Length of carotid stenosis predicts peri-procedural stroke or death and restenosis in patients randomized to endovascular treatment or endarterectomy.

BACKGROUND: The anatomy of carotid stenosis may influence the outcome of endovascular treatment or carotid endarterectomy. Whether anatomy favors one treatment over the other in terms of safety or efficacy has not been investigated in randomized trials. METHODS: In 414 patients with mostly symptomatic carotid stenosis randomized to endovascular treatment (angioplasty or stenting; n = 213) or carotid endarterectomy (n = 211) in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), the degree and length of stenosis and plaque surface irregularity were assessed on baseline intraarterial angiography. Outcome measures were stroke or death occurring between randomization and 30 days after treatment, and ipsilateral stroke and restenosis ≥50% during follow-up. RESULTS: Carotid stenosis longer than 0.65 times the common carotid artery diameter was associated with increased risk of peri-procedural stroke or death after both endovascular treatment [odds ratio 2.79 (1.17-6.65), P = 0.02] and carotid endarterectomy [2.43 (1.03-5.73), P = 0.04], and with increased long-term risk of restenosis in endovascular treatment [hazard ratio 1.68 (1.12-2.53), P = 0.01]. The excess in restenosis after endovascular treatment compared with carotid endarterectomy was significantly greater in patients with long stenosis than with short stenosis at baseline (interaction P = 0.003). Results remained significant after multivariate adjustment. No associations were found for degree of stenosis and plaque surface. CONCLUSIONS: Increasing stenosis length is an independent risk factor for peri-procedural stroke or death in endovascular treatment and carotid endarterectomy, without favoring one treatment over the other. However, the excess restenosis rate after endovascular treatment compared with carotid endarterectomy increases with longer stenosis at baseline. Stenosis length merits further investigation in carotid revascularisation trials

The Galex Ultraviolet Variability (GUVV) Catalog

We present Version 1.0 of the NASA Galaxy Evolution Explorer (GALEX) ultraviolet variability catalog (GUVV) that contains information on 84 time-variable and transient sources gained with simultaneous near and far ultraviolet photometric observations. These time-variable sources were serendipitously revealed in the various 1.2 degree star fields currently being surveyed by the GALEX satellite in two ultraviolet bands (NUV 1750-2750A, FUV 1350-1750A) with limiting AB magnitudes of 23-25. The largest-amplitude variable objects presently detected by GALEX are M-dwarf flare stars, which can brighten by 5-10 mag in both the NUV and FUV bands during short duration (< 500s) outbursts. Other types of large-amplitude ultraviolet variable objects include ab-type RR Lyrae stars, which can vary periodically by 2-5mag in the GALEX FUV band. This first GUVV catalog lists galactic positions and possible source identifications in order to provide the astronomical community with a list of time-variable objects that can now be repeatedly observed at other wavelengths. We expect the total number of time-variable source detections to increase as the GALEX mission progresses, such that later version numbers of the GUVV catalog will contain substantially more variable sources

Metabolic resistance and not voltage-gated sodium channel gene mutation is associated with pyrethroid resistance of Aedes albopictus (Skuse, 1894) from Cambodia

(1) Background: In Cambodia, Aedes albopictus is an important vector of the dengue virus. Vector control using insecticides is a major strategy implemented in managing mosquito-borne diseases. Resistance, however, threatens to undermine the use of insecticides. In this study, we present the levels of insecticide resistance of Ae. albopictus in Cambodia and the mechanisms involved. (2) Methods: Two Ae. albopictus populations were collected from the capital, Phnom Penh city, and from rural Pailin province. Adults were tested with diagnostic doses of malathion (0.8%), deltamethrin (0.03%), permethrin (0.25%), and DDT (4%) using WHO tube assays. Synergist assays using piperonyl butoxide (PBO) were implemented before the pyrethroid assays to detect the potential involvement of metabolic resistance mechanisms. Adult female mosquitoes collected from Phnom Penh and Pailin were tested for voltage-gated sodium channel (VGSC) kdr (knockdown resistance) mutations commonly found in Aedes sp.-resistant populations throughout Asia (S989P, V1016G, and F1534C), as well as for other mutations (V410L, L982W, A1007G, I1011M, T1520I, and D1763Y). (3) Results: The two populations showed resistance against all the insecticides tested (<90% mortality). The use of PBO (an inhibitor of P450s) strongly restored the efficacy of deltamethrin and permethrin against the two resistant populations. Sequences of regions of the vgsc gene showed a lack of kdr mutations known to be associated with pyrethroid resistance. However, four novel non-synonymous mutations (L412P/S, C983S, Q1554STOP, and R1718L) and twenty-nine synonymous mutations were detected. It remains to be determined whether these mutations contribute to pyrethroid resistance. (4) Conclusions: Pyrethroid resistance is occurring in two Ae. albopictus populations originating from urban and rural areas of Cambodia. The resistance is likely due to metabolic resistance specifically involving P450s monooxygenases. The levels of resistance against different insecticide classes are a cause for concern in Cambodia. Alternative tools and insecticides for controlling dengue vectors should be used to minimize disease prevalence in the country

On Suggesting Phrases vs. Predicting Words for Mobile Text Composition

A system capable of suggesting multi-word phrases while someone is writing could supply ideas about content and phrasing and allow those ideas to be inserted efficiently. Meanwhile, statistical language modeling has provided various approaches to predicting phrases that users type. We introduce a simple extension to the familiar mobile keyboard suggestion interface that presents phrase suggestions that can be accepted by a repeated-tap gesture. In an extended composition task, we found that phrases were interpreted as suggestions that affected the content of what participants wrote more than conventional single-word suggestions, which were interpreted as predictions. We highlight a design challenge: how can a phrase suggestion system make valuable suggestions rather than just accurate predictions

The value of a joint cerebrovascular neurology clinic in carotid surgery practice

Objectives: The aims of the clinic were to offer suitable patients carotid endarterectomy with minimal delay, to discuss patients with unclear symptoms and to offer the best advice to patients referred with asymptomatic carotid artery stenosis. Design: A retrospective note review of all the patients who attended the clinic over a two-year period between January 1997 and December 1998 was undertaken. A pro-forma was completed. Participants: Three hundred and ninety-nine patients who were seen in the joint clinic for investigations of cerebrovascular disease. Main outcome measures: Waiting time for specialist consultations and treatment. Results: During that period 118 new patients and 281 follow-up patients were seen in the clinic. Colour flow Doppler was performed on 102 new patients and 113 follow-up patients. Digital Subtraction Angiography was used in selected patients (16). Sixty -six patients had combined consultations. Twenty-nine (24.6%) patients were assessed and discharged from the clinic on their first consultation. Seventy-three (62%) patients were listed for carotid endarterectomy. The mean waiting time from referral to consultation was 2.6 weeks and from consultation to surgical treatment was 4.7 weeks. Both these waiting times were significantly better than the waiting times before the joint cerebrovascular neurology clinic was set up. Conclusion: The combined clinic provided an appropriate environment for one-stop rapid assessment and treatment of patients with preventable stroke