Benefits and harms of extending the duration of dual antiplatelet therapy after percutaneous coronary intervention with drug-eluting stents: a meta-analysis

Background. The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is unclear. Methods. We conducted a systematic review and meta-analysis of randomized controlled trials evaluating risk of adverse events in participants receiving different durations of DAPT following insertion of drug-eluting stents. Results. Five trials were included, but only four had data suitable for meta-analysis ( participants). No significant increase in the composite endpoint of death and nonfatal myocardial infarction was observed with earlier cessation of DAPT in any instance when compared to longer durations of DAPT (RR 0.64 95% CI 0.25–1.63 for 3 versus 12 months, RR 1.09 95% CI 0.84–1.41 for 6 versus 12 months and, RR 0.64 95% CI 0.35–1.16 for 12 versus 24 months). Pooled results showed a significantly lower risk of major bleeding (RR 0.48 95% CI 0.25–0.93) and total bleeding (RR 0.30 95% CI 0.16–0.54) for shorter compared to longer duration of DAPT. Subgroup analysis based on age, prior diabetes, and prior ACS failed to show any group where longer durations were consistently better than shorter ones. Conclusions. There are no cardiovascular or mortality benefits associated with extended duration of DAPT, but the risk of major bleeding was significantly lower with shorter lengths of therapy

Symbolic power: the future of nuclear energy in Lithuania

EU accession states may have thrown off their Soviet past in political terms, but abandoning some of the Soviet era technologies is proving to be harder. Civil nuclear power is on the way out in most of Europe, but for some ex-Soviet countries this may present serious problems of economic, social and cultural transformation -- especially in countries like Lithuania, where nuclear power supplies the bulk of the electricity. The issue has come to a head given the EU's insistence that several ex-Soviet states must agree to close their nuclear plant as a condition of EU entry. Lithuania is the accession country most wedded to and certainly most reliant on nuclear power. It has a nuclear plant which uses a technology (the RBMK, Chernobyl-type reactor) which the EU has insisted should be closed rapidly on safety grounds. This has proved an unpopular requirement in Lithuania for a variety of reasons. There are problem with ensuring continued energy supplies and replacing the lost employment and earning power. However Lithuania also has a more general commitment to this technology as a symbol of national prowess and independence. During and immediately after the struggle for national independence in 1991, the country had a mass anti-nuclear movement. This has been analysed as a covert expression of nationalist and anti-Soviet feeling, given that most opposition to nuclear power evaporated after independence (Dawson 1996). Subsequently the EU ruled that Lithuania's Ignalina nuclear plant should be closed. Yet now it is widely seen as a national asset, a view reinforced by resentment about the EU apparently imposing an unwarranted closure policy. This article will analyse how public and policy views on nuclear power have changed over time in Lithuania and how its symbolic meaning has changed during different phases of transformation of the Lithuanian society

A connection between stress and development in the multicelular prokaryote Streptomyces coelicolor

Morphological changes leading to aerial mycelium formation and sporulation in the mycelial bacterium Streptomyces coelicolor rely on establishing distinct patterns of gene expression in separate regions of the colony. sH was identified previously as one of three paralogous sigma factors associated with stress responses in S. coelicolor. Here, we show that sigH and the upstream gene prsH (encoding a putative antisigma factor of sH) form an operon transcribed from two developmentally regulated promoters, sigHp1 and sigHp2. While sigHp1 activity is confined to the early phase of growth, transcription of sigHp2 is dramatically induced at the time of aerial hyphae formation. Localization of sigHp2 activity using a transcriptional fusion to the green fluorescent protein reporter gene (sigHp2–egfp) showed that sigHp2 transcription is spatially restricted to sporulating aerial hyphae in wild-type S. coelicolor. However, analysis of mutants unable to form aerial hyphae (bld mutants) showed that sigHp2 transcription and sH protein levels are dramatically upregulated in a bldD mutant, and that the sigHp2–egfp fusion was expressed ectopically in the substrate mycelium in the bldD background. Finally, a protein possessing sigHp2 promoter-binding activity was purified to homogeneity from crude mycelial extracts of S. coelicolor and shown to be BldD. The BldD binding site in the sigHp2 promoter was defined by DNase I footprinting. These data show that expression of sH is subject to temporal and spatial regulation during colony development, that this tissue-specific regulation is mediated directly by the developmental transcription factor BldD and suggest that stress and developmental programmes may be intimately connected in Streptomyces morphogenesis

Partners of nulliparous women with severe fear of childbirth: a longitudinal 1 study of psychological well being

Background: Little is known about the psychological status of partners of women with severe fear of childbirth (FOC). In this longitudinal study from Helsinki University Central Hospital, we investigated FOC, depression and post- traumatic stress in the partners of women with severe FOC, and possible effects of group psychoeducation and mode of birth. Methods: During pregnancy, 250 partners of nulliparous women with severe FOC participated, 93 in the intervention group and 157 in the control group. At three months postpartum 52 partners in the intervention group and 93 in the control group participated. Both the partners and the childbearing women filled in the Wijma Delivery Expectancy Questionnaire and the Edinburgh Postnatal Depression Scale mid-pregnancy as well as three months postpartum, when they also filled in the Traumatic Event Scale. Results: Partners of women with severe FOC reported less antenatal and postnatal FOC and fewer depressive symptoms than the childbearing women. No partner reached the threshold of severe FOC. No partner reported a possible post-traumatic stress disorder. Group psychoeducation with relaxation was not associated with better or worse psychological well being of the partners. An emergency cesarean section 1 was associated with a more fearful delivery experience in the partners. Conclusion: Partners of nulliparous women with severe FOC neither seem to suffer from severe FOC nor reported post-traumatic stress symptoms after childbirth. They reported better psychological well being than the mothers both during pregnancy and after delivery. An unexpected cesarean may be a negative experience even for 6 partners of childbearing women

Constitutive expression of ftsZ overrides the whi developmental genes to initiate sporulation of Streptomyces coelicolor

The filamentous soil bacteria Streptomyces undergo a highly complex developmental programme. Before streptomycetes commit themselves to sporulation, distinct morphological checkpoints are passed in the aerial hyphae that are subject to multi-level control by the whi sporulation genes. Here we show that whi-independent expression of FtsZ restores sporulation to the early sporulation mutants whiA, whiB, whiG, whiH, whiI and whiJ. Viability, stress resistance and high-resolution electron microscopy underlined that viable spores were formed. However, spores from sporulation-restored whiA and whiG mutants showed defects in DNA segregation/condensation, while spores from the complemented whiB mutant had increased stress sensitivity, perhaps as a result of changes in the spore sheath. In contrast to the whi mutants, normal sporulation of ssgB null mutants—which fail to properly localise FtsZ—could not be restored by enhancing FtsZ protein levels, forming spore-like bodies that lack spore walls. Our data strongly suggest that the whi genes control a decisive event towards sporulation of streptomycetes, namely the correct timing of developmental ftsZ transcription. The biological significance may be to ensure that sporulation-specific cell division will only start once sufficient aerial mycelium biomass has been generated. Our data shed new light on the longstanding question as to how whi genes control sporulation, which has intrigued scientists for four decades

A previously functional tetracycline-regulated transactivator fails to target gene expression to the bone

<p>Abstract</p> <p>Background</p> <p>The tetracycline-controlled transactivator system is a powerful tool to control gene expression <it>in vitro </it>and to generate consistent and conditional transgenic <it>in vivo </it>model organisms. It has been widely used to study gene function and to explore pathological mechanisms involved in human diseases. The system permits the regulation of the expression of a target gene, both temporally and quantitatively, by the application of tetracycline or its derivative, doxycycline. In addition, it offers the possibility to restrict gene expression in a spatial fashion by utilizing tissue-specific promoters to drive the transactivator.</p> <p>Findings</p> <p>In this study, we report our problems using a reverse tetracycline-regulated transactivator (rtTA) in a transgenic mouse model system for the bone-specific expression of the Hutchinson-Gilford progeria syndrome mutation. Even though prior studies have been successful utilizing the same rtTA, expression analysis of the transactivator revealed insufficient activity for regulating the transgene expression in our system. The absence of transactivator could not be ascribed to differences in genetic background because mice in a mixed genetic background and in congenic mouse lines showed similar results.</p> <p>Conclusions</p> <p>The purpose of this study is to report our negative experience with previously functional transactivator mice, to raise caution in the use of tet-based transgenic mouse lines and to reinforce the need for controls to ensure the stable functionality of generated tetracycline-controlled transactivators over time.</p

Medicinal plant knowledge of the Bench ethnic group of Ethiopia: an ethnobotanical investigation

<p>Abstract</p> <p>Background</p> <p>Plants have traditionally been used as a source of medicine in Ethiopia since early times for the control of various ailments afflicting humans and their domestic animals. However, little work has been made in the past to properly document and promote the knowledge. Today medicinal plants and the associated knowledge in the country are threatened due to deforestation, environmental degradation and acculturation. Urgent ethnobotanical studies and subsequent conservation measures are, therefore, required to salvage these resources from further loss. The purpose of the present study was to record and analyse traditional medicinal plant knowledge of the Bench ethnic group in Southwest Ethiopia.</p> <p>Methods</p> <p>Semi-structured interviews were conducted with Bench informants selected during transect walks made to houses as well as those identified as knowledgeable by local administrators and elders to gather data regarding local names of medicinal plants used, parts harvested, ailments treated, remedy preparation methods, administration routes, dosage and side effects. The same method was also employed to gather information on marketability, habitat and abundance of the reported medicinal plants. Purposive sampling method was used in the selection of study sites within the study district. Fidelity Level (FL) value was calculated for each claimed medicinal plant to estimate its healing potential.</p> <p>Results</p> <p>The study revealed 35 Bench medicinal plants: 32 used against human ailments and three to treat both human and livestock ailments. The majority of Bench medicinal plants were herbs and leaf was the most frequently used part in the preparation of remedies. Significantly higher average number of medicinal plants was claimed by men, older people and illiterate ones as compared to women, younger people and literate ones, respectively. The majority of the medicinal plants used in the study area were uncultivated ones.</p> <p>Conclusion</p> <p>The study revealed acculturation as the major threat to the continuation of the traditional medical practice in the study area. Awareness should, therefore, be created among the Bench community, especially the young ones, by concerned organizations and individuals regarding the usefulness of the practice.</p

The role of atopy in otitis media with effusion among primary school children: audiological investigation

Objective of this study is to value the role of atopy in otitis media with effusion (OME) in children attending primary school in Western Sicily focusing on the audiological characteristics among atopic and non atopic subjects suffering from OME. 310 children (5-6 years old) were screened by skin tests and divided into atopics (G1) and non atopics (G2). The samples were evaluated for OME by pneumatic otoscopy, tympanogram and acoustic reflex tests. The parameters considered were: documented persistent middle ear effusion by otoscopic examination for a minimum of 3 months; presence of B or C tympanogram; absence of ipsilateral acoustic reflex and a conductive hearing loss greater than 25 dB at any one of the frequencies from 250 Hz through 4 kHz. 56 children (18.06%) resulted atopics while 254 were non atopics. OME was identified in 24 atopic children and in 16 non atopic children for a total number of 40 children; the overall prevalence rate was 12.9% (42.85% for G1 and 6.30% for G2). OME was bilateral in 28 children (70%), with a significative difference between G1 (79.17%) and G2 (56.25%). The prevalence of B tympanogram was 70.59%, corresponding to 79.07% for G1 and 56% for G2. The mean air conduction pure tone was respectively 31.97 dB for G1 and 29.8 dB for G2. The prevalence value of OME in atopics children, also supported by the higher predominance of bilaterality, B tympanogram and hearing loss among this group, could suggest the important role of allergy in the pathogenesis of OME