Interatrial conduction block with retrograde activation of the left atrium and paroxysmal supraventricular tachyarrhythmias: influence of preventive antiarrhythmic treatment.

Patients with advanced interatrial conduction block with retrograde activation to the left atrium present a high incidence of supraventricular tachyarrhythmias. We report the value of preventive antiarrhythmic treatment in these patients

Anaemia in a phase 2 study of a blood stage falciparum malaria vaccine

<p>Abstract</p> <p>Background</p> <p>A Phase 1-2b study of the blood stage malaria vaccine AMA1-C1/Alhydrogel was conducted in 336 children in Donéguébougou and Bancoumana, Mali. In the Phase 2 portion of the study (n = 300), no impact on parasite density or clinical malaria was seen; however, children who received the study vaccine had a higher frequency of anaemia (defined as haemoglobin < 8.5 g/dL) compared to those who received the comparator vaccine (Hiberix). This effect was one of many tested and was not significant after adjusting for multiple comparisons.</p> <p>Methods</p> <p>To further investigate the possible impact of vaccination on anaemia, additional analyses were conducted including patients from the Phase 1 portion of the study and controlling for baseline haemoglobin, haemoglobin types S or C, alpha-thalassaemia, G6PD deficiency, and age. A multiplicative intensity model was used, which generalizes Cox regression to allow for multiple events. Frailty effects for each subject were used to account for correlation of multiple anaemia events within the same subject. Intensity rates were calculated with reference to calendar time instead of time after randomization in order to account for staggered enrollment and seasonal effects of malaria incidence. Associations of anaemia with anti-AMA1 antibody were further explored using a similar analysis.</p> <p>Results</p> <p>A strong effect of vaccine on the incidence of anaemia (risk ratio [AMA1-C1 to comparator (Hiberix)]= 2.01, 95% confidence interval [1.26,3.20]) was demonstrated even after adjusting for baseline haemoglobin, haemoglobinopathies, and age, and using more sophisticated statistical models. Anti-AMA1 antibody levels were not associated with this effect.</p> <p>Conclusions</p> <p>While these additional analyses show a robust effect of vaccination on anaemia, this is an intensive exploration of secondary results and should, therefore, be interpreted with caution. Possible mechanisms of the apparent adverse effect on haemoglobin of vaccination with AMA1-C1/Alhydrogel and implications for blood stage vaccine development are discussed. The potential impact on malaria-associated anaemia should be closely evaluated in clinical trials of AMA1 and other blood stage vaccines in malaria-exposed populations.</p

Prevalence and Prognostic Influence of Peripheral Arterial Disease in Patients ≥40 Years Old Admitted into Hospital Following an Acute Coronary Event

AbstractObjectiveA significant proportion of patients with ischemic heart disease have associated peripheral arterial disease (PAD), but many are asymptomatic and this condition remains underdiagnosed. We aimed to study the prevalence of PAD in patients with an acute coronary syndrome (ACS) and to evaluate its influence in hospital clinical outcomes.MethodsThe PAMISCA register is a prospective, multicenter study involving patients ≥40 years old with ACS admitted to selected Spanish hospitals. All patients had their ankle-brachial index (ABI) measured between days 3 and 7 after the ischemic event.Results1410 ACS patients (71.4% male) were included. PAD determined by ABI was documented in 561 patients (39.8%). Factors independently related to PAD were age (OR: 1.04; 95% CI: 1.03–1.06; p<0.001), smoking (OR: 1.88; 95% CI: 1.41–2.49; p<0.0001), diabetes (OR: 1.30; 95% CI: 1.02–1.65; p<0.05), previous cardiac disease (OR: 1.54; 95% CI: 1.22–1.95; p<0.001) and previous cerebrovascular disease (OR: 1.90; 95% CI: 1.28–2.80; p<0.001). Following the ACS, an ABI≤0.90 was associated with increased cardiovascular mortality (OR: 5.45; 95% CI: 1.16–25.59; p<0.05) and a higher risk of cardiovascular complications.ConclusionThe prevalence of PAD in patients ≥40 years presenting with ACS is high and it is associated with increased cardiovascular risk

The impact of participation in Diversity Field Fora on farmer management of millet and Sorghum varieties in Mali

Malian farmers have been cultivating millet and sorghum for millennia, but they are slow to adopt and develop modern varieties because it is difficult to observe the difference in yields in their fields, given the challenging local growing conditions. Farmer participatory approaches are therefore recommended. This paper applies an instrumental variables method to survey data from Mali to evaluate the impacys of Diversity Field Fora, a type of farmer field school which aims to boost millet and sorghum yields by showing farmers how to manage diverse varieties. Impact indicators are expected and recalled millet and sorghum yields. the total number of unique attributes of millet and sorghum varieties stocked as seed, and the relative deprivation of the household farm with respect to these indicators. The findings suggest the project has had results at one of two sites where it has been implemented with the same local leadership and more intensively over a longer time frame

Polymorphic Inversions Underlie the Shared Genetic Susceptibility of Obesity-Related Diseases

The burden of several common diseases including obesity, diabetes, hypertension, asthma, and depression is increasing in most world populations. However, the mechanisms underlying the numerous epidemiological and genetic correlations among these disorders remain largely unknown. We investigated whether common polymorphic inversions underlie the shared genetic influence of these disorders. We performed an inversion association analysis including 21 inversions and 25 obesity-related traits on a total of 408,898 Europeans and validated the results in 67,299 independent individuals. Seven inversions were associated with multiple diseases while inversions at 8p23.1, 16p11.2, and 11q13.2 were strongly associated with the co-occurrence of obesity with other common diseases. Transcriptome analysis across numerous tissues revealed strong candidate genes for obesity-related traits. Analyses in human pancreatic islets indicated the potential mechanism of inversions in the susceptibility of diabetes by disrupting the cis-regulatory effect of SNPs from their target genes. Our data underscore the role of inversions as major genetic contributors to the joint susceptibility to common complex diseases.This research has received funding from Ministerio de Ciencia, Innovación y Universidades (MICIU), Agencia Estatal de Investigación (AEI) and Fondo Europeo de Desarrollo Regional, UE (RTI2018-100789-B-I00) also through the “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S); and the Catalan Government through the CERCA Program and projects SGR2017/801 and #016FI_B 00272 to CR-A. JG is funded by the European Commission (H2020-ERC-2014-CoG-647900) and the MINECO/AEI/FEDER, EU (BFU2017-82937-P). LAPJ lab was funded by the Spanish Ministry of Science and Innovation (ISCIII-FEDER P13/02481), the Catalan Department of Economy and Knowledge (SGR2014/1468, SGR2017/1974 and ICREA Acadèmia), and also acknowledges support from the Spanish Ministry of Economy and Competiveness “Programa de Excelencia María de Maeztu” (MDM-2014-0370). This research was conducted using the UK Biobank Resource under Application Number 43983. The Genotype-Tissue Expression (GTEx) Project was supported by the Common Fund of the Office of the Director of the National Institutes of Health, and by NCI, NHGRI, NHLBI, NIDA, NIMH, and NINDS.Peer ReviewedPostprint (author's final draft

Genetic Diversity of a Parasitic Weed, Striga hermonthica, on Sorghum and Pearl Millet in Mali

Eleven populations of witchweed, Striga hermonthica, were collected in four regions of Mali and investigated with 12 microsatellite markers. Extensive genetic diversity was observed, with most plants heterozygous for most markers. Allelic diversity was broadly distributed across populations with little genetic differentiation and large amounts of gene flow. Nearby fields of pearl millet and sorghum were found to have indistinguishable witchweed populations. Some population structure was apparent, but did not correlate with the local environment or host genotype, suggesting that seed transportation or other human-driven variables act to differentiate central Malian S. hermonthica populations from southern Malian populations