Readmissions and repeat procedures after catheter ablation for atrial fibrillation

Background: The aim of this study was to assess the frequency of all-cause rehospitalization and due to atrial fibrillation/flutter (AF/AFl), repeat ablation of AF/AFl, mortality within 30 days and 1-year follow-up in patients after AF/AFl ablation procedure. Methods: Using data from the National Health Fund we identified a database comprising 2,022 patients who underwent AF/AFl ablation between January, 2012 and December, 2012 in Poland. The primary endpoint was readmission to hospital with discharge diagnosis AF/AFl. The secondary endpoints included: repeat AF/AFl ablation, cardiovascular hospitalization, all-cause hospitalization, all-cause mortality assessed in 30-day and 1-year time frame. Results: The mean age was 58.6 ± 10.9 years (66.8% male). The mean time of the index ablation hospitalization was 3.8 ± 2.6 days. After discharge, 123 (6.1%) and 540 (26.7%) patients were hospitalized because of AF/AFl within 30 days and 1 year, respectively. During 1-year follow-up, 192 (9.5%) patients underwent subsequent AF/AFl ablations. The patients that underwent the second ablation were younger (56.6 ± 11.0 vs. 59.1 ± 10.8; p = 0.019) and the time of the index hospitalization was shorter (3.75 ± 2.16 vs. 4.45 ± 3.26; p = 0.03). Within 30 days 194 (9.6%) patients were hospitalized and 747 (36.9%) in 1-year follow-up. All-cause mortality was 0.1% and 1.4% in 30-day and 1-year follow-up, respectively. In a 1-year follow-up patients hospitalized from AF/AFl recurrence were more frequently hospital­ized due to cardiovascular diseases other than AF/AFl (9.6% vs. 6.7%; p = 0.026), especially due to hypertension (2.9% vs. 0.7%; p < 0.001). Conclusions: Over 1 out of 4 patients who underwent AF/AFl ablation were hospitalized due to arrhythmia recurrence in 1 year

First-in-human, open-label, phase 1/2 study of the monoclonal antibody programmed cell death protein-1 (PD-1) inhibitor cetrelimab (JNJ-63723283) in patients with advanced cancers

Melanoma; Monoclonal antibody PD-1 inhibitor efficacy; Pharmacokinetics/pharmacodynamicsMelanoma; Eficacia del inhibidor del anticuerpo monoclonal PD-1; Farmacocinética/farmacodinamiaMelanoma; Eficàcia de l'inhibidor de l'anticòs monoclonal PD-1; Farmacocinètica/farmacodinàmicaPurpose To assess the safety, pharmacokinetics, pharmacodynamics, and preliminary efficacy of cetrelimab (JNJ-63723283), a monoclonal antibody programmed cell death protein-1 (PD-1) inhibitor, in patients with advanced/refractory solid tumors in the phase 1/2 LUC1001 study. Methods In phase 1, patients with advanced solid tumors received intravenous cetrelimab 80, 240, 460, or 800 mg every 2 weeks (Q2W) or 480 mg Q4W. In phase 2, patients with melanoma, non-small-cell lung cancer (NSCLC), and microsatellite instability–high (MSI-H)/DNA mismatch repair-deficient colorectal cancer (CRC) received cetrelimab 240 mg Q2W. Response was assessed Q8W until Week 24 and Q12W thereafter. Results In phase 1, 58 patients received cetrelimab. Two dose-limiting toxicities were reported and two recommended phase 2 doses (RP2D) were defined (240 mg Q2W or 480 mg Q4W). After a first dose, mean maximum serum concentrations (Cmax) ranged from 24.7 to 227.0 µg/mL; median time to Cmax ranged from 2.0 to 3.2 h. Pharmacodynamic effect was maintained throughout the dosing period across doses. In phase 2, 146 patients received cetrelimab 240 mg Q2W. Grade ≥ 3 adverse events (AEs) occurred in 53.9% of patients. Immune-related AEs (any grade) occurred in 35.3% of patients (grade ≥ 3 in 6.9%). Overall response rate was 18.6% across tumor types, 34.3% in NSCLC, 52.6% in programmed death ligand 1–high (≥ 50% by immunohistochemistry) NSCLC, 28.0% in melanoma, and 23.8% in centrally confirmed MSI-H CRC. Conclusions The RP2D for cetrelimab was established. Pharmacokinetic/pharmacodynamic characteristics, safety profile, and clinical activity of cetrelimab in immune-sensitive advanced cancers were consistent with known PD-1 inhibitors.This study was funded by Janssen Research & Development

Back to the drawing board:Can we compare socioeconomic background scales?

Resumen basado en el de la publicaciónUtilizando datos de evaluaciones internacionales de gran escala, se evalúa la consistencia y la invarianza de las escalas de antecedentes socioeconómicos de los estudiantes entre los países participantes en estos estudios. Para ello, se utilizan las medidas de antecedentes socioeconómicos desarrolladas por PISA, TERCE y TIMSS, ya que cada estudio operacionaliza esta medida de manera diferente. Los resultados sugieren que ninguna de las escalas de contexto analizadas son completamente invariantes entre los países que participan en cada estudio, y por lo tanto las comparaciones entre países deben hacerse con precaución. Se discute sobre los niveles de equivalencia alcanzados por cada escala en cada estudio, así como el tipo de comparaciones que se pueden realizar dados estos resultados (e.g. comparación de los promedios nacionales de las escalas, comparación de relaciones o correlaciones entre las escalas evaluadas y otras variables, etc.).ES

Prevalence of Mycobacterium tuberculosis infection as measured by the QuantiFERON-TB Gold assay and ESAT-6 free IGRA among adolescents in Mwanza, Tanzania

Background The prevalence of latent tuberculosis infection (LTBI) is vastly higher than that of tuberculosis (TB) disease and this enormous reservoir of individuals with LTBI impacts the global TB control strategy. Adolescents are at greatest risk of TB infection and are thus an ideal target population for a potential effective TB vaccine to be added to the current BCG programme as it could reduce the number of latent infections and consequently the number of adults with TB disease. However, LTBI rates are often unknown for this population. This study aims to estimate the magnitude of LTBI and to determine if Tanzanian adolescents would be a good population for a prevention of TB infection trial. Methods This was a descriptive cross-sectional study that recruited 193 adolescents aged 12 and 16 years from government schools and directly from the community in Mwanza Region, Tanzania. Socio-demographic characteristics were collected for all enrolled participants. Blood was drawn and tested using QuantiFERON-TB Gold In-Tube (QFT-GIT), and Early Secretory Antigenic Target-6–Free Interferon-gamma Release Assay (ESAT-6 free IGRA). Concordance between QFT-GIT and ESAT-6 free IGRA was evaluated using the McNemar’s test. Results Overall estimates of LTBI prevalence were 19.2% [95%CI, 14.1; 25.2] and 18.6% [95%CI, 13.6; 24.6] as measured by QFT-GIT IGRA and ESAT-6 free IGRA, respectively. The 16-year-old cohort had a higher LTBI prevalence (23.7% [95%CI, 16.1; 32.9]) as compared to 12-year-old cohort (14.6% [95%CI, 8.6; 22.7]) as measured by QFT-GIT IGRA. When measured by ESAT-6 Free IGRA, LTBI prevalence was 24.7% (95%CI, 16.9; 34.0) for the 16-year-old cohort and 12.5% (95%CI, 7.0; 20.3) among the 12-year-old cohort. According to both tests the prevalence of TB infection and the corresponding annual risk of tuberculosis infection (ARTI) and force of infection were high and increased with age. Of all enrolled participants, 97.4% had concordant results for QFT-GIT IGRA and ESAT-6 free IGRA (p = 0.65). Conclusions The prevalence of LTBI and the associated ARTI and force of infection among adolescents is high and increases with age in Mwanza Region. There was a high concordance between the QFT-GIT and the novel ESAT-6 free IGRA assays. These findings suggest Mwanza is a promising area to conduct novel TB vaccine research prevention of infection (POI) studies targeting adolescents.publishedVersio

HST Grism-derived Forecasts for Future Galaxy Redshift Surveys

The mutually complementary Euclid and Roman galaxy redshift surveys will use Halpha- and [OIII]-selected emission line galaxies as tracers of the large scale structure at $0.9 \lesssim z \lesssim 1.9$ (Halpha) and $1.5 \lesssim z \lesssim 2.7$ ([OIII]). It is essential to have a reliable and sufficiently precise knowledge of the expected numbers of Halpha-emitting galaxies in the survey volume in order to optimize these redshift surveys for the study of dark energy. Additionally, these future samples of emission-line galaxies will, like all slitless spectroscopy surveys, be affected by a complex selection function that depends on galaxy size and luminosity, line equivalent width, and redshift errors arising from the misidentification of single emission-line galaxies. Focusing on the specifics of the Euclid survey, we combine two slitless spectroscopic WFC3-IR datasets -- 3D-HST+AGHAST and the WISP survey -- to construct a Euclid-like sample that covers an area of 0.56 deg$^2$ and includes 1277 emission line galaxies. We detect 1091 ($\sim$3270 deg$^{-2}$) Halpha+[NII]-emitting galaxies in the range $0.9\leq z \leq 1.6$ and 162 ($\sim$440 deg$^{-2}$) [OIII]$\lambda$5007-emitters over $1.5\leq z \leq 2.3$ with line fluxes $\geq 2 \times 10^{-16}$ erg s$^{-1}$ cm$^{-2}$. The median of the Halpha+[NII] equivalent width distribution is $\sim$250\r{A}, and the effective radii of the continuum and Halpha+[NII] emission are correlated with a median of $\sim$0.38" and significant scatter ($\sigma \sim$0.2"$-$0.35"). Finally, we explore the prevalence of redshift misidentification in future Euclid samples, finding potential contamination rates of $\sim$14-20% and $\sim$6% down to $2\times 10^{-16}$ and $6 \times 10^{-17}$ erg s$^{-1}$ cm$^{-2}$, respectively, though with increased wavelength coverage these percentages drop to nearly zero.Comment: Accepted for publication in ApJ. 27 pages, 17 figures, 3 table

HST Grism-derived Forecasts for Future Galaxy Redshift Surveys

The mutually complementary Euclid and Roman galaxy redshift surveys will use Hα- and [O III]-selected emission-line galaxies (ELGs) as tracers of the large-scale structure at 0.9 ≾ z ≾ 1.9 (Hα) and 1.5 ≾ z ≾ 2.7 ([O III]). It is essential to have a reliable and sufficiently precise knowledge of the expected numbers of Hα-emitting galaxies in the survey volume in order to optimize these redshift surveys for the study of dark energy. Additionally, these future samples of ELGs will, like all slitless spectroscopy surveys, be affected by a complex selection function that depends on galaxy size and luminosity, line equivalent width (EW), and redshift errors arising from the misidentification of single ELGs. Focusing on the specifics of the Euclid survey, we combine two slitless spectroscopic WFC3-IR data sets—3D-HST+AGHAST and the WFC3 Infrared Spectroscopic Parallel survey—to construct a Euclid-like sample that covers an area of 0.56 deg² and includes 1277 ELGs. We detect 1091 (~3270 deg⁻²) Hα+[N II]-emitting galaxies in the range 0.9 ≤ z ≤ 1.6 and 162 (~440 deg⁻²) [O III] λ5007 emitters over 1.5 ≤ z ≤ 2.3 with line fluxes ≥2 × 10⁻¹⁶ erg s⁻¹ cm⁻². The median of the Hα+[N II] EW distribution is ~250 Å, and the effective radii of the continuum and Hα+[N II] emission are correlated with a median of ~0.”38 and significant scatter (σ ~ 0.”2–0.”35). Finally, we explore the prevalence of redshift misidentification in future Euclid samples, finding potential contamination rates of ~14%–20% and ~6% down to 2 × 10⁻¹⁶ erg s⁻¹ cm−2 and 6 × 10⁻¹⁷ erg s⁻¹ cm⁻², respectively, although with increased wavelength coverage these percentages drop to nearly zero

A link between the ice nucleation activity and the biogeochemistry of seawater

Emissions of ice-nucleating particles (INPs) from sea spray can impact climate and precipitation by changing cloud formation, precipitation, and albedo. However, the relationship between seawater biogeochemistry and the ice nucleation activity of sea spray aerosols remains unclarified. Here, we demonstrate a link between the biological productivity in seawater and the ice nucleation activity of sea spray aerosol under conditions relevant to cirrus and mixed-phase cloud formation. We show for the first time that aerosol particles generated from both subsurface and microlayer seawater from the highly productive eastern tropical North Pacific Ocean are effective INPs in the deposition and immersion freezing modes. Seawater particles of composition similar to subsurface waters of highly productive regions may therefore be an unrealized source of effective INPs. In contrast, the subsurface water from the less productive Florida Straits produced less effective immersion mode INPs and ineffective depositional mode INPs. These results indicate that the regional biogeochemistry of seawater can strongly affect the ice nucleation activity of sea spray aerosol