The Benefits of Combined Anti-platelet Treatment in Carotid Artery Stenting

AbstractObjectiveTo assess the benefits of a combined anti-platelet regime of aspirin and clopidogrel in carotid artery stenting.MethodsA randomised controlled trial was performed comparing aspirin and 24-h heparin with aspirin and clopidogrel for patients undergoing carotid artery stenting. Outcome measures included 30-day bleeding and neurological complications and 30-day stenosis rates.ResultsBleeding complications (groin haematoma or excessive bleeding at the groin site) occurred in 17% of the heparin and 9% of the clopidogrel group (p=0.35; n.s). The neurological complication rate in the 24-h heparin group was 25% compared to 0% in the clopidogrel group (p=0.02). The 30-day 50–100% stenosis rates were 26% in the heparin group and 5% in the clopidogrel group (p=0.10; n.s).ConclusionsThe dual anti-platelet regime has a significant impact on reducing adverse neurological outcomes without an additional increase in bleeding complications. This study was terminated prematurely due to an unacceptable level of complications in the heparin arm of the trial

The quantitative soil pit method for measuring belowground carbon and nitrogen stocks

Many important questions in ecosystem science require estimates of stocks of soil C and nutrients. Quantitative soil pits provide direct measurements of total soil mass and elemental content in depth-based samples representative of large volumes, bypassing potential errors associated with independently measuring soil bulk density, rock volume, and elemental concentrations. The method also allows relatively unbiased sampling of other belowground C and nutrient stocks, including roots, coarse organic fragments, and rocks. We present a comprehensive methodology for sampling these pools with quantitative pits and assess their accuracy, precision, effort, and sampling intensity as compared to other methods. At 14 forested sites in New Hampshire, nonsoil belowground pools (which other methods may omit, double-count, or undercount) accounted for upward of 25% of total belowground C and N stocks: coarse material accounted for 4 and 1% of C and N in the O horizon; roots were 11 and 4% of C and N in the O horizon and 10 and 3% of C and N in the B horizon; and soil adhering to rocks represented 5% of total B-horizon C and N. The top 50 cm of the C horizon contained the equivalent of 17% of B-horizon carbon and N. Sampling procedures should be carefully designed to avoid treating these important pools inconsistently. Quantitative soil pits have fewer sources of systematic error than coring methods; the main disadvantage is that because they are time-consuming and create a larger zone of disturbance, fewer observations can be made than with cores

Strong Discontinuities in the Complex Photonic Band Structure of Transmission Metallic Gratings

Complex photonic band structures (CPBS) of transmission metallic gratings with rectangular slits are shown to exhibit strong discontinuities that are not evidenced in the usual energetic band structures. These discontinuities are located on Wood's anomalies and reveal unambiguously two different types of resonances, which are identified as horizontal and vertical surface-plasmon resonances. Spectral position and width of peaks in the transmission spectrum can be directly extracted from CPBS for both kinds of resonances.Comment: 4 pages, 4 figures, REVTeX version

There is detectable variation in the lipidomic profile between stable and progressive patients with idiopathic pulmonary fibrosis (IPF)

Background Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease characterized by fibrosis and progressive loss of lung function. The pathophysiological pathways involved in IPF are not well understood. Abnormal lipid metabolism has been described in various other chronic lung diseases including asthma and chronic obstructive pulmonary disease (COPD). However, its potential role in IPF pathogenesis remains unclear. Methods In this study, we used ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) to characterize lipid changes in plasma derived from IPF patients with stable and progressive disease. We further applied a data-independent acquisition (DIA) technique called SONAR, to improve the specificity of lipid identification. Results Statistical modelling showed variable discrimination between the stable and progressive subjects, revealing differences in the detection of triglycerides (TG) and phosphatidylcholines (PC) between progressors and stable IPF groups, which was further confirmed by mass spectrometry imaging (MSI) in IPF tissue. Conclusion This is the first study to characterise lipid metabolism between stable and progressive IPF, with results suggesting disparities in the circulating lipidome with disease progression

Complementarity and the uncertainty relations

We formulate a general complementarity relation starting from any Hermitian operator with discrete non-degenerate eigenvalues. We then elucidate the relationship between quantum complementarity and the Heisenberg-Robertson's uncertainty relation. We show that they are intimately connected. Finally we exemplify the general theory with some specific suggested experiments.Comment: 9 pages, 4 figures, REVTeX, uses epsf.sty and multicol.st

First-in-class Microbial Ecosystem Therapeutic 4 (MET4) in combination with immune checkpoint inhibitors in patients with advanced solid tumors (MET4-IO trial)

Background: The intestinal microbiome has been associated with response to immune checkpoint inhibitors (ICIs) in humans and causally implicated in ICI responsiveness in animal models. Two recent human trials demonstrated that fecal microbiota transplant (FMT) from ICI responders can rescue ICI responses in refractory melanoma, but FMT has specific limitations to scaled use.Patients and methods: We conducted an early-phase clinical trial of a cultivated, orally delivered 30-species microbial consortium (Microbial Ecosystem Therapeutic 4, MET4) designed for co-administration with ICIs as an alternative to FMT and assessed safety, tolerability and ecological responses in patients with advanced solid tumors.Results: The trial achieved its primary safety and tolerability outcomes. There were no statistically significant differences in the primary ecological outcomes; however, differences in MET4 species relative abundance were evident after randomization that varied by patient and species. Increases in the relative abundance of several MET4 taxa, including Enterococcus and Bifidobacterium, taxa previously associated with ICI responsiveness, were observed and MET4 engraftment was associated with decreases in plasma and stool primary bile acids.Conclusions: This trial is the first report of the use of a microbial consortium as an alternative to FMT in advanced cancer patients receiving ICI and the results justify the further development of microbial consortia as a therapeutic co-intervention for ICI treatment in cancer

Cost and performance of some carbon capture technology options for producing different quality CO₂ product streams

A techno-economic assessment of power plants with CO2 capture technologies with a focus on process scenarios that deliver different grades of CO2 product purity is presented. The three leading CO2 capture technologies are considered, namely; oxyfuel combustion, pre-combustion and post-combustion capture. The study uses a combination of process simulation of flue gas cleaning processes, modelling with a power plant cost and performance calculator and literature values of key performance criteria in order to evaluate the performance, cost and CO2 product purity of the considered CO2 capture options. For oxyfuel combustion capture plants, three raw CO2 flue gas processing strategies of compression and dehydration only, double flash system purification and distillation purification are considered. Analysis of pre-combustion capture options is based on integrated gasification combined cycle plants using physical solvent systems for capturing CO2 and sulfur species via three routes; co-capture of sulfur impurities with the CO2 stream using Selexol™ solvent, separate capture of CO2 and sulfur impurities using Selexol™, and Rectisol® solvent systems for separate capture of sulfur impurities and CO2. Analysis of post-combustion capture plants was made with and without some conventional pollution control devices. The results highlight the wide variation in CO2 product purity for different oxyfuel combustion capture scenarios and the wide cost variation for the pre-combustion capture scenarios. The post-combustion capture plant with conventional pollution control devices offers high CO2 purity (99.99 mol%) for average cost of considered technologies. The calculations performed will be of use in further analyses of whole chain CCS for the safe and economic capture, transport and storage of CO2

Discovery of Salmonella trehalose phospholipids reveals functional convergence with mycobacteria.

Salmonella species are among the world's most prevalent pathogens. Because the cell wall interfaces with the host, we designed a lipidomics approach to reveal pathogen-specific cell wall compounds. Among the molecules differentially expressed between Salmonella Paratyphi and S. Typhi, we focused on lipids that are enriched in S. Typhi, because it causes typhoid fever. We discovered a previously unknown family of trehalose phospholipids, 6,6'-diphosphatidyltrehalose (diPT) and 6-phosphatidyltrehalose (PT). Cardiolipin synthase B (ClsB) is essential for PT and diPT but not for cardiolipin biosynthesis. Chemotyping outperformed clsB homology analysis in evaluating synthesis of diPT. DiPT is restricted to a subset of Gram-negative bacteria: large amounts are produced by S. Typhi, lower amounts by other pathogens, and variable amounts by Escherichia coli strains. DiPT activates Mincle, a macrophage activating receptor that also recognizes mycobacterial cord factor (6,6'-trehalose dimycolate). Thus, Gram-negative bacteria show convergent function with mycobacteria. Overall, we discovered a previously unknown immunostimulant that is selectively expressed among medically important bacterial species