708-4 Can the Results of SPECT Scintigraphy Safely Guide Clinical Management of Patients with Active CAD?

Myocardial perfusion scintigraphy is increasingly used to categorize risk in pts with known or a high likelihood of CAD. This strategy will only be cost-effective if: 1) cardiologists will largely reserve further testing such as angiography (angio) to high-risk subsets; and 2) it is shown that less severe patterns of abnormality can be safely managed medically. We previously reported angio rates after all 4, 162 SPECT studies (excluding those with angio within 90 days beforeSPECT) at our cardiology practice-based nuclear lab: 4% (69/1663) in pts with fixed defects only and/or no ischemia; 60% (682/1141) in pts with high-risk ischemia (2 of multivessel or LAD distribution ischemia and abnormal lung uptake); and 9% (123/1352) for pts with mild-moderate ischemia. In this study, we determined outcome of the 1229 pts with mild-moderate ischemia who did not have referral for angio. Patient characteristics: mean age 65 yrs; known CAD=1061 (86%); prior CABG=344; prior MI=575; prior PTCA=674; angina=592. Twenty-eight (2%) pts were lost to follow-up. The remainder were followed for a mean of 18 months. There were 22 hard events (MI=15; cardiac death=71) (1.8%) and 54 pts required PTCA or CABG (total event rate 6.3%). Mean time to any event was 13.2 months from SPECT. Freedom from hard events at 1 yr was 99% and at 2 yrs 97%. Freedom from any event was 97% at 1 yr and 91% at 2 yrs.Conclusions1) SPECT can be a highly effective strategy for selecting pts for angio; 2) Even in a self-referral setting angio is largely reserved for pts with high-risk scans; and 3) Pts with mildly-moderately abnormal scans can be treated safely with medical therapy and close follow-u

Brain Genomics Superstruct Project initial data release with structural, functional, and behavioral measures

The goal of the Brain Genomics Superstruct Project (GSP) is to enable large-scale exploration of the links between brain function, behavior, and ultimately genetic variation. To provide the broader scientific community data to probe these associations, a repository of structural and functional magnetic resonance imaging (MRI) scans linked to genetic information was constructed from a sample of healthy individuals. The initial release, detailed in the present manuscript, encompasses quality screened cross-sectional data from 1,570 participants ages 18 to 35 years who were scanned with MRI and completed demographic and health questionnaires. Personality and cognitive measures were obtained on a subset of participants. Each dataset contains a T1-weighted structural MRI scan and either one (n=1,570) or two (n=1,139) resting state functional MRI scans. Test-retest reliability datasets are included from 69 participants scanned within six months of their initial visit. For the majority of participants self-report behavioral and cognitive measures are included (n=926 and n=892 respectively). Analyses of data quality, structure, function, personality, and cognition are presented to demonstrate the dataset’s utility

Post-natal parental care in a Cretaceous diapsid from northeastern China

Post-natal parental care seems to have evolved numerous times in vertebrates. Among extant amniotes, it is present in crocodilians, birds, and mammals. However, evidence of this behavior is extremely rare in the fossil record and is only reported for two types of dinosaurs, and a varanopid ‘pelycosaur’. Here we report new evidence for post-natal parental care in Philydrosaurus, a choristodere, from the Yixian Formation of western Liaoning Province, China. We review the fossil record of reproduction in choristoderes, and this represents the oldest record of post-natal parental care in diapsids to our knowledge

Life and death in the Chicxulub impact crater: a record of the Paleocene–Eocene Thermal Maximum

latitudes, with sea surface temperatures at some localities exceeding the 35 ∘C at which marine organisms experience heat stress. Relatively few equivalent terrestrial sections have been identified, and the response of land plants to this extreme heat is still poorly understood. Here, we present a new record of the PETM from the peak ring of the Chicxulub impact crater that has been identified based on nannofossil biostratigraphy, an acme of the dinoflagellate genus Apectodinium, and a negative carbon isotope excursion. Geochemical and microfossil proxies show that the PETM is marked by elevated TEXH86-based sea surface temperatures (SSTs) averaging ∼37.8 ∘C, an increase in terrestrial input and surface productivity, salinity stratification, and bottom water anoxia, with biomarkers for green and purple sulfur bacteria indicative of photic zone euxinia in the early part of the event. Pollen and plants spores in this core provide the first PETM floral assemblage described from Mexico, Central America, and the northern Caribbean. The source area was a diverse coastal shrubby tropical forest with a remarkably high abundance of fungal spores, indicating humid conditions. Thus, while seafloor anoxia devastated the benthic marine biota and dinoflagellate assemblages were heat-stressed, the terrestrial plant ecosystem thrived

A genomic storm in critically injured humans

Critical injury in humans induces a genomic storm with simultaneous changes in expression of innate and adaptive immunity genes