10 research outputs found
Weed Emergence Models
Weed emergence models are practical tools that aim to describe the dynamics of emergence in the field. Such models can be conceptualized from two main perspectives: a reductionist/mechanistic approach and an empirical modelling viewpoint. While the former provides a close description of the basic ecophysiological processes underlying weed emergence (i.e. seed dormancy, germination and pre-emergence growth), they usually require a large amount of difficult to estimate species-specific parameters, as well as sometimes unavailable or missing experimental data for model development/calibration/validation. Conversely, the latter aims to describe the emergence process as a whole by seeking a general mathematical description of field emergence data as a function of field environmental variables, mainly temperature and precipitation. As reviewed in the literature, most emergence models have been developed using nonlinear regression (NLR) techniques. NLR sigmoidal type models which are based on cumulative thermal or hydrothermal time have become the most popular approach as they are easy to develop and use. However, some statistical and bioecological limitations arise, for example, the lack of independence between samplings, censored data, need for threshold thermal/hydric parameter estimation and determination of ‘moment zero’ for thermal/hydrothermal-time accumulation, among other factors, which can lead to inaccurate descriptions of the emergence process. New approaches based on soft computing techniques (SCT) have recently been proposed as alternative models to tackle some of the previously mentioned limitations. In this chapter, we focus on empirical weed emergence models with special emphasis in NLR models, highlighting some of the main advantages, as well as the statistical and biological limitations that could affect their predictive accuracy. We briefly discuss new SCT-based approaches, such as artificial neural networks which have recently been used for weed emergence modelling.Fil: Royo Esnal, Aritz. Universidad de Lleida; EspañaFil: Torra, Joel. Universidad de Lleida; EspañaFil: Chantre Balacca, Guillermo Ruben. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; Argentina. Universidad Nacional del Sur. Departamento de Agronomía; Argentin
Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial
Background:
Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor.
Methods:
The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population).
Findings:
Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI.
Interpretation:
In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk