Outcomes Associated With Oral Anticoagulants Plus Antiplatelets in Patients With Newly Diagnosed Atrial Fibrillation.

Importance: Patients with nonvalvular atrial fibrillation at risk of stroke should receive oral anticoagulants (OAC). However, approximately 1 in 8 patients in the Global Anticoagulant Registry in the Field (GARFIELD-AF) registry are treated with antiplatelet (AP) drugs in addition to OAC, with or without documented vascular disease or other indications for AP therapy. Objective: To investigate baseline characteristics and outcomes of patients who were prescribed OAC plus AP therapy vs OAC alone. Design, Setting, and Participants: Prospective cohort study of the GARFIELD-AF registry, an international, multicenter, observational study of adults aged 18 years and older with recently diagnosed nonvalvular atrial fibrillation and at least 1 risk factor for stroke enrolled between March 2010 and August 2016. Data were extracted for analysis in October 2017 and analyzed from April 2018 to June 2019. Exposure: Participants received either OAC plus AP or OAC alone. Main Outcomes and Measures: Clinical outcomes were measured over 3 and 12 months. Outcomes were adjusted for 40 covariates, including baseline conditions and medications. Results: A total of 24 436 patients (13 438 [55.0%] male; median [interquartile range] age, 71 [64-78] years) were analyzed. Among eligible patients, those receiving OAC plus AP therapy had a greater prevalence of cardiovascular indications for AP, including acute coronary syndromes (22.0% vs 4.3%), coronary artery disease (39.1% vs 9.8%), and carotid occlusive disease (4.8% vs 2.0%). Over 1 year, patients treated with OAC plus AP had significantly higher incidence rates of stroke (adjusted hazard ratio [aHR], 1.49; 95% CI, 1.01-2.20) and any bleeding event (aHR, 1.41; 95% CI, 1.17-1.70) than those treated with OAC alone. These patients did not show evidence of reduced all-cause mortality (aHR, 1.22; 95% CI, 0.98-1.51). Risk of acute coronary syndrome was not reduced in patients taking OAC plus AP compared with OAC alone (aHR, 1.16; 95% CI, 0.70-1.94). Patients treated with OAC plus AP also had higher rates of all clinical outcomes than those treated with OAC alone over the short term (3 months). Conclusions and Relevance: This study challenges the practice of coprescribing OAC plus AP unless there is a clear indication for adding AP to OAC therapy in newly diagnosed atrial fibrillation

Changing the scattering of sheltered targets

Author name used in this publication: Lian-xing He2010-2011 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Flattening of conic reflectors via a transformation method

Author name used in this publication: He, Lian-Xing2011-2012 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Decreased Level of Nurr1 in Heterozygous Young Adult Mice Leads to Exacerbated Acute and Long-Term Toxicity after Repeated Methamphetamine Exposure

The abuse of psychostimulants, such as methamphetamine (METH), is prevalent in young adults and could lead to long-term adaptations in the midbrain dopamine system in abstinent human METH abusers. Nurr1 is a gene that is critical for the survival and maintenance of dopaminergic neurons and has been implicated in dopaminergic neuron related disorders. In this study, we examined the synergistic effects of repeated early exposure to methamphetamine in adolescence and reduction in Nurr1 gene levels. METH binge exposure in adolescence led to greater damage in the nigrostrial dopaminergic system when mice were exposed to METH binge later in life, suggesting a long-term adverse effect on the dopaminergic system. Compared to naïve mice that received METH binge treatment for the first time, mice pretreated with METH in adolescence showed a greater loss of tyrosine hydroxylase (TH) immunoreactivity in striatum, loss of THir fibers in the substantia nigra reticulata (SNr) as well as decreased dopamine transporter (DAT) level and compromised DA clearance in striatum. These effects were further exacerbated in Nurr1 heterozygous mice. Our data suggest that a prolonged adverse effect exists following adolescent METH binge exposure which may lead to greater damage to the dopaminergic system when exposed to repeated METH later in life. Furthermore, our data support that Nurr1 mutations or deficiency could be a potential genetic predisposition which may lead to higher vulnerability in some individuals

Preparation of stable magnetic nanofluids containing Fe3O4@PPy nanoparticles by a novel one-pot route

Stable magnetic nanofluids containing Fe3O4@Polypyrrole (PPy) nanoparticles (NPs) were prepared by using a facile and novel method, in which one-pot route was used. FeCl3·6H2O was applied as the iron source, and the oxidizing agent to produce PPy. Trisodium citrate (Na3cit) was used as the reducing reagent to form Fe3O4 NPs. The as-prepared nanofluid can keep long-term stability. The Fe3O4@PPy NPs can still keep dispersing well after the nanofluid has been standing for 1 month and no sedimentation is found. The polymerization reaction of the pyrrole monomers took place with Fe3+ ions as the initiator, in which these Fe3+ ions remained in the solution adsorbed on the surface of the Fe3O4 NPs. Thus, the core-shell NPs of Fe3O4@PPy were obtained. The particle size of the as-prepared Fe3O4@PPy can be easily controlled from 7 to 30 nm by the polymerization reaction of the pyrrole monomers. The steric stabilization and weight of the NPs affect the stability of the nanofluids. The as-prepared Fe3O4@PPy NPs exhibit superparamagnetic behavior

Extensive marine anoxia associated with the Late Devonian Hangenberg Crisis

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record The global Hangenberg Crisis near the Devonian-Carboniferous boundary (DCB) represents one of the major Phanerozoic mass extinction events, which shaped the roots of modern vertebrate biodiversity. Marine anoxia has been cited as the proximate kill mechanism for this event. However, the detailed timing, duration, and extent of global marine redox chemistry changes across this critical interval remain controversial because most of the studies to date only constrain changes in local or regional redox chemistry. Thus, opinions on the significance of anoxia as a kill mechanism are variable—from anoxia being a primary driver to being relatively unimportant. In this study, we explore the evolution of global marine redox chemistry using U isotopes of marine limestones. The δ238U trends at Long'an section in South China document systematic oscillations with three negative shifts punctuated by two positive events in between. The magnitude of the δ238U oscillations implies that the sediments do not record contemporaneous seawater with a constant offset at all times. The lack of covariation between δ238U data and diagenetic indicators (e.g., Mn and Sr contents, Mn/Sr ratio, δ18O) suggests that the δ238U trends are not produced by the same post-depositional diagenetic processes. Instead, trace-metal enrichments suggest that more reducing conditions prevailed during the deposition of the two positive events. We present plausible model scenarios that fit the observed δ238U trends in the context of redox-sensitive trace metal data suggesting marine anoxia expanded in the latest Devonian oceans to cover >5% of the continental shelf seafloor area. The rapid expansion of marine anoxia coincident with the onset of the Hangenberg Crisis supports marine anoxia as an important kill mechanism. Biogeochemical modeling of the coupled C-P-U cycles suggests that intensified continental weathering, for example, assisted by the spread of seed plants with deeper root systems at this time, could have triggered expansion of marine anoxia and other global changes (e.g., positive excursion in δ13Ccarb and decrease in sea surface temperature) in the latest Devonian. The anoxic event is inferred to have been transient as climatic cooling would have reduced weathering fluxes.Natural Environment Research Council (NERC

Use of stochastic simulation to evaluate the reduction in methane emissions and improvement in reproductive efficiency from routine hormonal interventions in dairy herds

This study predicts the magnitude and between herd variation in changes of methane emissions and production efficiency associated with interventions to improve reproductive efficiency in dairy cows. Data for 10,000 herds of 200 cows were simulated. Probability of conception was predicted daily from the start of the study (parturition) for each cow up to day 300 of lactation. Four scenarios of differing first insemination management were simulated for each herd using the same theoretical cows: A baseline scenario based on breeding from observed oestrus only, synchronisation of oestrus for pre-set first insemination using 2 methods, and a regime using prostaglandin treatments followed by first insemination to observed oestrus. Cows that did not conceive to first insemination were re-inseminated following detection of oestrus. For cows that conceived, gestation length was 280 days with cessation of milking 60 days before calving. Those cows not pregnant after 300 days of lactation were culled and replaced by a heifer. Daily milk yield was calculated for 730 days from the start of the study for each cow. Change in mean reproductive and economic outputs were summarised for each herd following the 3 interventions. For each scenario, methane emissions were determined by daily forage dry matter intake, forage quality, and cow replacement risk. Linear regression was used to summarise relationships. In some circumstances improvement in reproductive efficiency using the programmes investigated was associated with reduced cost and methane emissions compared to reliance on detection of oestrus. Efficiency of oestrus detection and the time to commencement of breeding after calving influenced variability in changes in cost and methane emissions. For an average UK herd this was a saving of at least £50 per cow and a 3.6% reduction in methane emissions per L of milk when timing of first insemination was pre-set

Disparities and risks of sexually transmissible infections among men who have sex with men in China: a meta-analysis and data synthesis.

BACKGROUND: Sexually transmitted infections (STIs), including Hepatitis B and C virus, are emerging public health risks in China, especially among men who have sex with men (MSM). This study aims to assess the magnitude and risks of STIs among Chinese MSM. METHODS: Chinese and English peer-reviewed articles were searched in five electronic databases from January 2000 to February 2013. Pooled prevalence estimates for each STI infection were calculated using meta-analysis. Infection risks of STIs in MSM, HIV-positive MSM and male sex workers (MSW) were obtained. This review followed the PRISMA guidelines and was registered in PROSPERO. RESULTS: Eighty-eight articles (11 in English and 77 in Chinese) investigating 35,203 MSM in 28 provinces were included in this review. The prevalence levels of STIs among MSM were 6.3% (95% CI: 3.5-11.0%) for chlamydia, 1.5% (0.7-2.9%) for genital wart, 1.9% (1.3-2.7%) for gonorrhoea, 8.9% (7.8-10.2%) for hepatitis B (HBV), 1.2% (1.0-1.6%) for hepatitis C (HCV), 66.3% (57.4-74.1%) for human papillomavirus (HPV), 10.6% (6.2-17.6%) for herpes simplex virus (HSV-2) and 4.3% (3.2-5.8%) for Ureaplasma urealyticum. HIV-positive MSM have consistently higher odds of all these infections than the broader MSM population. As a subgroup of MSM, MSW were 2.5 (1.4-4.7), 5.7 (2.7-12.3), and 2.2 (1.4-3.7) times more likely to be infected with chlamydia, gonorrhoea and HCV than the broader MSM population, respectively. CONCLUSION: Prevalence levels of STIs among MSW were significantly higher than the broader MSM population. Co-infection of HIV and STIs were prevalent among Chinese MSM. Integration of HIV and STIs healthcare and surveillance systems is essential in providing effective HIV/STIs preventive measures and treatments. TRIAL REGISTRATION: PROSPERO NO: CRD42013003721

Synthesis and Photoluminescence Property of Silicon Carbide Nanowires Via Carbothermic Reduction of Silica

Silicon carbide nanowires have been synthesized at 1400 °C by carbothermic reduction of silica with bamboo carbon under normal atmosphere pressure without metallic catalyst. X-ray diffraction, scanning electron microscopy, energy-dispersive spectroscopy, transmission electron microscopy and Fourier transformed infrared spectroscopy were used to characterize the silicon carbide nanowires. The results show that the silicon carbide nanowires have a core–shell structure and grow along <111> direction. The diameter of silicon carbide nanowires is about 50–200 nm and the length from tens to hundreds of micrometers. The vapor–solid mechanism is proposed to elucidate the growth process. The photoluminescence of the synthesized silicon carbide nanowires shows significant blueshifts, which is resulted from the existence of oxygen defects in amorphous layer and the special rough core–shell interface

Role of Organic Cation Transporter 1, OCT1 in the Pharmacokinetics and Toxicity of cis-Diammine(pyridine)chloroplatinum(II) and Oxaliplatin in Mice

PurposeThe goal of this study was to test the hypothesis that by controlling intracellular uptake, organic cation transporter 1, Oct1 is a key determinant of the disposition and toxicity of cis-diammine(pyridine)chloroplatinum(II)(CDPCP) and oxaliplatin.MethodsPharmacokinetics, tissue accumulation and toxicity of CDPCP and oxaliplatin were compared between Oct1-/- and wild-type mice.ResultsAfter intravenous administration, hepatic and intestinal accumulation of CDPCP was 2.7-fold and 3.9-fold greater in Oct1 wild-type mice (p &lt; 0.001). Deletion of Oct1 resulted in a significantly decreased clearance (0.444 ± 0.0391 ml/min*kg versus 0.649 ± 0.0807 ml/min*kg in wild-type mice, p &lt; 0.05) and volume distribution (1.90 ± 0.161 L/kg versus 3.37 ± 0.196 L/kg in wild-type mice, p &lt; 0.001). Moreover, Oct1 deletion resulted in more severe off-target toxicities in CDPCP-treated mice. Histologic examination of the liver and measurements of liver function indicated that the level of hepatic toxicity was mild and reversible, but was more apparent in the wild-type mice. In contrast, the effect of Oct1 on the pharmacokinetics and toxicity of oxaliplatin in the mice was minimal.ConclusionsOur study suggests that Oct1 plays an important role in the pharmacokinetics, tissue distribution and toxicity of CDPCP, but not oxaliplatin