The Effect of Everolimus Initiation and Calcineurin Inhibitor Elimination on Cardiac Allograft Vasculopathy in De Novo Recipients: One-Year Results of a Scandinavian Randomized Trial.

Early initiation of everolimus with calcineurin inhibitor therapy has been shown to reduce the progression of cardiac allograft vasculopathy (CAV) in de novo heart transplant recipients. The effect of de novo everolimus therapy and early total elimination of calcineurin inhibitor therapy has, however, not been investigated and is relevant given the morbidity and lack of efficacy of current protocols in preventing CAV. This 12-month multicenter Scandinavian trial randomized 115 de novo heart transplant recipients to everolimus with complete calcineurin inhibitor elimination 7-11 weeks after HTx or standard cyclosporine immunosuppression. Ninety-five (83%) patients had matched intravascular ultrasound examinations at baseline and 12 months. Mean (± SD) recipient age was 49.9 ± 13.1 years. The everolimus group (n = 47) demonstrated significantly reduced CAV progression as compared to the calcineurin inhibitor group (n = 48) (ΔMaximal Intimal Thickness 0.03 ± 0.06 and 0.08 ± 0.12 mm, ΔPercent Atheroma Volume 1.3 ± 2.3 and 4.2 ± 5.0%, ΔTotal Atheroma Volume 1.1 ± 19.2 mm(3) and 13.8 ± 28.0 mm(3) [all p-values ≤ 0.01]). Everolimus patients also had a significantly greater decline in levels of soluble tumor necrosis factor receptor-1 as compared to the calcineurin inhibitor group (p = 0.02). These preliminary results suggest that an everolimus-based CNI-free can potentially be considered in suitable de novo HTx recipients.

External validation of the Hospital-patient One-year Mortality Risk (HOMR) model for predicting death within 1 year after hospital admission

BACKGROUND Predicting long-term survival after admission to hospital is helpful for clinical, administrative and research purposes. The Hospital-patient One-year Mortality Risk (HOMR) model was derived and internally validated to predict the risk of death within 1 year after admission. We conducted an external validation of the model in a large multicentre study. METHODS We used administrative data for all nonpsychiatric admissions of adult patients to hospitals in the provinces of Ontario (2003-2010) and Alberta (2011-2012), and to the Brigham and Women's Hospital in Boston (2010-2012) to calculate each patient's HOMR score at admission. The HOMR score is based on a set of parameters that captures patient demographics, health burden and severity of acute illness. We determined patient status (alive or dead) 1 year after admission using population-based registries. RESULTS The 3 validation cohorts (n = 2,862,996 in Ontario, 210 595 in Alberta and 66,683 in Boston) were distinct from each other and from the derivation cohort. The overall risk of death within 1 year after admission was 8.7% (95% confidence interval [CI] 8.7% to 8.8%). The HOMR score was strongly and significantly associated with risk of death in all populations and was highly discriminative, with a C statistic ranging from 0.89 (95% CI 0.87 to 0.91) to 0.92 (95% CI 0.91 to 0.92). Observed and expected outcome risks were similar (median absolute difference in percent dying in 1 yr 0.3%, interquartile range 0.05%-2.5%). INTERPRETATION The HOMR score, calculated using routinely collected administrative data, accurately predicted the risk of death among adult patients within 1 year after admission to hospital for nonpsychiatric indications. Similar performance was seen when the score was used in geographically and temporally diverse populations. The HOMR model can be used for risk adjustment in analyses of health administrative data to predict long-term survival among hospital patients.

Seaweed - epiphyte - mesograzer communities were tested for their responses to elevated seawater temperature and [CO2] in benthic mesocosms experiments across four consecutive seasons of one year in Kiel, Germany

Rising seawater temperature and CO2 concentrations (ocean acidification) represent two of the most influential factors impacting marine ecosystems in the face of global climate change. In ecological climate change research full-factorial experiments across seasons in multi-species, cross-trophic level set-ups are essential as they allow making realistic estimations about direct and indirect effects and the relative importance of both major environmental stressors on ecosystems. In benthic mesocosm experiments we tested the responses of coastal Baltic Sea Fucus vesiculosus communities to elevated seawater temperature and CO2 concentrations across four seasons of one year. While increasing [CO2] levels only had minor effects, warming had strong and persistent effects on grazers which affected the Fucus community differently depending on season. In late summer a temperature-driven collapse of grazers caused a cascading effect from the consumers to the foundation species resulting in overgrowth of Fucus thalli by epiphytes. In fall/ winter, outside the growing season of epiphytes, intensified grazing under warming resulted in a significant reduction of Fucus biomass. Thus, we confirm the prediction that future increasing water temperatures influence marine food-web processes by altering top-down control, but we also show that specific consequences for food-web structure depend on season. Since Fucus vesiculosus is the dominant habitat-forming brown algal system in the Baltic Sea, its potential decline under global warming implicates the loss of key functions and services such as provision of nutrient storage, substrate, food, shelter and nursery grounds for a diverse community of marine invertebrates and fish in Baltic Sea coastal waters.

Investigations on Fucus vesiculosus and Fucus serratus at outer Kiel Fjord over one year (August 2012 - July 2013)

Macroalgae, especially perennial species, are exposed to a seasonally variable fouling pressure. It was hypothesized that macroalgae regulate their antifouling defense to fouling pressure. Over one year, the macrofouling pressure and the chemical anti-macrofouling defense strength of the brown algae Fucus vesiculosus and Fucus serratus were assessed with monthly evaluation. The anti-macrofouling defense was assessed by means of surface-extracted Fucus metabolites tested at near-natural concentrations in a novel in situ bioassay. Additionally, the mannitol content of both Fucus species was determined to assess resource availability for defense production. The surface chemistry of both Fucus species exhibited seasonal variability in attractiveness to Amphibalanus improvisus and Mytilus edulis. Of this variability, 50-60% is explained by a sinusoidal model. Only F. vesiculosus extracts originating from the spring and summer significantly deterred settlement of A. improvisus. The strength of macroalgal antifouling defense did not correlate either with in situ macrofouling pressure or with measured mannitol content, which, however, were never depleted.

Power output fluctuations in large scale PV plants: one year observations with one second resolution and a derived analytic model

The variable nature of the irradiance can produce significant fluctuations in the power generated by large grid-connected photovoltaic (PV) plants. Experimental 1 s data were collected throughout a year from six PV plants, 18 MWp in total. Then, the dependence of short (below 10 min) power fluctuation on PV plant size has been investigated. The analysis focuses on the study of fluctuation frequency as well as the maximum fluctuation value registered. An analytic model able to describe the frequency of a given fluctuation for a certain day is proposed

Implantation of a diffractive trifocal intraocular lens: One-year follow-up

Purpose: To evaluate the visual, refractive, contrast-sensitivity, and aberrometric outcomes during a 1-year follow-up after implantation of a trifocal intraocular lens (IOL). Setting: Premium Clinic, Teplice, Czech Republic. Design: Prospective case series. Methods: This study included eyes of patients having cataract surgery with implantation of the trifocal IOL model AT Lisa tri 839MP. Distance, intermediate (66 and 80 cm), and near (33 and 40 cm) vision; contrast sensitivity; aberrometric outcomes; and the defocus curve were evaluated during a 12-month follow-up. The level of posterior capsule opacification (PCO) was also evaluated. Results: In 120 eyes (60 patients), 1 month postoperatively, an improvement was observed in all visual parameters (P ≤ .03) except corrected near and intermediate visual acuities (both P ≥ .05). From 1 month to 12 months postoperatively, small but statistically significant changes were observed in uncorrected and corrected distance and near visual acuities (all P ≤ .03) and in uncorrected intermediate visual acuity (P = .01). In the defocus curve, no significant differences were found between visual acuities corresponding to defocus levels of −1.0 diopter (D) and −2.0 D (P = .22). The level of ocular spherical aberration decreased statistically significantly at 6 months (P < .001). Ocular and internal higher-order aberrations increased minimally but significantly from 6 to 12 months postoperatively (P < .001). The mean 12-month PCO score was 0.32 ± 0.44 (SD). Four eyes (3.3%) required neodymium:YAG capsulotomy. Conclusion: The trifocal IOL provided complete and stable visual restoration after cataract surgery during a 12-month follow-up, with good levels of visual quality.

Declaration signed by Harvard students to not speak in the vernacular for one year, 1712 August 23

The declaration, handwritten in Latin and signed by members of the junior and sophomore classes (Harvard Classes of 1714 and 1715), promises that the undersigned will not use the vernacular but instead "whenever, at meals, at banquets,...in our rooms, in all our gatherings, wherever and whenever" will speak in Latin, Greek, or Hebrew through the next May. Additional Latin text appears on both the front and back of the document. The original is accompanied by a typed transcription and two partial handwritten translations. Note at top of original: "Script. Leonardo Dowding, Composit. a Tho. Foxcroft."