PICKING THE BEST NOVEL ORAL ANTICOAGULANT FOR ATRIAL FIBRILLATION: EVIDENCE FROM A WARFARIN-CONTROLLED NETWORK META-ANALYSIS

Warfarin is a mainstay atrial ibrillation (AF) treatment, yet it has a narrow therapeutic window. Novel agents have been successfully tested against warfarin, yet no direct comparison among them is available. We thus performed a pair-wise and warfarin-adjusted network metaanalyses of novel oral anticoagulants for AF

Canopy bird assemblages are less influenced by habitat age and isolation than understory bird assemblages in Neotropical secondary forest

Secondary forest habitats are increasingly recognized for their potential to conserve biodiversity in the tropics. However, the development of faunal assemblages in secondary forest systems varies according to habitat quality and species‐specific traits. In this study, we predicted that the recovery of bird assemblages is dependent on secondary forest age and level of isolation, the forest stratum examined, and the species’ traits of feeding guild and body mass. This study was undertaken in secondary forests in central Panama; spanning a chronosequence of 60‐, 90‐, and 120‐year‐old forests, and in neighboring old‐growth forest. To give equal attention to all forest strata, we employed a novel method that paired simultaneous surveys in canopy and understory. This survey method provides a more nuanced picture than ground‐based studies, which are biased toward understory assemblages. Bird reassembly varied according to both habitat age and isolation, although it was challenging to separate these effects, as the older sites were also more isolated than the younger sites. In combination, habitat age and isolation impacted understory birds more than canopy‐dwelling birds. Proportions of dietary guilds did not vary with habitat age, but were significantly different between strata. Body mass distributions were similar across forest ages for small‐bodied birds, but older forest supported more large‐bodied birds, probably due to control of poaching at these sites. Canopy assemblages were characterized by higher species richness, and greater variation in both dietary breadth and body mass, relative to understory assemblages. The results highlight that secondary forests may offer critical refugia for many bird species, particularly specialist canopy‐dwellers. However, understory bird species may be less able to adapt to novel and isolated habitats and should be the focus of conservation efforts encouraging bird colonization of secondary forests

PREVALENCE OF 'BORDERLINE' VALUES OF CARDIOVASCULAR RISK FACTORS IN THE CLINICAL PRACTICE OF GENERAL MEDICINE IN ITALY: RESULTS OF THE BORDERLINE STUDY.

INTRODUCTION: The prevalence of patients with 'borderline' levels of cardiovascular risk factors has been rarely investigated, being often reported in studies evaluating abnormal values of these parameters. The BORDERLINE study represents a pilot experience to primarily identify the prevalence of 'high-normal' conditions, such as pre-hypertension, lipid and glucose levels in the upper range of normality in the setting of general practice in Italy. AIM: The aim of this study was to evaluate the prevalence of patients with 'borderline' values of cardiovascular risk factors in Italy. METHODS: Involved physicians were asked to evaluate the first 20 outpatients, consecutively seen in June 2009. Data were collected in a study-designed case-report form, in which physicians identified thresholds rather than reported absolute values of several clinical parameters. High-normal values were defined as follows: blood pressure (BP) 130-140/85-90 mmHg; total cholesterol 180-200 mg/dL; low-density lipoprotein cholesterol (LDL-C) 130-150 mg/dL; high-density lipoprotein cholesterol (HDL-C) 30-40 mg/dL in males and 40-50 mg/dL in females; triglycerides 130-150 mg/dL and fasting glucose 100-110 mg/dL. RESULTS: Fifty-three Italian physicians provided valuable clinical data on 826 individual outpatients, among which 692 (83.7%, 377 women, mean age 60.9 ± 13.2 years, body mass index 26.6 ± 5.0 kg/m2) were included in the present analysis. Prevalence of borderline values of systolic BP and total cholesterol levels were at least comparable with those in the normal limits of the corresponding parameters, whereas prevalence of borderline diastolic BP, LDL-C, HDL-C, triglycerides and fasting glucose levels was significantly lower than that of normal values, but higher than that of abnormal values of the corresponding parameters. CONCLUSIONS: Using this sample of healthy subjects in the setting of general practice in Italy, our results demonstrated a relatively high prevalence of borderline values of cardiovascular risk factors, which was at least comparable with that of normal, but significantly higher than that of abnormal thresholds. These preliminary findings may prompt more extensive investigations in the area of 'borderline' cardiovascular risk. This information may, in fact, potentially enable the design of more effective prevention strategies in the future to limit the burden of cardiovascular disease in the general population in Italy

A summary of the beatwave experiments at Ecole Polytechnique

We present a summary of the beatwave particle acceleration program developed at Ecole Polytechnique. In dedicated experiments, plasma formation, plasma wave generation and saturation, and particle acceleration were successively studied and understood in detail. A maximum energy gain of 1.3 MeV was obtained, which is compatible with an accelerating gradient of 0.7 GV/m.Comment: 3 pages, 4 figure

Performance of the LHC Arc Superconducting Quadrupoles Towards the End of their Series Fabrication

The fabrication of the 408 main arc quadrupole magnets and their cold masses will come to an end in summer 2006. A rich collection of measurement and test data has been accumulated and their analysis is presented in this paper. These data cover the fabrication and the efficiency in the use of the main components, the geometrical measurements and the achieved dimensional precision, the warm magnetic measurements in the factory and the performance at cold conditions, especially the training behaviour. The scrap rate of the Nb-Ti/Cu conductor as well as that of other components turned out to be acceptably low and the quench performance measured was in general very good. Most quadrupoles measured so far exceeded the operating field gradient with one or no quench. The multipole content at cold was measured for a limited number of quadrupoles in order to verify the warm-to-cold correlation. From the point of view of field quality, all quadrupoles could be accepted for the machine. The measures taken to overcome the problem of a too high permeability of a batch of collars are discussed

Developing innovative systems for reinforced masonry walls

The Commission of the European Communities has recently funded a CRAFT research project aimed at developing innovative systems for load and non-load-bearing reinforced masonry walls. The project involves twelve partners coming from four different European countries, among which there are universities and research centres, small and medium enterprises for the production of clay and concrete units and mortars, a company for advanced metal products and industrial associations of brick and block producers. The development of the reinforced masonry walls is based on the advancement of vertical reinforcement and fastenings, of mortar and concrete and on their integration with special clay and concrete blocks for the definition of new construction systems. The foreseen advantages are: new possibilities for masonry; more economical construction; quality increase for masonry walls; crack-free and earthquake resistant construction. The project follows three steps: assessment of the technical and economical feasibility of the envisaged construction technologies by means of extensive experimental and numerical activities; construction of prototypes as demonstration of the proposed technologies and materials; in situ testing to completely validate the systems. In the present contribution, an overview of the main objectives and steps of the project is given. Furthermore, the different construction systems that are being developed and designed are described. The main fields of application and the main technical problems encountered for the different construction systems is described, together with the experimental program outlined in order to characterize their mechanical behaviour under different serviceability and ultimate conditions

A microRNA prognostic signature in patients with diffuse intrinsic pontine gliomas through non-invasive liquid biopsy

Diffuse midline gliomas (DMGs) originate in the thalamus, brainstem, cerebellum and spine. This entity includes tumors that infiltrate the pons, called diffuse intrinsic pontine gliomas (DIPGs), with a rapid onset and devastating neurological symptoms. Since surgical removal in DIPGs is not feasible, the purpose of this study was to profile circulating miRNA expression in DIPG patients in an effort to identify a non-invasive prognostic signature with clinical impact. Using a high-throughput platform, miRNA expression was profiled in serum samples collected at the time of MRI diagnosis and prior to radiation and/or systemic therapy from 47 patients enrolled in clinical studies, combining nimotuzumab and vinorelbine with concomitant radiation. With progression-free survival as the primary endpoint, a semi-supervised learning approach was used to identify a signature that was also tested taking overall survival as the clinical endpoint. A signature comprising 13 circulating miRNAs was identified in the training set (n = 23) as being able to stratify patients by risk of disease progression (log-rank p = 0.00014; HR = 7.99, 95% CI 2.38–26.87). When challenged in a separate validation set (n = 24), it confirmed its ability to predict progression (log-rank p = 0.00026; HR = 5.51, 95% CI 2.03–14.9). The value of our signature was also confirmed when overall survival was considered (log-rank p = 0.0021, HR = 4.12, 95% CI 1.57–10.8). We have identified and validated a prognostic marker based on the expression of 13 circulating miRNAs that can shed light on a patient’s risk of progression. This is the first demonstration of the usefulness of nucleic acids circulating in the blood as powerful, easy-to-assay molecular markers of disease status in DIPG. This study provides Class II evidence that a signature based on 13 circulating miRNAs is associated with the risk of disease progression

Gene Expression in Biopsies of Acute Rejection and Interstitial Fibrosis/Tubular Atrophy Reveals Highly Shared Mechanisms That Correlate With Worse Long‐Term Outcomes

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/122411/1/ajt13728.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/122411/2/ajt13728-sup-0005-AppendixS5.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/122411/3/ajt13728-sup-0003-AppendixS3.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/122411/4/ajt13728_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/122411/5/ajt13728-sup-0004-AppendixS4.pd

Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients

Coronary artery disease is most common in older patients, but may occur in younger subjects. The outlook of young patients after percutaneous coronary intervention (PCI) of challenging lesion subsets such as coronary bifurcations, is not established. We thus aimed to appraise the early and long-term results of PCI for bifurcations in young patients