75 (95% confidence interval (CI 0.52-0.94, with no difference in the hazard of all-cause mortality (hazard ratio: 1.08; 95% CI: 0.77-1.68. However, when looking at stent diameters greater than 4 mm, no difference was seen in MACE rates between BMS and DES.ConclusionsOverall in our cohort of patients who had PCI for SVG disease, DES use resulted in lower MACE rates compared with BMS over a 5-year follow-up period; however, for stent diameters over 4 mm no difference in MACE rates was seen.

High-Dose Statin Pretreatment Decreases Periprocedural Myocardial Infarction and Cardiovascular Events in Patients Undergoing Elective Percutaneous Coronary Intervention: A Meta-Analysis of Twenty-Four Randomized Controlled Trials

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Wang, Le; Peng, Pingan; Zhang, Ou; Xu, Xiaohan; Yang, Shiwei; Zhao, Yingxin; Zhou, Yujie

2014-01-01

Background Evidence suggests that high-dose statin pretreatment may reduce the risk of periprocedural myocardial infarction (PMI) and major adverse cardiac events (MACE) for certain patients; however, previous analyses have not considered patients with a history of statin maintenance treatment. In this meta-analysis of randomized controlled trials (RCTs), we reevaluated the efficacy of short-term high-dose statin pretreatment to prevent PMI and MACE in an expanded set of patients undergoing elective percutaneous coronary intervention. Methods We searched the PubMed/Medline database for RCTs that compared high-dose statin pretreatment with no statin or low-dose statin pretreatment as a prevention of PMI and MACE. We evaluated the incidence of PMI and MACE, including death, spontaneous myocardial infarction, and target vessel revascularization at the longest follow-up for each study for subgroups stratified by disease classification and prior low-dose statin treatment. Results Twenty-four RCTs with a total of 5,526 patients were identified. High-dose statin pretreatment was associated with 59% relative reduction in PMI (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.34–0.49; Pstatin pretreatment on MACE was significant for statin-naive patients (OR: 0.69; 95% CI: 0.50–0.95; P = 0.02) and prior low dose statin-treated patients (OR: 0.28; 95% CI: 0.12–0.65; P = 0.003); and for patients with acute coronary syndrome (OR: 0.52; 95% CI: 0.34–0.79; P = 0.003), but not for patients with stable angina (OR: 0.71; 95% CI 0.45–1.10; P = 0.12). Long-term effects on survival were less obvious. Conclusions High-dose statin pretreatment can result in a significant reduction in PMI and MACE for patients undergoing elective PCI. The positive effect of high-dose statin pretreatment on PMI and MACE is significant for statin-naïve patients and patients with prior treatment. The positive effect of high-dose statin pretreatment on MACE is significant for

The Need for a Revised Joint Personnel Accounting Doctrine

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2011-05-22

recoveries to field operations for the 11 David R. Graham, Ashley N. Bybee , Susan L. Clark-Sestak, and...Naval War College, 2009), XI-43. 16 David R. Graham, Ashley N. Bybee , Susan L. Clark-Sestak, and Michal S. Finnin, Assessment of DOD Central...Division, 8 June 2005. Graham, David R., Ashley N. Bybee , Susan L. Clark-Sestak, and Michal S. Finnin. Assessment of DOD Central

Adverse cardiac events in children with Williams syndrome undergoing cardiovascular surgery: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.

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Hornik, Christoph P; Collins, Ronnie Thomas; Jaquiss, Robert D B; Jacobs, Jeffrey P; Jacobs, Marshall L; Pasquali, Sara K; Wallace, Amelia S; Hill, Kevin D

2015-06-01

Patients with Williams syndrome (WS) undergoing cardiac surgery are at risk for major adverse cardiac events (MACE). Prevalence and risk factors for such events have not been well described. We sought to define frequency and risk of MACE in patients with WS using a multicenter clinical registry. We identified cardiac operations performed in patients with WS using the Society of Thoracic Surgeons Congenital Heart Surgery Database (2000-2012). Operations were divided into 4 groups: isolated supravalvular aortic stenosis, complex left ventricular outflow tract (LVOT), isolated right ventricular outflow tract (RVOT), and combined LVOT/RVOT procedures. The proportion of patients with MACE (in-hospital mortality, cardiac arrest, or postoperative mechanical circulatory support) was described and the association with preoperative factors was examined. Of 447 index operations (87 centers), median (interquartile range) age and weight at surgery were 2.4 years (0.6-7.4 years) and 10.6 kg (6.5-21.5 kg), respectively. Mortality occurred in 20 patients (5%). MACE occurred in 41 patients (9%), most commonly after combined LVOT/RVOT (18 out of 87; 21%) and complex LVOT (12 out of 131; 9%) procedures, but not after isolated RVOT procedures. Odds of MACE decreased with age (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98-0.99), weight (OR, 0.97; 95% CI, 0.93-0.99), but increased in the presence of any preoperative risk factor (OR, 2.08; 95% CI, 1.06-4.00), and in procedures involving coronary artery repair (OR, 5.37; 95% CI, 2.05-14.06). In this multicenter analysis, MACE occurred in 9% of patients with WS undergoing cardiac surgery. Demographic and operative characteristics were associated with risk. Further study is needed to elucidate mechanisms of MACE in this high-risk population. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Effects of tofacitinib on cardiovascular risk factors and cardiovascular outcomes based on phase III and long-term extension data in patients with plaque psoriasis.

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Wu, Jashin J; Strober, Bruce E; Hansen, Peter R; Ahlehoff, Ole; Egeberg, Alexander; Qureshi, Abrar A; Robertson, Debbie; Valdez, Hernan; Tan, Huaming; Wolk, Robert

2016-11-01

Psoriasis is a systemic inflammatory condition that is associated with a higher risk of cardiovascular (CV) disease. Tofacitinib is being investigated as a treatment for psoriasis. We sought to evaluate the effects of tofacitinib on CV risk factors and major adverse CV events (MACEs) in patients with plaque psoriasis. Changes in select CV risk factors and the incidence rate (IR) of MACEs were evaluated in patients who were treated with tofacitinib. Tofacitinib treatment was associated with small, dose-dependent increases in total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol, while the total/HDL cholesterol ratio was unchanged. There were no changes in blood pressure and glycated hemoglobin levels; C-reactive protein levels decreased. The IRs of a MACE were low and similar for both tofacitinib doses. Among 3623 subjects treated with tofacitinib, the total patient-years of exposure was 5204, with a median follow-up of 527 days, and the IR of MACEs was 0.37 (95% confidence interval, 0.22-0.57) patients with events per 100 patient-years. There was relatively short follow-up time for patients who had MACEs. While treatment with tofacitinib is associated with a small increase in cholesterol levels, the total/HDL cholesterol ratio does not change, there are no unfavorable changes in several CV risk factors, and the incidence of MACEs is low. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Prognostic Value of Plasma Pentraxin-3 Levels in Patients with Stable Coronary Artery Disease after Drug-Eluting Stent Implantation

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Liu Haibo

2014-01-01

Full Text Available Pentraxin-3 (PTX3 is an inflammatory marker thought to be more specific to cardiovascular inflammation than C-reactive protein (CRP. Our aim was to assess the prognostic value of PTX3 in patients with stable coronary artery disease (CAD after drug eluting stent (DES implantation. Plasma PTX3 levels were measured before percutaneous coronary intervention (PCI and at 24 h post-PCI in 596 consecutive patients with stable CAD. Patients were followed up for a median of 3 years (range 1–5 for major adverse cardiovascular events (MACEs. We found that the post-PCI plasma PTX3 levels were significantly higher at 24 h after PCI than pre-PCI, patients with MACEs had higher post-PCI PTX3 levels compared with MACEs-free patients, patients with higher post-PCI PTX3 levels (median > 4.384 ng/mL had a higher risk for MACEs than those with PTX3 < 4.384 ng/mL, and post-PCI PTX3, cTnI, multiple stents, and age but not high-sensitivity CRP (hsCRP were independently associated with the prevalence of MACEs after DES implantation. The present study shows that post-PCI PTX3 may be a more reliable inflammatory predictor of long-term MACEs in patients with stable CAD undergoing DES implantation than CRP. Measurement of post-PCI PTX3 levels could provide a rationale for risk stratification of patients with stable CAD after DES implantation.

Mini mental state examination and the Addenbrooke's cognitive examination: effect of education and norms for a multicultural population.

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Mathuranath, P S; Cherian, Joseph P; Mathew, Robert; George, Annamma; Alexander, Aley; Sarma, Sankara P

2007-01-01

To derive population norms on the Malayalam adaptation of Addenbrooke's Cognitive Examination (M-ACE) and the inclusive Malayalam mini mental state examination (M-MMSE). Education-stratified norms were obtained on randomly selected cognitively unimpaired community elders (n = 519). Valid data on norms was available on 488 subjects (age 68.5 +/- 7.1 and education 7.9 +/- 5.4). Education and age, but not gender had a significant effect on both M-ACE and M-MMSE. When compared to the effect of age, the effect of education was sevenfold more on the M-ACE and ninefold more on the M-MMSE. The mean composite score on the M-ACE (and the M-MMSE) was 42.8 +/- 9.8 (14.9 +/- 3.1) for those with 0 (n = 72), 55.9 +/- 12.5 (19.7 +/- 4.1) with 1-4 (n = 96), 62.6 +/- 11.4 (21.9 +/- 3.7) with 5-8 (n = 81), 77 +/- 10.2 (25.7 +/- 2.4) with 9-12 (n = 136) and 83.4 +/- 7.2 (26.7 +/- 1.6) with > 12 (n = 103) years of formal education. Education has the most potent effect on performance on both M-ACE and M-MMSE in the Indian cohort. Education-stratified scores on the M-ACE and the M-MMSE, will provide a more appropriate means of establishing the cognitive status of patients. It is also our feeling that these cut-off scores will be useful across India.

Mars aqueous chemistry experiment

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Clark, Benton C.; Mason, Larry W.

1994-06-01

Mars Aqueous Chemistry Experiment (MACE) is designed to conduct a variety of measurements on regolith samples, encompassing mineral phase analyses, chemical interactions with H2O, and physical properties determinations. From these data, much can be learned or inferred regarding the past weathering environment, the contemporaneous soil micro-environments, and the general chemical and physical state of the Martian regolith. By analyzing both soil and duricrust samples, the nature of the latter may become more apparent. Sites may be characterized for comparative purposes and criteria could be set for selection of high priority materials on future sample return missions. The second year of the MACE project has shown significant progress in two major areas. MACE Instrument concept definition is a baseline design that has been generated for the complete MACE instrument, including definition of analysis modes, mass estimates and thermal model. The design includes multiple reagent reservoirs, 10 discrete analysis cells, sample manipulation capability, and thermal control. The MACE Measurement subsystems development progress is reported regarding measurement capabilities for aqueous ion sensing, evolved gas sensing, solution conductivity measurement, reagent addition (titration) capabilities, and optical sensing of suspended particles.

Mars aqueous chemistry experiment

Science.gov (United States)

Clark, Benton C.; Mason, Larry W.

1994-01-01

Mars Aqueous Chemistry Experiment (MACE) is designed to conduct a variety of measurements on regolith samples, encompassing mineral phase analyses, chemical interactions with H2O, and physical properties determinations. From these data, much can be learned or inferred regarding the past weathering environment, the contemporaneous soil micro-environments, and the general chemical and physical state of the Martian regolith. By analyzing both soil and duricrust samples, the nature of the latter may become more apparent. Sites may be characterized for comparative purposes and criteria could be set for selection of high priority materials on future sample return missions. The second year of the MACE project has shown significant progress in two major areas. MACE Instrument concept definition is a baseline design that has been generated for the complete MACE instrument, including definition of analysis modes, mass estimates and thermal model. The design includes multiple reagent reservoirs, 10 discrete analysis cells, sample manipulation capability, and thermal control. The MACE Measurement subsystems development progress is reported regarding measurement capabilities for aqueous ion sensing, evolved gas sensing, solution conductivity measurement, reagent addition (titration) capabilities, and optical sensing of suspended particles.

The Mini-Addenbrooke's Cognitive Examination: a new assessment tool for dementia.

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Hsieh, Sharpley; McGrory, Sarah; Leslie, Felicity; Dawson, Kate; Ahmed, Samrah; Butler, Chris R; Rowe, James B; Mioshi, Eneida; Hodges, John R

2015-01-01

We developed and validated the Mini-Addenbrooke's Cognitive Examination (M-ACE) in dementia patients. Comparisons were also made with the Mini Mental State Examination (MMSE). The M-ACE was developed using Mokken scaling analysis in 117 dementia patients [behavioural variant frontotemporal dementia (bvFTD), n = 25; primary progressive aphasia (PPA), n = 49; Alzheimer's disease (AD), n = 34; corticobasal syndrome (CBS), n = 9] and validated in an independent sample of 164 dementia patients (bvFTD, n = 23; PPA, n = 82; AD, n = 38; CBS, n = 21) and 78 controls, who also completed the MMSE. The M-ACE consists of 5 items with a maximum score of 30. Two cut-offs were identified: (1) ≤25/30 has both high sensitivity and specificity, and (2) ≤21/30 is almost certainly a score to have come from a dementia patient regardless of the clinical setting. The M-ACE is more sensitive than the MMSE and is less likely to have ceiling effects. The M-ACE is a brief and sensitive cognitive screening tool for dementia. Two cut-offs (25 or 21) are recommended. © 2014 S. Karger AG, Basel.

The relationship between duration of psoriasis, vascular inflammation, and cardiovascular events.

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Egeberg, Alexander; Skov, Lone; Joshi, Aditya A; Mallbris, Lotus; Gislason, Gunnar H; Wu, Jashin J; Rodante, Justin; Lerman, Joseph B; Ahlman, Mark A; Gelfand, Joel M; Mehta, Nehal N

2017-10-01

Psoriasis is associated with risk of cardiovascular (CV) disease (CVD) and a major adverse CV event (MACE). Whether psoriasis duration affects risk of vascular inflammation and MACEs has not been well characterized. We utilized two resources to understand the effect of psoriasis duration on vascular disease and CV events: (1) a human imaging study and (2) a population-based study of CVD events. First, patients with psoriasis (N = 190) underwent fludeoxyglucose F 18 positron emission tomography/computed tomography (duration effect reported as a β-coefficient). Second, MACE risk was examined by using nationwide registries (adjusted hazard ratios in patients with psoriasis (n = 87,161) versus the general population (n = 4,234,793). In the human imaging study, patients were young, of low CV risk by traditional risk scores, and had a high prevalence of cardiometabolic diseases. Vascular inflammation by fludeoxyglucose F 18 positron emission tomography/computed tomography was significantly associated with disease duration (β = 0.171, P = .002). In the population-based study, psoriasis duration had strong relationship with MACE risk (1.0% per additional year of psoriasis duration [hazard ratio, 1.010; 95% confidence interval, 1.007-1.013]). These studies utilized observational data. We found detrimental effects of psoriasis duration on vascular inflammation and MACE, suggesting that cumulative duration of exposure to low-grade chronic inflammation may accelerate vascular disease development and MACEs. Providers should consider inquiring about duration of disease to counsel for heightened CVD risk in psoriasis. Copyright © 2017 American Academy of Dermatology, Inc. All rights reserved.

[Analysis of triterpenoids in Ganoderma lucidum by microwave-assisted continuous extraction].

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Lu, Yan-fang; An, Jing; Jiang, Ye

2015-04-01

For further improving the extraction efficiency of microwave extraction, a microwave-assisted contijuous extraction (MACE) device has been designed and utilized. By contrasting with the traditional methods, the characteristics and extraction efficiency of MACE has also been studied. The method was validated by the analysis of the triterpenoids in Ganoderma lucidum. The extraction conditions of MACE were: using 95% ethanol as solvent, microwave power 200 W and radiation time 14.5 min (5 cycles). The extraction results were subsequently compared with traditional heat reflux extraction ( HRE) , soxhlet extraction (SE), ultrasonic extraction ( UE) as well as the conventional microwave extraction (ME). For triterpenoids, the two methods based on the microwaves (ME and MACE) were in general capable of finishing the extraction in 10, 14.5 min, respectively, while other methods should consume 60 min and even more than 100 min. Additionally, ME can produce comparable extraction results as the classical HRE and higher extraction yield than both SE and UE, however, notably lower extraction yield than MASE. More importantly, the purity of the crud extract by MACE is far better than the other methods. MACE can effectively combine the advantages of microwave extraction and soxhlet extraction, thus enabling a more complete extraction of the analytes of TCMs in comparison with ME. And therefore makes the analytic result more accurate. It provides a novel, high efficient, rapid and reliable pretreatment technique for the analysis of TCMs, and it could potentially be extended to ingredient preparation or extracting techniques of TCMs.

[Relationship between epicardial adipose tissue and clinical prognosis of patients with coronary heart disease after percutaneous coronary intervention].

Science.gov (United States)

Zhang, Y Y; Li, X; Lin, W H; Liu, J J; Jing, R; Lu, Y J; Di, C Y; Shi, H Y; Gao, P

2018-01-16

Objective: To further evaluate the clinical value of epicardial adipose tissue volume (EATV) in predicting the prognosis of coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods: From July 2013 to July 2016 in TEDA International Cardiovascular Disease Hospital, a total of 474 patients diagnosed with CHD were included in this study.According to the result of EATV, patients were divided into three groups, group A (EATV≤75 ml), group B (75 mlEATVEATV≥150 ml). Then the level of body mass index (BMI), hypersensitive c-reactive protein (hs-CRP), interleukin (IL)-6 and tumor necrosis factor (TNF)-α were tested for all the three groups.All the patients were followed up for 1 year for major adverse cardiovascular events (MACE). The clinical value of EATV in predicting the occurrence of MACE events was evaluated. Results: The BMI, level of hs-CRP, TNF-α in group B were higher than group A, group C were significantly higher than group B, with statistically significant difference across all the comparisons ( P EATV was positively correlated with hs-CRP, IL-6, TNF-α ( r =0.675-0.700, P EATV level was 120.39 ml to predict MACE (area under cure: 0.751, 95% CI : 0.634-0.868, P EATV>120.39 ml can be used as an independent risk factor for predicting the occurrence of MACE. Conclusion: The level of EATV is closely related to the occurrence of MACE events, and EATV>120.39 ml is an independent risk factor for MACE in patients with CHD after PCI.

Prognostic value of coronary atherosclerosis progression evaluated by coronary CT angiography in patients with stable angina

International Nuclear Information System (INIS)

Gu, Hui; Gao, Yang; Hou, Zhihui; Lu, Bin; Schoepf, U.J.; Snyder, Alan N.; Duguay, Taylor M.; Wang, Ximing

2018-01-01

To investigate the progression of coronary atherosclerosis burden by coronary CT angiography (CCTA) and to demonstrate its association with the incidence of major adverse cardiac events (MACE). We retrospectively studied patients with stable angina who had undergone repeat CCTA due to recurrent or worsening symptoms. Lipid-rich, fibrous, calcified and total plaque burden as well as coronary diameter stenosis were quantitatively analysed. The incidence of MACE during follow-up was determined. The final cohort consisted of 268 patients (mean age 52.9 ± 9.8 years, 71 % male) with a mean follow-up period of 4.6 ± 0.9 years. Patients with lipid-rich, fibrous, calcified and total plaque burden (%) progression, as well as coronary diameter stenosis (%) progression had a significantly higher incidence of MACE than those without (all p < 0.05). The progression of lipid-rich plaque (HR = 1.601, p = 0.021), total plaque burden (HR = 2.979, p = 0.043) and coronary diameter stenosis (HR = 4.327, p <0.001) were independent predictors of MACE (all p < 0.05). Patients presenting with recurrent or worsening symptoms associated with coronary artery disease who have coronary atherosclerosis progression on CCTA are at an increased risk of future MACE. (orig.)

Prognostic value of coronary atherosclerosis progression evaluated by coronary CT angiography in patients with stable angina

Energy Technology Data Exchange (ETDEWEB)

Gu, Hui [Shandong University, Department of CT, Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Jinan, Shandong (China); Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Beijing (China); Gao, Yang; Hou, Zhihui; Lu, Bin [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Beijing (China); Schoepf, U.J.; Snyder, Alan N.; Duguay, Taylor M. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Wang, Ximing [Shandong University, Department of CT, Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Jinan, Shandong (China)

2018-03-15

To investigate the progression of coronary atherosclerosis burden by coronary CT angiography (CCTA) and to demonstrate its association with the incidence of major adverse cardiac events (MACE). We retrospectively studied patients with stable angina who had undergone repeat CCTA due to recurrent or worsening symptoms. Lipid-rich, fibrous, calcified and total plaque burden as well as coronary diameter stenosis were quantitatively analysed. The incidence of MACE during follow-up was determined. The final cohort consisted of 268 patients (mean age 52.9 ± 9.8 years, 71 % male) with a mean follow-up period of 4.6 ± 0.9 years. Patients with lipid-rich, fibrous, calcified and total plaque burden (%) progression, as well as coronary diameter stenosis (%) progression had a significantly higher incidence of MACE than those without (all p < 0.05). The progression of lipid-rich plaque (HR = 1.601, p = 0.021), total plaque burden (HR = 2.979, p = 0.043) and coronary diameter stenosis (HR = 4.327, p <0.001) were independent predictors of MACE (all p < 0.05). Patients presenting with recurrent or worsening symptoms associated with coronary artery disease who have coronary atherosclerosis progression on CCTA are at an increased risk of future MACE. (orig.)

Narmer, Scorpion and the representation of the early Egyptian court

NARCIS (Netherlands)

Kelder, J.M.

2013-01-01

Numerous academic and popular articles have been published on the Narmer Palette, the Narmer Mace-head and the Scorpion Mace-head, arguably three of the most iconic early Egyptian monuments. It is generally recognized that these three objects are the climax of a centuries-old tradition of

Facility-level association of preoperative stress testing and postoperative adverse cardiac events.

Science.gov (United States)

Valle, Javier A; Graham, Laura; Thiruvoipati, Thejasvi; Grunwald, Gary; Armstrong, Ehrin J; Maddox, Thomas M; Hawn, Mary T; Bradley, Steven M

2018-06-22

Despite limited indications, preoperative stress testing is often used prior to non-cardiac surgery. Patient-level analyses of stress testing and outcomes are limited by case mix and selection bias. Therefore, we sought to describe facility-level rates of preoperative stress testing for non-cardiac surgery, and to determine the association between facility-level preoperative stress testing and postoperative major adverse cardiac events (MACE). We identified patients undergoing non-cardiac surgery within 2 years of percutaneous coronary intervention in the Veterans Affairs (VA) Health Care System, from 2004 to 2011, facility-level rates of preoperative stress testing and postoperative MACE (death, myocardial infarction (MI) or revascularisation within 30 days). We determined risk-standardised facility-level rates of stress testing and postoperative MACE, and the relationship between facility-level preoperative stress testing and postoperative MACE. Among 29 937 patients undergoing non-cardiac surgery at 131 VA facilities, the median facility rate of preoperative stress testing was 13.2% (IQR 9.7%-15.9%; range 6.0%-21.5%), and 30-day postoperative MACE was 4.0% (IQR 2.4%-5.4%). After risk standardisation, the median facility-level rate of stress testing was 12.7% (IQR 8.4%-17.4%) and postoperative MACE was 3.8% (IQR 2.3%-5.6%). There was no correlation between risk-standardised stress testing and composite MACE at the facility level (r=0.022, p=0.81), or with individual outcomes of death, MI or revascularisation. In a national cohort of veterans undergoing non-cardiac surgery, we observed substantial variation in facility-level rates of preoperative stress testing. Facilities with higher rates of preoperative stress testing were not associated with better postoperative outcomes. These findings suggest an opportunity to reduce variation in preoperative stress testing without sacrificing patient outcomes. © Article author(s) (or their employer(s) unless otherwise

Effect of calcifediol treatment on cardiovascular outcomes in patients with acute coronary syndrome and percutaneous revascularization.

Science.gov (United States)

Navarro-Valverde, Cristina; Quesada-Gómez, Jose M; Pérez-Cano, Ramón; Fernández-Palacín, Ana; Pastor-Torres, Luis F

2018-01-03

Vitamin D deficiency has been consistently linked with cardiovascular diseases. However, results of intervention studies are contradictory. The aim of this study was to evaluate the effect of treatment with calcifediol (25(OH)D 3 ) on the cardiovascular system of patients with non-ST-elevation acute coronary syndrome after percutaneous coronary intervention. A prospective study assessing≥60-year-old patients with non-ST-elevation acute coronary syndrome, coronary artery disease and percutaneous revascularisation. We randomly assigned 41 patients (70.6±6.3 years) into 2 groups: Standard treatment+25(OH)D 3 supplementation or standard treatment alone. Major adverse cardiovascular events (MACE) were evaluated at the conclusion of the 3-month follow-up period. 25(OH)D levels were analysed with regard to other relevant analytical variables and coronary disease extent. Basal levels of 25(OH)D≤50nmol/L were associated with multivessel coronary artery disease (RR: 2.6 [CI 95%:1.1-7.1], P=.027) and 25(OH)D≤50nmol/L+parathormone ≥65pg/mL levels correlated with increased risk for MACE (RR: 4 [CI 95%: 1.1-21.8], P=.04]. One MACE was detected in the supplemented group versus five in the control group (P=.66). Among patients with 25(OH)D levels≤50nmol/L at the end of the study, 28.6% had MACE versus 0% among patients with 25(OH)D>50nmol/L (RR: 1,4; P=.037). Vitamin D deficiency plus secondary hyperparathyroidism may be an effective predictor of MACE. A trend throughout the follow up period towards a reduction in MACE among patients supplemented with 25(OH)D 3 was detected. 25(OH)D levels≤50nmol/L at the end of the intervention period were significantly associated with an increased number of MACE, hence, 25(OH)D level normalisation could improve cardiovascular health in addition to bone health. Copyright © 2017. Published by Elsevier España, S.L.U.

76 FR 6087 - Draft Weapons Safety Assessment on the Use of Enhanced Weapons; Notice of Availability and...

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2011-02-03

...: 301-415-6557; e-mail: [email protected] ; or Susan Bagley, Office of Nuclear Security and Incident...: Susan.Bagley@nrc.gov . SUPPLEMENTARY INFORMATION: On August 8, 2005, President Bush signed into law the...

Assessment of DoD’s Central Identification Lab and the Feasibility of Increasing Identification Rates

Science.gov (United States)

2009-06-01

Lab and the Feasibility of Increasing Identification Rates David R. Graham Ashley N. Bybee Susan L. Clark-Sestak Michael S. Finnin Approved for public...Feasibility of Increasing Identification Rates David R. Graham Ashley N. Bybee Susan L. Clark-Sestak Michael S. Finnin iii PREFACE This study was...6 . A U TH O R ( S ) 5 d . P R O JE C T N O. David R. Graham, Ashley N. Bybee , Susan L. Clark-Sestak, Michael S. Finnin 5 e . TAS K N O

75 FR 10793 - FY2010 Supplemental Funding for Brownfields Revolving Loan Fund (RLF) Grantees

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2010-03-09

... (213) 244- 1850. EPA Region 10, Susan Morales, AK, ID, OR, WA 1200 Sixth Avenue, Suite Morales.Susan...: March 2, 2010. David R. Lloyd, Director, Office of Brownfields and Land Revitalization, Office of Solid...

Olímpia de Épiro: uma leitura dos Comportamentos Barbarescos da Rainha Macedônica na obra Vidas paralelas de Plutarco * Olympia of Epirus: reading the Aarbarian Acting of the Macedonian Queen in the work Parallel lives of Plutarch

Directory of Open Access Journals (Sweden)

DOMINIQUE VIEIRA COELHO DOS SANTOS

2014-01-01

Full Text Available Resumo: O objetivo deste artigo é analisar o papel que Olímpia de Épiro – mãe de Alexandre, o Grande – desempenha na narrativa plutarqueana dentro da obra Vidas Paralelas. Tal empreendimento pode nos auxiliar a compreender, por exemplo, como Plutarco aborda a dicotomia grego/bárbaro, pois quando descreve a rainha macedônica ele a caracteriza como detentora de uma natureza rude e comportamentos religiosos desviantes, sendo tão barbaresca quanto às mulheres Edômas e Trácias.  Palavras-chave: Plutarco – Alexandre – Religião – Barbárie – Olímpia de Épiro. Abstract: This paper aim is to analyze the role that Olympia of Epirus - mother of Alexander the Great - plays in the Plutarchian narrative in the work Parallel Lives. Such an effort can help us to understand, for example, how Plutarch discusses the dichotomy greek/barbarian, as when he describes the Macedonian Queen he characterizes her as having a tough nature and deviant religious behavior, being as barbaric as Edonian and Thracian women.Keywords: Plutarch – Alexander – Religion – Barbarism – Olympia of Epirus.

Usefulness of Beta2-Microglobulin as a Predictor of All-Cause and Nonculprit Lesion-Related Cardiovascular Events in Acute Coronary Syndromes (from the PROSPECT Study).

Science.gov (United States)

Möckel, Martin; Muller, Reinhold; Searle, Julia; Slagman, Anna; De Bruyne, Bernard; Serruys, Patrick; Weisz, Giora; Xu, Ke; Holert, Fabian; Müller, Christian; Maehara, Akiko; Stone, Gregg W

2015-10-01

In the Providing Regional Observations to Study Predictors of Events in the Coronary Tree (PROSPECT) study, plaque burden, plaque composition, and minimal luminal area were associated with an increased risk of adverse cardiovascular events arising from untreated atherosclerotic lesions (vulnerable plaques) in patients with acute coronary syndromes (ACS). We sought to evaluate the utility of biomarker profiling and clinical risk factors to predict 3-year all-cause and nonculprit lesion-related major adverse cardiac events (MACEs). Of 697 patients who underwent successful percutaneous coronary intervention (PCI) for ACS, an array of 28 baseline biomarkers was analyzed. Median follow-up was 3.4 years. Beta2-microglobulin displayed the strongest predictive power of all variables assessed for all-cause and nonculprit lesion-related MACE. In a classification and regression tree analysis, patients with beta2-microglobulin >1.92 mg/L had an estimated 28.7% 3-year incidence of all-cause MACE; C-peptide 1.92 mg/L identified a cohort with a 3-year rate of 18.5%, and C-peptide PROSPECT study, beta2-microglobulin strongly predicted all-cause and nonculprit lesion-related MACE within 3 years after PCI in ACS. C-peptide and HDL provided further risk stratification to identify angiographically mild nonculprit lesions prone to future MACE. Copyright © 2015 Elsevier Inc. All rights reserved.

Long-term prognostic performance of low-dose coronary computed tomography angiography with prospective electrocardiogram triggering

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Clerc, Olivier F.; Kaufmann, Basil P.; Possner, Mathias; Liga, Riccardo; Vontobel, Jan; Mikulicic, Fran; Graeni, Christoph; Benz, Dominik C.; Fuchs, Tobias A.; Stehli, Julia; Pazhenkottil, Aju P.; Gaemperli, Oliver; Kaufmann, Philipp A.; Buechel, Ronny R. [University Hospital Zurich, Cardiac Imaging, Department of Nuclear Medicine, Zurich (Switzerland)

2017-11-15

To assess long-term prognosis after low-dose 64-slice coronary computed tomography angiography (CCTA) using prospective electrocardiogram-triggering. We included 434 consecutive patients with suspected or known coronary artery disease referred for low-dose CCTA. Patients were classified as normal, with non-obstructive or obstructive lesions, or previously revascularized. Coronary artery calcium score (CACS) was assessed in 223 patients. Follow-up was obtained regarding major adverse cardiac events (MACE): cardiac death, myocardial infarction and elective revascularization. We performed Kaplan-Meier analysis and Cox regressions. Mean effective radiation dose was 1.7 ± 0.6 mSv. At baseline, 38% of patients had normal arteries, 21% non-obstructive lesions, 32% obstructive stenosis and 8% were revascularized. Twenty-nine patients (7%) were lost to follow-up. After a median follow-up of 6.1 ± 0.6 years, MACE occurred in 0% of patients with normal arteries, 6% with non-obstructive lesions, 30% with obstructive stenosis and 39% of those revascularized. MACE occurrence increased with increasing CACS (P < 0.001), but 4% of patients with CACS = 0 experienced MACE. Multivariate Cox regression identified obstructive stenosis, lesion burden in CCTA and CACS as independent MACE predictors (P ≤ 0.001). Low-dose CCTA with prospective electrocardiogram-triggering has an excellent long-term prognostic performance with a warranty period >6 years for patients with normal coronary arteries. (orig.)

Long-term prognostic performance of low-dose coronary computed tomography angiography with prospective electrocardiogram triggering

International Nuclear Information System (INIS)

Clerc, Olivier F.; Kaufmann, Basil P.; Possner, Mathias; Liga, Riccardo; Vontobel, Jan; Mikulicic, Fran; Graeni, Christoph; Benz, Dominik C.; Fuchs, Tobias A.; Stehli, Julia; Pazhenkottil, Aju P.; Gaemperli, Oliver; Kaufmann, Philipp A.; Buechel, Ronny R.

2017-01-01

To assess long-term prognosis after low-dose 64-slice coronary computed tomography angiography (CCTA) using prospective electrocardiogram-triggering. We included 434 consecutive patients with suspected or known coronary artery disease referred for low-dose CCTA. Patients were classified as normal, with non-obstructive or obstructive lesions, or previously revascularized. Coronary artery calcium score (CACS) was assessed in 223 patients. Follow-up was obtained regarding major adverse cardiac events (MACE): cardiac death, myocardial infarction and elective revascularization. We performed Kaplan-Meier analysis and Cox regressions. Mean effective radiation dose was 1.7 ± 0.6 mSv. At baseline, 38% of patients had normal arteries, 21% non-obstructive lesions, 32% obstructive stenosis and 8% were revascularized. Twenty-nine patients (7%) were lost to follow-up. After a median follow-up of 6.1 ± 0.6 years, MACE occurred in 0% of patients with normal arteries, 6% with non-obstructive lesions, 30% with obstructive stenosis and 39% of those revascularized. MACE occurrence increased with increasing CACS (P < 0.001), but 4% of patients with CACS = 0 experienced MACE. Multivariate Cox regression identified obstructive stenosis, lesion burden in CCTA and CACS as independent MACE predictors (P ≤ 0.001). Low-dose CCTA with prospective electrocardiogram-triggering has an excellent long-term prognostic performance with a warranty period >6 years for patients with normal coronary arteries. (orig.)

Is non-HDL-cholesterol a better predictor of long-term outcome in patients after acute myocardial infarction compared to LDL-cholesterol? : a retrospective study.

Science.gov (United States)

Wongcharoen, Wanwarang; Sutthiwutthichai, Satjatham; Gunaparn, Siriluck; Phrommintikul, Arintaya

2017-01-05

It has recently been shown that non-high density lipoprotein cholesterol (non-HDL-C) may be a better predictor of cardiovascular risk than low density lipoprotein cholesterol (LDL-C). Based on known ethic differences in lipid parameters and cardiovascular risk prediction, we sought to study the predictability of attaining non-HDL-C target and long-term major adverse cardiovascular event (MACE) in Thai patients after acute myocardial infarction (AMI) compared to attaining LDL-C target. We retrospectively obtained the data of all patients who were admitted at Maharaj Nakorn Chiang Mai hospital due to AMI during 2006-2013. The mean non-HDL-C and LDL-C during long-term follow-up were used to predict MACE at each time point. The patients were classified as target attainment if non-HDL-C LDL-C LDL-C target and 21.2% experienced MACEs. LDL-C and non-HDL-C were directly compared in Cox regression model. Compared with non-HDL-C 130 mg/dl had higher incidence of MACEs (HR 3.15, 95% CI 1.46-6.80, P = 0.003). Surprisingly, LDL-C >100 mg/dl was associated with reduced risk of MACE as compared to LDL LDL-C goal was not associated with the higher risk. Therefore, non-HDL-C may be a more suitable target of dyslipidemia treatment than LDL-C in patients after AMI.

Combined Value of Red Blood Cell Distribution Width and Global Registry of Acute Coronary Events Risk Score for Predicting Cardiovascular Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

Directory of Open Access Journals (Sweden)

Na Zhao

Full Text Available Global Registry of Acute Coronary Events (GRACE risk score and red blood cell distribution width (RDW content can both independently predict major adverse cardiac events (MACEs in patients with acute coronary syndrome (ACS. We investigated the combined predictive value of RDW and GRACE risk score for cardiovascular events in patients with ACS undergoing percutaneous coronary intervention (PCI for the first time. We enrolled 480 ACS patients. During a median follow-up time of 37.2 months, 70 (14.58% patients experienced MACEs. Patients were divided into tertiles according to the baseline RDW content (11.30-12.90, 13.00-13.50, 13.60-16.40. GRACE score was positively correlated with RDW content. Multivariate Cox analysis showed that both GRACE score and RDW content were independent predictors of MACEs (hazard ratio 1.039; 95% confidence interval [CI] 1.024-1.055; p < 0.001; 1.699; 1.294-2.232; p < 0.001; respectively. Furthermore, Kaplan-Meier analysis demonstrated that the risk of MACEs increased with increasing RDW content (p < 0.001. For GRACE score alone, the area under the receiver operating characteristic (ROC curve for MACEs was 0.749 (95% CI: 0.707-0.787. The area under the ROC curve for MACEs increased to 0.805 (0.766-0.839, p = 0.034 after adding RDW content. The incremental predictive value of combining RDW content and GRACE risk score was significantly improved, also shown by the net reclassification improvement (NRI = 0.352, p < 0.001 and integrated discrimination improvement (IDI = 0.023, p = 0.002. Combining the predictive value of RDW and GRACE risk score yielded a more accurate predictive value for long-term cardiovascular events in ACS patients who underwent PCI as compared to each measure alone.

Discriminative Power of the HEART Score for Obstructive Coronary Artery Disease in Acute Chest Pain Patients Referred for CCTA.

Science.gov (United States)

Kolff, Adriana Q; Bom, Michiel J; Knol, Remco J J; van de Zant, Friso M; van der Zee, Petrus M; Cornel, Jan H

2016-03-01

To investigate the ability of the HEART score to predict the presence of obstructive coronary artery disease (CAD) determined by coronary computed tomography angiography (CCTA) and its ability to predict the occurrence of major adverse cardiac events (MACE) in patients referred for CCTA after emergency department (ED) presentation. From December 2011 to August 2014, 710 ED patients with chest pain who underwent CCTA within 30 days were included. The HEART score was retrospectively calculated and patients were followed for MACE, comprised of death, myocardial infarction, and revascularization. Association of CAD at CCTA in the different categories of the HEART score was analyzed using χ test. The performance of the HEART score in discriminating between those with and without obstructive CAD was evaluated by receiver operating characteristics. Kaplan-Meier analysis was used to assess MACE-free survival stratified by HEART-score categories. During median follow-up of 826 days (interquartile range: 563-1056), MACE occurred in 46 (6.5%) patients; 3 (0.4%) myocardial infarction, 8 (1.1%) death, and 36 (5.1%) revascularizations. A low HEART score was a significant predictor for MACE-free survival (P = 0.010). CCTA revealed obstructive CAD in 11.7% of patients, with no significant difference between patients with a low and intermediate/high HEART score, respectively 10.7% and 13.2% (P = 0.29). The ability of the HEART score to identify obstructive CAD was poor with an AUC of the receiver operating characteristics curve of 0.53. The HEART score does not adequately identify patients with obstructive CAD at CCTA. It does however predict occurrence of MACE in medium-term follow-up. Excluding patients from additional testing based solely on a low HEART score may lead to suboptimal patient management. CCTA had important implications on patient management and may be a more appropriate tool to further stratify risk in ED chest pain patients.

Moderate-intensity statin therapy seems ineffective in primary cardiovascular prevention in patients with type 2 diabetes complicated by nephropathy. A multicenter prospective 8 years follow up study.

Science.gov (United States)

Sasso, Ferdinando Carlo; Lascar, Nadia; Ascione, Antonella; Carbonara, Ornella; De Nicola, Luca; Minutolo, Roberto; Salvatore, Teresa; Rizzo, Maria Rosaria; Cirillo, Plinio; Paolisso, Giuseppe; Marfella, Raffaele

2016-10-13

Although numerous studies and metanalysis have shown the beneficial effect of statin therapy in CVD secondary prevention, there is still controversy such the use of statins for primary CVD prevention in patients with DM. The purpose of this study was to evaluate the occurrence of total major adverse cardio-vascular events (MACE) in a cohort of patients with type 2 diabetes complicated by nephropathy treated with statins, in order to verify real life effect of statin on CVD primary prevention. We conducted an observational prospective multicenter study on 564 patients with type 2 diabetic nephropathy free of cardiovascular disease attending 21 national outpatient diabetes clinics and followed them up for 8 years. 169 of them were treated with statins (group A) while 395 were not on statins (group B). Notably, none of the patients was treated with a high-intensity statin therapy according to last ADA position statement. Total MACE occurred in 32 patients from group A and in 68 patients from group B. Fatal MACE occurred in 13 patients from group A and in 30 from group B; nonfatal MACE occurred in 19 patients from group A and in 38 patients from group B. The analysis of the Kaplan-Meier survival curves showed a not statistically significant difference in the incidence of total (p 0.758), fatal (p 0.474) and nonfatal (p 0.812) MACE between the two groups. HbA1c only showed a significant difference in the incidence of MACE between the two groups (HR 1.201, CI 1.041-1.387, p 0.012). These findings suggest that, in a real clinical setting, moderate-intensity statin treatment is ineffective in cardiovascular primary prevention for patients with diabetic nephropathy. Trial registration ClinicalTrials.gov Identifier NCT00535925. Date of registration: September 24, 2007, retrospectively registered.

Left atrial enlargement increases the risk of major adverse cardiac events independent of coronary vasodilator capacity

Energy Technology Data Exchange (ETDEWEB)

Koh, Angela S. [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); National Heart Centre Singapore, Singapore (Singapore); Murthy, Venkatesh L.; Sitek, Arkadiusz; Gayed, Peter; Bruyere, John; Di Carli, Marcelo F. [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Wu, Justina [Brigham and Women' s Hospital, Division of Cardiology, Department of Medicine, and the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Boston, MA (United States); Dorbala, Sharmila [Brigham and Women' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Brigham and Women' s Hospital, Department of Radiology and the Division of Cardiology, Noninvasive Cardiovascular Imaging Section, Boston, MA (United States)

2015-09-15

Longstanding uncontrolled atherogenic risk factors may contribute to left atrial (LA) hypertension, LA enlargement (LAE) and coronary vascular dysfunction. Together they may better identify risk of major adverse cardiac events (MACE). The aim of this study was to test the hypothesis that chronic LA hypertension as assessed by LAE modifies the relationship between coronary vascular function and MACE. In 508 unselected subjects with a normal clinical {sup 82}Rb PET/CT, ejection fraction ≥40 %, no prior coronary artery disease, valve disease or atrial fibrillation, LAE was determined based on LA volumes estimated from the hybrid perfusion and CT transmission scan images and indexed to body surface area. Absolute myocardial blood flow and global coronary flow reserve (CFR) were calculated. Subjects were systematically followed-up for the primary end-point - MACE - a composite of all-cause death, myocardial infarction, hospitalization for heart failure, stroke, coronary artery disease progression or revascularization. During a median follow-up of 862 days, 65 of the subjects experienced a composite event. Compared with subjects with normal LA size, subjects with LAE showed significantly lower CFR (2.25 ± 0.83 vs. 1.95 ± 0.80, p = 0.01). LAE independently and incrementally predicted MACE even after accounting for clinical risk factors, medication use, stress left ventricular ejection fraction, stress left ventricular end-diastolic volume index and CFR (chi-squared statistic increased from 30.9 to 48.3; p = 0.001). Among subjects with normal CFR, those with LAE had significantly worse event-free survival (risk adjusted HR 5.4, 95 % CI 2.3 - 12.8, p < 0.0001). LAE and reduced CFR are related but distinct cardiovascular adaptations to atherogenic risk factors. LAE is a risk marker for MACE independent of clinical factors and left ventricular volumes; individuals with LAE may be at risk of MACE despite normal coronary vascular function. (orig.)

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by an emblem and a flag as a creditable sovereign institution. On 25th July, 2009 UMaT introduced its first ceremo- nial mace to be experienced at its first's congregation. This paper brings to the fore the concepts and philosophical dimensions of the emblem, flag and ceremonial mace as unique symbols of UMaT's erudition, ...

Sadhana | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Sadhana. SEBA SUSAN. Articles written in Sadhana. Volume 41 Issue 12 December 2016 pp 1393-1406. Image coding based on maximum entropy partitioning for identifying improbable intensities related to facial expressions · SEBA SUSAN NANDINI AGGARWAL SHEFALI CHAND AYUSH GUPTA.

Impact of lesion morphology on angiographic and clinical outcomes in patients with chronic total occlusion after recanalization with drug-eluting stents: a multislice computed tomography study

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Ito, Tsuyoshi [Toyohashi Heart Center, Toyohashi (Japan); Nagoya City University Graduate School of Medical Sciences, Department of Cardio-Renal Medicine and Hypertension, Nagoya (Japan); Tsuchikane, Etsuo; Nasu, Kenya; Kimura, Masashi; Terashima, Mitsuyasu; Kinoshita, Yoshihisa; Habara, Maoto; Suzuki, Takahiko [Toyohashi Heart Center, Toyohashi (Japan); Suzuki, Yoriyasu; Ehara, Mariko [Nagoya Heart Center, Nagoya (Japan); Ohte, Nobuyuki [Nagoya City University Graduate School of Medical Sciences, Department of Cardio-Renal Medicine and Hypertension, Nagoya (Japan)

2015-10-15

The aim of this study was to investigate the multislice computed tomography (MSCT) parameters associated with adverse outcomes after chronic total occlusion percutaneous coronary intervention (CTO-PCI) with drug-eluting stents. A total of 285 patients who underwent MSCT before CTO-PCI were analyzed. Lesion morphology was assessed with MSCT. Angiographic restenosis, reocclusion, and MACE (a composite of cardiac death, myocardial infarction, stent thrombosis, and target lesion revascularization) were analyzed. MACE was observed in 36 patients (13.6 %). Occlusion length was greater (39.5 ± 19.9 mm vs. 22.3 ± 13.7 mm, p < 0.01), minimal vessel area smaller (11.2 ± 5.7 mm{sup 2} vs. 14.5 ± 5.6 mm{sup 2}, p < 0.01), and severe calcification more common (36 % vs. 12 %, p < 0.01) in the MACE group compared to the non-MACE group. We defined occluded length >25.4 mm, minimal vessel area <11.9 mm{sup 2}, which were identified by receiver operating characteristic analysis, and severe calcification as CT-derived risk factors. Angiographic restenosis (60 % vs. 12 % vs. 7 %, p < 0.01), reocclusion (29 % vs. 2 % vs. 2 %, p < 0.01), and MACE (43 % vs. 6 % vs. 3 %, p < 0.01) were more common in patients with 2 or more risk factors than in those with 1 or 0. MSCT characteristics associated with adverse outcomes after CTO-PCI were occlusion length, minimal vessel area, and severe calcification. (orig.)

Visit-to-visit blood pressure variability as a prognostic marker in patients with cardiovascular and cerebrovascular diseases--relationships and comparisons with vascular markers of atherosclerosis.

Science.gov (United States)

Lau, Kui Kai; Wong, Yuen Kwun; Chan, Yap Hang; Teo, Kay Cheong; Chan, Koon Ho; Wai Li, Leonard Sheung; Cheung, Raymond Tak Fai; Siu, Chung Wah; Ho, Shu Leong; Tse, Hung Fat

2014-07-01

Visit-to-visit blood pressure variability (BPV) is a simple surrogate marker for the development of atherosclerotic diseases, cardiovascular and all-cause mortality. Nevertheless, the relative prognostic value of BPV in comparison with other established vascular assessments remain uncertain. We prospectively followed-up 656 high-risk patients with diabetes or established cardiovascular or cerebrovascular diseases for the occurrence of major adverse cardiovascular events (MACEs). Baseline brachial endothelial function, carotid intima-media thickness (IMT) and plaque burden, ankle-brachial index and arterial stiffness were determined. Visit-to-visit BPV were recorded during a mean 18 ± 9 outpatient clinic visits. After a mean 81 ± 12 month's follow-up, 123 patients (19%) developed MACEs. Patients who developed a MACE had significantly higher systolic BPV, more severe endothelial function, arterial stiffness and systemic atherosclerotic burden compared to patients who did not develop a MACE (all Parea under receiver operating characteristic curve (AUC) 0.69 ± 0.03, PAUC 0.65 ± 0.03, P<0.01). After adjustment of confounding factors, a high BPV remained a significant independent predictor of MACE (hazards ratio 1.67, 95% confidence interval 1.14-2.43, P<0.01). Compared with established surrogate markers of atherosclerosis, visit-to-visit BPV provides similar prognostic information and may represent a new and simple marker for adverse outcomes in patients with vascular diseases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Army Cyber Mission Force - Ambitions and Realities

Science.gov (United States)

2015-05-21

London: A & C Black, 2006), 219. 3 Ibid., 227. 4 Susan Pines, Veda Dickerson, and Lori Cates, eds., O*NET Dictionary of Occupational Titles, 2nd ed...Pines, Susan, Veda Dickerson, and Lori Cates. "Experience." In O*NET Dictionary of Occupational Titles

04 Brittan pp 55-77

African Journals Online (AJOL)

Tienie

Brink claims that censorship turns the writer into a “physio- logist” who must ..... her personal awakening in terms that may remind us of Susan du Toit. Like Susan, she is ... language. Once the image of Ben and Melanie is captured on film, it.

Idufirma Silicon Valleyta / Susan Adams

Index Scriptorium Estoniae

Adams, Susan

2014-01-01

Tarkvarafirma Apprenda toodab teenindusplatvormi tarkvara, mis võimaldab klientidel luua ja hoida käigus uusi mobiilseid ja pilvetehnoloogiapõhiseid rakendusi. Oma töötajatele pakub odavaid elamispindu ja madalaid makse

Comparing rat and rabbit embryo-fetal developmental toxicity data for 379 pharmaceuticals: on systemic dose and developmental effects

NARCIS (Netherlands)

Peter T. Theunissen; Bruce Beyer; Sonia Beken

2016-01-01

And co-authors William J. Breslin, Gregg D. Cappon, Connie L. Chen, Gary Chmielewski, Luc de Schaepdrijver, Brian Enright, Jennifer E. Foreman, Wafa Harrouk, Kok-Wah Hew, Alan M. Hoberman, Julia Y. Hui, Thomas B. Knudsen, Susan B. Laffan, Susan L. Makris, Matthew Martin, Mary Ellen McNerney,

77 FR 31719 - Grading and Inspection, General Specifications for Approved Plants and Standards for Grades of...

Science.gov (United States)

2012-05-30

.... DATES: Effective: June 29, 2012. FOR FURTHER INFORMATION CONTACT: Susan Sausville, Chief, Standardization Branch, Dairy Programs, AMS, USDA, telephone (202) 720- 9382 or email Susan[email protected] before being picked up; however, if the person making the test is unable to get to the farm before the...

76 FR 77206 - Citric Acid and Certain Citrate Salts From the People's Republic of China: Final Results of...

Science.gov (United States)

2011-12-12

... Memorandum to Susan H. Kuhbach, Office Director, AD/CVD Operations, Office 1, from David Layton..., 2011. \\3\\ See Memorandum to Susan H. Kuhbach, Office Director, AD/CVD Operations, Office 1, from Austin... provision of sulfuric acid for less than adequate remuneration (``LTAR'') for both RZBC and Yixing, and...

Association Between Helicobacter Pylori Infection and Long-term Outcome in Patients with Drug-eluting Stent Implantation

Science.gov (United States)

Wang, Rui; Chen, Lei-Lei; Wang, De-Zhao; Chen, Bu-Xing

2017-07-01

To investigate the relationship between Helicobacter pylori (Hp) infection and the long-term outcome in acute coronary syndrome (ACS) patients with drug-eluting stent (DES) implantation and so as to explore the significance of Hp eradication therapy in preventing major adverse cardiac events (MACE) and upper gastrointestinal bleeding (UGIB). 539 ACS patients with DES implantation from January 1, 2010 to December 31, 2012 were analyzed. All the patients were divided into two groups according to the result of 13C urea breath test. 253 patients with Hp infection were put into group A (Hp+), and 286 cases without Hp infection were put into group B (Hp-). Demographic data was collected and all patients went through biochemical indicators and other routine blood examinations. We explored the correlations of Hp infection with MACE and UGIB after 3 to 5 years of follow-up using survival analysis. Survival analysis showed that Hp infection was a predictor of MACE and UGI. Sub-group analysis showed that patients with Hp eradication therapy had no relationship with MACE but had a lower rate of UGIB than those without Hp eradication therapy.

Relationship between left main coronary artery plaque burden and nonleft main coronary atherosclerosis: results from the PROSPECT study.

Science.gov (United States)

Shimizu, Takehisa; Mintz, Gary S; De Bruyne, Bernard; Farhat, Naim Z; Inaba, Shinji; Cao, Yang; Marso, Steven P; Weisz, Giora; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

2018-05-17

Whether the severity of left main coronary artery (LMCA) disease reflects LMCA and overall coronary atherosclerotic burden is not known. We aimed to assess nonculprit LMCA disease characteristics and the relationship with atherosclerosis in the rest of the coronary arteries as well as patient outcomes. In the PROSPECT study, 697 patients with acute coronary syndromes underwent three-vessel gray-scale and radiofrequency intravascular ultrasound after percutaneous coronary intervention. Overall, 552 patients with adequate LMCA imaging were compared according to LMCA plaque burden. The tertile with the highest plaque burden in the LMCA had the smallest LMCA minimum lumen area (17.4, 14.2, 10.5, lowest through highest tertiles, respectively, PPROSPECT predictors of future nonculprit major adverse cardiac events (MACE) (minimum lumen area≤4 mm, plaque burden≥70%, and virtual histology thin-cap fibroatheroma), the tertile with the highest LMCA plaque burden had the highest number of patients with at least one of three PROSPECT predictors (P=0.03). In multivariable model, though total atheroma volume (per 1%) was an independent predictor of all MACE [hazard ratio (95% confidence interval)=1.06 (1.01-1.11), P=0.02] and strong trend for non-culprit-related MACE [hazard ratio (95% confidence interval)=1.06 (1.00-1.13), P=0.06], plaque burden at LMCA was not (all MACE, P=0.90, non-culprit-related MACE, P=0.85). The severity of atherosclerosis in LMCA predicted the overall atherosclerotic plaque burden as well as the presence of high-risk plaques in the three major epicardial coronary arteries.

Short- and Long-Term Prognostic Utility of the HEART Score in Patients Evaluated in the Emergency Department for Possible Acute Coronary Syndrome.

Science.gov (United States)

Jain, Tarun; Nowak, Richard; Hudson, Michael; Frisoli, Tiberio; Jacobsen, Gordon; McCord, James

2016-06-01

The HEART score is a risk-stratification tool that was developed and validated for patients evaluated for possible acute coronary syndrome (ACS) in the emergency department (ED). We sought to determine the short-term and long-term prognostic utility of the HEART score. A retrospective single-center analysis of 947 patients evaluated for possible ACS in the ED in 1999 was conducted. Patients were followed for major adverse cardiac events (MACEs) at 30 days: death, acute myocardial infarction, or revascularization procedure. All-cause mortality was assessed at 5 years. The HEART score was compared with the Thrombolysis in Myocardial Infarction (TIMI) score. At 30 days, 14% (135/947) of patients had an MACE: 48 deaths (5%), 84 acute myocardial infarctions (9%), and 48 (5%) revascularization procedures. The MACE rate in patients with HEART score ≤3 was 0.6% (1/175) involving a revascularization procedure, 9.5% (53/557) in patients with HEART score between 4 and 6, and 38% (81/215) with HEART score ≥7. The C-statistic for the HEART score was 0.82 and 0.68 for the TIMI score for predicting 30-day MACE (P < 0.05). Patients with HEART score ≤3 had lower 5-year mortality rate compared with those with TIMI score of 0 (10.6% vs. 20.5%, P = 0.02). The HEART score is a valuable risk-stratification tool in predicting not only short-term MACE but also long-term mortality in patients evaluated for possible ACS in the ED. The HEART score had a superior prognostic value compared with the TIMI score.

A Comparison of HAART Outcomes between the US Military HIV Natural History Study (NHS) and HIV Atlanta Veterans Affairs Cohort Study (HAVACS)

Science.gov (United States)

2013-05-01

Acknowledgments The IDCRP HIV Working Group includes: Susan Banks, RN, CAPT Mary Bavaro, MD, Ionut Bebu, PhD, Helen Chun, MD, Nancy Crum- Cianflone, MD, MPH...Cathy Decker, MD, Conner Eggleston, LTC Tomas Ferguson, MD, COL Susan Fraser, MD, MAJ Joshua Hartzell, MD, MAJ Joshua Hawley, MD, LTC Gunther Hsue, MD

The Development of the C3 Framework

Science.gov (United States)

Social Education, 2013

2013-01-01

Susan Griffin, executive director of NCSS, was chair of the Task Force of Professional Organizations that initiated and guided the development of "The College, Career, and Civic Life (C3) Framework for Social Studies State Standards", which will soon be released. In this interview with "Social Education", Susan explains how the…

Left atrial enlargement increases the risk of major adverse cardiac events independent of coronary vasodilator capacity.

Science.gov (United States)

Koh, Angela S; Murthy, Venkatesh L; Sitek, Arkadiusz; Gayed, Peter; Bruyere, John; Wu, Justina; Di Carli, Marcelo F; Dorbala, Sharmila

2015-09-01

Longstanding uncontrolled atherogenic risk factors may contribute to left atrial (LA) hypertension, LA enlargement (LAE) and coronary vascular dysfunction. Together they may better identify risk of major adverse cardiac events (MACE). The aim of this study was to test the hypothesis that chronic LA hypertension as assessed by LAE modifies the relationship between coronary vascular function and MACE. In 508 unselected subjects with a normal clinical (82)Rb PET/CT, ejection fraction ≥40 %, no prior coronary artery disease, valve disease or atrial fibrillation, LAE was determined based on LA volumes estimated from the hybrid perfusion and CT transmission scan images and indexed to body surface area. Absolute myocardial blood flow and global coronary flow reserve (CFR) were calculated. Subjects were systematically followed-up for the primary end-point - MACE - a composite of all-cause death, myocardial infarction, hospitalization for heart failure, stroke, coronary artery disease progression or revascularization. During a median follow-up of 862 days, 65 of the subjects experienced a composite event. Compared with subjects with normal LA size, subjects with LAE showed significantly lower CFR (2.25 ± 0.83 vs. 1.95 ± 0.80, p = 0.01). LAE independently and incrementally predicted MACE even after accounting for clinical risk factors, medication use, stress left ventricular ejection fraction, stress left ventricular end-diastolic volume index and CFR (chi-squared statistic increased from 30.9 to 48.3; p = 0.001). Among subjects with normal CFR, those with LAE had significantly worse event-free survival (risk adjusted HR 5.4, 95 % CI 2.3 - 12.8, p < 0.0001). LAE and reduced CFR are related but distinct cardiovascular adaptations to atherogenic risk factors. LAE is a risk marker for MACE independent of clinical factors and left ventricular volumes; individuals with LAE may be at risk of MACE despite normal coronary vascular function.

Stress Perfusion Coronary Flow Reserve Versus Cardiac Magnetic Resonance for Known or Suspected CAD.

Science.gov (United States)

Kato, Shingo; Saito, Naka; Nakachi, Tatsuya; Fukui, Kazuki; Iwasawa, Tae; Taguri, Masataka; Kosuge, Masami; Kimura, Kazuo

2017-08-15

Phase-contrast (PC) cine magnetic resonance imaging (MRI) of the coronary sinus is a noninvasive method to quantify coronary flow reserve (CFR). This study sought to compare the prognostic value of CFR by cardiac magnetic resonance (CMR) and stress perfusion CMR to predict major adverse cardiac events (MACE). Participants included 276 patients with known coronary artery disease (CAD) and 400 with suspected CAD. CFR was calculated as myocardial blood flow during adenosine triphosphate infusion divided by myocardial blood flow at rest using PC cine MRI of the coronary sinus. During a median follow-up of 2.3 years, 47 patients (7%) experienced MACE. Impaired CFR (10% ischemia on stress perfusion CMR were significantly associated with MACE in patients with known CAD (hazard ratio [HR]: 5.17 and HR: 5.10, respectively) and suspected CAD (HR: 14.16 and HR: 6.50, respectively). The area under the curve for predicting MACE was 0.773 for CFR and 0.731 for stress perfusion CMR (p = 0.58) for patients with known CAD, and 0.885 for CFR and 0.776 for stress perfusion CMR (p = 0.059) in the group with suspected CAD. In patients with known CAD, sensitivity, specificity, and positive and negative predictive values to predict MACE were 64%, 91%, 38%, and 97%, respectively, for CFR, and 82%, 59%, 15%, and 97%, respectively, for stress perfusion CMR. In the suspected CAD group, these values were 65%, 99%, 80%, and 97%, respectively, for CFR, and 72%, 83%, 22%, and 98%, respectively, for stress perfusion CMR. The predictive values of CFR and stress perfusion CMR for MACE were comparable in patients with known CAD. In patients with suspected CAD, CFR showed higher HRs and areas under the curve than stress perfusion CMR, suggesting that CFR assessment by PC cine MRI might provide better risk stratification for patients with suspected CAD. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

A direct comparison of decision rules for early discharge of suspected acute coronary syndromes in the era of high sensitivity troponin.

Science.gov (United States)

Chew, Pei Gee; Frost, Fredrick; Mullen, Liam; Fisher, Michael; Zadeh, Heidar; Grainger, Ruth; Albouaini, Khaled; Dodd, James; Patel, Bilal; Velavan, Periaswamy; Kunadian, Babu; Rawat, Anju; Obafemi, Toba; Tong, Sarah; Jones, Julia; Khand, Aleem

2018-02-01

We tested the hypothesis that a single high sensitivity troponin at limits of detection (LOD HSTnT) (Acute Coronary Events (GRACE) (acute coronary syndrome. In a prospective cohort study, risk scores were computed in consecutive patients with suspected acute coronary syndrome presenting to the Emergency Room of a large English hospital. Adjudication of myocardial infarction, as per third universal definition, involved a two-physician, blinded, independent review of all biomarker positive chest pain re-presentations to any national hospital. The primary and secondary outcome was a composite of type 1 myocardial infarction, unplanned coronary revascularisation and all cause death (MACE) at six weeks and one year. Of 3054 consecutive presentations with chest pain 1642 had suspected acute coronary syndrome (52% male, median age 59 years, 14% diabetic, 20% previous myocardial infarction). Median time from chest pain to presentation was 9.7 h. Re-presentations occurred in eight hospitals with 100% follow-up achieved. Two hundred and eleven (12.9%) and 279 (17%) were adjudicated to suffer MACE at six weeks and one year respectively. Only HEART ≤3 (negative predictive value MACE 99.4%, sensitivity 97.6%, %discharge 53.4) and LOD HSTnT strategy (negative predictive value MACE 99.8%, sensitivity 99.5%, %discharge 36.9) achieved pre-specified negative predictive value of >99% for MACE at six weeks. For type 1 myocardial infarction alone the negative predictive values at six weeks and one year were identical, for both HEART ≤3 and LOD HSTnT at 99.8% and 99.5% respectively. HEART ≤3 or LOD HSTnT strategy rules out short and medium term myocardial infarction with ≥99.5% certainty, and short-term MACE with >99% certainty, allowing for early discharge of 53.4% and 36.9% respectively of suspected acute coronary syndrome. Adoption of either strategy has the potential to greatly reduce Emergency Room pressures and minimise follow-up investigations. Very early presenters (<3 h

Biomarker evaluation as a potential cause of gender differences in obesity paradox among patients with STEMI.

Science.gov (United States)

Baumann, Stefan; Koepp, Johanna; Becher, Tobias; Huseynov, Aydin; Bosch, Katharina; Behnes, Michael; Fastner, Christian; El-Battrawy, Ibrahim; Renker, Matthias; Lang, Siegfried; Weiß, Christel; Borggrefe, Martin; Lehmann, Ralf; Akin, Ibrahim

2016-03-01

Obesity with its worldwide growing prevalence is an established cardiovascular risk factor with increased morbidity and mortality. However, the phenomenon, that mild to moderate obesity seems to represent a protective effect on diseases has been termed the "obesity paradox". We retrospectively assessed 529 patients (72.6% male, mean age 59.7±12.7years) admitted with ST-elevation myocardial infarction (STEMI). The female and male study populations were separated into four body mass index (BMI) groups: ≤24.9kg/m(2), 25.0-29.9kg/m(2), 30.0-34.9kg/m(2) and ≥35.0kg/m(2). Blood samples of high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) were analyzed. With increasing BMI group the rate of major adverse cardiac events (MACE) decreased in all patients (test for trend p=0.041). No gender difference between MACE and BMI could be noticed (p=0.16). A higher risk for MACE was indicated in group BMI ≤18.5kg/m(2) in comparison to group BMI 25.0-29.9kg/m(2) (OR: 7.93; 95% CI: 1.75-35.89; p=0.0091), whereas group BMI 30.0-34.9kg/m(2) was significant associated with a lower risk in comparison to group BMI 25.0-29.9kg/m(2) (OR: 0.65; 95% CI: 0.21-1.96; p=0.044). An association between HDL-c (p=0.55) or LDL-c (p=0.10) and MACE could not be detected. The study demonstrates that patients with STEMI and a BMI of 30.0-34.9kg/m(2) have a decreased risk for MACE compared to patients with normal BMI. No gender related differences were indicated. An association between MACE and lipoproteins could not be detected. Copyright © 2016 Elsevier Inc. All rights reserved.

Association of β-Blocker Therapy With Risks of Adverse Cardiovascular Events and Deaths in Patients With Ischemic Heart Disease Undergoing Noncardiac Surgery

DEFF Research Database (Denmark)

Andersson, Charlotte; Mérie, Charlotte; Jørgensen, Mads Wissenberg

2014-01-01

IMPORTANCE: Clinical guidelines have been criticized for encouraging the use of β-blockers in noncardiac surgery despite weak evidence. Relevant clinical trials have been small and have not convincingly demonstrated an effect of β-blockers on hard end points (ie, perioperative myocardial infarction......, ischemic stroke, cardiovascular death, and all-cause death). OBJECTIVE: To assess the association of β-blocker treatment with major cardiovascular adverse events (MACE) and all-cause mortality in patients with ischemic heart disease undergoing noncardiac surgery. DESIGN, SETTING, PARTICIPANTS, AND EXPOSURE...... to calculate the 30-day risks of MACE (ischemic stroke, myocardial infarction, or cardiovascular death) and all-cause mortality associated with β-blocker therapy. MAIN OUTCOMES AND MEASURES: Thirty-day risk of MACE and all-cause mortality. RESULTS: Of 28,263 patients with ischemic heart disease undergoing...

The relationship between duration of psoriasis, vascular inflammation, and cardiovascular events

DEFF Research Database (Denmark)

Egeberg, Alexander; Skov, Lone; Joshi, Aditya A.

2017-01-01

of psoriasis duration [hazard ratio, 1.010; 95% confidence interval, 1.007-1.013]). Limitations These studies utilized observational data. Conclusion We found detrimental effects of psoriasis duration on vascular inflammation and MACE, suggesting that cumulative duration of exposure to low-grade chronic......Background Psoriasis is associated with risk of cardiovascular (CV) disease (CVD) and a major adverse CV event (MACE). Whether psoriasis duration affects risk of vascular inflammation and MACEs has not been well characterized. Objectives We utilized two resources to understand the effect...... of psoriasis duration on vascular disease and CV events: (1) a human imaging study and (2) a population-based study of CVD events. Methods First, patients with psoriasis (N = 190) underwent fludeoxyglucose F 18 positron emission tomography/computed tomography (duration effect reported as a β...

78 FR 16472 - Deposit of Biological Materials

Science.gov (United States)

2013-03-15

... comment'' in the subject line of the message. Mail: Susan K. Fawcett, Records Officer, Office of the Chief... by FedEx ``Domestic Overnight'' is estimated to be $75. If the shipment requires pick-up by FedEx... responses. Dated: March 12, 2013. Susan K. Fawcett, Records Officer, USPTO, Office of the Chief Information...

Predictive value of cardiac magnetic resonance imaging-derived myocardial strain for poor outcomes in patients with acute myocarditis

Energy Technology Data Exchange (ETDEWEB)

Lee, Ji Won; Jeong, Yeon Joo; Lee, Gee Won; Lee, Nam Kyung; Lee, Hye Won; Kim, Jin You [Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of); Choi, Bum Sung; Choo, Ki Seok [Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

2017-08-01

To evaluate the utility of cardiovascular magnetic resonance (CMR)-derived myocardial strain measurement for the prediction of poor outcomes in patients with acute myocarditis We retrospectively analyzed data from 37 patients with acute myocarditis who underwent CMR. Left ventricular (LV) size, LV mass index, ejection fraction and presence of myocardial late gadolinium enhancement (LGE) were analyzed. LV circumferential strain (EccSAX), radial strain (ErrSAX) from mid-ventricular level short-axis cine views and LV longitudinal strain (EllLV), radial strain (ErrLax) measurements from 2-chamber long-axis views were obtained. In total, 31 of 37 patients (83.8%) underwent follow-up echocardiography. The primary outcome was major adverse cardiovascular event (MACE). Incomplete LV functional recovery was a secondary outcome. During an average follow-up of 41 months, 11 of 37 patients (29.7%) experienced MACE. Multivariable Cox proportional hazard regression analysis, which included LV mass index, LV ejection fraction, the presence of LGE, EccSAX, ErrSAX, EllLV, and ErrLax values, indicated that the presence of LGE (hazard ratio, 42.88; p = 0.014), together with ErrLax (hazard ratio, 0.77 per 1%, p = 0.004), was a significant predictor of MACE. Kaplan-Meier analysis demonstrated worse outcomes in patient with LGE and an ErrLax value ≤ 9.48%. Multivariable backward regression analysis revealed that ErrLax values were the only significant predictors of LV functional recovery (hazard ratio, 0.54 per 1%; p = 0.042). CMR-derived ErrLax values can predict poor outcomes, both MACE and incomplete LV functional recovery, in patients with acute myocarditis, while LGE is only a predictor of MACE.

Risk and timing of clinical events according to diabetic status of patients treated with everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting stent: 2-year results from a propensity score matched comparison of ABSORB EXTEND and SPIRIT trials.

Science.gov (United States)

Campos, Carlos M; Caixeta, Adriano; Franken, Marcelo; Bartorelli, Antonio L; Whitbourn, Robert J; Wu, Chiung-Jen; Li Paul Kao, Hsien; Rosli, Mohd Ali; Carrie, Didier; De Bruyne, Bernard; Stone, Gregg W; Serruys, Patrick W; Abizaid, Alexandre

2018-02-15

to compare the occurrence of clinical events in diabetics treated with the Absorb bioresorbable vascular scaffold (Absorb BVS; Abbott Vascular, Santa Clara, CA) versus everolimus-eluting metal stents (EES; XIENCE V; Abbott Vascular, Santa Clara, CA) BACKGROUND: There are limited data dedicated to clinical outcomes of diabetic patients treated with bioresorbable scaffolds (BRS) at 2-year horizon. The present study included 812 patients in the ABSORB EXTEND study in which a total of 215 diabetic patients were treated with Absorb BVS. In addition, 882 diabetic patients treated with EES in pooled data from the SPIRIT clinical program (SPIRIT II, SPIRIT III and SPIRIT IV trials) were used for comparison by applying propensity score matching using 29 different variables. The primary endpoint was ischemia driven major adverse cardiac events (ID-MACE), including cardiac death, myocardial infarction (MI), and ischemia driven target lesion revascularization (ID-TLR). After 2 years, the ID-MACE rate was 6.5% in the Absorb BVS vs. 8.9% in the Xience group (P = 0.40). There was no difference for MACE components or definite/probable device thrombosis (HR: 1.43 [0.24,8.58]; P = 0.69). The occurrence of MACE was not different for both diabetic status (insulin- and non-insulin-requiring diabetes) in all time points up to the 2-year follow-up for the Absorb and Xience groups. In this largest ever patient-level pooled comparison on the treatment of diabetic patients with BRS out to two years, individuals with diabetes treated with the Absorb BVS had a similar rate of MACE as compared with diabetics treated with the Xience EES. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Stent parameters predict major adverse clinical events and the response to platelet glycoprotein IIb/IIIa blockade: findings of the ESPRIT trial.

Science.gov (United States)

Tcheng, James E; Lim, Ing Haan; Srinivasan, Shankar; Jozic, Joseph; Gibson, C Michael; O'Shea, J Conor; Puma, Joseph A; Simon, Daniel I

2009-02-01

Only limited data describe relationships between stent parameters (length and diameter), adverse events after percutaneous coronary intervention, and effects of platelet glycoprotein IIb/IIIa blockade by stent parameters. In this post hoc analysis of the 1983 patients receiving a stent in the Enhanced Suppression of the Platelet Glycoprotein IIb/IIIa Receptor with Integrilin Therapy randomized percutaneous coronary intervention trial of eptifibatide versus placebo, rates of the major adverse cardiac event (MACE) end point (death, myocardial infarction, urgent target-vessel revascularization, or thrombotic bailout) at 48 hours and 1 year were correlated with stent parameters and then analyzed by randomization to eptifibatide versus placebo. In the placebo group, MACE increased with number of stents implanted, total stent length (by quartiles of or=30 mm), and total stented vessel area (by quartiles of area or=292 mm(2)). By stent parameters, MACE at 48 hours was reduced in the eptifibatide group at stent lengths of 18 to or=30 mm (OR, 0.43; 95% CI, 0.25 to 0.75; P=0.003), stent diameters of >2.5 to <3.5 mm (OR, 0.56; 95% CI, 0.39 to 0.82; P=0.002), and with 2 stents implanted (OR, 0.39; 95% CI, 0.22 to 0.69; P=0.001). In the placebo group, near-linear relationships were observed between both increasing stent length and increasing stented vessel area and MACE at 48 hours and 1 year (all, P<0.001); these gradients were flattened in the eptifibatide group (P=0.005 for stent length). Stent parameters predict MACE after percutaneous coronary intervention. Glycoprotein IIb/IIIa blockade mitigates much of the hazard of increasing procedural complexity.

Impaired masturbation-induced erections: a new cardiovascular risk factor for male subjects with sexual dysfunction.

Science.gov (United States)

Rastrelli, Giulia; Boddi, Valentina; Corona, Giovanni; Mannucci, Edoardo; Maggi, Mario

2013-04-01

Erectile dysfunction (ED) is considered an early surrogate marker of silent, or even overt, cardiovascular diseases (CVD). However, epidemiological studies take into account only sexual intercourse-related erections. Although autoeroticism is a very common practice, data on masturbation-induced erections as a possible predictor of major adverse cardiovascular events (MACE) are lacking. To evaluate the clinical correlates of impaired masturbation-induced erections and to verify the importance of this sexual aspect in predicting MACE. A consecutive series of 4,031 male patients attending the Outpatient Clinic for sexual dysfunction for the first time was retrospectively studied. Among these subjects, 64% reported autoeroticism during the last 3 months, and only this subset was considered in the following analyses. In the longitudinal study, 862 subjects reporting autoeroticism were enrolled. Several clinical, biochemical, and instrumental (Prostaglandin E1 [PGE1 ] test and penile color Doppler ultrasound) parameters were studied. Subjects with an impaired erection during masturbation (46% of those reporting autoeroticism) had more often a positive personal or family history of CVD, a higher risk of reduced intercourse- and sleep-related erections, hypoactive sexual desire and perceived reduced ejaculate volume, and impaired PGE1 test response. Prolactin levels were lower in those having impaired erection during masturbation. In the longitudinal study, unadjusted incidence of MACE was significantly associated with impaired masturbation-induced erections. When dividing the population according to the median age and diagnosis of diabetes, the association between impaired masturbation-induced erections and incidence of MACE was maintained only in the youngest (masturbation-induced erections, can provide further insights on forthcoming MACE in particular in "low risk" subjects. © 2013 International Society for Sexual Medicine.

Does Late Gadolinium Enhancement still have Value? Right Ventricular Internal Mechanical Work, Ea/Emax and Late Gadolinium Enhancement as Prognostic Markers in Patients with Advanced Pulmonary Hypertension via Cardiac MRI.

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Abouelnour, Amr Ei; Doyle, Mark; Thompson, Diane V; Yamrozik, June; Williams, Ronald B; Shah, Moneal B; Soma, Siva Kr; Murali, Srinivas; Benza, Raymond L; Biederman, Robert Ww

2017-01-01

Investigate the impact of Right Ventricular (RV) Internal Work (IW), ratio of arterial to ventricular end-systolic elastance (E a /E max ), and RV Insertion Point (IP) Late Gadolinium Enhancement (LGE) on outcome in Pulmonary Hypertension (PH) patients. LGE is well known to be present within the RVIPs and Inter Ventricular Septum (IVS) in PH patients, but its prognostic role remains complex and potentially overestimated via 2D qualitative relative to the 3D quantitative measures now available. However, E a /E max , a measure of ventricular-arterial coupling and IW, when added to external cardiac work i.e. the P-V loop area as correlates to the heart's energy demands, might fundamentally improve measures of prognosis as they interrogate physiology beyond just the RV. Cardiac Magnetic Resonance Imaging (CMR) of 124 PH patients (age = 60±13, 85F) referred to a large tertiary PH center, was retrospectively examined for RV volumetric and functional indices and RVIP LGE%. Right Heart Catheterizations (RHC) performed within 1±2 months of the CMR were reviewed. E a /E max was derived as RV End-Systolic Volume (ESV/RVSV). IW was estimated as RVESV ×(RV end-systolic pressure-RV diastolic pressure). Patients were followed from date of CMR for up to 5 years for MACE (death, hospitalized RV failure, initiation of parenteral prostacyclin, sustained ventricular arrhythmia or referral for lung transplantation). MACE was high; 48/124 (39%) patients had MACE by 1.6±1.3 years. Neither RVIP nor IVS LGE using visual assessment or even 3D quantization predicted MACE. The strongest predictor of MACE was RVIW (OR=1.00013, pright-sided human myocardial pathologies.

Disease activity and lifestyle influence comorbidities and cardiovascular events in patients with acromegaly.

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Sardella, Chiara; Cappellani, Daniele; Urbani, Claudio; Manetti, Luca; Marconcini, Giulia; Tomisti, Luca; Lupi, Isabella; Rossi, Giuseppe; Scattina, Ilaria; Lombardi, Martina; Di Bello, Vitantonio; Marcocci, Claudio; Martino, Enio; Bogazzi, Fausto

2016-11-01

The primary objective of this study is to identify the predictors of comorbidities and major adverse cardiovascular events (MACE) that can develop after diagnosis of acromegaly. The role of therapy for acromegaly in the event of such complications was also evaluated. Retrospective cohort study was conducted on 200 consecutive acromegalic patients in a tertiary referral center. The following outcomes were evaluated: diabetes, hypertension and MACE. Each patient was included in the analysis of a specific outcome, unless they were affected when acromegaly was diagnosed, and further classified as follows: (i) in remission after adenomectomy (Hx), (ii) controlled by somatostatin analogues (SSA) (SSAc) or (iii) not controlled by SSA (SSAnc). Data were evaluated using Cox regression analysis. After diagnosis of acromegaly, diabetes occurred in 40.8% of patients. The SSAnc group had a three-fold higher risk of diabetes (HR: 3.32, P = 0.006), whereas the SSAc group had a 1.4-fold higher risk of diabetes (HR: 1.43, P = 0.38) compared with the Hx group. Hypertension occurred in 35.5% of patients, after diagnosis. The determinants of hypertension were age (HR: 1.06, P = 0.01) and BMI (HR: 1.05, P = 0.01). MACE occurred in 11.8% of patients, after diagnosis. Age (HR: 1.09, P = 0.005) and smoking habit (HR: 5.95, P = 0.01) were predictors of MACE. Conversely, therapy for acromegaly did not influence hypertension or MACE. After diagnosis of acromegaly, control of the disease (irrespective of the type of treatment) and lifestyle are predictors of comorbidities and major adverse cardiovascular events. © 2016 European Society of Endocrinology.

Long-term follow-up after near-infrared spectroscopy coronary imaging: Insights from the lipid cORe plaque association with CLinical events (ORACLE-NIRS) registry.

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Danek, Barbara Anna; Karatasakis, Aris; Karacsonyi, Judit; Alame, Aya; Resendes, Erica; Kalsaria, Pratik; Nguyen-Trong, Phuong-Khanh J; Rangan, Bavana V; Roesle, Michele; Abdullah, Shuaib; Banerjee, Subhash; Brilakis, Emmanouil S

Coronary lipid core plaque may be associated with the incidence of subsequent cardiovascular events. We analyzed outcomes of 239 patients who underwent near-infrared spectroscopy (NIRS) coronary imaging between 2009-2011. Multivariable Cox regression was used to identify variables independently associated with the incidence of major adverse cardiovascular events (MACE; cardiac mortality, acute coronary syndromes (ACS), stroke, and unplanned revascularization) during follow-up. Mean patient age was 64±9years, 99% were men, and 50% were diabetic, presenting with stable coronary artery disease (61%) or an acute coronary syndrome (ACS, 39%). Target vessel pre-stenting median lipid core burden index (LCBI) was 88 [interquartile range, IQR 50-130]. Median LCBI in non-target vessels was 57 [IQR 26-94]. Median follow-up was 5.3years. The 5-year MACE rate was 37.5% (cardiac mortality was 15.0%). On multivariable analysis the following variables were associated with MACE: diabetes mellitus, prior percutaneous coronary intervention performed at index angiography, and non-target vessel LCBI. Non-target vessel LCBI of 77 was determined using receiver-operating characteristic curve analysis to be a threshold for prediction of MACE in our cohort. The adjusted hazard ratio (HR) for non-target vessel LCBI ≥77 was 14.05 (95% confidence interval (CI) 2.47-133.51, p=0.002). The 5-year cumulative incidence of events in the above-threshold group was 58.0% vs. 13.1% in the below-threshold group. During long-term follow-up of patients who underwent NIRS imaging, high LCBI in a non-PCI target vessel was associated with increased incidence of MACE. Published by Elsevier Inc.

ORBIT II sub-analysis: Impact of impaired renal function following treatment of severely calcified coronary lesions with the Orbital Atherectomy System.

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Lee, Michael S; Lee, Arthur C; Shlofmitz, Richard A; Martinsen, Brad J; Hargus, Nick J; Elder, Mahir D; Généreux, Philippe; Chambers, Jeffrey W

2017-04-01

To investigate the safety and efficacy of the coronary Orbital Atherectomy System (OAS) to prepare severely calcified lesions for stent deployment in patients grouped by renal function. Percutaneous coronary intervention (PCI) of severely calcified lesions is associated with increased rates of major adverse cardiac events (MACE), including death, myocardial infarction (MI), and target vessel revascularization (TVR) compared with PCI of non-calcified vessels. Patients with chronic kidney disease (CKD) are at increased risk for MACE after PCI. The impact of CKD on coronary orbital atherectomy treatment has not been well characterized. ORBIT II was a prospective, multicenter trial in the U.S., which enrolled 443 patients with severely calcified coronary lesions. The MACE rate was defined as a composite of cardiac death, MI, and target vessel revascularization. Of the 441 patients enrolled with known estimated glomerular filtration rate (eGFR) values at baseline, 333 (75.5%) patients had eGFR renal impairment had a higher MACE rate through one year follow-up due to a higher rate of periprocedural MI. Interestingly, the rates of cardiac death and revascularization through 1-year were similar in patients with eGFR renal impairment and severely calcified coronary lesions. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Combined Value of Red Blood Cell Distribution Width and Global Registry of Acute Coronary Events Risk Score for Predicting Cardiovascular Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

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Zhao, Na; Mi, Lan; Liu, Xiaojun; Pan, Shuo; Xu, Jiaojiao; Xia, Dongyu; Liu, Zhongwei; Zhang, Yong; Xiang, Yu; Yuan, Zuyi; Guan, Gongchang; Wang, Junkui

2015-01-01

Global Registry of Acute Coronary Events (GRACE) risk score and red blood cell distribution width (RDW) content can both independently predict major adverse cardiac events (MACEs) in patients with acute coronary syndrome (ACS). We investigated the combined predictive value of RDW and GRACE risk score for cardiovascular events in patients with ACS undergoing percutaneous coronary intervention (PCI) for the first time. We enrolled 480 ACS patients. During a median follow-up time of 37.2 months, 70 (14.58%) patients experienced MACEs. Patients were divided into tertiles according to the baseline RDW content (11.30-12.90, 13.00-13.50, 13.60-16.40). GRACE score was positively correlated with RDW content. Multivariate Cox analysis showed that both GRACE score and RDW content were independent predictors of MACEs (hazard ratio 1.039; 95% confidence interval [CI] 1.024-1.055; p risk of MACEs increased with increasing RDW content (p value of combining RDW content and GRACE risk score was significantly improved, also shown by the net reclassification improvement (NRI = 0.352, p value of RDW and GRACE risk score yielded a more accurate predictive value for long-term cardiovascular events in ACS patients who underwent PCI as compared to each measure alone.

Big Data for Education: Data Mining, Data Analytics, and Web Dashboards. Governance Studies at Brookings

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West, Darrell M.

2012-01-01

Twelve-year-old Susan took a course designed to improve her reading skills. She read short stories and the teacher would give her and her fellow students a written test every other week measuring vocabulary and reading comprehension. A few days later, Susan's instructor graded the paper and returned her exam. The test showed that she did well on…

Characterizing Musculoskeletal Injury among Aeromedical Evacuation Personnel: An Observational Study

Science.gov (United States)

2016-09-28

Jennifer Serres, PhD; Col Susan Dukes, PhD; Molly Wade, MS; Brittany Fouts, MS; Mandy Cowgill, MS; Daniel Pohlman, BS September 2016...CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Jennifer Serres, Susan Dukes, Molly Wade, Brittany Fouts, Mandy... environment . 2.0 INTRODUCTION Musculoskeletal injuries (MSIs) result from the cumulative trauma associated with repetitive and physically

Aspirin effect on the incidence of major adverse cardiovascular events in patients with diabetes mellitus: a systematic review and meta-analysis

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Ghali William A

2011-04-01

Full Text Available Abstract Background Aspirin has been recommended for the prevention of major adverse cardiovascular events (MACE, composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death in diabetic patients without previous cardiovascular disease. However, recent meta-analyses have prompted re-evaluation of this practice. The study objective was to evaluate the relative and absolute benefits and harms of aspirin for the prevention of incident MACE in patients with diabetes. Methods We performed a systematic review and meta-analysis on seven studies (N = 11,618 reporting on the use of aspirin for the primary prevention of MACE in patients with diabetes. Two reviewers conducted a systematic search of electronic databases (MEDLINE, EMBASE, the Cochrane Library, and BIOSIS and hand searched bibliographies and clinical trial registries. Reviewers extracted data in duplicate, evaluated the quality of the trials, and calculated pooled estimates. Results A total of 11,618 participants were included in the analysis. The overall risk ratio (RR for MACE was 0.91 (95% confidence intervals, CI, 0.82-1.00 with little heterogeneity among trials (I2 0.0%. Secondary outcomes of interest included myocardial infarction (RR, 0.85; 95% CI, 0.66-1.10, stroke (RR, 0.84; 95% CI, 0.64-1.11, cardiovascular death (RR, 0.95; 95% CI, 0.71-1.27, and all-cause mortality (RR, 0.95; 95% CI, 0.85-1.06. There were higher rates of hemorrhagic and gastrointestinal events. In absolute terms, these relative risks indicate that for every 10,000 diabetic patients treated with aspirin, 109 MACE may be prevented at the expense of 19 major bleeding events (with the caveat that the relative risk for the latter is not statistically significant. Conclusions The studies reviewed suggest that aspirin reduces the risk of MACE in patients with diabetes without cardiovascular disease, while also causing a trend toward higher rates of bleeding and gastrointestinal complications

Calculated trends and the atmospheric abundance of 1,1,1,2-tetrafluoroethane, 1,1-dichloro-1-fluoroethane, and 1-chloro-1,1-difluoroethane using automated in-situ gas chromatography-mass spectrometry measurements recorded at Mace Head, Ireland, from October 1994 to March 1997

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Simmonds, P. G.; O'Doherty, S.; Huang, J.; Prinn, R.; Derwent, R. G.; Ryall, D.; Nickless, G.; Cunnold, D.

1998-01-01

The first in-situ measurements by automated gas chromatograph-mass spectrometer are reported for 1,1,1,2-tetrafluoroethane (HFC-134a), 1,1-dichloro-1-fluoroethane, (HCFC-141b), and 1-chloro-1,1-difluoroethane, (HCFC-142b). These compounds are steadily replacing the chlorofluorocarbons (CFCs) as refrigerants, foam-blowing agents, and solvents. The concentrations of all three compounds are shown to be rapidly increasing in the atmosphere, with 134a increasing at a rate of 2.05±0.02 ppt yr-1 over the 30 months of observations. Similarly, 141b and 142b increased at rates of 2.49±0.03 and 1.24±0.02 ppt yr-1, respectively, over the same period. The concentrations recorded at the atmospheric research station at Mace Head, Ireland, on January 1, 1996, the midpoint of the time series, were 3.67 ppt (134a), 7.38 ppt (141b), and 8.78 ppt (142b). From these observations we optimally estimate the HCFC and HFC emissions using a 12-box global model and OH concentrations derived from global 1,1,1-trichloroethane (CCl3CH3) measurements. Comparing two methods of estimating emissions with independent industry estimates shows satisfactory agreement for 134a and 141b, while for 142b, industry estimates are less than half those required to explain our observations.

Blood Glucose Reduction by Diabetic Drugs with Minimal Hypoglycemia Risk for Cardiovascular Outcomes

DEFF Research Database (Denmark)

Huang, Chi-Jung; Wang, Wei-Ting; Sung, Shih-Hsien

2018-01-01

of antidiabetic drugs with less hypoglycemia risk were comprehensively searched in MEDLINE, Embase, and the Cochrane Library up to January 27, 2018. Mixed-effects meta-regression analysis was conducted to explore the relationship between haemoglobin A1c (HbA1c) reduction and the risk of major adverse...... concentration was 0.42% lower (median, 0.27-0.86%) for participants given antihyperglycemic agents than those given placebo. The meta-regression analysis demonstrated that HbA1c reduction was significantly associated with a decreased risk of MACE (β value, -0.39 to -0.55; P...-40%) for MACE. By contrast, the meta-regression analysis for trials using conventional agents failed to demonstrate a significant relationship between achieved HbA1c difference and MACE risk (P>0.74). CONCLUSIONS: Compared with placebo, newer T2D agents with less hypoglycemic hazard significantly reduced...

Comparison of Outcomes in Patients With Versus Without Diabetes Mellitus After Revascularization With Everolimus- and Sirolimus-Eluting Stents (from the SORT OUT IV Trial)

DEFF Research Database (Denmark)

Jensen, Lisette Okkels; Thayssen, Per; Junker, Anders

2012-01-01

Diabetes is associated with increased risk of major adverse cardiac events (MACEs) after percutaneous coronary intervention. The purpose of this substudy of the SORT OUT IV trial was to compare clinical outcomes in patients with and without diabetes mellitus treated with everolimus-eluting stents...... (EESs) or sirolimus-eluting stents (SESs). In total 2,774 patients (390 with diabetes, 14.1%) were randomized to stent implantation with EESs (n = 1,390, diabetes in 14.0%) or SESs (n = 1,384, diabetes in 14.2%). Randomization was stratified by presence/absence of diabetes. The primary end point...... was MACEs, a composite of cardiac death, myocardial infarction, definite stent thrombosis, or target vessel revascularization within 18 months. MACEs were higher in diabetic than in nondiabetic patients (13.1% vs 6.4%, hazard ratio [HR] 2.08, 95% confidence interval [CI] 1.51 to 2.86). In diabetic patients...

Diastolic dysfunction revisited

DEFF Research Database (Denmark)

Johansen, Niklas Dyrby; Biering-Sørensen, Tor; Jensen, Jan Skov

2017-01-01

BACKGROUND: Echocardiographic classification of DDF has been widely discussed. The aim of this study was to investigate the independent prognostic value of established echocardiographic measures in a community-based population and create a new classification of DDF. METHODS: Within the Copenhagen...... City Heart Study, a prospective, community-based study, 1851 participants were examined by echocardiography including Tissue Doppler Imaging (TDI) in 2001 to 2003 and followed with regard to MACE (median, 10.9 years). RESULTS: We found that persons with impaired myocardial relaxation as defined by low.......97 (1.13-3.45, P=.017), E/e' ≥ 17 (HR 1.89 (1.34-2.65), P2 (HR 5.24 (1.91-14.42), P=.001) provided additional and independent prognostic information on MACE. Based on these findings, we created a new classification of DDF where all grades were significant predictors of MACE independently...

The predictive value of arterial stiffness on major adverse cardiovascular events in individuals with mildly impaired renal function

Directory of Open Access Journals (Sweden)

Han J

2016-08-01

Full Text Available Jie Han,* Xiaona Wang,* Ping Ye, Ruihua Cao, Xu Yang, Wenkai Xiao, Yun Zhang, Yongyi Bai, Hongmei Wu Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Objectives: Despite growing evidence that arterial stiffness has important predictive value for cardiovascular disease in patients with advanced stages of chronic kidney disease, the predictive significance of arterial stiffness in individuals with mildly impaired renal function has not been established. The aim of this study was to evaluate the predictive value of arterial stiffness on cardiovascular disease in this specific population. Materials and methods: We analyzed measurements of arterial stiffness (carotid–femoral pulse-wave velocity [cf-PWV] and the incidence of major adverse cardiovascular events (MACEs in 1,499 subjects from a 4.8-year longitudinal study. Results: A multivariate Cox proportional-hazard regression analysis showed that in individuals with normal renal function (estimated glomerular filtration rate [eGFR] ≥90 mL/min/1.73 m2, the baseline cf-PWV was not associated with occurrence of MACEs (hazard ratio 1.398, 95% confidence interval 0.748–2.613; P=0.293. In individuals with mildly impaired renal function (eGFR <90 mL/min/1.73 m2, a higher baseline cf-PWV level was associated with a higher risk of MACEs (hazard ratio 2.334, 95% confidence interval 1.082–5.036; P=0.031. Conclusion: Arterial stiffness is a moderate and independent predictive factor for MACEs in individuals with mildly impaired renal function (eGFR <90 mL/min/1.73 m2. Keywords: epidemiology, arterial stiffness, impaired renal function, predictive value, MACEs

Relationship of testis size and LH levels with incidence of major adverse cardiovascular events in older men with sexual dysfunction.

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Rastrelli, Giulia; Corona, Giovanni; Lotti, Francesco; Boddi, Valentina; Mannucci, Edoardo; Maggi, Mario

2013-11-01

Measurement of testis volume (TV) is a reliable clinical procedure that predicts reproductive fitness. However, the role of TV in overall and cardiovascular (CV) fitness has never been studied. The study aims to analyze the clinical correlates of TV in patients with sexual dysfunction (SD) and to verify the value of this parameter and its determinants (i.e., luteinizing hormone [LH] levels) in predicting major adverse CV events (MACE). A consecutive series of 2,809 subjects without testiculopathy (age 51.2 ± 13.1) consulting for SD was retrospectively studied. A subset of this sample (n=1,395) was enrolled in a longitudinal study. Several clinical and biochemical parameters were investigated. After adjusting for confounders, TV was negatively associated with both LH (Adj. r=-0.234; PTV (hazard ratio [HR]=1.041 [1.021-1.061], PTV (Adj. r=0.157; PTV were only partially related to changes in gonadotropin levels. In the longitudinal analysis, after adjusting for confounders, TV was associated with a higher incidence of MACE (HR=1.066 [1.013-1.122]; P=0.014), and the stepwise introduction in the Cox model of lifestyle factors, mean blood pressure and body mass index progressively smoothed out the association, which was no longer statistically significant in the fully adjusted model. Conversely, the association of higher LH levels with increased incidence of MACE was not attenuated by the progressive introduction of the aforementioned confounders in the model. Our data show that in SD subjects, TV and LH are associated with an adverse CV risk profile that mediate the higher TV-associated incidence of MACE. High LH levels are an independent marker of CV risk. Further studies are needed for clarifying determinants and mechanisms of testis enlargement that, beyond gonadotropins, could mediate the increased incidence of MACE. © 2013 International Society for Sexual Medicine.

Prognostic Utility of a Modified HEART Score in Chest Pain Patients in the Emergency Department.

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McCord, James; Cabrera, Rafael; Lindahl, Bertil; Giannitsis, Evangelos; Evans, Kaleigh; Nowak, Richard; Frisoli, Tiberio; Body, Richard; Christ, Michael; deFilippi, Christopher R; Christenson, Robert H; Jacobsen, Gordon; Alquezar, Aitor; Panteghini, Mauro; Melki, Dina; Plebani, Mario; Verschuren, Franck; French, John; Bendig, Garnet; Weiser, Silvia; Mueller, Christian

2017-02-01

The TRAPID-AMI trial study (High-Sensitivity Troponin-T Assay for Rapid Rule-Out of Acute Myocardial Infarction) evaluated high-sensitivity cardiac troponin-T (hs-cTnT) in a 1-hour acute myocardial infarction (AMI) exclusion algorithm. Our study objective was to evaluate the prognostic utility of a modified HEART score (m-HS) within this trial. Twelve centers evaluated 1282 patients in the emergency department for possible AMI from 2011 to 2013. Measurements of hs-cTnT (99th percentile, 14 ng/L) were performed at 0, 1, 2, and 4 to 14 hours. Evaluation for major adverse cardiac events (MACEs) occurred at 30 days (death or AMI). Low-risk patients had an m-HS≤3 and had either hs-cTnT<14 ng/L over serial testing or had AMI excluded by the 1-hour protocol. By the 1-hour protocol, 777 (60%) patients had an AMI excluded. Of those 777 patients, 515 (66.3%) patients had an m-HS≤3, with 1 (0.2%) patient having a MACE, and 262 (33.7%) patients had an m-HS≥4, with 6 (2.3%) patients having MACEs (P=0.007). Over 4 to 14 hours, 661 patients had a hs-cTnT<14 ng/L. Of those 661 patients, 413 (62.5%) patients had an m-HS≤3, with 1 (0.2%) patient having a MACE, and 248 (37.5%) patients had an m-HS≥4, with 5 (2.0%) patients having MACEs (P=0.03). Serial testing of hs-cTnT over 1 hour along with application of an m-HS identified a low-risk population that might be able to be directly discharged from the emergency department. © 2017 American Heart Association, Inc.

Validation of a multidimensional evaluation scale for use in elderly cancer patients.

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Monfardini, S; Ferrucci, L; Fratino, L; del Lungo, I; Serraino, D; Zagonel, V

1996-01-15

Although aging is one of the most important risk factors for cancer, elderly patients tend to be excluded from cancer clinical trials, only on the basis of chronologic age. Performance Status (PS) has been used widely to select adult patients for entry into clinical trials, but it does not include a comprehensive evaluation of various age-related factors in the elderly. This study was designed to assess the reliability and validity of a multidimensional geriatric assessment protocol for elderly patients with cancer. Thirty consecutive elderly patients (> or = 65 years), diagnosed with hematologic neoplasia or solid tumors and undergoing chemotherapy or radiotherapy, were given a specifically structured multidimensional questionnaire (MACE) three times during one week by two different physicians. MACE was intended to collect information on demographics, socioeconomic status, cognitive status, depression, physical performance, disability, and tumor characteristics. In parallel with MACE, information was collected by means of the Sickness Impact Profile (SIP). Both for inter-rater and test-retest reliability, the values of the intraclass correlation coefficient (ICC) were generally higher than 0.7. Disability, cognitive status, depressive symptoms, and the number of days spent in bed sick in the last two weeks were markedly correlated with the global, physical, and social SIP score. Disability alone explained 70% of the variance in the SIP global score, 83% of the variance in the SIP physical score, and 45% of the variance in the SIP psychosocial score. MACE proved to be applicable in a reasonable amount of time (around 30 minutes) for a medical oncology ward. These data indicate that this structured evaluation of functional status is feasible and reliable. MACE is therefore proposed as a clinical research tool to avoid arbitrary decisions on patient selection for enrollment in clinical trials, to favor uniform monitoring of treatment, and to allow a better comparison

Clinical Outcome After DK Crush Versus Culotte Stenting of Distal Left Main Bifurcation Lesions: The 3-Year Follow-Up Results of the DKCRUSH-III Study.

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Chen, Shao-Liang; Xu, Bo; Han, Ya-Ling; Sheiban, Imad; Zhang, Jun-Jie; Ye, Fei; Kwan, Tak W; Paiboon, Chitprapai; Zhou, Yu-Jie; Lv, Shu-Zheng; Dangas, George D; Xu, Ya-Wei; Wen, Shang-Yu; Hong, Lang; Zhang, Rui-Yan; Wang, Hai-Chang; Jiang, Tie-Ming; Wang, Yan; Sansoto, Teguh; Chen, Fang; Yuan, Zu-Yi; Li, Wei-Min; Leon, Martin B

2015-08-24

The present study aimed to investigate the difference in major adverse cardiac events (MACE) at 3 years after double-kissing (DK) crush versus culotte stenting for unprotected left main distal bifurcation lesions (LMDBLs). The multicenter and randomized DKCRUSH-III (Comparison of double kissing crush versus culotte stenting for unprotected distal left main bifurcation lesions: results from a multicenter, randomized, prospective study) showed that DK crush stenting was associated with fewer MACE at 1-year follow-up in patients with LMDBLs compared with culotte stenting. Here, we report the 3-year clinical outcome of the DKCRUSH-III study. A total of 419 patients with LMDBLs who were randomly assigned to either the DK crush or culotte group in the DKCRUSH-III study were followed for 3 year. The primary endpoint was the occurrence of a MACE at 3 years. Stent thrombosis (ST) was the safety endpoint. Patients were classified by simple and complex LMDBLs according to the DEFINITION (Definition and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents) study criteria. At 3 years, MACE occurred in 49 patients the culotte group and in 17 patients in the DK crush group (cumulative event rates of 23.7% and 8.2%, respectively; p DK crush group (p = 0.007). Complex LMDBLs were associated with a higher rate of MACE (35.3%) at 3 years compared with a rate of 8.1% in patients with simple LMDBLs (p DK] Crush Versus Culotte Stenting for the Treatment of Unprotected Distal Left Main Bifurcation Lesions: DKCRUSH-III, a Multicenter Randomized Study Comparing Double-Stent Techniques; ChiCTR-TRC-11001877). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Paracetamol, Ibuprofen, and Recurrent Major Cardiovascular and Major Bleeding Events in 19 120 Patients With Recent Ischemic Stroke.

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Gonzalez-Valcarcel, Jaime; Sissani, Leila; Labreuche, Julien; Bousser, Marie-Germaine; Chamorro, Angel; Fisher, Marc; Ford, Ian; Fox, Kim M; Hennerici, Michael G; Mattle, Heinrich P; Rothwell, Peter M; Steg, Philippe Gabriel; Vicaut, Eric; Amarenco, Pierre

2016-04-01

The presumed safety of paracetamol in high-cardiovascular risk patients has been questioned. We determined whether paracetamol or ibuprofen use is associated with major cardiovascular events (MACE) or major bleeding in 19 120 patients with recent ischemic stroke or transient ischemic attack of mainly atherothrombotic origin included in the Prevention of cerebrovascular and cardiovascular events of ischemic origin with terutroban in patients with a history of ischemic stroke or transient ischemic attack (PERFORM) trial. We performed 2 nested case-control analysis (2153 cases with MACE during trial follow-up and 4306 controls matched on Essen stroke risk score; 809 cases with major bleeding matched with 1616 controls) and a separate time-varying analysis. 12.3% were prescribed paracetamol and 2.5% ibuprofen. Median duration of treatment was 14 (interquartile range 5-145) days for paracetamol and 9 (5-30) days for ibuprofen. Paracetamol, but not ibuprofen, was associated with increased risk of MACE (odds ratio 1.21, 95% confidence interval [CI] 1.04-1.42) or a major bleeding (odds ratio 1.60, 95% CI 1.26-2.03), with no impact of daily dose and duration of paracetamol treatment. Time-varying analysis found an increased risk of MACE with both paracetamol (hazard ratio 1.22, 95% CI 1.05-1.43) and ibuprofen (hazard ratio 1.47, 95% CI 1.06-2.03) and of major bleeding with paracetamol (hazard ratio 1.95, 95% CI 1.45-2.62). There was a weak and inconsistent signal for association between paracetamol or ibuprofen and MACE or major bleeding, which may be related to either a genuine but modest effect of these drugs or to residual confounding. http://www.isrctn.com. Unique identifier: ISRCTN66157730. © 2016 American Heart Association, Inc.

Exploring the world of human development and reproduction.

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Red-Horse, Kristy; Drake, Penelope M; Fisher, Susan

2014-01-01

Susan Fisher has spent her career studying human development, proteomics, and the intersection between the two. When she began studying human placentation, there had been extensive descriptive studies of this fascinating organ that intertwines with the mother's vasculature during pregnancy. Susan can be credited with numerous major findings on the mechanisms that regulate placental cytotrophoblast invasion. These include the discovery that cytotrophoblasts undergo vascular mimicry to insert themselves into uterine arteries, the finding that oxygen tension greatly effects placentation, and identifying how these responses go awry in pregnancy complications such as preeclamsia. Other important work has focused on the effect of post-translational modifications such as glycosylation on bacterial adhesion and reproduction. Susan has also forayed into the world of proteomics to identify cancer biomarkers. Because her work is truly groundbreaking, many of these findings inspire research in other laboratories around the world resulting in numerous follow up papers. Likewise, her mentoring and support inspires young scientists to go on and make their own important discoveries. In this interview, Susan shares what drove her science, how she continued to do important research while balancing other aspects of life, and provides insights for the next generation.

Impact of sirolimus-eluting stent fractures without early cardiac events on long-term clinical outcomes: A multislice computed tomography study

Energy Technology Data Exchange (ETDEWEB)

Ito, Tsuyoshi [Toyohashi Heart Center, Oyama-cho, Toyohashi (Japan); Nagoya City University Graduate School of Medical Sciences, Department of Cardio-Renal Medicine and Hypertension, Nagoya (Japan); Kimura, Masashi; Ehara, Mariko; Terashima, Mitsuyasu; Nasu, Kenya; Kinoshita, Yoshihisa; Habara, Maoto; Tsuchikane, Etsuo; Suzuki, Takahiko [Toyohashi Heart Center, Oyama-cho, Toyohashi (Japan)

2014-05-15

This study sought to evaluate the impact of sirolimus-eluting stent (SES) fractures on long-term clinical outcomes using multislice computed tomography (MSCT). In this study, 528 patients undergoing 6- to 18-month follow-up 64-slice MSCT after SES implantation without early clinical events were followed clinically (the median follow-up interval was 4.6 years). A CT-detected stent fracture was defined as a complete gap with Hounsfield units (HU) <300 at the site of separation. The major adverse cardiac events (MACEs), including cardiac death, stent thrombosis, and target lesion revascularisation, were compared according to the presence of stent fracture. Stent fractures were observed in 39 patients (7.4 %). MACEs were more common in patients with CT-detected stent fractures than in those without (46 % vs. 7 %, p < 0.01). Univariate Cox regression analysis indicated a significant relationship between MACE and stent fracture [hazard ratio (HR) 7.65; p < 0.01], age (HR 1.03; p = 0.04), stent length (HR 1.03; p < 0.01), diabetes mellitus (HR 1.77; p = 0.04), and chronic total occlusion (HR 2.54; p = 0.01). In the multivariate model, stent fracture (HR 5.36; p < 0.01) and age (HR 1.03; p = 0.04) remained significant predictors of MACE. An SES fracture detected by MSCT without early clinical events was associated with long-term clinical adverse events. (orig.)

Measuring the Foundation of Homeland Security

Science.gov (United States)

2007-03-01

Pirak Kevin Eack Susan Pyle Chuck Eaneff Joseph Saitta Susan Fernandez Shelly Schechter Helen Fitzpatrick Rick Schwein Jay...multiple disciplines. The scope of this literature review is to cast a broad net and then narrow to specific literature related to Homeland Security...Suez Canal. His successes as a planner, diplomat and promoter made him the most celebrated man in Europe. Because of these successes, De Lesseps

Possible Regulatory Improvements of the American Housing Finance System

DEFF Research Database (Denmark)

Lunde, Jens

2018-01-01

Book review of: Susan M. Wachter and Joseph Tracy (eds.): Principles of Housing Finance Reform. PENN—University of Pennsylvania Press, Philadelphia, 282 pp, $65.00s, ISBN: 978-0-8122-4862-3......Book review of: Susan M. Wachter and Joseph Tracy (eds.): Principles of Housing Finance Reform. PENN—University of Pennsylvania Press, Philadelphia, 282 pp, $65.00s, ISBN: 978-0-8122-4862-3...

Clinical Outcomes of patients with coronary artery disease who underwent FFR evaluation of intermediate coronary lesionS– COFFRS study

Directory of Open Access Journals (Sweden)

Srinivasa Prasad

2017-07-01

Conclusion: In our experience, MACE events were not higher in patients with FFR > 0.8 and kept under medical therapy and were similarly lower in patients with FFR ≤0.8 and underwent revascularisation (p = 0.73. Also MACE events were higher in patients with FFR ≤ 0.8 and did not undergo revascularisation compared to other two appropriately treated groups (p = 0.03. FFR based revascularization decision appears to be a safe strategy in Indian patients.

Susan G. Komen for the Cure

Science.gov (United States)

... de sus senos:Consejos útiles para mujeres El Cancer de Mama y el Medio Ambiente: Preguntas y Respuestas Guía de herramientas de educación sobre el cancer de seno para comunidades hispanas/Latinas About Us ...

Roberts, Dennis C. & Komives, Susan R.

African Journals Online (AJOL)

Enhancing Student Learning and Development in Cross-Border Higher ... importance of the integration of students' experience in both the classroom ... practices can be motivated, the diversity in terms of offerings – on institutional and cultural.

Guilt-Free War: Post-Traumatic Stress and an Ethical Framework for Battlefield Decisions

Science.gov (United States)

2015-12-01

Susan Wolf, “ Moral Obligations and Social Command,” in Metaphysics and the Good: Themes from the Philosophy of Robert Merrihew Adams, edited by...1–18. Wolf, Susan. “ Moral Obligations and Social Command.” In Metaphysics and the Good: Themes from the Philosophy of Robert Merrihew Ad- ams, edited...Analysis of Recent Studies 5 Discussion of Various Approaches to Addressing Moral Injuries 7 Recommendations 17 Conclusion 19 Abbreviations 25

AFRICOM: Does Location Matter?

Science.gov (United States)

2009-03-01

Decision Model,” 242-244. 26 Susan Hesse Owen & Mark S. Daskin , “Strategic Facility Location: A Review,” European Journal of Operational Research...Susan Hesse & Mark S. Daskin . “Strategic Facility Location: A Review,” European Journal of Operational Research 111 (1998), 423-447. Paye-Layeleh...ES) N/ A 10. SPONSORING/MONITORING AGENCY REPORT NUMBER 11. SUPPLEMENTARY NOTES The views expressed in this thesis are those of the author and

The NATO SOF Air Wing: A Basing Decision

Science.gov (United States)

2012-12-01

11 Susan Hesse Owen & Mark S. Daskin , “Strategic Facility Location: A Review,” European Journal of Operational Research 111, (1998), 423. 6 the...Journal of Travel Research 45, (2006):167–174. Owen, Susan Hesse and Daskin , Mark S. “Strategic Facility Location: A Review.” European Journal of...WING: A BASING DECISION by James M. Cox December 2012 Thesis Advisor: William Fox Second Reader: Brian Greenshields THIS PAGE

Wanna play?

DEFF Research Database (Denmark)

Sanderhoff, Merete

2015-01-01

Part of the online publication series CODE | WORDS. Technology and Theory in the Museum, edited by Ed Rodley (Peabody Essex Museum), Robert Stein (Dallas Museum of Art) and Susan Cairns (Baltimore Museum of Art)......Part of the online publication series CODE | WORDS. Technology and Theory in the Museum, edited by Ed Rodley (Peabody Essex Museum), Robert Stein (Dallas Museum of Art) and Susan Cairns (Baltimore Museum of Art)...

Linear and Nonlinear Multiset Canonical Correlation Analysis (invited talk)

DEFF Research Database (Denmark)

Hilger, Klaus Baggesen; Nielsen, Allan Aasbjerg; Larsen, Rasmus

2002-01-01

This paper deals with decompositioning of multiset data. Friedman's alternating conditional expectations (ACE) algorithm is extended to handle multiple sets of variables of different mixtures. The new algorithm finds estimates of the optimal transformations of the involved variables that maximize...... the sum of the pair-wise correlations over all sets. The new algorithm is termed multi-set ACE (MACE) and can find multiple orthogonal eigensolutions. MACE is a generalization of the linear multiset correlations analysis (MCCA). It handles multivariate multisets of arbitrary mixtures of both continuous...

Quantification of coronary flow reserve in patients with ischaemic and non-ischaemic cardiomyopathy and its association with clinical outcomes.

Science.gov (United States)

Majmudar, Maulik D; Murthy, Venkatesh L; Shah, Ravi V; Kolli, Swathy; Mousavi, Negareh; Foster, Courtney R; Hainer, Jon; Blankstein, Ron; Dorbala, Sharmila; Sitek, Arkadiusz; Stevenson, Lynne W; Mehra, Mandeep R; Di Carli, Marcelo F

2015-08-01

Patients with left ventricular systolic dysfunction frequently show abnormal coronary vascular function, even in the absence of overt coronary artery disease. Moreover, the severity of vascular dysfunction might be related to the aetiology of cardiomyopathy.We sought to determine the incremental value of assessing coronary vascular dysfunction among patients with ischaemic (ICM) and non-ischaemic (NICM) cardiomyopathy at risk for adverse cardiovascular outcomes. Coronary flow reserve (CFR, stress/rest myocardial blood flow) was quantified in 510 consecutive patients with rest left ventricular ejection fraction (LVEF) ≤45% referred for rest/stress myocardial perfusion PET imaging. The primary end point was a composite of major adverse cardiovascular events (MACE) including cardiac death, heart failure hospitalization, late revascularization, and aborted sudden cardiac death.Median follow-up was 8.2 months. Cox proportional hazards model was used to adjust for clinical variables. The annualized MACE rate was 26.3%. Patients in the lowest two tertiles of CFR (CFR ≤ 1.65) experienced higher MACE rates than those in the highest tertile (32.6 vs. 15.5% per year, respectively, P = 0.004), irrespective of aetiology of cardiomyopathy. Impaired coronary vascular function, as assessed by reduced CFR by PET imaging, is common in patients with both ischaemic and non-ischaemic cardiomyopathy and is associated with MACE. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Poor adherence to P2Y12 antagonists increased cardiovascular risks in Chinese PCI-treated patients.

Science.gov (United States)

Sun, Yang; Li, Chenze; Zhang, Lina; Hu, Dong; Zhang, Xudong; Yu, Ting; Tao, Min; Wang, Dao Wen; Shen, Xiaoqing

2017-03-01

Low adherence to secondary prevention medications (ATM) of patients after acute coronary syndrome (ACS) is associated with poor clinical outcomes. However, literature provides limited data on assessment of ATM and risks associated with poor in Chinese patients with ACS. In the current work, ATM was assessed in consecutively recruited patients with ACS in Tongji Hospital from November 5, 2013 to December 31, 2014. A total of 2126 patients were classified under low adherence (proportion of days covered (PDC) C50%) groups based on their performance after discharge. All patients were followed up at the 1st, 6th, and 12th month of discharge while recording ATM and major adverse cardiac events (MACE). Bivariate logistic regression was used to identify the factors associated with ATM. Cox regression was used to analyze the association between ATM and MACE within one year after discharge. Results showed that coronary artery bypass grafting (CABG) alone had significantly lower proportion of high adherence to P2Y12 antagonists (83.0% vs. 90.7%, P < 0.01) than patients treated with percutaneous coronary intervention (PCI) only. Moreover, in patients undergoing PCI, high adherence to P2Y12 antagonists decreased the risk of MACE (hazard ratio = 0.172, 95% confidence interval: 0.039-0.763; P = 0.021). In conclusion, PCI-treated patients are more prone to remaining adherent to medications than CABG-treated patients. High adherence to P2Y12 antagonists was associated with lower risk of MACE.

Clinical effect of selective thrombus aspiration during primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Directory of Open Access Journals (Sweden)

Hai-wei LIU

2015-06-01

Full Text Available Objective　To assess impact of selective thrombus aspiration (TA during primary percutaneous coronary intervention (pPCI on long-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI. Methods　 Between Jan. 2008 and Jan. 2014, a total of 2357 STEMI patients [429 in thrombus aspiration (TA group and 1928 in routine percutaneous coronsry intorventim (PCI group (control group] were eligible for the study criteria and candidates for pPCI were enrolled in this study. The reflow of the involved vessel in pPCI procedure, stent thrombosis and major adverse cardiac events (MACE were comparatively analyzed in the two groups during hospital stay and 12-month follow-up period. Results　Although the success rate of TA procedure was significantly lower in TA group compared with that in control group (P＜0.001, both the TIMI flow grade ≥2 after TA procedure and stent implantation occurred more frequently in TA group than in control group (P＜0.05. The rates of MACE and stent thrombosis showed no difference between two groups during in-hospital and 12-month follow-up period (P>0.05. But the rates of total MACE and target vessel revascularization were significantly higher in control group than in TA group (P=0.04. Conclusion　Selective TA procedure before primary PCI could improve final myocardial reperfusion, reduce the incidence of MACE and improve the 1-year clinical result for STEMI patients. DOI: 10.11855/j.issn.0577-7402.2015.04.04

South Asian Ethnicity as a Risk Factor for Major Adverse Cardiovascular Events after Renal Transplantation

Science.gov (United States)

Vangala, Sai K.; Silver, Samuel A.; Wong, Steven C.W.; Huang, Michael; Rapi, Lindita; Nash, Michelle M.; Zaltzman, Jeffrey S.

2011-01-01

Summary Background and objectives South Asians (SAs) comprise 25% of all Canadian visible minorities. SAs constitute a group at high risk for cardiovascular disease in the general population, but the risk in SA kidney transplant recipients has never been studied. Design, setting, participants, & measurements In a cohort study of 864 kidney recipients transplanted from 1998 to 2007 and followed to June 2009, we identified risk factors including ethnicity associated with major cardiac events (MACEs, a composite of nonfatal myocardial infarction, coronary intervention, and cardiac death) within and beyond 3 months after transplant. Kaplan-Meier methodology and multivariate Cox regression analysis were used to determine risk factors for MACEs. Results There was no difference among SAs (n = 139), whites (n = 550), blacks (n = 65), or East Asians (n = 110) in baseline risk, including pre-existing cardiac disease. Post-transplant MACE rate in SAs was 4.4/100 patient-years compared with 1.31, 1.16, and 1.61/100 patient-years in whites, blacks, and East Asians, respectively (P diabetes, systolic BP, and prior cardiac disease. SAs also experienced more MACEs within 3 months after transplant compared with whites (P < 0.0001), blacks (P = 0.04), and East Asians (P = 0.006). However, graft and patient survival was similar to other groups. Conclusions SA ethnicity is an independent risk factor for post-transplant cardiac events. Further study of this high-risk group is warranted. PMID:20884776

Breast cancer and autism.

Science.gov (United States)

Radcliff, Lisa

2013-03-01

Case Study Amy is a 44-year-old woman with severe autism. She lives with her sister Susan, who is her caregiver and guardian. Amy is ambulatory and able to dress and feed herself. She is a healthy individual with no other significant comorbidities. She walks daily and enjoys her sister's company. Amy's life expectancy is greater than 10 years. However, she is difficult to care for medically, as she will not allow a physical examination and strikes out when strangers try to touch her. She is nonverbal and unable to participate in decision-making. INITIAL DIAGNOSIS Amy has a history of breast cancer diagnosed 2 years ago, originally presenting as a stage I lesion (T2N0) that was palpated by her caregiver while bathing. She underwent right simple mastectomy with sentinel lymph node resection. Susan recalls that the mastectomy was a very challenging ordeal, as Amy kept pulling out IV lines, drains, and dressings. Susan felt that Amy withdrew from her after the procedure as she most likely associated Susan with the cause of the pain, making her role as caregiver more difficult. Pathology confirmed an invasive ductal carcinoma, moderately differentiated, 2.4 cm, estrogen/progesterone receptor negative, HER2/neu negative, with negative surgical margins. Two right axillary sentinel lymph nodes were negative for disease. The standard of care for a patient with these tumor features is surgery plus adjuvant chemotherapy (National Comprehensive Cancer Network [NCCN], 2012). According to the Adjuvant Online! database (2012), Amy's risk for relapse was approximately 40% without adjuvant treatment; her risk for mortality was approximately 29%. After meeting with a medical oncologist, Amy did not receive adjuvant chemotherapy. According to Susan, she was not offered the choice, and the decision was not explained to them. She was simply told that it was not necessary. Aside from pathology, previous records were unavailable for review. Medical assessment of Amy's level of autism

Impact of positive and negative lesion site remodeling on clinical outcomes: insights from PROSPECT.

Science.gov (United States)

Inaba, Shinji; Mintz, Gary S; Farhat, Naim Z; Fajadet, Jean; Dudek, Dariusz; Marzocchi, Antonio; Templin, Barry; Weisz, Giora; Xu, Ke; de Bruyne, Bernard; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

2014-01-01

This study investigated coronary artery remodeling patterns associated with clinical outcomes. In the prospective, multicenter PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree: An Imaging Study in Patients With Unstable Atherosclerotic Lesions) study, reported predictors of nonculprit lesion (NCL) major adverse cardiac events (MACE) were an intravascular ultrasound (IVUS) minimal lumen area (MLA) ≤4 mm(2), a plaque burden ≥70%, and a IVUS-virtual histology (VH) thin-cap fibroatheroma (TCFA), but not lesion site remodeling. Overall, 697 consecutive patients with an acute coronary syndrome were enrolled and underwent 3-vessel gray-scale and IVUS-VH; 3,223 NCLs were identified by IVUS. The remodeling index (RI) was calculated as the external elastic membrane area at the MLA site divided by the average of the proximal and distal reference external elastic membrane areas. First, one third of the patients were randomly selected to determine RI cutoffs related to NCL MACE (development cohort). Receiver-operating characteristic analysis showed that there were 2 separate cut points that predicted NCL MACE: RI = 0.8789 and RI = 1.0046 (area under the curve = 0.663). These cut points were used to define negative remodeling as an RI 1.00. Second, we used the remaining two-thirds of patients to validate these cut points with respect to lesion morphology and clinical outcomes (validation cohort). Kaplan-Meier curve analysis in the validation cohort showed that NCL MACE occurred more frequent (and equally) in negative and positive remodeling lesions compared with intermediate remodeling lesions. In this cohort, negative remodeling lesions had the smallest MLA, positive remodeling lesions had the largest plaque burden, and VH TCFA, especially VH TCFA with multiple necrotic cores, was most common in negatively remodeling lesions. The present study showed the novel concept that positive and negative lesion site remodeling was

Short-versus long-term Dual Antiplatelet therapy after drug-eluting stent implantation in women versus men: A sex-specific patient-level pooled-analysis of six randomized trials.

Science.gov (United States)

Sawaya, Fadi J; Morice, Marie-Claude; Spaziano, Marco; Mehran, Roxana; Didier, Romain; Roy, Andrew; Valgimigli, Marco; Kim, Hyo-Soo; Woo Park, Kyung; Hong, Myeong-Ki; Kim, Byeong-Keuk; Jang, Yangsoo; Feres, Fausto; Abizaid, Alexandre; Costa, Ricardo A; Colombo, Antonio; Chieffo, Alaide; Giustino, Gennaro; Stone, Gregg W; Bhatt, Deepak L; Palmerini, Tullio; Gilard, Martine

2017-02-01

Whether the efficacy and safety of dual antiplatelet therapy (DAPT) are uniform between sexes is unclear. We sought to compare clinical outcomes between short- (≤6 months) versus long-term (≥1 year) DAPT after drug-eluting stent (DES) placement in women and men. We pooled individual patient data from 6 randomized trials of DAPT (EXCELLENT, OPTIMIZE, PRODIGY, RESET, SECURITY, ITALIC PLUS). The primary outcome was 1-year risk of major adverse cardiac events (MACE). The main secondary outcome was 1-year risk of any bleeding. Out of the 11,473 randomized patients included in the pooled dataset, 3,454 (30%) were females. At 1-year follow-up, women had higher risk of MACE (3.6% vs. 2.8%; P = 0.01) but similar risk of bleeding (1.9% vs. 1.6%; P = 0.16) as compared with men. Compared with long-term DAPT, short-term DAPT was associated with similar rates of MACE in both women (HR 0.88; 95% CI 0.62-1.25) and men (HR 1.25; 95% CI 0.95-1.6; P interaction = 0.08)]. At 1-year follow-up, short-term DAPT was associated with lower rates of bleeding as compared with long-term DAPT in both women (HR 0.84; 95% CI 0.51-1.37) and men (HR 0.58; 95% CI 0.40-0.84; P-interaction = 0.25). The presence of MVD was associated with higher MACE rates in the short-term DAPT group in women (HR: 1.16; CI 0.60-2.23) and men (HR: 2.29; CI 1.22-4.29; P interaction = 0.25). Short-term DAPT is associated with similar rates of MACE but lower risk of bleeding when as compared with prolonged DAPT. There was no significant difference between sexes in the population studied. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Clinical values of left ventricular mechanical dyssynchrony assessment by gated myocardial perfusion SPECT in patients with acute myocardial infarction and multivessel disease

International Nuclear Information System (INIS)

Cho, Sang-Geon; Park, Ki Seong; Kim, Jahae; Kim, Jong Sang; Song, Ho-Chun; Jabin, Zeenat; Kang, Sae-Ryung; Kwon, Seong Young; Jeong, Geum-Cheol; Song, Minchul; Min, Jung-Joon; Bom, Hee-Seung; Cho, Jae Yeong; Kim, Hyun Kuk

2017-01-01

The aim of this study was to evaluate the prognostic value of additional evaluation of left ventricular mechanical dyssynchrony (LVMD) by gated myocardial perfusion single-photon emission computed tomography (GMPS) in patients with acute myocardial infarction (MI) and multivessel disease. One hundred and nine acute MI patients with >50 % stenosis in at least one non-culprit artery who underwent GMPS within 2 weeks were enrolled. All patients underwent successful revascularization of the culprit arteries. Those with previous MI, atrial fibrillation, or frequent ventricular premature complexes, cardiac devices, significant patient motion, or procedure-related events were excluded. Phase standard deviation (PSD) and phase histogram bandwidth (PBW) were measured for assessment of LVMD. Patients were followed up for a median of 26 months after index MI, for composite major adverse cardiac events (MACE), which consisted with all-cause death, unplanned hospitalization due to heart failure and severe ventricular arrhythmias (sustained ventricular tachycardia or ventricular fibrillation). Independent predictors of MACE were evaluated. MACE occurred in 22 patients (20 %). Stress PSD (53.3 ± 17.3 vs. 35.3 ± 18.9 ; p <0.001), stress PBW (147.6 ± 54.6 vs. 96.8 ± 59.2 ; p = 0.001) and resting PBW (126.8 ± 37.5 vs. 96.6 ± 48.9 ; p = 0.001) were significantly higher in patients with MACE compared to those without. Multivariate analysis revealed that stress PSD ≥45.5 and stress PBW ≥126.0 were predictive of MACE, as well as suboptimal non-culprit artery revascularization (SNR) and renin-angiotensin system (RAS) blockade medication. Higher stress PSD and stress PBW were associated with poorer prognosis both in patients with and without SNR, and those with RAS blockade medication, but not in those without RAS blockade medication. LVMD measured by GMPS showed added prognostic value in acute MI with multivessel disease. GMPS could serve as a comprehensive evaluation imaging

The Manchester Acute Coronary Syndromes (MACS) decision rule: validation with a new automated assay for heart-type fatty acid binding protein.

Science.gov (United States)

Body, Richard; Burrows, Gillian; Carley, Simon; Lewis, Philip S

2015-10-01

The Manchester Acute Coronary Syndromes (MACS) decision rule may enable acute coronary syndromes to be immediately 'ruled in' or 'ruled out' in the emergency department. The rule incorporates heart-type fatty acid binding protein (h-FABP) and high sensitivity troponin T levels. The rule was previously validated using a semiautomated h-FABP assay that was not practical for clinical implementation. We aimed to validate the rule with an automated h-FABP assay that could be used clinically. In this prospective diagnostic cohort study we included patients presenting to the emergency department with suspected cardiac chest pain. Serum drawn on arrival was tested for h-FABP using an automated immunoturbidimetric assay (Randox) and high sensitivity troponin T (Roche). The primary outcome, a diagnosis of acute myocardial infarction (AMI), was adjudicated based on 12 h troponin testing. A secondary outcome, major adverse cardiac events (MACE; death, AMI, revascularisation or new coronary stenosis), was determined at 30 days. Of the 456 patients included, 78 (17.1%) had AMI and 97 (21.3%) developed MACE. Using the automated h-FABP assay, the MACS rule had the same C-statistic for MACE as the original rule (0.91; 95% CI 0.88 to 0.92). 18.9% of patients were identified as 'very low risk' and thus eligible for immediate discharge with no missed AMIs and a 2.3% incidence of MACE (n=2, both coronary stenoses). 11.1% of patients were classed as 'high-risk' and had a 92.0% incidence of MACE. Our findings validate the performance of a refined MACS rule incorporating an automated h-FABP assay, facilitating use in clinical settings. The effectiveness of this refined rule should be verified in an interventional trial prior to implementation. UK CRN 8376. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Clinical values of left ventricular mechanical dyssynchrony assessment by gated myocardial perfusion SPECT in patients with acute myocardial infarction and multivessel disease

Energy Technology Data Exchange (ETDEWEB)

Cho, Sang-Geon; Park, Ki Seong; Kim, Jahae; Kim, Jong Sang; Song, Ho-Chun [Chonnam National University Hospital, Department of Nuclear Medicine, Gwang-ju (Korea, Republic of); Jabin, Zeenat; Kang, Sae-Ryung; Kwon, Seong Young; Jeong, Geum-Cheol; Song, Minchul; Min, Jung-Joon; Bom, Hee-Seung [Chonnam National University Hwasun Hospital, Department of Nuclear Medicine, Hwasun-gun, Jeonnam (Korea, Republic of); Cho, Jae Yeong; Kim, Hyun Kuk [Chonnam National University Hospital, Department of Cardiology, Gwang-ju (Korea, Republic of)

2017-02-15

The aim of this study was to evaluate the prognostic value of additional evaluation of left ventricular mechanical dyssynchrony (LVMD) by gated myocardial perfusion single-photon emission computed tomography (GMPS) in patients with acute myocardial infarction (MI) and multivessel disease. One hundred and nine acute MI patients with >50 % stenosis in at least one non-culprit artery who underwent GMPS within 2 weeks were enrolled. All patients underwent successful revascularization of the culprit arteries. Those with previous MI, atrial fibrillation, or frequent ventricular premature complexes, cardiac devices, significant patient motion, or procedure-related events were excluded. Phase standard deviation (PSD) and phase histogram bandwidth (PBW) were measured for assessment of LVMD. Patients were followed up for a median of 26 months after index MI, for composite major adverse cardiac events (MACE), which consisted with all-cause death, unplanned hospitalization due to heart failure and severe ventricular arrhythmias (sustained ventricular tachycardia or ventricular fibrillation). Independent predictors of MACE were evaluated. MACE occurred in 22 patients (20 %). Stress PSD (53.3 ± 17.3 vs. 35.3 ± 18.9 ; p <0.001), stress PBW (147.6 ± 54.6 vs. 96.8 ± 59.2 ; p = 0.001) and resting PBW (126.8 ± 37.5 vs. 96.6 ± 48.9 ; p = 0.001) were significantly higher in patients with MACE compared to those without. Multivariate analysis revealed that stress PSD ≥45.5 and stress PBW ≥126.0 were predictive of MACE, as well as suboptimal non-culprit artery revascularization (SNR) and renin-angiotensin system (RAS) blockade medication. Higher stress PSD and stress PBW were associated with poorer prognosis both in patients with and without SNR, and those with RAS blockade medication, but not in those without RAS blockade medication. LVMD measured by GMPS showed added prognostic value in acute MI with multivessel disease. GMPS could serve as a comprehensive evaluation imaging

Managing the risk of extreme climate events in Australian major wheat production systems

Science.gov (United States)

Luo, Qunying; Trethowan, Richard; Tan, Daniel K. Y.

2018-06-01

Extreme climate events (ECEs) such as drought, frost risk and heat stress cause significant economic losses in Australia. The risk posed by ECEs in the wheat production systems of Australia could be better managed through the identification of safe flowering (SFW) and optimal time of sowing (TOS) windows. To address this issue, three locations (Narrabri, Roseworthy and Merredin), three cultivars (Suntop and Gregory for Narrabri, Mace for both Roseworthy and Merredin) and 20 TOS at 1-week intervals between 1 April and 12 August for the period from 1957 to 2007 were evaluated using the Agricultural Production System sIMulator (APSIM)-Wheat model. Simulation results show that (1) the average frequency of frost events decreased with TOS from 8 to 0 days (d) across the four cases (the combination of locations and cultivars), (2) the average frequency of heat stress events increased with TOS across all cases from 0 to 10 d, (3) soil moisture stress (SMS) increased with earlier TOS before reaching a plateau and then slightly decreasing for Suntop and Gregory at Narrabri and Mace at Roseworthy while SMS increased with TOS for Mace at Merredin from 0.1 to 0.8, (4) Mace at Merredin had the earliest and widest SFW (216-260) while Mace at Roseworthy had latest SFW (257-280), (5) frost risk and heat stress determine SFW at wetter sites (i.e. Narrabri and Roseworthy) while frost risk and SMS determine SFW at drier site (i.e. Merredin) and (6) the optimal TOS (window) to maximise wheat yield are 6-20 May, 13-27 May and 15 April at Narrabri, Roseworthy and Merredin, respectively. These findings provide important and specific information for wheat growers about the management of ECE risk on farm. Furthermore, the coupling of the APSIM crop models with state-of-the-art seasonal and intra-seasonal climate forecast information provides an important tool for improved management of the risk of ECEs in economically important cropping industries in the foreseeable future.

Beyond triage: the diagnostic accuracy of emergency department nursing staff risk assessment in patients with suspected acute coronary syndromes.

Science.gov (United States)

Carlton, Edward Watts; Khattab, Ahmed; Greaves, Kim

2016-02-01

To establish the accuracy of emergency department (ED) nursing staff risk assessment using an established chest pain risk score alone and when incorporated with presentation high-sensitivity troponin testing as part of an accelerated diagnostic protocol (ADP). Prospective observational study comparing nursing and physician risk assessment using the modified Goldman (m-Goldman) score and a predefined ADP, incorporating presentation high-sensitivity troponin. A UK District ED. Consecutive patients, aged ≥18, with suspected cardiac chest pain and non-ischaemic ECG, for whom the treating physician determined serial troponin testing was required. 30-day major adverse cardiac events (MACE). 960 participants were recruited. 912/960 (95.0%) had m-Goldman scores recorded by physicians and 745/960 (77.6%) by nursing staff. The area under the curve of the m-Goldman score in predicting 30-day MACE was 0.647 (95% CI 0.594 to 0.700) for physicians and 0.572 (95% CI 0.510 to 0.634) for nursing staff (p=0.09). When incorporated into an ADP, sensitivity for the rule-out of MACE was 99.2% (95% CI 94.8% to 100%) and 96.7% (90.3% to 99.2%) for physicians and nurses, respectively. One patient in the physician group (0.3%) and three patients (1.1%) in the nursing group were classified as low risk yet had MACE. There was fair agreement in the identification of low-risk patients (kappa 0.31, 95% CI 0.24 to 0.38). The diagnostic accuracy of ED nursing staff risk assessment is similar to that of ED physicians and interobserver reliability between assessor groups is fair. When incorporating high-sensitivity troponin testing, a nurse-led ADP has a miss rate of 1.1% for MACE at 30 days. Controlled Trials Database (ISRCTN no. 21109279). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Critical Rare Earths, National Security, and U.S.-China Interactions: A Portfolio Approach to Dysprosium Policy Design

Science.gov (United States)

2015-01-01

from Donald and Susan Rice , both funds which enabled me to focus on the dissertation. I thank Dean Susan Marquis for her dedication to the growth of...quota of 89,2000 tonnes (Table 2.2). The sprawling black market not only prevents Beijing’s efforts to bring the production under its levers to...yttrium are often used for pigmentation for consumer products such as paint and sunglasses. REE-based lasers are used for cosmetic , epidermal, and

Focusing on life beyond numers

DEFF Research Database (Denmark)

Prip, Anne; Christiansen, Anette Wendelboe; Zoffmann, Vibeke

for interventions which are especially tailored to young adult women with poorly controlled Type 1 Diabetes (T1D), applicable by clinicians in practice and effective in promoting health and preventing complications. Susan, a 24-year-old woman, was one of 200 patients between 18 and 35 years old with type 1 diabetes...... provide insight into how the autonomy supportive intervention is experienced, from the person perspective. Methods A case study was conducted one year after Susan had finished the trial. Susan was interviewed by two external interviewers who were not involved in the intervention. The interview...... was thematically analysed according to a procedure suggested by Braun and Clarke. An overview of Susan’s diabetes management from onset until after the GSD intervention was made based on the interview and electronic patient record data on HbA1c, treatment and complication status. Finally, changes on psychometric...

Asteroid Redirect Crewed Mission Space Suit and EVA System Architecture Trade Study

Science.gov (United States)

Bowie, Jonathan; Buffington, Jesse; Hood, Drew; Kelly, Cody; Naids, Adam; Watson, Richard; Blanco, Raul; Sipila, Stephanie

2014-01-01

The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability from the Orion spacecraft. For this mission, the pressure garment selected for both functions is the Modified Advanced Crew Escape Suit (MACES) with EVA enhancements and the life support option that was selected is the Exploration Portable Life Support System (PLSS) currently under development for Advanced Exploration Systems (AES). The proposed architecture meets the ARCM constraints, but much more work is required to determine the details of the suit upgrades, the integration with the PLSS, and the tools and equipment necessary to accomplish the mission. This work has continued over the last year to better define the operations and hardware maturation of these systems. EVA simulations were completed in the Neutral Buoyancy Lab (NBL) and interfacing options were prototyped and analyzed with testing planned for late 2014. This paper discusses the work done over the last year on the MACES enhancements, the use of tools while using the suit, and the integration of the PLSS with the MACES.

Defect level characterization of silicon nanowire arrays: Towards novel experimental paradigms

Energy Technology Data Exchange (ETDEWEB)

Carapezzi, Stefania; Castaldini, Antonio; Cavallini, Anna [Department of Physics and Astronomy, University of Bologna, V.le Berti Pichat 6/2, Bologna (Italy); Irrera, Alessia [IPCF CNR, Viale Stagno D' Alcontres n. 37-98158, Messina, Italy and MATIS IMM CNR, Viale Santa Sofia n. 64, 95123 Catania (Italy)

2014-02-21

The huge amount of knowledge, and infrastructures, brought by silicon (Si) technology, make Si Nanowires (NWs) an ideal choice for nano-electronic Si-based devices. This, in turn, challenges the scientific research to adapt the technical and theoretical paradigms, at the base of established experimental techniques, in order to probe the properties of these systems. Metal-assisted wet-Chemical Etching (MaCE) [1, 2] is a promising fast, easy and cheap method to grow high aspect-ratio aligned Si NWs. Further, contrary to other fabrication methods, this method avoids the possible detrimental effects related to Au diffusion into NWs. We investigated the bandgap level diagram of MaCE Si NW arrays, phosphorous-doped, by means of Deep Level Transient Spectroscopy. The presence of both shallow and deep levels has been detected. The results have been examined in the light of the specificity of the MaCE growth. The study of the electronic levels in Si NWs is, of course, of capital importance in view of the integration of Si NW arrays as active layers in actual devices.

Cardiovascular safety of linagliptin in type 2 diabetes: a comprehensive patient-level pooled analysis of prospectively adjudicated cardiovascular events.

Science.gov (United States)

Rosenstock, Julio; Marx, Nikolaus; Neubacher, Dietmar; Seck, Thomas; Patel, Sanjay; Woerle, Hans-Juergen; Johansen, Odd Erik

2015-05-21

The cardiovascular (CV) safety of linagliptin was evaluated in subjects with type 2 diabetes (T2DM). Pre-specified patient-level pooled analysis of all available double-blind, randomized, controlled trials, ≥ 12 weeks' duration (19 trials, 9459 subjects) of linagliptin versus placebo/active treatment. Primary end point: composite of prospectively adjudicated CV death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization for unstable angina (4P-MACE). Hospitalization for congestive heart failure (CHF) was also evaluated; adjudication of CHF was introduced during the phase 3 program (8 trials; 3314 subjects). 4P-MACE was assessed in placebo-controlled trials (subgroup of 18 trials; 7746 subjects). Investigator-reported events suggestive of CHF from 24 placebo-controlled trials (including trials 4P-MACE incidence rates: 13.4 per 1000 patient-years, linagliptin (60 events), 18.9, total comparators (62 events); overall hazard ratio (HR), 0.78 (95% confidence interval [CI], 0.55-1.12). HR for adjudicated hospitalization for CHF (n = 21): 1.04 (0.43-2.47). For placebo-controlled trials, 4P-MACE incidence rates: 14.9 per 1000 patient-years, linagliptin (43 events), 16.4, total comparators (29 events); overall HR, 1.09 (95% CI, 0.68-1.75). Occurrence of investigator-reported events suggestive of CHF was low for linagliptin- (26 events, 0.5%; serious: 16 events, 0.3%) and placebo-treated (8 events, 0.2%; serious: 6 events, 0.2%) patients. Linagliptin is not associated with increased CV risk versus pooled active comparators or placebo in patients with T2DM.

Prognostic value of serum resistin levels in patients with acute myocardial infarction.

Science.gov (United States)

Erer, Hatice Betul; Sayar, Nurten; Guvenc, Tolga Sinan; Aksaray, Sebahat; Yilmaz, Hale; Altay, Servet; Turer, Ayca; Oz, Tugba Kemaloglu; Karadeniz, Fatma Ozpamuk; Oz, Dilaver; Ekmekci, Ahmet; Zencirci, Aycan Esen; Eren, Mehmet

2014-01-01

Resistin is a novel adipokine that is suggested to be involved in inflammatory conditions and atherosclerosis. To investigate the prognostic importance of resistin in acute myocardial infarction (AMI) patients. Resistin levels were measured in a population of 132 patients with AMI, of whom 72 (54%) had a diagnosis of ST elevation myocardial infarction (STEMI), and 60 (46%) had non-ST elevation myocardial infarction (NSTEMI). Thirty-three consecutive subjects who were referred to elective coronary angiography due to chest pain evaluation with normal coronary angiograms served as controls. All patients were followed-up for the occurrence of major adverse cardiac events (MACE). There was a significant increase in serum resistin levels in patients with AMI compared to controls (3.71 ± 4.20 vs. 2.00 ± 1.05, p = 0.001, respectively). However, serum resistin levels were similar in patients with STEMI and NSTEMI. (4.26 ± 5.11 vs. 3.06 ± 2.64, p = 0.49, respectively). The patients with MACE had significantly higher levels of serum resistin levels compared to either the AMI or the control group (6.35 ± 5.47, p = 0.005, respectively). Logistic regression analysis revealed that resistin, left ventricular ejection fraction, and coronary artery bypass graft were independent predictors of MACE in AMI patients (OR = 1.11, 95% CI 1.01-1.22, p = 0.03 and OR = 3.84, 95% CI 1.26-11.71, p = 0.018, respectively). Serum resistin level was increased in patients with AMI and constituted a risk factor for MACE in this group.

Six-Month Clinical and Angiographic Results of Paclitaxel Eluting Simpax Stent

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Mehmet Muhsin Türkmen

2012-08-01

Full Text Available Introduction: We aimed to evaluate the safety and efficacy of the simpax stent in the treatmentof different patient groups.Patients and Methods: Forty-five patients were treated with the simpax stent. Of these patients,23 patients gave consent for six months of follow-up by quantitative coronary angiography (QSAand six patients were evaluated by exercise electrocardiographic test. Only the patients havinglesions with stenosis > 50% of diameter and lengths > 16 mm with reference diameters < 2.75mm were included.Results: The device success rate was 100% and procedure success rate was 97.7%. The meanstent length was 24.6 ± 7.3 mm and stent size was 2.54 ± 0.24 mm. The overall six months incidenceof major adverse cardiac events (MACE was 8.8%. MACE was consisted of two casesof non-Q wave myocardial infarction and two cases of repeated revascularization of the targetlesion. MACE rate was higher in chronic total occlusion (CTO group than non-CTO group (respectively33.3% and 5.1. Also when compared to stent size, MACE rate was 25% in < 2.5 mm,0% ≥ 2.5 mm. The QSA results at six months showed in-stent late lumen loss witha diameter of0.25 ± 0.15 mm in 17 patients.Conclusion: The six month results in this study demonsrated excellent procedural and devicesuccess. Simpax stent was associated with a low in-stent late lumen loss. Also this study showedsimpax stent was a safe and effective device in non-CTO group with stent size ≥ 2.5 mm.

Prevalence of prediabetes in patients with acute coronary syndrome: impact on in-hospital outcomes.

Science.gov (United States)

AbuShady, M M; Mohamady, Y; Enany, B; Nammas, W

2015-02-01

Prediabetes is a serious condition that is associated with an increase in cardiovascular morbidity and mortality. We sought to explore the prevalence of prediabetes in patients admitted with acute coronary syndrome (ACS) who were not known to have diabetes and to determine the impact of prediabetes on in-hospital clinical outcomes versus non-diabetic patients. Prospectively, we enrolled 200 patients not known to have diabetes or prediabetes, admitted with ACS. Laboratory tests included fasting plasma glucose (FPG), 2-h plasma glucose (2hPG) after 75 g glucose, HbA1c and lipid profile. Electrocardiogram and echocardiography were done. The primary end-point was in-hospital major adverse cardiovascular events (MACE). Mean age was 50.9 ± 6.8 years (70.5% males). The prevalence of patients with diabetes and patients with prediabetes was 24.5% and 20% respectively. Newly discovered diabetic patients were excluded. Compared with patients without diabetes, prediabetic patients had a higher body mass index (BMI) (P = 0.002) and a longer hospital stay (P = 0.09). In-hospital MACE occurred in 10 (25%) patients with prediabetes versus six (5.4%) in patients without diabetes (P = 0.001). In-hospital MACE correlated with prediabetes (r = 0.28, P prediabetes as the only independent predictor of in-hospital MACE. Prediabetes is common in patients presenting with ACS who are not previously known to have diabetes. Prediabetic patients had worse in-hospital clinical outcomes compared with patients without diabetes. © 2014 Royal Australasian College of Physicians.

Does quantifying epicardial and intrathoracic fat with noncontrast computed tomography improve risk stratification beyond calcium scoring alone?

Science.gov (United States)

Forouzandeh, Farshad; Chang, Su Min; Muhyieddeen, Kamil; Zaid, Rashid R; Trevino, Alejandro R; Xu, Jiaqiong; Nabi, Faisal; Mahmarian, John J

2013-01-01

Noncontrast cardiac computed tomography allows calculation of coronary artery calcium score (CACS) and measurement of epicardial adipose tissue (EATv) and intrathoracic fat (ITFv) volumes. It is unclear whether fat volume information contributes to risk stratification. Cardiac computed tomography was performed in 760 consecutive patients with acute chest pain admitted thorough the emergency department. None had prior coronary artery disease. CACS was calculated using the Agatston method. EATv and ITFv were semiautomatically calculated. Median patient follow-up was 3.3 years. Mean patient age was 54.4±13.7 years and Framingham risk score 8.2±8.2. The 45 patients (5.9%) with major acute cardiac events (MACE) were older (64.8±13.9 versus 53.7±13.4 years), more frequently male (60% versus 40%), and had a higher median Framingham risk score (16 versus 4) and CACS (268 versus 0) versus those without events (all PEATv (154 versus 116 mL) and ITFv (330 versus 223 mL), and a higher prevalence of EATv >125 mL (67% versus 44%) and ITFv >250 mL (64% versus 42%) (all PEATv, and ITFv were all independently associated with MACE. CACS was associated with MACE after adjustment for fat volumes (PEATv and ITFv improved the risk model only in patients with CACS >400. CACS and fat volumes are independently associated with MACE in acute chest pain patients and beyond that provided by clinical information alone. Although fat volumes may add prognostic value in patients with CACS >400, CACS is most strongly correlated with outcome.

The SABRE Trial (Sirolimus Angioplasty Balloon for Coronary In-Stent Restenosis)

DEFF Research Database (Denmark)

Verheye, Stefan; Vrolix, Mathias; Kumsars, Indulis

2017-01-01

centers, 50 ISR patients were treated with the Virtue balloon. Angiographic measurements at 6 months are reported, along with 12-month clinical follow-up. RESULTS Procedural success in the intention-to-treat population was 100 The primary safety endpoint was target lesion failure (TLF) (cardiac death...... and 14.3% MACE and for the per-protocol population were 2.8% TLF and 2.8% MACE. CONCLUSIONS This first-in-human study showed excellent procedural success for the Virtue sirolimus-eluting angioplasty balloon, 6-month LLL rates in line with current stent-free ISR treatment options, and clinical outcomes...

In Conversation with Susan Holtz | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

2010-11-26

Nov 26, 2010 ... I would say that almost all the practical, on-the-ground progress that is ... on how the integration of different people's perspectives actually happens. ... more and less successful efforts within any one of these approaches.

Entretien avec Susan Holtz | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

26 nov. 2010 ... À cause des difficultés que pose la convergence des politiques, il semble y avoir un besoin criant d'institutions et de processus nouveaux, voire d'une nouvelle manière d'être culturelle et sociale. À quoi pouvons-nous nous attendre de façon réaliste en ce qui concerne un consensus entre les intervenants, ...

Solenoid pick-up problem in the CREN-K Triga Mark 2 reactor

International Nuclear Information System (INIS)

Malu wa Kalenga; Kobakozete Itono; Diazengwa Mpaka; Mampaka Mana Mouiny; Itio Momba

1981-01-01

During a lazy susan forty irradiation tube inspection with the specimen lifting device, the solenoid-operated specimen pick-up tool happened to be locked in the number fourteen position loading tube. The present paper describes the successful experiment which was carried out to solve a potential damaging situation for the safe and useful operation of the reactor. The first step in the investigation process was to ascertain what has indeed occurred in the reactor core to avoid any ill advised step which will worsen the situation. The alternatives were the following: a) The specimen tube was not lined with the loading tube; b) The lazy susan was not working properly due example to the fact that a roll pin in a drive shaft coupling inside the drive shaft tube has been broken; c) The pick-up tool has produced through the cleanout hole in the bottom of the specimen tube and engage the hole; d) The pick-up tool might have slided most of the way between the lazy susan and its housing. By moving up and down the pick-up tool and rotating back and forth the lazy susan it was possible to come to the conclusion that alternative c) was the most likely. It was not possible to release the pick-up tool because its engaging arms could not be activated as was often the case when lifting aluminium container

Solenoid pick-up problem in the CREN-K Triga Mark 2 reactor

Energy Technology Data Exchange (ETDEWEB)

Malu wa Kalenga; Kobakozete Itono; Diazengwa Mpaka; Mampaka Mana Mouiny; Itio Momba (Commissariat des Sciences Nucleaires, Kinshasa (Zaire). Centre Regional d' Etudes Nucleaires)

1981-01-01

During a lazy susan forty irradiation tube inspection with the specimen lifting device, the solenoid-operated specimen pick-up tool happened to be locked in the number fourteen position loading tube. The present paper describes the successful experiment which was carried out to solve a potential damaging situation for the safe and useful operation of the reactor. The first step in the investigation process was to ascertain what has indeed occurred in the reactor core to avoid any ill advised step which will worsen the situation. The alternatives were the following: a) The specimen tube was not lined with the loading tube; b) The lazy susan was not working properly due example to the fact that a roll pin in a drive shaft coupling inside the drive shaft tube has been broken; c) The pick-up tool has produced through the cleanout hole in the bottom of the specimen tube and engage the hole; d) The pick-up tool might have slided most of the way between the lazy susan and its housing. By moving up and down the pick-up tool and rotating back and forth the lazy susan it was possible to come to the conclusion that alternative c) was the most likely. It was not possible to release the pick-up tool because its engaging arms could not be activated as was often the case when lifting aluminium container.

Comparison between Exclusive and Selective Drug-Eluting Stent Strategies in Treating Patients with Multivessel Coronary Artery Disease.

Science.gov (United States)

Tung, Ying-Chang; Hsiao, Ping-Gune; Hsu, Lung-An; Kuo, Chi-Tai; Chang, Chi-Jen

2014-05-01

The expanded usage of drug-eluting stents (DES) in treating patients with multivessel coronary artery disease (CAD) may sometimes be limited in real-world practice due to cost concerns. We compared the clinical outcomes of exclusive and selective DES use in treating patients with multivessel CAD. From November 2004 to December 2011, 110 patients with multivessel CAD who received four or more stents were enrolled into this study, and divided into two groups according to the DES strategy employed: exclusive DES (n = 52), or selective DES (n = 58). In the selective DES group, DES was reserved for complex lesions only, such that the incidence and predictors of clinical events were assessed. At a mean follow-up of 41.4 ± 26.5 months, there were no significant differences between the two strategies in terms of baseline characteristics, all-cause mortality (exclusive vs. selective: 1.9% vs. 6.9%, p = 0.21), cardiac death (1.9% vs. 1.7%, p = 0.94) and nonfatal myocardial infarction (3.8% vs. 5.2%, p = 0.74). Despite the presence of more ostial lesions in the exclusive DES group, there was a trend such that major adverse cardiac events (MACE) and target lesion revascularization (TLR) rates were higher in the selective DES group (MACE: 17.3% vs. 31%, p = 0.16; TLR: 11.5% vs. 24.1%, p = 0.08). The higher MACE rate in the selective DES group was mainly driven by a higher target vessel revascularization (TVR) rate (15.4% vs. 29.3%, p = 0.08). In the exclusive DES group, SYNTAX score was an independent predictor of MACE [Haxard ratio (HR): 1.09, 95% confidence internal (CI): 1.02-1.16, p = 0.01] and TVR (HR 1.08, 95% CI 1.01-1.15, p = 0.04). Compared to the exclusive DES strategy, the selective DES strategy with reservation of DES for complex lesions is associated with numerically higher, but not statistically significant, rates of MACE and all-cause mortality in this small group of patients with multivessel CAD receiving four or more stents. Bare metal stent; Drug

Principal component approach in variance component estimation for international sire evaluation

Directory of Open Access Journals (Sweden)

Jakobsen Jette

2011-05-01

Full Text Available Abstract Background The dairy cattle breeding industry is a highly globalized business, which needs internationally comparable and reliable breeding values of sires. The international Bull Evaluation Service, Interbull, was established in 1983 to respond to this need. Currently, Interbull performs multiple-trait across country evaluations (MACE for several traits and breeds in dairy cattle and provides international breeding values to its member countries. Estimating parameters for MACE is challenging since the structure of datasets and conventional use of multiple-trait models easily result in over-parameterized genetic covariance matrices. The number of parameters to be estimated can be reduced by taking into account only the leading principal components of the traits considered. For MACE, this is readily implemented in a random regression model. Methods This article compares two principal component approaches to estimate variance components for MACE using real datasets. The methods tested were a REML approach that directly estimates the genetic principal components (direct PC and the so-called bottom-up REML approach (bottom-up PC, in which traits are sequentially added to the analysis and the statistically significant genetic principal components are retained. Furthermore, this article evaluates the utility of the bottom-up PC approach to determine the appropriate rank of the (covariance matrix. Results Our study demonstrates the usefulness of both approaches and shows that they can be applied to large multi-country models considering all concerned countries simultaneously. These strategies can thus replace the current practice of estimating the covariance components required through a series of analyses involving selected subsets of traits. Our results support the importance of using the appropriate rank in the genetic (covariance matrix. Using too low a rank resulted in biased parameter estimates, whereas too high a rank did not result in

Newly diagnosed rheumatic heart disease among indigenous populations in the Pacific.

Science.gov (United States)

Mirabel, Mariana; Tafflet, Muriel; Noël, Baptiste; Parks, Tom; Axler, Olivier; Robert, Jacques; Nadra, Marie; Phelippeau, Gwendolyne; Descloux, Elodie; Cazorla, Cécile; Missotte, Isabelle; Gervolino, Shirley; Barguil, Yann; Rouchon, Bernard; Laumond, Sylvie; Jubeau, Thierry; Braunstein, Corinne; Empana, Jean-Philippe; Marijon, Eloi; Jouven, Xavier

2015-12-01

Rheumatic heart disease (RHD) remains the leading acquired heart disease in the young worldwide. We aimed at assessing outcomes and influencing factors in the contemporary era. Hospital-based cohort in a high-income island nation where RHD remains endemic and the population is captive. All patients admitted with newly diagnosed RHD according to World Heart Federation echocardiographic criteria were enrolled (2005-2013). The incidence of major cardiovascular events (MACEs) including heart failure, peripheral embolism, stroke, heart valve intervention and cardiovascular death was calculated, and their determinants identified. Of the 396 patients, 43.9% were male with median age 18 years (IQR 10-40)). 127 (32.1%) patients presented with mild, 131 (33.1%) with moderate and 138 (34.8%) with severe heart valve disease. 205 (51.8%) had features of acute rheumatic fever. 106 (26.8%) presented with at least one MACE. Among the remaining 290 patients, after a median follow-up period of 4.08 (95% CI 1.84 to 6.84) years, 7 patients (2.4%) died and 62 (21.4%) had a first MACE. The annual incidence of first MACE and of heart failure were 59.05‰ (95% CI 44.35 to 73.75) and 29.06‰ (95% CI 19.29 to 38.82), respectively. The severity of RHD at diagnosis (moderate vs mild HR 3.39 (0.95 to 12.12); severe vs mild RHD HR 10.81 (3.11 to 37.62), pdisease and no secondary prophylaxis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The short- and long-term outcomes of percutaneous intervention with drug-eluting stent vs bare-metal stent in saphenous vein graft disease: An updated meta-analysis of all randomized clinical trials.

Science.gov (United States)

Kheiri, Babikir; Osman, Mohammed; Abdalla, Ahmed; Ahmed, Sahar; Bachuwa, Ghassan; Hassan, Mustafa

2018-05-11

The use of drug-eluting stents (DES) vs bare-metal stents (BMS) in saphenous vein graft (SVG) lesions remains controversial. We conducted a meta-analysis of all randomized clinical trials comparing the outcomes of DES with BMS in SVG percutaneous coronary interventions. A search of PubMed, Embase, the Cochrane Register of Controlled Trials, and Clinicaltrials.gov was performed for all randomized clinical trials. We evaluated the short- and long-term clinical outcomes of the following: all-cause mortality, major adverse cardiovascular events (MACE), definite/probable stent thrombosis, target lesion revascularization (TLR), and target-vessel revascularization (TVR). From a total of 1582 patients in 6 randomized clinical trials, 797 had DES and 785 had BMS. Patients with DES had lower short-term MACE, TLR, and TVR in comparison with BMS (odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.35-0.91, P = 0.02; OR: 0.43, 95% CI: 0.19-0.99, P = 0.05; and OR: 0.45, 95% CI: 0.22-0.95, P = 0.04, respectively). However, there were no different outcomes for all-cause mortality (P = 0.63) or stent thrombosis (P = 0.21). With long-term follow-up, there were no significant reductions of MACE (P = 0.20), TLR (P = 0.57), TVR (P = 0.07), all-cause mortality (P = 0.29), and stent thrombosis (P = 0.76). The use of DES in SVG lesions was associated with lower short-term MACE, TLR, and TVR in comparison with BMS. However, there were no significant differences with long-term follow-up. © 2018 Wiley Periodicals, Inc.

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test

Science.gov (United States)

Calasans, Flávia Ricci; Santos, Bruno Fernandes de Oliveira; Silveira, Débora Consuelo Rocha; de Araújo, Ana Carla Pereira; Melo, Luiza Dantas; Barreto-Filho, José Augusto; Sousa, Antônio Carlos Sobral; Oliveira, Joselina Luzia Menezes

2013-01-01

Background Exercise test (ET) is the preferred initial noninvasive test for the diagnosis and risk stratification of coronary artery disease (CAD), however, its lower sensitivity may fail to identify patients at greater risk of adverse events. Objective To assess the value of stress echocardiography (SE) for predicting all-cause mortality and major cardiac events (MACE) in patients with intermediate pretest probability of CAD and a normal ET. Methods 397 patients with intermediate CAD pretest probability, estimated by the Morise score, and normal ET who underwent SE were studied. The patients were divided into two groups according to the absence (G1) or presence (G2) of myocardial ischemia on SE .End points evaluated were all-cause mortality and MACE, defined as cardiac death and nonfatal acute myocardial infarction (AMI). Results G1 group was comprised of 329 (82.8%) patients. The mean age of the patients was 57.37 ± 11 years and 44.1% were male. During a mean follow-up of 75.94 ± 17.24 months, 13 patients died, three of them due to cardiac causes, and 13 patients suffered nonfatal AMI. Myocardial ischemia remained an independent predictor of MACE (HR 2.49; [CI] 95% 1.74-3.58). The independent predictors for all-cause mortality were male gender (HR 9.83; [CI] 95% 2.15-44.97) and age over 60 years (HR 4.57; [CI] 95% 1.39-15.23). Conclusion Positive SE for myocardial ischemia is a predictor of MACE in the studied sample, which helps to identify a subgroup of patients at higher risk of events despite having normal ET. PMID:23765384

Comparison of neutrophil-to-lymphocyte ratio and mean platelet volume in the prediction of adverse events after primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction.

Science.gov (United States)

Machado, Guilherme Pinheiro; Araujo, Gustavo Neves de; Carpes, Christian Kunde; Lech, Mateus; Mariani, Stefani; Valle, Felipe Homem; Bergoli, Luiz Carlos Corsetti; Gonçalves, Sandro Cadaval; Wainstein, Rodrigo V; Wainstein, Marco V

2018-07-01

Elevated neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) are indirect inflammatory markers. There is some evidence that both are associated with worse outcomes in ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). The aim of the present study was to compare the capacity of NLR and MPV to predict adverse events after primary PCI. In a prospective cohort study, 625 consecutive patients with STEMI, who underwent primary PCI, were followed. Receiver operating characteristic (ROC) curve analysis was performed to calculate the area under the curve (AUC) for the occurrence of procedural complications, mortality and major adverse cardiovascular events (MACE). Mean age was 60.7 (±12.1) years, 67.5% were male. The median of NLR was 6.17 (3.8-9.4) and MPV was 10.7 (10.0-11.3). In multivariate analysis, both NLR and MPV remained independent predictors of no-reflow (relative risk [RR] = 2.26; 95%confidence interval [95%CI] = 1.16-4.32; p = 0.01 and RR = 2.68; 95%CI = 1.40-5.10; p  0.05). NLR had an excellent negative predictive value (NPV) of 96.7 for no-reflow and 89.0 for in-hospital MACE. Despite no difference in the ROC curve comparison with MPV, only NLR remained an independent predictor for in-hospital MACE. A low NLR has an excellent NPV for no-reflow and in-hospital MACE, and this could be of clinical relevance in the management of low-risk patients. Copyright © 2018 Elsevier B.V. All rights reserved.

Prognostic Utility of Neutrophil-to-Lymphocyte Ratio on Adverse Clinical Outcomes in Patients with Severe Calcific Aortic Stenosis.

Directory of Open Access Journals (Sweden)

Kyoung Im Cho

Full Text Available Inflammation is an important factor in the pathogenesis of calcific aortic stenosis (AS. We aimed to evaluate the association between an inflammatory marker, neutrophil-to-lymphocyte ratio (NLR and major adverse cardiovascular events (MACE in patients with severe calcific AS.A total of 336 patients with isolated severe calcific AS newly diagnosed between 2010 and 2015 were enrolled in this study. Using Cox proportional hazards (PH regression models, we investigated the prognostic value of NLR adjusted for baseline covariates including logistic European System for Cardiac Operative Risk Evaluation score (EuroSCORE-I and undergoing aortic valve replacement (AVR. We also evaluated the clinical relevance of NLR risk groups (divided into low, intermediate, high risk as categorized by NLR cutoff values. MACE was defined as a composite of all-cause mortality, cardiac death and non-fatal myocardial infarction during the follow-up period.The inflammatory marker NLR was an independent prognostic factor most significantly associated with MACE [hazard ratio (HR, 1.06; 95% confidence interval (CI, 1.04-1.09; p-value 9, respectively.The findings of the present study demonstrate the potential utility of NLR in risk stratification of patients with severe calcific AS.

Study comparing the double kissing (DK) crush with classical crush for the treatment of coronary bifurcation lesions: the DKCRUSH-1 Bifurcation Study with drug-eluting stents.

Science.gov (United States)

Chen, S L; Zhang, J J; Ye, F; Chen, Y D; Patel, T; Kawajiri, K; Lee, M; Kwan, T W; Mintz, G; Tan, H C

2008-06-01

Classical crush has a lower rate of final kissing balloon inflation (FKBI) immediately after percutaneous coronary intervention (PCI). The double kissing (DK) crush technique has the potential to increase the FKBI rate, and no prospective studies on the comparison of classical with DK crush techniques have been reported. Three hundred and eleven patients with true bifurcation lesions were randomly divided into classical (n = 156) and DK crush (n = 155) groups. Clinical and angiographic details at follow-up at 8 months were indexed. The primary end point was major adverse cardiac events (MACE) including myocardial infarction, cardiac death and target lesion revascularization (TLR) at 8 months. FKBI was 76% in the classical crush group and 100% in the DK group (P DK crush group. Cumulative 8 month MACE was 24.4% in the classical crush group and 11.4% in the DK crush group (P = 0.02). The TLR-free survival rate was 75.4% in the classical crush group and 89.5% in the DK crush group (P = 0.002). DK crush technique has the potential of increasing FKBI rate and reducing stent thrombosis, with a further reduction of TLR and cumulative MACE rate at 8 months.

[Comparison of DK crush with classical crush technique with drug-eluting stents for the treatment of coronary bifurcation lesions from DKCRUSH-1 study].

Science.gov (United States)

Chen, Shao-liang; Zhang, Jun-jie; Ye, Fei; Chen, Yun-dai; Lü, Shu-zheng; Tan, Huaycheem; Patel, Tejas; Kenji, Kawajiri; Tamari, Israel; Shan, Shou-jie; Zhu, Zhong-sheng; Lin, Song; Tian, Nai-liang; Li, Xiao-bo; Liu, Zhi-zhong; Lee, Michael; Wei, Meng; Xu, Ya-wei; Yuan, Zheng-bai; Qian, Jun; Sun, Xue-wen; Yang, Song; Chen, Jin-guo; He, Ben; Sumit, Suji

2008-02-01

To determine independent factors correlated with clinical effects of DK crush and classical crush technique with drug-eluting stents on bifurcation lesions. 311 patients with bifurcation lesions were randomized to classical (C, n = 156) or double kissing (DK) crush (n = 155) stent implantation group. The primary endpoints included major adverse cardiac events (MACE). Final kissing balloon inflation (FKBI) success rate was 76% in C and 100% in DK groups (P DK crush procedure was characterized by lower unsatisfactory FKBI rate (27.6% vs.6.3%, P DK groups (P = 0.01), respectively. Cumulative 8-month MACE was 35.9% in without-FKBI and 19.7% in with-FKBI sub-groups, and 11.4% in DK group (P = 0.02). The incidence of stent thrombosis was 3.2% in C group (5.1% without vs. 1.7% with FKBI) and 1.3% in DK group (P > 0.05). The predictive factors of MACE included minimal side branch stent lumen diameter and lack of DK crush technique. DK crush technique is an alternative of double stenting techniques in terms of improvement of restenosis and clinical outcomes.

Hyperspectral material identification on radiance data using single-atmosphere or multiple-atmosphere modeling

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Mariano, Adrian V.; Grossmann, John M.

2010-11-01

Reflectance-domain methods convert hyperspectral data from radiance to reflectance using an atmospheric compensation model. Material detection and identification are performed by comparing the compensated data to target reflectance spectra. We introduce two radiance-domain approaches, Single atmosphere Adaptive Cosine Estimator (SACE) and Multiple atmosphere ACE (MACE) in which the target reflectance spectra are instead converted into sensor-reaching radiance using physics-based models. For SACE, known illumination and atmospheric conditions are incorporated in a single atmospheric model. For MACE the conditions are unknown so the algorithm uses many atmospheric models to cover the range of environmental variability, and it approximates the result using a subspace model. This approach is sometimes called the invariant method, and requires the choice of a subspace dimension for the model. We compare these two radiance-domain approaches to a Reflectance-domain ACE (RACE) approach on a HYDICE image featuring concealed materials. All three algorithms use the ACE detector, and all three techniques are able to detect most of the hidden materials in the imagery. For MACE we observe a strong dependence on the choice of the material subspace dimension. Increasing this value can lead to a decline in performance.

Fantastiske forbindelser relationer i undervisning og læringssamvær

DEFF Research Database (Denmark)

Antologiens artikler er lavet af en række anerkendte forskere og ide-folk fra Danmark, Norge, Holland, England og USA. Herunder Peter Lang, Daniel Stern, Maria Aarts, Thomas Armstrong, Maria Aarts, Jan Tønnesvang, Stein Bråten, Jesper Juul og Susan Hart......Antologiens artikler er lavet af en række anerkendte forskere og ide-folk fra Danmark, Norge, Holland, England og USA. Herunder Peter Lang, Daniel Stern, Maria Aarts, Thomas Armstrong, Maria Aarts, Jan Tønnesvang, Stein Bråten, Jesper Juul og Susan Hart...

Capturing the Transformation and Dynamic Nature of an Elementary Teacher Candidate's Identity Development as a Teacher of Science

Science.gov (United States)

Naidoo, Kara

2017-12-01

This study examines the transformation and dynamic nature of one teacher candidate's (Susan) identity as a learner and teacher of science throughout an innovative science methods course. The goal of this paper is to use theoretically derived themes grounded in cultural-historical activity theory (CHAT) and situated learning theory to determine the ways in which Susan's identity as a learner and teacher of science was influenced by her experiences in the course, and to describe how she made meaning of her transformative process. The following are the three theoretical themes: (1) learning contributes to identity development, (2) identity development is a dialogical process that occurs between individuals, not within individuals, and (3) social practice leads to transformations and transformations lead to the creation of new social practices. Within each theme, specific experiences in the science methods course are identified that influenced Susan's identity development as a teacher of science. Knowing how context and experiences influence identity development can inform design decisions concerning teacher education programs, courses, and experiences for candidates.

Usefulness of Coronary Atheroma Burden to Predict Cardiovascular Events in Patients Presenting With Acute Coronary Syndromes (from the PROSPECT Study).

Science.gov (United States)

Shan, Peiren; Mintz, Gary S; McPherson, John A; De Bruyne, Bernard; Farhat, Naim Z; Marso, Steven P; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

2015-12-01

We investigated the relation between overall atheroma burden and clinical events in the Providing Regional Observations to Study Predictors of Events in the Coronary Tree (PROSPECT) study. In PROSPECT, 660 patients (3,229 nonculprit lesions with a plaque burden ≥ 40% and complete intravascular ultrasound data) were divided into tertiles according to baseline percent atheroma volume (PAV: total plaque/vessel volume). Patients were followed for 3.4 years (median); major adverse cardiac events (MACE: death from cardiac causes, cardiac arrest, myocardial infarction, or rehospitalization because of unstable or progressive angina) were adjudicated to either culprit or nonculprit lesions. Compared with patients in low or intermediate PAV tertiles, patients in the high PAV tertile had the greatest prevalence of plaque rupture and radiofrequency thin-cap fibroatheroma (VH-TCFA) and the highest percentage of necrotic core volume; they were also more likely to have high-risk lesion characteristics: ≥ 1 lesion with minimal luminal area ≤ 4 mm(2), plaque burden >70%, and/or VH-TCFA. Three-year cumulative nonculprit lesion-related MACE was greater in the intermediate and high tertiles than in the low tertile (6.3% vs 14.7% vs 15.1%, low vs intermediate vs high tertiles, p = 0.009). On Cox multivariable analysis, insulin-dependent diabetes (hazard ratio [HR] 3.98, p = 0.002), PAV (HR 1.06, p = 0.03), and the presence of ≥1 VH-TCFA (HR 1.80, p = 0.02) were independent predictors of nonculprit MACE. In conclusion, increasing baseline overall atheroma burden was associated with more advanced, complex, and vulnerable intravascular ultrasound lesion morphology and independently predicted nonculprit lesion-related MACE in patients with acute coronary syndromes after successful culprit lesion intervention. Copyright © 2015 Elsevier Inc. All rights reserved.

Prognostic impact of nutritional status assessed by the Controlling Nutritional Status score in patients with stable coronary artery disease undergoing percutaneous coronary intervention.

Science.gov (United States)

Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Konishi, Hirokazu; Naito, Ryo; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

2017-11-01

Recently, malnutrition has been shown to be related to worse clinical outcomes in patients with heart failure. However, the association between nutritional status and clinical outcomes in patients with coronary artery disease (CAD) remains unclear. We investigated the prognostic value of malnutrition assessed by the Controlling Nutritional Status (CONUT; range 0-12, higher = worse, consisting of serum albumin, cholesterol and lymphocytes) score in patients with CAD. The CONUT score was measured on admission in a total of 1987 patients with stable CAD who underwent elective percutaneous coronary intervention (PCI) between 2000 and 2011. Patients were divided into two groups according to their CONUT score (0-1 vs. ≥2). The incidence of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction, was evaluated. The median CONUT score was 1 (interquartile range 0-2). During the median follow-up of 7.4 years, 342 MACE occurred (17.2%). Kaplan-Meier curves revealed that patients with high CONUT scores had higher rates of MACE (log-rank p < 0.0001). High CONUT scores showed a significant increase in the incidence of MACE compared with low CONUT scores, even after adjusting for confounding factors (hazard ratio: 1.64, 95% confidence interval 1.30-2.07, p < 0.0001). Adding CONUT scores to a baseline model with established risk factors improved the C-index (p = 0.02), net reclassification improvement (p = 0.004) and integrated discrimination improvement (p = 0.0003). Nutritional status assessed by the CONUT score was significantly associated with long-term clinical outcomes in patients with CAD. Pre-PCI assessment of the CONUT score may provide useful prognostic information.

Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT

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Yokota, Shu; Ottervanger, Jan Paul; Timmer, Jorik R. [Isala Hospital, Department of Cardiology, Zwolle (Netherlands); Mouden, Mohamed; Engbers, Elsemiek [Isala Hospital, Department of Cardiology, Zwolle (Netherlands); Isala Hospital, Department of Nuclear Medicine, Zwolle (Netherlands); Knollema, Siert; Jager, Pieter L. [Isala Hospital, Department of Nuclear Medicine, Zwolle (Netherlands)

2016-02-15

Single photon emission computed tomography (SPECT) myocardial perfusion imaging has proven to have prognostic importance in patients with suspected stable coronary artery disease (CAD). The recently introduced ultrafast cadmium zinc telluride (CZT)-based gamma cameras have been associated with less equivocal findings and more normal interpretations, allowing stress-only imaging to be performed more often. However, it is yet unclear whether normal stress-only CZT SPECT has comparable prognostic value as normally interpreted stress-only conventional SPECT. The study population consisted of 1,650 consecutive patients without known CAD with normal stress-only myocardial perfusion results with either conventional (n = 362) or CZT SPECT (n = 1,288). The incidence of major adverse cardiac events (MACE, all-cause death, non-fatal myocardial infarction and/or coronary revascularization) was compared between the conventional SPECT and CZT SPECT groups. Multivariable analyses using the Cox model were used to adjust for differences in baseline variables. Patients scanned with CZT were less often male (33 vs 39 %), had less often hypercholesterolaemia (41 vs 50 %) and had more often a family history of CAD (57 vs 49 %). At a median follow-up time of 37 months (interquartile range 28-45 months) MACE occurred in 68 patients. The incidence of MACE was 1.5 %/year in the CZT group, compared to 2.0 %/year in the conventional group (p = 0.08). After multivariate analyses, there was a trend to a lower incidence of MACE in the CZT SPECT group (hazard ratio 0.61, 95 % confidence interval 0.35-1.04, p = 0.07). The prognostic value of normal stress-only CZT SPECT is at least comparable and may be even better than that of normal conventional stress SPECT. (orig.)

Two-dimensional speckle tracking echocardiography prognostic parameters in patients after acute myocardial infarction.

Science.gov (United States)

Haberka, Maciej; Liszka, Jerzy; Kozyra, Andrzej; Finik, Maciej; Gąsior, Zbigniew

2015-03-01

The aim of the study was to evaluate the left ventricle (LV) function with speckle tracking echocardiography (STE) and to assess its relation to prognosis in patients after acute myocardial infarction (AMI). Sixty-three patients (F/M = 16/47 pts; 62.33 ± 11.85 years old) with AMI (NSTEMI/STEMI 24/39 pts) and successful percutaneous coronary intervention (PCI) with stent implantation (thrombolysis in myocardial infarction; TIMI 3 flow) were enrolled in this study. All patients underwent baseline two-dimensional conventional echocardiography and STE 3 days (baseline) and 30 days after PCI. All patients were followed up for cardiovascular clinical endpoints, major adverse cardiovascular endpoint (MACE), and functional status (Canadian Cardiovascular Society and New York Heart Association). During the follow-up (31.9 ± 5.1 months), there were 3 cardiovascular deaths, 15 patients had AMI, 2 patients had cerebral infarction, 24 patients reached the MACE. Baseline LV torsion (P = 0.035), but none of the other strain parameters were associated with the time to first unplanned cardiovascular hospitalization. Univariate analysis showed that baseline longitudinal two-chamber and four-chamber strain (sLa2 0 and sLa4 0) and the same parameters obtained 30 days after the AMI together with transverse four-chamber strain (sLa2 30, sLa4 30, and sTa4 30) were significantly associated with combined endpoint (MACE). The strongest association in the univariate analysis was found for the baseline sLa2. However, in multivariable analysis only a left ventricular remodeling (LVR - 27% pts) was significantly associated with MACE and strain parameters were not associated with the combined endpoint. The assessment of LV function with STE may improve cardiovascular risk prediction in postmyocardial infarction patients. © 2014, Wiley Periodicals, Inc.

Uric Acid Level Has a U-shaped Association with Clinical Outcomes in Patients with Vasospastic Angina.

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Gwag, Hye Bin; Yang, Jeong Hoon; Park, Taek Kyu; Song, Young Bin; Hahn, Joo Yong; Choi, Jin Ho; Lee, Sang Hoon; Gwon, Hyeon Cheol; Choi, Seung Hyuk

2017-08-01

No data are available on the association of serum uric acid and vasospastic angina (VSA) which has endothelial dysfunction as a possible pathophysiologic mechanism. Low uric acid level might cause adverse outcomes in VSA in connection with endothelial dysfunction. We enrolled 818 VSA patients whose uric acid level was measured at admission. Patients were categorized according to tertiles of uric acid level: group I, ≤ 4.8 mg/dL; group II, 4.9-5.9 mg/dL; and group III, ≥ 6.0 mg/dL. Primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, acute myocardial infarction (MI), ischemic stroke, coronary revascularization, and rehospitalization for angina. Median follow-up duration was 49.2 months. Median uric acid values were 4.1 mg/dL for group I, 5.4 mg/dL for group II, and 6.7 mg/dL for group III. In the overall population, group II had a significantly lower incidence of MACE compared to group I (47 [17.1%] vs. 66 [24.6%]; hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.02-2.26; P = 0.040) and a tendency of lower incidence of MACEs compared to Group III (47 [17.1%] vs. 62 [22.5%]; HR, 1.44; 95% CI, 0.98-2.13; P = 0.067). Among group I patients, those who received nitrates had a higher incidence of MACEs than those without nitrate therapy (P uric acid level was associated with adverse clinical outcomes, while high uric acid level had a trend toward an increase in it. Use of nitrate in patients with low uric acid level might have adverse effects on clinical outcomes of VSA. © 2017 The Korean Academy of Medical Sciences.

Clinical outcomes of patients with major bleeding after primary coronary intervention for acute ST-segment elevation myocardial infarction

International Nuclear Information System (INIS)

Zheng Hongchao; Zhang Qi; Zhang Ruiyan; Hu Jian; Yang Zhenkun; Zhang Jiansheng; Shen Weifeng

2009-01-01

Objective: To evaluate the clinical outcomes of patients complicated with major bleeding after primary coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI). Methods: During the period of January 2004-January 2008, primary PCI was performed in 412 consecutive patients with acute STEMI at Shanghai Ruijin Hospital. The clinical data were retrospectively analyzed. Major adverse cardiac events (MACE), including death, reoccurrence of myocardial infarction and target vessel revascularization, in patients with major bleeding were compared with that in patients without major bleeding. Results: Compared to patients without bleeding, the patients with bleeding were older (70.0 ± 8.9 years vs 64.9 ± 12.7 years, P=0.04), mainly the females (51.9% vs 23.1%, P=0.001) and treated more often with glycoprotein (GP) IIb / IIIa receptor inhibitor (88.9% vs 69.4%, P=0.03) or intra-aortic balloon pump (7.4% vs 1.3%, P=0.02). In-hospital and one-year MACE rate in the patients with bleeding was 18.5% and 37.0% respectively,which were significantly higher than that in the patients without bleeding (5.7% and 14.3%, with P=0.008 and P=0.002, respectively). Multivariate analysis indicated that patient aged over 70 years, feminine gender and use of GP IIb/IIIa receptor inhibitor were independent predictors for the occurrence of major bleeding. The occurrence of major bleeding after primary PCI was significantly correlated with MACE occurred within one year after the procedure (OR 2.79, 95% CI: 2.21-5.90, P<0.001). Conclusion: In patients with acute STEMI, the occurrence of major bleeding after primary PCI is closely linked to the increased MACE rate within one year after the treatment.Feminine gender, aged patient and use of GPIIb/IIIa receptor inhibitor are independent predictors to increase the danger of major bleeding. (authors)

PALOMA : an isotope analyzer using static mass spectrometry, coupled with cryogenic and chemical trapping, for the MSL mission to Mars

Science.gov (United States)

Chassefiere, E.; Jambon, A.; Berthelier, J.-J.; Goulpeau, G.; Leblanc, F.; Montmessin, F.; Sarda, P.; Agrinier, P.; Fouchet, T.; Waite, H.

The technique of GCMS analysis has to be completed by static mass spectrometry for precise in-situ measurements of the isotopic composition of planetary atmospheres (noble gases, stable isotopes), and volatile outgassed products from solid sample pyrolysis. Static mass spectrometry, coupled with gas separation by cryo-separation and gettering, is commonly used in the laboratory to study volatiles extracted from terrestrial and meteoritic samples. Such an instrument (PALOMA) is presently developed in our laboratories, and it will be coupled with a Pyr-GCMS analyzer (MACE), built by a US consortium of science laboratories and industrials (University of Michigan, Southwest Research Institute, JPL, Ball Aerospace). The MACE/PALOMA experiment will be proposed on the NASA Mars Science Laboratory mission, planned to be launched in 2009. The scientific objectives of PALOMA, coupled with MACE, may be listed as follows : (i) search for isotopic signatures of past life in atmosphere, rock, dust and ice samples, with emphasis on carbon, nitrogen and hydrogen; (ii) accurately measure isotopic composition of atmospheric noble gases, and stable isotopes, in order to better constrain past escape, surface interaction, outgassing history and climate evolution; (iii) precisely measure diurnal/ seasonal variations of isotopic ratios of H2O, CO2, and N2, for improving our understanding of present and past climate, and of the role of water cycle. Main measurement objectives are : (i) C, H, O, N isotopic composition in both organic evolved samples (provided by MACE pyrolysis system) and atmosphere with high accuracy (a few per mil at 1-s level); (ii) noble gas (He, Ne, Ar, Kr, Xe) and stable (C, H, O, N) isotope composition in atmosphere with high accuracy (a few per mil at 1-s level); (iii) molecular and isotopic composition of inorganic evolved samples (salts, hydrates, nitrates, {ldots}), including ices; (iv) diurnal and seasonal monitoring of D/H in water vapor, and water ice.

Safety and efficacy of limus-eluting stents and balloon angioplasty for sirolimus-eluting in-stent restenosis

Energy Technology Data Exchange (ETDEWEB)

Ota, Hideaki [Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010 (United States); Mahmoudi, Michael [University of Surrey, Guildford Road, Surrey, GU2-7XH (United Kingdom); Kitabata, Hironori; Torguson, Rebecca; Chen, Fang; Satler, Lowell F.; Suddath, William O.; Pichard, Augusto D. [Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010 (United States); Waksman, Ron, E-mail: ron.waksman@medstar.net [Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010 (United States)

2015-03-15

Objectives: The aim of this study was to compare the safety and efficacy of everolimus-eluting stent (EES), sirolimus-eluting stent (SES), and plain old balloon angioplasty (POBA) for the treatment of SES in-stent restenosis (S-ISR). Background: The optimal treatment for drug-eluting in-stent restenosis remains controversial. Methods: The study cohort comprised 310 consecutive patients (444 lesions) who presented with S-ISR to our institution and underwent treatment with EES (43 patients), SES (102), or POBA (165). The analyzed clinical parameters were the 1-year rates of death, Q-wave myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), definite stent thrombosis (ST) and major adverse cardiac event (MACE) defined as the composite of death, MI, or TLR at 1-year. Results: The three groups were well matched for the conventional risk factors for coronary artery disease except for smoking. The 1-year analyzed clinical parameters were similar in the three groups: MACE (EES = 14%, SES = 18%, POBA = 20%; p = 0.65), death (EES = 2.3%, SES = 6.2%, POBA = 6.1%; p = 0.61), MI (EES = 4.8%, SES = 2.1%, POBA = 2.5%; p = 0.69), TLR (EES = 11.9%, SES = 12.1%, POBA = 24%; p = 0.78), and TVR (EES = 11.9%, SES = 24.8%, POBA = 22.2%; p = 0.23). There were no cases of definite ST. MACE-free rate was significantly lower in patients with recurrent in-stent restenosis (log-rank p = 0.006). Presentation with acute MI, number of treated lesions and a previous history of MI were found to be independent predictors of MACE. Conclusions: In patients presenting with S-ISR, treatment with implantation of an EES, SES, or POBA is associated with similar clinical outcomes. Patients presenting with recurrent ISR may have a poorer clinical outcome.

Homocysteine enhances the predictive value of the GRACE risk score in patients with ST-elevation myocardial infarction.

Science.gov (United States)

Fan, Yan; Wang, Jianjun; Zhang, Sumei; Wan, Zhaofei; Zhou, Dong; Ding, Yanhong; He, Qinli; Xie, Ping

2017-09-01

The present study aims to investigate whether the addition of homocysteine level to the Global Registry of Acute Coronary Events (GRACE) risk score enhances its predictive value for clinical outcomes in ST-elevation myocardial infarction (STEMI). A total of 1143 consecutive patients with STEMI were included in this prospective cohort study. Homocysteine was detected, and the GRACE score was calculated. The predictive power of the GRACE score alone or combined with homocysteine was assessed by the receiver operating characteristic (ROC) analysis, methods of net reclassification improvement (NRI) and integrated discrimination improvement (IDI). During a median follow-up period of 36.7 months, 271 (23.7%) patients reached the clinical endpoints. It showed that the GRACE score and homocysteine could independently predict all-cause death [GRACE: HR=1.031 (1.024-1.039), p<0.001; homocysteine: HR=1.023 (1.018-1.028), p<0.001] and MACE [GRACE: HR=1.008 (1.005-1.011), p<0.001; homocysteine: HR=1.022 (1.018-1.025), p<0.001]. When they were used in combination to assess the clinical outcomes, the area under the ROC curve significantly increased from 0.786 to 0.884 (95% CI=0.067-0.128, Z=6.307, p<0.001) for all-cause death and from 0.678 to 0.759 (95% CI=0.055-0.108, Z=5.943, p<0.001) for MACE. The addition of homocysteine to the GRACE model improved NRI (all-cause death: 0.575, p<0.001; MACE: 0.621, p=0.008) and IDI (all-cause death: 0.083, p<0.001; MACE: 0.130, p=0.016), indicating effective discrimination and reclassification. Both the GRACE score and homocysteine are significant and independent predictors for clinical outcomes in patients with STEMI. A combination of them can develop a more predominant prediction for clinical outcomes in these patients.

Effects of statin therapy on clinical outcomes after acute myocardial infarction in patients with advanced renal dysfunction: A propensity score-matched analysis.

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Kim, Jin Sug; Kim, Weon; Park, Ji Yoon; Woo, Jong Shin; Lee, Tae Won; Ihm, Chun Gyoo; Kim, Yang Gyun; Moon, Ju-Young; Lee, Sang Ho; Jeong, Myung Ho; Jeong, Kyung Hwan

2017-01-01

Lipid lowering therapy is widely used for the prevention of cardiovascular complications after acute myocardial infarction (AMI). However, some studies show that this benefit is uncertain in patients with renal dysfunction, and the role of statins is based on the severity of renal dysfunction. In this study, we investigated the impact of statin therapy on major adverse cardiac events (MACEs) and all-cause mortality in patients with advanced renal dysfunction undergoing percutaneous coronary intervention (PCI) after AMI. This study was based on the Korea Acute Myocardial Infarction Registry database. We included 861 patients with advanced renal dysfunction from among 33,205 patients who underwent PCI after AMI between November 2005 and July 2012. Patients were divided into two groups: a statin group (n = 537) and a no-statin group (n = 324). We investigated the 12-month MACEs (cardiac death, myocardial infarction, repeated PCI or coronary artery bypass grafting) and all-cause mortality of each group. Subsequently, a propensity score-matched analysis was performed. In the total population studied, no significant differences were observed between the two groups with respect to the rate of recurrent MI, repeated PCI, coronary artery bypass grafting (CABG), or all-cause mortality. However, the cardiac death rate was significantly lower in the statin group (p = 0.009). Propensity score-matched analysis yielded 274 pairs demonstrating, results similar to those obtained from the total population. However, there was no significant difference in the cardiac death rate in the propensity score-matched population (p = 0.103). Cox-regression analysis revealed only left ventricular ejection fraction to be an independent predictor of 12-month MACEs (Hazard ratio [HR] of 0.979, 95% confidence interval [CI], 0962-0.996, p = 0.018). Statin therapy was not significantly associated with a reduction in the 12-month MACEs or all-cause mortality in patients with advanced renal dysfunction

High-Sensitivity C-Reactive Protein as a Predictor of Cardiovascular Events after ST-Elevation Myocardial Infarction

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Ribeiro, Daniel Rios Pinto; Ramos, Adriane Monserrat; Vieira, Pedro Lima; Menti, Eduardo; Bordin, Odemir Luiz Jr.; Souza, Priscilla Azambuja Lopes de; Quadros, Alexandre Schaan de; Portal, Vera Lúcia, E-mail: veraportal.pesquisa@gmail.com [Programa de Pós-Graduação em Ciências da Saúde: Cardiologia - Instituto de Cardiologia/Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil)

2014-07-15

The association between high-sensitivity C-reactive protein and recurrent major adverse cardiovascular events (MACE) in patients with ST-elevation myocardial infarction who undergo primary percutaneous coronary intervention remains controversial. To investigate the potential association between high-sensitivity C-reactive protein and an increased risk of MACE such as death, heart failure, reinfarction, and new revascularization in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. This prospective cohort study included 300 individuals aged >18 years who were diagnosed with ST-elevation myocardial infarction and underwent primary percutaneous coronary intervention at a tertiary health center. An instrument evaluating clinical variables and the Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores was used. High-sensitivity C-reactive protein was determined by nephelometry. The patients were followed-up during hospitalization and up to 30 days after infarction for the occurrence of MACE. Student's t, Mann-Whitney, chi-square, and logistic regression tests were used for statistical analyses. P values of ≤0.05 were considered statistically significant. The mean age was 59.76 years, and 69.3% of patients were male. No statistically significant association was observed between high-sensitivity C-reactive protein and recurrent MACE (p = 0.11). However, high-sensitivity C-reactive protein was independently associated with 30-day mortality when adjusted for TIMI [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.07-1.51; p = 0.005] and GRACE (OR, 1.26; 95% CI, 1.06-1.49; p = 0.007) risk scores. Although high-sensitivity C-reactive protein was not predictive of combined major cardiovascular events within 30 days after ST-elevation myocardial infarction in patients who underwent primary angioplasty and stent implantation, it was an independent predictor

Blood transfusion after percutaneous coronary intervention and risk of subsequent adverse outcomes: a systematic review and meta-analysis.

Science.gov (United States)

Kwok, Chun Shing; Sherwood, Matthew W; Watson, Sarah M; Nasir, Samina B; Sperrin, Matt; Nolan, Jim; Kinnaird, Tim; Kiatchoosakun, Songsak; Ludman, Peter F; de Belder, Mark A; Rao, Sunil V; Mamas, Mamas A

2015-03-01

This study sought to define the prevalence and prognostic impact of blood transfusions in contemporary percutaneous coronary intervention (PCI) practice. Although the presence of anemia is associated with adverse outcomes in patients undergoing PCI, the optimal use of blood products in patients undergoing PCI remains controversial. A search of EMBASE and MEDLINE was conducted to identify PCI studies that evaluated blood transfusions and their association with major adverse cardiac events (MACE) and mortality. Two independent reviewers screened the studies for inclusion, and data were extracted from relevant studies. Random effects meta-analysis was used to estimate the risk of adverse outcomes with blood transfusions. Statistical heterogeneity was assessed by considering the I(2) statistic. Nineteen studies that included 2,258,711 patients with more than 54,000 transfusion events were identified (prevalence of blood transfusion 2.3%). Crude mortality rate was 6,435 of 50,979 (12.6%, 8 studies) in patients who received a blood transfusion and 27,061 of 2,266,111 (1.2%, 8 studies) in the remaining patients. Crude MACE rates were 17.4% (8,439 of 48,518) in patients who had a blood transfusion and 3.1% (68,062 of 2,212,730) in the remaining cohort. Meta-analysis demonstrated that blood transfusion was independently associated with an increase in mortality (odds ratio: 3.02, 95% confidence interval: 2.16 to 4.21, I(2) = 91%) and MACE (odds ratio: 3.15, 95% confidence interval: 2.59 to 3.82, I(2) = 81%). Similar observations were recorded in studies that adjusted for baseline hematocrit, anemia, and bleeding. Blood transfusion is independently associated with increased risk of mortality and MACE events. Clinicians should minimize the risk for periprocedural transfusion by using available bleeding-avoidance strategies and avoiding liberal transfusion practices. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

A pilot study on utility of Malayalam version of Addenbrooke's Cognitive Examination in detection of amnestic mild cognitive impairment: A critical insight into utility of learning and recall measures.

Science.gov (United States)

Menon, Ramshekhar; Lekha, Vs; Justus, Sunitha; Sarma, P Sankara; Mathuranath, Ps

2014-10-01

This pilot study sought to determine whether the Malayalam adaptation of Addenbrooke's Cognitive Examination (M-ACE) can effectively identify patients with amnestic mild cognitive impairment (a-MCI) and the impact of measures of learning and free recall. A cohort of 23 patients with a-MCI aged between 55-80 years diagnosed as per current criteria and 23 group matched cognitively normal healthy controls (CNHC) were studied. The measures of acquisition and delayed recall were the Rey Auditory Verbal Learning Test (RAVLT) and Wechsler Memory Scale (WMS)-III (verbal and visual subsets) and Delayed Matching-to-sample Test (DMS)-48. Test scores of M-ACE registration and recall scores were included. To examine the differences in test performances between the groups, we compared the number of subjects with test scores less than 1.5 standard deviation (SD) of the control scores. Comparisons between a-MCI and controls were drawn using Fisher's exact test and Mann-Whitney U tests. M-ACE registration component ascertained on a 24-point scale failed to demonstrate any differences between a-MCI and controls (P = 0.665) as opposed to recall judged on a cumulative 10-point scale (P = 0.001). Significant differences were noted in RAVLT list learning (P < 0.001) and list recall (P = 0.003), WMS-III paragraph learning (P <0.001) and recall (P = 0.007), visual learning (P = 0.004) and recall (P = 0.001). M-ACE recall scores are an effective screening tool to identify patients with suspected a-MCI. Both word list and paragraph learning and recall components have been found to be sensitive to concretely identify a-MCI and impairment on at least 2 tests should be considered in the diagnostic criteria of MCI rather than rely on a single screening battery.

Assessment of vertebral microarchitecture in overt and mild Cushing's syndrome using trabecular bone score.

Science.gov (United States)

Vinolas, Helene; Grouthier, Virginie; Mehsen-Cetre, Nadia; Boisson, Amandine; Winzenrieth, Renaud; Schaeverbeke, Thierry; Mesguich, Charles; Bordenave, Laurence; Tabarin, Antoine

2018-05-21

Osteoporotic fractures associated with Cushing's syndrome (CS) may occur despite normal bone mineral density (BMD). Few studies have described alterations in vertebral microarchitecture in glucocorticoid-treated patients and during CS. Trabecular bone score (TBS) estimates trabecular microarchitecture from dual-energy X-ray absorptiometry acquisitions. Our aim was to compare vertebral BMD and TBS in patients with overt CS and mild autonomous cortisol secretion (MACE), and following cure of overt CS. University Hospital. Monocentric retrospective cross-sectional and longitudinal studies of consecutive patients. A total of 110 patients were studied: 53 patients had CS (35, 11 and 7 patients with Cushing's disease, bilateral macronodular adrenal hyperplasia and ectopic ACTH secretion respectively); 39 patients had MACE (10 patients with a late post-operative recurrence of Cushing's disease and 29 patients with adrenal incidentalomas); 18 patients with non-secreting adrenal incidentalomas. 14 patients with overt CS were followed for up to 2 years after cure. Vertebral osteoporosis at BMD and degraded microarchitecture at TBS were found in 24% and 43% of patients with CS, respectively (P < .03). As compared to patients with nonsecreting incidentalomas, patients with MACE had significantly decreased TBS (P < .04) but not BMD. Overt fragility fractures tended to be associated with low TBS (P = .07) but not with low BMD. TBS, but not BMD values, decreased with the intensity of hypercortisolism independently of its aetiology (P < .01). Following remission of CS, TBS improved more markedly and rapidly than BMD (10% vs 3%, respectively; P < .02). Trabecular bone score may be a promising, noninvasive, widely available and inexpensive complementary tool for the routine assessment of the impact of CS and MACE on bone in clinical practice. © 2018 John Wiley & Sons Ltd.

Elevated serum osteoprotegerin levels predict in-hospital major adverse cardiac events in patients with ST elevation myocardial infarction.

Science.gov (United States)

Çanga, Aytun; Durakoğlugil, Murtaza Emre; Erdoğan, Turan; Kirbaş, Aynur; Yilmaz, Adnan; Çiçek, Yüksel; Ergül, Elif; Çetin, Mustafa; Kocaman, Sinan Altan

2012-11-01

The aim of our study was to investigate whether osteoprotegerin (OPG) is related to in-hospital major adverse cardiac events (MACE) and reperfusion parameters in patients with ST elevation myocardial infarction (STEMI). The OPG/receptor activator of nuclear factor-κB (RANK)/RANK ligand pathway has recently been associated with atherosclerosis. OPG is a predictor of cardiovascular events in patients with acute coronary syndrome. This study included 96 consecutive patients with STEMI undergoing primary percutaneous coronary intervention (PCI). Two groups with equal number of patients were formed according to median OPG level. The association of OPG levels on admission with post-procedural reperfusion parameters, and in-hospital MACE were investigated. Patients with higher OPG levels displayed higher neutrophil/lymphocyte ratio, admission troponin, admission glucose, and high-sensitive C-reactive protein. Higher OPG levels were associated with increased thrombolysis in myocardial infarction (TIMI) risk score, TIMI risk index, pain to balloon time, need for inotropic support, shock, and MACE, mainly driven by death. Reperfusion parameters were not different between the two groups. TIMI risk score, TIMI risk index, myocardial blush grade, estimated glomerular filtration rate (eGFR), number of obstructed vessels, and OPG significantly predicted adverse cardiac events. Multiple logistic regression analysis revealed OPG as an independent predictor of MACE as well as eGFR, number of obstructed vessels, and corrected TIMI frame count. OPG, a bidirectional molecule displaying both atheroprotective and pro-atherosclerotic properties, is currently known as a marker of inflammation and a predictor of cardiovascular mortality. The present study, for the first time, demonstrated that an increased OPG level is related to in-hospital adverse cardiovascular events after primary PCI in patients with STEMI. Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd

A pilot study on utility of Malayalam version of Addenbrooke′s Cognitive Examination in detection of amnestic mild cognitive impairment: A critical insight into utility of learning and recall measures

Directory of Open Access Journals (Sweden)

Ramshekhar Menon

2014-01-01

Full Text Available Aims: This pilot study sought to determine whether the Malayalam adaptation of Addenbrooke′s Cognitive Examination (M-ACE can effectively identify patients with amnestic mild cognitive impairment (a-MCI and the impact of measures of learning and free recall. Materials and Methods: A cohort of 23 patients with a-MCI aged between 55-80 years diagnosed as per current criteria and 23 group matched cognitively normal healthy controls (CNHC were studied. The measures of acquisition and delayed recall were the Rey Auditory Verbal Learning Test (RAVLT and Wechsler Memory Scale (WMS-III (verbal and visual subsets and Delayed Matching-to-sample Test (DMS-48. Test scores of M-ACE registration and recall scores were included. To examine the differences in test performances between the groups, we compared the number of subjects with test scores less than 1.5 standard deviation (SD of the control scores. Comparisons between a-MCI and controls were drawn using Fisher′s exact test and Mann-Whitney U tests. Results: M-ACE registration component ascertained on a 24-point scale failed to demonstrate any differences between a-MCI and controls (P = 0.665 as opposed to recall judged on a cumulative 10-point scale (P = 0.001. Significant differences were noted in RAVLT list learning (P < 0.001 and list recall (P = 0.003, WMS-III paragraph learning (P <0.001 and recall (P = 0.007, visual learning (P = 0.004 and recall (P = 0.001. Conclusions: M-ACE recall scores are an effective screening tool to identify patients with suspected a-MCI. Both word list and paragraph learning and recall components have been found to be sensitive to concretely identify a-MCI and impairment on at least 2 tests should be considered in the diagnostic criteria of MCI rather than rely on a single screening battery.

Wintertime aerosol chemical composition and source apportionment of the organic fraction across Ireland

Science.gov (United States)

Ovadnevaite, J.; Lin, C.; Ceburnis, D.; Huang, R. J. J.; O'Dowd, C. D. D.

2017-12-01

A national wide characterization of PM1 was studied for the first time using a high-time resolution Aerosol Chemical Speciation Monitor (ACSM) and Aethalometer in Ireland during the heating season. Dublin, the capital of Ireland, is the most polluted area with an average PM1 of 7.6 μg/m3, with frequent occurrence of peak concentration over 200 μg/m3 primarily due to solid fuels burning, while Mace Head, in the west coast, is least polluted with an average PM1 of 0.8 μg/m3 due to the distance from the emission sources. The organic aerosol is the most dominant species across Ireland, contributing 65%, 58%, 32%, 33% to total PM1 mass in Dublin, Birr, Carnsore Point, and Mace Head, respectively. Birr, a small town in the midland of Ireland, has comparable PM1 levels (4.8 μg/m3) and similar chemical compositions with that in Dublin. Carnsore Point, on the southeast coast, has similar composition with that at Mace Head, but nearly 3 times the levels of PM1 mass due to its relative closeness to other European countries. Positive matrix factorization (PMF) with the multi-linear engine (ME-2) was performed on the organic matrix to quantify the contribution of factor candidates. Peat burning was found to be the dominant factor across Ireland, contributing more than 40% of the total organic mass in Dublin and Birr while OOA is dominant at rural Carnsore Point and Mace Head. Possible geographic origins of PM1 species and organic factors using polar plots were explored. The findings of solid fuels burning (primarily peat burning) driving the pollution episodes suggest an elimination or controlled emission of solid fuels burning would reduce PM1 by at least 50%.

Clinical significance of a presystolic wave on Doppler examination of the left ventricular outflow tract.

Science.gov (United States)

Joshi, Kamal R; Kabirdas, Deepa; Romero-Corral, Abel; Shah, Mahek; Figueredo, Vincent M; Pressman, Gregg S

2014-11-15

A presystolic wave (PSW) is commonly seen on Doppler examination of the left ventricular outflow tract (LVOT), but is little studied. We conducted a retrospective study to assess the prevalence of the PSW, correlations with various Doppler parameters, and its clinical significance. Two hundred echocardiograms, 100 with ejection fraction (EF) >55% and 100 with EF <45%, were reviewed. Mitral inflow velocities, septal annular velocities, LVOT, and PSW velocities were measured. Major adverse cardiovascular events (MACE [death, heart failure hospitalization, atrial fibrillation, and stroke]) were compared between those with and without a PSW, in both EF groups. Mean age was 58 ± 15 years; 56% were men and 69% were African-American. PSW prevalence was similar between normal (68%) and reduced EF groups (62%). However, its velocity was less in the low EF group (37 ± 10 vs 48 ± 16 cm/s, p <0.0001). In subjects with normal EF PSW velocity correlated with mitral A velocity (rho = 0.43, p = 0.0003). In subjects with reduced EF the association with A velocity was not significant (rho = 0.22, p = 0.09), but there was a significant association with annular a' velocity (rho = 0.38, p = 0.002). Over a mean follow-up of 1.7 ± 0.3 years, 57 subjects (28%) experienced MACE. Those without a PSW had more MACE (39% vs 23%, p = 0.02); PSW absence remained predictive of MACE after adjustment for multiple variables, especially in patients with reduced EF. In conclusion, PSW is common in the LVOT. Its presence and magnitude are associated with measures of atrial contraction. Its absence is associated with increased rates of adverse events, especially in patients with low EF. Copyright © 2014 Elsevier Inc. All rights reserved.

Patterns and associations between DAPT cessation and 2-year clinical outcomes in left main/proximal LAD versus other PCI: Results from the Patterns of Non-Adherence to Dual Antiplatelet Therapy in Stented Patients (PARIS) registry.

Science.gov (United States)

Chandrasekhar, Jaya; Baber, Usman; Sartori, Samantha; Aquino, Melissa; Tomey, Matthew; Kruckoff, Mitchell; Moliterno, David; Henry, Timothy D; Weisz, Giora; Gibson, C Michael; Iakovou, Ioannis; Kini, Annapoorna; Faggioni, Michela; Vogel, Birgit; Farhan, Serdar; Colombo, Antonio; Steg, P Gabriel; Witzenbichler, Bernhard; Chieffo, Alaide; Cohen, David; Stuckey, Thomas; Ariti, Cono; Pocock, Stuart; Dangas, George; Mehran, Roxana

2017-09-15

Percutaneous coronary intervention (PCI) of the left main (LM) or proximal left anterior descending artery (pLAD) is considered high-risk as these segments subtend substantial left ventricular myocardial area. We assessed the patterns and associations between dual antiplatelet therapy (DAPT) cessation and 2-year outcomes in LM/pLAD vs. other PCI from the all-comer PARIS registry. Two-year major adverse cardiovascular events (MACE) were a composite of cardiac death, myocardial infarction, definite/probable stent thrombosis or target lesion revascularization. DAPT cessation was predefined as physician-guided permanent discontinuation, temporary interruption, or non-recommended disruption due to non-compliance or bleeding. Of the study population (n=5018), 25.0% (n=1252) underwent LM/pLAD PCI and 75.0% (n=3766) PCI to other segments. Compared to others, LM/pLAD patients presented with fewer comorbidities, less frequent acute coronary syndromes but more multivessel and bifurcation disease treated with greater stent lengths. Two-year adjusted risk of MACE (11.4% vs. 11.6%; HR 1.10, 95% CI 0.90-1.34, p=0.36) was similar between LM/pLAD vs. other patients. DAPT discontinuation was significantly higher (43.3% vs. 39.4%, p=0.01) in LM/pLAD patients with borderline significance for lower disruption (10.0% vs. 14.7%, p=0.059) compared to other patients. DAPT discontinuation was not associated with higher risk of MACE in LM/pLAD (HR 0.65, 95% CI 0.34-1.25) or other PCI groups (HR 0.67, 95% CI 0.47-0.95). LM/pLAD PCI was not an independent predictor of 2-year MACE. Compared to other PCI, patients undergoing LM/pLAD PCI had higher rates of physician recommended DAPT discontinuation, however, discontinuation did not result in greater adverse events. Copyright © 2017 Elsevier B.V. All rights reserved.

Associations Between Complex PCI and Prasugrel or Clopidogrel Use in Patients With Acute Coronary Syndrome Who Undergo PCI: From the PROMETHEUS Study.

Science.gov (United States)

Chandrasekhar, Jaya; Baber, Usman; Sartori, Samantha; Aquino, Melissa; Kini, Annapoorna S; Rao, Sunil; Weintraub, William; Henry, Timothy D; Farhan, Serdar; Vogel, Birgit; Sorrentino, Sabato; Ge, Zhen; Kapadia, Samir; Muhlestein, Joseph B; Weiss, Sandra; Strauss, Craig; Toma, Catalin; DeFranco, Anthony; Effron, Mark B; Keller, Stuart; Baker, Brian A; Pocock, Stuart; Dangas, George; Mehran, Roxana

2018-03-01

Potent P2Y 12 inhibitors might offer enhanced benefit against thrombotic events in complex percutaneous coronary intervention (PCI). We examined prasugrel use and outcomes according to PCI complexity, as well as analyzing treatment effects according to thienopyridine type. PROMETHEUS was a multicentre observational study that compared clopidogrel vs prasugrel in acute coronary syndrome patients who underwent PCI (n = 19,914). Complex PCI was defined as PCI of the left main, bifurcation lesion, moderate-severely calcified lesion, or total stent length ≥ 30 mm. Major adverse cardiac events (MACE) were a composite of death, myocardial infarction, stroke, or unplanned revascularization. Outcomes were adjusted using multivariable Cox regression for effect of PCI complexity and propensity-stratified analysis for effect of thienopyridine type. The study cohort included 48.9% (n = 9735) complex and 51.1% (n = 10,179) noncomplex patients. Second generation drug-eluting stents were used in 70.1% complex and 66.2% noncomplex PCI patients (P PCI was associated with greater adjusted risk of 1-year MACE (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.20-1.39; P PCI patients (P = 0.30). Compared with clopidogrel, prasugrel significantly decreased adjusted risk for 1-year MACE in complex PCI (HR, 0.79; 95% CI, 0.68-0.92) but not noncomplex PCI (HR, 0.91; 95% CI, 0.77-1.08), albeit there was no evidence of interaction (P interaction = 0.281). Despite the use of contemporary techniques, acute coronary syndrome patients who undergo complex PCI had significantly higher rates of 1-year MACE. Adjusted magnitude of treatment effects with prasugrel vs clopidogrel were consistent in complex and noncomplex PCI without evidence of interaction. Copyright © 2018. Published by Elsevier Inc.

Significance of prior percutaneous revascularisation in patients with acute coronary syndromes: insights from the prospective PROSPECT registry.

Science.gov (United States)

Iñiguez, Andrés; Brener, Sorin J; Jiménez, Victor A; Maehara, Akiko; Mintz, Gary S; Xu, Ke; Weisz, Giora; Lansky, Alexandra J; De Bruyne, Bernard; Serruys, Patrick W; Stone, Gregg W

2016-04-20

Prior percutaneous coronary intervention (PCI) is increasingly encountered in acute coronary syndrome (ACS) patients, with uncertain significance. We sought to evaluate the impact of prior PCI in ACS patients. Patients with ACS enrolled in the prospective PROSPECT registry underwent three-vessel intravascular ultrasound and virtual histology evaluation after successful PCI of the culprit lesion(s). We identified patients with prior PCI (>6 months before index ACS) and compared their outcomes to those without prior PCI. Time-to-event for major adverse cardiac events (MACE) was estimated up to three years, and the independent association between prior PCI and MACE was evaluated in a multivariable model. Among 696 patients enrolled, 77 (11.1%) had prior PCI. They were older and more likely to have prior myocardial infarction, chronic kidney disease, and congestive heart failure. At three years, patients with prior PCI had significantly higher rates of cardiac death, rehospitalisation for worsening angina, and MACE (adjusted HR=1.73 [95% CI: 1.09, 2.75], p=0.02), independent of other comorbidities and intravascular ultrasound findings. Prior PCI was noted in over 10% of patients with ACS and was associated with higher mortality and morbidity, independent of other comorbidities. Prior PCI should be considered a high-risk feature when evaluating ACS patients.

Two-Year Clinical Outcomes of Newer-Generation Drug-Eluting Stent Implantation Following Rotational Atherectomy for Heavily Calcified Lesions.

Science.gov (United States)

Jinnouchi, Hiroyuki; Kuramitsu, Shoichi; Shinozaki, Tomohiro; Kobayashi, Yohei; Hiromasa, Takashi; Morinaga, Takashi; Mazaki, Toru; Sakakura, Kenichi; Soga, Yoshimitsu; Hyodo, Makoto; Shirai, Shinichi; Ando, Kenji

2015-01-01

Clinical outcomes of implantation of the newer-generation drug-eluting stent (DES) following rotational atherectomy for heavily calcified lesions remain unclear in the real-world setting. We enrolled 252 consecutive patients (273 lesions) treated with newer-generation DES following rotational atherectomy. The primary endpoint was the cumulative 2-year incidence of major adverse cardiovascular events (MACE), defined as cardiac death, myocardial infarction, clinically-driven target lesion revascularization, and definite stent thrombosis. Complete clinical follow-up information at 2-year was obtained for all patients. The mean age was 73.2±9.0 years and 155 patients (61.5%) were male. Cumulative 2-year incidence of MACE (cardiac death, myocardial infarction, clinically-driven target lesion revascularization and definite stent thrombosis) was 20.3% (7.0%, 2.1%, 18.1% and 2.1%, respectively). Predictors of MACE were presenting with acute coronary syndrome (hazard ratio [HR]: 3.80, 95% confidence interval [CI]: 1.29-11.2, P=0.02), hemodialysis (HR: 1.93, 95% CI: 1.04-3.56, P=0.04) and previous coronary artery bypass graft (HR: 2.26, 95% CI: 1.02-5.00, P=0.045). PCI for calcified lesions requiring rotational atherectomy is still challenging even in the era of newer-generation DES.

Dobutamine stress MRI. Part II. Risk stratification with dobutamine cardiovascular magnetic resonance in patients suspected of myocardial ischemia

International Nuclear Information System (INIS)

Kuijpers, Dirkjan; Dijkman, Paul R.M. van; Janssen, Caroline H.C.; Vliegenthart, Rozemarijn; Zijlstra, Felix; Oudkerk, Matthijs

2004-01-01

The aim of this study was to determine the prognostic value of dobutamine cardiovascular magnetic resonance (CMR) in patients suspected of myocardial ischemia. Clinical data and dobutamine-CMR results were analyzed in 299 consecutive patients. Follow-up data were analyzed in categories of risk levels defined by the history of coronary artery disease and presence of rest wall motion abnormalities (RWMA). Major adverse cardiac events (MACE) as evaluated end points included cardiac death, nonfatal myocardial infarction and clinically indicated coronary revascularization. Follow-up was completed in 214 (99%) patients with a negative dobutamine-CMR study (no signs of inducible myocardial ischemia) with an average of 24 months. The patients with a negative dobutamine-CMR study and RWMA showed a significantly higher annual MACE rate (18%) than the patients without RWMA (0.56%) (P<0.001). Patients without RWMA showed an annual MACE rate of 2% when they had a history of coronary artery disease and <0.1% without a previous coronary event (P<0.001). Dobutamine-CMR showed a positive and negative predictive value of 95 and 93%, respectively. The cardiovascular occurrence-free survival rate was 96.2%. In patients suspected of myocardial ischemia, dobutamine-CMR is able to assess risk levels for coronary events with high accuracy. (orig.)

Safety and efficacy of low-dose paclitaxel utilizing the cobra-P drug-eluting stent system with a novel biodegradable coating in de novo coronary lesions: The PLUS-ONE first-in-man study

International Nuclear Information System (INIS)

Calderas, Carlos; Condado, Jose Francisco; Condado, Jose Antonio; Flores, Alejandra; Mueller, Amy; Thomas, Jack; Nakatani, Daisaku; Honda, Yasuhiro; Waseda, Katsuhisa; Fitzgerald, Peter

2014-01-01

Background: The Cobra-P drug-eluting stent (DES) system consists of cobalt chromium alloy with bio-absorbable siloxane sol–gel matrix coating that elutes low dose paclitaxel within 6 months. The aim of this first-in-man trial was to evaluate the safety and performance of 2 doses of the Cobra-P DES. Methods: A total of 60 lesions (54 patients) were sequentially assigned to 2 different paclitaxel doses: group A (3.7 μg/18 mm, n = 30) or group B (8 μg/18 mm, n = 30). The primary endpoint was MACE at 4 months defined as cardiac death, myocardial infarction, and target lesion revascularization. Results: Patient and lesion characteristics were matched between the 2 groups except for male sex. MACE at 4 months was 3.3% and 0% respectively (P = 1.000) and at 1-year follow-up remained unchanged. In-stent late loss at 4 months was similar in both groups (0.36 ± 0.30 mm and 0.34 ± 0.20 mm P = .773). Conclusions: In this FIM study, implantation of the Cobra-P low dose paclitaxel-eluting stent with a bioabsorbable sol–gel coating was proven to be feasible and safe. Moderate neointimal proliferation was observed as well as an acceptable MACE rate up to 1 year

Safety and efficacy of low-dose paclitaxel utilizing the cobra-P drug-eluting stent system with a novel biodegradable coating in de novo coronary lesions: the PLUS-ONE first-in-man study.

Science.gov (United States)

Calderas, Carlos; Condado, Jose Francisco; Condado, Jose Antonio; Flores, Alejandra; Mueller, Amy; Thomas, Jack; Nakatani, Daisaku; Honda, Yasuhiro; Waseda, Katsuhisa; Fitzgerald, Peter

2014-01-01

The Cobra-P drug-eluting stent (DES) system consists of cobalt chromium alloy with bio-absorbable siloxane sol-gel matrix coating that elutes low dose paclitaxel within 6 months. The aim of this first-in-man trial was to evaluate the safety and performance of 2 doses of the Cobra-P DES. A total of 60 lesions (54 patients) were sequentially assigned to 2 different paclitaxel doses: group A (3.7 μg/18mm, n=30) or group B (8 μg/18mm, n=30). The primary endpoint was MACE at 4 months defined as cardiac death, myocardial infarction, and target lesion revascularization. Patient and lesion characteristics were matched between the 2 groups except for male sex. MACE at 4 months was 3.3% and 0% respectively (P=1.000) and at 1-year follow-up remained unchanged. In-stent late loss at 4 months was similar in both groups (0.36 ± 0.30mm and 0.34 ± 0.20mm P=.773). In this FIM study, implantation of the Cobra-P low dose paclitaxel-eluting stent with a bioabsorbable sol-gel coating was proven to be feasible and safe. Moderate neointimal proliferation was observed as well as an acceptable MACE rate up to 1 year. © 2014.

Strain-induced generation of silicon nanopillars

International Nuclear Information System (INIS)

Bollani, Monica; Osmond, Johann; Nicotra, Giuseppe; Spinella, Corrado; Narducci, Dario

2013-01-01

Silicon metal-assisted chemical etching (MACE) is a nanostructuring technique exploiting the enhancement of the silicon etch rate at some metal–silicon interfaces. Compared to more traditional approaches, MACE is a high-throughput technique, and it is one of the few that enables the growth of vertical 1D structures of virtually unlimited length. As such, it has already found relevant technological applications in fields ranging from energy conversion to biosensing. Yet, its implementation has always required metal patterning to obtain nanopillars. Here, we report how MACE may lead to the formation of porous silicon nanopillars even in the absence of gold patterning. We show how the use of inhomogeneous yet continuous gold layers leads to the generation of a stress field causing spontaneous local delamination of the metal—and to the formation of silicon nanopillars where the metal disruption occurs. We observed the spontaneous formation of nanopillars with diameters ranging from 40 to 65 nm and heights up to 1 μm. Strain-controlled generation of nanopillars is consistent with a mechanism of silicon oxidation by hole injection through the metal layer. Spontaneous nanopillar formation could enable applications of this method to contexts where ordered distributions of nanopillars are not required, while patterning by high-resolution techniques is either impractical or unaffordable. (paper)

Safety and efficacy of low-dose paclitaxel utilizing the cobra-P drug-eluting stent system with a novel biodegradable coating in de novo coronary lesions: The PLUS-ONE first-in-man study

Energy Technology Data Exchange (ETDEWEB)

Calderas, Carlos [Instituto de Clinicas Urologia Tamanaco, Caracas (Venezuela, Bolivarian Republic of); Condado, Jose Francisco; Condado, Jose Antonio [Hospital Centro Medico de Caracas y Hospital Miguel Perez Carreno, Caracas (Venezuela, Bolivarian Republic of); Flores, Alejandra [Instituto de Clinicas Urologia Tamanaco, Caracas (Venezuela, Bolivarian Republic of); Mueller, Amy; Thomas, Jack [Medlogics Device Corporation, Santa Rosa, CA (United States); Nakatani, Daisaku; Honda, Yasuhiro; Waseda, Katsuhisa [Stanford University, Stanford, CA (United States); Fitzgerald, Peter, E-mail: crci-cvmed@stanford.edu [Stanford University, Stanford, CA (United States)

2014-01-15

Background: The Cobra-P drug-eluting stent (DES) system consists of cobalt chromium alloy with bio-absorbable siloxane sol–gel matrix coating that elutes low dose paclitaxel within 6 months. The aim of this first-in-man trial was to evaluate the safety and performance of 2 doses of the Cobra-P DES. Methods: A total of 60 lesions (54 patients) were sequentially assigned to 2 different paclitaxel doses: group A (3.7 μg/18 mm, n = 30) or group B (8 μg/18 mm, n = 30). The primary endpoint was MACE at 4 months defined as cardiac death, myocardial infarction, and target lesion revascularization. Results: Patient and lesion characteristics were matched between the 2 groups except for male sex. MACE at 4 months was 3.3% and 0% respectively (P = 1.000) and at 1-year follow-up remained unchanged. In-stent late loss at 4 months was similar in both groups (0.36 ± 0.30 mm and 0.34 ± 0.20 mm P = .773). Conclusions: In this FIM study, implantation of the Cobra-P low dose paclitaxel-eluting stent with a bioabsorbable sol–gel coating was proven to be feasible and safe. Moderate neointimal proliferation was observed as well as an acceptable MACE rate up to 1 year.

Dobutamine stress MRI. Part II. Risk stratification with dobutamine cardiovascular magnetic resonance in patients suspected of myocardial ischemia

Energy Technology Data Exchange (ETDEWEB)

Kuijpers, Dirkjan [State University and Academic Hospital Groningen, Department of Radiology and Cardiology, Groningen (Netherlands); Bronovo Hospital, Department of Radiology and Cardiology, Bronovolaan 1, P.O. Box 96900, The Hague (Netherlands); Dijkman, Paul R.M. van [Bronovo Hospital, Department of Radiology and Cardiology, Bronovolaan 1, P.O. Box 96900, The Hague (Netherlands); Janssen, Caroline H.C.; Vliegenthart, Rozemarijn; Zijlstra, Felix; Oudkerk, Matthijs [State University and Academic Hospital Groningen, Department of Radiology and Cardiology, Groningen (Netherlands)

2004-11-01

The aim of this study was to determine the prognostic value of dobutamine cardiovascular magnetic resonance (CMR) in patients suspected of myocardial ischemia. Clinical data and dobutamine-CMR results were analyzed in 299 consecutive patients. Follow-up data were analyzed in categories of risk levels defined by the history of coronary artery disease and presence of rest wall motion abnormalities (RWMA). Major adverse cardiac events (MACE) as evaluated end points included cardiac death, nonfatal myocardial infarction and clinically indicated coronary revascularization. Follow-up was completed in 214 (99%) patients with a negative dobutamine-CMR study (no signs of inducible myocardial ischemia) with an average of 24 months. The patients with a negative dobutamine-CMR study and RWMA showed a significantly higher annual MACE rate (18%) than the patients without RWMA (0.56%) (P<0.001). Patients without RWMA showed an annual MACE rate of 2% when they had a history of coronary artery disease and <0.1% without a previous coronary event (P<0.001). Dobutamine-CMR showed a positive and negative predictive value of 95 and 93%, respectively. The cardiovascular occurrence-free survival rate was 96.2%. In patients suspected of myocardial ischemia, dobutamine-CMR is able to assess risk levels for coronary events with high accuracy. (orig.)

Dobutamine stress MRI. Part II. Risk stratification with dobutamine cardiovascular magnetic resonance in patients suspected of myocardial ischemia.

Science.gov (United States)

Kuijpers, Dirkjan; van Dijkman, Paul R M; Janssen, Caroline H C; Vliegenthart, Rozemarijn; Zijlstra, Felix; Oudkerk, Matthijs

2004-11-01

The aim of this study was to determine the prognostic value of dobutamine cardiovascular magnetic resonance (CMR) in patients suspected of myocardial ischemia. Clinical data and dobutamine-CMR results were analyzed in 299 consecutive patients. Follow-up data were analyzed in categories of risk levels defined by the history of coronary artery disease and presence of rest wall motion abnormalities (RWMA). Major adverse cardiac events (MACE) as evaluated end points included cardiac death, nonfatal myocardial infarction and clinically indicated coronary revascularization. Follow-up was completed in 214 (99%) patients with a negative dobutamine-CMR study (no signs of inducible myocardial ischemia) with an average of 24 months. The patients with a negative dobutamine-CMR study and RWMA showed a significantly higher annual MACE rate (18%) than the patients without RWMA (0.56%) ( P<0.001). Patients without RWMA showed an annual MACE rate of 2% when they had a history of coronary artery disease and <0.1% without a previous coronary event ( P<0.001). Dobutamine-CMR showed a positive and negative predictive value of 95 and 93%, respectively. The cardiovascular occurrence-free survival rate was 96.2%. In patients suspected of myocardial ischemia, dobutamine-CMR is able to assess risk levels for coronary events with high accuracy.

The Emerging Role of miR-223 in Platelet Reactivity: Implications in Antiplatelet Therapy

Science.gov (United States)

Shi, Rui; Zhou, Xin; Ji, Wen-Jie; Zhang, Ying-Ying; Ma, Yong-Qiang; Zhang, Jian-Qi

2015-01-01

Platelets are anuclear cells and are devoid of genomic DNA, but they are capable of de novo protein synthesis from mRNA derived from their progenitor cells, megakaryocytes. There is mounting evidence that microRNA (miRNA) plays an important role in regulating gene expression in platelets. miR-223 is the most abundant miRNAs in megakaryocytes and platelets. One of the miR-223-regulated genes is ADP P2Y12, a key target for current antiplatelet drug therapy. Recent studies showed that a blunted response to P2Y12 antagonist, that is, high on-treatment platelet reactivity (HTPR), is a strong predictor of major cardiovascular events (MACEs) in coronary heart disease (CHD) patients receiving antiplatelet treatment. Recent clinical cohort study showed that the level of circulating miR-223 is inversely associated with MACE in CHD patients. In addition, our recent data demonstrated that the level of both intraplatelet and circulating miR-223 is an independent predictor for HTPR, thus providing a link between miR-223 and MACE. These lines of evidence indicate that miR-223 may serve as a potential regulatory target for HTPR, as well as a diagnostic tool for identification of HTPR in clinical settings. PMID:26221610

An Assessment of Pseudo-Operational Ground-Based Light Detection and Ranging Sensors to Determine the Boundary-Layer Structure in the Coastal Atmosphere

Directory of Open Access Journals (Sweden)

Conor Milroy

2012-01-01

Full Text Available Twenty-one cases of boundary-layer structure were retrieved by three co-located remote sensors, One LIDAR and two ceilometers at the coastal site of Mace Head, Ireland. Data were collected during the ICOS field campaign held at the GAW Atmospheric Station of Mace Head, Ireland, from 8th to 28th of June, 2009. The study is a two-step investigation of the BL structure based on (i the intercomparison of the backscatter profiles from the three laser sensors, namely the Leosphere ALS300 LIDAR, the Vaisala CL31 ceilometer and the Jenoptik CHM15K ceilometer; (ii and the comparison of the backscatter profiles with twenty-three radiosoundings performed during the period from the 8th to the 15th of June, 2009. The sensor-independent Temporal Height-Tracking algorithm was applied to the backscatter profiles as retrieved by each instrument to determine the decoupled structure of the BL over Mace Head. The LIDAR and ceilometers-retrieved BL heights were compared to the radiosoundings temperature profiles. The comparison between the remote and the in-situ data proved the existence of the inherent link between temperature and aerosol backscatter profiles and opened at future studies focusing on the further assessment of LIDAR-ceilometer comparison.

Midregional-proAtrial Natriuretic Peptide and High Sensitive Troponin T Strongly Predict Adverse Outcome in Patients Undergoing Percutaneous Repair of Mitral Valve Regurgitation.

Directory of Open Access Journals (Sweden)

Jochen Wöhrle

Full Text Available It is not known whether biomarkers of hemodynamic stress, myocardial necrosis, and renal function might predict adverse outcome in patients undergoing percutaneous repair of severe mitral valve insufficiency. Thus, we aimed to assess the predictive value of various established and emerging biomarkers for major adverse cardiovascular events (MACE in these patients.Thirty-four patients with symptomatic severe mitral valve insufficiency with a mean STS-Score for mortality of 12.6% and a mean logistic EuroSCORE of 19.7% undergoing MitraClip therapy were prospectively included in this study. Plasma concentrations of mid regional-proatrial natriuretic peptide (MR-proANP, Cystatin C, high-sensitive C-reactive protein (hsCRP, high-sensitive troponin T (hsTnT, N-terminal B-type natriuretic peptide (NT-proBNP, galectin-3, and soluble ST-2 (interleukin 1 receptor-like 1 were measured directly before procedure. MACE was defined as cardiovascular death and hospitalization for heart failure (HF.During a median follow-up of 211 days (interquartile range 133 to 333 days, 9 patients (26.5% experienced MACE (death: 7 patients, rehospitalization for HF: 2 patients. Thirty day MACE-rate was 5.9% (death: 2 patients, no rehospitalization for HF. Baseline concentrations of hsTnT (Median 92.6 vs 25.2 ng/L, NT-proBNP (Median 11251 vs 1974 pg/mL and MR-proANP (Median 755.6 vs 318.3 pmol/L, all p<0.001 were clearly higher in those experiencing an event vs event-free patients, while other clinical variables including STS-Score and logistic EuroSCORE did not differ significantly. In Kaplan-Meier analyses, NT-proBNP and in particular hsTnT and MR-proANP above the median discriminated between those experiencing an event vs event-free patients. This was further corroborated by C-statistics where areas under the ROC curve for prediction of MACE using the respective median values were 0.960 for MR-proANP, 0.907 for NT-proBNP, and 0.822 for hsTnT.MR-proANP and hsTnT strongly

Association of a Family History of Atrial Fibrillation With Incidence and Outcomes of Atrial Fibrillation: A Population-Based Family Cohort Study.

Science.gov (United States)

Chang, Shang-Hung; Kuo, Chang-Fu; Chou, I-Jun; See, Lai-Chu; Yu, Kuang-Hui; Luo, Shue-Fen; Huang, Lu-Hsiang; Zhang, Weiya; Doherty, Michael; Wen, Ming-Shien; Kuo, Chi-Tai; Yeh, Yung-Hsin

2017-08-01

The heritability of atrial fibrillation (AF), the contribution of genetic and environmental factors, and the association of a family history of AF with prognosis are unclear. To measure genetic and environmental factors in the familial aggregation of AF and to estimate the association of a family history of AF with major adverse cardiovascular events (MACE). In this Taiwanese nationwide population-based study among more than 23 million people, a custom data set was obtained using the data of all patients having a diagnosis of AF recorded between January 1996 and December 2013 in the Taiwan National Health Insurance Research Database. The study population comprised all 23 422 955 individuals registered with the database in 2013, of whom 177 770 had a diagnosis of AF and were included in the heritability estimation. From the latter, a subgroup of patients having newly diagnosed AF with a first-degree relative affected by AF between 2000 and 2010 were selected and matched 1:4 to controls without a family history for estimating MACE-free survival. The dates of analysis were January 2010 to December 2013. The prevalence and relative risk of AF in relatives of patients with AF, as well as the relative contributions of heritability and shared and nonshared environmental factors to AF susceptibility. Also measured was MACE-free survival after AF was diagnosed. In total, 1510 patients (204 [13.5%] female; mean [SD] age, 57.9 [9.2] years) had newly diagnosed AF with a first-degree relative affected by AF. Individuals with a first-degree relative affected by AF had a relative risk of 1.92 (95% CI, 1.84-1.99) for AF. The accountability for the phenotypic variance of AF was 19.9% for genetic factors (heritability), 3.5% for shared environmental factors, and 76.6% for nonshared environmental factors. After matching for age, sex, hypertension, type 2 diabetes, previous stroke, and anticoagulation, incident AF patients with vs without an affected first-degree relative had

2015 Pollock Acoustic/Trawl Survey Gulf of Alaska EK60 Raw Data

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Scientists from the Midwater Assessment and Conservation Engineering (MACE) Program of the Alaska Fisheries Science Center's (AFSC) Resource Assessment and...

Gulf of Alaska Acoustic-Trawl Surveys of Walleye Pollock (DY1201, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Survey of Walleye Pollock on the U.S. and Russian Bering Sea Shelf (DY1006, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Survey of Walleye Pollock in the Southeastern Aleutian Basin near Bogoslof Island (DY0903, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Survey of Walleye Pollock in the Gulf of Alaska (DY1503, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Survey of Walleye Pollock in the Eastern Bering Sea (DY1608, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Southeastern Aleutian Basin (Bogoslof Island) Acoustic-Trawl Survey of Walleye Pollock (DY1202, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Survey of Walleye Pollock (DY1506, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Survey of Walleye Pollock in the Gulf of Alaska (DY1604, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Survey of Walleye Pollock (DY1506, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Surveys of Walleye Pollock (DY1001, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Survey of Walleye Pollock on the U.S. and Russian Bering Sea Shelf (DY1207, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Survey of Walleye Pollock (DY1403, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Survey of Walleye Pollock (DY1401, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Surveys of Walleye Pollock (DY1203, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Surveys of Walleye Pollock in the Central Gulf of Alaska (DY0904, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Survey of Walleye Pollock (DY1303, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Survey of Walleye Pollock (DY1307, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Assessment of Rockfish Species in Untrawlable Habitat in the Gulf of Alaska (DY0912, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Southeastern Aleutian Basin (Bogoslof Island) Acoustic-Trawl Survey of Walleye Pollock (DY1402, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Surveys of Walleye Pollock (DY1002, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Surveys of Walleye Pollock in the Central Gulf of Alaska (DY0904, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-trawl (AT) survey of Walleye Pollock in the Gulf of Alaska (DY1502, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Southeastern Aleutian Basin (Bogoslof Island) Acoustic-Trawl Survey of Walleye Pollock (DY1603, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Survey of Walleye Pollock in the Gulf of Alaska (OD0501, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Survey of Walleye Pollock on the U.S. and Russian Bering Sea Shelf (DY0909, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Survey of Walleye Pollock in the Gulf of Alaska (MF0309, EK500)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Survey of Walleye Pollock (DY1302, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Survey of Walleye Pollock (DY1602, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Gulf of Alaska Acoustic-Trawl Surveys of Walleye Pollock (DY0901, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Acoustic-Trawl Survey of Walleye Pollock on the U.S. and Russian Bering Sea Shelf (DY0909, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA National Marine Fisheries Service (NMFS), Alaska Fisheries Science Center (AFSC)...

Terra Preta Sanitation: A Key Component for Sustainability in the Urban Environment

Directory of Open Access Journals (Sweden)

Thorsten Schuetze

2014-11-01

Full Text Available Terra Preta Sanitation (TPS plays a key role in sustainable sanitation (SuSan and in the sustainable management of resources such as water, energy, soil (agriculture, liquid and solid organic waste streams as well as in the development of sustainable urban environment and infrastructure systems. This paper discusses the advantages of, and requirements for, SuSan systems, focusing on TPS. Case studies showing the stepwise extension and re-development of conventional sanitation systems (CSS using TPS technologies and system approaches are presented and discussed. Decentralized TPS systems integrated in sustainable urban resource management were implemented in the German cities of Hamburg and Berlin. The compilation of best practice examples and findings using the newest TPS systems illustrates the immense potential of this approach for the transformation from conventional to SuSan systems. For this purpose, the potential savings of drinking water resources and the recycling potential of nutrient components are quantified. The results strongly suggest the need to encourage the development and application of innovative decentralized sanitation technologies, urban infrastructures, and resource management systems that have TP as a key component.

Shelikof Strait Acoustic-Trawl Survey of Walleye Pollock (DY1002, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of the Alaska Fisheries Science Center (AFSC; NOAA National Marine Fisheries Service) conducted...

Shumagin Islands Acoustic-Trawl Survey of Walleye Pollock (DY1302, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA's National Marine Fisheries Service, Alaska Fisheries Science Center (AFSC), conducted an...

Shumagin Islands Acoustic-Trawl Survey of Walleye Pollock (DY1001, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of the Alaska Fisheries Science Center (AFSC; NOAA National Marine Fisheries Service) conducted...

Shelikof Strait Acoustic-Trawl Survey of Walleye Pollock (DY1303, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA's National Marine Fisheries Service, Alaska Fisheries Science Center (AFSC) conducted an...

Gulf of Alaska Acoustic-Trawl Survey of Walleye Pollock (DY1307, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of NOAA's National Marine Fisheries Service, Alaska Fisheries Science Center (AFSC) conducted an...

Eastern Bering Sea Acoustic-Trawl Survey of Walleye Pollock (DY1006, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of the Alaska Fisheries Science Center (AFSC; NOAA National Marine Fisheries Service) conducted...

Antenatal care--antenatal screening for fetal abnormality.

Science.gov (United States)

Baston, Helen

2003-02-01

JOANNA IS NOW 24 WEEKS pregnant. She is feeling very well and finding that now her energy has returned, she is really enjoying being preganant. She still proudly shows her precious scan picture to interested friends and takes the occasional glance herself during quiet moments. Joanna, has a cousin, Susan, who has Down's syndrome. Susan is a happy and loving child who has brought a lot of joy, as well as heartache, to the extended family. Although Joanna has no delusions about the hard work and continuing care that her cousin requires, she would not herself contemplate terminating a pregnancy if her baby had the condition.

β-Blocker-Associated Risks in Patients With Uncomplicated Hypertension Undergoing Noncardiac Surgery

DEFF Research Database (Denmark)

Jørgensen, Mads E; Hlatky, Mark A; Køber, Lars Valeur

2015-01-01

IMPORTANCE: Perioperative β-blocker strategies are important to reduce risks of adverse events. Effectiveness and safety may differ according to patients' baseline risk. OBJECTIVE: To determine the risk of major adverse cardiovascular events (MACEs) associated with long-term β-blocker therapy...... antihypertensive drugs (β-blockers, thiazides, calcium antagonists, or renin-angiotensin system [RAS] inhibitors) undergoing noncardiac surgery between 2005 and 2011. INTERVENTIONS: Various antihypertensive treatment regimens, chosen as part of usual care. MAIN OUTCOMES AND MEASURES: Thirty-day risk of MACEs...... (cardiovascular death, nonfatal ischemic stroke, nonfatal myocardial infarction) and all-cause mortality, assessed using multivariable logistic regression models and adjusted numbers needed to harm (NNH). RESULTS: The baseline characteristics of the 14,644 patients who received β-blockers (65% female, mean [SD...

Beta-blocker subtype and risks of perioperative adverse events following non-cardiac surgery

DEFF Research Database (Denmark)

Jørgensen, Mads E.; Sanders, Robert D.; Køber, Lars

2017-01-01

Aims Beta-blockers vary in pharmacodynamics and pharmacokinetic properties. It is unknown whether specific types are associated with increased perioperative risks. We evaluated perioperative risks associated with beta-blocker subtypes, overall and in patient subgroups. Methods and results We...... performed a Danish Nationwide cohort study, 2005-2011, of patients treated chronically with beta blocker (atenolol, bisoprolol, carvedilol, metoprolol, propranolol, or other) prior to non-cardiac surgery. Risks of 30-day all-cause mortality (ACM) and 30-day major adverse cardiovascular events (MACE) were...... in analyses stratified by age, surgery priority, duration of anaesthesia or surgery risk (all P for interaction >0.05). Conclusion Risks of ACM and MACE did not systematically differ by beta-blocker subtype. Findings may guide clinical practice and future trials....

Body mass index and risk of perioperative cardiovascular adverse events and mortality in 34,744 Danish patients undergoing hip or knee replacement

DEFF Research Database (Denmark)

Thornqvist, Catharina; Gislason, Gunnar H; Køber, Lars

2014-01-01

underwent elective primary hip or knee replacement surgery between 2005 and 2011. We used multivariable Cox regression models to calculate the 30-day risks of MACE and mortality associated with 5 BMI groups (underweight (BMI ...BACKGROUND AND PURPOSE: Obesity is a risk factor for osteoarthritis in the lower limb, yet the cardiovascular risks associated with obesity in hip or knee replacement surgery are unknown. We examined associations between body mass index (BMI) and the risk of a major adverse cardiovascular event...... (MACE: ischemic stroke, acute myocardial infarction, or cardiovascular death) or the risk of all-cause mortality in a nationwide Danish cohort of patients who underwent primary hip or knee replacement surgery. METHODS: Using Danish nationwide registries, we identified 34,744 patients aged ≥ 20 years who...

Francisco de Valderrama, verdadero autor de las mazas del Ayuntamiento de Sevilla

Directory of Open Access Journals (Sweden)

Santos Márquez, Antonio Joaquín

2009-06-01

Full Text Available In this article the author reveals the true creator of the maces of Seville Town Hall, Francisco de Valderrama, a rediscovered silversmith about whom new biographical data is offered. Also included is a detailed study of these civic maces (traditionally attributed erroneously to Francisco de Alfaro, key works of Sevillian Mannerism.

En este artículo se da a conocer el verdadero autor de las mazas del ayuntamiento de Sevilla, Francisco de Valderrama, orfebre redescubierto del que además aportamos nuevos datos biográficos. Asimismo, hacemos un estudio pormenorizado de estas mazas capitulares, obra clave de la plástica manierista sevillana y que tradicionalmente había sido atribuida erróneamente a Francisco de Alfaro.

Relation of Serum Adiponectin Levels to Number of Traditional Atherosclerotic Risk Factors and All-Cause Mortality and Major Adverse Cardiovascular Events (from the Copenhagen City Heart Study)

DEFF Research Database (Denmark)

Lindberg, Soren; Mogelvang, Rasmus; Pedersen, Sune H

2013-01-01

adiponectin has been associated with increased mortality and an increasing number of major adverse CV events (MACE). Because of these conflicting results, the true role of adiponectin remains to be elucidated. In the Copenhagen City Heart Study, we prospectively followed up 5,624 randomly selected men...... and women from the community without CV disease. Plasma adiponectin was measured at the beginning of the study. The median follow-up time was 7.8 years (interquartile range 7.3 to 8.3). The end point was all-cause mortality (n = 801), and the combined end point was MACE, consisting of CV mortality...... or nonfatal myocardial infarction or ischemic stroke (n = 502). High adiponectin was inversely associated with an increasing number of traditional CV risk factors (p...

Prognostic value of Angiographic Perfusion Score (APS) following percutaneous interventions in acute coronary syndromes.

Science.gov (United States)

Narain, V S; Fischer, L; Puri, A; Sethi, R; Dwivedi, S K

2013-01-01

Identifying reperfusion and predicting post procedure risk is important following Percutaneous Coronary Interventions (PCI). An Angiographic Perfusion Score (APS) combining TIMI flow (TFG) and myocardial perfusion (TMPG) grades before and after PCI can accurately measure both epicardial and myocardial perfusion and predict Major Adverse Cardiac Events (MACE). APS was calculated in 226 (88 ST elevation Myocardial Infarction (STEMI) and 138 Non STEMI) patients. Maximum score being 12, reperfusion was defined as failed: 0-3, partial: 4-9, and full APS: 10-12. Thirty day MACE were observed. APS identified reperfusion significantly more than TMPG alone (STEMI: 50.6% vs 11.8% (p APS group (1.8% vs 22.5%) (p APS detects more low risk reperfused patients, post PCI. Copyright © 2012. Published by Elsevier B.V.

Interaction of angiotensin-converting enzyme (ACE) with membrane-bound carboxypeptidase M (CPM) - a new function of ACE.

Science.gov (United States)

Sun, Xiaoou; Wiesner, Burkhard; Lorenz, Dorothea; Papsdorf, Gisela; Pankow, Kristin; Wang, Po; Dietrich, Nils; Siems, Wolf-Eberhard; Maul, Björn

2008-12-01

Angiotensin-converting enzyme (ACE) demonstrates, besides its typical dipeptidyl-carboxypeptidase activity, several unusual functions. Here, we demonstrate with molecular, biochemical, and cellular techniques that the somatic wild-type murine ACE (mACE), stably transfected in Chinese Hamster Ovary (CHO) or Madin-Darby Canine Kidney (MDCK) cells, interacts with endogenous membranal co-localized carboxypeptidase M (CPM). CPM belongs to the group of glycosylphosphatidylinositol (GPI)-anchored proteins. Here we report that ACE, completely independent of its known dipeptidase activities, has GPI-targeted properties. Our results indicate that the spatial proximity between mACE and the endogenous CPM enables an ACE-evoked release of CPM. These results are discussed with respect to the recently proposed GPI-ase activity and function of sperm-bound ACE.

Shelikof Strait Acoustic-Trawl Survey of Walleye Pollock (DY1203, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of the Alaska Fisheries Science Center (AFSC) conducted an acoustic-trawl (AT) stock assessment...

Shumagin Islands Acoustic-Trawl Survey of Walleye Pollock (DY1201, ME70)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Midwater Assessment and Conservation Engineering (MACE) program of the Alaska Fisheries Science Center (AFSC) conducted an acoustic-trawl (AT) stock assessment...

DY1207 Bering Sea ME70

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Scientists from the Midwater Assessment and Conservation Engineering (MACE) Program of the Alaska Fisheries Science Center (AFSC) have conducted summer surveys to...

From Estonian Exile to Executive Office / Susan Frith

Index Scriptorium Estoniae

Frith, Susan

2008-01-01

Eesti Vabariigi Presidendi Toomas Hendrik Ilvese elukäigust, haridusteest, poliitilistest vaadetest. T. H. Ilves lõpetas Pennsylvania ülikooli psühholoogia alal magistrikraadiga 1978. a. Artiklis on kasutatud telefoniintervjuud presidendiga. T. H. Ilvese kohta avaldavad arvamust ülikoolikaaslane Brian Wandell ja Eesti Rahvuskomitee Ühendriikides endine president Juhan Simonson. Ülevaade artiklist ilmunud ka: Vaba Eesti Sõna, 24. jaan. 2008, lk. 7, 10: Vaga, Airi. Eesti president Toomas H. Ilves Pennsylvania ülikooli ajakirjas

A polarised SUSANS facility to study magnetic systems

Indian Academy of Sciences (India)

The experiment was carried out at the V12b double crystal diffractometer set ... upper pole piece and just below the lower pole piece, within a magnet-grade soft iron 'C'. ... about 3 µm with the up- and 9 µm with the down-spin neutrons.

Interview with Pennsylvania PUC chairman Susan M. Shanaman

International Nuclear Information System (INIS)

Utroska, D.

1981-01-01

Chairman Shanaman notes that Pennsylvania law justifies the Public Utility Commission (PUC) refusal to charge ratepayers for the cost of Three Mile Island units 1 and 2, neither of which are providing service, because ratepayers are already paying the costs of replacement power. The PUC chairman points to other service territories around the country where rates are kept below national averages because the average income level is low. The Metropolitan Edison Company is seeking Federal relief as well as legislative permission to put TMI-1 back into the rate base in fairness to ratepayers, but the PUC does not see bankruptcy for the utility as an appropriate way to force Federal assistance. The Administration needs to understand the local impact of Federal policies, especially those which are incompatible with state situations. Appropriate involvement includes nuclear waste research and underwriting some of the cleanup costs of onsite accidents that are too large for a single utility to handle. Chairman Shanaman feels that ratepayers should contribute to the insurance premium for future accidents, but not retroactively to support TMI-2. Nuclear power plant construction in the US will not progress until the issues of TMI-2 are resolved

Correlation or Limits of Agreement? Applying the Bland-Altman Approach to the Comparison of Cognitive Screening Instruments.

Science.gov (United States)

Larner, A J

2016-01-01

Calculation of correlation coefficients is often undertaken as a way of comparing different cognitive screening instruments (CSIs). However, test scores may correlate but not agree, and high correlation may mask lack of agreement between scores. The aim of this study was to use the methodology of Bland and Altman to calculate limits of agreement between the scores of selected CSIs and contrast the findings with Pearson's product moment correlation coefficients between the test scores of the same instruments. Datasets from three pragmatic diagnostic accuracy studies which examined the Mini-Mental State Examination (MMSE) vs. the Montreal Cognitive Assessment (MoCA), the MMSE vs. the Mini-Addenbrooke's Cognitive Examination (M-ACE), and the M-ACE vs. the MoCA were analysed to calculate correlation coefficients and limits of agreement between test scores. Although test scores were highly correlated (all >0.8), calculated limits of agreement were broad (all >10 points), and in one case, MMSE vs. M-ACE, was >15 points. Correlation is not agreement. Highly correlated test scores may conceal broad limits of agreement, consistent with the different emphases of different tests with respect to the cognitive domains examined. Routine incorporation of limits of agreement into diagnostic accuracy studies which compare different tests merits consideration, to enable clinicians to judge whether or not their agreement is close. © 2016 S. Karger AG, Basel.

The association of antidepressant and statin use with death and incident cardiovascular disease varies by depression severity.

Science.gov (United States)

May, Heidi T; Bair, Tami L; Reiss-Brennan, Brenda; Knight, Stacey; Anderson, Jeffrey L; Horne, Benjamin D; Brunisholz, Kimberly D; Muhlestein, Joseph B

2017-09-01

Depression has been reported to be associated with a greater risk of death and cardiovascular disease (CVD); however, the impact of antidepressants (ADM) on CVD risk remains controversial. Statin use is known to decrease CVD risk. Whether the use of these medications together affects CVD risk has not been studied. Patients (N = 26,828) completing the patient health questionnaire (PHQ-9), ≥40 years of age, without prior CVD, and no prior ADM use were studied. Depressive severity was categorized as none-mild (PHQ-9 score ≤14, n = 21,517) and moderate-severe (PHQ-9 score ≥15, n = 5311). Cox hazard regression was used to evaluate the association of no ADM/no statin use (n = 23,104 [86.1%]), ADM/no statin use (n = 877 [3.3%]), no ADM/statin use (n = 2627 [9.8%]), and ADM/statin use (n = 220 [.8%]) with major adverse cardiovascular events (MACE: death, CAD, stroke). Patients averaged 56 ± 12 years; 61% female. There were 1182 (4.4%) 3 year MACE events. The association of ADM and statin use with MACE varied by depressive symptom severity, with statin therapy associated with a decreased risk in the none-mild group (HR = .78, p = .007) and ADM in the moderate-high group (HR = 0.58, p = 0.02). Concomitant use of ADMs and statins did not appear to provide additive benefit.

Thermochemical Erosion Modeling of the 25-MM M242/M791 Gun System

National Research Council Canada - National Science Library

Sopok, Samuel

1997-01-01

The MACE gun barrel thermochemical erosion modeling code addresses wall degradations due to transformations, chemical reactions, and cracking coupled with pure mechanical erosion for the 25-mm M242/M791 gun system...

Metabolic and cardiovascular outcomes of fatherhood: results from a cohort of study in subjects with sexual dysfunction.

Science.gov (United States)

Fisher, Alessandra D; Rastrelli, Giulia; Bandini, Elisa; Corona, Giovanni; Balzi, Daniela; Melani, Cecilia; Monami, Matteo; Matta, Vanessa; Mannucci, Edoardo; Maggi, Mario

2012-11-01

Previous cross-sectional and longitudinal studies reported a negative correlation between fatherhood and testosterone (T) levels, likely due to a centrally mediated downregulation of the hypothalamic-pituitary-gonadal axis. Moreover, epidemiological data indicate that fatherhood might affect metabolic and cardiovascular outcomes, although different results have been reported. Up to now, no studies have evaluated these associations in a population of men seeking treatment for sexual dysfunction (SD). To explore biological and clinical correlates of number of children (NoC) and its possible associations with forthcoming major cardiovascular events (MACE) in a sample of men with SD. A consecutive series of 4,045 subjects (mean age 52 ± 13.1 years old) attending the Outpatient Clinic for SD was retrospectively studied. A subset of the previous sample (N = 1,687) was enrolled in a longitudinal study. Information on MACE was obtained through the City of Florence Registry Office. Among patients studied, 31.6% had no children, while 26.3% reported having one child, 33.4% two, and 8.8% three or more children. Although fatherhood was negatively related with follicle-stimulating hormone levels and positively with testis volume, we found a NoC-dependent, stepwise decrease in T plasma levels, not compensated by a concomitant increase in luteinizing hormone. NoC was associated with a worse metabolic and cardiovascular profile, as well as worse penile blood flows and a higher prevalence of metabolic syndrome (MetS). In the longitudinal study, after adjusting for confounders, NoC was independently associated with a higher incidence of MACE. However, when the presence of MetS was introduced as a further covariate, the association was no longer significant. This study supports the hypothesis that bond maintenance contexts and fatherhood are associated with an adaptive downregulation of the gonadotropin-gonadal axis, even in a sample of men with SD. Moreover, our data suggest that

Orbital Atherectomy for Treating De Novo Severely Calcified Coronary Narrowing (1-Year Results from the Pivotal ORBIT II Trial).

Science.gov (United States)

Généreux, Philippe; Lee, Arthur C; Kim, Christopher Y; Lee, Michael; Shlofmitz, Richard; Moses, Jeffrey W; Stone, Gregg W; Chambers, Jeff W

2015-06-15

Percutaneous coronary intervention of severely calcified lesions has historically been associated with major adverse cardiac event (MACE) rates as high as 30%. In the ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial, treatment of de novo severely calcified lesions with the Diamondback 360° Coronary Orbital Atherectomy System (OAS) resulted in low rates of procedural and 30-day adverse ischemic events. The long-term results from this trial have not been reported. We sought to determine the 1-year outcomes after orbital atherectomy of severely calcified coronary lesions. ORBIT II was a single-arm trial enrolling 443 subjects at 49 US sites with severely calcified lesions usually excluded from randomized trials. OAS utilizes a centrifugal differential sanding mechanism of action for plaque modification prior to stent implantation. After OAS drug-eluting stents were implanted in 88.2% of the patients. The primary safety end point was 30-day MACE, the composite of cardiac death, myocardial infarction, or target vessel revascularization [TVR]. The present analysis reports the 1-year follow-up results from ORBIT II. One-year data were available in 433 of 443 patients (97.7%), with median follow-up time of 16.7 months. The 1-year MACE rate was 16.4%, including cardiac death (3.0%), myocardial infarction (9.7%), and target vessel revascularization (5.9%). The 1-year target lesion revascularization rate was 4.7%, and stent thrombosis occurred in 1 patient (0.2%). Independent predictors of 1-year MACE and target vessel revascularization were diameter stenosis at baseline and the use of bare-metal stents. In patients with severely calcified lesions who underwent percutaneous coronary intervention, the use of OAS was associated with low rates of 1-year adverse ischemic events compared with historical controls. This finding has important clinical implications for the selection of optimum treatment strategies for patients

Cardiovascular and heart failure safety profile of vildagliptin: a meta-analysis of 17 000 patients.

Science.gov (United States)

McInnes, G; Evans, M; Del Prato, S; Stumvoll, M; Schweizer, A; Lukashevich, V; Shao, Q; Kothny, W

2015-11-01

To report the cardiovascular (CV) safety profile and heart failure (HF) risk of vildagliptin from a large pool of studies, including trials in high-risk patients with type 2 diabetes mellitus (T2DM), such as those with congestive HF and/or moderate/severe renal impairment. We conducted a retrospective meta-analysis of prospectively adjudicated CV events. Patient-level data were pooled from 40 double-blind, randomized controlled phase III and IV vildagliptin studies. The primary endpoint was occurrence of major adverse CV events (MACEs; myocardial infarction, stroke and CV death). Assessments of the individual MACE components and HF events (requiring hospitalization or new onset) were secondary endpoints. The risk ratio (RR) of vildagliptin (50 mg once- and twice-daily combined) versus comparators (placebo and all non-vildagliptin treatments) was calculated using the Mantel-Haenszel (M-H) method. Of the 17 446 patients, 9599 received vildagliptin (9251.4 subject-years of exposure) and 7847 received comparators (7317.0 subject-years of exposure). The mean age of the patients was 57 years, body mass index 30.5 kg/m(2) (nearly 50% obese), glycated haemoglobin concentration 8.1% and T2DM duration 5.5 years. A MACE occurred in 83 (0.86%) vildagliptin-treated patients and 85 (1.20%) comparator-treated patients, with an M-H RR of 0.82 [95% confidence interval (CI) 0.61-1.11]. Similar RRs were observed for the individual events. Confirmed HF events were reported in 41 (0.43%) vildagliptin-treated patients and 32 (0.45%) comparator-treated patients, with an M-H RR 1.08 (95% CI 0.68-1.70). This large meta-analysis indicates that vildagliptin is not associated with an increased risk of adjudicated MACEs relative to comparators. Moreover, this analysis did not find a significant increased risk of HF in vildagliptin-treated patients. © 2015 John Wiley & Sons Ltd.

Myristica oil poisoning

Science.gov (United States)

Nutmeg oil; Myristicin ... Myristica oil ( Myristica fragrans ) can be harmful. It comes from the seed of a nutmeg. ... Myristica oil is found in: Aromatherapy products Mace Nutmeg Other products may also contain myristica oil.

76 FR 65500 - Fisheries of the Exclusive Economic Zone Off Alaska; Recordkeeping and Reporting Requirements...

Science.gov (United States)

2011-10-21

.../seattlelakeunion/location.php . FOR FURTHER INFORMATION CONTACT: Susan Hall, 907-586-7462. SUPPLEMENTARY... workshops will be physically accessible to people with disabilities. Requests for sign language...

Comparison of the clinical features and outcomes in two age-groups of elderly patients with atrial fibrillation

Directory of Open Access Journals (Sweden)

Shao XH

2014-08-01

Full Text Available Xing-Hui Shao,1 Yan-Min Yang,1 Jun Zhu,1 Han Zhang,1 Yao Liu,1 Xin Gao,1 Li-Tian Yu,1 Li-Sheng Liu,1 Li Zhao,2 Peng-Fei Yu,3 Hua Zhang,4 Qing He,5 Xiao-Dan Gu6 1Emergency and Intensive Care Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 2Department of Emergency, Fu Xing Hospital, Capital Medical University, Beijing, 3Department of Cardiology, Pingdu People’s Hospital, Pingdu, 4Department of Emergency, Qingdao Municipal Hospital, Qingdao, 5Department of Emergency, West China Hospital, Sichuan University, Chengdu, 6Department of Emergency, Sixth People’s Hospital of Chengdu, Chengdu, People’s Republic of China Background: Atrial fibrillation (AF disproportionately affects older adults. However, direct comparison of clinical features, medical therapy, and outcomes in AF patients aged 65–74 and ≥75 years is rare. The objective of the present study was to evaluate the differences in clinical characteristics and prognosis in these two age-groups of geriatric patients with AF.Materials and methods: A total of 1,336 individuals aged ≥65 years from a Chinese AF registry were assessed in the present study: 570 were in the 65- to 74-year group, and 766 were in the ≥75-year group. Multivariable Cox hazards regression was performed to analyze the major adverse cardiac events (MACEs between groups.Results: In our population, the older group were more likely to have coronary artery disease, hypertension, previous stroke, cognitive disorder, or chronic obstructive pulmonary disease, and the 65- to 74-year group were more likely to have valvular heart disease, left ventricular systolic dysfunction, or sleep apnea. The older patients had 1.2-fold higher mean CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes, stroke scores, but less ­probability of being prescribed drugs. Compared with those aged 65–74 years, the older group had a higher risk of death (hazard ratio 2

Postsystolic Shortening by Speckle Tracking Echocardiography Is an Independent Predictor of Cardiovascular Events and Mortality in the General Population

DEFF Research Database (Denmark)

Brainin, Philip; Biering-Sørensen, Sofie Reumert; Møgelvang, Rasmus

2018-01-01

BACKGROUND: Postsystolic shortening (PSS) has been proposed as a novel marker of contractile dysfunction in the myocardium. Our objective was to assess the prognostic potential of PSS on cardiovascular events and death in the general population. METHODS AND RESULTS: The study design consisted...... of a prospective cohort study of 1296 low-risk participants from the general population, who were examined by speckle tracking echocardiography. The primary end point was the composite of heart failure, myocardial infarction, and cardiovascular death, defined as major adverse cardiovascular events (MACEs...... as having MACEs and 236 participants (18%) died. Increasing number of walls with PSS predicted both end points, an association that persisted after adjustment for age, sex, estimated glomerular filtration rate, global longitudinal strain, hypertension, heart rate, left ventricular ejection fraction, LV mass...

Noncardiac Surgery in Patients With Aortic Stenosis

DEFF Research Database (Denmark)

Andersson, Charlotte; Jørgensen, Mads Emil; Martinsson, Andreas

2014-01-01

(MACE) and all-cause mortality were investigated in a contemporary Danish cohort. HYPOTHESIS: AS is not an independent risk factor for adverse outcomes in noncardiac surgery. METHODS: All patients with and without diagnosed AS who underwent noncardiac surgery in 2005 to 2011 were identified through......BACKGROUND: Past research has identified aortic stenosis (AS) as a major risk factor for adverse outcomes in noncardiac surgery; however, more contemporary studies have questioned the grave prognosis. To further our understanding of this, the risks of a 30-day major adverse cardiovascular event...... nationwide administrative registers. AS patients (n = 2823; mean age, 75.5 years, 53% female) were matched with patients without AS (n = 2823) on propensity score for AS and surgery type. RESULTS: In elective surgery, MACE (ie, nonfatal myocardial infarction, ischemic stroke, or cardiovascular death...

76 FR 21741 - Emergency Access Advisory Committee; Announcement of Establishment, and of Members and Co...

Science.gov (United States)

2011-04-18

... Gallaudet University--Norman Williams Hearing, Speech & Deafness Center--Donna Platt Intrado, Inc.--John... Communications--Kevin Green, alternate Susan Sherwood Vonage Holding Corp.--Brendan Kasper Washington Parish, LA...

78 FR 29200 - Advisory Committee for the Study of Eastern Europe and the Independent States of the Former...

Science.gov (United States)

2013-05-17

... advanced graduate training, language training, and postdoctoral research. The committee includes...: April 19, 2013. Susan H. Nelson, Executive Director, Advisory Committee for Study of Eastern Europe and...

77 FR 61019 - Aquatic Nuisance Species Task Force Meeting

Science.gov (United States)

2012-10-05

...: http://anstaskforce.gov/meetings.php . FOR FURTHER INFORMATION CONTACT: Susan Mangin, Executive... information are on the ANS Task Force Web site at: http://anstaskforce.gov/meetings.php . Accessibility...

76 FR 15334 - Aquatic Nuisance Species Task Force Meeting

Science.gov (United States)

2011-03-21

... Task Force Web site at: http://anstaskforce.gov/meetings.php . FOR FURTHER INFORMATION CONTACT: Susan...: http://anstaskforce.gov/meetings.php . Dated: March 14, 2011. Jeffrey Underwood, Acting Assistant...

Raamatututvustus / Rein Põder

Index Scriptorium Estoniae

Põder, Rein, 1943-

1995-01-01

Rousseau, Jean-Jacques. Üksildase uitaja mõtisklused; Hill, Susan. Proua de Winter; Kõrvemaast põhjarannani : Kuusalu kihelkonna kirjanduslik-kodulooline antoloogia / Koost. Helmut Elstrok; Tead.toim. Oskar Kuningas

77 FR 24491 - Change in Bank Control Notices; Acquisitions of Shares of a Bank or Bank Holding Company

Science.gov (United States)

2012-04-24

... Smyrna, Tennessee; James A. Campbell, Nashville, Tennessee; William Kent Coleman, Murfreesboro, Tennessee... River Hills, Wisconsin; David J. Lubar, Fox Point, Wisconsin; Susan Lubar Solvang, and Joan P. Lubar...

78 FR 57675 - Notice of Passenger Facility Charge Approvals and Disapprovals

Science.gov (United States)

2013-09-19

... efficient off-road vehicle. DETERMINATION: Disapproved. Each project was determined to not meet the... credits. DECISION DATE: March 20, 2013. FOR FURTHER INFORMATION CONTACT: Susan Moore, Orlando Airports...

Source Array Support for Continuous Monitoring of Fish Population and Behavior by Instantaneous Continental-Shelf-Scale Imaging Using Ocean-Waveguide Acoustics

National Research Council Canada - National Science Library

Rynne, Ed; Gillette, David

2006-01-01

...) Multistatic ASW Capability Enhancement Program (MACE) as the source of underwater sounds to support active bi-static sonar capabilities for monitoring fish populations and behaviors during a September/October 2006 sea test off the coast of Maine...

75 FR 15457 - Aquatic Nuisance Species Task Force Meeting

Science.gov (United States)

2010-03-29

...: http://anstaskforce.gov/meetings.php . FOR FURTHER INFORMATION CONTACT: Susan Mangin, Executive... on the ANS Task Force Web site at: http://anstaskforce.gov/meetings.php . Dated: March 19, 2010...

Governing how we care: contesting community and defining difference in U.S. public health programs

National Research Council Canada - National Science Library

Shaw, Susan J., Dr

2012-01-01

.... In Governing How We Care, medical anthropologist Susan Shaw examines the relationship between government and citizens using case studies of needle exchange and Welfare-to-Work programs to illustrate...

75 FR 59209 - Certain Coated Paper Suitable for High-Quality Print Graphics Using Sheet-Fed Presses from...

Science.gov (United States)

2010-09-27

.... Lorentzen, Deputy Assistant Secretary for Import Administration, from Susan Kuhbach, Director, Office 1.... Provision of Standing Timber for Less Than Adequate Remuneration 2. Government Prohibition of Log Exports 3...

Investigation of manganese homeostasis in dogs with anaemia and ...

African Journals Online (AJOL)

Investigation of manganese homeostasis in dogs with anaemia and chronic enteropathy. Marisa da Fonseca Ferreira, Arielle Elizabeth Ann Aylor, Richard John Mellanby, Susan Mary Campbell, Adam George Gow ...

Táctica macedónica en tiempos de Filipo II

Directory of Open Access Journals (Sweden)

Jorge Juan Moreno Hernández

2002-01-01

Full Text Available Una de las claves del ascenso de Macedonia durante el siglo IV a.C. se centra en la superioridad del ejército y de las tácticas empleadas por Filipo II. Este monarca, tras llevar a cabo ciertas reformas militares, obtendrá una victoria tras otra hasta situarse a la cabeza de la Grecia Continental y los Balcanes. El objetivo del presente artículo es analizar cada una de las batallas de Filipo (aquellas en que disponemos de suficiente información, así como la composición del ejército, para poder examinar en profundidad las tácticas desplegadas por el macedonio, que una y otra vez le condujeron a la victoria frente a los más potentes ejércitos de la época.

Clinical Use of Ultrasensitive Cardiac Troponin I Assay in Intermediate- and High-Risk Surgery Patients

Directory of Open Access Journals (Sweden)

Flávia Kessler Borges

2013-01-01

Full Text Available Background. Cardiac troponin levels have been reported to add value in the detection of cardiovascular complications in noncardiac surgery. A sensitive cardiac troponin I (cTnI assay could provide more accurate prognostic information. Methods. This study prospectively enrolled 142 patients with at least one Revised Cardiac Risk Index risk factor who underwent noncardiac surgery. cTnI levels were measured postoperatively. Short-term cardiac outcome predictors were evaluated. Results. cTnI elevation was observed in 47 patients, among whom 14 were diagnosed as having myocardial infarction (MI. After 30 days, 16 patients had major adverse cardiac events (MACE. Excluding patients with a final diagnosis of MI, predictors of cTnI elevation included dialysis, history of heart failure, transoperative major bleeding, and elevated levels of pre- and postoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP. Maximal cTnI values showed the highest sensitivity (94%, specificity (75%, and overall accuracy (AUC 0.89; 95% CI 0.80–0.98 for postoperative MACE. Postoperative cTnI peak level (OR 9.4; 95% CI 2.3–39.2 and a preoperative NT-proBNP level ≥917 pg/mL (OR 3.47; 95% CI 1.05–11.6 were independent risk factors for MACE. Conclusions. cTnI was shown to be an independent prognostic factor for cardiac outcomes and should be considered as a component of perioperative risk assessment.

Measurements of granular flow dynamics with high speed digital images

Energy Technology Data Exchange (ETDEWEB)

Lee, Jingeol [Univ. of Florida, Gainesville, FL (United States)

1994-01-01

The flow of granular materials is common to many industrial processes. This dissertation suggests and validates image processing algorithms applied to high speed digital images to measure the dynamics (velocity, temperature and volume fraction) of dry granular solids flowing down an inclined chute under the action of gravity. Glass and acrylic particles have been used as granular solids in the experiment. One technique utilizes block matching for spatially averaged velocity measurements of the glass particles. This technique is compared with the velocity measurement using an optic probe which is a conventional granular flow velocity measurement device. The other technique for measuring the velocities of individual acrylic particles is developed with correspondence using a Hopfield network. This technique first locates the positions of particles with pattern recognition techniques, followed by a clustering technique, which produces point patterns. Also, several techniques are compared for particle recognition: synthetic discriminant function (SDF), minimum average correlation energy (MACE) filter, modified minimum average correlation energy (MMACE) filter and variance normalized correlation. The author proposes an MMACE filter which improves generalization of the MACE filter by adjusting the amount of averaged spectrum of training images in the spectrum whitening stages of the MACE filter. Variance normalized correlation is applied to measure the velocity and temperature of flowing glass particles down the inclined chute. The measurements are taken for the steady and wavy flow and qualitatively compared with a theoretical model of granular flow.

Rotational atherectomy before paclitaxel-eluting stent implantation in complex calcified coronary lesions: Two-year clinical outcome of the randomized ROTAXUS trial.

Science.gov (United States)

de Waha, Suzanne; Allali, Abdelhakim; Büttner, Heinz-Joachim; Toelg, Ralph; Geist, Volker; Neumann, Franz-Josef; Khattab, Ahmed A; Richardt, Gert; Abdel-Wahab, Mohamed

2016-03-01

In the randomized ROTAXUS trial, routine lesion preparation of complex calcified coronary lesions using rotational atherectomy (RA) prior to paclitaxel-eluting stent implantation did not reduce the primary endpoint of angiographic late lumen loss at 9 months compared to stenting without RA. So far, no long-term data of prospective head-to-head comparisons between both treatment strategies have been reported. ROTAXUS randomly assigned patients with complex calcified coronary lesions to RA followed by stenting (n = 120) or stenting without RA (n = 120). The primary endpoint of the current analysis was the occurrence of major adverse cardiac events (MACE) at 2-year follow-up defined as the composite of death, myocardial infarction, and target vessel revascularization (TVR). At 2 years, MACE occurred in 32 patients in the RA group and 37 patients in the standard therapy group (29.4% vs. 34.3%, P = 0.47). The rates of death (8.3% vs. 7.4%, P = 1.00), myocardial infarction (8.3% vs. 6.5%, P = 0.80), target lesion revascularization (TLR, 13.8% vs. 16.7%, P = 0.58), and TVR (19.3% vs. 22.2%, P = 0.62) were similar in both groups. Despite high rates of initial angiographic success, nearly one third of patients enrolled in ROTAXUS experienced MACE within 2-year follow-up, with no differences between patients treated with or without RA. © 2015 Wiley Periodicals, Inc.

Effect of rosuvastatin dose-loading on serum sLox-1, hs-CRP, and postoperative prognosis in diabetic patients with acute coronary syndromes undergoing selected percutaneous coronary intervention (PCI).

Science.gov (United States)

Jiao, Yungen; Hu, Feng; Zhang, Zhengang; Gong, Kaizheng; Sun, Xiaoning; Li, Aihua; Liu, Naifeng

2015-01-01

To investigate the effect of rosuvastatin dose-loading on serum levels of lectin-like oxidized low-density lipoprotein receptor-1 (Lox-1) and high-sensitivity c-reactive protein (hs-CRP) and postoperative prognosis in patients with diabetes and non-ST segment elevation acute coronary syndromes (NSTEACS) undergoing selected percutaneous coronary intervention (PCI). A total of 72 patients with diabetes and NSTEACS were randomized to either the group treated with 20 mg rosuvastatin 12 hours prior to PCI with a second dose administered just before PCI (n = 33), or a control group treated with standard method according guideline (n = 39). Serum levels of sLox-1, hs-CRP, CK-MB, and cTnI were measured prior to PCI, and at 24 hours and 30 days after PCI. The 30-day incidence of major adverse cardiac events (MACE) was recorded in both groups. Compared to pre-PCI, serum levels of sLox-1 and hs-CRP of the two groups were increased at 24 hours after PCI (P PCI (P PCI, the levels of TC and LDL-C were not changed at 24 hours after PCI (P > 0.05) until 30 days after PCI (P PCI; the 30-day incidence of MACE occurred in 6.06% of patients in the loading-dose rosuvastatin-treated group and in 23.08% of patients in the control-treated group (P PCI, and also reduce the occurrence of MACE 30 days after PCI.

Ämbliku jäljed kivimüüril / Sigrid Saarep

Index Scriptorium Estoniae

Saarep, Sigrid, 1963-

2009-01-01

Suurbritannia paviljonis 53. Veneetsia kunstibiennaalil esinevad kunstnikud Steve McQueen, John Cale (Wales), Martin Boyce (Šotimaa) ja Susan MacWilliam (Põhja-Iirimaa). Videokunstnik Steve McQueeni filmist "Giardini" (2009)

Postsystolic Shortening by Speckle Tracking Echocardiography Is an Independent Predictor of Cardiovascular Events and Mortality in the General Population

DEFF Research Database (Denmark)

Brainin, Philip; Biering-Sørensen, Sofie Reumert; Møgelvang, Rasmus

2018-01-01

). The secondary end point was all-cause death. The postsystolic index (PSI) was defined as follows: [(maximum strain in cardiac cycle-peak systolic strain)/(maximum strain in cardiac cycle)]×100. PSS was regarded as present if PSI >20%. During a median follow-up of 11 years, 149 participants (12%) were diagnosed...... as having MACEs and 236 participants (18%) died. Increasing number of walls with PSS predicted both end points, an association that persisted after adjustment for age, sex, estimated glomerular filtration rate, global longitudinal strain, hypertension, heart rate, left ventricular ejection fraction, LV mass...... index, pro-B-type natriuretic peptide, previous ischemic heart disease, systolic blood pressure, average peak early diastolic longitudinal mitral annular velocity (e'), ratio between peak transmitral early and late diastolic inflow velocity (E/A), and left atrial volume index: MACEs (hazard ratio, 1...

A pulsed, mono-energetic and angular-selective UV photo-electron source for the commissioning of the KATRIN experiment

Energy Technology Data Exchange (ETDEWEB)

Behrens, J. [Institut fuer Kernphysik, WWU Muenster, Muenster (Germany); Karlsruhe Institute of Technology, IEKP, Eggenstein-Leopoldshafen (Germany); Ranitzsch, P.C.O.; Hannen, V.; Ortjohann, H.W.; Rest, O.; Winzen, D.; Zacher, M.; Weinheimer, C. [Institut fuer Kernphysik, WWU Muenster, Muenster (Germany); Beck, M. [Institut fuer Kernphysik, WWU Muenster, Muenster (Germany); Johannes-Gutenberg Universitaet, Institut fuer Physik, Mainz (Germany); Beglarian, A. [Karlsruhe Institute of Technology, IPE, Eggenstein-Leopoldshafen (Germany); Erhard, M.; Groh, S.; Kraus, M. [IEKP, Karlsruhe Institute of Technology, Eggenstein-Leopoldshafen (Germany); Schloesser, K.; Thuemmler, T. [Karlsruhe Institute of Technology, IKP, Karlsruhe (Germany); Valerius, K. [Institut fuer Kernphysik, WWU Muenster, Muenster (Germany); Karlsruhe Institute of Technology, IKP, Karlsruhe (Germany); Wierman, K.; Wilkerson, J.F. [University of North Carolina, Department of Physics and Astronomy, Chapel Hill, NC (United States)

2017-06-15

The KATRIN experiment aims to determine the neutrino mass scale with a sensitivity of 200 meV/c{sup 2} (90% C.L.) by a precision measurement of the shape of the tritium β-spectrum in the endpoint region. The energy analysis of the decay electrons is achieved by a MAC-E filter spectrometer. To determine the transmission properties of the KATRIN main spectrometer, a mono-energetic and angular-selective electron source has been developed. In preparation for the second commissioning phase of the main spectrometer, a measurement phase was carried out at the KATRIN monitor spectrometer where the device was operated in a MAC-E filter setup for testing. The results of these measurements are compared with simulations using the particle-tracking software ''Kassiopeia'', which was developed in the KATRIN collaboration over recent years. (orig.)

Prognostic factors of male patients with acute coronary syndrome after percutaneous coronary intervention therapy

International Nuclear Information System (INIS)

Xu Peng; Zhang Gaofeng; Wu Xusheng; Qiao Qi; Yu Liqun

2005-01-01

Objective: To study the prognostic risk factors of male patients with coronary heart disease in stent placement era. Methods: One hundred and four patients were enrolled in this study (aged 64.9 ± 9.6 years) including 61 diagnosed as acute myocardial infarction, and 43 as unstable angina with followed up 11.9 ± 8.7 months. All factors including demographic factors, non-interventional work-up, associated clinical complications and results of coronary artery angiography reached a model of Logistic regression analysis. Results: Based on MACE (major adverse cardiac events), as quantitative factors, diseased proximal middle left anterior descending artery was a significant independent variable (P<0.05), and its coefficient was 22.00. Conclusions: Diseased proximal middle left anterior descending coronary artery is the prognostic factor of MACE in male patients with acute coronary syndrome. (authors)

Los comienzos de la terapia ocupacional en Estados Unidos (siglo XIX y XX: una perspectiva feminista desde los estudios de Ciencia, Tecnología y Género

Directory of Open Access Journals (Sweden)

Rodolfo Morrison Jara

2016-10-01

Full Text Available This article corresponds to a historical reconstruction of the beginnings of occupational therapy in the United States, a space where women assumed a leading role during the 20th century. It reviews the processes, interrelations and main strategies, as links to women’s circles and alliances with male doctors, employed to position occupational therapy as an independent discipline of medicine. Furthermore, it explores the life and work of three important women in the profession: Julia Lathrop, Susan Tracy and Susan Cox Johnson. The methodology consisted of the documentary analysis of primary sources from a gender perspective. As a conclusión it points out the relevance of recognizing the position of women in the history of occupational therapy as fundamental pillars its construction.

Coronary artery disease is associated with an increased mortality rate following video-assisted thoracoscopic lobectomy

DEFF Research Database (Denmark)

Sandri, Alberto; Petersen, Rene Horsleben; Decaluwé, Herbert

2017-01-01

OBJECTIVE: To compare the incidence of major adverse cardiac events (MACE) and mortality following video-assisted thoracoscopic surgery (VATS) lobectomy in patients with and without coronary artery disease (CAD). METHODS: Multicentre retrospective analysis of 1699 patients undergoing VATS lobectomy...

75 FR 36356 - Announcement of Changes to the Membership of the Performance Review Board

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2010-06-25

..., ITA (new). 4. Edward C. Yang, Senior Director, China Non-Market Economy Compliance Unit, ITA. 5. Joel... Management, OS. Dated: June 18, 2010. Susan Boggs, Director, Office of Staffing, Recruitment and...

78 FR 19716 - International Consortium of Cardiovascular Registries

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2013-04-02

... employees) is through Building 1 where routine security check procedures will be performed. For parking and... Internet access should contact Susan Monahan to register ( [email protected] or 301-796-5661...

Air Force Follow-On Review. Protecting The Force: Lessons From Fort Hood

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2010-01-01

Demorah Hayes Mrs. Sherry Terrell Ms. Jeanne Shamburger Mr. Andrew Thayer Graphic Designers Mr. Daniel Armstrong Ms. Susan Fair Printing Specialists Ms. Ann Bailey Mrs. Nedra Looney Mrs. Vivian O’Neal

Eesti president Toomas H. Ilves Pennsylvania ülikooli ajakirjas / Airi Vaga

Index Scriptorium Estoniae

Vaga, Airi, 1940-

2008-01-01

University of Pennsylvania ajakirjas "The Pennsylvania Gazette" ilmunud artiklist "From Estonian Exile to Executive Office", autor Susan Frith - järjekordsest võimalusest tutvustada Eestit ja eestlasi USA ülikoolide kaudu

77 FR 75143 - Submission for OMB Review; Comment Request

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2012-12-19

... the Year, Excellence in Promoting Cultural and Ethnic Diversity (in honor of Secretary Ronald Brown), Excellence in Business Leadership, and the Susan Snow Cotter Award for Excellence in Ocean and Coastal...

Prognostic value of combined CT angiography and myocardial perfusion imaging versus invasive coronary angiography and nuclear stress perfusion imaging in the prediction of major adverse cardiovascular events

DEFF Research Database (Denmark)

Chen, Marcus Y.; Rochitte, Carlos E.; Arbab-Zadeh, Armin

2017-01-01

Purpose: To compare the prognostic importance (time to major adverse cardiovascular event [MACE]) of combined computed tomography (CT) angiography and CT myocardial stress perfusion imaging with that of combined invasive coronary angiography (ICA) and stress single photon emission CT myocardial p...

Prognostic value of absence or presence of coronary artery disease determined by 64-slice computed tomography coronary angiography A systematic review and meta-analysis

DEFF Research Database (Denmark)

Abdulla, Jawdat; Asferg, Camilla Lundegaard; Kofoed, Klaus Fuglsang

2011-01-01

To determine via a meta-analysis the prognostic value of 64-slice computed tomography angiography (CTA) by quantifying risk of major adverse cardiac events (MACE) in different patient groups classified according to CT angiographic findings. A systematic literature search and meta...

Dapagliflozin Compared to DPP-4 inhibitors is Associated with Lower Risk of Cardiovascular Events and All-cause Mortality in Type 2 Diabetes Patients (CVD-REAL Nordic)

DEFF Research Database (Denmark)

Persson, F; Nyström, Thomas; Jørgensen, Marit Eika

2018-01-01

AIMS: To compare the sodium glucose-cotransporter-2-inhibitor (SGLT-2i) dapagliflozin versus dipeptidyl peptidase-4 inhibitors (DPP-4i) regarding risk associations of MACE (nonfatal myocardial infarction, nonfatal stroke or cardiovascular [CV] mortality), hospital events for heart failure (HHF), ...

Kui sulg ei jookse... / Jaanus Noormets

Index Scriptorium Estoniae

Noormets, Jaanus

2003-01-01

Kuidas stsenarist Charlie Kaufman kirjutas stsenaariumi oma loomevaevadest Susan Orleani raamatu filmiks kirjutamisel : mängufilm "Kuidas kirjutada kassafilmi" ("Adaptation") : režissöör Spike Jonze : Ameerika Ühendriigid 2002

Association Between Changes in CMS Reimbursement Policy and Drug Labels for Erythrocyte-Stimulating Agents With Outcomes for Older Patients Undergoing Hemodialysis Covered by Fee-for-Service Medicare.

Science.gov (United States)

Wang, Cunlin; Kane, Robert; Levenson, Mark; Kelman, Jeffrey; Wernecke, Michael; Lee, Joo-Yeon; Kozlowski, Steven; Dekmezian, Carmen; Zhang, Zhiwei; Thompson, Aliza; Smith, Kimberly; Wu, Yu-Te; Wei, Yuqin; Chillarige, Yoganand; Ryan, Qin; Worrall, Chris; MaCurdy, Thomas E; Graham, David J

2016-12-01

In 2011, the US Centers for Medicare & Medicaid Services (CMS) changed its reimbursement policy for hemodialysis to a bundled comprehensive payment system that included the cost of erythrocyte-stimulating agents (ESAs). Also in 2011, the US Food and Drug Administration revised the drug label for ESAs, recommending more conservative dosing in patients with chronic kidney disease. In response to concerns that these measures could have adverse effects on patient care and outcomes, the CMS and the FDA initiated a collaboration to assess the effect. To assess the effects of the changes in reimbursement policy and the ESA drug label on patients who underwent incident hemodialysis. For this retrospective cohort study, patients 66 years or older who had undergone incident hemodialysis, and were enrolled in Medicare parts A, B, or D for at least 12 months prior to hemodialysis initiation between January 1, 2008, and December 31, 2013, were recruited from hemodialysis centers across the United States. Patients were divided into 2 cohorts based on their date of hemodialysis initiation and followed: January 1, 2008, to December 31, 2009, for the prepolicy cohort and July 1, 2011, to June 30, 2013, for the postpolicy cohort, with the exclusion of January 1, 2010, to June 30, 2011, as a transition period. Changes in CMS reimbursement policy for dialysis and the FDA label for ESAs. Major adverse cardiovascular events (MACEs), including acute myocardial infarction (AMI), stroke, and all-cause mortality; hospitalized congestive heart failure (H-CHF); venous thromboembolism; and red blood cell transfusions. Secondary outcomes included evaluating effects on black and other patient subgroups. Baseline characteristics of the 69 718 incident hemodialysis patients were similar between cohorts. Compared with the prepolicy period, the risk of MACE, death, H-CHF, and venous thromboembolism were similar in the postpolicy period, and the risk of stroke decreased (hazard ratio [HR], 0.77; 95

Foundations of health psychology

National Research Council Canada - National Science Library

Friedman, Howard S; Silver, Roxane Cohen

2007-01-01

... and Effective Treatment 9 Adjustment to Chronic Disease: Progress and Promise in Research Annette L. Stanton and Tracey A. Revenson 203 10 Aging and Health 234 Karen S. Rook, Susan T. Charles, and...

Resistance ja Rootsi turvaühiskond / Peeter Linnap

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Linnap, Peeter, 1960-

2001-01-01

"Vastupanukunsti" näitus "The Path of Resistance : MoMa meets Moderna" Stockholmi Moodsa Kunsti Muuseumis, kuraatorid Susan Kismaric ja Joshua Siegel. Resistance'i kunsti raames käsitletakse ka nn. poliitilist kunsti

76 FR 2905 - FY2011 Supplemental Funding for Brownfields Revolving Loan Fund (RLF) Grantees

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2011-01-18

...- 3364, Fax (415) 972- 3364. EPA Region 10, Susan Morales, AK, ID, OR, WA... 1200 Sixth Avenue, Morales.... Dated: January 10, 2011. David R. Lloyd, Director, Office of Brownfields and Land Revitalization, Office...

76 FR 57036 - Notice of Open Meeting of the Advisory Committee of the Export-Import Bank of the United States...

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2011-09-15

..., and you may contact Susan Houser to be placed on an attendee list. If any person wishes auxiliary aids (such as a sign language interpreter) or other special accommodations, please contact, prior to...

Impact of Pre-Diabetes on Coronary Plaque Composition and Clinical Outcome in Patients With Acute Coronary Syndromes: An Analysis From the PROSPECT Study.

Science.gov (United States)

Farhan, Serdar; Redfors, Björn; Maehara, Akiko; McAndrew, Thomas; Ben-Yehuda, Ori; De Bruyne, Bernard; Mehran, Roxana; Giustino, Gennaro; Kirtane, Ajay J; Serruys, Patrick W; Mintz, Gary S; Stone, Gregg W

2017-10-14

The aim of this study was to investigate the impact of pre-diabetes (pre-DM) on coronary plaque characteristics and ischemic outcomes in patients with acute coronary syndromes (ACS). Pre-DM (i.e., the early stages of glucometabolic disturbance) is common among patients with ACS, but the extent to which pre-DM influences coronary plaque characteristics and the risk for adverse ischemic events is unclear. In the PROSPECT (Providing Regional Observations to Study Predictors of Events in Coronary Tree) study, patients with ACS underwent quantitative coronary angiography, grayscale intravascular ultrasound, and radiofrequency intravascular ultrasound after successful percutaneous coronary intervention. Patients were divided into 3 groups according to their glucometabolic status, as defined by the American Diabetes Association: normal glucose metabolism (NGM), pre-DM, and diabetes mellitus (DM). These groups were compared with regard to coronary plaque characteristics and the risk for major adverse cardiac events (MACEs) (defined as cardiac death or arrest, myocardial infarction, or rehospitalization for unstable or progressive angina). Among 547 patients, 162 (29.6%) had NGM, 202 (36.9%) had pre-DM, and 183 (33.4%) had DM. There were no significant differences between the groups with regard to intravascular ultrasound findings indicative of vulnerable plaques. Patients with DM had a higher crude rate of MACEs than those with pre-DM or NGM (25.9% vs. 16.3% and 16.1%; p = 0.03 and p = 0.02, respectively). In an adjusted Cox regression model using NGM as the reference group, DM (hazard ratio: 2.20; 95% confidence interval: 1.25 to 3.86; p = 0.006) but not pre-DM (hazard ratio: 1.29; 95% confidence interval: 0.71 to 2.33; p = 0.41) was associated with increased risk for MACEs. Impaired glucose metabolism is common among patients presenting with ACS. DM but not pre-DM is associated with an increased risk for MACEs. Thus, preventing patients from progressing from pre

Resistant hypertension, patient characteristics, and risk of stroke.

Directory of Open Access Journals (Sweden)

Chen-Ying Hung

Full Text Available Little is known about the prognosis of resistant hypertension (RH in Asian population. This study aimed to evaluate the impacts of RH in Taiwanese patients with hypertension, and to ascertain whether patient characteristics influence the association of RH with adverse outcomes.Patients aged ≥45 years with hypertension were identified from the National Health Insurance Research Database. Medical records of 111,986 patients were reviewed in this study, and 16,402 (14.6% patients were recognized as having RH (continuously concomitant use of ≥3 anti-hypertensive medications, including a diuretic, for ≥2 years. Risk of major adverse cardiovascular events (MACE, a composite of all-cause mortality, acute coronary syndrome, and stroke [included both fatal and nonfatal events] in patients with RH and non-RH was analyzed. A total of 11,856 patients experienced MACE in the follow-up period (average 7.1±3.0 years. There was a higher proportion of females in the RH group, they were older than the non-RH (63.1 vs. 60.5 years patients, and had a higher prevalence of cardiovascular co-morbidities. Overall, patients with RH had higher risks of MACE (adjusted HR 1.17; 95%CI 1.09-1.26; p<0.001. Significantly elevated risks of stroke (10,211 events; adjusted HR 1.17; 95%CI 1.08-1.27; p<0.001, especially ischemic stroke (6,235 events; adjusted HR 1.34; 95%CI 1.20-1.48; p<0.001, but not all-cause mortality (4,594 events; adjusted HR 1.06; 95%CI 0.95-1.19; p = 0.312 or acute coronary syndrome (2,145 events; adjusted HR 1.17; 95%CI 0.99-1.39; p = 0.070 were noted in patients with RH compared to those with non-RH. Subgroup analysis showed that RH increased the risks of stroke in female and elderly patients. However, no significant influence was noted in young or male patients.Patients with RH were associated with higher risks of MACE and stroke, especially ischemic stroke. The risks were greater in female and elderly patients than in male or young

Orbital atherectomy for treating de novo, severely calcified coronary lesions: 3-year results of the pivotal ORBIT II trial.

Science.gov (United States)

Lee, Michael; Généreux, Philippe; Shlofmitz, Richard; Phillipson, Daniel; Anose, Bynthia M; Martinsen, Brad J; Himmelstein, Stevan I; Chambers, Jeff W

2017-06-01

The presence of heavy coronary artery calcification increases the complexity of percutaneous coronary intervention (PCI) and increases the incidence of major adverse cardiac events (MACE): death, myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis. The ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial reported low rates of procedural, 30-day, 1-year, and 2-year ischemic complications after treatment of de novo, severely calcified lesions with the Diamondback 360° Coronary Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc.). ORBIT II was a single-arm trial that enrolled 443 patients at 49U.S. sites; in this study, de novo, severely calcified coronary lesions were treated with OAS prior to stenting. The primary safety endpoint was 30-day MACE: the composite of cardiac death, MI, and TVR (inclusive of target lesion revascularization (TLR)). The primary efficacy endpoint was procedural success: stent delivery with a residual stenosis of atherectomy. There were 360 (81.3%) subjects who completed the protocol-mandated 3-year visit.The overall cumulative rate of 3-year MACE was 23.5%, including cardiac death (6.7%), MI (11.2%), and TVR (10.2%). The 3-year target lesion revascularization rate was 7.8%. In the final 3-year analysis of the ORBIT II trial, orbital atherectomy of severely calcified coronary lesions followed by stenting resulted in a low rate of adverse ischemic events compared with historical controls.Orbital atherectomy represents a safe and effective revascularization strategy for patients with severely calcified coronary lesions. The ORBIT II trial enrolled 443 subjects to study orbital atherectomy followed by stenting for de novo severely calcified coronary lesions. The overall cumulative 3-year MACE rate was 23.5%, including cardiac death (6.7%), MI (11.2%), and TVR (10.2%); the 3-year target lesion revascularization rate was 7.8%. Orbital atherectomy

Clinical trial simulation methods for estimating the impact of DPP-4 inhibitors on cardiovascular disease

Directory of Open Access Journals (Sweden)

Schuetz CA

2015-06-01

Full Text Available Charles Andy Schuetz,1 Siew Hwa Ong,2 Matthias Blüher3 1Evidera Inc., Bethesda, MD, USA; 2Novartis Pharma AG, Basel, Switzerland; 3Department of Medicine, University of Leipzig, Leipzig, Germany Introduction: Dipeptidyl peptidase-4 (DPP-4 inhibitors are a class of oral antidiabetic agents for the treatment of type 2 diabetes mellitus, which lower blood glucose without causing severe hypoglycemia. However, the first cardiovascular (CV safety trials have only recently reported their results, and our understanding of these therapies remains incomplete. Using clinical trial simulations, we estimated the effectiveness of DPP-4 inhibitors in preventing major adverse cardiovascular events (MACE in a population like that enrolled in the SAVOR-TIMI (the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus – Thrombolysis in Myocardial Infarction 53 trial. Methods: We used the Archimedes Model to simulate a clinical trial of individuals (N=11,000 with diagnosed type 2 diabetes and elevated CV risk, based on established disease or multiple risk factors. The DPP-4 class was modeled with a meta-analysis of HbA1c and weight change, pooling results from published trials of alogliptin, linagliptin, saxagliptin, sitagliptin, and vildagliptin. The study treatments were added-on to standard care, and outcomes were tracked for 20 years. Results: The DPP-4 class was associated with an HbA1c drop of 0.66% (0.71%, 0.62% and a weight drop of 0.14 (-0.07, 0.36 kg. These biomarker improvements produced a relative risk (RR for MACE at 5 years of 0.977 (0.968, 0.986. The number needed to treat to prevent one occurrence of MACE at 5 years was 327 (233, 550 in the elevated CV risk population. Conclusion: Consistent with recent trial publications, our analysis indicates that DPP-4 inhibitors do not increase the risk of MACE relative to the standard of care. This study provides insights about the long-term benefits of DPP-4 inhibitors and

Effect of Loading Dose of Atorvastatin Prior to Planned Percutaneous Coronary Intervention on Major Adverse Cardiovascular Events in Acute Coronary Syndrome: The SECURE-PCI Randomized Clinical Trial.

Science.gov (United States)

Berwanger, Otavio; Santucci, Eliana Vieira; de Barros E Silva, Pedro Gabriel Melo; Jesuíno, Isabella de Andrade; Damiani, Lucas Petri; Barbosa, Lilian Mazza; Santos, Renato Hideo Nakagawa; Laranjeira, Ligia Nasi; Egydio, Flávia de Mattos; Borges de Oliveira, Juliana Aparecida; Dall Orto, Frederico Toledo Campo; Beraldo de Andrade, Pedro; Bienert, Igor Ribeiro de Castro; Bosso, Carlos Eduardo; Mangione, José Armando; Polanczyk, Carisi Anne; Sousa, Amanda Guerra de Moraes Rego; Kalil, Renato Abdala Karam; Santos, Luciano de Moura; Sposito, Andrei Carvalho; Rech, Rafael Luiz; Sousa, Antônio Carlos Sobral; Baldissera, Felipe; Nascimento, Bruno Ramos; Giraldez, Roberto Rocha Corrêa Veiga; Cavalcanti, Alexandre Biasi; Pereira, Sabrina Bernardez; Mattos, Luiz Alberto; Armaganijan, Luciana Vidal; Guimarães, Hélio Penna; Sousa, José Eduardo Moraes Rego; Alexander, John Hunter; Granger, Christopher Bull; Lopes, Renato Delascio

2018-04-03

The effects of loading doses of statins on clinical outcomes in patients with acute coronary syndrome (ACS) and planned invasive management remain uncertain. To determine if periprocedural loading doses of atorvastatin decrease 30-day major adverse cardiovascular events (MACE) in patients with ACS and planned invasive management. Multicenter, double-blind, placebo-controlled, randomized clinical trial conducted at 53 sites in Brazil among 4191 patients with ACS evaluated with coronary angiography to proceed with a percutaneous coronary intervention (PCI) if anatomically feasible. Enrollment occurred between April 18, 2012, and October 6, 2017. Final follow-up for 30-day outcomes was on November 6, 2017. Patients were randomized to receive 2 loading doses of 80 mg of atorvastatin (n = 2087) or matching placebo (n = 2104) before and 24 hours after a planned PCI. All patients received 40 mg of atorvastatin for 30 days starting 24 hours after the second dose of study medication. The primary outcome was MACE, defined as a composite of all-cause mortality, myocardial infarction, stroke, and unplanned coronary revascularization through 30 days. Among the 4191 patients (mean age, 61.8 [SD, 11.5] years; 1085 women [25.9%]) enrolled, 4163 (99.3%) completed 30-day follow-up. A total of 2710 (64.7%) underwent PCI, 333 (8%) underwent coronary artery bypass graft surgery, and 1144 (27.3%) had exclusively medical management. At 30 days, 130 patients in the atorvastatin group (6.2%) and 149 in the placebo group (7.1%) had a MACE (absolute difference, 0.85% [95% CI, -0.70% to 2.41%]; hazard ratio, 0.88; 95% CI, 0.69-1.11; P = .27). No cases of hepatic failure were reported; 3 cases of rhabdomyolysis were reported in the placebo group (0.1%) and 0 in the atorvastatin group. Among patients with ACS and planned invasive management with PCI, periprocedural loading doses of atorvastatin did not reduce the rate of MACE at 30 days. These findings do not support the routine use

Implante de Stent guiado por ultrassom intracoronariano melhora desfechos: meta-análise de ensaios randomizados

Directory of Open Access Journals (Sweden)

Graciele Sbruzzi

2012-01-01

Full Text Available FUNDAMENTO: Ultrassom Intracoronariano (USIC tem sido usado como um método auxiliar a fim de otimizar o implante de stents. No entanto, o impacto desse método em alguns resultados é controverso. OBJETIVO: Analisar sistematicamente o impacto dos stents coronarianos guiados por USIC, em comparação com os stents guiados angiograficamente, sobre os resultados clínicos e angiográficos. MÉTODOS: Foi realizada uma busca em bases de dados (MEDLINE, Cochrane CENTRAL, EMBASE e referências de estudos publicados entre 1982 e 2010. Foram incluídos Ensaios Clínicos Randomizados (ECR que compararam o implante de stents coronarianos guiados por angiografia e USIC versus implante de stents coronarianos guiados apenas por angiografia (ANGIO. O seguimento mínimo foi de seis meses e os resultados avaliados foram eventos cardíacos adversos importantes (MACE, Revascularização da Lesão-alvo (RLA e reestenose angiográfica. Dois revisores extraíram os dados de forma independente. Razão de risco sumário e intervalos de confiança de 95% (CI foram calculados com modelos com efeitos aleatórios. A abordagem GRADE foi utilizada para determinar a qualidade geral de evidências para cada resultado. RESULTADOS: Dos 3.631 artigos identificados, oito ECR avaliando um total de 2.341 pacientes foram incluídos. Houve uma redução de 27% na reestenose angiográfica (95% IC: 3% -46% e uma redução de 38% em RLA (95% IC: 17% -53% em favor de USIC versus ANGIO. No entanto, os MACE não foram reduzidos por USIC (RR: 0,79; 95%CI: 0,61-1,03. Os dados MACE representam apenas 47% do tamanho ótimo de informações necessárias para detectar com segurança um efeito de tratamento plausível. CONCLUSÕES: Observamos que o implante de stent coronariano guiado por USIC oferece reduções significativas em RLA e reestenose angiográfica em comparação com implante de stent guiado por angiografia, porém não reduz casos de MACE.

Resistant Hypertension, Patient Characteristics, and Risk of Stroke

Science.gov (United States)

Hung, Chen-Ying; Wang, Kuo-Yang; Wu, Tsu-Juey; Hsieh, Yu-Cheng; Huang, Jin-Long; Loh, El-Wui; Lin, Ching-Heng

2014-01-01

Background Little is known about the prognosis of resistant hypertension (RH) in Asian population. This study aimed to evaluate the impacts of RH in Taiwanese patients with hypertension, and to ascertain whether patient characteristics influence the association of RH with adverse outcomes. Methods and Results Patients aged ≥45 years with hypertension were identified from the National Health Insurance Research Database. Medical records of 111,986 patients were reviewed in this study, and 16,402 (14.6%) patients were recognized as having RH (continuously concomitant use of ≥3 anti-hypertensive medications, including a diuretic, for ≥2 years). Risk of major adverse cardiovascular events (MACE, a composite of all-cause mortality, acute coronary syndrome, and stroke [included both fatal and nonfatal events]) in patients with RH and non-RH was analyzed. A total of 11,856 patients experienced MACE in the follow-up period (average 7.1±3.0 years). There was a higher proportion of females in the RH group, they were older than the non-RH (63.1 vs. 60.5 years) patients, and had a higher prevalence of cardiovascular co-morbidities. Overall, patients with RH had higher risks of MACE (adjusted HR 1.17; 95%CI 1.09–1.26; p<0.001). Significantly elevated risks of stroke (10,211 events; adjusted HR 1.17; 95%CI 1.08–1.27; p<0.001), especially ischemic stroke (6,235 events; adjusted HR 1.34; 95%CI 1.20–1.48; p<0.001), but not all-cause mortality (4,594 events; adjusted HR 1.06; 95%CI 0.95–1.19; p = 0.312) or acute coronary syndrome (2,145 events; adjusted HR 1.17; 95%CI 0.99–1.39; p = 0.070) were noted in patients with RH compared to those with non-RH. Subgroup analysis showed that RH increased the risks of stroke in female and elderly patients. However, no significant influence was noted in young or male patients. Conclusions Patients with RH were associated with higher risks of MACE and stroke, especially ischemic stroke. The risks were greater in female and

Provisional versus elective two-stent strategy for unprotected true left main bifurcation lesions: Insights from a FAILS-2 sub-study.

Science.gov (United States)

Kawamoto, Hiroyoshi; Chieffo, Alaide; D'Ascenzo, Fabrizio; Jabbour, Richard J; Naganuma, Toru; Cerrato, Enrico; Ugo, Fabrizio; Pavani, Marco; Varbella, Ferdinando; Boccuzzi, Giacomo; Pennone, Mauro; Garbo, Roberto; Conrotto, Federico; Biondi-Zoccai, Giuseppe; D'Amico, Maurizio; Moretti, Claudio; Escaned, Javier; Gaita, Fiorenzo; Nakamura, Sunao; Colombo, Antonio

2018-01-01

This study sought to investigate the optimal percutaneous coronary intervention (PCI) strategy for true unprotected left main coronary artery (ULMCA) bifurcations. The FAILS-2 was a retrospective multi-center study including patients with ULMCA disease treated with second-generation drug-eluting stents. Of these, we compared clinical outcomes of a provisional strategy (PS; n=216) versus an elective two-stent strategy (E2S; n=161) for true ULMCA bifurcations. The primary endpoint was the incidence of major adverse cardiac events (MACEs) at 3-years. We further performed propensity-score adjustment for clinical outcomes. There were no significant differences between the groups in terms of patient and lesion characteristics. 9.7% of patients in the PS group crossed over to a provisional two-stent strategy. MACEs were not significantly different between groups (MACE at 3-year; PS 28.1% vs. E2S 28.9%, adjusted p=0.99). The rates of target lesion revascularization (TLR) on the circumflex artery (LCX) were numerically high in the E2S group (LCX-TLR at 3-years; PS 11.8% vs. E2S 16.6%, adjusted p=0.51). E2S was associated with a comparable MACE rate to PS for true ULMCA bifurcations. The rates of LCX-TLR tended to be higher in the E2S group although there was no statistical significance. This study sought to compare the clinical outcomes of a provisional strategy (PS) with an elective two-stent strategy (E2S) for the treatment of true unprotected left main coronary artery bifurcations. 377 Patients (PS 216 vs. E2S 161 patients) were evaluated, and 9.7% in the PS group crossed over to a two-stent strategy. E2S was associated with a similar major adverse cardiac event rate at 3-years when compared to the PS strategy (PS 28.1% vs. E2S 28.9%, p=0.99). However, the left circumflex artery TLR rate at 3-year tended to be higher in the E2S group (PS 11.8% vs. E2S 16.6%, p=0.51). Copyright © 2017 Elsevier B.V. All rights reserved.

Circunferência abdominal como preditor de evolução em 30 dias na síndrome coronariana aguda

Directory of Open Access Journals (Sweden)

Priscilla Azambuja Lopes de Souza

2011-05-01

Full Text Available FUNDAMENTO: A circunferência abdominal (CA é a medida que mais se correlaciona com os fatores de risco e morte por doença cardiovascular. Entretanto, o impacto da obesidade no prognóstico de pacientes com doenças cardiovasculares permanece controverso e requer maiores esclarecimentos. OBJETIVO: Avaliar a CA como preditor de evolução em 30 dias em pacientes que internaram com síndrome coronariana aguda (SCA, em hospital de referência no tratamento de doenças cardiovasculares. MÉTODOS: Coorte contemporânea com 267 pacientes que internaram por SCA e que foram seguidos por 30 dias após a alta levando em consideração os eventos cardiovasculares maiores - MACE - (óbito, reinfarto, reinternação para procedimentos de revascularização. Nas primeiras 24 horas da admissão, os pacientes responderam a um questionário e posteriormente tiveram a CA mensurada. A análise estatística foi realizada com SPSS 17.0, utilizando o teste do Qui-quadrado para variáveis categóricas e o teste t de Student para as variáveis numéricas, com o nível de significância de p < 0,05. As variáveis que apresentaram valores de p < 0,10, na análise bivariada, foram incluídas em um modelo de regressão logística para avaliar o papel da CA como preditor independente de MACE. RESULTADOS: Após análise multivariável, apenas o gênero feminino (RC = 8,86; 95% IC:4,55-17,10; p < 0,00, hipertensão arterial sistêmica (RC = 2,06; 95% IC:1,10-3,87; p = 0,02 e história familiar de cardiopatia isquêmica (RC = 2,10; 95% IC:1,17-3,74; p = 0,01 permaneceram associados com os MACE. CONCLUSÃO: Em nosso estudo, a CA alterada não se associou à maior incidência de MACE em 30 dias de seguimento.

Meteorological influences on coastal new particle formation

NARCIS (Netherlands)

Leeuw, G. de; Kunz, G.J.; Buzorius, G.; O`Dowd, C.D.

2002-01-01

The meteorological situation at the midlatitude coastal station of Mace Head, Ireland, is described based on observations during the New Particle Formation and Fate in the Coastal Environment (PARFORCE) experiments in September 1998 and June 1999. Micrometeorological sensors were mounted near the

Coastal new particle formation: environmental conditions and aerosol physicochemical characteristics during nucleation bursts

NARCIS (Netherlands)

O'Dowd, C.D.; Haemeri, K.; Maekelae, J.M.; Vaekeva, M.; Aalto, P.; Leeuw, G. de; Kunz, G.J.; Becker, E.; Hansson, H-C.; Allen, A.G.; Harrison, R.M.; Berresheim, H.; Kleefeld, C.; Geever, M.; Jennings, S.G.; Kulmala, M.

2002-01-01

Nucleation mode aerosol was characterized during coastal nucleation events at Mace Head during intensive New Particle Formation and Fate in the Coastal Environment (PARFORCE) field campaigns in September 1998 and June 1999. Nucleation events were observed almost on a daily basis during the

Kui kapital veab alt, siis turvaliselt / Aleksander Tsapov

Index Scriptorium Estoniae

Tsapov, Aleksander

2006-01-01

Kuraatorinäitus "Kapital (see veab meid alt)" Tallinna Kunstihoones. Kuraator Simon Sheikh. Fia-Stina Sandlundi, Katya Sanderi, Oliver Ressleri, Ashley Hunti ja Susan Kelly&Stephen Mortoni töödest näitusel

75 FR 29759 - Notice of Open Meeting of the Advisory Committee of the Export-Import Bank of the United States...

Science.gov (United States)

2010-05-27

... building, and you may contact Susan Houser to be placed on an attendee list. If any person wishes auxiliary aids (such as a sign language interpreter) or other special accommodations, please contact, prior to...

African Journal of AIDS Research - Vol 13, No 4 (2014)

African Journals Online (AJOL)

Clemens Ley, Lloyd Leach, María Rato Barrio, Susan Bassett ... Charles Omondi Olang'o, Erick Nyambedha, Jens Aagaard-Hansen ... Bierhuizen, Arlinda Zango, Nienke Veldhuijzen, Fidelina Cumbe, Paul J Feldblum, Janneke van de Wijgert.

ST peak during percutaneous coronary intervention serves as an early prognostic predictor in patients with ST-segment elevation myocardial

DEFF Research Database (Denmark)

Lønborg, Jacob; Kelbæk, Henning; Engstrøm, Thomas

2014-01-01

AIMS: To evaluate the clinical importance of the ST peak phenomenon during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS: Continuous ST monitoring was performed in 942 STEMI patients from arrival until 90...... minutes after revascularisation. ST peak was defined as ≥1 mm increase in the ST-segment during PCI compared with the ST elevation before intervention. ST peak was observed in 26.9% of patients. During median follow-up of 4.1 years, 20.7% of patients experienced a major adverse cardiac event (MACE). ST...... and ST peak including ST resolution and epicardial flow, ST peak remained significantly associated with MACE: adjusted hazard ratio (HR) 1.40 (95% confidence interval [CI] 1.01-1.95) and 1.41 (95% CI: 1.02-1.96). CONCLUSIONS: In the largest study hitherto evaluating the ST peak phenomenon during primary...

Very high energy gamma ray astronomy from Hanle

International Nuclear Information System (INIS)

Chitnis, Varsha R.

2015-01-01

Over a past decade very high energy (VHE) gamma ray astronomy has emerged as a major astronomical discipline. In India, we have a long tradition of experiments in this field. Few years ago, multi-institutional Himalayan Gamma Ray Observatory (HiGRO) collaboration was formed to set up VHE gamma rays experiments at Hanle, a high altitude location in Himalayas. HAGAR, the first phase of this collaboration is operational since 2008. HAGAR has successfully detected VHE gamma ray emission from some of the extragalactic objects like Mrk 421, Mrk 501 as well as galactic sources including Crab nebula/pulsar. Details of HAGAR telescope system and results obtained will be discussed. HiGRO is now gearing up for the next phase, i.e. 21 m diameter MACE telescope, which is being installed at Hanle at present. Details of MACE telescope system and future plans will be discussed. (author)

Effect of gamma-irradiation on the phenolic acids of some Indian spices

International Nuclear Information System (INIS)

Variyar, P.S.; Bandyopadhyay, C.; Thomas, P.

1998-01-01

Five commercially important spices, namely cinnamon, clove, cardamom, nutmeg and mace, were subjected to gamma-irradiation using a dose of 10 kGy, which is recommended for microbial decontamination. Various phenolic acids present in these spices were analysed by high-performance liquid chromatography (HPLC). In clove and nutmeg, quantitatively significant changes were noted in some of the phenolic acids upon irradiation. The content of gallic and syringic acids in irradiated clove increased by 2.2- and 4.4-fold respectively, whereas in irradiated nutmeg many of the phenolic acids showed wide increases and decreases in the range of two- to sixfold compared with the control samples. No qualitative and major quantitative changes were, however, observed in the phenolic acids of cinnamon, cardamom and mace upon irradiation. The possibility that gamma-radiation induced breakdown of tannins could be responsible for the changes in phenolic acids content of clove and nutmeg is discussed

A method of camera calibration with adaptive thresholding

Science.gov (United States)

Gao, Lei; Yan, Shu-hua; Wang, Guo-chao; Zhou, Chun-lei

2009-07-01

In order to calculate the parameters of the camera correctly, we must figure out the accurate coordinates of the certain points in the image plane. Corners are the important features in the 2D images. Generally speaking, they are the points that have high curvature and lie in the junction of different brightness regions of images. So corners detection has already widely used in many fields. In this paper we use the pinhole camera model and SUSAN corner detection algorithm to calibrate the camera. When using the SUSAN corner detection algorithm, we propose an approach to retrieve the gray difference threshold, adaptively. That makes it possible to pick up the right chessboard inner comers in all kinds of gray contrast. The experiment result based on this method was proved to be feasible.

Configurações do discurso machista na internet: O blog "Testosterona" e os embates ideológicos na era digital

Directory of Open Access Journals (Sweden)

Marianna Michelle Medina

2018-04-01

Full Text Available No presente trabalho, propõe-se uma leitura crítica do blog Testosterona, observando como ocorre a descrição das características femininas, reduzindo-as a uma classificação unívoca, de acordo com o ponto de vista pretensamente masculino e hegemônico. Para tal análise, utiliza-se as teorizações de Susan Faludi, Elisabeth Badinter e Simone Beauvoir. Palavras-chave: Ideologia; Discurso; Machismo. -------------------------------------------- In this paper, we propose a critical reading of the blog Testosterona, watching as the description of the female characteristics occurs, reducing women to a univocal classification in accordance with the masculine and hegemonic viewpoint allegedly. For this analysis, we use the theories of Susan Faludi, Elisabeth Badinter and Simone Beauvoir. Keywords: Ideology; Speech; Machismo.

Incidence of adverse cardiac events 5 years after polymer-free sirolimus eluting stent implantation: Results from the prospective Bad Berka Yukon Choice™ registry.

Science.gov (United States)

Ohlow, Marc-Alexander; von Korn, Hubertus; Gunkel, Oliver; Farah, Ahmed; Fuhrmann, Joerg T; Lauer, Bernward

2014-12-01

Drug-eluting stents (DES) constitute a major achievement in preventing re-stenosis, concerns remain regarding the increased inflammatory responses associated with the polymers used. This analysis focuses on outcomes in patients receiving the polymer-free sirolimus-eluting stent system YUKON-Choice (Yukon-DES, Translumina, Germany). From 01/2006-09/2008 all patients receiving Yukon-DES (≥2.5 mm diameter) were prospectively enrolled in our registry. The primary endpoint was long-term major adverse cardiac events (MACE). 701 patients were included in our registry. Mean age was 65.7 ± 10 years (73% male gender, 35.5% diabetes, and 32.2% acute coronary syndrome). 76% of the lesions were of Type B2/C. Lesion length was 24.6 ± 5.2 mm and mean stent diameter was 2.8 ± 0.4 mm. A total of 511 pts (72%) underwent 6-months angiographic follow-up, target vessel revascularization was noted in 23.5%. At 5 years clinical outcomes were: cardiac death 5.8%; myocardial infarction 3.4%; and TVR 24.6%. The incidence of MACE differed significantly between "on-label" and "off-label" indications (14.8% vs. 40.8% MACE; P 1 year) ST occurred in 0.29%. Our data suggests that the implantation of the sirolimus-coated polymer-free YUKON-DES is safe and feasible with a very low incidence of ST in this real world patient cohort with high percentage of diabetes and small vessels. © 2013 Wiley Periodicals, Inc.

Aerosol light absorption in the North Atlantic: trends and seasonal characteristics during the period 1989 to 2003

Directory of Open Access Journals (Sweden)

C. Junker

2006-01-01

Full Text Available Aerosol light attenuation on quartz fibre filters has been measured since February 1989 at the Mace Head Atmospheric Research station near Carna, Co. Galway, Ireland, using an Aethalometer. The frequency of occurrence of the hourly averaged aerosol absorption data is found to be bimodally distributed. The two modes result from clean marine air and anthropogenically polluted continental air both being advected to the station dependent on the prevailing wind direction. The hourly averages of the marine portion of the aerosol light absorption are found to follow closely a lognormal distribution with a geometric mean of 0.310 Mm-1. The hourly averages of continental sector aerosol absorption are neither normally nor lognormally distributed and have an arithmetic mean of 6.36 Mm-1, indicating the presence of anthropogenic sources for BC east of the Mace Head station. The time series of the monthly averaged attenuation coefficient σatt of both marine and continental sector aerosol shows an increase from 1989 to 1997 and a levelling off thereafter. The monthly maximum of marine sector σatt is found in May. Trend and seasonal characteristics of the clean marine aerosol attenuation coefficients observed at Mace Head appear to be driven by meteorological factors, as indicated by rainfall data and by trends in the North Atlantic Oscillation (NAO indices. The observed increasing trends of the continental sector σatt from 1989 up to 1997 are possibly related to changes in BC emissions over Ireland, calculated from UNSTAT (2002 fuel consumption data.

Prognostic Value of MicroRNAs in Coronary Artery Diseases: A Meta-Analysis.

Science.gov (United States)

Kim, Ji Suk; Pak, Kyoungjune; Goh, Tae Sik; Jeong, Dae Cheon; Han, Myoung Eun; Kim, Jihyun; Oh, Sae Ock; Kim, Chi Dae; Kim, Yun Hak

2018-06-01

Coronary artery diseases (CADs) are the leading causes of death in the world. Recent studies have reported that differentially expressed microRNAs (miRNAs) are associated with prognosis or major adverse cardiac events (MACEs) in CAD patients. In a previous meta-analysis, the authors made serious mistakes that we aimed to correct through an updated systematic review and meta-analysis of the prognostic value of altered miRNAs in patients with CADs. We performed a systematic search of MEDLINE (from inception to May 2017) and EMBASE (from inception to May 2017) for English-language publications. Studies of CADs with results on miRNAs that reported survival data or MACEs were included. Data were extracted from each publication independently by two reviewers. After reviewing 515 articles, a total eight studies were included in this study. We measured pooled hazard ratios (HRs) and 95% confidence intervals (CIs) of miRNA 133a with a fixed-effect model (pooled HR, 2.35; 95% CI, 1.56-3.55). High expression of miRNA 133a, 208b, 126, 197, 223, and 122-5p were associated with high mortality. Additionally, high levels of miRNA 208b, 499-5p, 134, 328, and 34a were related with MACEs. The present study confirmed that miRNA 133a, which was associated with high mortality in CAD patients, holds prognostic value in CAD. More importantly, this study corrected issues raised against a prior meta-analysis and provides accurate information. © Copyright: Yonsei University College of Medicine 2018.

Added prognostic value of ischaemic threshold in radionuclide myocardial perfusion imaging: a common-sense integration of exercise tolerance and ischaemia severity

Energy Technology Data Exchange (ETDEWEB)

Marini, Cecilia [IRCCS AOU San Martino-National Institute for Cancer Research, CNR Institute of Bioimaging and Molecular Physiology, Section of Genoa c/o Nuclear Medicine, Pad. Sommariva, Genoa (Italy); Acampa, Wanda [National Council of Research, Naples (Italy); Bauckneht, Matteo; Capitanio, Selene; Fiz, Francesco; Dib, Bassam; Sambuceti, Gianmario [University of Genoa, IRCCS-AOU San Martino-National Institute for Cancer Research, Nuclear Medicine, Department of Health Science, Genoa (Italy); Daniele, Stefania; Cantoni, Valeria; Zampella, Emilia; Assante, Roberta; Cuocolo, Alberto [University Federico II, Nuclear Medicine, Naples (Italy); Bruzzi, Paolo [IRCCS AOU San Martino-National Institute for Cancer Research, Epidemiology Unit, Genoa (Italy)

2015-04-01

Reversible ischaemia at radionuclide myocardial perfusion imaging (MPI) accurately predicts risk of cardiac death and nonfatal myocardial infarction (major adverse cardiac events, MACE). This prognostic penetrance might be empowered by accounting for exercise tolerance as an indirect index of ischaemia severity. The present study aimed to verify this hypothesis integrating imaging assessment of ischaemia severity with exercise maximal rate pressure product (RPP) in a large cohort of patients with suspected or known coronary artery disease (CAD). We analysed 1,502 consecutive patients (1,014 men aged 59 ± 10 years) submitted to exercise stress/rest MPI. To account for exercise tolerance, the summed difference score (SDS) was divided by RPP at tracer injection providing a clinical prognostic index (CPI). Reversible ischaemia was documented in 357 patients (24 %) and was classified by SDS as mild (SDS 2-4) in 180, moderate (SDS 5-7) in 118 and severe (SDS >7) in 59. CPI values of ischaemic patients were clustered into tertiles with lowest and highest values indicating low and high risk, respectively. CPI modified SDS risk prediction in 119/357 (33 %) patients. During a 60-month follow-up, MACE occurred in 68 patients. Kaplan-Meier analysis revealed that CPI significantly improved predictive power for MACE incidence with respect to SDS alone. Multivariate Cox analysis confirmed the additive independent value of CPI-derived information. Integration of ischaemic threshold and ischaemia extension and severity can improve accuracy of exercise MPI in predicting long-term outcome in a large cohort of patients with suspected or known CAD. (orig.)

1. IV avati Tallinna Kunstihoone galeriis šoti videokunstinäitus "Nähtamatud väljad"

Index Scriptorium Estoniae

2004-01-01

Kuraatorid Sarah Felton ja Su Grierson, osalevad kunstnikud Victoria Clare Bernie, Samantha Clark, Maria Doyle, S. Felton, S. Grierson, Belinda Guidi, Anne Bjerge Hansen, Metacorpus, Jane McInally, Rosalind Nashashibi, Susannah Silver ja Susan Sloan

78 FR 45538 - The Patient Preference Initiative: Incorporating Patient Preference Information Into the Medical...

Science.gov (United States)

2013-07-29

... beginning at 7 a.m. If you need special accommodations due to a disability, please contact Susan Monahan... within the Total Product Life Cycle regulatory paradigm? In what ways should it not be used? What...

78 FR 16675 - First Technology Transitions; Policy Task Force Workshop

Science.gov (United States)

2013-03-18

..., please submit name and company affiliation ahead of time by sending an email to susan[email protected] allow time to go through our security process. Lunch: Attendees may pre-order lunch, to be picked up by...

77 FR 51845 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

Science.gov (United States)

2012-08-27

.... Miska (MN), Susan L. Mosel (WI), Mark T. L. Owings (KS), Jacob D. Oxford (ID), Derek W. Palmer (MA), Robert D. Regavich (NJ), Jack W. Schlichting (MN), Lonnie H. Shere (WA), Craig A. Trimmer (OH), Lisa E...

Matrix modulation of the toxicity of alkenylbenzenes, studied by an integrated approach using in vitro, in vivo, and physiologically based biokinetic models

NARCIS (Netherlands)

Al-Husainy, W.A.A.M.

2013-01-01

Alkenylbenzenes such as estragole and methyleugenol are common components of spices and herbs such as tarragon, basil, fennel, mace, allspice, star anise and anise and their essential oils (Smithet al., 2002). There is an interest in the safety evaluation of alkenylbenzenes because

Outcomes after revascularisation with everolimus- and sirolimus-eluting stents in patients with acute coronary syndromes and stable angina pectoris

DEFF Research Database (Denmark)

Antonsen, Lisbeth; Thayssen, Per; Hansen, Henrik S

2014-01-01

): cardiac death, myocardial infarction (MI), stent thrombosis, or target vessel revascularisation within 18 months. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for the endpoints. At 18-month follow-up, patients with ACS had higher rates of MACE compared to patients with SAP (8...

MR-proANP improves prediction of mortality and cardiovascular events in patients with STEMI

DEFF Research Database (Denmark)

Lindberg, Søren; Jensen, Jan Skov; Pedersen, Sune H

2015-01-01

drawn immediately before PCI. Plasma MR-proANP was measured using an automated processing assay. Endpoints were all-cause mortality (n = 137) and the combined endpoint (n = 170) of major adverse cardiovascular events (MACE) defined as cardiovascular mortality and admission due to recurrent MI, ischaemic...

Current but not past smoking increases the risk of cardiac events: Insights from coronary computed tomographic angiography

NARCIS (Netherlands)

R. Nakanishi (Rine); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); H. Gransar (Heidi); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor Y.); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.C. Cury (Ricardo); A. Delago (Augustin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); F.Y. Lin (Fay); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); T.C. Villines (Todd); A. Dunning (Allison); J.K. Min (James)

2015-01-01

textabstractAims We evaluated coronary artery disease (CAD) extent, severity, and major adverse cardiac events (MACEs) in never, past, and current smokers undergoing coronary CT angiography (CCTA). Methods and results We evaluated 9456 patients (57.1 ± 12.3 years, 55.5% male) without known CAD (1588

Prediction of clinical outcome by myocardial CT perfusion in patients with low-risk unstable angina pectoris

DEFF Research Database (Denmark)

Linde, Jesper J; Sørgaard, Mathias; Kühl, Jørgen T

2017-01-01

The prognostic implications of myocardial computed tomography perfusion (CTP) analyses are unknown. In this sub-study to the CATCH-trial we evaluate the ability of adenosine stress CTP findings to predict mid-term major adverse cardiac events (MACE). In 240 patients with acute-onset chest pain, y...

Toussaint y Hegel. Lecciones desde Abya Yala; Toussaint e Hegel. Lições de Abya Yala; Toussaint and Hegel. Lessons from Abya Yala

Directory of Open Access Journals (Sweden)

Abdiel Rodríguez Reyes

2017-01-01

Full Text Available Resumen: Nos parece sugerente la hipótesis de Susan Buck-Morss en su libro Hegel, Haití y la historia universal, nos invita a reflexionar en torno a la relación entre Hegel y las experiencias revolucionarias en Abya Yala. En éste artículo queremos ver ésta relación y otras más, en donde las experiencias y recursos de Abya Yala sirvieron para el desarrollo de Occidente. Palabras clave: pensamiento, Américas, filosofía, racismo, revolución   Resumo: Parece hipótese sugestiva de Susan Buck-Morss em seu livro “Hegel, Haiti e História do Mundo”, nos convida a refletir sobre a relação entre Hegel e experiências revolucionárias em Abya Yala. Neste artigo vamos ver esse relacionamento e outros, onde as experiências e recursos de Abya Yala serviu para o desenvolvimento do Ocidente. Palavras-chaves: pensamento, Américas, filosofia, racismo, revolução.   Abstract: We are tempted by the hypothesis of Susan Buck-Morss in her book Hegel, Haiti and universal history, which invites us to reflect on the relationship between Hegel and the revolutionary experiences in Abya Yala. In this article we want to see this relationship and others in which the experiences and resources of Abya Yala served for the development of the West. Key words: thinking, Americas, philosophy, racism, revolution.

Clinical evaluation of domestic biodegradable drug-eluting stents in the treatment of coronary heart disease

International Nuclear Information System (INIS)

Yu Hongying; Suo Chuantao; Shang Ruiping

2009-01-01

Objective: To evaluate the safety and efficacy of domestic biodegradable drug-eluting stent, EXCEL, in clinical treatment of coronary heart disease. Methods: During the period of Jan. 2008-Oct. 2008, 100 patients with coronary heart disease who consented to PCI and postoperative coronary angiography were selected and enrolled in the study. The patients were divided into EXCEL group (n = 58) and Cypher group (n = 42). The immediate successful rate of interventional therapy and the complications occurred during hospitalization were observed. Postoperative follow-up and checkup coronary angiography were conducted. Results: No significant difference in the relevant clinical data, in the number and type of diseased coronary branch and in the mean length of implanted stents existed between two groups. Also, no statistically significant difference in the occurrence of major adverse cardiac event (MACE), in-stent restenosis and thrombosis was present between two groups. Conclusion: Compared with Cypher stenting, EXCEL stenting carries similar, i.e. rather low, occurrence of MACE and in-stent restenosis. (authors)

Tritium source-related systematic uncertainties of the KATRIN experiment

Energy Technology Data Exchange (ETDEWEB)

Seitz-Moskaliuk, Hendrik [Karlsruher Institut fuer Technologie, Institut fuer experimentelle Kernphysik, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany); Collaboration: KATRIN-Collaboration

2016-07-01

KATRIN will perform a direct, kinematics-based measurement of the neutrino mass with a sensitivity of 200 meV (90 % C. L.) reached after 3 years of measurement time. The neutrino mass is obtained by determining the shape of the spectrum of tritium β decay electrons close to the endpoint of 18.6 keV with a spectrometer of MAC-E filter type. To achieve the planned sensitivity, the systematic measurement uncertainties have to be carefully controlled and evaluated. Main sources of systematics are the MAC-E filter on the one hand and the source and transport section (STS) on the other hand. Most of the operational parameters of KATRIN have to be stable at or even below the per mille level and have to meet further strict requirements. This talk reviews the KATRIN systematics with a special focus on the STS. Early commissioning measurements to determine the main systematics are introduced.

Newest results from the Mainz neutrino-mass experiment

International Nuclear Information System (INIS)

Bonn, J.; Bornschein, B.; Bornschein, L.; Fickinger, L.; Kraus, Ch.; Otten, E.W.; Ulrich, H.; Weinheimer, Ch.; Kazachenko, O.; Kovalik, A.

2000-01-01

The Mainz neutrino-mass experiment investigates the endpoint region of the tritium β-decay spectrum with a MAC-E spectrometer to determine the mass of the electron antineutrino. By the recent upgrade, the former problem of dewetting T 2 films has been solved, and the signal-to-background ratio was improved by a factor of 10. The latest measurement leads to m ν 2 -3.7 ± 5.3(stat.) ± 2.1(syst.) eV 2 /c 4 , from which an upper limit of m ν 2 (95% C.L.) is derived. Some indication for the anomaly, reported by the Troitsk group, was found, but its postulated half-year period is contradicted by our data. To push the sensitivity on the neutrino mass below 1 eV/c 2 , a new larger MAC-E spectrometer is proposed. Besides its integrating mode, it could run in a new nonintegration operation MAC-E-TOF mode

Relationship between admission blood glucose level and prognosis in elderly patients without previously known diabetes who undergo emergency non-cardiac surgery.

Science.gov (United States)

Ma, Jinling; He, Lei; Wang, Xiujie; Gao, Meng; Zhao, Yuexiang; Liu, Jie

2015-08-01

Elevated blood glucose levels on admission are important as a marker for adverse events in patients who undergo surgery. This study aims to evaluate the relationship between admission glucose level and adverse outcome during the 30-day follow-up period in elderly patients without previously known diabetes who undergo emergency non-cardiac surgery. The primary and secondary end points were all-cause and major adverse cardiac event (MACE) mortalities, respectively, during the 30-day postoperative follow-up period. Higher 30-day all-cause (24.1 %) and MACE (13.7 %) mortalities were observed in patients with an admission glucose ≥ 11.1 mmol/L than in patients with admission glucose blood glucose level is an independent predictor for the development of the 30-day all-cause mortality [odds ratio (OR), 1.91; 95 % confidence interval (CI), 1.746-2.082; p blood glucose level ≥ 11.1 mmol/L has worse event-free survival than an admission blood glucose level <11.1 mmol/L.

Change of trace elements content in sewage water under the influence of hydrophilic macrophytes

International Nuclear Information System (INIS)

Akhmed-Ogly, K V; Savichev, O G

2014-01-01

According to the researches carried out by authors in 2013, the estimate of the effectiveness of domestic sewage treatment with the help of hydrophilic vegetation was received. It has been shown that if sewage is treated with the help of macrophytes, copper and lead concentration reduces. Thus, if the volume of sewage treated by reed mace is 500 ml and 1 l, lead concentration decreases 5 and 3,5 times, if sewage is treated by reed, lead concentration decreases 2,5 times in both cases; if sewage is treated by reed mace copper concentration decreases 0,9 and 1,8 times (if the volume of sewage is 500 ml and 1 l), if sewage is treated by reed, copper concentration decreases 1,4 and 1,5 times respectively. The conclusion has been drawn: in West Siberia it is possible to use the shallow reservoirs with natural aeration and hydrophilic vegetation for effective sewage treatment from such heavy metals as lead and copper

Is Children's Programming Improving?

Science.gov (United States)

Potter, Rosemary Lee

1979-01-01

Susan Futterman, a former teacher and early childhood specialist for Action for Children's Television, comments on changing formats for children's programs, as well as on the role of educators in using television as a learning vehicle. (Editor/KC)

75 FR 46938 - Ocean Transportation Intermediary License Applicants

Science.gov (United States)

2010-08-04

... Logistics LLC (NVO), 120 S. Woodland Blvd., 216, DeLand, FL 32720, Officers: Dietmar Lutte, Manager Member, (Qualifying Individual), Susan Lutte, Member, Application Type: New NVO License. Bridgeline Logistics..., (Qualifying Individual), Application Type: New OFF License. [[Page 46939

Sexual Health Concerns in Patients with Cardiovascular Disease

Science.gov (United States)

... Patient Page Sexual Health Concerns in Patients With Cardiovascular Disease Lindsey Rosman , John M. Cahill , Susan L. McCammon , ... and difficulty achieving and maintaining an erection. 2 Cardiovascular disease and its treatment may also affect a man’s ...

TB in Wild Asian Elephants

Centers for Disease Control (CDC) Podcasts

2017-05-10

Dr. Susan Mikota, co-founder of Elephant Care International, discusses TB in wild Asian elephants.  Created: 5/10/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 5/10/2017.

75 FR 37990 - Airworthiness Directives; Ontic Engineering and Manufacturing, Inc. Propeller Governors, Part...

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2010-07-01

...-mail: Bill.nolan@ontic.com ; telephone (818) 725-2323; fax (818) 725-2535; or e-mail: [email protected] 91311, e-mail: Bill.nolan@ontic.com ; telephone (818) 725-2323; fax (818) 725-2535; or e-mail: Susan...

Isast, Pojast ja Pühast Arhitektuurist / Toivo Tammik

Index Scriptorium Estoniae

Tammik, Toivo

2006-01-01

Dokumentaalfilmist Saaremaalt pärit ameerika arhitektist Louis Kahnist "My Architect : A Son's Journey" (režissöör Nathaniel Kahn, produtsent Susan Behr, USA, 2003, 116 min.) ja viibimisest Philadelphias seoses Louis Kahni päevade ettevalmistamisega

77 FR 64794 - Membership of the Economic Development Administration Performance Review Board

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2012-10-23

... INFORMATION CONTACT: Ronda L. Holbrook, U.S. Department of Commerce, Human Resources Operations Center... Management, Minority Business Development Agency, career. Dated: October 11, 2012. Susan Boggs, Director, Office of Staffing, Recruitment and Classification, Department of Commerce Human Resources Operations...

76 FR 72013 - Self-Regulatory Organizations; Municipal Securities Rulemaking Board; Notice of Filing of...

Science.gov (United States)

2011-11-21

...''); Colette J. Irwin-Knott, CIPFA, President, National Association of Independent Public Finance Advisors...''); and Susan Gaffney, Director, Federal Liaison Center, Government Finance Officers Association, dated... principles of trade, to foster cooperation and coordination with persons engaged in regulating, clearing...

AFSC/RACE/MACE: Results of 2012 Chukchi Sea Acoustic/Trawl Survey

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — We conducted acoustic-trawl (AT) surveys of the Alaska northern Bering and Chukchi Seas during ice-free periods with a focus on Arctic cod (Boreogadus saida), a key...

Long-termserial non-invasive multislice computed tomography angiography with functional evaluation after coronary implantation of a bioresorbable everolimus-eluting scaffold: the ABSORB cohort BMSCT substudy

NARCIS (Netherlands)

Onuma, Yoshinobu; Collet, Carlos; van Geuns, Robert-Jan; de Bruyne, Bernard; Christiansen, Evald; Koolen, Jacques; Smits, Pieter; Chevalier, Bernard; McClean, Dougal; Dudek, Dariusz; Windecker, Stephan; Meredith, Ian; Nieman, Koen; Veldhof, Susan; Ormiston, John; Serruys, Patrick W.

2017-01-01

Aims Multimodality invasive imaging of the first-in-man cohort demonstrated at 5 years stable lumen dimensions and a low rate of major adverse cardiac events (MACE). However, the long-term non-invasive assessment of this device remains to be documented. The objective was to describe the 72-month

A guide to innovation in informal settings | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

2012-11-06

Nov 6, 2012 ... Innovation in Informal Settings: A Research Agenda by Susan Cozzens and Judith Sutz presents a framework that can be used by researchers, ... will find this theoretical guide useful as it explores the five criteria of innovation: ...

78 FR 69885 - NASA Advisory Council; Aeronautics Committee; Meeting

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2013-11-21

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice: 13-133] NASA Advisory Council; Aeronautics... Aeronautics and Space Administration announces a meeting of the Aeronautics Committee of the NASA Advisory... INFORMATION CONTACT: Ms. Susan L. Minor, Executive Secretary for the Aeronautics Committee, NASA Headquarters...

Käsk number üks - saavutada täiskontroll - on täidetud / Toomas Hendrik Ilves

Index Scriptorium Estoniae

Ilves, Toomas Hendrik, 1953-

2006-01-01

Raamatuarvustus: Baker, Peter; Glasser, Susan. Kremlin Rising: Vladimir Putin's Russia and the End of Revolution. New York: Scribner, 2005. Raamatu autorid on USA ajalehe Washington Post Moskva korrespondendid. Arvustus ilmunud ka: Sirp : Diplomaatia 7. okt. 2005 nr. 25, lk. 14-15

Prevención de tabaquismo en mujeres adolescentes /

OpenAIRE

Calleja Bello, Nazira sustentante.

2009-01-01

 tesis que para obtener el grado de Doctor en Psicología, presenta Nazira Calleja Bello ; asesor Susan Pick Steiner. 296 páginas : ilustraciones. Doctorado en Psicología UNAM, Facultad de Psicología, 2009

Clinical outcomes associated with per-operative discontinuation of aspirin in patients with coronary artery disease: A systematic review and meta-analysis.

Science.gov (United States)

Luni, Faraz Khan; Riaz, Haris; Khan, Abdur Rahman; Riaz, Talha; Husnain, Muhammad; Riaz, Irbaz Bin; Khan, Muhammad Shahzeb; Taleb, Mohammed; Kanjwal, Yusuf; Cooper, Christopher J; Khuder, Sadik A

2017-06-01

Postoperative state is characterized by increased thrombotic risk by virtue of platelet activation. Whether aspirin ameliorates this risk in patients with established coronary artery disease undergoing cardiac or noncardiac surgery is unknown. We conducted a systematic review and meta-analysis to compare the risk of major adverse cardiac events (MACE) and the risk of bleeding in patients with early (3-5 or more days before surgery) vs. late discontinuation(aspirin. Multiple databases were searched from inception of these databases until March 2015 to identify studies that reported discontinuation of aspirin in patients undergoing surgery. The outcomes measured were all cause mortality, nonfatal myocardial infarction and other relevant thrombotic events (MACE) which also may include, fatal and nonfatal MI, stent thrombosis and restenosis, stroke, perioperative cardiovascular complications (heart failure, MI, VTE, acute stroke) and perioperative bleeding during the perioperative period to up to 30 days after surgery. A total of 1,018 titles were screened, after which six observational studies met the inclusion criteria. Our analysis suggests that there is no difference in MACE with planned discontinuation of aspirin (OR = 1.17, 95% CI = 0.76-1.81; P = 0.05; I 2  = 55%). Early discontinuation of aspirin showed a decreased risk of peri-operative bleeding (OR 0.82, 95% CI = 0.67-0.99; P = 0.04; I 2  = 42%). Our analysis suggests that planned short-term discontinuation in the appropriate clinical setting appears to be safe in the correct clinical setting with no increased risk of thrombotic events and with a decreased risk of bleeding. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Effect of PlA1/A2 glycoprotein IIIa gene polymorphism on the long-term outcome after successful coronary stenting

Directory of Open Access Journals (Sweden)

Riddell John

2007-11-01

Full Text Available Abstract Aim To prospectively determine the role of platelet glycoprotein IIIa (GP IIIa gene PlA1/PlA2 polymorphism on the long-term clinical outcome in patients with coronary artery disease undergoing coronary stenting. Design and setting Prospective observational study in the University Hospital of Caen (France. Patients and methods 1 111 symptomatic consecutive Caucasian patients treated with percutaneous coronary intervention including stent implantation underwent genotyping for GP IIIa PlA1/A2. Main outcome measures Long-term clinical outcome in terms of the rate of major adverse cardiac events (MACE, ie death from any cause, non-fatal Q wave or non Q wave myocardial infarction, and need for coronary revascularisation was obtained and subsequently stratified according to the GP IIIa PlA1/A2 polymorphism. Results Three groups of patients were determined according to the GP IIIa PlA1/A2 polymorphism (71.6% had the A1/A1, 25.8% had the A1/A2 and 2.6% had the A2/A2 genotype. These three groups were comparable for all clinical characteristics including sex ratio, mean age, vascular risk factors, previous coronary events, baseline angiographic exam, indication for the percutaneous coronary intervention and drug therapy. The incidence of MACE was similar in these 3 groups of patients during a mean follow-up period of 654+/-152 days. Independent risk factors for MACE were a left ventricular ejection fraction Conclusion The GP IIIa PlA1/A2 polymorphism does not influence the clinical long-term outcome in patients with symptomatic coronary disease undergoing percutaneous coronary intervention with stent implantation.

Long term outcomes of new generation drug eluting stents versus coronary artery bypass grafting for multivessel and/or left main coronary artery disease. A Bayesian network meta-analysis of randomized controlled trials.

Science.gov (United States)

Mina, George S; Watti, Hussam; Soliman, Demiana; Shewale, Anand; Atkins, Jessica; Reddy, Pratap; Dominic, Paari

2018-01-05

Most data guiding revascularization of multivessel disease (MVD) and/or left main disease (LMD) favor coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI). However, those data are based on trials comparing CABG to bare metal stents (BMS) or old generation drug eluting stents (OG-DES). Hence, it is essential to outcomes of CABG to those of new generation drug eluting stents (NG-DES). We searched PUBMED and Cochrane database for trials evaluating revascularization of MVD and/or LMD with CABG and/or PCI. A Bayesian network meta-analysis was performed to calculate odds ratios (OR) and 95% credible intervals (CrI). Primary outcome was major adverse cardiovascular events (MACE) at 3-5 years. Secondary outcomes were mortality, cerebrovascular accidents (CVA), myocardial infarction (MI) and repeat revascularization. We included 10 trials with a total of 9287 patients. CABG was associated with lower MACE when compared to BMS or OG-DES. However, MACE was not significantly different between CABG and NG-DES (OR 0.79, CrI 0.45-1.40). Moreover, there were no significant differences between CABG and NG-DES in mortality (OR 0.78, CrI 0.45-1.37), CVA (OR 0.93 CrI 0.35-2.2) or MI (OR 0.6, CrI 0.17-2.0). On the other hand, CABG was associated with lower repeat revascularization (OR 0.55, CrI 0.36-0.84). Our study suggests that NG-DES is an acceptable alternative to CABG in patients with MVD and/or LMD. However, repeat revascularization remains to be lower with CABG than with PCI. Copyright © 2018. Published by Elsevier Inc.

Optimal percutaneous coronary intervention in patients with ST-elevation myocardial infarction and multivessel disease: An updated, large-scale systematic review and meta-analysis.

Science.gov (United States)

Nguyen, An Vu; Thanh, Le Van; Kamel, Mohamed Gomaa; Abdelrahman, Sara Attia Mahmoud; El-Mekawy, Mohamed; Mokhtar, Mohamed Ashraf; Ali, Aya Ashraf; Hoang, Nam Nguyen Nho; Vuong, Nguyen Lam; Abd-Elhay, Fatma Abd-Elshahed; Omer, Omer Abdelbagi; Mohamed, Ahmed Abdou; Hirayama, Kenji; Huy, Nguyen Tien

2017-10-01

Our study aimed to compare three different percutaneous coronary intervention (PCI) approaches: culprit-only (COR) and complete (CR) revascularization - categorizing into immediate (ICR) or staged (SCR). We searched 13 databases for randomized controlled trials. Articles were included if they compared at least two strategies. To have more studies in each analysis, an adjusted analysis was performed using person-years to incorporate follow-up durations and obtain pooled rate ratios (RR), with their corresponding 95% confidence interval. Thirteen trials were included with a population of 2830 patients. COR significantly increased major adverse cardiac event (MACE) (adjusted RR 1.67, 95% CI: 1.27-2.19) and repeat revascularization (2.12, 1.67-2.69), which was driven by repeat PCI, without any difference in all-cause mortality and myocardial infarction (MI) compared to CR. When categorizing CR into SCR and ICR, the trend repeated with COR increased MACE (1.99, 1.53-2.6 for ICR), cardiovascular mortality (2.06, 1.07-3.96 for ICR), MI for ICR (1.72, 1.04-2.86), repeat revascularization and repeat PCI for both ICR and SCR. Non-cardiovascular mortality, stroke, nephropathy, re-hospitalization, stent thrombosis and bleeding were similar among all approaches. In MVD-STEMI patients, CR is better than COR in terms of MACE, cardiovascular mortality, repeat revascularization with no difference in safety outcomes. There was a trend towards to a reduction of cardiovascular mortality and MI in ICR compared to SCR when each matched with COR; even though there is no statistically significant difference between ICR and SCR when compared together. Copyright © 2017 Elsevier B.V. All rights reserved.

Relative associations between depression and anxiety on adverse cardiovascular events: does a history of coronary artery disease matter? A prospective observational study.

Science.gov (United States)

Pelletier, Roxanne; Bacon, Simon L; Arsenault, André; Dupuis, Jocelyn; Laurin, Catherine; Blais, Lucie; Lavoie, Kim L

2015-12-15

To assess whether depression and anxiety increase the risk of mortality and major adverse cardiovascular events (MACE), among patients with and without coronary artery disease (CAD). DECADE (Depression Effects on Coronary Artery Disease Events) is a prospective observational study of 2390 patients referred at the Montreal Heart Institute. Patients were followed for 8.8 years, between 1998 and 2009. Depression and anxiety were assessed using a psychiatric interview (Primary Care Evaluation of Mental Disorders, PRIME-MD). Outcomes data were obtained from Quebec provincial databases. All-cause mortality and MACE. After adjustment for covariates, patients with depression were at increased risks of all-cause mortality (relative risk (RR)=2.84; 95% CI 1.25 to 6.49) compared with patients without depression. Anxiety was not associated with increased mortality risks (RR=0.86; 95% CI 0.31 to 2.36). When patients were stratified according to CAD status, depression increased the risk of mortality among patients with no CAD (RR=4.39; 95% CI 1.12 to 17.21), but not among patients with CAD (RR=2.32; 95% CI 0.78 to 6.88). Neither depression nor anxiety was associated with MACE among patients with or without CAD. Depression, but not anxiety, was an independent risk factor for all-cause mortality in patients without CAD. The present study contributes to a better understanding of the relative and unique role of depression versus anxiety among patients with versus without CAD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Two-year follow-up of percutaneous coronary intervention using EucaTax or Cypher

International Nuclear Information System (INIS)

Shuvalova, Yulia A.; Shirokov, Roman O.; Kaminnaya, Violetta I.; Samko, Anatoliy N.; Kaminnyi, Alexander I.

2013-01-01

Background: The EucaTax stent (EUPES) is a coronary stent with biodegradable polymer and camouflage coating that has been developed to promote the complete elution of drugs and decrease the risk of late complications. The aim of this study was to evaluate the efficacy and safety of the double-coated EUPES in patients with stable angina versus sirolimus-eluting stent CYPHER (SES) with permanent polymer coating. Methods and Materials: The study included consecutive patient with at least 70% de novo coronary lesions in one or two native coronary arteries and who had undergone the coronary stenting using either EUPES or SES. We evaluated the 2-year major adverse cardiac events (MACE) rates, including total death (cardiac, non-cardiac), myocardial infarction (MI), target lesion revascularisation (TLR) and stent thrombosis. Results: Between 2006 and 2009 this observational, prospective, single centre study included 602 patients (282 with EUPES and 320 with SES). At 2 years, the rates of TLR (16.3% versus 6.25%; p = 0.0001) and MACE (18.4% versus 7.8%; p = 0.001) were significantly higher in the EUPES than in the SES group. The rate of TLR was significantly higher in the EUPES group compared with SES group in stenting of artery with a diameter less than 3 mm, using stent length more than 18 mm, as well as when the residual stenosis was more than 12%. Conclusions: We found that EUPES was inferior to SES during the 2-year follow-up with respect to rates of MACE and TLR that were significantly higher in the EUPES than in the SES group

Two-year follow-up of percutaneous coronary intervention using EucaTax or Cypher

Energy Technology Data Exchange (ETDEWEB)

Shuvalova, Yulia A., E-mail: shuvalovaj@mail.ru [Russian Cardiology Research and Production Complex, Department of Atherosclerosis Problems (Russian Federation); Shirokov, Roman O. [Russian Cardiology Research and Production Complex, Laboratory of Radio Vascular Therapy (Russian Federation); Kaminnaya, Violetta I. [Russian Cardiology Research and Production Complex, Department of Atherosclerosis Problems (Russian Federation); Samko, Anatoliy N. [Russian Cardiology Research and Production Complex, Laboratory of Radio Vascular Therapy (Russian Federation); Kaminnyi, Alexander I. [Russian Cardiology Research and Production Complex, Department of Atherosclerosis Problems (Russian Federation)

2013-09-15

Background: The EucaTax stent (EUPES) is a coronary stent with biodegradable polymer and camouflage coating that has been developed to promote the complete elution of drugs and decrease the risk of late complications. The aim of this study was to evaluate the efficacy and safety of the double-coated EUPES in patients with stable angina versus sirolimus-eluting stent CYPHER (SES) with permanent polymer coating. Methods and Materials: The study included consecutive patient with at least 70% de novo coronary lesions in one or two native coronary arteries and who had undergone the coronary stenting using either EUPES or SES. We evaluated the 2-year major adverse cardiac events (MACE) rates, including total death (cardiac, non-cardiac), myocardial infarction (MI), target lesion revascularisation (TLR) and stent thrombosis. Results: Between 2006 and 2009 this observational, prospective, single centre study included 602 patients (282 with EUPES and 320 with SES). At 2 years, the rates of TLR (16.3% versus 6.25%; p = 0.0001) and MACE (18.4% versus 7.8%; p = 0.001) were significantly higher in the EUPES than in the SES group. The rate of TLR was significantly higher in the EUPES group compared with SES group in stenting of artery with a diameter less than 3 mm, using stent length more than 18 mm, as well as when the residual stenosis was more than 12%. Conclusions: We found that EUPES was inferior to SES during the 2-year follow-up with respect to rates of MACE and TLR that were significantly higher in the EUPES than in the SES group.

Prevalence, correlates, and impact of coronary calcification on adverse events following PCI with newer-generation DES: Findings from a large multiethnic registry.

Science.gov (United States)

Copeland-Halperin, Robert S; Baber, Usman; Aquino, Melissa; Rajamanickam, Anitha; Roy, Swathi; Hasan, Choudhury; Barman, Nitin; Kovacic, Jason C; Moreno, Pedro; Krishnan, Prakash; Sweeny, Joseph M; Mehran, Roxana; Dangas, George; Kini, Annapoorna S; Sharma, Samin K

2018-04-01

We sought to determine the prevalence, predictors, and clinical impact of target lesion calcification in patients undergoing percutaneous coronary intervention (PCI) with newer generation drug-eluting stents (DES) and devices. Coronary calcification is independently associated with adverse outcomes following PCI. While newer DES and contemporary devices are considered safer and more efficacious, their influence on outcomes following PCI of heavily calcified lesions is unknown. We performed a retrospective analysis of a large, multiethnic cohort of patients undergoing PCI with new generation DES at an academic center between 2009 and 2013. Coronary calcification was qualitatively assessed as none/mild, moderate, or severe. Independent demographic, clinical, and anatomic predictors of moderate/severe calcification were identified using logistic regression. Associations between coronary calcification and 1-year MACE (death, myocardial infarction, or target vessel revascularization) were examined using Cox modeling. Compared to patients with none/mild (n = 10,180; 82.0%), those with moderate (n = 1,271; 10.0%) or severe (n = 994; 8.0%) calcification were older, more often Caucasian, had more complex target lesions, and worse renal function. The strongest demographic, clinical, and anatomic correlates of moderate/severe calcification were age, Caucasian race, renal dysfunction, lesion length, and left main location. Unadjusted MACE rates among those with none/mild, moderate, and severe calcification were 8.3, 14.6, and 17.8%, respectively (P < 0.001). After multivariable adjustment, the hazard ratio (95% CI) for MACE associated with moderate or severe coronary calcification was 1.63. Target lesion calcification remains independently associated with adverse outcomes in patients treated with newer generation DES and modern devices. © 2017 Wiley Periodicals, Inc.

DK mini-culotte stenting in the treatment of true coronary bifurcation lesions: a propensity score matching comparison with T-provisional stenting.

Science.gov (United States)

Fan, Lin; Chen, Lianglong; Luo, Yukun; Zhang, Linlin; Zhong, Wenliang; Lin, Chaogui; Chen, Zhaoyang; Peng, Yafei; Zhen, Xingchun; Dong, Xianfeng

2016-03-01

The conventional culotte technique remains not to be widely used for the treatment of coronary bifurcation lesions due to its inherent drawbacks. Here, we developed a double kissing mini-culotte stenting (DK mini-culotte) and assessed its efficacy and safety by a propensity score matching comparison (PSM) with T-provisional stenting. From June 2010 to June 2012, a total of 223 consecutive patients with true coronary bifurcation lesions (TCBLs) were treated with DK mini-culotte (91 patients with 92 lesions) or T-provisional stenting (132 patients with 135 lesions). We performed a PSM to correct the confounders from clinical and lesion's characteristics. The primary endpoint was cumulative major adverse cardiac event (MACE) at 1 year including cardiac death, myocardial infarction, and target vessel revascularization or target lesion revascularization (TVR/TLR). The secondary endpoint was the rate of side branch (SB) restenosis at 12 months. After a PSM, there were 66 patients in each group. Additional SB stenting in the T-provisional group was performed in 10 (15.2 %) lesions. The incidence of 1-year cumulative MACE was 4.55 % for the DK mini-culotte versus 13.6 % for T-provisional stenting (P = 0.127), the rate of TVR/TLR was 1.52 % for DK mini-culotte versus 12.12 % for T-provisional stenting (P = 0.033). The SB binary restenosis rate was 5.6 % in the DK mini-culotte group and 22.4 % in the T-provisional group (P = 0.014). In summary, despite that there is no difference in MACE between groups, DK mini-culotte significantly reduce TVR/TLR and SB restenosis in the treatment of true coronary bifurcation lesions.

Hyperhomocysteinemia is an independent predictor of long-term clinical outcomes in Chinese octogenarians with acute coronary syndrome

Directory of Open Access Journals (Sweden)

Fu Z

2015-09-01

Full Text Available Zhenhong Fu,1,* Geng Qian,1,* Hao Xue,1,* Jun Guo,1 Lian Chen,1 Xia Yang,1 Mingzhi Shen,2 Wei Dong,1 Yundai Chen11Department of Cardiology, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China; 2Department of Cardiology, Hainai Branch of Chinese People’s Liberation Army General Hospital, Sanya, Hainan, People’s Republic of China*These authors contributed equally to this workObjective: To evaluate the prognostic value of homocysteine (Hcy in Chinese acute coronary syndrome (ACS octogenarians.Methods: The study cohort comprised 660 consecutive ACS octogenarians who underwent coronary angiography. We classified the patients into three groups according to Hcy tertiles. Kaplan–Meier method was performed for survival and major adverse cardiac events (MACE rates. Multivariate Cox regression was performed to identify mortality predictors. Receiver operating characteristic curve analysis was performed to predict the cutoff value of Hcy for all-cause mortality.Results: The follow-up period was 28 (inter-quartile range: 16–38 months. Diastolic blood pressure, ratios of male, renal failure and old myocardial infarction in high plasma level Hcy (H-Hcy group were higher than those in low (L-Hcy and middle (M-Hcy plasma level of Hcy groups (P<0.05. The Hcy level was positively correlated with uric acid level (r=0.211, P=0.001 and Cystatin C (Cys C level (r=0.212, P=0.001 and negatively correlated with estimated glomerular filtration rate (r=−0.148, P=0.018. For the long-term outcomes, the cumulative survival rate of H-Hcy group was significantly lower than that of L-Hcy and M-Hcy groups (P=0.006. All-cause mortality and MACE of H-Hcy group were higher than those of L-Hcy and M-Hcy group (P=0.0001, P=0.0008. Hcy is an independent predictor for long-term all-cause mortality (odds ratio =2.26, 95% CI=1.23–4.16, P=0.023 and MACE (odds ratio =1.91, 95% CI=1.03–3.51, P=0.039. Receiver operating characteristic

Antonio van Diemen : de opkomst van de VOC in Azië

NARCIS (Netherlands)

Witteveen, Willem Menno

2011-01-01

The Dutch East India Company, the VOC (Verenigde Oostindische Compagnie ) was founded in 1602 and was the first company with permanent capital, tradable shares and limited liability. Its aim was to monopolise the trade in valuable spices as nutmeg, mace and cloves found only in a remote part of the

Author Details

African Journals Online (AJOL)

Mireku-Gyimah, D. Vol 11 (2010) - Articles Symbolism of umat's emblem, flag and ceremonial mace - conglomeration of the university's essence and aspirations. Abstract PDF · Vol 15, No 1 (2015) - Articles A Spatio-Temporal Based Estimation of Sequestered Carbon in the Tarkwa Mining Area of Ghana Abstract PDF · Vol ...

Ghana Mining Journal - Vol 11 (2010)

African Journals Online (AJOL)

Symbolism of umat's emblem, flag and ceremonial mace - conglomeration of the university's essence and aspirations · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. M.F Annku, D Mireku-Gyimah. http://dx.doi.org/10.4314/gm.v11i1.53275 ...

Mulheres atletas: re-significações da corporalidade feminina Women athletes: re-signifying the female body?

Directory of Open Access Journals (Sweden)

Miriam Adelman

2003-12-01

Full Text Available A participação esportiva das mulheres contribui para uma re-significação da corporalidade feminina? Lembrando da idéia de Susan Brownmiller, para quem a feminilidade representa, na sociedade moderna, uma "estética da limitação", e trabalhando com noções de gênero e corporalidade advindas particularmente da produção recente de Susan Bordo e Judith Butler, procuro identificar mudanças nas práticas e representações do corpo feminino que decorrem da atividade esportiva. Analiso depoimentos de atletas brasileiras profissionais, algumas praticantes de um esporte de elite (hipismo e, outras, de um esporte mais popular (o vôlei. Incorporo também a análise de imagens culturais da atleta, como veiculadas nos meios de comunicação. Evidências de pesquisa de campo mostram que, se, por um lado, as atletas de fato participam da "desconstrução" de certos elementos da mencionada "estética da limitação", por outro, continuam em uma cultura na qual a atividade esportiva das mulheres pode 'comprometer a feminilidade' da atleta.How does women's participation in sport contribute to the re-signification of women's corporality? Considering Susan Brownmiller's notion that femininity, in modern society, can be understood as an "aesthetic of limitation", I also work with notions of gender and corporality taken from recent work by Susan Bordo and Judith Butler, in an attempt to identify changes in women's practices and representations of the female body propitiated by sporting activity. I analyze the testimonies of Brazilian women athletes, most of whom can be considered professionals, from two sporting fields: on the one hand, equestriennes engaged in the elite sport of showjumping, and on the other, women involved in the popular sport of volleyball. I also look at cultural images of women athletes as currently produced in mass media. he evidence that I obtain through field work leads me to identify conflicting tendencies of "deconstruction" of

Environmental Investigations and Analyses for Los Angeles-Long Beach Harbors, Los Angeles, California, 1973-1976.

Science.gov (United States)

1976-12-01

Christine Yonai Fred Piltz Ichthyology Jay Carroll Karl Lyde John Helle Scott Ralston S. Ishikawa Steve Subber Catherine Kusick Catherine Terry...Charles Greaves Catherine Link Susan Harrison Julie Thompson Kaoru 0. Kendis Ismay Stanley Randall Kendis Marine Technicians Bruce Adams Gene Mummert

Beck PRIDE Center - An Effective Solution for Combat Injured Student Veterans

Science.gov (United States)

2016-09-01

unknown reasons/unable to contact to reschedule (16). Treatment A and Treatment B lasted one hour. Participants were assessed after each session...consider doing work in this area. Have a great academic year! Sincerely, Susan Hanrahan, Dean College of Nursing and Health Professions

SSC San Diego Command History Calendar Year 2007

Science.gov (United States)

2008-03-01

Camargo , Sylvia Salazar, Karen Manley-Guerrero, Dina Demuth, Clay Oeholke, Gannon Graue, Dee Johnson, Erwin Mier, Hoa Nguyen. Navy Multiband Terminal...Davenport, Brian Devine, Greg Doriguzzi, Richard Felkins, John Fleming, Cheryl Francisco , Sid Graser, Eric Hillis, Craig LaMaster, Susan Manor, Joel

75 FR 31812 - Receipt of Applications for Endangered Species Permits

Science.gov (United States)

2010-06-04

... Atlantic Ocean. Applicant: Carol Johnston, Auburn, Alabama, TE178666 The applicant requests authorization... the Indiana bat in Kentucky. Applicant: Susan Loeb, U.S. Forest Service, Clemson, South Carolina... bat in the following locations: Cherokee National Forest and Great Smoky Mountains National Park...

Sadhana | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Sadhana. SHEFALI CHAND. Articles written in Sadhana. Volume 41 Issue 12 December 2016 pp 1393-1406. Image coding based on maximum entropy partitioning for identifying improbable intensities related to facial expressions · SEBA SUSAN NANDINI AGGARWAL SHEFALI CHAND AYUSH GUPTA.

75 FR 29545 - Ocean Transportation Intermediary License Applicants

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2010-05-26

.... Atlantic Cargo Logistics LLC (OFF & NVO), 120 South Woodland Blvd., 216, Deland, FL 32720. Officers: Dietmar Lutte, Manager, (Qualifying Individual) Susan Lutte, Member, Application Type: New OFF & NVO License. Direct Delivery Logistics and Supply, LLC (OFF & NVO) 2006 Wilson Road, Humble, TX 77396...

African Zoology - Vol 32, No 2 (1997)

African Journals Online (AJOL)

Metabolic rate and body temperature of an African sun bird, Nectarinia chalybea: daily rhythm and the effect of ambient temperature · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Belle Leon, Susan W Nicolson ...

76 FR 64313 - Multilayered Wood Flooring From the People's Republic of China: Final Affirmative Countervailing...

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2011-10-18

... Countervailing Duty Operations, from Susan H. Kuhbach, Office Director AD/CVD Operations, Office 1... provision of electricity for less than adequate remuneration, and 2) the countervailable subsidy rates for... Other Programs Comment 4 Provision of Electricity for Less Than Adequate Remuneration Comment 5...

76 FR 53885 - Patent and Trademark Resource Centers Metrics

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2011-08-30

... DEPARTMENT OF COMMERCE United States Patent and Trademark Office Patent and Trademark Resource Centers Metrics ACTION: Proposed collection; comment request. SUMMARY: The United States Patent and... ``Patent and Trademark Resource Centers Metrics comment'' in the subject line of the message. Mail: Susan K...

School Nurse Perspectives

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Borja, Mary C.; Amidon, Christine; Spellings, Diane; Franzetti, Susan; Nasuta, Mary

2009-01-01

This article features school nurses from across the country who are championing for school-located influenza immunization within their communities. These nurses are: (1) Mary C. Borja; (2) Christine Amidon; (3) Diane Spellings; (4) Susan Franzetti; and (5) Mary Nasuta. (Contains 6 figures.)

75 FR 53362 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

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2010-08-31

..., 2009 (``NSCP letter''); letter from Clifford E. Kirsch and Susan Krawczyk, Sutherland Asbill & Brennan..., dated July 29, 2009 (``Sutherland letter''); letter from Gary A. Sanders, National Association of... rule. \\17\\ Sutherland letter. This commenter requested guidance on facts and circumstances that would...

Teachers' approaches to teaching physics

Science.gov (United States)

2012-12-01

Benjamin Franklin said, "Tell me, and I forget. Teach me, and I remember. Involve me, and I learn." He would not be surprised to learn that research in physics pedagogy has consistently shown that the traditional lecture is the least effective teaching method for teaching physics. We asked high school physics teachers which teaching activities they used in their classrooms. While almost all teachers still lecture sometimes, two-thirds use something other than lecture most of the time. The five most often-used activities are shown in the table below. In the January issue, we will look at the 2013 Nationwide Survey of High School Physics teachers. Susan White is Research Manager in the Statistical Research Center at the American Institute of Physics; she directs the Nationwide Survey of High School Physics Teachers. If you have any questions, please contact Susan at swhite@aip.org.

Contravene, write ... About the pain of others of Susan Sontag

Directory of Open Access Journals (Sweden)

Lucía Belén Couso

2014-08-01

Full Text Available Regarding the pain of others challenges our knowledge, challenges what is held as true. We appreciate this attitude condensed in the verb “to defy”. We analyze how Sontag develops her hypothesis and, from that point onward, which is the idea of criticism that emerges from the writing of Regarding the pain of others. Our analysis focuses on three of its topics: the reviewing of the ideas about the war that Virginia Woolf establishes on Three Guineas, the discussion of her own text On photography, and the criticism about Sebastião Salgado’s photography.

Entretien avec Susan Holtz | CRDI - Centre de recherches pour le ...

International Development Research Centre (IDRC) Digital Library (Canada)

26 nov. 2010 ... ... Centre de recherches pour le développement international comme l'un des ... Toutefois, le discours public sur l'intégration d'objectifs environnementaux et .... très conservatrice des experts du droit commercial international, ...

Rene Valner ja Mikk Suursild - lihtsa elu tegelased / Susan Lahesalu

Index Scriptorium Estoniae

Lahesalu, Susan

2007-01-01

Arhitekt Rene Valner ja Mikk Suursild - tandem nimega UNITe - ehitavad ökonoomseid ja ökoloogilisi looduslikest materjalidest maju. Nende koostöös on valminud ka Peipsi ääres Nina külas 3 põhumaja. Ott Kadariku, Margit Mutso ja Kuido Kartau kommentaarid

Large-scale budget applications of mathematical programming in the Forest Service

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Malcolm Kirby

1978-01-01

Mathematical programming applications in the Forest Service, U.S. Department of Agriculture, are growing. They are being used for widely varying problems: budgeting, lane use planning, timber transport, road maintenance and timber harvest planning. Large-scale applications are being mace in budgeting. The model that is described can be used by developing economies....

Defense.gov Special Report: Feds Feed Families 2013

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Susan Fuller. Photo by Steve Lawson, Corporate Communications To date, DFAS Indianapolis Site Director Campaign Materials DOD FFF Flyer Logo Contacts Army: Steve Bickel Navy: Rama Latin Air Force: Carl Buchanan Biographies Organization Mission History Frequently Asked Questions Available jobs with DOD Top Issues

77 FR 27509 - Self-Regulatory Organizations; Municipal Securities Rulemaking Board; Order Approving Proposed...

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2012-05-10

... September 30, 2010 (``BDA Letter I''); Colette J. Irwin-Knott, CIPFA, President, National Association of... December 1, 2011 (``BDA Letter II''); Susan Gaffney, Director, Federal Liaison Center, Government Finance... America, dated January 30, 2012 (``BDA Letter III''); Colette J. Irwin-Knott, CIPFA, President, National...

Book Review | Dunn-Coetzee | Journal of Student Affairs in Africa

African Journals Online (AJOL)

Roberts, Dennis C. & Komives, Susan R. (Eds.) (2016). Enhancing Student Learning and Development in Cross- Border Higher Education. San Francisco: Jossey-Bass. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online.

Commentary

Indian Academy of Sciences (India)

PRAKASH

all known Neurospora mutants, chromosome rearrangements, wild and .... Robert Metzenberg and colleagues, including David's associate N B Raju, ... tetrasperma was Dodge's favorite species and he tried (without success) to get his visitors interested in ... They are survived by their daughter Susan and her husband John.

78 FR 67333 - Performance Review Board Membership

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2013-11-12

... DEPARTMENT OF COMMERCE Performance Review Board Membership AGENCY: Economics and Statistics... eligible to serve on the Performance Review Board (PRB) in accordance with the Economics and Statistics.... Arnold William G. Bostic, Jr. Stephen B. Burke Joanne Buenzli Crane Susan R. Helper Ron S. Jarmin Enrique...

75 FR 74007 - Federal Aquatic Nuisance Species Research Risk Analysis Protocol

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2010-11-30

... site, http://anstaskforce.gov/documents.php . To obtain a hard copy of the Protocol, see Document... aquatic species that are the target of this risk analysis. Language used in the NANPCA differentiates...: http://anstaskforce.gov/documents.php Write: Susan Pasko, National Oceanic and Atmospheric...

Pilot-in-the-Loop CFD Method Development

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2017-04-20

separate computers providing Image Generation, interface with the control loading system, cockpit instrument displays, and the math model of the...Dynamics Specialist Naval Air Systems Command Code 4.3.2.1 Applied Aerodynamics & Store Separation Branch susan.polsky@navy.mil 301-342-8575 (Voice

77 FR 269 - Matters Related to Patent Appeals

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2012-01-04

... DEPARTMENT OF COMMERCE United States Patent and Trademark Office Matters Related to Patent Appeals ACTION: Proposed collection; comment request. SUMMARY: The United States Patent and Trademark Office... Matters Related to Patent Appeals comment'' in the subject line of the message. Mail: Susan K. Fawcett...

Whither Educational Evaluation: Life, Death, and Reincarnation? Research into Practice Project.

Science.gov (United States)

Herman, Joan; And Others

1984-01-01

The current health and future well-being of educational evaluation is considered in terms of financial support, official mandate, evaluators' status, evaluation prevalence, and evaluation utility in these seven symposium papers. "Educational Evaluation--Indicators of Life, Death, or Reincarnation," by Susan Klein, assesses recent federal…

Diseño y evaluación de un programa de habilidades para la salud en niños en comunidades rurales /

OpenAIRE

Anaya González, Cecilia Irene sustentante.

2009-01-01

 tesis que para obtener el grado de Doctor en Psicología, presenta Cecilia Irene Anaya González ; asesor Susan Pick Steiner. 197 páginas : ilustraciones. Doctorado en Psicología UNAM, Facultad de Psicología, 2009

Long-Term Outcome in Levothyroxine Treated Patients With Subclinical Hypothyroidism and Concomitant Heart Disease.

Science.gov (United States)

Andersen, Mette Nygaard; Olsen, Anne-Marie Schjerning; Madsen, Jesper Clausager; Kristensen, Søren Lund; Faber, Jens; Torp-Pedersen, Christian; Gislason, Gunnar H; Selmer, Christian

2016-11-01

Subclinical hypothyroidism is a common condition that may lead to impaired cardiac function. This study sought to examine the effects of levothyroxine treatment in patients with subclinical hypothyroidism and heart disease. This was a register-based historical cohort study. The study was composed of Danish primary care patients and hospital outpatients age 18 years and older with established heart disease who were diagnosed with subclinical hypothyroidism in 1997-2011. Patients were stratified according to whether they claimed a subsequent prescription of levothyroxine. Event rates and incidence rate ratios (IRR) were calculated by use of time-dependent multivariable Poisson regression models. Measures included all-cause mortality and major adverse cardiac events (MACEs), defined as cardiovascular death, fatal or nonfatal myocardial infaction and stroke, and all-cause hospital admissions. Of 61 611 patients with a diagnosis of cardiac disease having their first time thyroid function testing, 1192 patients with subclinical hypothyroidism (mean age 73.6 [SD ± 13.3] y, 63.8% female) were included, of whom 136 (11.4%) were treated with levothyroxine. During a median follow-up time of 5.6 y (interquartile range, 6.5 y), 694 (58.2%) patients died. Patients treated with levothyroxine displayed no significantly increased risk of all-cause mortality (adjusted IRR, 1.17; 95% confidence interval [CI], 0.90-1.52), MACE (adjusted IRR, 1.08; 95% CI, 0.80-1.45), or hospital admission (adjusted IRR, 0.94; 95% CI, 0.71-1.24), when compared with patients not treated with levothyroxine. Levothyroxine treatment in patients with subclinical hypothyroidism and heart disease was not associated with a significant benefit nor risk of all-cause mortality, MACE, or hospital admission in this large real-world cohort study.

Texturization of diamond-wire-sawn multicrystalline silicon wafer using Cu, Ag, or Ag/Cu as a metal catalyst

Science.gov (United States)

Wang, Shing-Dar; Chen, Ting-Wei

2018-06-01

In this work, Cu, Ag, or Ag/Cu was used as a metal catalyst to study the surface texturization of diamond-wire-sawn (DWS) multi-crystalline silicon (mc-Si) wafer by a metal-assisted chemical etching (MACE) method. The DWS wafer was first etched by standard HF-HNO3 acidic etching, and it was labeled as AE-DWS wafer. The effects of ratios of Cu(NO3)2:HF, AgNO3:HF, and AgNO3:Cu(NO3)2 on the morphology of AE-DWS wafer were investigated. After the process of MACE, the wafer was treated with a NaF/H2O2 solution. In this process, H2O2 etched the nanostructure, and NaF removed the oxidation layer. The Si {1 1 1} plane was revealed by etching the wafer in a mixture of 0.03 M Cu(NO3)2 and 1 M HF at 55 °C for 2.5 min. These parallel Si {1 1 1} planes replaced some parallel saw marks on the surface of AE-DWS wafers without forming a positive pyramid or an inverted pyramid structure. The main topography of the wafer is comprised of silicon nanowires grown in direction when Ag or Ag/Cu was used as a metal catalyst. When silicon is etched in a mixed solution of Cu(NO3)2, AgNO3, HF and H2O2 at 55 °C with a concentration ratio of [Cu2+]/[Ag+] of 50 or at 65 °C with a concentration ratio of [Cu2+]/[Ag+] of 33, a quasi-inverted pyramid structure can be obtained. The reflectivity of the AE-DWS wafers treated with MACE is lower than that of the multiwire-slurry-sawn (MWSS) mc-Si wafers treated with traditional HF + HNO3 etching.

Incidence and Clinical Features of Early Stent Thrombosis in the Era of New P2y12 Inhibitors (PLATIS-2.

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Elad Asher

Full Text Available Early stent thrombosis (EST (≤ 30 days after stent implantation is a relatively rare but deleterious complication of percutaneous coronary intervention (PCI. Administration of newer P2Y12 inhibitors (prasugrel and ticagrelor combined with aspirin has been shown to reduce the incidence of sub-acute and late stent thrombosis, compared with clopidogrel. We investigated the "real life" incidence of EST in patients from a large acute coronary syndrome (ACS national registry, where newer P2Y12 inhibitors are widely used. Patients were derived from the ACS Israeli Survey (ACSIS, conducted during 2006, 2008, 2010 and 2013. Major adverse cardiac events (MACE at 30days were defined as all-cause death, recurrent ACS, EST and stroke.Of the 4717 ACS patients who underwent PCI and stenting, 83% received clopidogrel and 17% newer P2Y12 inhibitors. The rate of EST was similar in both groups (1.7% in the newer P2Y12 inhibitor group vs. 1.4% in the clopidogrel-treated patients, p = 0.42. Results were consistent after multivariate analysis (adjusted HR = 1.06 [p = 0.89]. MACE occurred in 6.4% in the newer P2Y12 inhibitor group compared with 9.2% in the clopidogrel group (P<0.01. However, multivariate logistic regression modeling showed that treatment with newer P2Y12 inhibitors was not significantly associated with the secondary endpoint of MACE when compared with clopidogrel therapy [OR = 1.26 95%CI (0.93-1.73, P = 0.136]. The incidence of "real life" EST at 1month is relatively low, and appears to be similar in patients who receive newer P2Y12 inhibitors as well as in those who receive clopidogrel.

Incidence and Clinical Features of Early Stent Thrombosis in the Era of New P2y12 Inhibitors (PLATIS-2)

Science.gov (United States)

Asher, Elad; Abu-Much, Arsalan; Goldenberg, Ilan; Segev, Amit; Sabbag, Avi; Mazin, Israel; Shlezinger, Meital; Atar, Shaul; Zahger, Doron; Polak, Arthur; Beigel, Roy; Matetzky, Shlomi

2016-01-01

Early stent thrombosis (EST) (≤ 30 days after stent implantation) is a relatively rare but deleterious complication of percutaneous coronary intervention (PCI). Administration of newer P2Y12 inhibitors (prasugrel and ticagrelor) combined with aspirin has been shown to reduce the incidence of sub-acute and late stent thrombosis, compared with clopidogrel. We investigated the “real life” incidence of EST in patients from a large acute coronary syndrome (ACS) national registry, where newer P2Y12 inhibitors are widely used. Patients were derived from the ACS Israeli Survey (ACSIS), conducted during 2006, 2008, 2010 and 2013. Major adverse cardiac events (MACE) at 30days were defined as all-cause death, recurrent ACS, EST and stroke.Of the 4717 ACS patients who underwent PCI and stenting, 83% received clopidogrel and 17% newer P2Y12 inhibitors. The rate of EST was similar in both groups (1.7% in the newer P2Y12 inhibitor group vs. 1.4% in the clopidogrel-treated patients, p = 0.42). Results were consistent after multivariate analysis (adjusted HR = 1.06 [p = 0.89]). MACE occurred in 6.4% in the newer P2Y12 inhibitor group compared with 9.2% in the clopidogrel group (P<0.01). However, multivariate logistic regression modeling showed that treatment with newer P2Y12 inhibitors was not significantly associated with the secondary endpoint of MACE when compared with clopidogrel therapy [OR = 1.26 95%CI (0.93–1.73), P = 0.136]. The incidence of "real life" EST at 1month is relatively low, and appears to be similar in patients who receive newer P2Y12 inhibitors as well as in those who receive clopidogrel. PMID:27310147

Systolic blood pressure target in systemic arterial hypertension: Is lower ever better? Results from a community-based Caucasian cohort.

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Di Nora, Concetta; Cioffi, Giovanni; Iorio, Annamaria; Rivetti, Luigi; Poli, Stefano; Zambon, Elena; Barbati, Giulia; Sinagra, Gianfranco; Di Lenarda, Andrea

2018-02-01

Extensive evidence exists about the prognostic role of systolic blood pressure (SBP) reduction ≤140mmHg. Recently, the SPRINT trial successfully tested the strategy of lowering SBP<120mmHg in patients with arterial hypertension (AH). To assess whether the SPRINT results are reproducible in a real world community population. Cross-sectional, population-based study analyzing data of 24,537 Caucasian people with AH from the Trieste Observatory of CV disease, 2010 to 2015. We selected and divided 2306 subjects with AH according to the SPRINT trial criteria; similarly, SPRINT clinical outcomes were considered. Study patients median age was 75±8years, two third male, one third had ischemic heart disease. They were older, with lower body mass index, higher SBP and Framingham CV risk score than the SPRINT patients. Three-hundred-sixty-eight patients (16%) had SBP<120mmHg. During 48 [36-60] months of follow-up, 751 patients (32%) experienced a major adverse cardiac event (MACE). The SBP <120mmHg group had higher incidence of MACE, CV deaths and all-cause death than SBP≥120mmHg group (37% vs 31%; 10% vs 4%; 19% vs 10%, all p<0.05). The condition of SBP<120mmHg was an independent predictor of MACE in multivariate Cox analysis together with older age, male gender, higher Charlson score. In our experience, the SBP<120mmHg condition is associated with worse clinical outcomes, suggesting the SPRINT results are not reproducible tout court in Caucasian community populations. These differences should be taken as a warning against aggressive reducing of SBP<120mmHg. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Contemporary sex differences among patients with acute coronary syndrome treated by emergency percutaneous coronary intervention.

Science.gov (United States)

Wada, Hideki; Ogita, Manabu; Miyauchi, Katsumi; Tsuboi, Shuta; Konishi, Hirokazu; Shitara, Jun; Kunimoto, Mitsuhiro; Sonoda, Taketo; Iso, Takashi; Ebina, Hideki; Aoki, Eriko; Kitamura, Kenichi; Tamura, Hiroshi; Suwa, Satoru; Daida, Hiroyuki

2017-10-01

Acute coronary syndrome (ACS) is an important cause of mortality and morbidity in the general population. Recent advances in percutaneous coronary intervention (PCI) and optimal medical treatment have helped to improve the prognosis of patients with ACS. The previous reports indicated that women with ACS have a higher risk of adverse outcomes. However, sex differences in clinical outcomes with contemporary coronary revascularization and medical therapy for ACS have not been elucidated. We analyzed data from 676 consecutive patients with ACS (female, n = 166; male, n = 510) who were treated by emergency PCI between 2011 and 2014 at Juntendo Shizuoka Hospital. The patients were grouped according to sex. We defined major adverse cardiovascular events as a composite of all-cause death and ACS recurrence at 1 year and compared rates of major adverse cardiac events (MACE) between the groups. Women were older (75.4 ± 11.0 vs. 66.2 ± 12.2 years) and had a higher rate of multi-vessel disease, chronic kidney disease, and Killip IV at presentation. The cumulative rate of MACE at 1 year was significantly higher among women than men (17.5 vs. 10.2 %, p = 0.02, log-rank test). However, the association between women and a higher risk of MACE was attenuated after adjusting for age (HR 1.25, 95 % CI 0.77-2.00, p = 0.36) and other variables (HR 0.93, 95 % CI 0.36-2.44, p = 0.88). Adjustment for age and other risk factors attenuated sex differences in mid-term clinical outcomes among patients with ACS after emergency PCI.

Clinical utility of the HEART score in patients admitted with chest pain to an inner-city hospital in the USA.

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Patnaik, Soumya; Shah, Mahek; Alhamshari, Yaser; Ram, Pradhum; Puri, Ritika; Lu, Marvin; Balderia, Percy; Imms, John B; Maludum, Obiora; Figueredo, Vincent M

2017-06-01

Chest pain is one of the most common presentations to a hospital, and appropriate triaging of these patients can be challenging. The HEART score has been used for such purposes in some countries and only a few validation studies from the USA are available. We aim to determine the utility of the HEART score in patients presenting with chest pain to an inner-city hospital in the USA. We retrospectively screened 417 consecutive patients admitted with chest pain to the observation/telemetry units at Einstein Medical Center Philadelphia. After applying inclusion and exclusion criteria, 299 patients were included in the analysis. Patients were divided into low-risk (0-3) and intermediate-high (≥4)-risk HEART score groups. Baseline characteristics, thrombolysis in myocardial infarction score, need for revascularization during index hospitalization, and major adverse cardiovascular events (MACE) at 6 weeks and 12 months were recorded. There were 98 and 201 patients in the low-score group and intermediate-high-score group, respectively. Compared with the low-score group, patients in the intermediate-high-risk group had a higher incidence of revascularization during the index hospital stay (16.4 vs. 0%; P=0.001), longer hospital stay, higher MACE at 6 weeks (9.5 vs. 0%) and 12 months (20.4 vs. 3.1%), and higher cardiac readmissions. HEART score of at least 4 independently predicted MACE at 12 months (odds ratio 7.456, 95% confidence interval: 2.175-25.56; P=0.001) after adjusting for other risk factors in regression analysis. HEART score of at least 4 was predictive of worse outcomes in patients with chest pain in an inner-city USA hospital. If validated in multicenter prospective studies, the HEART score could potentially be useful in risk-stratifying patients presenting with chest pain in the USA and could impact clinical decision-making.

The Value of the SYNTAX Score II in Predicting Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation.

Science.gov (United States)

Ryan, Nicola; Nombela-Franco, Luis; Jiménez-Quevedo, Pilar; Biagioni, Corina; Salinas, Pablo; Aldazábal, Andrés; Cerrato, Enrico; Gonzalo, Nieves; Del Trigo, María; Núñez-Gil, Iván; Fernández-Ortiz, Antonio; Macaya, Carlos; Escaned, Javier

2017-11-27

The predictive value of the SYNTAX score (SS) for clinical outcomes after transcatheter aortic valve implantation (TAVI) is very limited and could potentially be improved by the combination of anatomic and clinical variables, the SS-II. We aimed to evaluate the value of the SS-II in predicting outcomes in patients undergoing TAVI. A total of 402 patients with severe symptomatic aortic stenosis undergoing transfemoral TAVI were included. Preprocedural TAVI angiograms were reviewed and the SS-I and SS-II were calculated using the SS algorithms. Patients were stratified in 3 groups according to SS-II tertiles. The coprimary endpoints were all-cause death and major adverse cardiovascular events (MACE), a composite of all-cause death, cerebrovascular event, or myocardial infarction at 1 year. Increased SS-II was associated with higher 30-day mortality (P=.036) and major bleeding (P=.015). The 1-year risk of death and MACE was higher among patients in the 3rd SS-II tertile (HR, 2.60; P=.002 and HR, 2.66; P<.001) and was similar among patients in the 2nd tertile (HR, 1.27; P=.507 and HR, 1.05; P=.895) compared with patients in the 1st tertile. The highest SS-II tertile was an independent predictor of long-term mortality (P=.046) and MACE (P=.001). The SS-II seems more suited to predict clinical outcomes in patients undergoing TAVI than the SS-I. Increased SS-II was associated with poorer clinical outcomes at 1 and 4 years post-TAVI, independently of the presence of coronary artery disease. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Investigating the prevalence, predictors, and prognosis of suboptimal statin use early after a non-ST elevation acute coronary syndrome.

Science.gov (United States)

Turner, Richard M; Yin, Peng; Hanson, Anita; FitzGerald, Richard; Morris, Andrew P; Stables, Rod H; Jorgensen, Andrea L; Pirmohamed, Munir

High-potency statin therapy is recommended in the secondary prevention of cardiovascular disease but discontinuation, dose reduction, statin switching, and/or nonadherence occur in practice. To determine the prevalence and predictors of deviation from high-potency statin use early after a non-ST elevation acute coronary syndrome (NSTE-ACS) and its association with subsequent major adverse cardiovascular events (MACE) and all-cause mortality (ACM). A total of 1005 patients from a UK-based prospective NSTE-ACS cohort study discharged on high-potency statin therapy (atorvastatin 80 mg, rosuvastatin 20 mg, or 40 mg daily) were included. At 1 month, patients were divided into constant high-potency statin users, and suboptimal users incorporating statin discontinuation, dose reduction, switching statin to a lower equivalent potency, and/or statin nonadherence. Follow-up was a median of 16 months. There were 156 suboptimal (∼15.5%) and 849 constant statin users. Factors associated in multivariable analysis with suboptimal statin occurrence included female sex (odds ratio 1.75, 95% confidence interval [CI] 1.14-2.68) and muscular symptoms (odds ratio 4.28, 95% CI 1.30-14.08). Suboptimal statin use was associated with increased adjusted risks of time to MACE (hazard ratio 2.10, 95% CI 1.25-3.53, P = .005) and ACM (hazard ratio 2.46, 95% CI 1.38-4.39, P = .003). Subgroup analysis confirmed that the increased MACE/ACM risks were principally attributable to statin discontinuation or nonadherence. Conversion to suboptimal statin use is common early after NSTE-ACS and is partly related to muscular symptoms. Statin discontinuation or non-adherence carries an adverse prognosis. Interventions that preserve and enhance statin utilization could improve post NSTE-ACS outcomes. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

In-hospital management and outcome of patients on warfarin undergoing coronary stent implantation: results of the multicenter, prospective WARfarin and coronary STENTing (WAR-STENT) registry.

Science.gov (United States)

Rubboli, Andrea; Sciahbasi, Alessandro; Briguori, Carlo; Saia, Francesco; Palmieri, Cataldo; Moroni, Luigi Andrea; Calabrò, Paolo; Leone, Antonio Maria; Franco, Nicoletta; Valgimigli, Marco; Varani, Elisabetta; Santi, Michela; Pasqualini, Paola; Capecchi, Alessandro; Piccalò, Giacomo; Margheri, Massimo; di Pasquale, Giuseppe; Galvani, Marcello; Bolognese, Leonardo; Gonzini, Lucio; Maggioni, Aldo Pietro

2013-04-01

The in-hospital management of patients on warfarin undergoing coronary stent implantation (PCI-S) is variable, and the in-hospital outcome incompletely defined. To determine the adherence to the current recommendations, and the incidence of adverse events, we carried out the prospective, multicenter, observational WARfarin and coronary STENTing (WAR-STENT) registry (ClinicalTrials.gov identifier NCT00722319). All consecutive patients on warfarin undergoing PCI-S at 37 Italian centers were enrolled and followed for 12 months. Outcome measures were: major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, need for urgent revascularization, stroke, and venous thromboembolism, and major and minor bleeding. In this paper, we report the in-hospital findings. Out of the 411 patients enrolled, 92% were at non-low (ie, moderate or high) thromboembolic risk. The radial approach and bare-metal stents were used in 61% and 60% of cases, respectively. Drug-eluting stents were essentially reserved to patients with diabetes, which in turn, significantly predicted the implantation of drug-eluting stents (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.29-3.17; P=.002). The in-hospital MACE and major bleeding rates were 2.7% and 2.1%, respectively. At discharge, triple therapy (TT) of warfarin, aspirin, and clopidogrel was prescribed to 76% of patients. Prescription of TT was significantly more frequent in the non-low thromboembolic risk group. Non-low thromboembolic risk, in turn, was a significant predictor of TT prescription (OR, 11.2; 95% CI, 4.83-26.3; P<.0001). In conclusion, real-world warfarin patients undergoing PCI-S are largely managed according to the current recommendations. As a consequence, the risk of in-hospital MACE and major bleedings appears limited and acceptable.

Association between B vitamins supplementation and risk of cardiovascular outcomes: a cumulative meta-analysis of randomized controlled trials.

Directory of Open Access Journals (Sweden)

Chi Zhang

Full Text Available BACKGROUND: Observational studies suggest that B vitamin supplementation reduces cardiovascular risk in adults, but this association remains controversial. This study aimed to summarize the evidence from randomized controlled trials (RCTs investigating B vitamin supplementation for the primary or secondary prevention of major adverse cardiovascular outcomes and to perform a cumulative meta-analysis to determine the evidence base. METHODOLOGY AND PRINCIPAL FINDINGS: In April 2013, we searched PubMed, Embase, and the Cochrane Library to identify relevant RCTs. We included RCTs investigating the effect of B vitamin supplementation on cardiovascular outcome. Relative risk (RR was used to measure the effect using a random-effect model. Statistical heterogeneity scores were assessed using the Q statistic. We included data on 57,952 individuals from 24 RCTs: 12 primary prevention trials and 12 secondary prevention trials. In 23 of these trials, 10,917 major adverse cardiovascular events (MACE occurred; in 20 trials, 7,203 deaths occurred; in 15 trials, 3,422 cardiac deaths occurred; in 19 trials, 3,623 myocardial infarctions (MI occurred; and in 18 trials, 2,465 strokes occurred. B vitamin supplementation had little or no effect on the incidence of MACE (RR, 0.98; 95% confidence interval [CI]: 0.93-1.03; P = 0.37, total mortality (RR, 1.01; 95% CI: 0.97-1.05; P = 0.77, cardiac death (RR, 0.96; 95% CI: 0.90-1.02; P = 0.21, MI (RR, 0.99; 95% CI: 0.93-1.06; P = 0.82, or stroke (RR, 0.94; 95% CI: 0.85-1.03; P = 0.18. CONCLUSION/SIGNIFICANCE: B vitamin supplementation, when used for primary or secondary prevention, is not associated with a reduction in MACE, total mortality, cardiac death, MI, or stroke.

First-Generation Versus Second-Generation Drug-Eluting Stents in Coronary Chronic Total Occlusions: Two-Year Results of a Multicenter Registry.

Directory of Open Access Journals (Sweden)

Jong-Hwa Ahn

Full Text Available Limited data are available regarding the long-term clinical outcomes of second-generation drug-eluting stents (DES versus first-generation DES in patients with coronary chronic total occlusion (CTO who undergo percutaneous coronary intervention (PCI. The aim of this study was to compare the clinical outcomes of second-generation DES with those of first-generation DES for the treatment of CTO.Between March 2003 and February 2012, 1,006 consecutive patients with CTO who underwent successful PCI using either first-generation DES (n = 557 or second-generation DES (n = 449 were enrolled in a multicenter, observational registry. Propensity-score matching was also performed. The primary outcome was cardiac death over a 2-year follow-up period. No significant differences were observed between the two groups regarding the incidence of cardiac death (first-generation DES versus second-generation DES; 2.5% vs 2.0%; hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.37 to 1.98; p = 0.72 or major adverse cardiac events (MACE, 11.8% vs 11.4%; HR: 1.00; 95% CI: 0.67 to 1.50; p = 0.99. After propensity score matching, the incidences of cardiac death (HR: 0.86; 95% CI: 0.35 to 2.06; p = 0.86 and MACE (HR: 0.93; 95% CI: 0.63 to 1.37; p = 0.71 were still similar in both groups. Furthermore, no significant differences were observed between sirolimus-eluting, paclitaxel-eluting, zotarolimus-eluting, and everolimus-eluting stents regarding the incidence of cardiac death or MACE.This study shows that the efficacy of second-generation DES is comparable to that of first-generation DES for treatment of CTO over 2 years of follow-up.

Comparison of RISK-PCI, GRACE, TIMI risk scores for prediction of major adverse cardiac events in patients with acute coronary syndrome.

Science.gov (United States)

Jakimov, Tamara; Mrdović, Igor; Filipović, Branka; Zdravković, Marija; Djoković, Aleksandra; Hinić, Saša; Milić, Nataša; Filipović, Branislav

2017-12-31

To compare the prognostic performance of three major risk scoring systems including global registry for acute coronary events (GRACE), thrombolysis in myocardial infarction (TIMI), and prediction of 30-day major adverse cardiovascular events after primary percutaneous coronary intervention (RISK-PCI). This single-center retrospective study involved 200 patients with acute coronary syndrome (ACS) who underwent invasive diagnostic approach, ie, coronary angiography and myocardial revascularization if appropriate, in the period from January 2014 to July 2014. The GRACE, TIMI, and RISK-PCI risk scores were compared for their predictive ability. The primary endpoint was a composite 30-day major adverse cardiovascular event (MACE), which included death, urgent target-vessel revascularization (TVR), stroke, and non-fatal recurrent myocardial infarction (REMI). The c-statistics of the tested scores for 30-day MACE or area under the receiver operating characteristic curve (AUC) with confidence intervals (CI) were as follows: RISK-PCI (AUC=0.94; 95% CI 1.790-4.353), the GRACE score on admission (AUC=0.73; 95% CI 1.013-1.045), the GRACE score on discharge (AUC=0.65; 95% CI 0.999-1.033). The RISK-PCI score was the only score that could predict TVR (AUC=0.91; 95% CI 1.392-2.882). The RISK-PCI scoring system showed an excellent discriminative potential for 30-day death (AUC=0.96; 95% CI 1.339-3.548) in comparison with the GRACE scores on admission (AUC=0.88; 95% CI 1.018-1.072) and on discharge (AUC=0.78; 95% CI 1.000-1.058). In comparison with the GRACE and TIMI scores, RISK-PCI score showed a non-inferior ability to predict 30-day MACE and death in ACS patients. Moreover, RISK-PCI was the only scoring system that could predict recurrent ischemia requiring TVR.

Absence of gender disparity in short-term clinical outcomes in patients with acute ST-segment elevation myocardial infarction undergoing sirolimus-eluting stent based primary coronary intervention: a report from Shanghai Acute Coronary Event (SACE) Registry.

Science.gov (United States)

Zhang, Qi; Qiu, Jian-Ping; Zhang, Rui-Yan; Li, Yi-Gang; He, Ben; Jin, Hui-Gen; Zhang, Jun-Feng; Wang, Xiao-Long; Jiang, Li; Liao, Min-Lei; Hu, Jian; Shen, Wei-Feng

2010-04-05

Randomized, controlled trials have demonstrated the superiority of sirolimus-eluting stent (SES) implantation during primary percutaneous coronary intervention (PCI), as opposed to bare-metal stents, in patients with ST-elevation myocardial infarction (STEMI). This study aimed to test the hypothesis that clinical benefits of SES treatment were independent of gender in this setting. A total of 2042 patients with STEMI undergoing SES-based primary PCI were prospectively enrolled into Shanghai Acute Coronary Event (SACE) registry (1574 men and 468 women). Baseline demographics, angiographic and PCI features, and in-hospital and 30-day major adverse cardiac events (MACE) were analyzed as a function of gender. Compared with men, women were older and more frequently had hypertension, diabetes, and hypercholesterolemia. Use of platelet glycoprotein IIb/IIIa receptor inhibitor (GPI, 65.5% vs. 62.2%, P = 0.10) and procedural success rate (95.0% vs. 94.2%, P = 0.52) were similar in both genders. In-hospital death and MACE occurred in 3.8% and 7.6%, and 4.5% and 8.1% in the male and female patients, respectively (all P > 0.05). At 30-day follow-up, survival (94.3% vs. 93.8%, P = 0.66) and MACE-free survival (90.2% vs. 89.3%, P = 0.52) did not significantly differ between men and women. After adjustment for differences in patient demographics, angiographic and procedural features, there were no significant difference in either in-hospital (OR = 0.77, 95%CI of 0.48 to 1.22, P = 0.30) or 30-day mortality (OR = 1.28, 95%CI of 0.73 to 2.23, P = 0.38) between women and men. Despite more advanced age and clustering of risk factors in women, female patients with STEMI treated by SES-based primary PCI had similar in-hospital and short-term clinical outcomes as their male counterparts.

Author Details

African Journals Online (AJOL)

Annku, M.F. Vol 11 (2010) - Articles Symbolism of umat's emblem, flag and ceremonial mace - conglomeration of the university's essence and aspirations. Abstract PDF. ISSN: 0855-210X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

Fabrication of 20.19% Efficient Single-Crystalline Silicon Solar Cell with Inverted Pyramid Microstructure.

Science.gov (United States)

Zhang, Chunyang; Chen, Lingzhi; Zhu, Yingjie; Guan, Zisheng

2018-04-03

This paper reports inverted pyramid microstructure-based single-crystalline silicon (sc-Si) solar cell with a conversion efficiency up to 20.19% in standard size of 156.75 × 156.75 mm 2 . The inverted pyramid microstructures were fabricated jointly by metal-assisted chemical etching process (MACE) with ultra-low concentration of silver ions and optimized alkaline anisotropic texturing process. And the inverted pyramid sizes were controlled by changing the parameters in both MACE and alkaline anisotropic texturing. Regarding passivation efficiency, the textured sc-Si with normal reflectivity of 9.2% and inverted pyramid size of 1 μm was used to fabricate solar cells. The best batch of solar cells showed a 0.19% higher of conversion efficiency and a 0.22 mA cm -2 improvement in short-circuit current density, and the excellent photoelectric property surpasses that of the same structure solar cell reported before. This technology shows great potential to be an alternative for large-scale production of high efficient sc-Si solar cells in the future.

Patients on hemodialysis are better served by a proximal arteriovenous fistula for long-term venous access.

LENUS (Irish Health Repository)

Sultan, Sherif

2012-11-01

Patients with end-stage renal disease should have arteriovenous fistula (AVF) formation 3 to 6 months prior to commencing hemodialysis (HD). However, this is not always possible with strained health care resources. We aim to compare autologous proximal AVF (PAVF) with distal AVF (DAVF) in patients already on HD. Primary end point is 4-year functional primary. Secondary end point is freedom from major adverse clinical events (MACEs). From January 2003 to June 2009, out of 495 AVF formations, 179 (36%) patients were already on HD. These patients had 200 AVF formations (49 DAVF vs 151 PAVF) in arms in which no previous fistula had been formed. No synthetic graft was used. Four-year primary functional patency significantly improved with PAVF (68.9% ± SD 8.8%) compared to DAVF (7.3% ± SD 4.9%; P < .0001). Five-year freedom from MACE was 85% with PAVF compared to 40% with DAVF (P < .005). Proximal AVF bestows long-term functional access with fewer complications compared to DAVF for patients already on HD.

Long-term Outcomes of Paclitaxel-Eluting Versus Sirolimus-Eluting Stent for Percutaneous Coronary Intervention: A Meta-Analysis

International Nuclear Information System (INIS)

Kong, J.; Liu, P.; Fan, X.; Wen, J.; Zhang, J.; Zhen, Y.; Li, J.; Cui, Y.; Zheng, X.; Ye, Z.

2017-01-01

The relative long-term efficacy and safety of sirolimus-eluting stents (SES) compared with paclitaxel-eluting stents (PES) in multiple comparative studies remains controversial. This report evaluates 29 randomized trials with 18,379 patients in whom long-term (more than 1 year) outcomes were evaluated. The primary outcomes were target lesion revascularization (TLR) and the secondary end points were death, cardiac death, myocardial infarction (MI), major adverse cardiac events (MACEs), target vessel revascularization (TVR)and stent thrombosis (ST). In comparison with PES, SES significantly reduced the long-term risk of TLR (RR=0.68; 95% CI=0.57 to 0.80, p<0.001), TVR (RR=0.69; 95% CI= 0.60 to 0.79, p<0.001) and MACE (RR=0.82; 95% CI= 0.77 to 0.88, p<0.001), while there were no significant difference with respect to death, cardiac death, MI and ST between the two groups. SES performance was significantly better for reducing the former three outcomes and comparable for the majority of the secondary end points when compared against PES. (author)

Fermilab Education Office - Contacts

Science.gov (United States)

Search The Office of Education and Public Outreach: Contacts All telephone numbers require area code Presentations for Presenters 840-3094 Office of Education and Public Outreach Spencer Pasero spasero@fnal.gov Education Office 840-3076 Fermilab Friends for Science Education General Questions Susan Dahl sdahl@fnal.gov

The Cyber Dimensions of the Syrian Civil War: Implications for Future Conflict

Science.gov (United States)

2015-04-15

worldview of US cyber operations, which has recently been portrayed in an unflattering light after leaks by Edward Snowden .65 Many cyber...Christine Fox, Susan Lee, Mark Lewellyn, Thomas Mahnken, Peter Nanos, and Edward Smyth. About the Author Captain Edwin J. Grohe, a native of Milford

Tanzania Journal of Health Research - Vol 20, No 2 (2018)

African Journals Online (AJOL)

Socio-demographic determinants of dengue infection during an outbreak in Dar es Salaam City, Tanzania · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Neema Camara, Billy Ngasala, Germana Leyna, Ahmed Abade, Susan F. Rumisha, Ndekya M. Oriyo, Leonard ...

75 FR 57974 - Senior Executive Service Performance Review Board

Science.gov (United States)

2010-09-23

.... Crocetti Jr., Louis D. Cullen, Susan M. Cummiskey, Chris Daitch, William Davis, Delia P. Dayton, Mark de.... Armstrong, Charles R. Ayala, Janice Aytes, Michael L. Bacon, Roxana Baldwin, William D. Baroukh, Nader Barr... Brundage, William Bucella, Donna A. Bucher, Steven P. Buckingham, Patricia A. Burke, Richard Butcher...

75 FR 1406 - National Mall and Memorial Parks, Washington, DC; Notice of Availability of an Environmental...

Science.gov (United States)

2010-01-11

... Washington, DC. The National Mall Plan is a long-range management plan that focuses on the use and... Spain, Project Executive. Before including your address, phone number, e-mail address, or other personal... Impact Statement. FOR FURTHER INFORMATION CONTACT: Susan Spain, Project Executive, National Mall Plan at...

Steven Moffat and Sue Vertue visits CERN

CERN Multimedia

Caraban Gonzalez, Noemi

2016-01-01

Steven William Moffat, OBE is a Scottish television writer and producer, known for his work as showrunner, writer and producer of the British television series Doctor Who and Sherlock. Susan "Sue" Nicola Vertue is an English television producer, mainly of comedy shows, including Mr. Bean and Coupling.

Ring Two: The Librarians Comment

Science.gov (United States)

American Libraries, 1978

1978-01-01

Three librarians give their impressions of sales representatives who work at library conventions. Henry Stewart discusses how they can be knowledgeable information sources about current products and services; Susan Martin describes how library automation vendors can help librarians learn about new technology; and Peggy Sullivan discusses the…

77 FR 19192 - Circular Welded Carbon-Quality Steel Pipe From India: Preliminary Affirmative Countervailing Duty...

Science.gov (United States)

2012-03-30

.... See Memorandum to Susan H. Kuhbach, Director, Office 1 from David Layton, International Trade Analyst... Provision of Hot-Rolled Steel by the Steel Authority of India (``SAIL'') for Less Than Adequate Remuneration... the questions regarding land received at less than adequate remuneration, Zenith prevented us from...

Remedial principles and meaningful engagement in education ...

African Journals Online (AJOL)

This article evaluates the meaningful engagement doctrine in the education rights jurisprudence of the Constitutional Court in the light of a set of normative principles developed by Susan Sturm for evaluating participatory public law remedies. It commences by identifying four principles for evaluating participatory remedies ...

75 FR 82212 - Endangered and Threatened Species; Take of Anadromous Fish

Science.gov (United States)

2010-12-29

... and Threatened Species; Take of Anadromous Fish AGENCY: National Marine Fisheries Service (NMFS... Chinook salmon under Limit 6 of the Endangered Species Act (ESA) 4(d) Rule for salmon and steelhead, a.... Dated: December 22, 2010. Susan Pultz, Acting Chief, Endangered Species Division, Office of Protected...

77 FR 25538 - Quarterly Publication of Individuals, Who Have Chosen To Expatriate

Science.gov (United States)

2012-04-30

... ERIK PAUL FURLER NICOLAS SILVAN FURRER GAJA MARIA FURRER JONAS KEVIN FURRER SACHA GABRIELLA GAGNON... CATHERINE MARIE MILNE NATASHA JANE MIN CHRIS SHIK MIN STEVE BAE MIZRACHI ELI HAIM MONTAGUE ALEXANDRE NICOLAS... CHRISTIAN MARTIN SYZ ISABEL SUSAN TAN CHUAN LIONG TAN WEI-EE BEVERLY [[Page 25544

"Feminist" Teaching/Teaching "Feminism"

Science.gov (United States)

Carillo, Ellen C.

2007-01-01

The stakes are high for feminist teachers. Susan A. Basow, Nancy T. Silberg, Kathryn Duncan, Michael Stasio, and others have reported disturbing findings regarding the discrepancy between student evaluations of male professors and female professors. Professors who have identified themselves as feminists or committed to practicing feminist…

Information Broker/Free Lance Librarian--New Careers--New Library Services. Miscellaneous Studies No. 3

Science.gov (United States)

Minor, Barbara B., Ed.

Proceedings of a workshop on the information broker--a person or organization that provides information on demand for a fee, usually to make a profit--includes edited transcripts of the following presentations: "Introduction," Maxine Davis; "The Free-Lance Alternative: Turning Traditional Skills New Directions," Susan Klement;…

Persistent Patriarchy: Women Workers on Sri Lankan Plantations

NARCIS (Netherlands)

R. Kurian (Rachel); K. Jayawardena (Kumari)

2014-01-01

markdownabstract__Abstract__ The early suffragists in the United States had decried the “prolonged slavery of woman” as the “darkest page in human history” with one of the leaders, Susan B. Anthony, stating on Independence Day in 1876 that “Universal manhood suffrage, by establishing

75 FR 63813 - Membership of the Bureau Industry Security Performance Review Board

Science.gov (United States)

2010-10-18

..., Department of Commerce Human Resources Operations Center (DOCHROC), Office of Executive Resources Operations... Administration. Susan Boggs, Director, Office of Staffing, Recruitment and Classification, Department of Commerce Human Resources Operations Center. [FR Doc. 2010-26168 Filed 10-15-10; 8:45 am] BILLING CODE 3510-25-P ...

Media Violence and Freedom of Speech : How to Use Empirical Data

NARCIS (Netherlands)

de Bruin, Boudewijn

Susan Hurley has argued against a well known argument for freedom of speech, the argument from autonomy, on the basis of two hypotheses about violence in the media and aggressive behaviour. The first hypothesis says that exposure to media violence causes aggressive behaviour; the second, that humans

75 FR 60780 - Announcement of Funding Awards for Fiscal Year 2010 Alaska Native/Native Hawaiian Institutions...

Science.gov (United States)

2010-10-01

...-income, consistent with the purpose of Title I of the Housing and Community Development Act of 1974, as amended. FOR FURTHER INFORMATION CONTACT: Susan Brunson, Office of University Partnerships, U.S... administered by the Office of University Partnerships under the Office of the Assistant Secretary for Policy...

Collection of $^{83}$Rb at low implantation energy for KATRIN

CERN Multimedia

Zboril, M

KATRIN, the KArlsruhe TRItium Neutrino experiment aims to measure the neutrino mass by spectroscopy of the tritium $\\beta$-decay at the endpoint by means of Magnetic Adiabatic Collimation combined with an Electrostatic filter (MAC-E filter). To monitor the HV-system of the KATRIN-setup, we would need one or two $^{83}$Rb sources roughly every half a year.

Case Series Mitrofanoff Urinary Diversion: A Report of Three Cases ...

African Journals Online (AJOL)

KIGZ

A 2 cm segment of the ileum on its blood supply was resected and a spiral Monti channel made from it over a 14FG feeding tube as a stent. Mitrofanoff procedure was performed and the channel brought out at the umbilicus. The appendix was used to create a Malone Antegrade Caecal Enema (MACE) 'stoma' and brought.

Primary Prevention Approaches to the Development of Mental Health Services for Ethnic Minorities: A Challenge to Social Work Education and Practice.

Science.gov (United States)

Miller, Samuel O., Ed.; And Others

This monograph contains articles on mental health needs, experiences, and preventive social work programs in ethnic minority communities. An overview by Gwenelle Styles O'Neal reviews factors that influence the mental health of ethnic minorities and explores family and community support networks for alleviating stress. Susan Bellinger examines…

Eliminate the "Bounce"!

Science.gov (United States)

Leigh, Susan

2016-01-01

The "bounce" (coined by students at Susan Leigh's last campus) refers to the amount of time students spent chasing signatures and removing often-unnecessary registration "holds" in order to attend their classes. Leigh explains that all this chaos from complex, separately housed transactional business processes has led to the…

Communicators take nine Virginia Press Women awards

OpenAIRE

Owczarski, Mark

2008-01-01

Three Virginia Tech communicators have won Virginia Press Women awards. The winners - Susan Trulove, research division communications manager; Clara Cox, university publications director; and Heather Riley Chadwick, College of Architecture and Urban Studies communication manager - were announced at the Virginia Press Women Annual Spring Conference in Staunton, Va.

Malaria Genome Sequencing Project

Science.gov (United States)

2004-01-01

UTTERBACK, TERESA RIGGS, FLORENCE VAN AKEN, SUSAN RIZZO, MICHAEL VISWANATHAN, LAKSHMI ROMERO , CALUDIA DEVI ROONEY, TIMOTHY VON ARX, ANNA RUCH, KAREN...Clark*, R. Clark*, C. Corton *, well with the predictions from the optical map. Chromosome 13 is A. Cronin*, R. Davies*, P. Davis*, P. Dear§, F. Dearden

75 FR 65648 - Notice of Proposed Withdrawal Extension and Opportunity for Public Meeting for the Peony, Pole...

Science.gov (United States)

2010-10-26

..., Pole Pick, and Frank Burge Seed Orchards; Washington AGENCY: Bureau of Land Management, Interior... functionality of the seed orchards, along with the investment of Federal funds at the Peony, Pole Pick, and.../Washington State Office, (503) 808-6189, or Susan Daugherty, USFS Pacific Northwest Region, (503) 808-2416...

75 FR 1566 - Public Hearings for Reconsideration of the 2008 National Ambient Air Quality Standards for Ozone

Science.gov (United States)

2010-01-12

..., Moody Ballroom (located on the ground floor), 8181 Airport Boulevard, Houston, Texas 77061. Telephone... Standards for Ozone'' proposed rule should be addressed to Ms. Susan Lyon Stone, U.S. EPA, Office of Air... Park, NC 27711, telephone: (919) 541-1146, e-mail: stone[email protected] . SUPPLEMENTARY INFORMATION: The...

Crowdsourced Geospatial Data: A Report on the Emerging Phenomena of Crowdsourced and User-Generated Geospatial Data

Science.gov (United States)

2012-11-01

www.osmfoundation.org/wiki/Data_Working_Group.   126   Devillers, Rodolphe, Alfred Stein, Yvan Bédard, Nicholas Chrisman, Peter Fisher, and Wenzhong Shi...Francis, Peter J. Blancher, Susan R. Drennan, Mar- shall A. Howe, Denis Lepage, Chandler . S. Robbins, Kenneth V. Rosen- berg, John R. Sauer, and

Reference Correction to: Making Air Pollution Visible: A Tool for Promoting Environmental Health Literacy.

Science.gov (United States)

Galkina Cleary, Ekaterina; Patton, Allison P; Wu, Hsin-Ching; Xie, Alan; Stubblefield, Joseph; Mass, William; Grinstein, Georges; Koch-Weser, Susan; Brugge, Doug; Wong, Carolyn

2017-12-20

[This corrects the article DOI: 10.2196/publichealth.7492.]. ©Ekaterina Galkina Cleary, Allison P Patton, Hsin-Ching Wu, Alan Xie, Joseph Stubblefield, William Mass, Georges Grinstein, Susan Koch-Weser, Doug Brugge, Carolyn Wong. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 20.12.2017.

Forum: Cultural Identity and (Dis)Continuities of Children of Immigrant Communities

Science.gov (United States)

Obsiye, Mohamed; Cook, Rachel

2016-01-01

Susan Harper's study centres on "funds of knowledge" as a pedagogical resource for the development of a science curriculum, drawing on Karen refugee parents' cultural knowledge and identity. She argues that engagement in this process helps the parent generation of this community to "rebuild their cultural resilience" and cope…

Assessment of diagnostic technology in health care: rationale, methods, problems, and directions

National Research Council Canada - National Science Library

Sox, Harold C

1989-01-01

... Rationale, Methods, Problems, and Directions Harold Sox, Susan Stern, Douglas Owens, and Herbert L. Abrams Institute of Medicine NATIONAL ACADEMY PRESS WASHINGTON, D.C. 1989 Copyrightthe cannot be not from book, paper however, version for formatting, original authoritative the typesetting-specific the as from created publication files XML from...

Voyage on the SS "School Library Leadership": Collaboration in Teaching and Learning at the University of Vermont

Science.gov (United States)

Kaplan, Judith L.; Ballard, Susan D.

2012-01-01

This article describes the SS "School Library Leadership" maiden voyage, which departed from the University of Vermont (UVM) during the 2010 fall semester. Twelve intrepid sailors followed their sense of adventure into uncharted waters with cocaptains Judy Kaplan and Susan Ballard in an online collaboration that provided a powerful…

75 FR 9163 - Certain Seamless Carbon and Alloy Steel Standard, Line, and Pressure Pipe From the People's...

Science.gov (United States)

2010-03-01

..., International Trade Compliance Analyst, Office 1 to Susan H. Kuhbach, Director, Office 1, ``New Subsidy... rounds for less than adequate remuneration by the GOC. We requested information from the GOC about the... the owners, members of the board of directors, or managers of the suppliers who were also government...