Gender Disparities in the Presentation,Management and Outcomes of Acute Coronary Syndrome Patients: Data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2)

Background

Gender-related differences in mortality of acute coronary syndrome (ACS) have been reported. The extent and causes of these differences in the Middle-East are poorly understood. We studied to what extent difference in outcome, specifically 1-year mortality are attributable to demographic, baseline clinical differences at presentation, and management differences between female and male patients.

Methodology/Principal Findings

Baseline characteristics, treatment patterns, and 1-year mortality of 7390 ACS patients in 65 hospitals in 6 Arabian Gulf countries were evaluated during 2008–2009, as part of the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2). Women were older (61.3±11.8 vs. 55.6±12.4; P<0.001), more overweight (BMI: 28.1±6.6 vs. 26.7±5.1; P<0.001), and more likely to have a history of hypertension, hyperlipidemia or diabetes. Fewer women than men received angiotensin-converting enzyme inhibitors (ACE), aspirin, clopidogrel, beta blockers or statins at discharge. They also underwent fewer invasive procedures including angiography (27.0% vs. 34.0%; P<0.001), percutaneous coronary intervention (PCI) (10.5% vs. 15.6%; P<0.001) and reperfusion therapy (6.9% vs. 20.2%; P<0.001) than men. Women were at higher unadjusted risk for in-hospital death (6.8% vs. 4.0%, P<0.001) and heart failure (HF) (18% vs. 11.8%, P<0.001). Both 1-month and 1-year mortality rates were higher in women than men (11% vs. 7.4% and 17.3% vs. 11.4%, respectively, P<0.001). Both baseline and management differences contributed to a worse outcome in women. Together these variables explained almost all mortality disparities.

Conclusions/Significance

Differences between genders in mortality appeared to be largely explained by differences in prognostic variables and management patterns. However, the origin of the latter differences need further study.     

Ecoregion-Based Conservation Planning in the Mediterranean: Dealing with Large-Scale Heterogeneity

Spatial priorities for the conservation of three key Mediterranean habitats, i.e. seagrass Posidonia oceanica meadows, coralligenous formations, and marine caves, were determined through a systematic planning approach. Available information on the distribution of these habitats across the entire Mediterranean Sea was compiled to produce basin-scale distribution maps. Conservation targets for each habitat type were set according to European Union guidelines. Surrogates were used to estimate the spatial variation of opportunity cost for commercial, non-commercial fishing, and aquaculture. Marxan conservation planning software was used to evaluate the comparative utility of two planning scenarios: (a) a whole-basin scenario, referring to selection of priority areas across the whole Mediterranean Sea, and (b) an ecoregional scenario, in which priority areas were selected within eight predefined ecoregions. Although both scenarios required approximately the same total area to be protected in order to achieve conservation targets, the opportunity cost differed between them. The whole-basin scenario yielded a lower opportunity cost, but the Alboran Sea ecoregion was not represented and priority areas were predominantly located in the Ionian, Aegean, and Adriatic Seas. In comparison, the ecoregional scenario resulted in a higher representation of ecoregions and a more even distribution of priority areas, albeit with a higher opportunity cost. We suggest that planning at the ecoregional level ensures better representativeness of the selected conservation features and adequate protection of species, functional, and genetic diversity across the basin. While there are several initiatives that identify priority areas in the Mediterranean Sea, our approach is novel as it combines three issues: (a) it is based on the distribution of habitats and not species, which was rarely the case in previous efforts, (b) it considers spatial variability of cost throughout this socioeconomically heterogeneous basin, and (c) it adopts ecoregions as the most appropriate level for large-scale planning.     

乌鲁木齐南部山区地生地衣群落分布格局

为了查明乌鲁木齐南部山区地生地衣群落分布格局,作者选取了24个样点(20 m×20 m),设置了240个50cm×50 cm样方,调查地生地衣的种类及盖度,分析其分布格局及其与环境因子的关系.结果表明,乌鲁木齐南部山区共有地生地衣17种,隶属于2目5科10属.聚类分析和DCA排序将该地区的地生地衣分为4个主要样点组,分...     

维吾尔族2 型糖尿病患者糖尿病肾病相关因素分析

目的:探讨维吾尔族2型糖尿病肾病(DN)发病的相关临来因素。方法:分析292例维吾尔族2型糖尿病患者的临床资科。结果:维吾尔族2型糖尿病患者糖尿病肾病(DN)发病率为43.49%(127/292)。DN患者的病程、SBP、TC、TG、FBG、HbAIC、LDL-C、BUN和Cr均显著高于NDN患者(P<0.05);但DBP、HDL-C、BMI之间无统计学差异(P>0.05)。Logistic归分析结果显示,DM病程、患病年龄、SBP、FBP、TC、TG、LDL-C、HbA1c、BUN、Cr是DN的危险因素(OR值>1)。结论:维吾尔族2型糖尿病患者的DM病程、患病年龄、SBP、FBP、TC、TG、LDL-C、HbA1c、BUN、Cr等参数与糖尿病肾病并发率之间有相关性。     

An essential role of Hrs/Vps27 in endosomal cholesterol trafficking

The endosomal sorting complex required for transport (ESCRT) plays a crucial role in the degradation of ubiquitinated endosomal membrane proteins. Here, we report that Hrs, a key protein of the ESCRT-0 complex, is required for the transport of low-density lipoprotein-derived cholesterol from endosomes to the endoplasmic reticulum. This function of Hrs in cholesterol transport is distinct from its previously defined role in lysosomal sorting and downregulation of membrane receptors via the ESCRT pathway. In line with this, knocking down other ESCRT proteins does not cause prominent endosomal cholesterol accumulation. Importantly, the localization and biochemical properties of key cholesterol-sorting proteins, NPC1 and NPC2, appear to be unchanged upon Hrs knockdown. Our data identify Hrs as a regulator of endosomal cholesterol trafficking and provide additional insights into the budding of intralumenal vesicles.     

Calciotropic hormones raise the chemically detectable [Pi] in UMR 106–06 osteoblast-like cells

Uptake of orthophosphate (Pi) by osteoblast-like cells is known to be stimulated by parathyroid hormone (PTH), but effects on intracellular [Pi] have not been investigated. Here we show in rat osteoblast-like cells (UMR 106-06) that PTH (10^?11 to 10^?7 M ) increases both ³²Pi uptake and cellular [Pi] by up to 50 per cent. 1,25 Dihydroxyvitamin D₃ (1,25D) (10^?12 to 10^?6 M ) and salmon calcitonin (CT) (10^?12 to 10^?6 g ml^?1) also increased cellular [Pi] (by up to 60 per cent), but the percentage increases in total cellular ³²Pi uptake were smaller. The effects of 1,25D were transient (observable at 80 min and 6 h but not 24 h), and were also observed with 24,25 dihydroxy- and 25 hydroxyvitamin D₃. Transient degradation of organic phosphorus pools to Pi might contribute to this increased [Pi]. These pools remain to be identified but were not shown to be phospholipids. Foetal bovine serum also affected cellular [Pi]. Care is therefore needed in distinguishing direct hormonal effects on cellular [Pi] from indirect effects arising from changes in the rate of cell growth.     

新疆平茶渍属地衣生态分布与地理区系成分分析

根据多年的实地调查资料和前人研究资料,对新疆平茶渍属（Aspicilia）地衣的种类以及它们的分布区、区系特征进行了初步研究。结果表明,分布在新疆的平茶渍属地衣共有33种,主要分布在天山、阿勒泰山、昆仑山和准噶尔盆地。根据它们对环境的适应特征和选择性,将新疆平茶渍属地衣的地理区系划分为广布种、环极北极高山种、环极低北极及北方种、北美东部种、中亚种、中国特有种、分布范围不清楚的种等7种类型。同时把新疆平茶渍属地衣的地理分布区域划分为欧亚森林植物亚区、亚洲荒漠植物亚区、青藏高原亚区等三种分布区域。研究还发现分布在阿勒泰山、天山、昆仑山和准噶尔盆地的平茶渍属主要生长在岩石上面,生长基物比较单一。     

Greater Flamingo (Phoenicopterus roseus): Important wintering sites and breeding records in the United Arab Emirates

Greater Flamingo (Phoenicopterus roseus) monitoring was undertaken in the United Arab Emirates from 2003 to 2015 at 36 permanent sites to find key wintering and breeding sites. Bul Syayeef Marine Protected Area with monthly mean of 6553 (±3594) flamingos followed by Al Wathba Wetland Reserve with 1228 (±1190) flamingos topped the list. In addition, Shahama Wetland and Al Aryam Mudflats in Abu Dhabi Emirate form a complex of four nearby sites that hold the majority of nearly 15,000–20,000 birds wintering in the country. Lagoons (Khors) in the northern emirates are the other key wintering sites, that suffer habitat destruction and high disturbance. Breeding has been sporadic and infrequent since the first breeding attempt in 1993. Greater Flamingos have bred successfully only in the Abu Dhabi Emirate on 10 occasions at three sites with the highest eight breeding attempts at Al Wathba and one each at Shahama and Bul Syayeef. A total of 1,972 young have fledged with a high overall breeding success of 43%. The highest number of 801 young fledged at Bul Syayeef in 2009 followed by 420 at Al Wathba in 2015 and 350 at Shahama in 2007. Successful breeding occurred both in summer and winter seasons, breeding attempts were more (58%) in summer compared to winter. Flamingos have bred regularly at Al Wathba Wetland Reserve since 2011, this was made possible due to the provision of an artificial island to aid nesting and better control of predators. Breeding is successful at sites that maintain higher bird numbers and are free from disturbance.