Clinical outcomes in patients treated for coronary in-stent restenosis with drug-eluting balloons: Impact of high platelet reactivity.

BACKGROUND: The impact of high platelet reactivity (HPR) on clinical outcomes after elective percutaneous coronary interventions (PCI) with drug-eluting balloons (DEB) due to in-stent restenosis (ISR) is unknown. OBJECTIVE: We sought to evaluate the prognostic importance of HPR together with conventional risk factors in patients treated with DEB. METHODS: Patients treated with DEB due to ISR were enrolled in a single-centre, prospective registry between October 2009 and March 2015. Only patients with recent myocardial infarction (MI) received prasugrel, others were treated with clopidogrel. HPR was defined as an ADP-test >46U with the Multiplate assay and no adjustments were done based on results. The primary endpoint of the study was a composite of cardiovascular mortality, MI, any revascularization or stroke during one-year follow-up. RESULTS: 194 stable angina patients were recruited of whom 90% were treated with clopidogrel. Clinical characteristics and procedural data were available for all patients; while platelet function testing was performed in 152 subjects of whom 32 (21%) had HPR. Patients with HPR had a higher risk for the primary endpoint (HR: 2.45; CI: 1.01-5.92; p = 0.03). The difference was primarily driven by a higher risk for revascularization and MI. According to the multivariate analysis, HPR remained a significant, independent predictor of the primary endpoint (HR: 2.88; CI: 1.02-8.14; p = 0.04), while total DEB length and statin treatment were other independent correlates of the primary outcome. CONCLUSION: HPR was found to be an independent predictor of repeat revascularization and MI among elective patients with ISR undergoing PCI with DEB

Reduction in primary production followed by rapid recovery of plant biomass in response to repeated mid-season droughts in a semiarid shrubland

The frequency and severity of extreme weather events, including droughts, are expected to increase due to the climate change. Climate manipulation field experiments are widely used tools to study the response of key parameters like primary production to the treatments. Our study aimed to detect the effect of drought on the aboveground biomass and primary production both during the treatments as well as during the whole growing seasons in semiarid vegetation. We estimated aboveground green biomass of vascular plants in a Pannonian sand forest-steppe ecosystem in Hungary. We applied non-destructive field remote sensing method in control and drought treatments. Drought treatment was carried out by precipitation exclusion in May and June, and was repeated in each year from 2002. We measured NDVI before the drought treatment, right after the treatment, and at the end of the summer in 2011 and 2013. We found that the yearly biomass peaks, measured in control plots after the treatment periods, were decreased or absent in drought treatment plots, and consequently, the aboveground net primary production was smaller than in the control plots. At the same time, we did not find general drought effects on all biomass data. The studied ecosystem proved resilient, as the biomass in the drought-treated plots recovered by the next drought treatment. We conclude that the effect of drought treatment can be overestimated with only one measurement at the time of the peak biomass, while multiple within-year measurements better describe the response of biomass

Lack of Galanin 3 Receptor Aggravates Murine Autoimmune Arthritis

Neurogenic inflammation mediated by peptidergic sensory nerves has a crucial impact on the pathogenesis of various joint diseases. Galanin is a regulatory sensory neuropeptide, which has been shown to attenuate neurogenic inflammation, modulate neutrophil activation, and be involved in the development of adjuvant arthritis, but our current understanding about its targets and physiological importance is incomplete. Among the receptors of galanin (GAL1-3), GAL3 has been found to be the most abundantly expressed in the vasculature and on the surface of some immune cells. However, since there are minimal in vivo data on the role of GAL3 in joint diseases, we analyzed its involvement in different inflammatory mechanisms of the K/BxN serum transfer-model of autoimmune arthritis employing GAL 3 gene-deficient mice. After arthritis induction, GAL3 knockouts demonstrated increased clinical disease severity and earlier hindlimb edema than wild types. Vascular hyperpermeability determined by in vivo fluorescence imaging was also elevated compared to the wild-type controls. However, neutrophil accumulation detected by in vivo luminescence imaging or arthritic mechanical hyperalgesia was not altered by the lack of the GAL3 receptor. Our findings suggest that GAL3 has anti-inflammatory properties in joints by inhibiting vascular hyperpermeability and consequent edema formation

Model development and optimization in interactive computing environments

65K30, 90C05, 90C31, Advanced systems modeling and optimization, Interactive electronic documents for research and education, Integrated computing systems, Maple, Global Optimization Toolbox, Illustrative examples and applications,