Prevalence, predictors, and prognostic implications of residual impairment of functional capacity after transcatheter aortic valve implantation

Background: Patients with degenerative aortic stenosis (AS) referred for transcatheter aortic valve implantation (TAVI) typically have advanced cardiac and vascular adverse remodeling and multiple comorbidities and, therefore, might not recover a normal functional capacity after valve replacement. We sought to investigate the prevalence, the predictors, and the prognostic impact of residual impairment of functional capacity after TAVI. Methods and results: Out of 790 patients undergoing TAVI with impaired functional capacity (NYHA II–IV

Heavy quarkonium: progress, puzzles, and opportunities

A golden age for heavy quarkonium physics dawned a decade ago, initiated by the confluence of exciting advances in quantum chromodynamics (QCD) and an explosion of related experimental activity. The early years of this period were chronicled in the Quarkonium Working Group (QWG) CERN Yellow Report (YR) in 2004, which presented a comprehensive review of the status of the field at that time and provided specific recommendations for further progress. However, the broad spectrum of subsequent breakthroughs, surprises, and continuing puzzles could only be partially anticipated. Since the release of the YR, the BESII program concluded only to give birth to BESIII; the $B$-factories and CLEO-c flourished; quarkonium production and polarization measurements at HERA and the Tevatron matured; and heavy-ion collisions at RHIC have opened a window on the deconfinement regime. All these experiments leave legacies of quality, precision, and unsolved mysteries for quarkonium physics, and therefore beg for continuing investigations. The plethora of newly-found quarkonium-like states unleashed a flood of theoretical investigations into new forms of matter such as quark-gluon hybrids, mesonic molecules, and tetraquarks. Measurements of the spectroscopy, decays, production, and in-medium behavior of c\bar{c}, b\bar{b}, and b\bar{c} bound states have been shown to validate some theoretical approaches to QCD and highlight lack of quantitative success for others. The intriguing details of quarkonium suppression in heavy-ion collisions that have emerged from RHIC have elevated the importance of separating hot- and cold-nuclear-matter effects in quark-gluon plasma studies. This review systematically addresses all these matters and concludes by prioritizing directions for ongoing and future efforts.Comment: 182 pages, 112 figures. Editors: N. Brambilla, S. Eidelman, B. K. Heltsley, R. Vogt. Section Coordinators: G. T. Bodwin, E. Eichten, A. D. Frawley, A. B. Meyer, R. E. Mitchell, V. Papadimitriou, P. Petreczky, A. A. Petrov, P. Robbe, A. Vair

Fauna of euglossina (Hymenoptera: Apidae) from southwestern Amazonia, Acre, Brazil

Male orchid bees were collected between December 2005 and September 2006 in 11 forest areas of different sizes in the region of Rio Branco, Acre, Southwestern Amazonia, Brazil. The bees were attracted by 6 aromatic compounds and collected by insect nets and scent baited traps. A total of 3,675 males of Euglossina in 4 genera and 36 species were collected. Eulaema cingulata (Fabricius) was the most common (24.6%), followed by Eulaema meriana (Olivier) (14.6%), Euglossa amazonica Dressler (10.5%), Eulaema nigrita Lepeletier (10.5%) and Eulaema pseudocingulata (Oliveira) (7.2%). Cineole was the scent that attracted the greatest number of individuals (23.8%) and methyl salicylate the greatest number of species (28) for both methods of sampling. Thirty one bees of 9 species with pollinar orchid attached to their bodies were collected. The accumulative number of species stabilized after the 48th collection. Few species were abundant; the great majority were represented by less than 50 bees. The lack of standardized sample protocols limited very much the conclusions derived from comparisons among the majority of studies on Euglossina assemblages. However, the results presented here suggest that the State of Acre is very rich in those bees compared to other regions.Machos de abelhas Euglossina foram coletados entre dezembro de 2005 e setembro de 2006 em 11 áreas florestais de diferentes tamanhos na região de Rio Branco, Acre, Amazônia Sul-Ocidental. As abelhas foram atraídas por 6 substâncias odoríferas e coletadas com rede entomológica e armadilhas. Um total de 3.675 machos de Euglossina pertencentes a 4 gêneros e 36 espécies foi coletado. Eulaema cingulata (Fabricius) foi a espécie mais comum (24,6%), seguida por Eulaema meriana (Olivier) (14,6%), Euglossa amazonica Dressler (10,5%), Eulaema nigrita Lepeletier (10,5%) e Eulaema pseudocingulata (Oliveira) (7,2%). Cineol foi a substância que atraiu maior número de indivíduos (23,8%) e metil salicilato o maior número de espécies (28) para ambos os métodos de coleta. Foram coletados 31 indivíduos pertencentes a 9 espécies portando polinários. O número acumulado de espécies coletadas na região estabilizou a partir da 48ª coleta. Poucas espécies foram abundantes, a maioria representada por menos que 50 indivíduos. A falta de um protocolo amostral padronizado tem limitado comparações entre trabalhos realizados em diferentes regiões. Contudo, os resultados aqui apresentados indicam que o Acre apresenta elevada riqueza dessas abelhas

Association between transcatheter aortic valve replacement and subsequent infective endocarditis and in-hospital death

Importance Limited data exist on clinical characteristics and outcomes of patients who had infective endocarditis after undergoing transcatheter aortic valve replacement (TAVR). Objective To determine the associated factors, clinical characteristics, and outcomes of patients who had infective endocarditis after TAVR. Design, Setting, and Participants The Infectious Endocarditis after TAVR International Registry included patients with definite infective endocarditis after TAVR from 47 centers from Europe, North America, and South America between June 2005 and October 2015. EXPOSURE Transcatheter aortic valve replacement for incidence of infective endocarditis and infective endocarditis for in-hospital mortality. MAIN OUTCOMES AND MEASURES Infective endocarditis and in-hospital mortality after infective endocarditis. Results A total of 250 cases of infective endocarditis occurred in 20 006 patients after TAVR (incidence, 1.1% per person-year; 95% CI, 1.1%-1.4%; median age, 80 years; 64% men). Median time from TAVR to infective endocarditis was 5.3 months (interquartile range [IQR], 1.5-13.4 months). The characteristics associated with higher risk of progressing to infective endocarditis after TAVR was younger age (78.9 years vs 81.8 years; hazard ratio [HR], 0.97 per year; 95% CI, 0.94-0.99), male sex (62.0% vs 49.7%; HR, 1.69; 95% CI, 1.13-2.52), diabetes mellitus (41.7% vs 30.0%; HR, 1.52; 95% CI, 1.02-2.29), and moderate to severe aortic regurgitation (22.4% vs 14.7%; HR, 2.05; 95% CI, 1.28-3.28). Health care?associated infective endocarditis was present in 52.8% (95% CI, 46.6%-59.0%) of patients. Enterococci species and Staphylococcus aureus were the most frequently isolated microorganisms (24.6%; 95% CI, 19.1%-30.1% and 23.3%; 95% CI, 17.9%-28.7%, respectively). The in-hospital mortality rate was 36% (95% CI, 30.0%-41.9%; 90 deaths; 160 survivors), and surgery was performed in 14.8% (95% CI, 10.4%-19.2%) of patients during the infective endocarditis episode. In-hospital mortality was associated with a higher logistic EuroSCORE (23.1% vs 18.6%; odds ratio [OR], 1.03 per 1% increase; 95% CI, 1.00-1.05), heart failure (59.3% vs 23.7%; OR, 3.36; 95% CI, 1.74-6.45), and acute kidney injury (67.4% vs 31.6%; OR, 2.70; 95% CI, 1.42-5.11). The 2-year mortality rate was 66.7% (95% CI, 59.0%-74.2%; 132 deaths; 115 survivors). Conclusions and Relevance Among patients undergoing TAVR, younger age, male sex, history of diabetes mellitus, and moderate to severe residual aortic regurgitation were significantly associated with an increased risk of infective endocarditis. Patients who developed endocarditis had high rates of in-hospital mortality and 2-year mortality

International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Comparing deregression methods for genomic prediction of test‐day traits in dairy cattle

We aimed to investigate the performance of three deregression methods (VanRaden, VR; Wiggans, WG; and Garrick, GR) of cows’ and bulls’ breeding values to be used as pseudophenotypes in the genomic evaluation of test‐day dairy production traits. Three scenarios were considered within each deregression method: (i) including only animals with reliability of estimated breeding value (RELEBV ) higher than the average of parent reliability (RELPA ) in the training and validation populations; (ii) including only animals with RELEBV higher than 0.50 in the training and RELEBV higher than RELPA in the validation population; and (iii) including only animals with RELEBV higher than 0.50 in both training and validation populations. Individual random regression coefficients of lactation curves were predicted using the genomic best linear unbiased prediction (GBLUP), considering either unweighted or weighted residual variances based on effective records contributions. In summary, VR and WG deregression methods seemed more appropriate for genomic prediction of test‐day traits without need for weighting in the genomic analysis, unless large differences in RELEBV between training population animals exist