Two-year clinical outcome from the Iberian registry patients after left atrial appendage closure

AIMS: The aim of this study was to observe the percentage of thromboembolic and haemorrhagic events over a 2-year follow-up in patients with non-valvular atrial fibrillation (NVAF) undergoing closure of the left atrial appendage (LAA) with an occlusion device. Observed events and CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke history), CHA2DS2-VASc (also adding: vascular disease and sex) and HAS-BLED (hypertension, abnormal liver/renal function, stroke history, bleeding predisposition, labile international normalised ratios, elderly, drugs/alcohol use)-predicted events were compared. METHODS: LAA closure with an occlusion device was performed in 167 NVAF patients contraindicated for oral anticoagulants and recruited from 12 hospitals between 2009 and 2013. At least two transoesophageal echocardiograms were performed in the first 6 months postimplantation. Antithrombotics included clopidogrel and aspirin. Patients were monitored for death, stroke, major and relevant bleeding and hospitalisation for concomitant conditions. Mean age was 74.68±8.58, median follow-up was 24 months, 5.38% had intraoperative complications and implantation was successful in 94.6% of subjects. Mortality during follow-up was 10.8%, mostly (9.5%) non-cardiac related. Bleeding occurred in 10.1% of subjects, 5.7% major and 4.4% minor though relevant, and 4.4% suffered stroke. Major bleeding and stroke/transient ischaemic attack events within 2 years (annual event rates, 290 patients/year) were less frequent than expected from CHADS2 (2.4% vs 9.6%), CHA2DS2-VASc (2.4% vs 8.3%) and HAS-BLED (3.1% vs 6.6%) risk scores (p<0.001, p=0.003, p=0.047, respectively). CONCLUSIONS: LAA closure with an occlusion device in patients contraindicated for oral anticoagulants is a therapeutic option associated with fewer thromboembolic and haemorrhagic events than expected from risk scores, particularly in the second year postimplantation

Estimating a threshold price for CO2 emissions of buildings to improve their energy performance level. Case study of a new Spanish home

Energy consumption in homes produces CO2. In many countries, building regulations are being set to enable energy efficiency performance levels to be issued. In Spain, there is a regulated procedure to certify the energy performance of buildings according to their CO2 emissions. Consequently, some software tools have been design to simulate buildings and to obtain their energy consumption and CO2 emissions. In this paper the investment, maintenance and energy consumption costs are calculated for different energy performance levels and for various climatic zones, in a single-family home. According to the results, more energy efficient buildings imply higher construction and maintenance costs, which are not compensated by lower energy costs. Therefore, under current conditions, economic criteria do not support the improvement of the energy efficiency of a dwelling. Among the possible measures to promote energy efficiency, a price on CO2 emissions is to be suggested, including the social cost in the analysis. For this purpose, the cost-optimal methodology is used. In different scenarios for the discount rate y energy prices, various prices for CO2 are obtained, depending on the climatic zone and energy performance level.Ruá Aguilar, MJ.; Guadalajara Olmeda, MN. (2015). Estimating a threshold price for CO2 emissions of buildings to improve their energy performance level. Case study of a new Spanish home. Energy Efficiency. 8(2):183-203. doi:10.1007/s12053-014-9286-2S18320382AICIA. (2009). Escala de calificación energética. Edificios de nueva construcción. Madrid: Instituto para la Diversificación y Ahorro de la Energía, Ministerio de Industria, Turismo y Comercio.Al-Homoud, M. S. (2005). Performance characteristics and practical applications of common building thermal insulation materials. Building and Environment, 40(3), 353–360.Amecke, H. (2012). The impact of energy performances certificates: a survey of German home owners. Energy Policy, 46, 4–14.Andaloro, A., Salomone, R., Ioppolo, G., & Andaloro, L. (2010). Energy certification of buildings: a comparative analysis of progress towards implementation in European countries. Energy Policy, 38(10), 5840–5866.Annunziata, E., Frey, M., & Rizzi, F. (2013). Towards nearly zero-energy buildings: the state-of-art of national regulations in Europe. Energy, 57, 125–133. doi: 10.1016/j.energy.2012.11.049 .Audenaert, A., De Boeck, L., & Roelants, K. (2010). Economic analysis of the profitability of energy-saving architectural measures for the achievement of the EPBD-standard. Energy, 35(7), 2965–2971.Bertrán, A. (2009). Las mediciones en las obras adaptadas al CTE (4th ed.). Granada: Editorial Jorge Loring S.I.Brathal, D., & Langemo, M. (2004). Facilities management: a guide for total workplace design and management. Grand Forks: Knight Printing.Brown, D. W. (1996). Facility maintenance: the manager’s practical guide and handbook. New York: AMACOM American Management Association. New York, NY 10019.Concerted Action EPBD (2008). Implementation of the energy performance of buildings directive. Country reports 2008. Brussels: Directorate General for Energy and Transport, European Commission (available at www.epbd.ca.eu and www.buildup.eu ).Concerted Action EPBD (2011). Implementing the energy performance of buildings directive. Country reports 2011. Brussels: European Union (available at www.epbd.ca.eu and www.buildup.eu ).Davies, H., & Wyatt, D. (2004). Appropriate use or method for durability and service life prediction. Building Research and Information, 32(6), 552–553.Dresner, S., & Ekins, P. (2006). Economic instruments to improve UK home energy efficiency without negative social impacts. Fiscal Studies, 27(1), 47–74.Drury, C. (2008). Management and cost accounting, 7th ed. London.Eurostat European Comission, Instituto de Diversificación y Ahorro de Energía (IDAE), Ministerio de Industria, Energía y Turismo (2011). Proyecto SECH-SPAHOUSEC. Análisis del consumo energético del sector residencial en España. Informe Final. Madrid.Fraunhofer Institute for Systems and Innovation Research ISI (Germany) (2012). Financing the energy efficient transformation of the building sector in the EU. Lessons from the ODYSSEE-MURE project.Garrido, N., Almecija, J. C., Folch, C., Martínez, I. (2011). Certificación energética de edificios. Grupo de Estudios de Energía para la Sostenibilidad (CEES). Cátedra Unesco Sostenibilidad, Universitat Politècnica de Catalunya. (Available at: upcommons.upc.edu/e-prints/bitstream/2117/11820/1/GAS Natural_090406.pdf).Gómez, J. M., & Esteban, M. A. (2010). Sostenibilidad en la edificación. Comparación de dos tipologías constructivas. Rendimiento de los recursos. Ingeniería de Edificación Universitat Politècnica de Catalunya. (Available at: upcommons.upc.edu/pfc/bitstream/2099.1/…/1/PFG_Completo.pdf).Gram-Hanssen, K., Bartiaux, F., Michael Jensen, O., & Cantaert, M. (2007). Do homeowners use energy labels? A comparison between Denmark and Belgium. Energy Policy, 35(5), 2879–2888.Institut de Tecnologia de la Construcció de Catalunya (ITEC) (1991a). Manual de uso y conservación de la vivienda. COAAT Principado de Asturias. Simancas Ediciones S.A. Valladolid.Institut de Tecnologia de la Construcció de Catalunya (ITEC). (1991b). Manteniment de l’edifici. Fitxes (1st ed.). Badalona: Gràfiques Pacífic.Institut de Tecnologia de la Construcció de Catalunya (ITEC). (1991c). Manteniment instal.lacions. Fitxes (1st ed.). Badalona: Gràfiques Pacífic.Institut de Tecnologia de la Construcció de Catalunya (ITEC). (1991d). Manteniment urbanització. Fitxes (1st ed.). Badalona: Gràfiques Pacífic.Institut de Tecnologia de la Construcció de Catalunya (ITEC). (1994). L’actualitat i el cost del manteniment en edificis d’habitatge. Guia pràctic (1st ed.). Barcelona: Gama S.L. Servicios editoriales.Institut de Tecnologia de la Construcció de Catalunya (ITEC). (1996). Ús i manteniment de l’habitatge. Quadern de l’usuari (1st ed.). Zaragoza: Gràfiques Cometa.Institut de Tecnologia de la Construcció de Catalunya (ITEC) (1997). La vivienda: Manual de uso y mantenimient, COAAT de Cantabria. 1ª ed.Institut de Tecnologia de la Construcció de Catalunya (ITEC) (1999). La vivienda: Manual de uso y mantenimiento, COAAT Principado de Asturias. 2ª ed. Simancas Edicionas S.A. Valladolid.Instituto de Diversificación y Ahorro de Energía (IDAE), Ministerio de Industria, Turismo y Comercio (MITYC) (2010). Guía Técnica: Condiciones climáticas exteriores de proyecto, (available at: http://www.minetur.gob.es/energia/desarrollo/eficienciaenergetica/rite/reconocidos/reconocidos/condicionesclimaticas.pdf ).Instituto Eduardo Torroja de Ciencias de la Construcción (IETCC) (2010). Catálogo de Elementos Constructivos del Código Técnico, versión CAT-EC-v06.3-MARZO10. Madrid.Jáber-López, J. T., Valencia-Salazar, I., Peñalvo-López, E., Álvarez-Bel, C., Rivera-López, R., Merino-Hernández, E. (2011). Are energy certification tools for buildings effective? A Spanish case study, Proceedings of the 2011 3rd International Youth Conference on Energetics. Leiria, July 7–9.Johnstone, I. M. (2001a). Energy and mass flows of housing: a model and example. Building and Environment, 36, 27–41.Johnstone, I. M. (2001b). Energy and mass flows of housing: estimating mortality. Building and Environment, 36, 43–51.Kaiser, H. H. (2001). The facilities audit. A process for improving facilities conditions. Arlington: Kirby Lithographic. APPA. The Association of Higher Education Facilities Officers.Kjaerbye, V. H. (2008). Does energy label on residential housing cause energy savings? AKF, Danish Institute of Governmental Research.La Roche, P. (2010). Calculating green house emissions for houses: analysis of the performance of several carbon counting tools in different climates. Informes de la Construcción, 62(517), 61–80.Larsen, B. M., & Nebakken, R. (1997). Norwegian emissions of CO2 1987–1994. Environmental and Resource Economics, 9, 275–290.Laustsen, J. (2008). Energy efficiency requirements in building codes, energy efficiency policies for new buildings. Paris: International Energy Agency information paper.Linares, P., & Labandeira, X. (2010). Energy efficiency: economics and policy. Journal of Economic Surveys, 24(3), 573–592.Liska, R. W. (2000). Means facilities maintenance standards. Kingston: R.S. Means Company, Inc. Construction Publishers & Consultants.Majcen, D., Itard, H., & Visscher, H. (2013). Theoretical vs. actual energy consumption of labelled dwellings in the Netherlands: discrepancies and policy implications. Energy Policy, 54, 125–136.Mercader, M. P., Olivares, M., & Ramírez de Arellano, A. (2012). Modelo de cuantificación del consumo energético en edificación. Informes de la Construcción, 62(308), 567–582.Ministry of Development of Spain. Directorate for Architecture, Housing and Planning. Report on cost optimal calculations and comparison with the current and future energy performance requirements of buildings in Spain. Version 1.1, 7th June 2013.Pérez-Lombard, L., Ortiz, J., & González, R. (2009). A review of benmarching, rating and labelling concepts within the framework of building energy certification schemes. Energy and Buildings, 41(3), 272–278.Piper, J. E. (1995). Handbook of facility management: tools and techniques, formulas and tables. Upper Saddle River: Prentice Hall Inc.Popescu, D., Bienert, S., Schützenhofer, C., & Boazu, R. (2012). Impact of energy efficiency measures on the economic value of buildings. Applied Energy, 89(1), 454–463.Ramírez de Arellano, A. (2004). Presupuestación de obras. 3ª ed. Universidad de Sevilla. Secretariado de Publicaciones. Colección Manuales Universitarios, 37.Rodríguez-González, A. B., Vinagre-Díaz, J. J., Caañamo, A. J., & Wilby, M. R. (2011). Energy and buildings, 43(4), 980–987.Ruá, M. J., & Guadalajara, N. (2013). Application of compromise programming to a semi-detached housing development in order to balance economic and environmental criteria. Journal of the Operational Research Society, 64, 459–468.Ruá, M. J., & Guadalajara, N. (2014). Using the building energy rating software for mathematically modelling operation costs in a simulated home. International Journal of Computer Mathematics. doi: 10.1080/00207160.2014.892588 .Ruá, M. J., & López-Mesa, B. (2012). Certificación energética de edificios en España y sus implicaciones económicas. Informes de la Construcción, 64(527), 307–318.Rudbeck, C. (2002). Service life of building envelope components: making it operational in economical assessment. Construction and Building Materials, 16(2), 83–89.Ruiz, M. C., & Romero, E. (2011). Energy saving in the conventional design of a Spanish house using thermal simulation. Energy and Building, 43(11), 3226–3235.Sanstad, A. H., Blumstein, C., & Stoff, S. E. (1995). How high are option values in energy-efficiency investments? Energy Policy, 23(9), 739–743.Sumner, J., Bird, L., Smith, H. (2009). Carbon taxes: a review of experience and policy design consideration. Technical Report NREL/TP-6A2-47312. National Renewable Energy Laboratory. US Department of Energy.Tuominen, P., Forsström, J., & Honkatukia, J. (2013). Economic effects of energy efficiency improvements in the Finnish building stock. Energy Policy, 52, 181–189.Ucar, A., & Balo, F. (2009). Effect of fuel type on the optimum thickness of selected insulation materials for the four different climatic regions of Turkey. Applied Energy, 86(5), 730–736.Universidad Politécnica De Madrid. Departamento de Construcción y Vías Rurales (2009). Evaluación de los costes constructivos y consumos energéticos derivados de la calificación energética de viviendas. Precost&E. Fase1.Uzsilaityte, L., & Martinaitis, V. (2010). Search for optimal solution of public building renovation in terms of life cycle. Journal of Environmental Engineering and Landscape Management, 18(2), 102–110.Verbruggen, A. (2012). Financial appraisal of efficiency investments: why the good may be the worst enemy of the best. Energy Efficiency, 5, 571–582

Graphene Photonics and Optoelectronics

The richness of optical and electronic properties of graphene attracts enormous interest. Graphene has high mobility and optical transparency, in addition to flexibility, robustness and environmental stability. So far, the main focus has been on fundamental physics and electronic devices. However, we believe its true potential to be in photonics and optoelectronics, where the combination of its unique optical and electronic properties can be fully exploited, even in the absence of a bandgap, and the linear dispersion of the Dirac electrons enables ultra-wide-band tunability. The rise of graphene in photonics and optoelectronics is shown by several recent results, ranging from solar cells and light emitting devices, to touch screens, photodetectors and ultrafast lasers. Here we review the state of the art in this emerging field.Comment: Review Nature Photonics, in pres

Dynamical Boson Stars

The idea of stable, localized bundles of energy has strong appeal as a model for particles. In the 1950s John Wheeler envisioned such bundles as smooth configurations of electromagnetic energy that he called {\em geons}, but none were found. Instead, particle-like solutions were found in the late 1960s with the addition of a scalar field, and these were given the name {\em boson stars}. Since then, boson stars find use in a wide variety of models as sources of dark matter, as black hole mimickers, in simple models of binary systems, and as a tool in finding black holes in higher dimensions with only a single killing vector. We discuss important varieties of boson stars, their dynamic properties, and some of their uses, concentrating on recent efforts.Comment: 79 pages, 25 figures, invited review for Living Reviews in Relativity; major revision in 201

Reaction rates and transport in neutron stars

Understanding signals from neutron stars requires knowledge about the transport inside the star. We review the transport properties and the underlying reaction rates of dense hadronic and quark matter in the crust and the core of neutron stars and point out open problems and future directions.Comment: 74 pages; commissioned for the book "Physics and Astrophysics of Neutron Stars", NewCompStar COST Action MP1304; version 3: minor changes, references updated, overview graphic added in the introduction, improvements in Sec IV.A.

Comparative serology techniques for the diagnosis of Trypanosoma cruzi infection in a rural population from the state of Querétaro, Mexico

Immunological diagnostic methods for Trypanosoma cruzi depend specifically on the presence of antibodies and parasitological methods lack sensitivity during the chronic and “indeterminate” stages of the disease. This study performed a serological survey of 1,033 subjects from 52 rural communities in 12 of the 18 municipalities in the state of Querétaro, Mexico. We detected anti-T. cruzi antibodies using the following tests: indirect haemagglutination assay (IHA), indirect immunofluorescence assay (IFA), ELISA and recombinant ELISA (rELISA). We also performed Western blot (WB) analysis using iron superoxide dismutase (FeSOD), a detoxifying enzyme excreted by the parasite, as the antigen. Positive test results were distributed as follows: ELISA 8%, rELISA 6.2%, IFA and IHA 5.4% in both cases and FeSOD 8%. A comparative study of the five tests was undertaken. Sensitivity levels, specificity, positive and negative predictive values, concordance percentage and kappa index were considered. Living with animals, trips to other communities, gender, age, type of housing and symptomatology at the time of the survey were statistically analysed using SPSS software v.11.5. Detection of the FeSOD enzyme that was secreted by the parasite and used as an antigenic fraction in WBs showed a 100% correlation with traditional ELISA tests

Does CT colonography have a role for population-based colorectal cancer screening?

Colorectal cancer (CRC) is the second most common cancer and second most common cause of cancer-related deaths in Europe. CRC screening has been proven to reduce disease-specific mortality and several European countries employ national screening programmes. These almost exclusively rely on stool tests, with endoscopy used as an adjunct in some countries. Computed tomographic colonography (CTC) is a potential screening test, with an estimated sensitivity of 88 % for advanced neoplasia ≥10 mm. Recent randomised studies have shown that CTC and colonoscopy have similar yields of advanced neoplasia per screened invitee, indicating that CTC is potentially viable as a primary screening test. However, the evidence is not fully elaborated. It is unclear whether CTC screening is cost-effective and the impact of extracolonic findings, both medical and economic, remains unknown. Furthermore, the effect of CTC screening on CRC-related mortality is unknown, as it is also unknown for colonoscopy. It is plausible that both techniques could lead to decreased mortality, as for sigmoidoscopy and gFOBT. Although radiation exposure is a drawback, this disadvantage may be over-emphasised. In conclusion, the detection characteristics and acceptability of CTC suggest it is a viable screening investigation. Implementation will depend on detection of extracolonic disease and health-economic impact

Varespladib and cardiovascular events in patients with an acute coronary syndrome: the VISTA-16 randomized clinical trial

IMPORTANCE: Secretory phospholipase A2(sPLA2) generates bioactive phospholipid products implicated in atherosclerosis. The sPLA2inhibitor varespladib has favorable effects on lipid and inflammatory markers; however, its effect on cardiovascular outcomes is unknown. OBJECTIVE: To determine the effects of sPLA2inhibition with varespladib on cardiovascular outcomes. DESIGN, SETTING, AND PARTICIPANTS: A double-blind, randomized, multicenter trial at 362 academic and community hospitals in Europe, Australia, New Zealand, India, and North America of 5145 patients randomized within 96 hours of presentation of an acute coronary syndrome (ACS) to either varespladib (n = 2572) or placebo (n = 2573) with enrollment between June 1, 2010, and March 7, 2012 (study termination on March 9, 2012). INTERVENTIONS: Participants were randomized to receive varespladib (500 mg) or placebo daily for 16 weeks, in addition to atorvastatin and other established therapies. MAIN OUTCOMES AND MEASURES: The primary efficacy measurewas a composite of cardiovascular mortality, nonfatal myocardial infarction (MI), nonfatal stroke, or unstable angina with evidence of ischemia requiring hospitalization at 16 weeks. Six-month survival status was also evaluated. RESULTS: At a prespecified interim analysis, including 212 primary end point events, the independent data and safety monitoring board recommended termination of the trial for futility and possible harm. The primary end point occurred in 136 patients (6.1%) treated with varespladib compared with 109 patients (5.1%) treated with placebo (hazard ratio [HR], 1.25; 95%CI, 0.97-1.61; log-rank P = .08). Varespladib was associated with a greater risk of MI (78 [3.4%] vs 47 [2.2%]; HR, 1.66; 95%CI, 1.16-2.39; log-rank P = .005). The composite secondary end point of cardiovascular mortality, MI, and stroke was observed in 107 patients (4.6%) in the varespladib group and 79 patients (3.8%) in the placebo group (HR, 1.36; 95% CI, 1.02-1.82; P = .04). CONCLUSIONS AND RELEVANCE: In patients with recent ACS, varespladib did not reduce the risk of recurrent cardiovascular events and significantly increased the risk of MI. The sPLA2inhibition with varespladib may be harmful and is not a useful strategy to reduce adverse cardiovascular outcomes after ACS. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01130246. Copyright 2014 American Medical Association. All rights reserved

Genomic Characterization of Host Factors Related to SARS-CoV-2 Infection in People with Dementia and Control Populations: The GR@ACE/DEGESCO Study

Emerging studies have suggested several chromosomal regions as potential host genetic factors involved in the susceptibility to SARS-CoV-2 infection and disease outcome. We nested a COVID-19 genome-wide association study using the GR@ACE/DEGESCO study, searching for susceptibility factors associated with COVID-19 disease. To this end, we compared 221 COVID-19 confirmed cases with 17,035 individuals in whom the COVID-19 disease status was unknown. Then, we performed a meta-analysis with the publicly available data from the COVID-19 Host Genetics Initiative. Because the APOE locus has been suggested as a potential modifier of COVID-19 disease, we added sensitivity analyses stratifying by dementia status or by disease severity. We confirmed the existence of the 3p21.31 region (LZTFL1, SLC6A20) implicated in the susceptibility to SARS-CoV-2 infection and TYK2 gene might be involved in COVID-19 severity. Nevertheless, no statistically significant association was observed in the COVID-19 fatal outcome or in the stratified analyses (dementia-only and non-dementia strata) for the APOE locus not supporting its involvement in SARS-CoV-2 pathobiology or COVID-19 prognosis

Experimental demonstration of the microscopic origin of circular dichroism in two-dimensional metamaterials

Optical activity and circular dichroism are fascinating physical phenomena originating from the interaction of light with chiral molecules or other nano objects lacking mirror symmetries in three-dimensional (3D) space. While chiral optical properties are weak in most of naturally occurring materials, they can be engineered and significantly enhanced in synthetic optical media known as chiral metamaterials, where the spatial symmetry of their building blocks is broken on a nanoscale. Although originally discovered in 3D structures, circular dichroism can also emerge in a two-dimensional (2D) metasurface. The origin of the resulting circular dichroism is rather subtle, and is related to non-radiative (Ohmic) dissipation of the constituent metamolecules. Because such dissipation occurs on a nanoscale, this effect has never been experimentally probed and visualized. Using a suite of recently developed nanoscale-measurement tools, we establish that the circular dichroism in a nanostructured metasurface occurs due to handedness-dependent Ohmic heating.ope