Atrial assist device, a new alternative to lifelong anticoagulation?

OBJECTIVE: Atrial fibrillation is a very common heart arrhythmia, associated with a five-fold increase in the risk of embolic strokes. Treatment strategies encompass palliative drugs or surgical procedures all of which can restore sinus rhythm. Unfortunately, atria often fail to recover their mechanical function and patients therefore require lifelong anticoagulation therapy. A motorless volume displacing device (Atripump) based on artificial muscle technology, positioned on the external surface of atrium could avoid the need of oral anticoagulation and its haemorrhagic complications. An animal study was conducted in order to assess the haemodynamic effects that such a pump could provide. METHODS: Atripump is a dome-shape siliconecoated nitinol actuator sewn on the external surface of the atrium. It is driven by a pacemaker-like control unit. Five non-anticoagulated sheep were selected for this experiment. The right atrium was surgically exposed, the device sutured and connected. Haemodynamic parameters and intracardiac ultrasound (ICUS) data were recorded in each animal and under three conditions; baseline; atrial fibrillation (AF); atripump assisted AF (aaAF). RESULTS: In two animals, after 20 min of AF, small thrombi appeared in the right atrial appendix and were washed out once the pump was turned on. Assistance also enhanced atrial ejection fraction. 31% baseline; 5% during AF; 20% under aaAF. Right atrial systolic surfaces (cm2) were; 5.2 +/- 0.3 baseline; 6.2 +/- 0.1 AF; 5.4 +/- 0.3 aaAF. CONCLUSION: This compact and reliable pump seems to restore the atrial "kick" and prevents embolic events. It could avoid long-term anticoagulation therapy and open new hopes in the care of end-stage heart failure.

Induction of the alternative NF-κB pathway by lymphotoxin αβ (LTαβ) relies on internalization of LTβ receptor.

Several tumor necrosis factor receptor (TNFR) family members activate both the classical and the alternative NF-κB pathways. However, how a single receptor engages these two distinct pathways is still poorly understood. Using lymphotoxin β receptor (LTβR) as a prototype, we showed that activation of the alternative, but not the classical, NF-κB pathway relied on internalization of the receptor. Further molecular analyses revealed a specific cytosolic region of LTβR essential for its internalization, TRAF3 recruitment, and p100 processing. Interestingly, we found that dynamin-dependent, but clathrin-independent, internalization of LTβR appeared to be required for the activation of the alternative, but not the classical, NF-κB pathway. In vivo, ligand-induced internalization of LTβR in mesenteric lymph node stromal cells correlated with induction of alternative NF-κB target genes. Thus, our data shed light on LTβR cellular trafficking as a process required for specific biological functions of NF-κB.

L'induction rapide du sevrage par des antagonistes des opiacés sous anesthésie: une alternative dans le traitement de la dépendance aux opiacés [Rapid induction of withdrawal with opiate antagonists under anesthesia: an alternative to treatment of opiate dependence?]

Rapid induction of withdrawal by opiate antagonists under anesthesia is an opiate detoxification technique. This technique is useful to reduce intensity and duration of withdrawal. Therefore, this technique represents an alternative strategy in the treatment of opiate addicted patients. This paper attempts to present a brief history of this technique, and a critical review of related issues.

Alternative reproductive strategies in Formica lugubris Zett (Hymenoptera, Formicidae)

A long term study on the reproductive strategies of Formica lugubris (Formica rufa group) has revealed many new important facts. Within a supercolony the sex-ratio is strongly female biased. Some of the sexuals mate on the nest surface, whereas others fly from the nest. Those sexuals participating in flights aggregate in particular meadow sites (mating places). On these places females attract males by releasing a sex pheromone.

Legitimacy and Accountability of Independent Regulatory Agencies: A Critical Review

This article reviews the literature that deals with the problem of legitimizing regulatory governance, with a special attention to the question of the accountability of independent regulatory agencies. The discussion begins with the presentation of the traditional arguments concerning the democratic deficit of the regulatory state. The positive evaluation of regulatory performance by citizens is presented as an alternative source of legitimacy. It follows the discussion of the existing approaches to make agencies accountable, so as to ensure the procedural legitimacy of regulatory governance. Some insights concerning new forms of accountability are offered in the last section, namely with reference to the establishment and ongoing consolidation of formal and informal networks of regulators.

The cross-cultural generalizability of Zuckerman's alternative Five-Factor Model of personality

The aim of this study was to analyze the cross-cultural generalizability of the alternative Five-Factor Model (AFFM). The total sample was made up of 9,152 subjects from six countries: China, Germany, Italy, Spain, Switzerland, and the United States. The internal consistencies for all countries were generally similar to those found for the normative American sample. Factor analyses within cultures showed that the normative American structure was replicated in all cultures, however the congruence coefficients were slightly lower in China and Italy. A similar analysis at the facet level confirmed the high cross-cultural replicability of the AFFM. Mean-level comparisons did not always show the hypothesized effects. The mean score differences across countries were very small.