Toward an international consensus-Integrating lipoprotein apheresis and new lipid-lowering drugs

Background: Despite advances in pharmacotherapy of lipid disorders, many dyslipidemic patients do not attain sufficient lipid lowering to mitigate risk of atherosclerotic cardiovascular disease. Several classes of novel lipid-lowering agents are being evaluated to reduce atherosclerotic cardiovascular disease risk. Lipoprotein apheresis (LA) is effective in acutely lowering the plasma concentrations of atherogenic lipoproteins including low-density lipoprotein cholesterol and lipoprotein(a), and novel lipid-lowering drugs may dampen the lipid rebound effect of LA, with the possibility that LA frequency may be decreased, in some cases even be discontinued. Sources of material: This document builds on current American Society for Apheresis guidelines and, for the first time, makes recommendations from summarized data of the emerging lipid-lowering drug classes (inhibitors of proprotein convertase subtilisin/kexin type 9 or microsomal triglyceride transfer protein, high-density lipoprotein mimetic), including the available evidence on combination therapy with LA with respect to the management of patients with dyslipidemia. Abstract of findings: Recommendations for different indications are given based on the latest evidence. However, except for lomitapide in homozygous familial hypercholesterolemia and alirocumab/evolocumab in heterozygous familial hypercholesterolemia subjects, limited data are available on the effectiveness and safety of combination therapy. More studies on combining LA with novel lipid-lowering drugs are needed. Conclusion: Novel lipid-lowering agents have potential to improve the performance of LA, but more evidence is needed. The Multidisciplinary International Group for Hemapheresis TherapY and Metabolic DIsturbances Contrast scientific society aims to establish an international registry of clinical experience on LA combination therapy to expand the evidence on this treatment in individuals at high cardiovascular disease risk

Suicide risk in schizophrenia: learning from the past to change the future

Suicide is a major cause of death among patients with schizophrenia. Research indicates that at least 5–13% of schizophrenic patients die by suicide, and it is likely that the higher end of range is the most accurate estimate. There is almost total agreement that the schizophrenic patient who is more likely to commit suicide is young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Awareness of illness has been reported as a major issue among suicidal schizophrenic patients, yet some researchers argue that insight into the illness does not increase suicide risk. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening schizophrenics for suicide. Although, there is general consensus on the risk factors, accurate knowledge as well as early recognition of patients at risk is still lacking in everyday clinical practice. Better knowledge may help clinicians and caretakers to implement preventive measures. This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. This is the first attempt to present a consensus report as well as the development of a set of guidelines for reducing suicide risk among schizophenia patients

Remote detection of invasive alien species

The spread of invasive alien species (IAS) is recognized as the most severe threat to biodiversity outside of climate change and anthropogenic habitat destruction. IAS negatively impact ecosystems, local economies, and residents. They are especially problematic because once established, they give rise to positive feedbacks, increasing the likelihood of further invasions and spread. The integration of remote sensing (RS) to the study of invasion, in addition to contributing to our understanding of invasion processes and impacts to biodiversity, has enabled managers to monitor invasions and predict the spread of IAS, thus supporting biodiversity conservation and management action. This chapter focuses on RS capabilities to detect and monitor invasive plant species across terrestrial, riparian, aquatic, and human-modified ecosystems. All of these environments have unique species assemblages and their own optimal methodology for effective detection and mapping, which we discuss in detail

Women on boards of Malaysian firms: Impact on market and accounting performance

We seek to offer some reconciliation for the conflicting theoretical arguments and empirical findings regarding the impact of women’s participation in boards on firms’ performance.We suggest that this impact differs in relation to market- and accounting-performance, and it is firm-specific, and varies by firms’ ownership type and the composition of their boards.These arguments find theoretical underpinnings in agency and resource-dependency theories, combined with behavioral and discrimination theories that articulate women behavior in the workplace and market perception of gender equality.The empirical analysis is based on a dataset of 841 publicly-listed firms in Malaysia.The results show positive impact of women’s participation on accounting-performance and negative impact on market-performance, suggesting that women directors create economic value, which is undervalued by the market. We interpret the findings with reference to the perception of women’s role in society and business in Malaysia, and the nature of corporate governance and ownership types prevalent among Malaysian firms.We suggest that the relationships might be context-specific, and hence the desired level of women’s participation varies across countries.We discuss the normative implications of the findings for government authorities considering legislation of gender-quota on boards, and for firms

The Effect of Various Test Parameters on the Steady Flow Test Results of a Four-Valve Spark Ignition Engine: A Tentative Approach toward Standardization

The present paper is an account of an experimental analysis carried out to investigate to what extent the flow characteristics in the intake system of a 4-valve, spark ignition internal combustion engine depend on the experimental conditions at the steady flow test bench. In this respect, the study is aimed at determining the influences of the intake adaptor, test pressure, adaptor length and diameter, adaptor roughness, paddle wheel diameter, and asymmetric valves lifting on the flow coefficient and the swirl intensity measurements. In studies of this kind, researchers generally tend to adopt different test parameters to arrive at a nonuniform base to compare results from several investigations. This work is aimed at verifying the quantitative differences detected using these test parameters. The findings revealed that the swirl intensity depends on the pressure test, adaptor length, and the entry type to a significant degree. Moreover, it was observed that the intake adaptor is the most effective test parameter on the flow coefficient. Finally, the sensitivity analysis has been performed in order to investigate the experimental results and to correlate them with the test parameters

Effect of Ferrofluid on the Performance and Emission Patterns of a Four-Stroke Diesel Engine

Experimental tests were carried out to investigate the effects of adding water-based ferrofluid to diesel fuel in a diesel engine. These effects included the combustion performance and exhaust emission characteristics of the diesel engine. To this end, emulsified diesel fuels of 0, 0.4, and 0.8 ferrofluid/diesel ratios by volume were used in a four-stroke diesel engine, operating at 2200 rpm. The results indicate that adding ferrofluid to diesel fuel has a perceptible effect on engine performance, increasing the brake thermal efficiency relatively up to 12% and decreasing the brake-specific fuel consumption relatively up to 11% as compared to diesel fuel. Furthermore, from the analysis of gaseous species of engine exhaust, it was found that NOx emissions were lower than that of diesel fuel while the CO emissions increased. In addition, it was found that nanoparticles can be collected at the exhaust flow using a magnetic bar