Incident venous thromboembolic events in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER)

<p>Background: Venous thromboembolic events (VTE), including deep venous thrombosis and pulmonary embolism, are common in older age. It has been suggested that statins might reduce the risk of VTE however positive results from studies of middle aged subjects may not be generalisable to elderly people. We aimed to determine the effect of pravastatin on incident VTE in older people; we also studied the impact of clinical and plasma risk variables.</p> <p>Methods: This study was an analysis of incident VTE using data from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), a randomized, double-blind, placebo-controlled trial of pravastatin in men and women aged 70-82. Mean follow-up was 3.2 years. Risk for VTE was examined in non-warfarin treated pravastatin (n = 2834) and placebo (n = 2865) patients using a Cox's proportional hazard model, and the impact of other risk factors assessed in a multivariate forward stepwise regression analysis. Baseline clinical characteristics, blood biochemistry and hematology variables, plasma levels of lipids and lipoproteins, and plasma markers of inflammation and adiposity were compared. Plasma markers of thrombosis and hemostasis were assessed in a nested case (n = 48) control (n = 93) study where the cohort was those participants, not on warfarin, for whom data were available.</p> <p>Results: There were 28 definite cases (1.0%) of incident VTE in the pravastatin group recipients and 20 cases (0.70%) in placebo recipients. Pravastatin did not reduce VTE in PROSPER compared to placebo [unadjusted hazard ratio (95% confidence interval) 1.42 (0.80, 2.52) p = 0.23]. Higher body mass index (BMI) [1.09 (1.02, 1.15) p = 0.0075], country [Scotland vs Netherlands 4.26 (1.00, 18.21) p = 0.050 and Ireland vs Netherlands 6.16 (1.46, 26.00) p = 0.013], lower systolic blood pressure [1.35 (1.03, 1.75) p = 0.027] and lower baseline Mini Mental State Examination (MMSE) score [1.19 (1.01, 1.41) p = 0.034] were associated with an increased risk of VTE, however only BMI, country and systolic blood pressure remained significant on multivariate analysis. In a nested case control study of definite VTE, plasma Factor VIII levels were associated with VTE [1.52 (1.01, 2.28), p = 0.044]. However no other measure of thrombosis and haemostasis was associated with increased risk of VTE.</p> <p>Conclusions: Pravastatin does not prevent VTE in elderly people at risk of vascular disease. Blood markers of haemostasis and inflammation are not strongly predictive of VTE in older age however BMI, country and lower systolic blood pressure are independently associated with VTE risk.</p&gt

Statins, fibrates, and venous thromboembolism: a meta-analysis.

Aims The aim is to make a systematic review of the literature to assess the effect of lipid-lowering drugs on venous thromboembolism (VTE) occurrence. Methods and results MEDLINE and EMBASE databases were searched to identify studies that evaluated the effect of lipid-lowering drugs, in particular statins and fibrates, on VTE risk until April 2009. A scoring system was used to divide studies into two quality categories. Odds ratios (ORs) and 95% confidence intervals (CIs) were then calculated and pooled using a fixed and a random-effects model. Statistical heterogeneity was evaluated through the use of I2 statistics. Three randomized controlled trials (RCTs), three cohort, and eight case\u2013control studies were included in our systematic review, for a total of 863 805 patients. Statins use significantly reduced VTE risk [OR, 0.81; 95% CI, 0.66\u20130.99, random-effect model)]. There was a very high heterogeneity among the studies (I2 > 80%). The use of fibrates was associated with a significant increase in the risk of VTE (OR, 1.58; 95% CI, 1.23\u20132.02), without heterogeneity (I2 = 0%). Data on other lipid-lowering drugs were lacking. Conclusion This meta-analysis of available literature suggests that statins may lower the risk of VTE, whereas fibrates may increase this risk. Due to several methodological limitations, this conclusion should be considered with caution, and additional, specifically designed RCTs are warranted

Robot bin picking: 3D pose retrieval based on Point Cloud Library

This work covers the problem of object recognition and 6 DOF pose estimation in a point cloud data structure, using PCL (Point Cloud Library). The result of the computation will be used for bin picking purposes, but it can also be applied to any context that require to find and align a specific pattern. The goal is to align an object model to all the visible instances of it in an input cloud. The algorithm that will be presented is based on local geometry FPFH descriptors that are computed on a set of uniform keypoints of the point clouds. Correspondences (best match) between such features will be filtered with RANSAC procedure: from this data comes a rough alignment, that will be refined by ICP algorithm. Robust dedicated validation functions will guide the entire process with a greedy approach. Parallelism has also been implemented using OpenMP API. Time and effectiveness will be deeply discussed, since the target industrial application imposes strict constraints of performance and robustness. The result of the proposed solution is really appreciable, since the algorithm is able to recognize almost all the present objects, with a minimal percentage of false negatives and an almost zero false positives rate. Experiments have been conducted on a large dataset, that was acquired with a triangulation system made up by one camera and two intersecting lasers as structured light sources. Such vision system has been mounted first on a fixed position over a conveyor belt, then on a moving robotic arm, in order to cover a larger areope

DESIGN, REALIZATION AND CHARACTERIZATION OF INNOVATIVE ANODE MATERIALS FOR LOW AND INTERMEDIATE TEMPERATURE DIRECT METHANE SOLID OXIDE FUEL CELLS

The Solid Oxide Cells (SOFC) are high temperature electrochemical devices able to convert with high efficiency the chemical energy of a fuel into electric energy and reverse. Ni/YSZ is the state of art electrode material, while hydrogen is the mainly used fuel in the nowadays commercial devices. The usage of green hydrogen must be the main goal of our research in the energetic field. Anyway, it is unrealistic to think that in a very short time our cities can be ready to use hydrogen as main fuel. A possible compromise could be the usage of biogas, that can be produced in a green way from the biowaste of our agriculture activities. Since the main component of biogas is methane, in this work, the possibility to implement methane fueled Solid Oxide Fuel Cells in our cities is investigated. The main problem to achieve this result is to identify a new anodic material that can replace the state of art Ni based cermet. Indeed, Ni strongly catalyze carbon coking and this lead in a short application time to the surface poisoning. In addition, is consolidated the knowledge about the mechanical breakage of Ni/YSZ when exposed to carbon containing molecules. Therefore, new Ni free anode materials will be discussed in this work. The choice of the candidate material was made trying to transform a handicap to an opportunity. If we must avoid the state of art anode material, why not try to use a compound that is possible to use both as anode and both as cathode? In this way, the productive costs can be considerably lowered. Otherwise, why not try to lower the working temperatures of this technology with the consequent lowering of the operative costs? Before the show up of the proposed materials and their results, a general introduction to the technology and its challenge is given. Different composition and Cu doped formulation of La1-xSrxMnO3 (LSM), state of art cathode material, were synthetized and characterized. The effective realization of the desired compound is confirmed by X-Ray Diffractometry (XRD), while the morphology of the powders is observed by Scanning electronic Microscopy (SEM). The surface chemical composition is studied by X-Ray Photoelectron Spectroscopy (XPS), while the surface area of all the samples is calculated by BET analysis performed on N2 Adsorption-desorption isotherm. One of the most important goals of this work is the confirmation of the LSM stability in reductive atmospheres (H2 and CH4), that was confirmed by XRD after Temperature Programmed Reduction (H2-TPR) and the catalytic tests. In fact, the catalytic properties of this material towards methane oxidation were studied through a Gas Chromatographer (GC) and, finally, the electrochemical activity through Electronic Impedance Spectroscopy (EIS). Must be mentioned the attempt to increase the performances by changing the morphology. For this reason, LSM nanofibers, synthetized by Prof. Costamagna’s research group from University of Genova, were characterized and compared with LSM powders. To lower the working temperature to about 500 °C, another solution was investigated. In this case avoiding noble metal does not give satisfactory results from an applicative point of view. What we can do is to limit the quantity of noble metals and trying to enhance their properties by downsizing the dimension of the metal catalysts to a nanoscale. The creation of nanoparticles can significantly improve the catalytic performances through the creation of new crystalline planes. A Cu/GDC cermet with Pd nanoparticle infiltration was investigated. These two different solutions that can be effective for two different tasks, must have a common requirement: avoiding the carbon deposition on the electrode surface. For this reason, quantitative and qualitative analyses of the carbon deposition was studied by Raman Operando Spectroscopy performed at Danmarks Tekniske Universitet (DTU) under the supervision of Prof. Peter Holtappels.The Solid Oxide Cells (SOFC) are high temperature electrochemical devices able to convert with high efficiency the chemical energy of a fuel into electric energy and reverse. Ni/YSZ is the state of art electrode material, while hydrogen is the mainly used fuel in the nowadays commercial devices. The usage of green hydrogen must be the main goal of our research in the energetic field. Anyway, it is unrealistic to think that in a very short time our cities can be ready to use hydrogen as main fuel. A possible compromise could be the usage of biogas, that can be produced in a green way from the biowaste of our agriculture activities. Since the main component of biogas is methane, in this work, the possibility to implement methane fueled Solid Oxide Fuel Cells in our cities is investigated. The main problem to achieve this result is to identify a new anodic material that can replace the state of art Ni based cermet. Indeed, Ni strongly catalyze carbon coking and this lead in a short application time to the surface poisoning. In addition, is consolidated the knowledge about the mechanical breakage of Ni/YSZ when exposed to carbon containing molecules. Therefore, new Ni free anode materials will be discussed in this work. The choice of the candidate material was made trying to transform a handicap to an opportunity. If we must avoid the state of art anode material, why not try to use a compound that is possible to use both as anode and both as cathode? In this way, the productive costs can be considerably lowered. Otherwise, why not try to lower the working temperatures of this technology with the consequent lowering of the operative costs? Before the show up of the proposed materials and their results, a general introduction to the technology and its challenge is given. Different composition and Cu doped formulation of La1-xSrxMnO3 (LSM), state of art cathode material, were synthetized and characterized. The effective realization of the desired compound is confirmed by X-Ray Diffractometry (XRD), while the morphology of the powders is observed by Scanning electronic Microscopy (SEM). The surface chemical composition is studied by X-Ray Photoelectron Spectroscopy (XPS), while the surface area of all the samples is calculated by BET analysis performed on N2 Adsorption-desorption isotherm. One of the most important goals of this work is the confirmation of the LSM stability in reductive atmospheres (H2 and CH4), that was confirmed by XRD after Temperature Programmed Reduction (H2-TPR) and the catalytic tests. In fact, the catalytic properties of this material towards methane oxidation were studied through a Gas Chromatographer (GC) and, finally, the electrochemical activity through Electronic Impedance Spectroscopy (EIS). Must be mentioned the attempt to increase the performances by changing the morphology. For this reason, LSM nanofibers, synthetized by Prof. Costamagna’s research group from University of Genova, were characterized and compared with LSM powders. To lower the working temperature to about 500 °C, another solution was investigated. In this case avoiding noble metal does not give satisfactory results from an applicative point of view. What we can do is to limit the quantity of noble metals and trying to enhance their properties by downsizing the dimension of the metal catalysts to a nanoscale. The creation of nanoparticles can significantly improve the catalytic performances through the creation of new crystalline planes. A Cu/GDC cermet with Pd nanoparticle infiltration was investigated. These two different solutions that can be effective for two different tasks, must have a common requirement: avoiding the carbon deposition on the electrode surface. For this reason, quantitative and qualitative analyses of the carbon deposition was studied by Raman Operando Spectroscopy performed at Danmarks Tekniske Universitet (DTU) under the supervision of Prof. Peter Holtappels

Pharmacological thromboprophylaxis in acutely ill medical patients: some work remains to be done

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InterPro in 2017-beyond protein family and domain annotations

InterPro (http://www.ebi.ac.uk/interpro/) is a freely available database used to classify protein sequences into families and to predict the presence of important domains and sites. InterProScan is the underlying software that allows both protein and nucleic acid sequences to be searched against InterPro's predictive models, which are provided by its member databases. Here, we report recent developments with InterPro and its associated software, including the addition of two new databases (SFLD and CDD), and the functionality to include residue-level annotation and prediction of intrinsic disorder. These developments enrich the annotations provided by InterPro, increase the overall number of residues annotated and allow more specific functional inferences