Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Reduced costs with bisoprolol treatment for heart failure - An economic analysis of the second Cardiac Insufficiency Bisoprolol Study (CIBIS-II)

Background Beta-blockers, used as an adjunctive to diuretics, digoxin and angiotensin converting enzyme inhibitors, improve survival in chronic heart failure. We report a prospectively planned economic analysis of the cost of adjunctive beta-blocker therapy in the second Cardiac Insufficiency BIsoprolol Study (CIBIS II). Methods Resource utilization data (drug therapy, number of hospital admissions, length of hospital stay, ward type) were collected prospectively in all patients in CIBIS . These data were used to determine the additional direct costs incurred, and savings made, with bisoprolol therapy. As well as the cost of the drug, additional costs related to bisoprolol therapy were added to cover the supervision of treatment initiation and titration (four outpatient clinic/office visits). Per them (hospital bed day) costings were carried out for France, Germany and the U.K. Diagnosis related group costings were performed for France and the U.K. Our analyses took the perspective of a third party payer in France and Germany and the National Health Service in the U.K. Results Overall, fewer patients were hospitalized in the bisoprolol group, there were fewer hospital admissions perpatient hospitalized, fewer hospital admissions overall, fewer days spent in hospital and fewer days spent in the most expensive type of ward. As a consequence the cost of care in the bisoprolol group was 5-10% less in all three countries, in the per them analysis, even taking into account the cost of bisoprolol and the extra initiation/up-titration visits. The cost per patient treated in the placebo and bisoprolol groups was FF35 009 vs FF31 762 in France, DM11 563 vs DM10 784 in Germany and pound 4987 vs pound 4722 in the U.K. The diagnosis related group analysis gave similar results. Interpretation Not only did bisoprolol increase survival and reduce hospital admissions in CIBIS II, it also cut the cost of care in so doing. This `win-win' situation of positive health benefits associated with cost savings is Favourable from the point of view of both the patient and health care systems. These findings add further support for the use of beta-blockers in chronic heart failure

Changes to the Fossil Record of Insects through Fifteen Years of Discovery

The first and last occurrences of hexapod families in the fossil record are compiled from publications up to end-2009. The major features of these data are compared with those of previous datasets (1993 and 1994). About a third of families (>400) are new to the fossil record since 1994, over half of the earlier, existing families have experienced changes in their known stratigraphic range and only about ten percent have unchanged ranges. Despite these significant additions to knowledge, the broad pattern of described richness through time remains similar, with described richness increasing steadily through geological history and a shift in dominant taxa, from Palaeoptera and Polyneoptera to Paraneoptera and Holometabola, after the Palaeozoic. However, after detrending, described richness is not well correlated with the earlier datasets, indicating significant changes in shorter-term patterns. There is reduced Palaeozoic richness, peaking at a different time, and a less pronounced Permian decline. A pronounced Triassic peak and decline is shown, and the plateau from the mid Early Cretaceous to the end of the period remains, albeit at substantially higher richness compared to earlier datasets. Origination and extinction rates are broadly similar to before, with a broad decline in both through time but episodic peaks, including end-Permian turnover. Origination more consistently exceeds extinction compared to previous datasets and exceptions are mainly in the Palaeozoic. These changes suggest that some inferences about causal mechanisms in insect macroevolution are likely to differ as well

Physical methods of microalgal biomass pretreatment

The prospect of depletion of natural energy resources on the Earth forces researchers to seek and explore new and alternative energy sources. Biomass is a composite resource that can be used in many ways leading to diversity of products. Therefore, microalgal biomass offers great potential. The main aim of this study is to find the best physical method of microalgal bio- mass pretreatment that guarantees efficient lipid extraction. These studies identifies biochemical composition of microalgal biomass as source for biodisel production. The influence of drying at dif- ferent temperatures and lyophilization was investigated. In addi- tion, wet and untreated biomass was examined. Cell disruption (sonication and microwave) techniques were used to improve lipid extraction from wet biomass. Additionally, two different extrac- tion methods were carried out to select the best method of crude oil extraction. The results of this study show that wet biomass after sonication is the most suitable for extraction. The fatty acid com- position of microalgal biomass includes linoleic acid (C18:2), palmitic acid (C16:0), oleic acid (C18:1), linolenic acid (C18:3), and stearic acid (C18:0), which play a key role in biodiesel production

Personality-Based Lexical Diferences in Services Adaptation Process

In the near future, the reality we live in will undergo a significant transformation caused by the development of advanced information technologies. Artificial intelligence, robots, virtual agents, as well as advanced intelligent virtual services will become ubiquitous. Available digital data and technologies can be used to create new services that are actively adapting to the user. The results presented in the article come from preliminary research indicating how to use data available in digital services to both proling users according to their personality, and providing them with personalised services. We will also present an idea howto use such analyses to create a personalized response from intelligent services. This can have a significant impact on lowering human-machine communication barriers and reducing technological exclusion. It can certainly improve the satisfaction and comfort of using services intelligent enough to be able to self-adapt to a user

Late Svecofennian sedimentary basins in the crystalline basement of NE Poland and adjacent area of Lithuania: ages, major sources of detritus, and correlations

The Pre cam brian base ment of Lith u a nia and NE Po land, much of which is metasedimentary paragneiss, can be ac cessed only by cores from deep bore holes. Ion microprobe dat ing of de tri tal zir cons from sam ples of these meta sedi ments and the geo chem i cal sig na tures of the rocks pro vide new in sights into their age and prov e nance. De tri tal zir cons from meta sedi ments from Jastrzebna and Monki have Pb iso to pic ages in the ranges 3.14–1.83 and 3.53–1.82 Ga, re spec tively. Sim i lar re sults have been ob tained from the Lith u a nian Lazdijai and Bliudziai paragneisses. About 30% of the ana lysed Pol ish de tri tal zir con cores are of Late Archaean age (2.90–2.60 Ga) and about 70% are Palaeoproterozoic (2.10–1.90 Ga), sim i lar to the age dis tri bu tions of de tri tal zir con from Svecofennian meta sedi ments ex posed in Cen tral Swe den and South ern Fin land. The youn gest de tri tal zir con sub-groups in di cate max i mum de po si tion ages of about 1.86 Ga, sim i lar to the ages of ex posed Svecofennian sed i men tary bas ins. Pos si ble source rocks of com pa ra ble ages and af fin i ties can be found within Fennoscandia, Green land and Sarmatia

A novel capillary nano-immunoassay for assessing androgen receptor splice variant 7 in plasma. Correlation with CD133 antigen expression in circulating tumor cells. A pilot study in prostate cancer patients

[Purpose]: Androgen receptor (AR) splice variant 7 (AR-V7) has been related with both a higher risk of prostate cancer (PC) progression and differential responsiveness to hormonal agents versus chemotherapy. The objective of this study was to investigate the feasibility of a novel capillary nano-immunoassay in assessing AR-V7 in plasma from PC patients. [Methods]: Patients with either localized or advanced PC were included in the study. Assessment of AR-V7 in plasma was performed through a capillary nano-immunoassay platform. Correlation with clinical data, stem cell biomarkers (such as CD133+), AR amplification and PTEN status was identified. [Results]: The study included 72 PC patients. AR-V7 signal was detected in 21 (29%) patients: 17 (81%) had a Gleason score ≥7, 15 (71%) castration-resistant prostate cancer (CRPC), 18 (86%) metastatic disease and PSA (median) high than AR-V7 negative (p < 0.05). CD133 was expressed in 69 (96%) patients. The median CD133+ expression in circulating tumor cells CTCs was higher among the 21 AR-V7 positive cases versus AR-V7 negative (7 vs. 3). Androgen Receptor and PTEN fluorescence in situ hybridization (FISH) on CD133+ captured cells were performed: 37 cases showed ≥four CD133+ CTCs, of which 81% showed an increased AR copy number. This percentage was similar in both AR-V7-positive and AR-V7-negative patients. A total of 68% of the cases showed deletion of PTEN: 70% were ARV-7 positive vs. 67%, which were AR-V7 negative. [Conclusions]: Assessing the presence of AR-V7 in plasma from PC patients is feasible by a novel capillary nano-immunoassay. AR-V7 was observed in 29% of the tumors and is more frequent in aggressive tumors.Partiality supported by Grant from Gerencia Regional de Salud, Junta de Castilla y Leon (Refs: GRS 992/A/14 y BIO/SA35/14) and INNOCAMPUS Program (CEI10-1-0010).Peer Reviewe