Safety and efficacy of hybrid platform design sirolimus eluting stent system in percutaneous coronary intervention in ST elevation myocardial infarction patients at 1 year after treatment

Background: STEMI is among the most complex and dramatic clinical presentation of coronary artery disease. The highest risk of mortality and stent thrombosis is observed in the subjects undergoing primary PCI. Choice of stent is often critical in Primary Angioplasty in Myocardial Infarction. GenXsync (MIV Therapeutics India Ltd, Surat India) is a stent having hybrid stent platform biodegradable polymers with the confidence of Sirolimus. The primary objective of this study was to establish safety and efficacy of GenXsync Sirolimus Eluting hybrid design stent in STEMI.Methods: A total of 73 patients of STEMI undergoing PCI were enrolled from June 2013 to January 2014. The average door to balloon time was 30±0.04 minutes with the minimumbeing15 minutes and maximum of 2 hours 44min. Most of the patients (69/ 73: 94.52%) underwent primary PCI. One patient (1.37%) was taken up for PCI after successful thrombolysis and two patients had to undergo rescue PCI after failed thrombolysis. All subjects underwent PCI with GenXsync Sirolimus Eluting hybrid design stent. Total 79 stents were used (average 1.08±0.38 stent per patient).  The subjects were followed up for one year after discharge.Results: There were 80.82% (59) males, 41.09% (30) diabetic, 27.39% (20) hypertensive, 52.05% (38) current smokers and 2 (2.74%), patients with chronic renal disease. The cardiac history was significantly complex, characterized by prior coronary artery disease in 4 (5.48%), prior MI in 5 (6.85%) including prior PCI in 2 (2.74%), congestive heart failure in 1 (1.37%), ST depression in 71 (97.26%), complete heart block in 4 (5.48%) and left bundle branchblock 1 (1.37%). At admission, 4 (5.4%) patients had cardiac arrest. Among the patients 32 (43.84%), 34 (46.58%), 7 (9.59%) had single, double and triple vessel disease respectively. Average Troponin I was 55.20± 59.34 and by Killip classification, the subjects with class I, class III and class IV were 65 (89.04%), 4 (5.48%), 4 (5.48%) respectively. At discharge there were 3 (3.34%) Major adverse cardiac events and at 1 year, there were 5 (5.48%) major adverse cardiac events. There were no acute stent thromboses. All subjects received dual antiplatelet therapy for one year (Aspirin and one among Clopidogrel, Prasugrel or Ticagrelor at the discretion of the operator). There were total of 2 (2.74%) stent thrombosis events between discharge and 1 year, including in 1 subject who discontinued Antiplatelet therapy within 1 year. None of 4 deaths including 2 cardiac were practically related with the device and procedure. These 4 deaths were due to cardiogenic shock (1), during MVR surgery (1), During surgery on leg, due to major bleeding (1) and Due to pre-existing CHF (1).Conclusions: In contemporary practice of percutaneous coronary intervention in ST Elevation Myocardial Infarction, Genxsync stent was associated with low risks of stent thrombosis and MACE

Laboratory based surveillance of travel-related Shigella sonnei and Shigella flexneri in Alberta from 2002 to 2007

Between 2002 and 2007, travel related cases of Shigella sonnei and S. flexneri in Alberta, Canada were acquired from Central America, the Indian subcontinent and North America. Of this group, resistance to ciprofloxacin and nalidixic acid was identified in isolates from patients who had travelled to the Indian subcontinent. This study provides a Canadian perspective to a growing body of literature linking ciprofloxacin and nalidixic acid resistance to travel to the Indian subcontinent

Quantum Correlated Interstitials and the Hall Resistivity of the Magnetically Induced Wigner Crystal

We study a trial wavefunction for an interstitial in a Wigner crystal. We find that the electron correlations, ignored in a conventional Hartree-Fock treatment, dramatically lower the interstitial energy, especially at fillings close to an incompressible liquid state. The correlation between the interstitial electron and the lattice electrons at $\nu <1/m$ is introduced by constructing a trial wave- function which bears a Jastrow factor of a Laughlin state at $\nu=1/m$. For fillings close to but just below $\nu=1/m$, we find that a perfect Wigner crystal becomes unstable against formation of such interstitials. It is argued that conduction due to correlated interstitials in the presence of weak disorder leads to the {\it classical} Hall resistivity, as seen experimentally.Comment: 10 pages, RevTe

Bonding, Moment Formation, and Magnetic Interactions in Ca14MnBi11 and Ba14MnBi11

The ``14-1-11'' phase compounds based on magnetic Mn ions and typified by Ca14MnBi11 and Ba14MnBi11 show unusual magnetic behavior, but the large number (104) of atoms in the primitive cell has precluded any previous full electronic structure study. Using an efficient, local orbital based method within the local spin density approximation to study the electronic structure, we find a gap between a bonding valence band complex and an antibonding conduction band continuum. The bonding bands lack one electron per formula unit of being filled, making them low carrier density p-type metals. The hole resides in the MnBi4 tetrahedral unit and partially compensates the high spin d^5 Mn moment, leaving a net spin near 4 \mu_B that is consistent with experiment. These manganites are composed of two disjoint but interpenetrating `jungle gym' networks of spin 4/2 MnBi4^{9-} units with ferromagnetic interactions within the same network, and weaker couplings between the networks whose sign and magnitude is sensitive to materials parameters. Ca14MnBi11 is calculated to be ferromagnetic as observed, while for Ba14MnBi11 (which is antiferromagnetic) the ferro- and antiferromagnetic states are calculated to be essentially degenerate. The band structure of the ferromagnetic states is very close to half metallic.Comment: 17 pages, containing 10 postscript figures and 5 tables. Two additional figures (Fig.8 and 11 of the paper) are provided in JPG format in separate files. Submitted to Phys. Rev. B on September 20th 200

Pandemic Influenza A H1N1 2009 Infection versus Vaccination: A Cohort Study Comparing Immune Responses in Pregnancy

Background: With the emergence of H1N1 pandemic (pH1N1) influenza, the CDC recommended that pregnant women be one of five initial target groups to receive the 2009 monovalent H1N1 vaccine, regardless of prior infection with this influenza strain. We sought to compare the immune response of pregnant women to H1N1 infection versus vaccination and to determine the extent of passive immunity conferred to the newborn. Methods/Findings: During the 2009-2010 influenza season, we enrolled a cohort of women who either had confirmed pH1N1 infection during pregnancy, did not have pH1N1 during pregnancy but were vaccinated against pH1N1, or did not have illness or vaccination. Maternal and umbilical cord venous blood samples were collected at delivery. Hemagglutination inhibition assays (HAI) for pH1N1 were performed. Data were analyzed using linear regression analyses. HAIs were performed for matched maternal/cord blood pairs for 16 women with confirmed pH1N1 infection, 14 women vaccinated against pH1N1, and 10 women without infection or vaccination. We found that pH1N1 vaccination and wild-type infection during pregnancy did not differ with respect to (1) HAI titers at delivery, (2) HAI antibody decay slopes over time, and (3) HAI titers in the cord blood. Conclusions: Vaccination against pH1N1 confers a similar HAI antibody response as compared to pH1N1 infection durin

Variational quantum Monte Carlo study of two-dimensional Wigner crystals: exchange, correlation, and magnetic field effects

The two-dimensional Wigner crystals are studied with the variational quantum Monte Carlo method. The close relationship between the ground-state wavefunction and the collective excitations in the system is illustrated, and used to guide the construction of the ground-state wavefunction of the strongly correlated solid. Exchange, correlation, and magnetic field effects all give rise to distinct physical phenomena. In the absence of any external magnetic field, interesting spin-orderings are observed in the ground-state of the electron crystal in various two-dimensional lattices. In particular, two-dimensional bipartite lattices are shown not to lead necessarily to an antiferromagnetic ground-state. In the quantum Hall effect regime, a strong magnetic field introduces new energy and length scales. The magnetic field quenches the kinetic energy and poses constraints on how the electrons may correlate with each other. Care is taken to ensure the appropriate translational properties of the wavefunction when the system is in a uniform magnetic field. We have examined the exchange, intra-Landau-level correlation as well as Landau-level-mixing effects with various variational wavefunctions. We also determine their dependences on the experimental parameters such as the carrier effective mass at a modulation-doped semiconductor heterojunction. Our results, when combined with some recent calculations for the energy of the fractional quantum Hall liquid including Landau-level-mixing, show quantitatively that in going from $n$-doping to $p$-doping in $GaAS/AlGaAS$ heterojunction systems, the crossover filling factor from the fractional quantum Hall liquid to the Wigner crystal changes from filling factor $\nu \sim 1/5$ to $\nu \sim 1/3$. This lends strong support to the claim that theComment: LaTex file, 14 figures available from [email protected]

Modulation of the β-Catenin Signaling Pathway by the Dishevelled-Associated Protein Hipk1

BACKGROUND:Wnts are evolutionarily conserved ligands that signal through beta-catenin-dependent and beta-catenin-independent pathways to regulate cell fate, proliferation, polarity, and movements during vertebrate development. Dishevelled (Dsh/Dvl) is a multi-domain scaffold protein required for virtually all known Wnt signaling activities, raising interest in the identification and functions of Dsh-associated proteins. METHODOLOGY:We conducted a yeast-2-hybrid screen using an N-terminal fragment of Dsh, resulting in isolation of the Xenopus laevis ortholog of Hipk1. Interaction between the Dsh and Hipk1 proteins was confirmed by co-immunoprecipitation assays and mass spectrometry, and further experiments suggest that Hipk1 also complexes with the transcription factor Tcf3. Supporting a nuclear function during X. laevis development, Myc-tagged Hipk1 localizes primarily to the nucleus in animal cap explants, and the endogenous transcript is strongly expressed during gastrula and neurula stages. Experimental manipulations of Hipk1 levels indicate that Hipk1 can repress Wnt/beta-catenin target gene activation, as demonstrated by beta-catenin reporter assays in human embryonic kidney cells and by indicators of dorsal specification in X. laevis embryos at the late blastula stage. In addition, a subset of Wnt-responsive genes subsequently requires Hipk1 for activation in the involuting mesoderm during gastrulation. Moreover, either over-expression or knock-down of Hipk1 leads to perturbed convergent extension cell movements involved in both gastrulation and neural tube closure. CONCLUSIONS:These results suggest that Hipk1 contributes in a complex fashion to Dsh-dependent signaling activities during early vertebrate development. This includes regulating the transcription of Wnt/beta-catenin target genes in the nucleus, possibly in both repressive and activating ways under changing developmental contexts. This regulation is required to modulate gene expression and cell movements that are essential for gastrulation

A Large-Scale Multi-ancestry Genome-wide Study Accounting for Smoking Behavior Identifies Multiple Significant Loci for Blood Pressure

Genome-wide association analysis advanced understanding of blood pressure (BP), a major risk factor for vascular conditions such as coronary heart disease and stroke. Accounting for smoking behavior may help identify BP loci and extend our knowledge of its genetic architecture. We performed genome-wide association meta-analyses of systolic and diastolic BP incorporating gene-smoking interactions in 610,091 individuals. Stage 1 analysis examined similar to 18.8 million SNPs and small insertion/deletion variants in 129,913 individuals from four ancestries (European, African, Asian, and Hispanic) with follow-up analysis of promising variants in 480,178 additional individuals from five ancestries. We identified 15 loci that were genome-wide significant (p <5 x 10(-8)) in stage 1 and formally replicated in stage 2. A combined stage 1 and 2 meta-analysis identified 66 additional genome-wide significant loci (13, 35, and 18 loci in European, African, and trans-ancestry, respectively). A total of 56 known BP loci were also identified by our results (p <5 x 10(-8)). Of the newly identified loci, ten showed significant interaction with smoking status, but none of them were replicated in stage 2. Several loci were identified in African ancestry, highlighting the importance of genetic studies in diverse populations. The identified loci show strong evidence for regulatory features and support shared pathophysiology with cardiometabolic and addiction traits. They also highlight a role in BP regulation for biological candidates such as modulators of vascular structure and function (CDKN1B, BCAR1-CFDP1, PXDN, EEA1), ciliopathies (SDCCAG8, RPGRIP1L), telomere maintenance (TNKS, PINX1, AKTIP), and central dopaminergic signaling MSRA, EBF2).Peer reviewe

Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective.

Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events