ICDs at higher age and clinical risk factors

Background

The implantable cardioverter defibrillator (ICD) is effective in preventing sudden cardiac death. However, in elderly patients (aged 75 years or older) the role of ICDs is still not well-defined and controversial.

Methods

We retrospectively analysed all clinical and survival data of all ICD patients who were ≥75 years at the date of implantation in the Erasmus MC, Rotterdam, the Netherlands and the University Hospital, Basel, Switzerland. Kaplan-Meier survival analysis was performed, and mortality predictors were identified. Mortality of the cohort was compared with a random sample of patients aged 60–70 years originating from the same database and to an age- and sex-matched cohort of Dutch persons.

Results

The study cohort consisted of 179 patients aged 75 years or older who were implanted between February 1999 and July 2008. The median follow-up time was 2.0 (IQR 2.8) years. Survival rates after 1, 2 and 3 years were 87, 82, 75 %, respectively. Survival was similar for primary and secondary prevention. Mortality in this study population could be predicted by combining four clinical risk factors: QRS duration >120 ms, NYHA class > II, renal failure and atrial fibrillation (AF). Survival was worse compared with the group of ICD patients aged 60–70 years and to the age- and sex-matched group of elderly persons. However, survival was not significantly worse when comparing elderly ICD patients without additional risk factors to the general population.

Conclusions

Elderly patients still have an acceptable survival probability independent of prevention indication, certainly if there are no additional clinical risk factors. The presence or absence of additional clinical risk factors should be taken into account when making the decision for implantation, since they strongly correlate with survival.     

Rapid detection and species identification of Mycobacterium spp. using real-time PCR and DNA-microarray

Infections with mycobacteria are an important issue in public health care. Here we present a "proof-of-principle" concept for the identification of 37 different Mycobacterium species using 5' exonuclease real-time PCR and DNA microarray based on the region upstream of the 65 kDa heat shock protein. With our two PCR probes, one complementary to all mycobacteria species, the other specific for the M. tbc-complex, 34 species were properly classified by real-time PCR. After reamplification and hybridization to a DNA microarray, all species showed a specific pattern. All 10 blindly tested positive cultures revealed a positive real-time PCR signal with the genus probe. After reamplification and hybridization, six samples could unambiguously be identified. One sample showed a mixture of presumably three species-specific patterns and sequencing the 16S rRNA confirmed the presence of a mixture. The hybridization results of three specimens could not be interpreted because the signal to background ratio was not sufficient. Two samples considered as negative controls (LAL Reagent Water (Cambrex) and DNA of Candida albicans) gave neither a genus nor a M. tbc-complex positive PCR signal. Based on these results we consider our method to be a promising tool for the rapid identification of different mycobacteria species, with the advantage of possible identification of mixed infections or contaminations.     

Evolutionary trace report_maker: a new type of service for comparative analysis of proteins

: Evolutionary trace report_maker offers a new type of service for researchers investigating the function of novel proteins. It pools, from different sources, information about protein sequence, structure and elementary annotation, and to that background superimposes inference about the evolutionary behavior of individual residues, using real-valued evolutionary trace method. As its only input it takes a Protein Data Bank identifier or UniProt accession number, and returns a human-readable document in PDF format, supplemented by the original data needed to reproduce the results quoted in the report.     

Life Cycle Assessment of the Mobile Communication System UMTS: Towards Eco-efficient Systems (12 pp)

Goal, Scope and Background Goal of this study is an evaluation of the environmental sustainability of the UMTS mobile communication system in Switzerland by means of a Life Cycle Assessment (LCA). A baseline environmental impact profile across the full life cycle of the UMTS (Universal Mobile Telecommunication System) and its predecessor, the GSM (Global System for Mobile Communication) is presented. The baseline assessment was a necessary first step to evaluate the environmental impacts of the mobile communication systems use and growth, thus permitting the evaluation of its environmental sustainability. Main Features Two functional units are defined: a data set of 1 Gbit (1.000.000 kbit), and the yearly mobile communication of an average customer. In the UMTS, both data packages and calls can be conveyed. In order to be able to standardize the results, an equivalence between these two kinds of transmission is formed. Two different options are defined, which represent different ways of transferring the data: mobile phone to mobile phone, and mobile phone to fixed network. All components of the UMTS network like the mobile phones, base stations, antennae, switching systems and the components of the landline like cable system and switching centers, are assessed. The environmental impacts are assessed taking into account all major life cycle phases like raw material extraction, manufacturing, use, disassembly and disposal of the product and the needed infrastructure. Electronic components like printed wiring boards and integrated circuits are assessed using a simple model based on the size (for IC) or number of layers (for PWB), respectively. Mining of precious metals (gold, silver) is included. The study was carried out by ESU-services, Motorola, Swisscom and Deutsche Telekom. Thanks to the industrial partners it can rely on primary data for the production of mobile phone and base station, and for the operation of the networks. As the UMTS network is still being built, no actual data of network operation is available. Data from the GSM (Global System for Mobile Communication) were used in case of data gaps. Results and Conclusions About 25 kg CO2 are emitted and 800 MJ-eq (non-renewable) primary energy are required for the transfer of 1 Gbit information from mobile phone to mobile phone in the UMTS network. For a transfer from mobile to fixed network, these values are 20 kg CO2 and 640 MJ-eq, respectively. On the other hand, the fixed network requires more resources like copper (0.07 kg for the mobile to mobile option vs. 0.12 kg for mobile to fixed network). From an environmental point of view, the mobile telephone is the most important element of the mobile communication network (UMTS and GSM). The short service life of the mobile phone plays a substantial role. Increasing the utilization period of the mobile phone (e.g. by leasing, re-use, extension of the innovation cycles, etc.) could thus represent a large potential for its improvement. The second most important components are the base stations. In the assessment mainly the use phase proved to be important. The lower environmental impact (per Gbit data transfer) as compared to the mobile phone can be explained by the longer service life (around factor 8). Main impacts are caused by the electricity consumption, in particular the energy needed for cooling the base stations. By choosing an environmentally benign electricity mix and/or by increasing the portion of renewable sources of energy, the network operators have a substantial potential of lower the environmental impacts (in particular the greenhouse gas emissions) of mobile telecommunication. Furthermore, the manufacturing of electronic components, the life time of the appliances and energy consumption are key parameters influencing the environmental profile of the networks most. Given its larger data transfer rate, the UMTS is ecologically more favorable in terms of data transfer rate than its predecessor, the GSM system. The higher energy consumption and the more complex production of the devices in the UMTS system are compensated by the faster data transmission rate. Per customer, the result is inverse, however, since the higher efficiency is compensated by the higher data communication per user in the UMTS system. The UMTS network in its state of 2004 according to the 2001 planning and with the accordingly calculated number of customers and data transfer causes 2.1 times more CO2 emissions and requires 2.4 times more (non-renewable) primary energy per customer than for the GSM system in its current state. It must be noted, however, that the UMTS technology supports other services than the GSM system. The development of the UMTS is accompanied with an increased consumption of resources and emissions of pollutants and greenhouse gases regarding the entire system for mobile telephone communication. The GSM system is a mature technology, while the UMTS is still at the beginning of its learning curve. Thus, it can be safely assumed that large improvement potentials are still present for the UMTS network components concerning expenditures and emissions both at production and by the use of the devices. This study provides the necessary information where such improvements are most effective in environmental terms.     

BioMove – an integrated platform simulating the dynamic response of species to environmental change

BioMove simulates plant species' geographic range shifts in response to climate, habitat structure and disturbance, at annual time steps. This spatially explicit approach integrates species' bioclimatic suitability and population‐level demographic rates with simulation of landscape‐level processes (dispersal, disturbance, species' response to dynamic dominant vegetation structure). Species population dynamics are simulated through matrix modelling that includes scaling demographic rates by climatic suitability. Dispersal functions simulate population spread. User‐specified plant functional types (PFTs) provide vegetation structure that determines resource competition and disturbance. PFTs respond annually through dispersal, inter‐PFT competition and demographic shifts. BioMove provides a rich framework for dynamic range simulations.     

Phenotypic selection and covariation in the life‐history traits of elephant seals: heavier offspring gain a double selective advantage

Early developmental conditions contribute to individual heterogeneity of both phenotypic traits and fitness components, ultimately affecting population dynamics. Although the demographic consequences of ontogenic growth are best quantified using an integrated measure of fitness, most analyses to date have instead studied individual fitness components in isolation. Here, we estimated phenotypic selection on weaning mass in female southern elephant seals Mirounga leonina by analyzing individual‐based data collected between 1986 and 2016 with capture–recapture and matrix projection models. In support of a hypothesis predicting a gradual decrease of weaning mass effects with time since weaning (the replacement hypothesis), we found that the estimated effects of weaning mass on future survival and recruitment probability was of intermediate duration (rather than transient or permanent). Heavier female offspring had improved odds of survival in early life and a higher probability to recruit at an early age. The positive link between weaning mass and recruitment age is noteworthy, considering that pre‐recruitment mortality already imposed a strong selective filter on the population, leaving only the most ‘robust’ individuals to reproduce. The selection gradient on asymptotic population growth rate, a measure of mean absolute fitness, was weaker than selection on first‐year survival and recruitment probabilities. Weaker selection on mean fitness occurs because weaning mass has little impact on adult survival, the fitness component to which the population growth of long‐lived species is most sensitive. These results highlight the need to interpret individual variation in phenotypic traits in a context that considers the demographic pathways between the trait and an inclusive proxy of individual fitness. Although variation in weaning mass do not translate to permanent survival differences among individuals in adulthood, it explains heterogeneity and positive covariation between survival and breeding in early life, which contribute to between‐individual variation in fitness.     

Real-time on-line flow cytometry for bioprocess monitoring

As the understanding of variation is the key to a good process and product quality one should pay attention to dynamics on the single-cell level. The basic idea of this approach was to qualify and quantify variations on the single-cell level during bioreactor cultivations by monitoring the expression of an eGFP tagged target protein (human membrane protein) using fully automated real-time, flow injection flow cytometry (FI-FCM). The FI-FCM system consists of a sampling- and defoaming- as well as of a dilution-section. It allows a very short monitoring interval (5 min) and is able to dilute the reactor sample by a factor ranging up to more than 10,000.In bioreactor cultivations of recombinant Pichia pastoris expressing the eGFP tagged target protein, high correlations (R² ≥ 0.97) between the FI-FCM fluorescent signal and other, however, population-averaged fluorescence signals (off-line fluorescence, in situ fluorescence probe) were obtained. FI-FCM is the only method able to distinguish between few cells with high fluorescence and many cells with low fluorescence intensity and proved that cells differ significantly from each other within the population during bioreactor cultivations. Single-cell fluorescence was distributed over a broad range within the cell population. These distributions strongly suggest that (a) the AOX-I promoter is leaky and (b) a fraction of the population is able to express more protein of interest within shorter time and (c) a fraction of the population does not express the fusion protein at all. These findings can help in the selection of high producing, stable strains. To show the platform-independency of the system, it has successfully been tested during bioreactor cultivations of three different strains (P. pastoris, Saccharomyces cerevisiae, Escherichia coli).Along with its applications in PAT, the FI-FCM could be used as a platform-independent (prokaryotes and eukaryotes) method in various other applications; for example in the closed-loop-control of bioprocesses using different kinds of fluorescent reporters, (waste- and drinking-) water analysis, clone selection in combination with FACS or even for surgery applications.