Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Recommendations for the Generation, Quantification, Storage, and Handling of Peptides Used for Mass Spectrometry-Based Assays

BACKGROUND: For many years, basic and clinical researchers have taken advantage of the analytical sensitivity and specificity afforded by mass spectrometry in the measurement of proteins. Clinical laboratories are now beginning to deploy these work flows as well. For assays that use proteolysis to generate peptides for protein quantification and characterization, synthetic stable isotope-labeled internal standard peptides are of central importance. No general recommendations are currently available surrounding the use of peptides in protein mass spectrometric assays. CONTENT: The Clinical Proteomic Tumor Analysis Consortium of the National Cancer Institute has collaborated with clinical laboratorians, peptide manufacturers, metrologists, representatives of the pharmaceutical industry, and other professionals to develop a consensus set of recommendations for peptide procurement, characterization, storage, and handling, as well as approaches to the interpretation of the data generated by mass spectrometric protein assays. Additionally, the importance of carefully characterized reference materials-in particular, peptide standards for the improved concordance of amino acid analysis methods across the industry-is highlighted. The alignment of practices around the use of peptides and the transparency of sample preparation protocols should allow for the harmonization of peptide and protein quantification in research and clinical care

Identifying the variables maintaining self injurious behavior.

Reliability and validity data are reported for an instrument designed to identify variables maintaining self-injurious behavior. The Motivation Assessment Scale (MAS) is a 16-item questionnaire that addresses the situational determinants of self-injurious behavior in persons with autism and other developmental disorders. The reliability study indicated that teachers of 50 developmentally disabled persons could agree on the variables presumably maintaining their student\u27s self-injury (interrater reliability), and that they would be in agreement again 30 days later (test-retest reliability). The validity study indicated that teacher\u27s ratings on the MAS of 8 subjects\u27 self-injury predicted how their students would behave in analogue situations. Specifically, the MAS predicted the subjects\u27 self-injurious behavior in situations with decreased adult attention, with increased academic demands, with restricted access to tangibles, and in unstructured settings. The MAS is presented as an alternative or adjunct to more formal functional analyses in efforts to identify the variables controlling self-injurious behavior

The Motivation Assessment Scale (MAS) administration guide.

https://digitalcommons.usf.edu/books/1049/thumbnail.jp

Assessment and treatment of psychotic speech in an autistic child.

The psychotic speech of autistic and other developmentally disabled children can be defined as words or phrases that are intelligible, but appear out of context. In the present investigation we conducted an analysis of the psychotic speech of a 9-year-old autistic boy. Three experiments were constructed to determine the functional significance of this child\u27s psychotic speech and a method of intervention. The first study involved an analysis of the role of adult attention and task demands in the maintenance of psychotic speech. When task demands were increased, the frequency of psychotic speech increased. Varying adult attention had no effect on psychotic speech. We then performed a second analysis in which the consequence for psychotic speech was a 10-second time-out. Psychotic speech increased, suggesting that it may have been maintained through escape from task demands. Finally, the third experiment involved teaching an appropriate escape response ( Help me ). Psychotic speech was greatly reduced by this intervention. Thus, teaching an appropriate equivalent phrase proved to be a viable alternative to interventions using aversive consequences. The present study represents the first observation that psychotic speech may serve to remove children from unpleasant situations and also introduces a nonaversive intervention for this behavior

Rain Gauges to Range Conditions: Collaborative Development of a Drought Information System to Support Local Decision-Making

Drought monitoring and drought planning are complex endeavors. Measures of precipitation or streamflow provide little context for understanding how social and environmental systems impacted by drought are responding. Here the authors report on collaborative work with the Hopi Tribe-a Native American community in the U.S. Southwest-to develop a drought information system that is responsive to local needs. A strategy is presented for developing a system that is based on an assessment of how drought is experienced by Hopi citizens and resource managers, that can incorporate local observations of drought impacts as well as conventional indicators, and that brings together local expertise with conventional science-based observations. The system described here is meant to harness as much available information as possible to inform tribal resource managers, political leaders, and citizens about drought conditions and to also engage these local drought stakeholders in observing, thinking about, and helping to guide planning for drought.National Oceanic and Atmospheric Administration's Climate Program Office from the Regional Integrated Science and Assessment program [NA13OAR4310166]; Sectoral Applications Research Program [NA10OAR4310183]Published Online: 18 August 2016; 6 month embargoThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Discerning “Flavors” of Drought Using Climate Extremes Indices

Monitoring drought conditions in arid and semiarid regions characterized by high levels of intra-and interannual hydroclimatic variability is a challenging task. Typical drought-monitoring indices that are based on monthly-scale data lack sufficient temporal resolution to detect hydroclimatic extremes and, when used operationally, may not provide adequate indication of drought status. In a case study focused on the Four Corners region of the southwestern United States, the authors used recently standardized World Meteorological Organization climate extremes indices to discern intra-annual hydroclimatic extremes and diagnose potential drought status in conjunction with the simple metric of annual total precipitation. By applying datareduction methods to a suite of metrics calculated using daily data for 1950-2014, the authors identified five extremes indices that provided additional insight into interannual hydroclimatic variability. Annual time series of these indices revealed anomalous years characterized by shifts in the seasonal distribution of precipitation and in the intensity and frequency of individual events. The driest 4-yr intervals over the study period, characterized by similar annual and interval total precipitation anomalies, represent dramatically different assemblages of index values, which are interpreted as different "flavors'' of drought. In turn, it is expected that varying drought impacts on ecosystems, agricultural systems, and water resources would emerge under these different flavors of drought. Results from this study indicate that operational drought monitoring and historical drought assessments in arid and semiarid regions would benefit from the additional insight that daily-based hydroclimatic extremes indices provide, especially in light of expected climate change-driven changes to the hydrologic cycle.National Oceanic and Atmospheric Administration's Climate Program Office from Regional Integrated Science and Assessment Program [NA13OAR4310166]; National Oceanic and Atmospheric Administration's Climate Program Office from Sectoral Applications Research Program [NA10OAR4310183]6 month embargo; Published Online: 22 March 2017This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]