Increased hazard of myocardial infarction with insulin‐provision therapy in actively smoking patients with diabetes mellitus and stable ischemic heart disease: The BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial

Background In the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial, randomization of diabetic patients with stable ischemic heart disease to insulin provision ( IP ) therapy, as opposed to insulin sensitization ( IS ) therapy, resulted in biochemical evidence of impaired fibrinolysis but no increase in adverse clinical outcomes. We hypothesized that the prothrombotic effect of IP therapy in combination with the hypercoagulable state induced by active smoking would result in an increased risk of myocardial infarction ( MI ). Methods and Results We analyzed BARI 2D patients who were active smokers randomized to IP or IS therapy. The primary end point was fatal or nonfatal MI . PAI ‐1 (plasminogen activator inhibitor 1) activity was analyzed at 1, 3, and 5 years. Of 295 active smokers, MI occurred in 15.4% randomized to IP and in 6.8% randomized to IS over the 5.3 years ( P =0.023). IP therapy was associated with a 3.2‐fold increase in the hazard of MI compared with IS therapy (hazard ratio: 3.23; 95% confidence interval, 1.43–7.28; P =0.005). Baseline PAI ‐1 activity (19.0 versus 17.5 Au/mL, P =0.70) was similar in actively smoking patients randomized to IP or IS therapy. However, IP therapy resulted in significantly increased PAI ‐1 activity at 1 year (23.0 versus 16.0 Au/mL, P =0.001), 3 years (24.0 versus 18.0 Au/mL, P =0.049), and 5 years (29.0 versus 15.0 Au/mL, P =0.004) compared with IS therapy. Conclusions Among diabetic patients with stable ischemic heart disease who were actively smoking, IP therapy was independently associated with a significantly increased hazard of MI . This finding may be explained by higher PAI ‐1 activity in active smokers treated with IP therapy. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 00006305. </jats:sec

The HPV cellular transactivator Brn-3a can be used to predict cervical adenocarcinoma and squamous carcinoma precancer lesions in the developed and developing worlds

The cellular transactivator Brn-3a has previously been shown to be expressed at elevated levels in the cervix of women with squamous cell carcinoma of the cervix (SCC) and to activate the expression of HPV E6 mRNA. In this study, we show that common and rare cervical precancer lesions, including those of adenocarcinoma (AC), which are usually difficult to diagnose using classical procedures, also expressed high levels of Brn-3a and can be diagnosed by measuring the levels of Brn-3a and E6 mRNAs

Ir d-band Derived Superconductivity in the Lanthanum-Iridium System LaIr3

The electronic properties of the heavy metal superconductor LaIr3 are reported. The estimated superconducting parameters obtained from physical properties measurements indicate that LaIr3 is a BCS-type superconductor. Electronic band structure calculations show that Ir d- states dominate the Fermi level. A comparison of electronic band structures of LaIr3 and LaRh3 shows that the Ir-compound has a strong spin-orbit-coupling effect, which creates a complex Fermi surface.Comment: 6 pages and 5 figure

Determining smallholder farmers’ preferences for Push-Pull technology dissemination pathways in western Kenya

The push-pull technology (PPT) has widely been disseminated to control stemborer (Chilo partellus and Busseola fusca) and Striga weeds (Striga hermonthica and Striga asiatica) in maize fields in Kenya. This study examined farmers’ preferences for various dissemination pathways in order to proffer better targeting of resources in an optimal dissemination strategy. The pathways considered were public meetings (barazas), radio, farmer field schools (FFS), field days (FD), farmer teachers (FT), the fellow farmers (FF) and print materials. Using a weighted score index and ordered probit regression, the different pathways were sequentially ranked as FD, FT, FFS, FF, print materials, Radio, and barazas. Marginal effects from ordered probit showed that farmers had the least preferences for baraza and radio pathways. The farmer categories with the highest preference for particular pathways were: less educated farmers for FD, farmers with small land sizes for FT, farmers belonging to groups for FFS, and young educated farmers for the print materials. This information is extremely important for targeting the different segments of farmers.Push-pull technology, Stemborer, Striga, Dissemination pathways, preference, Research and Development/Tech Change/Emerging Technologies,

Self-Assembly of Coil/Liquid-Crystalline Diblock Copolymers in a Liquid Crystal Solvent

Diblock copolymers having a random-coil polymer block (polystyrene, PS) connected to a side-group liquid crystal polymer (SGLCP) self-assemble in a nematic liquid crystal (LC), 4-pentyl-4′-cyanobiphenyl, into micelles with PS-rich cores and SGLCP-rich coronas. The morphologies of block copolymers with varying PS content are characterized as a function of temperature and concentration using small-angle neutron scattering, rheometry, and transmission electron microscopy. Unlike conventional solvents, the nematic LC can undergo a first-order transition between distinct fluid phases, accessing the regimes of both strong and slight selectivity in a single polymer/solvent pair. Micelles dissolve away above a microphase separation temperature (MST) that is often equal to the solution’s isotropization point, TNI. However, increasing or decreasing the polymer’s PS content can shift the MST to be above or below TNI, respectively, and in the former case, micelles abruptly swell with solvent at TNI. Comparable effects can be achieved by modulating the overall polymer concentration

Relative effects of different non-vitamin K antagonist oral anticoagulants on global thrombotic status in atrial fibrillation

This is an Accepted Manuscript of an article published by Taylor & Francis GroupNon-vitamin K antagonist oral anticoagulants (NOACs) reduce the risk of thromboembolism in patients with atrial fibrillation (AF). There has been no head-to-head comparison of the effect of these agents on ex vivo thrombotic and thrombolytic status. Enhanced platelet reactivity and impaired endogenous thrombolysis are risk factors for recurrent thrombotic events. We aimed to assess the comparative effect of NOACs and warfarin using an ex vivo test of thrombosis and thrombolysis. Eighty patients with newly diagnosed non-valvular AF were tested before, and after being established on apixaban (n = 20), dabigatran (n = 20), rivaroxaban (n = 20), or warfarin (n = 20). Thrombotic status was assessed with the automated, point-of-care Global Thrombosis Test (GTT) that assesses both platelet reactivity and endogenous thrombolysis from native blood. The time taken to form an occlusive thrombus (occlusion time, OT) and the time required to restore flow through endogenous thrombolysis (lysis time, LT) were measured. All anticoagulants caused OT prolongation compared to baseline (apixaban 403 ± 102s vs. 496 ± 125s, p = 0.006; dabigatran 471 ± 106s vs. 656 ± 165s, p < 0.00001; rivaroxaban 381 ± 119s vs. 579 ± 158, p < 0.00001; warfarin 420 ± 145s vs. 604 ± 124s, p < 0.00001). Apixaban reduced LT from baseline (1895[1702-2167]s vs. 1435[347-1990]s; p = 0.006). A trend for LT reduction was seen with other NOACs (dabigatran 1594[1226-2069]s vs. 1539[561-2316]s, p = 0.499; rivaroxaban 2085[1366-2428]s vs. 1885[724-2420]s, p = 0.295) but not with warfarin (1490[1206-1960]s vs. 1776[1545-2334], p = 0.601). Our results suggest that NOACs and warfarin have a similar favorable effect on reducing platelet reactivity. All NOACs exhibited a trend toward enhancing endogenous thrombolytic status, although this was significant only for apixaban. This raises the possibility of using NOACs to enhance impaired endogenous fibrinolysis in patients at high-thrombotic risk.Peer reviewedFinal Accepted Versio

Spline Based Intrusion Detection in Vehicular Ad Hoc Networks (VANET)

Intrusion detection systems (IDSs) play a crucial role in the identification and mitigation for attacks on host systems. Of these systems, vehicular ad hoc networks (VANETs) are particularly difficult to protect due to the dynamic nature of their clients and their necessity for constant interaction with their respective cyber-physical systems. Currently, there is a need for a VANET-specific IDS that can satisfy these requirements. Spline function-based IDSs have shown to be effective in traditional network settings. By examining the various construction of splines and testing their robustness, the viability for a spline-based IDS can be determined