Length of carotid stenosis predicts peri-procedural stroke or death and restenosis in patients randomized to endovascular treatment or endarterectomy.

BACKGROUND: The anatomy of carotid stenosis may influence the outcome of endovascular treatment or carotid endarterectomy. Whether anatomy favors one treatment over the other in terms of safety or efficacy has not been investigated in randomized trials. METHODS: In 414 patients with mostly symptomatic carotid stenosis randomized to endovascular treatment (angioplasty or stenting; n = 213) or carotid endarterectomy (n = 211) in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), the degree and length of stenosis and plaque surface irregularity were assessed on baseline intraarterial angiography. Outcome measures were stroke or death occurring between randomization and 30 days after treatment, and ipsilateral stroke and restenosis ≥50% during follow-up. RESULTS: Carotid stenosis longer than 0.65 times the common carotid artery diameter was associated with increased risk of peri-procedural stroke or death after both endovascular treatment [odds ratio 2.79 (1.17-6.65), P = 0.02] and carotid endarterectomy [2.43 (1.03-5.73), P = 0.04], and with increased long-term risk of restenosis in endovascular treatment [hazard ratio 1.68 (1.12-2.53), P = 0.01]. The excess in restenosis after endovascular treatment compared with carotid endarterectomy was significantly greater in patients with long stenosis than with short stenosis at baseline (interaction P = 0.003). Results remained significant after multivariate adjustment. No associations were found for degree of stenosis and plaque surface. CONCLUSIONS: Increasing stenosis length is an independent risk factor for peri-procedural stroke or death in endovascular treatment and carotid endarterectomy, without favoring one treatment over the other. However, the excess restenosis rate after endovascular treatment compared with carotid endarterectomy increases with longer stenosis at baseline. Stenosis length merits further investigation in carotid revascularisation trials

The Galex Ultraviolet Variability (GUVV) Catalog

We present Version 1.0 of the NASA Galaxy Evolution Explorer (GALEX) ultraviolet variability catalog (GUVV) that contains information on 84 time-variable and transient sources gained with simultaneous near and far ultraviolet photometric observations. These time-variable sources were serendipitously revealed in the various 1.2 degree star fields currently being surveyed by the GALEX satellite in two ultraviolet bands (NUV 1750-2750A, FUV 1350-1750A) with limiting AB magnitudes of 23-25. The largest-amplitude variable objects presently detected by GALEX are M-dwarf flare stars, which can brighten by 5-10 mag in both the NUV and FUV bands during short duration (< 500s) outbursts. Other types of large-amplitude ultraviolet variable objects include ab-type RR Lyrae stars, which can vary periodically by 2-5mag in the GALEX FUV band. This first GUVV catalog lists galactic positions and possible source identifications in order to provide the astronomical community with a list of time-variable objects that can now be repeatedly observed at other wavelengths. We expect the total number of time-variable source detections to increase as the GALEX mission progresses, such that later version numbers of the GUVV catalog will contain substantially more variable sources

On Suggesting Phrases vs. Predicting Words for Mobile Text Composition

A system capable of suggesting multi-word phrases while someone is writing could supply ideas about content and phrasing and allow those ideas to be inserted efficiently. Meanwhile, statistical language modeling has provided various approaches to predicting phrases that users type. We introduce a simple extension to the familiar mobile keyboard suggestion interface that presents phrase suggestions that can be accepted by a repeated-tap gesture. In an extended composition task, we found that phrases were interpreted as suggestions that affected the content of what participants wrote more than conventional single-word suggestions, which were interpreted as predictions. We highlight a design challenge: how can a phrase suggestion system make valuable suggestions rather than just accurate predictions

The value of a joint cerebrovascular neurology clinic in carotid surgery practice

Objectives: The aims of the clinic were to offer suitable patients carotid endarterectomy with minimal delay, to discuss patients with unclear symptoms and to offer the best advice to patients referred with asymptomatic carotid artery stenosis. Design: A retrospective note review of all the patients who attended the clinic over a two-year period between January 1997 and December 1998 was undertaken. A pro-forma was completed. Participants: Three hundred and ninety-nine patients who were seen in the joint clinic for investigations of cerebrovascular disease. Main outcome measures: Waiting time for specialist consultations and treatment. Results: During that period 118 new patients and 281 follow-up patients were seen in the clinic. Colour flow Doppler was performed on 102 new patients and 113 follow-up patients. Digital Subtraction Angiography was used in selected patients (16). Sixty -six patients had combined consultations. Twenty-nine (24.6%) patients were assessed and discharged from the clinic on their first consultation. Seventy-three (62%) patients were listed for carotid endarterectomy. The mean waiting time from referral to consultation was 2.6 weeks and from consultation to surgical treatment was 4.7 weeks. Both these waiting times were significantly better than the waiting times before the joint cerebrovascular neurology clinic was set up. Conclusion: The combined clinic provided an appropriate environment for one-stop rapid assessment and treatment of patients with preventable stroke

Disruption of NaS1 sulfate transport function in mice leads to enhanced acetaminophen-induced hepatotoxicity

Sulfate is required for detoxification of xenobiotics such as acetaminophen (APAP), a leading cause of liver failure in humans. The NaS1 sulfate transporter maintains blood sulfate levels sufficiently high for sulforiation reactions to work effectively for drug detoxification. In the present study, we identified two loss-of-function polymorphisms in the human NaS1 gene and showed the Nas1-null mouse to be hypersensitive to APAP hepatotoxicity. APAP treatment led to increased liver damage and decreased hepatic glutathione levels in the hyposulfatemic Nas1-null mice compared with that in normosulfatemic wild-type mice. Analysis of urinary APAP metabolites revealed a significantly lower ratio of APAP-sulfate to APAP-glucuronide in the Nas1-null mice. These results suggest hyposulfatemia increases sensitivity to APAP-induced hepatotoxicity by decreasing the sulfonation capacity to metabolize APAP. In conclusion, the results of this study highlight the importance of plasma sulfate level as a key modulator of acetaminophen metabolism and suggest that individuals with reduced NaS1 sulfate transporter function would be more sensitive to hepatotoxic agents