Following Tetraploidy in Maize, a Short Deletion Mechanism Removed Genes Preferentially from One of the Two Homeologs

Following genome duplication and selfish DNA expansion, maize used a heretofore unknown mechanism to shed redundant genes and functionless DNA with bias toward one of the parental genomes

SJS/TEN 2019: From Science to Translation

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are potentially life-threatening, immune-mediated adverse reactions characterized by widespread erythema, epidermal necrosis, and detachment of skin and mucosa. Efforts to grow and develop functional international collaborations and a multidisciplinary interactive network focusing on SJS/TEN as an uncommon but high burden disease will be necessary to improve efforts in prevention, early diagnosis and improved acute and long-term management. SJS/TEN 2019: From Science to Translation was a 1.5-day scientific program held April 26-27, 2019, in Vancouver, Canada. The meeting successfully engaged clinicians, researchers, and patients and conducted many productive discussions on research and patient care needs

Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes

Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p <.001. Over 24 months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10 ml/min/1.73 m2 decrease), that was most notable in patients with eGFR <30 ml/min/1.73 m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90 ml/min/1.73 m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

Distribution of Reinforcing Particles in the Pressure Die Cast AlSi11/20% Sic Composite

A method of pressure die casting of composites with AlSi11 alloy matrix reinforced with 20 vol. % of SiC particles and the analysis of the distribution of particles within the matrix are presented. The composite castings were produced at various values of the piston velocity in the second stage of injection, at diverse intensification pressure values, and various injection gate width values. The distribution of particles over the entire cross-section of the tensile specimen is shown. The index of distribution was determined on the basis of particle count in elementary measuring fields. The regression equation describing the change of the considered index was found as a function of the pressure die casting parameters. The conclusion presents an analysis of the obtained results and their interpretation.Przedstawiono metodykę odlewania ciśnieniowego kompozytów na osnowie stopu AlSi11 zbrojonego 20% udziałem objętościowym cząstek SiC i ich rozmieszczenia w osnowie. Odlewy kompozytowe wykonano przy różnych wielkościach prędkości tłoka w II fazie ruchu, ciśnieniu doprasowania i szerokości szczeliny wlewowej. Przedstawiono rozmieszczenie cząstek SiC na całym przekroju odlewu próbki do badania rozciągania. Na podstawie zliczeń liczby cząstek w elementarnych polach pomiarowych określono wskaźnik ich rozmieszczenia. Obliczono równanie regresji zmiany tego wskaźnika jako funkcję parametrów odlewania ciśnieniowego. W podsumowaniu przedstawiono analizę uzyskanych wyników i ich interpretację

The Influence of Pressure Die Casting Parameters on the Mechanical Properties of AlSi11/10 Vol.% SiC Composite

The paper presents the method of preparing a composite slurry composed of AlSi11 alloy matrix and 10 vol.% of SiC particles, as well as the method of its high-pressure die casting and the measurement results concerning the tensile strength, the yield point, the elongation and hardness of the obtained composite. Composite castings were produced at various values of the piston velocity in the second stage of injection, diverse intensification pressure values, and various injection gate width values. There were found the regression equations describing the change of mechanical properties of the examined composite as a function of pressure die casting process parameters. The conclusion gives the analysis and the interpretation of the obtained results

The influence of pressure die casting parameters on distribution of reinforcing particles in the AlSi11/10% SiC composite

The method of pressure die casting of composites with AlSi11 alloy matrix reinforced with 10 vol. % of SiC particles and the analysis of the distribution of particles within the matrix is presented. The composite castings were produced at various values of the piston velocity in the second stage of injection, at diverse intensification pressure values, and various injection gate width values. The distribution of particles over the entire cross-section of the tensile specimen is shown. The index of distribution was determined on the basis of particle count in elementary measuring fields. The regression equation describing the change of the considered index was found as a function of the pressure die casting parameters. The conclusion presents an analysis of the obtained results and their interpretation

The Influence of Pressure Die Casting Parameters on the Mechanical Properties of AlSi11/10 Vol.% SiC Composite

The paper presents the method of preparing a composite slurry composed of AlSi11 alloy matrix and 10 vol.% of SiC particles, as well as the method of its high-pressure die casting and the measurement results concerning the tensile strength, the yield point, the elongation and hardness of the obtained composite. Composite castings were produced at various values of the piston velocity in the second stage of injection, diverse intensification pressure values, and various injection gate width values. There were found the regression equations describing the change of mechanical properties of the examined composite as a function of pressure die casting process parameters. The conclusion gives the analysis and the interpretation of the obtained results