334 research outputs found
The Right Prediction⁎⁎Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.
Introduction
This special issue of Kunapipi is a tribute to tlie work and career of Professor
Shirley Chew, who retires in June 2003 as Professor of Commonwealth and
Postcolonial Literatures in the School of English, University of Leeds, UK. She
has occupied the Chair at Leeds since 1993, but her association with the School
of English dates from 1974. Along with other scholars at Leeds, such as Arthur
Ravenscroft, William Walsh, Lynette Hunter and David Richards — and in
association with international figures such as the late Anna Rutherford — Shirley
has dedicated her academic career to the teaching, researching and promoting
of literatures in English from Commonwealth countries
Initial United States experience with the Paracor HeartNet⁎⁎Paracor Medical, Inc, Sunnyvale, Calif. myocardial constraint device for heart failure
ObjectiveThis study was undertaken to review the initial results and surgical safety data for the US Food and Drug Administration safety and feasibility trial of the Paracor HeartNet (Paracor Medical, Inc, Sunnyvale, Calif.) myocardial constraint device.MethodsPatients with New York Heart Association functional class II or III heart failure underwent device implantation (n = 21) through a left minithoracotomy.ResultsThe average age was 53 years (31–72 years). There were 18 men and 3 women, and 17 patients had nonischemic etiology of heart failure. Mean heart failure duration was 8.3 years (1.4-18.8 years). Average ejection fraction was 22% (11%-33%), with an average left ventricular end-diastolic dimension of 74 mm (55-94 mm). Previous medical therapy included angiotensin-converting enzyme inhibitors, β-blockers, diuretics, digoxin, and aldosterone receptor blockers. At implantation, 17 patients had implantable electronic devices: 1 biventricular pacemaker, 11 biventricular pacemakers with cardioverter-defibrillators, and 5 implantable cardioverter-defibrillators. Patient comorbidities included hypertension in 10 cases, diabetes mellitus in 8, myocardial infarction in 1, and ventricular tachycardia in 8. Mean operative time was 68 minutes (42–102 minutes), and implantation time averaged 15 minutes (5–51 minutes). The average time to ambulation was 1.6 days (1–4 days). The intensive care unit stay averaged 3.3 days (1–16 days), and hospital stay averaged 6.3 days (4–16 days). Atrial fibrillation occurred in 2 patients, and there were 2 in-hospital deaths.ConclusionsThe Paracor device can be implanted in patients with heart failure and reduced left ventricular function with a high degree of success. Significant surgical complications were infrequent. The initial US experience supports the conduct of a randomized, controlled, pivotal trial
The effect of cardiac resynchronization without a defibrillator on morbidity and mortality: an individual patient data meta-analysis of COMPANION and CARE-HF
AIMS: Cardiac resynchronization therapy (CRT) reduces morbidity and mortality for patients with heart failure, reduced left ventricular ejection fraction, QRS duration >130 ms and in sinus rhythm. The aim of this study was to identify patient characteristics that predict the effect, specifically, of CRT pacemakers (CRT-P) on all-cause mortality or the composite of hospitalization for heart failure or all-cause mortality. METHODS AND RESULTS: We conducted an individual patient data meta-analysis of the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) and Cardiac Resynchronization-Heart Failure (CARE-HF) trials. Only patients assigned to CRT-P or control (n = 1738) were included in order to avoid confounding from concomitant defibrillator therapy. The influence of baseline characteristics on treatment effects was investigated. Median age was 67 (59-73) years, most patients were men (70%), 68% had a QRS duration of 150-199 ms and 80% had left bundle branch block. Patients assigned to CRT-P had lower rates for all-cause mortality (hazard ratio [HR] 0.68, 95% confidence interval [CI] 0.56-0.81; p < 0.0001) and the composite outcome (HR 0.67, 95% CI 0.58-0.78; p < 0.0001). No pre-specified characteristic, including sex, aetiology of ventricular dysfunction, QRS duration (within the studied range) or morphology or PR interval significantly influenced the effect of CRT-P on all-cause mortality or the composite outcome. However, CRT-P had a greater effect on the composite outcome for patients with lower body surface area and those prescribed beta-blockers. CONCLUSIONS: Cardiac resynchronization therapy-pacemaker reduces morbidity and mortality in appropriately selected patients with heart failure. Benefits may be greater in smaller patients and in those receiving beta-blockers. Neither QRS duration nor morphology independently predicted the benefit of CRT-P. CLINICAL TRIAL REGISTRATION: COMPANION, NCT00180258; CARE-HF, NCT00170300
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Retinoic Acid Can Enhance Conversion of Naive into Regulatory T Cells Independently of Secreted Cytokines
It has been reported that retinoic acid (RA) enhances regulatory T (T reg) cell conversion by inhibiting the secretion of cytokines that interfere with conversion. This report shows that these conclusions provide a partial explanation at best. First, RA not only interfered with cytokine secretion but also with the ability of these cytokines to inhibit T reg cell conversion of naive T cells. Furthermore, RA enhanced conversion even in the absence of inhibitory cytokines. The latter effect depended on the RA receptor α (RARα) but did not require Smad3, despite the fact that RA enhanced Smad3 expression. The RARα1 isoform was not essential for RA-dependent enhancement of transforming growth factor β–driven conversion, suggesting that conversion can also be mediated by RARα2. Interleukin (IL)-6 strongly reduced RARα expression levels such that a deficiency of the predominant RARα1 isoform leaves too little RARα2 for RA to inhibit the generation of Th17 cells in the presence of IL-6
Firm finances, weather derivatives and geography
This paper considers some intellectual, practical and political dimensions of collaboration between human and physical geographers exploring how firms are using relatively new financial products – weather derivatives – to displace any costs of weather-related uncertainty and risk. The paper defines weather derivatives and indicates how they differ from weather insurance products before considering the geo-political, cultural and economic context for their creation. The paper concludes by reflecting on the challenges of research collaboration across the human–physical geography divide and suggests that while such initiatives may be undermined by a range of institutional and intellectual factors, conversations between physical and human geographers remain and are likely to become increasingly pertinent. The creation of a market in weather derivatives raises a host of urgent political and regulatory questions and the confluence of natural and social knowledges, co-existing within and through the geography academy, provides a constructive and creative basis from which to engage with this new market and wider discourses of uneven economic development and climate change
First detection of porcine respirovirus 1 in Germany and the Netherlands
Porcine respirovirus 1, also referred to as porcine parainfluenza virus 1 (PPIV-1), was first detected in deceased pigs from Hong Kong in 2013. It has since then been found in the USA, Chile and most recently in Hungary. Information on the pathogenicity and global spread is sparse. However, it has been speculated to play a role in the porcine respiratory disease complex. To investigate the porcine virome, we screened 53 pig samples from 26 farms within the Dutch-German border region using shotgun metagenomics sequencing (SMg). After detecting PPIV-1 in five farms through SMg, a real-time reverse transcriptase PCR (RT-qPCR) assay was designed, which not only confirmed the presence of the virus in 1 of the 5 farms but found an additional 6 positive farms. Phylogenetic analysis found the closest match to be the first detected PPIV-1 strain in Hong Kong. The Dutch-German region represents a significant area of pig farming within Europe and could provide important information on the characterization and circulation of porcine viruses, such as PPIV-1. With its recent detection in Hungary, these findings suggest widespread circulation of PPIV-1 in Central Europe, highlighting the need for further research on persistence, pathogenicity and transmission in Europe
Distinct pressure evolution of coupled nematic and magnetic orders in FeSe
We present a microscopic study of nematicity and magnetism in FeSe over a wide temperature and pressure range using high-energy x-ray diffraction and time-domain Mössbauer spectroscopy. The low-temperature magnetic hyperfine field increases monotonically up to ∼ 6 GPa. The orthorhombic distortion initially decreases under increasing pressure but is stabilized at intermediate pressures by cooperative coupling to the pressure-induced magnetic order. Close to the reported maximum of the superconducting critical temperature at p = 6.8 GPa , the orthorhombic distortion suddenly disappears and a new tetragonal magnetic phase occurs. The pressure and temperature evolution of the structural and magnetic order parameters suggests that they have distinct origins
Alien palm invasion leads to selective biotic filtering of resident plant communities towards competitive functional traits
Biological invasions drive biodiversity loss and ecosystem change on tropical islands. However, we know little about the implications of species losses on the functional structure of both resident and novel communities. Herein, we examined the potential effect of a non-native palm species, Pinanga coronata, on the taxonomic and functional assemblages of understory plant species in a Fijian rainforest. We predicted that competition from this invasive species would lead to trait convergence according to the competitive hierarchy hypothesis. Using a trait-based approach, we sampled plant communities in 280 plots across a gradient of P. coronata densities. We measured five functional traits, including height and leaf traits related to nutrient acquisition. We found that an increase in P. coronata density is strongly correlated with a decrease in taxonomic diversity (i.e., about − 50% for species richness and − 33% for Shannon diversity index) and a decrease in functional richness. Community-weighted mean values of traits of resident species (i.e., excluding P. coronata) converged toward competitive strategies such as higher leaf nitrogen content (LNC), lower carbon-to-nitrogen (C:N) ratios and leaf dry matter content (LDMC), a pattern that is significantly non-random for LDMC and C:N. This study demonstrates that P. coronata might act as a strong biotic filter responsible for species loss and functional changes. Our findings suggest that in response to increasing competition with this invasive plant, resident and novel plant communities shift toward less diverse and more competitive assemblages. Nevertheless, the intensity of this filtering is habitat dependent (e.g. less filtering effect under mahogany trees). Lastly, changes in resource acquisition strategies (mainly nutrient-based) in particular in low nutrient status of rainforest soils, could lead to long-term impacts on tree regeneration, in turn causing large-scale changes in ecosystem properties
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