Multidetector computed tomography angiography for assessment of in-stent restenosis: meta-analysis of diagnostic performance

<p>Abstract</p> <p>Background</p> <p>Multi-detector computed tomography angiography (MDCTA)of the coronary arteries after stenting has been evaluated in multiple studies.</p> <p>The purpose of this study was to perform a structured review and meta-analysis of the diagnostic performance of MDCTA for the detection of in-stent restenosis in the coronary arteries.</p> <p>Methods</p> <p>A Pubmed and manual search of the literature on in-stent restenosis (ISR) detected on MDCTA compared with conventional coronary angiography (CA) was performed. Bivariate summary receiver operating curve (SROC) analysis, with calculation of summary estimates was done on a stent and patient basis. In addition, the influence of study characteristics on diagnostic performance and number of non-assessable segments (NAP) was investigated with logistic meta-regression.</p> <p>Results</p> <p>Fourteen studies were included. On a stent basis, Pooled sensitivity and specificity were 0.82(0.72–0.89) and 0.91 (0.83–0.96). Pooled negative likelihood ratio and positive likelihood ratio were 0.20 (0.13–0.32) and 9.34 (4.68–18.62) respectively. The exclusion of non-assessable stents and the strut thickness of the stents had an influence on the diagnostic performance. The proportion of non-assessable stents was influenced by the number of detectors, stent diameter, strut thickness and the use of an edge-enhancing kernel.</p> <p>Conclusion</p> <p>The sensitivity of MDTCA for the detection of in-stent stenosis is insufficient to use this test to select patients for further invasive testing as with this strategy around 20% of the patients with in-stent stenosis would be missed. Further improvement of scanner technology is needed before it can be recommended as a triage instrument in practice. In addition, the number of non-assessable stents is also high.</p

Survival and long-term maintenance of tertiary trees in the Iberian Peninsula during the Pleistocene. First record of Aesculus L.

The Italian and Balkan peninsulas have been places traditionally highlighted as Pleistocene glacial refuges. The Iberian Peninsula, however, has been a focus of controversy between geobotanists and palaeobotanists as a result of its exclusion from this category on different occasions. In the current paper, we synthesise geological, molecular, palaeobotanical and geobotanical data that show the importance of the Iberian Peninsula in the Western Mediterranean as a refugium area. The presence of Aesculus aff. hippocastanum L. at the Iberian site at Cal Guardiola (Tarrasa, Barcelona, NE Spain) in the Lower– Middle Pleistocene transition helps to consolidate the remarkable role of the Iberian Peninsula in the survival of tertiary species during the Pleistocene. The palaeodistribution of the genus in Europe highlights a model of area abandonment for a widely-distributed species in the Miocene and Pliocene, leading to a diminished and fragmentary presence in the Pleistocene and Holocene on the southern Mediterranean peninsulas. Aesculus fossils are not uncommon within the series of Tertiary taxa. Many appear in the Pliocene and suffer a radical impoverishment in the Lower–Middle Pleistocene transition. Nonetheless some of these tertiary taxa persisted throughout the Pleistocene and Holocene up to the present in the Iberian Peninsula. Locating these refuge areas on the Peninsula is not an easy task, although areas characterised by a sustained level of humidity must have played an predominant role

CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

A HYDRAULIC CONDUCTIVITY MODEL POINTS TO POST-NEOGENE SURVIVAL OF THE MEDITERRANEAN OLIVE

Research on the subfossil record and paleoecology of Olea europaea suggests a new interpretation of its history and ecology with reference to the Mediterranean climatesince the Neogene. New results are based on the wood anatomy of ancient and extant Olea and a model estimating hydraulic conductance established for wild forms belonging to Olea europaea subsp. europaea. These suggest that during glacial periods wild olive populations survived in protected microenvironments, particularly riparian habitats. Thereafter, the postglacial expansion of olive associated with climatic warming took place from these refuge areas. This new evidence suggests that the continued existence of Olea in Mediterranean areas since the Neogene was made possible either by preferential survival of Olea lineages adaptable to the Holocene climate or from enhanced adaptation to extreme environmental variation, a trait possibly originating from Tertiary predecessors and maintained in postglacial olive populations

Fossil mega- and micro-flora from Bernasso (Early Pleistocene, southern France): A multimethod comparative approach for paleoclimatic reconstruction

International audienceBernasso is an Early Pleistocene locality that has a well-dated floral fossil content including both pollen grains and megaremains. Pollen record shows vegetation changes corresponding to two glacial and one interglacial periods. The megafloral fossil assemblage was interpreted as an association of present-day Mediterranean and Caucasian taxa that developed during a late interglacial stage of the beginning of the Pleistocene. In the present study, climatic reconstruction using the Climate Leaf Analysis Multivariate Program (CLAMP) and the Leaf Margin Analysis (LMA) methods based on the megaflora on one hand and using the Climatic Amplitude Method (CAM) based on the pollen flora on the other hand have been used to check the qualitative climatic estimates based on the comparison between paleovegetation data and similar modern ecosystems. CLAMP and LMA analyses show that the Bernasso climate was colder than the present-day climate of Southern France and of the Hyrcanian and Euxinian regions. On contrary, CAM shows mean annual temperatures higher than the modern Bernasso temperature and equivalent to the temperature of the Hyrcanian and Euxinian regions. Mean annual precipitation and relative humidity reconstructed by CLAMP and CAM are in agreement and indicate that the climate was wetter than today at Bernasso. The differences between the three methods highlight important methodological biases that could be solved by including additional calibration sites in Europe and in the Mediterranean region