Translation of experimental cardioprotective capability of P2Y(12) inhibitors into clinical outcome in patients with ST-elevation myocardial infarction

We studied the translational cardioprotective potential of P2Y12 inhibitors against acute myocardial ischemia/reperfusion injury (IRI) in an animal model of acute myocardial infarction and in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). P2Y12 inhibitors may have pleiotropic effects to induce cardioprotection against acute myocardial IRI beyond their inhibitory effects on platelet aggregation. We compared the cardioprotective effects of clopidogrel, prasugrel, and ticagrelor on infarct size in an in vivo rat model of acute myocardial IRI, and investigated the effects of the P2Y12 inhibitors on enzymatic infarct size (48-h area-under-the-curve (AUC) troponin T release) and clinical outcomes in a retrospective study of STEMI patients from the CONDI-2/ERIC-PPCI trial using propensity score analyses. Loading with ticagrelor in rats reduced infarct size after acute myocardial IRI compared to controls (37 ± 11% vs 52 ± 8%, p  0.99 and 49 ± 9%, p > 0.99, respectively). Correspondingly, troponin release was reduced in STEMI patients treated with ticagrelor compared to clopidogrel (adjusted 48-h AUC ratio: 0.67, 95% CI 0.47–0.94). Compared to clopidogrel, the composite endpoint of cardiac death or hospitalization for heart failure within 12 months was reduced in STEMI patients loaded with ticagrelor (HR 0.63; 95% CI 0.42–0.94) but not prasugrel (HR 0.84, 95% CI 0.43–1.63), prior to PPCI. Major adverse cardiovascular events did not differ between clopidogrel, ticagrelor, or prasugrel. The cardioprotective effects of ticagrelor in reducing infarct size may contribute to the clinical benefit observed in STEMI patients undergoing PPCI

Chemical Engineering Division waste management programs. Quarterly report, January--March 1975

Development work on the study of consolidation techniques for Zircaloy fuel-cladding hulls included scouting tests on volatility schemes for separating the zirconium as the volatile tetrachloride and ignition tests on several Zircaloy materials to further characterize the pyrophoric behavior of Zircaloy. All tests were with nonirradiated metal pending acquisition of irradiated samples. Installation is nearly complete of a glovebox facility for studies on the salvage of alpha-contaminated metals by pyrochemical methods. Disposal of a major portion of fission product tritium formed in light water reactor fuels by deep- well injection of the low-level aqueous waste from plants reprocessing such fuels is being evaluated. The question of siting is a very important factor in determining the feasibility of this particular disposal option. A review is given of the status of information for U. S. sedimentary basins, the areas most likely to be generally suitable for siting of waste wells. Work on the reliability of high-level-waste canisters included an examination of creep, shot- peening, and subcooling of the filler canister below storage temperatures, as methods of relieving stresses induced in canisters due to differential contraction of canister and glass during cooling. A method was investigated for relieving stresses in calcine-filled canisters. Properties of fission product oxides were examined to elucidate possible adverse corrosive effects at the canister-waste interface. (LK

REFERQUAL: A pilot study of a new service quality assessment instrument in the GP Exercise Referral scheme setting

Background The development of an instrument accurately assessing service quality in the GP Exercise Referral Scheme (ERS) industry could potentially inform scheme organisers of the factors that affect adherence rates leading to the implementation of strategic interventions aimed at reducing client drop-out. Methods A modified version of the SERVQUAL instrument was designed for use in the ERS setting and subsequently piloted amongst 27 ERS clients. Results Test re-test correlations were calculated via Pearson's 'r' or Spearman's 'rho', depending on whether the variables were Normally Distributed, to show a significant (mean r = 0.957, SD = 0.02, p < 0.05; mean rho = 0.934, SD = 0.03, p < 0.05) relationship between all items within the questionnaire. In addition, satisfactory internal consistency was demonstrated via Cronbach's 'α'. Furthermore, clients responded favourably towards the usability, wording and applicability of the instrument's items. Conclusion REFERQUAL is considered to represent promise as a suitable tool for future evaluation of service quality within the ERS community. Future research should further assess the validity and reliability of this instrument through the use of a confirmatory factor analysis to scrutinise the proposed dimensional structure

Digital Signal Processing Research Program

Contains table of contents for Section 2, an introduction, reports on twenty research projects and a list of publications.Lockheed Sanders, Inc. Contract BZ4962U.S. Army Research Laboratory Grant QK-8819U.S. Navy - Office of Naval Research Grant N00014-93-1-0686National Science Foundation Grant MIP 95-02885U.S. Navy - Office of Naval Research Grant N00014-95-1-0834U.S. Navy - Office of Naval Research Grant N00014-96-1-0930U.S. Navy - Office of Naval Research Grant N00014-95-1-0362National Defense Science and Engineering FellowshipU.S. Air Force - Office of Scientific Research Grant F49620-96-1-0072National Science Foundation Graduate Research Fellowship Grant MIP 95-02885Lockheed Sanders, Inc. Grant N00014-93-1-0686National Science Foundation Graduate FellowshipU.S. Army Research Laboratory/ARL Advanced Sensors Federated Lab Program Contract DAAL01-96-2-000

Digital Signal Processing Research Program

Contains table of contents for Section 2, an introduction, reports on twenty-two research projects and a list of publications.Sanders, a Lockheed-Martin Corporation Contract BZ4962U.S. Army Research Laboratory Contract DAAL01-96-2-0001U.S. Navy - Office of Naval Research Grant N00014-93-1-0686National Science Foundation Grant MIP 95-02885U.S. Navy - Office of Naval Research Grant N00014-96-1-0930National Defense Science and Engineering FellowshipU.S. Air Force - Office of Scientific Research Grant F49620-96-1-0072U.S. Navy - Office of Naval Research Grant N00014-95-1-0362National Science Foundation Graduate Research FellowshipAT&T Bell Laboratories Graduate Research FellowshipU.S. Army Research Laboratory Contract DAAL01-96-2-0002National Science Foundation Graduate FellowshipU.S. Army Research Laboratory/Advanced Sensors Federated Lab Program Contract DAAL01-96-2-000

HABITAT: A longitudinal multilevel study of physical activity change in mid-aged adults

Purpose. To explore the role of the neighborhood environment in supporting walking Design. Cross sectional study of 10,286 residents of 200 neighborhoods. Participants were selected using a stratified two-stage cluster design. Data were collected by mail survey (68.5% response rate). Setting. The Brisbane City Local Government Area, Australia, 2007. Subjects. Brisbane residents aged 40 to 65 years. Measures. Environmental: street connectivity, residential density, hilliness, tree coverage, bikeways, and street lights within a one kilometer circular buffer from each resident’s home; and network distance to nearest river or coast, public transport, shop, and park. Walking: minutes in the previous week categorized as < 30 minutes, ≥ 30 < 90 minutes, ≥ 90 < 150 minutes, ≥ 150 < 300 minutes, and ≥ 300 minutes. Analysis. The association between each neighborhood characteristic and walking was examined using multilevel multinomial logistic regression and the model parameters were estimated using Markov chain Monte Carlo simulation. Results. After adjustment for individual factors, the likelihood of walking for more than 300 minutes (relative to <30 minutes) was highest in areas with the most connectivity (OR=1.93, 99% CI 1.32-2.80), the greatest residential density (OR=1.47, 99% CI 1.02-2.12), the least tree coverage (OR=1.69, 99% CI 1.13-2.51), the most bikeways (OR=1.60, 99% CI 1.16-2.21), and the most street lights (OR=1.50, 99% CI 1.07-2.11). The likelihood of walking for more than 300 minutes was also higher among those who lived closest to a river or the coast (OR=2.06, 99% CI 1.41-3.02). Conclusion. The likelihood of meeting (and exceeding) physical activity recommendations on the basis of walking was higher in neighborhoods with greater street connectivity and residential density, more street lights and bikeways, closer proximity to waterways, and less tree coverage. Interventions targeting these neighborhood characteristics may lead to improved environmental quality as well as lower rates of overweight and obesity and associated chromic disease