Exploring the Magnetic and Electric Side of Light through Plasmonic Nanocavities

Light–matter interactions are often considered to be mediated by the electric component of light only, neglecting the magnetic contribution. However, the electromagnetic energy density is equally distributed between both parts of the optical fields. Within this scope, we experimentally demonstrate here, in excellent agreement with numerical simulations, that plasmonic nanostructures can selectively manipulate and tune the magnetic versus electric emission of luminescent nanocrystals. In particular, we show selective enhancement or decay of magnetic and electric emission from trivalent europium-doped nanoparticles in the vicinity of plasmonic nanocavities, designed to efficiently couple to either the electric or magnetic emission of the quantum emitter. Specifically, by precisely controlling the spatial position of the emitter with respect to our plasmonic nanostructures, by means of a near-field optical microscope, we record local distributions of both magnetic and electric radiative local densities of states (LDOS) with nanoscale precision. The distribution of the radiative LDOS reveals the modification of both the magnetic and electric optical quantum environments induced by the presence of the metallic nanocavities. This manipulation and enhancement of magnetic light–matter interaction by means of plasmonic nanostructures opens up new possibilities for the research fields of optoelectronics, chiral optics, nonlinear and nano-optics, spintronics, and metamaterials, among others

Risk of Bleeding and Stroke with Oral Anticoagulation and Antiplatelet Therapy in Patients with Atrial Fibrillation in Taiwan: A Nationwide Cohort Study

<div><p>Background</p><p>Data on the use of oral anticoagulation (OAC) and antiplatelet therapy and the risk of bleeding and stroke amongst Asian patients with atrial fibrillation (AF) are limited. We investigated the risks of bleeding and stroke with use of oral anticoagulation (OAC) and antiplatelet therapy as mono- or combination therapy, in patients with AF from a Chinese nationwide cohort study.</p><p>Methods</p><p>We studied a cohort of 10384 patients (57.2% men, age 67.8 ± 13.2 yrs) between 1999 and 2010 from the National Health Insurance Research Database in Taiwan. Records of prescriptions were obtained during follow-up. The main outcome was a recurrent stroke during the follow-up period. Time-dependent Cox proportional hazards models were used for this analysis.</p><p>Results</p><p>We documented 1009 events for bleeding, as well as 224 hemorrhagic stroke and 1642 ischemic stroke events during a median 3.2 (interquartile range, 1.05-6.54) years’ follow-up. Compared with warfarin users, patients with antiplatelet therapy had a lower risk of bleeding (adjusted relative risk [RR], 0.59, 95% confidence interval [CI], 0.49-0.71, p<0.001) whilst combination therapy had a non-statistically significant higher bleeding risk (RR, 1.33, 95%, 0.91-1.94, p = 0.20). Patients on antiplatelet monotherapy had a similar risk for ischemic stroke compared with OAC (RR 1.05, 95% CI, 0.89-1.25, p = 0.50), whilst those on combination therapy had a significantly higher risk (RR 1.90, 95% CI, 1.34-2.70, p<0.001).</p><p>Conclusion</p><p>In a national representative cohort, antiplatelet therapy had no significant difference in ischemic stroke risk to warfarin. For bleeding, aspirin had a lower risk compared to warfarin. This may reflect poor anticoagulation control, highlighting important missed opportunities for improved stroke prevention, especially in countries where anticoagulation management is suboptimal.</p></div

Relative risks for the risk of bleeding (A), hemorrhagic stroke (B), and ischemic stroke (C), associated with the use of warfarin, aspirin, clopidogrel, and combinations of these drugs in the study patients.

<p>CI indicates confidence interval.</p

Trends of various antiplatelet and anticoagulant agent usages during the study period, 1999–2010.

<p>Trends of various antiplatelet and anticoagulant agent usages during the study period, 1999–2010.</p

Incidence rate and relative risks, 95% confidence intervals of events associated with anticoagulant and antiplatelet within different risk strata.

<p>Abbreviations: CI, confidence interval; RR, relative risk.</p><p>*Incidence rate/1000 person-years</p><p>The detailed breakdown by actual therapy shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0125257#pone.0125257.g002" target="_blank">Fig 2</a> shows that compared to warfarin (reference), aspirin was associated with less bleeding. However, bleeding risk was not significantly different for other categories of drug exposures.</p><p>Incidence rate and relative risks, 95% confidence intervals of events associated with anticoagulant and antiplatelet within different risk strata.</p

Study cohort and comorbidities at 2 years before index AF.

<p>a: Comorbidities(Acute MI, Ischemic heart ^b Heart failure ^c, Hypertension, Ischemic stroke, Diabetes, Liver disease, Renal failure, Malignancy, Bleeding, Gastrointestinal bleeding ^d, Gastrointestinal bleeding ^e, Intracranial bleeding, Urinary tract bleeding and Airway bleeding) were defined before index AF (including index admission date) were defined 2 years before index AF (including index admission date).</p><p>b: Ischemic heart disease was defined as having treatments of treadmill exercise and coronary angioplasty, or nuclear medicine image and coronary angioplasty.</p><p>c: Included hospitalized patients only.</p><p>d: Gastrointestinal bleeding was defined as having operations of panendoscopy.</p><p>e: Non-specific type of operations on gastrointestinal bleeding.</p><p>f: Previous antithrombotic treatment was defined 90 days before index AF (including index admission date).</p><p>Study cohort and comorbidities at 2 years before index AF.</p

Pitavastatin and Atorvastatin Double-Blind Randomized ComPArative Study among HiGh-Risk Patients, Including ThOse with Type 2 Diabetes Mellitus, in Taiwan (PAPAGO-T Study)

<div><p>Background</p><p>Evidence about the efficacy and safety of statin treatment in high-risk patients with hypercholesterolemia is available for some populations, but not for ethnic Chinese. To test the hypothesis that treatment with pitavastatin (2 mg/day) is not inferior to treatment with atorvastatin (10 mg/day) for reducing low-density lipoprotein cholesterol (LDL-C), a 12-week multicenter collaborative randomized parallel-group comparative study of high-risk ethnic Chinese patients with hypercholesterolemia was conducted in Taiwan. In addition, the effects on other lipid parameters, inflammatory markers, insulin-resistance-associated biomarkers and safety were evaluated.</p> <p>Methods and Results</p><p>Between July 2011 and April 2012, 251 patients were screened, 225 (mean age: 58.7 ± 8.6; women 38.2% [86/225]) were randomized and treated with pitavastatin (n = 112) or atorvastatin (n = 113) for 12 weeks. Baseline characteristics in both groups were similar, but after 12 weeks of treatment, LDL-C levels were significantly lower: pitavastatin group = −35.0 ± 14.1% and atorvastatin group = −38.4 ± 12.8% (both: p < 0.001). For the subgroup with diabetes mellitus (DM) (n = 125), LDL-C levels (−37.1 ± 12.9% vs. −38.0 ± 13.1%, p = 0.62) were similarly lowered after either pitavastatin (n = 63) or atorvastatin (n = 62) treatment. Triglycerides, non-high density lipoprotein cholesterol, and apoprotein B were similarly and significantly lower in both treatment groups. In non-lipid profiles, HOMA-IR and insulin levels were higher to a similar degree in both statin groups. Hemoglobin A₁C was significantly (p = 0.001) higher in the atorvastatin group but not in the pitavastatin group. Both statins were well tolerated, and both groups had a similar low incidence of treatment-emergent adverse events.</p> <p>Conclusion</p><p>Both pitavastatin (2 mg/day) and atorvastatin (10 mg/day) were well tolerated, lowered LDL-C, and improved the lipid profile to a comparable degree in high-risk Taiwanese patients with hypercholesterolemia.</p> <p>Trial Registration</p><p><a href="http://clinicaltrials.gov" target="_blank">ClinicalTrials.gov</a> NCT01386853 <a href="http://clinicaltrials.gov/ct2/show/nct01386853?term=nct01386853&rank=1" target="_blank"><u>http://clinicaltrials.gov/ct2/show/NCT01386853?term=NCT01386853&rank=1</u></a></p> </div

Subgroup analysis comparing the percentage of participants with final LDL-C level < 100 mg/dL after 12 weeks of either pitavastatin (2 mg) or atorvastatin (10 mg) treatment.

<p>Continuous variables are means ± SD. ADMA = asymmetric dimethylarginine; ALT = alanine aminotransferase; Apo A1 = apolipoprotein A1; Apo B = apolipoprotein B; AST = aspartate transaminase; BMI = body mass index; BUN = blood urea nitrogen; CPK = creatine phosphokinase; CRP = C-reactive protein; DM = Diabetes mellitus; Gamma GT = gamma-glutamyl transpeptidase; HDL-C = high-density lipoprotein cholesterol; HOMA-IR = homeostatic model assessment-insulin resistance; LDH = lactate dehydrogenase; LDL-C = low-density lipoprotein cholesterol; TG = triglyceride.</p

Enrollment and consort of study participants treated with pitavastatin or atorvastatin.

<p>Enrollment and consort of study participants treated with pitavastatin or atorvastatin.</p

Changes in lipid profiles before and after 12 weeks of treatment with pitavastatin (PTV) (2 mg) or atorvastatin (ATV) (10 mg).

<p>There is no significant difference in the percentage change of low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglyceride (TG), non-HDL-C, apolipoprotein A1 (Apo A1), or apolipoprotein B (Apo B) levels from baseline, between the PTV and ATV groups. Both statins similarly but significantly reduced LDL-C levels after 12 weeks of treatment. PTV and ATV significantly reduced TG, non-HDL-C, and Apo B; the percentage changes were not significantly different.</p