Lysmata Rafa, a New Species of Peppermint Shrimp (Crustacea, Caridea, Hippolytidae) from the Subtropical Western Atlantic

Lysmata rafa n. sp. is described from freshly collected specimens from the Keys West Lakes, Florida Keys, and from a museum specimen collected at Bear Cut, Biscayne Bay, Florida. The new species is morphologically most similar to the western Atlantic Lysmata rathbunae Chace, 1970 and the eastern PaciWc Lysmata gracilirostris Wicksten, 2000, but can be distinguished from them by the number of carpal segments in the second pereiopod; the length and dentition of the rostrum; the shape and number of spines on the dactylus of the third to Wfth pereiopods; and the absence of a tooth on the pterygostomial margin of the carapace. Despite being a shallow-water species, L. rafa n. sp. has extremely elongate walking legs and third maxilliped that are more typical to deep-water or cave dwelling carideans

Description of two new associated infaunal decapod crustaceans (Axianassidae and Alpheidae) from the tropical eastern Pacific

Two new species of infaunal decapod crustaceans are described based on material collected in Bahía Málaga, Pacific coast of Colombia, in 2009. The mud-shrimp Axianassa darrylfelderi sp. nov. (Axianassidae) appears to be most closely related to A. australis Rodrigues & Shimizu, 1992, A. canalis Kensley & Heard, 1990, and A. jamaicensis Kensley & Heard, 1990. The new species may be distinguished from each of them by a combination of morphological features, mainly on the uropodal exopod, antennal acicle, third maxilliped and first pleonite. The shrimp Leptalpheus canterakintzi sp. nov. (Alpheidae), associated with burrows of A. darrylfelderi sp. nov., undoubtedly represents the eastern Pacific sister species of the western Atlantic L. axianassae Dworschak & Coelho, 1999, which lives exclusively in burrows of A. australis. The two species are reliably distinguishable only by the proportions of the merus and propodus of the third pereiopod. Leptalpheus azuero Anker, 2011, previously known only from the Pacific coast of Panama, is reported for the first time from Bahía Málaga, Colombia.O presente estudo descreve duas novas espécies de crustáceos decápodos da infauna baseado em material coletado na Bahía Málaga, costa pacífica da Colombia, em 2009. A primeira delas, o corrupto Axianassa darrylfelderi sp. nov. (Axianassidae), aparenta estar mais relacionada morfologicamente a A. australis Rodrigues & Shimizu, 1992, A. canalis Kensley & Heard, 1990, e A. jamaicensis Kensley & Heard, 1990. Contudo, a nova espécie difere em uma combinação de caracteres morfológicos, principalmente no exópodo uropodial, acículo (escama) antenal, terceiro maxilípede e primeiro pleonito. A segunda espécie nova, o camarão Leptalpheus canterakintzi sp. nov. (Alpheidae), associado às galerias de A. darrylfelderi sp. nov., incontestavelmente representa a espécie-irmã no Pacífico Oriental da espécie L. axianassae Dworschak & Coelho, 1999 do Atlântico Ocidental, a qual vive exclusivamente em galerias de A. australis. As duas espécies são distinguíveis apenas pelas proporções do mero e propodo do terceiro par de pereiópodos. Além disso, Leptalpheus azuero Anker, 2011, previamente conhecido somente para o Panamá, é registrado pela primeira vez para a Colômbia

On a collection of caridean shrimps (Decapoda, Caridea) from St. Helena, south-central Atlantic, with further records from Ascension Island

We report on a recent collection of caridean shrimps from St. Helena in the south-central Atlantic Ocean, raising the total number of species known from the island to 24. Six species are newly recorded for the area, with no endemic species present. Additional three species are recorded from Ascension Island. A close biogeographical connection between the caridean faunas of St. Helena and Ascension Island is evident.Centre for Marine Sciences (CCMAR) of the University of Algarve, through the Portuguese Foundation for Science and Technology project [UID/Multi/04326/2013

Biomarkers of Sarcopenia in Clinical Trials—Recommendations from the International Working Group on Sarcopenia

Sarcopenia, the age-related skeletal muscle decline, is associated with relevant clinical and socioeconomic negative outcomes in older persons. The study of this phenomenon and the development of preventive/therapeutic strategies represent public health priorities. The present document reports the results of a recent meeting of the International Working Group on Sarcopenia (a task force consisting of geriatricians and scientists from academia and industry) held on June 7–8, 2011 in Toulouse (France). The meeting was specifically focused at gaining knowledge on the currently available biomarkers (functional, biological, or imaging-related) that could be utilized in clinical trials of sarcopenia and considered the most reliable and promising to evaluate age-related modifications of skeletal muscle. Specific recommendations about the assessment of aging skeletal muscle in older people and the optimal methodological design of studies on sarcopenia were also discussed and finalized. Although the study of skeletal muscle decline is still in a very preliminary phase, the potential great benefits derived from a better understanding and treatment of this condition should encourage research on sarcopenia. However, the reasonable uncertainties (derived from exploring a novel field and the exponential acceleration of scientific progress) require the adoption of a cautious and comprehensive approach to the subject

Bleeding Risk and Antithrombotic Strategy in Patients With Sinus Rhythm and Heart Failure With Reduced Ejection Fraction Treated With Warfarin or Aspirin

We sought to assess the performance of existing bleeding risk scores, such as the Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly (HAS-BLED) score or the Outpatient Bleeding Risk Index (OBRI), in patients with heart failure with reduced ejection fraction (HFrEF) in sinus rhythm (SR) treated with warfarin or aspirin. We calculated HAS-BLED and OBRI risk scores for 2,305 patients with HFrEF in SR enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction trial. Proportional hazards models were used to test whether each score predicted major bleeding, and comparison of different risk scores was performed using Harell C-statistic and net reclassification improvement index. For the warfarin arm, both scores predicted bleeding risk, with OBRI having significantly greater C-statistic (0.72 vs 0.61; p = 0.03) compared to HAS-BLED, although the net reclassification improvement for comparing OBRI to HAS-BLED was not significant (0.32, 95% confidence interval [CI] −0.18 to 0.37). Performance of the OBRI and HAS-BLED risk scores was similar for the aspirin arm. For participants with OBRI scores of 0 to 1, warfarin compared with aspirin reduced ischemic stroke (hazard ratio [HR] 0.51, 95% CI 0.26 to 0.98, p = 0.042) without significantly increasing major bleeding (HR 1.24, 95% CI 0.66 to 2.30, p = 0.51). For those with OBRI score of ≥2, there was a trend for reduced ischemic stroke with warfarin compared to aspirin (HR 0.56, 95% CI 0.27 to 1.15, p = 0.12), but major bleeding was increased (HR 4.04, 95% CI 1.99 to 8.22, p <0.001). In conclusion, existing bleeding risk scores can identify bleeding risk in patients with HFrEF in SR and could be tested for potentially identifying patients with a favorable risk/benefit profile for antithrombotic therapy with warfarin

CHA2 DS2 -VASc score and adverse outcomes in patients with heart failure with reduced ejection fraction and sinus rhythm

AIMS: The aim of this study was to determine whether the CHA2 DS2 -VASc score can predict adverse outcomes such as death, ischaemic stroke, and major haemorrhage, in patients with systolic heart failure in sinus rhythm. METHODS AND RESULTS: CHA2 DS2 -VASc scores were calculated for 1101 patients randomized to warfarin and 1123 patients randomized to aspirin. Adverse outcomes were defined as death or ischaemic stroke, death alone, ischaemic stroke alone, and major haemorrhage. Using proportional hazards models, we found that each 1-point increase in the CHA2 DS2 -VASc score was associated with increased hazard of death or ischaemic stroke events [hazard ratio (HR) for the warfarin arm = 1.21, 95% confidence interval (CI) 1.13-1.30, P < 0.001; for aspirin, HR = 1.20, 95% CI 1.11-1.29, P < 0.001]. Similar increased hazards for higher CHA2 DS2 -VASc scores were observed for death alone, ischaemic stroke alone, and major haemorrhage. Overall performance of the CHA2 DS2 -VASc score was assessed using c-statistics for full models containing the risk score, treatment assignment, and score-treatment interaction, with the c-statistics for the full models ranging from 0.57 for death to 0.68 for major haemorrhage. CONCLUSIONS: The CHA2 DS2 -VASc score predicted adverse outcomes in patients with systolic heart failure in sinus rhythm, with modest prediction accuracy

Validity of Verbal Autopsy Procedures for Determining Malaria Deaths in Different Epidemiological Settings in Uganda

BACKGROUND: Verbal autopsy (VA) procedures can be used to estimate cause of death in settings with inadequate vital registries. However, the sensitivity of VA for determining malaria-specific mortality may be low, and may vary with transmission intensity. We assessed the diagnostic accuracy of VA procedures as compared to hospital medical records for determining cause of death in children under five in three different malaria transmission settings in Uganda, including Tororo (high), Kampala (medium), and Kisoro (low). METHODS AND FINDINGS: Caretakers of children who died in participating hospitals were interviewed using a standardized World Health Organization questionnaire. Medical records from the child's hospitalization were also reviewed. Causes of death based on the VA questionnaires and the medical records were assigned independently by physician reviewers and then compared. A total of 719 cases were included in the final analysis, 67 in Tororo, 600 in Kampala, and 52 in Kisoro. Malaria was classified as the underlying or contributory cause of death by review of medical records in 33 deaths in Tororo, 60 in Kampala, and 0 in Kisoro. The sensitivity of VA procedures for determining malaria deaths in Tororo was 61% (95% CI 44-78%) and 50% in Kampala (95% CI 37-63%). Specificity for determining malaria deaths in Tororo and Kampala was high (>88%), but positive predictive value varied widely, from 83% in Tororo to 34% in Kampala (difference 49%, 95% CI 31-67, p<0.001). The difference between the cause-specific mortality fraction for malaria as determined by VA procedures and medical records was -11% in Tororo, +5% in Kampala, and +14% in Kisoro. CONCLUSIONS: Our results suggest that these VA methods have an acceptable level of diagnostic accuracy for determining malaria deaths at the population level in high and medium transmission areas, but not in low transmission areas

Identifying optimal doses of heart failure medications in men compared with women: a prospective, observational cohort study

Background: Guideline-recommended doses of angiotensin-converting-enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), and β blockers are similar for men and women with heart failure with reduced ejection fraction (HFrEF), even though there are known sex differences in pharmacokinetics of these drugs. We hypothesised that there might be sex differences in the optimal dose of ACE inhibitors or ARBs and β blockers in patients with HFrEF. Methods: We did a post-hoc analysis of BIOSTAT-CHF, a prospective study in 11 European countries of patients with heart failure in whom initiation and up-titration of ACE inhibitors or ARBs and β blockers was encouraged by protocol. We included only patients with left ventricular ejection fraction less than 40%, and excluded those who died within the first 3 months. Primary outcome was a composite of time to all-cause mortality or hospitalisation for heart failure. Findings were validated in ASIAN-HF, an independent cohort of 3539 men and 961 women with HFrEF. Findings: Among 1308 men and 402 women with HFrEF from BIOSTAT-CHF, women were older (74 [12] years vs 70 [12] years, p&lt;0·0001) and had lower bodyweights (72 [16] kg vs 85 [18] kg, p&lt;0·0001) and heights (162 [7] cm vs 174 [8] cm, p&lt;0·0001) than did men, although body-mass index did not differ significantly. A similar number of men and women reached guideline-recommended target doses of ACE inhibitors or ARBs (99 [25%] vs 304 [23%], p=0·61) and β blockers (57 [14%] vs 168 [13%], p=0·54). In men, the lowest hazards of death or hospitalisation for heart failure occurred at 100% of the recommended dose of ACE inhibitors or ARBs and β blockers, but women showed approximately 30% lower risk at only 50% of the recommended doses, with no further decrease in risk at higher dose levels. These sex differences were still present after adjusting for clinical covariates, including age and body surface area. In the ASIAN-HF registry, similar patterns were observed for both ACE inhibitors or ARBs and β blockers, with women having approximately 30% lower risk at 50% of the recommended doses, with no further benefit at higher dose levels. Interpretation: This study suggests that women with HFrEF might need lower doses of ACE inhibitors or ARBs and β blockers than men, and brings into question what the true optimal medical therapy is for women versus men