3-Year Comparison of Drug-Eluting Versus Bare-Metal Stents

ObjectivesThe aim of this study was to compare 3-year cumulative outcomes to landmark second- and third-year outcomes with the routine use of drug-eluting stents (DES) (>75% “off-label”) with a comparable group treated with bare-metal stents (BMS).BackgroundLong-term safety concerns after “off-label” DES use persist, despite recent 2-year data showing comparable safety to BMS use.MethodsClinical outcomes (nonfatal myocardial infarction, all-cause mortality) were assessed in 1,147 consecutive patients who received a BMS in the year before the introduction of DES at Wake Forest University Baptist Medical Center and 1,246 consecutive patients that received a DES after it became our routine choice with equivalent complete 3-year follow-up.ResultsStents were used for “off-label” indications in 80% of DES patients. At 3 years, the hazard ratio for DES compared with BMS for cumulative target vessel revascularization was 0.65 (95% confidence interval [CI]: 0.51 to 0.82), nonfatal myocardial infarction or death was 0.85 (95% CI: 0.71 to 1.03), and all-cause mortality 0.80 (95% CI: 0.64 to 1.01). The DES clinical benefits occurred entirely within the first year, with similar rates of these clinical end points in the second and third year. The cumulative hazard ratio of stent thrombosis DES compared with BMS was 1.07 (95% CI: 0.57 to 2.01), with similar rates of stent thrombosis in the third year (p = 0.70).ConclusionsThe routine clinical use of DES for “off-label” indications was associated with lower clinical end points at 3 years than treatment with BMS in a comparable group of patients, with similar cumulative rates of stent thrombosis. There was no evidence of late “catch-up” of adverse DES events

Revisiting the proposed planetary system orbiting the eclipsing polar HU Aquarii

It has recently been proposed, on the basis of eclipse-timing data, that the eclipsing polar cataclysmic variable HU Aquarii is host to at least two giant planets. However, that result has been called into question based upon the dynamical stability of the proposed planets. In this work, we present a detailed re-analysis of all eclipse timing data available for the HU Aquarii system, making use of standard techniques used to fit orbits to radial-velocity data. We find that the eclipse timings can be used to obtain a two-planet solution that does not require the presence of additional bodies within the system. We then perform a highly detailed dynamical analysis of the proposed planetary system. We show that the improved orbital parameters we have derived correspond to planets that are dynamically unstable on unfeasibly short timescales (of order 10^4 years or less). Given these results, we discuss briefly how the observed signal might in fact be the result of the intrinsic properties of the eclipsing polar, rather than being evidence of dynamically improbable planets. Taken in concert, our results highlight the need for caution in interpreting such timing variations as being planetary in nature.Comment: Accepted for publication in MNRA

Randomized Comparison of Everolimus- and Paclitaxel-Eluting Stents 2-Year Follow-Up From the SPIRIT (Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System) IV Trial

ObjectivesWe sought to determine whether the differences in outcomes present between everolimus-eluting stents (EES) and paclitaxel-eluting stents (PES) in the SPIRIT (Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System) IV trial at 1 year were sustained with longer-term follow-up.BackgroundIn the SPIRIT IV trial, patients undergoing percutaneous coronary intervention who were randomized to EES compared with PES experienced lower 1-year rates of target lesion failure (cardiac death, target vessel myocardial infarction [MI], or ischemia-driven target lesion revascularization [TLR]), with significant reductions in the individual rates of MI, TLR, and stent thrombosis.MethodsWe prospectively randomized 3,687 patients with up to 3 noncomplex previously untreated native coronary artery lesions to EES versus PES at 66 U.S. sites. Follow-up through 2 years is complete in 3,578 patents (97.0%).ResultsTreatment with EES compared with PES reduced the 2-year rates of TLF (6.9% vs. 9.9%, p = 0.003), all MI (2.5% vs. 3.9%, p = 0.02), Q-wave MI (0.1% vs. 0.8%, p = 0.002), stent thrombosis (0.4% vs. 1.2%, p = 0.008), and ischemia-driven TLR (4.5% vs. 6.9%, p = 0.004), with nonsignificantly different rates of all-cause and cardiac mortality. Between 1 year and 2 years, there were no significant differences in adverse event rates between the 2 stent types.ConclusionsIn the large-scale, prospective, multicenter, randomized SPIRIT IV trial, the benefits of EES compared with those of PES present at 1 year were sustained at 2 years. (Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System; NCT01016041

Age-specific variation in apparent survival rates of male lesser-prairie-chickens

We used mark-recapture methods to estimate age-specific apparent survival rates for male Lesser Prairie-Chickens (Tympanuchus pallidicinctus), a gamebird of conservation concern. A total of 311 male prairie-chickens (135 yearlings, 176 adults) were captured and banded during a 5-year study in southwest Kansas. Time-since-marking models were used to estimate apparent survival after first capture (ϕ¹), apparent survival among returning birds (ϕ²⁺), and probability of capture (p) for yearling and adult prairie-chickens. Apparent survival is the product of true survival and site fidelity, and our model-averaged estimates of this parameter were ranked: yearlings after first capture (ϕ̂¹[subscript]yr = 0.60 ± 0.12) > adults after first capture (ϕ̂¹[subscript]ad = 0.44 ± 0.10) > returning birds (ϕ̂²⁺ = 0.36 ± 0.10). In contrast, movement data showed that site fidelity to communal display sites (or leks) increased with male age; yearlings returned to leks at lower rates (80%, n = 60) than adults (92%, n = 65). Thus, true survival rates of male Lesser Prairie-Chickens likely decline with increasing age, an unusual pattern found in few species of birds. We hypothesized that declines in survival as males' age may be a feature of promiscuous mating systems where competition for mating opportunities are intense. A review of annual survival rates for holarctic grouse did not support this idea; age-specific declines in male survival were not restricted to lek-mating species, and appear to be a general feature of most grouse populations.Keywords: age-specific demography, mark-recapture, grouse, Kansas, Tetraonidae, Tympanuchus pallidicinctu

Lesser prairie-chicken brood habitat in sand sagebrush: invertebrate biomass and vegetation

Invertebrates are an important food source for grouse chicks, especially within the first 2 weeks of life. Invertebrate abundance is highly patchy and dependent upon herbaceous cover and vegetation structure. We examined the relationship between invertebrate biomass (from sweepnet samples) and habitat structure at lesser prairie-chicken (Tympanuchus pallidicinctus) brood-use and non-use areas during 2001 and 2002 in a sand sagebrush (Artemisia filifolia) prairie vegetation community of southwestern Kansas. We delineated use and non-use areas from paired sampling points within and outside 95% utilization distributions of radiomarked brood females, respectively, during the first 60 days post-hatch. We measured vegetation cover and invertebrate biomass (Acrididae and "other" invertebrates) at 71 paired points on 2 study sites (Site 1=4 broods, Site 11 = 12 broods). Both Acrididae and other invertebrate biomasses were greater at brood areas than non-use areas on both study sites, suggesting this food source likely had a greater influence on brood habitat use than vegetation type. Vegetation structure described brood-use areas better than vegetation type because brood-use areas had greater visual obstruction readings (VORs) than non-use areas regardless of dominant cover type. We also examined the predictive relationship between vegetation type and invertebrate biomass. Sand sagebrush density was the best linear predictor of Acrididae biomass, with lower densities having the greatest Acrididae biomass. We propose experiments to determine best management practices that produce abundant invertebrate biomasses for lesser prairie-chicken brood habitat, using our study as a baseline.Keywords: invertebrate biomass, habitat use, sand sagebrush, Acrididae, Kansas, Artemisia filifolia, lesser prairie-chicken, Tympanuchus pallidicinctu

Comparison of Zotarolimus-Eluting and Sirolimus-Eluting Stents in Patients With Native Coronary Artery Disease A Randomized Controlled Trial

ObjectivesThis trial examined the relative clinical efficacy, angiographic outcomes, and safety of zotarolimus-eluting coronary stents (ZES) with a phosphorylcholine polymer versus sirolimus-eluting stents (SES).BackgroundWhether a cobalt-based alloy stent coated with the novel antiproliferative agent, zotarolimus, and a phosphorylcholine polymer may provide similar angiographic and clinical benefit compared with SES is undetermined.MethodsA prospective, multicenter, 3:1 randomized trial was conducted to evaluate the safety and efficacy of ZES (n = 323) relative to SES (n = 113) in 436 patients undergoing elective percutaneous revascularization of de novo native coronary lesions with reference vessel diameters between 2.5 mm and 3.5 mm and lesion length ≥14 mm and ≤27 mm. The primary end point was 8-month angiographic in-segment late lumen loss.ResultsAngiographic in-segment late lumen loss was significantly higher among patients treated with ZES compared with SES (0.34 ± 0.44 mm vs. 0.13 ± 0.32 mm, respectively; p < 0.001). In-hospital major adverse cardiac events were significantly lower among patients treated with ZES (0.6% vs. 3.5%, p = 0.04). In-segment binary angiographic restenosis was also higher in the ZES cohort (11.7% vs. 4.3%, p = 0.04). Total (clinically and non-clinically driven) target lesion revascularization rates at 9 months were 9.8% and 3.5% for the ZES and SES groups, respectively (p = 0.04). However, neither clinically driven target lesion revascularization (6.3% zotarolimus vs. 3.5% sirolimus, p = 0.34) nor target vessel failure (12.0% zotarolimus vs. 11.5% sirolimus, p = 1.0) differed significantly.ConclusionsCompared with SES, treatment with a phosphorylcholine polymer-based ZES is associated with significantly higher late lumen loss and binary restenosis at 8-month angiographic follow-up.(The Endeavor III CR; http://clinicaltrials.gov/ct/show/NCT00265668?order=1?

The Bacteroidetes Aequorivita sp. and Kaistella jeonii Produce Promiscuous Esterases With PET-Hydrolyzing Activity

Certain members of the Actinobacteria and Proteobacteria are known to degrade polyethylene terephthalate (PET). Here, we describe the first functional PET-active enzymes from the Bacteroidetes phylum. Using a PETase-specific Hidden-Markov-Model- (HMM-) based search algorithm, we identified several PETase candidates from Flavobacteriaceae and Porphyromonadaceae. Among them, two promiscuous and cold-active esterases derived from Aequorivita sp. (PET27) and Kaistella jeonii (PET30) showed depolymerizing activity on polycaprolactone (PCL), amorphous PET foil and on the polyester polyurethane Impranil® DLN. PET27 is a 37.8 kDa enzyme that released an average of 174.4 nmol terephthalic acid (TPA) after 120 h at 30°C from a 7 mg PET foil platelet in a 200 μl reaction volume, 38-times more than PET30 (37.4 kDa) released under the same conditions. The crystal structure of PET30 without its C-terminal Por-domain (PET30ΔPorC) was solved at 2.1 Å and displays high structural similarity to the IsPETase. PET30 shows a Phe-Met-Tyr substrate binding motif, which seems to be a unique feature, as IsPETase, LCC and PET2 all contain Tyr-Met-Trp binding residues, while PET27 possesses a Phe-Met-Trp motif that is identical to Cut190. Microscopic analyses showed that K. jeonii cells are indeed able to bind on and colonize PET surfaces after a few days of incubation. Homologs of PET27 and PET30 were detected in metagenomes, predominantly aquatic habitats, encompassing a wide range of different global climate zones and suggesting a hitherto unknown influence of this bacterial phylum on man-made polymer degradation

Regional variation in mtDNA of the lesser prairie-chicken

Cumulative loss of habitat and long-term decline in the populations of the Lesser Prairie-Chicken (Tympanuchus pallidicinctus) have led to concerns for the species’ viability throughout its range in the southern Great Plains. For more efficient conservation past and present distributions of genetic variation need to be understood. We examined the distribution of mitochondrial DNA (mtDNA) variation in the Lesser Prairie-Chicken across Kansas, Colorado, Oklahoma, and New Mexico. Throughout the range we found little genetic differentiation except for the population in New Mexico, which was significantly different from most other populations. We did, however, find significant isolation by distance at the rangewide scale (r = 0.698). We found no relationship between haplotype phylogeny and geography, and our analyses provide evidence for a post-glacial population expansion within the species that is consistent with the idea that speciation within Tympanuchus is recent. Conservation actions that increase the likelihood of genetically viable populations in the future should be evaluated for implementation.This is the publisher’s final pdf. The article is copyrighted by Cooper Ornithological Society and published by Central Ornithology Publication Office. It can be found at: http://www.aoucospubs.org/loi/condKeywords: prairie grouse, Tympanuchus pallidicinctus, genetic diversity, Lesser Prairie-Chicken, DNA, mitochondrial DNAKeywords: prairie grouse, Tympanuchus pallidicinctus, genetic diversity, Lesser Prairie-Chicken, DNA, mitochondrial DN