D-dimer for risk stratification and antithrombotic treatment management in acute coronary syndrome patients: asystematic review and metanalysis

Background: Data on the prognostic role of D-dimer in patients with acute coronary syndrome (ACS) are controversial. Our aim was to summarize current evidence on the association between D-dimer levels and short/long-term poor prognosis of ACS patients. We also investigated the association between D-dimer and no-reflow phenomenon.Methods: Systematic review and metanalysis of observational studies including ACS patients and reporting data on D-dimer levels. PubMed and SCOPUS databases were searched. Data were combined with hazard ratio (HR) and metanalysed. The principal endpoint was a composite of cardiovascular events (CVEs) including myocardial infarction, all-cause and cardiovascular mortality.Results: Overall, 32 studies included in the systematic review with 28,869 patients. Of them, 6 studies investigated in-hospital and 26 studies long-term outcomes. Overall, 23 studies showed positive association of high D-dimer levels with CVEs. D-dimer levels predicted poor prognosis in all studies reporting in-hospital outcomes. Five studies satisfied inclusion criteria and were included in the metanalysis, with a total of 8616 patients. Median follow-up was 13.2 months with 626 CVEs. The pooled HR for D-dimer levels and CVEs was 1.264 (95% CI 1.134-1.409). Five out of 7 studies (4195 STEMI patients) investigating the association between D-dimer levels and no-reflow showed a positive correlation of D-dimer levels with no-reflow.Conclusions: In patients with ACS, D-dimer was associated with higher in-hospital and short/long-term complications. D-dimer was also higher in patients with no-reflow phenomenon. The use of D-dimer may help to identify patients with residual thrombotic risk after ACS

Feromônios sexuais no manejo de insetos-praga na fruticultura de clima temperado.

bitstream/item/95271/1/Feromonios-ULTIMA-VERSAO-08-07-2013.pdf; bitstream/item/95273/1/Capa-Feromonios.pd

Assessment of SPLAT formulations to control Grapholita molesta (Lepidoptera:Tortricidae) in a Brazilian apple orchard.

Mating disruption is a technique that uses synthetic copies of sex pheromones to control insect pests. We aimed to control Oriental fruit moth (OFM) Grapholita molesta (Busck) (Lepidoptera: Tortricidae) with formulations of SPLAT Grafo (SG) and SPLAT Grafo Attract and Kill (SGAK) in small (1 ha) apple (Malus domestica Borkh.) orchards. Our experiment was conducted in a commercial orchard with Gala trees (spacing 1.5 × 4.5 m) in Vacaria, Rio Grande do Sul State, Brazil. We evaluated the effect of four treatments on G. molesta population densities: a) SG at 1 kg ha-1 (300 point sources of 3.3 g each), b) SGAK at 1 kg ha-1 (1000 point sources of 1 g each), c) insecticides as recommended by Integrated Apple Production (IAP), and d) untreated control (no treatment). Specialized Pheromone and Lure Application Technology (SPLAT) treatments were applied on 1 August 2004 and reapplied after 120 d (1 December 2004). The treatment effect was evaluated by weekly counts of males captured in Delta traps baited with commercial synthetic sex pheromone lures (eight traps per treatment). We assessed fruit damage caused by G. molesta in eight replicates of 200 fruits each on 26 October, 30 November 2004, and 5 and 31 January 2005. Applying 1 kg ha-1 of SG and SGAK in August and December 2004 significantly reduced the number of male moths caught in Delta traps. Damage to fruits at harvest, however, did not differ significantly from the control. This indicates a decline in the efficacy of mating disruption when SG and SGAK are used to protect small areas (1 ha) under high Oriental fruit moth pressure

Integrated control of two tortricid (Lepidoptera) pests in apple orchards with sex pheromones and insecticides.

The apple is attacked by a significant number of insect pests in Brazilian commercial orchards, including Bonagota salubricola and Grapholita molesta (Lepidoptera: Tortricidae). Sexual disruption of B. salubricola and G. molesta was evaluated in apple orchard using the flowable pheromone formulations, SPLAT Grafo+Bona (SG+B), SPLAT Attract and Kill Grafo+Bona (SAKG+B), and compared with the standard insecticides used for management in the Integrated Apple Production (IAP) system. Both formulations were applied at a rate of 1kg/ha on October 10, 2005 and December 13, 2005 using 300 and 1000 point sources/ha of SG+B and SAKG+B, respectively in experimental units of 7 ha. Adult male captures of B. salubricola and G. molesta were evaluated weekly in Delta traps with specific synthetic sex pheromone from October 10, 2005 to February 14, 2006. Damage to fruits was evaluated on November 21 and December 21, 2005, and January 25 and February 14, 2006. In the SPLAT treated experimental units a significant reduction was observed in the number of B. salubricola and G. molesta males caught in Delta traps compared to the experimental unit IAP. Damage by B. salubricola at harvest ranged from 1.63 to 4.75% with no differences between treatments, while damage by G. molesta was near zero in all experimental units. Mating disruption using SG+B and SAKG+B was sufficient to control B. salubricola and G. molesta with results equivalent to IAP guidelines. This technology is promising for management of both pests in Brazilian apple orchards with immediate reduction of 43% in the number of insecticide applications

A Room Full of Rocking Chairs: Urban Appalachian Student Experiences in Community College

Urban Appalachian college students (UACS) face cultural and institutional barriers that impact their ability to persist and complete college. Designed to explore UACS experiences at a large urban community college, this study provides insight into Appalachian culture and identity as they impact their success in higher education. UACSs are more likely to come from a low-income family, and be the first in their family to attend college. First-generation college students more often lack the social and cultural capital needed to successfully navigate college, further increasing the risk of failure (Bradbury, 2009). Colleges and universities must seek out ways to improve the campus environment to reflect the needs and values of the students they serve and develop support systems that nurture the development of cultural capital needed to be successful in college and beyond (Oldfield, 2007).https://ecommons.udayton.edu/stander_posters/1382/thumbnail.jp