STABLE Results: Warfarin Home Monitoring Achieves Excellent INR Control

Objectives: Point-of-care, home international normalized ratio (INR) monitoring (patient self-testing, or PST) provides an opportunity to optimize warfarin therapy as demonstrated in randomized trials.This study sought to determine the quality of warfarin therapy as determined by time in therapeutic INR range (TTR) in patients who perform home monitoring outside of a clinical trial setting. Study Design: Retrospective analysis. Methods: The data base of an independent diagnostic testing facility was retrospectively queried over a 2.5-year period (January 2008-June 2011) and patientTTR was analyzed based on frequency of testing, age, gender, indication for therapy, duration of therapy, and critical value occurrence. Results: A total of 29,457 patients with multiple indications for warfarin therapy comprised the database.The mean TTR for the entire group was 69.7%, with weekly testers achieving a TTR of 74% versus 68.9% for variable testers (testing every 2-4 weeks)(P5.0) than did variable testers. Conclusions: Point-of-care patient self-testing at home achieves high-quality warfarin therapy outside of clinical trials and compares favorably with the results achieved in randomized trials or in anticoagulation clinic settings

STABLE Results: Warfarin Home Monitoring Achieves Excellent INR Control

Objectives: Point-of-care, home international normalized ratio (INR) monitoring (patient self-testing, or PST) provides an opportunity to optimize warfarin therapy as demonstrated in randomized trials.This study sought to determine the quality of warfarin therapy as determined by time in therapeutic INR range (TTR) in patients who perform home monitoring outside of a clinical trial setting. Study Design: Retrospective analysis. Methods: The data base of an independent diagnostic testing facility was retrospectively queried over a 2.5-year period (January 2008-June 2011) and patientTTR was analyzed based on frequency of testing, age, gender, indication for therapy, duration of therapy, and critical value occurrence. Results: A total of 29,457 patients with multiple indications for warfarin therapy comprised the database.The mean TTR for the entire group was 69.7%, with weekly testers achieving a TTR of 74% versus 68.9% for variable testers (testing every 2-4 weeks)(P5.0) than did variable testers. Conclusions: Point-of-care patient self-testing at home achieves high-quality warfarin therapy outside of clinical trials and compares favorably with the results achieved in randomized trials or in anticoagulation clinic settings

Excess crossovers impede faithful meiotic chromosome segregation in C. elegans.

During meiosis, diploid organisms reduce their chromosome number by half to generate haploid gametes. This process depends on the repair of double strand DNA breaks as crossover recombination events between homologous chromosomes, which hold homologs together to ensure their proper segregation to opposite spindle poles during the first meiotic division. Although most organisms are limited in the number of crossovers between homologs by a phenomenon called crossover interference, the consequences of excess interfering crossovers on meiotic chromosome segregation are not well known. Here we show that extra interfering crossovers lead to a range of meiotic defects and we uncover mechanisms that counteract these errors. Using chromosomes that exhibit a high frequency of supernumerary crossovers in Caenorhabditis elegans, we find that essential chromosomal structures are mispatterned in the presence of multiple crossovers, subjecting chromosomes to improper spindle forces and leading to defects in metaphase alignment. Additionally, the chromosomes with extra interfering crossovers often exhibited segregation defects in anaphase I, with a high incidence of chromatin bridges that sometimes created a tether between the chromosome and the first polar body. However, these anaphase I bridges were often able to resolve in a LEM-3 nuclease dependent manner, and chromosome tethers that persisted were frequently resolved during Meiosis II by a second mechanism that preferentially segregates the tethered sister chromatid into the polar body. Altogether these findings demonstrate that excess interfering crossovers can severely impact chromosome patterning and segregation, highlighting the importance of limiting the number of recombination events between homologous chromosomes for the proper execution of meiosis

Nonlocal string orders and entanglement spectrum in the spin-1/2 alternating Heisenberg-Ising chain

By the infinite time-evolving block decimation (iTEBD) technique, the quantum phase transitions (QPTs) and the ground-state properties of a spin-1/2 alternating Heisenberg-Ising chain are investigated. As the Ising coupling is generalized into the ferromagnetic case (J(I) < 0), in addition to two well-known phases (the antiferromagnetic phase and the disordered dimer phase), an antiferromagnetic stripe phase is induced. Two QPTs at J(I) = +/-2 can be described by the singular behavior of the bipartite entanglement entropy and the ground-state energy, and both are verified to be second-order transitions. Nonzero string orders (O-s(sigma), sigma = x, y, and z) and doubly degenerate entanglement spectra are observed in the disordered dimer phase, and these characters distinguish the disordered phase from other two phases. Especially, the string order introduced firstly to describe the Haldane phase of spin-1 chain is generalized to the spin-1/2 alternating Heisenberg-Ising chain.Physics, Condensed MatterSCI(E)[email protected]