Intervention For Non Research Articles

Enhancing resilience in rural Chinese preschoolers: a randomized controlled trial of play-based picture-book reading intervention for 4-5-year-olds

ABSTRACT This study addresses a gap in resilience interventions for rural preschoolers by validating a 14-week play-based picture-book reading program involving 80 Chinese preschoolers aged 4–5 years. Participants were randomly assigned to non-intervention (NI), play intervention (PI), picture-book reading intervention (PRI), or play-based picture-book reading intervention (PPRI) groups. Kindergarten teachers and parents reported children’s resilience with the Chinese version of Devereux Early Childhood Assessment for Preschoolers at pretest, post-test, and follow-up. Results revealed that intervention groups (PI, PRI, PPRI) exhibited higher resilience gain scores than the NI group. Notably, the PPRI group demonstrated greater resilience gains compared to the PRI and PI groups. Furthermore, the intervention effects of the PPRI group were maintained for two months following the intervention. Those findings suggest that PPRI may be a valuable intervention for enhancing resilience in preschoolers, with potential applications in kindergarten classrooms.

TCT-165 Aspirin-Free Prasugrel Monotherapy: 30-Day Clinical Outcome After Percutaneous Coronary Intervention in Chronic Coronary Syndrome and Non–ST-Segment Elevation Acute Coronary Syndrome

TCT-165 Aspirin-Free Prasugrel Monotherapy: 30-Day Clinical Outcome After Percutaneous Coronary Intervention in Chronic Coronary Syndrome and Non–ST-Segment Elevation Acute Coronary Syndrome

Outcomes of Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Non–ST-Elevation Myocardial Infarction-Propensity Matched Regression Analysis

Intravascular ultrasound (IVUS) guided percutaneous coronary intervention (PCI) is indicated in complex interventions. There is a paucity of evidence for outcomes with large studies on using IVUS during PCI in non-ST-elevation myocardial infarction (NSTEMI). Our objective was to compare the in-hospital outcome of IVUS-guided with that of nonguided PCI among NSTEMI hospitalizations. The National Inpatient Sample (2016 to 2019) was queried to identify all hospitalizations with a principal diagnosis of NSTEMI. In our study, we compared outcomes of PCI with and without IVUS guidance using a multivariate logistic regression model after propensity score matching, with the primary outcome being in-hospital mortality. A total of 671,280 NSTEMI-related hospitalizations were identified, of whom 48,285 (7.2%) underwent IVUS-guided PCI compared with 622,995 (92.8%) who underwent non-IVUS PCI. After adjusted analysis on matched pairs, we found that IVUS-guided PCI had a lower risk of in-hospital mortality than that of non-IVUS PCI (adjusted odds ratio [aOR] 0.736, confidence interval (CI) 0.578 to 0.937, p = 0.013). However, there was a higher use of mechanical circulatory support in the IVUS-guided PCI (aOR 2.138, CI 1.84 to 2.47, p <0.001) than in non-IVUS PCI. The odds of cardiogenic shock (aOR 1.11, CI 0.93 to 1.32, p = 0.233) and procedural complications (aOR 0.794, CI 0.549 to 1.14, p = 0.22) were similar between the cohorts. Hence, we conclude that patients with NSTEMIs who underwent IVUS-guided PCI had less risk of in-hospital mortality and a greater requirement of mechanical circulatory support than did those who underwent non-IVUS PCI, with no difference in procedural complications. Large prospective trials are essential to validate these findings.

TCT-17 Single Antiplatelet Therapy Directly After Percutaneous Coronary Intervention in Non–ST-Segment Elevation Acute Coronary Syndrome Patients: The OPTICA Pilot Study

TCT-17 Single Antiplatelet Therapy Directly After Percutaneous Coronary Intervention in Non–ST-Segment Elevation Acute Coronary Syndrome Patients: The OPTICA Pilot Study

Effectiveness of Arsenicum album 30C in Prevention of COVID-19 in Individuals Residing in Containment Zones of Delhi-A Prospective, Community-based, Parallel Cohort Study.

This work was undertaken to evaluate the protective effect of Arsenicum album 30C against COVID-19. The work was designed as a prospective parallel cluster cohort study. Participants were enrolled in a homeopathy intervention (HI) cohort (who received Arsenicum album) or in a non-intervention (NI) cohort (who received no systematic intervention) from COVID-19 containment areas of Delhi. Individuals of age 5 years or above were given four medicated pills of Arsenicum album 30C, while those from 1 to 5 years old were given two medicated pills in each dose. The analysis included 10,180 individuals residing in 11 COVID-19 containment areas in Delhi, out of which 6,590 individuals were in the HI cohort and 3,590 individuals were in the NI cohort. The overall protective effect of Arsenicum album 30C was 83.43% (95% confidence interval [CI], 76.77 to 88.17): 45 cases per 6,590 (8.34 per 10,000 person-weeks) in the Arsenicum album 30C group versus 143 cases per 3,590 (45.01 per 10,000 person-weeks) in the NI cohort. The protective effect of Arsenicum album 30C against laboratory confirmed COVID-19 was 74.40% (95% CI, 55.08 to 85.41): 18 cases per 6,590 (3.32 per 10,000 person-weeks) in the Arsenicum album 30C group versus 38 cases per 3,590 (11.85 per 10,000 person-weeks) in the NI cohort. The use of Arsenicum album 30C was associated with some protection against probable and laboratory-confirmed COVID-19 in a containment-zone setting. Randomized controlled trials are needed to confirm or refute these results.

Interim analysis of an open-label randomized controlled trial evaluating nasal irrigations in non-hospitalized patients with coronavirus disease 2019.

Interim analysis of an open-label randomized controlled trial evaluating nasal irrigations in non-hospitalized patients with coronavirus disease 2019.

TCT CONNECT-46 Trends and In-Hospital Outcomes of Percutaneous Coronary Intervention in Non–ST-Segment Elevation Myocardial Infarction and Prior Coronary Artery Bypass Graft

TCT CONNECT-46 Trends and In-Hospital Outcomes of Percutaneous Coronary Intervention in Non–ST-Segment Elevation Myocardial Infarction and Prior Coronary Artery Bypass Graft

Association of Pretreatment With P2Y12 Receptor Antagonists Preceding Percutaneous Coronary Intervention in Non–ST-Segment Elevation Acute Coronary Syndromes With Outcomes

Pretreatment of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) with P2Y12 receptor antagonists is a common practice despite the lack of definite evidence for its benefit. To investigate the association of P2Y12 receptor antagonist pretreatment vs no pretreatment with mortality, stent thrombosis, and in-hospital bleeding in patients with NSTE-ACS undergoing percutaneous coronary intervention (PCI). This cohort study used prospective data from the Swedish Coronary Angiography and Angioplasty Registry of 64 857 patients who underwent procedures between 2010 and 2018. All patients who underwent PCI owing to NSTE-ACS in Sweden were stratified by whether they were pretreated with P2Y12 receptor antagonists. Associations of pretreatment with P2Y12 receptor antagonists with the risks of adverse outcomes were investigated using instrumental variable analysis and propensity score matching. Data were analyzed from March to June 2019. Pretreatment with P2Y12 receptor antagonists. The primary end point was all-cause mortality within 30 days. Secondary end points were 1-year mortality, stent thrombosis within 30 days, and in-hospital bleeding. In total, 64 857 patients (mean [SD] age, 64.7 [10.9] years; 46 809 [72.2%] men) were included. A total of 59 894 patients (92.4%) were pretreated with a P2Y12 receptor antagonist, including 27 867 (43.7%) pretreated with clopidogrel, 34 785 (54.5%) pretreated with ticagrelor, and 1148 (1.8%) pretreated with prasugrel. At 30 days, there were 971 deaths (1.5%) and 101 definite stent thromboses (0.2%) in the full cohort. Pretreatment was not associated with better survival at 30 days (odds ratio [OR], 1.17; 95% CI, 0.66-2.11; P = .58), survival at 1 year (OR, 1.34; 95% CI, 0.77-2.34; P = .30), or decreased stent thrombosis (OR, 0.81; 95% CI, 0.42-1.55; P = .52). However, pretreatment was associated with increased risk of in-hospital bleeding (OR, 1.49; 95% CI, 1.06-2.12; P = .02). This cohort study found that pretreatment of patients with NSTE-ACS with P2Y12 receptor antagonists was not associated with improved clinical outcomes but was associated with increased risk of bleeding. These findings support the argument that pretreatment with P2Y12 receptor antagonists should not be routinely used in patients with NSTE-ACS.

The effect of acupuncture on exam anxiety in medical students: a randomized crossover study

ObjectiveAcupuncture (AC) has been used for treatment of chronic and pre- operative anxiety. However, no study has evaluated the effect of AC on exam anxiety in undergraduate students. The aim of this study was to evaluate whether AC reduces pre-examination anxiety compared to placebo (PL) and non- intervention (NI). MethodsTwenty students from the first terms of physiotherapy and dentistry courses were randomized to receive AC, PL and NI in a crossover manner and subsequently completed three anatomy exams with an interval of 1 month between exams/interventions. AC was performed on acupoints PC-6 (Neiguan), HT-7 (Shenmen), LV-3 (Taichong) and Yintang one day prior to each exam. The PL was performed outside the meridians and the needles were inserted superficially without obtaining De Qi. Levels of anxiety were measured using a visual analogue scale before and after each intervention as well as before each exam. ResultsAnxiety levels were reduced after AC and PL intervention compared to NI on the day before the exam, as well as on the day of the exam. ConclusionThese results suggest that AC can be used as an anxiolytic method in students under conditions of situational stress.

Association of Parenteral Anticoagulation Therapy With Outcomes in Chinese Patients Undergoing Percutaneous Coronary Intervention for Non–ST-Segment Elevation Acute Coronary Syndrome

The association of parenteral anticoagulation therapy with improved outcomes in patients with non-ST-segment elevation acute coronary syndrome was previously established. This benefit has not been evaluated in the era of dual antiplatelet therapy and percutaneous coronary intervention. To evaluate the association between parenteral anticoagulation therapy and clinical outcomes in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention. This cohort study included 8197 adults who underwent percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome from January 1, 2010, to December 31, 2014, at 5 medical centers in China. Patients receiving parenteral anticoagulation therapy only after percutaneous coronary intervention were excluded. Parenteral anticoagulation therapy. The primary outcome was in-hospital all-cause death and in-hospital major bleeding as defined by the Bleeding Academic Research Consortium definition (grades 3-5). Of 6804 patients who met the final criteria, 5104 (75.0%) were male, with a mean (SD) age of 64.2 (10.4) years. The incidence of in-hospital death was not significantly different between the patients who received and did not receive parenteral anticoagulation therapy (0.3% vs 0.1%; P = .13) (adjusted odds ratio, 1.27; 95% CI, 0.38-4.27; P = .70). A similar result was found for myocardial infarction (0.3% vs 0.3%; P = .82) (adjusted odds ratio, 0.77; 95% CI, 0.29-2.07; P = .61). In-hospital major bleeding was more frequent in the parenteral anticoagulation group (2.5% vs 1.0%; P < .001) (adjusted odds ratio, 1.94; 95% CI, 1.24-3.03; P = .004). At a median (interquartile range) follow-up of 2.96 years (1.93-4.46 years), all-cause death was not significantly different between the 2 groups (adjusted hazards ratio, 0.87; 95% CI, 0.71-1.07; P = .19), but the incidence of major bleeding was higher in the parenteral anticoagulation group (adjusted hazards ratio, 1.43; 95% CI, 1.01-2.02; P = .04). The propensity score analysis confirmed these primary analyses. In the patients undergoing percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome, parenteral anticoagulation therapy was not associated with a lower risk of all-cause death or myocardial infarction but was significantly associated with a higher risk of major bleeding. These findings raise important safety questions about the current practice of routine parenteral anticoagulation therapy while we await randomized trials of this practice.

Outcomes Following Percutaneous Coronary Intervention in Non-ST-Segment-Elevation Myocardial Infarction Patients With Coronary Artery Bypass Grafts.

Background There are limited data on outcomes of patients with previous coronary artery bypass graft (CABG) presenting with non-ST-segment-elevation myocardial infarction undergoing percutaneous coronary intervention (PCI). We compare clinical characteristics and outcomes in non-ST-segment-elevation myocardial infarction patients undergoing PCI with or without prior CABG surgery in a national cohort. Methods and Results We identified 205 039 patients with non-ST-segment-elevation myocardial infarction who underwent PCI between 2007 and 2014 in the British Cardiovascular Intervention Society database. Clinical, demographic, procedural, and outcome data were analyzed by dividing into 3 groups: group 1, PCI in native coronary arteries and no prior CABG (n=186 670); group 2, PCI in native arteries with prior CABG (n=8825); group 3, PCI in grafts (n=9544). Patients in group 2 and 3 were older and had more comorbidities and higher mortality at 30 days (group 2, 2.6% and group 3, 1.9%) and 1 year (group 2, 8.29% and group 3, 7.08%) as compared with group 1 (1.7% and 4.87%). After multivariable analysis, no significant difference in outcomes was observed in 30-days mortality (odds ratio; group 2=0.87 [CI, 0.69-1.80; P=0.20], group 3=0.91 [CI, 0.71-1.17; P=0.46]), in-hospital major adverse cardiovascular event (odds ratio: group 2=1.08 [CI, 0.88-1.34; P=0.45], group 3=0.97 [CI=0.77-1.23; P=0.82]), and in-hospital stroke (odds ratio: group 2=1.37 [CI, 0.71-2.69; P=0.35], group 3=1.13 [CI, 0.55-2.34; P=0.73]; group 1=reference). Conclusions Patients with prior CABG are presenting with non-ST-segment-elevation myocardial infarction and treated with PCI had more comorbid illnesses, but once these differences were adjusted for, prior CABG did not independently confer additional risk of mortality and major adverse cardiovascular event.

A Home-based Exercise Intervention for Non–Small Cell Lung Cancer Patients Post-Thoracotomy

There are no evidenced-based rehabilitative guidelines for postsurgical non-small cell lung cancer (NSCLC) patients. This qualitative study provides evidence on the acceptability of an effective postsurgical exercise intervention targeting the self-management of cancer-related fatigue to fill this gap. Qualitative perspective of 37 individuals randomized to a 6-week exercise program following hospital discharge post-thoracotomy for NSCLC. Postsurgical NSCLC participants found this rehabilitative exercise intervention highly acceptable because it removed traditional barriers to exercise. A highly acceptable and effective solution for meeting the unmet rehabilitative support needs of NSCLC patients has broader implications for extension to other vulnerable, aging, deconditioned populations.

Habitat complexity and individual acorn protectors enhance the post-fire restoration of oak forests via seed sowing

Abstract Oak reforestation via direct sowing has advantages over planting for economic and plant-morphological reasons, but the risk of high acorn predation usually dissuades land managers from using this method. In a previous study we hypothesised that overcoming acorn predation would require both large-scale solutions to reduce predation by large mammals – which we had effectively obtained through ecosystem management leading to greater habitat complexity – and small-scale protection to tackle predation by small mammals – which we had been unsuccessful to encounter. In this study we aimed to test this hypothesis under the same management areas but with a new acorn-scale protective device named seed shelter. We carried out an acorn predation experiment in Sierra Nevada (S Spain), in a burnt area with three replicates of each of two post-fire management treatments: non-intervention (NI), with high habitat complexity due to the abundance of lying burnt trees, and salvage logging (SL), with low habitat complexity due to the previous felling and piling of the tree trunks and chopping of the branches. In each replicate we sowed 50 acorns with seed shelter and 50 acorns without (N = 600 acorns). After 129 days, predation by rodents averaged 17% for control acorns, while the seed shelter reduced this to nil. Predation by boars (17.5% overall) was not affected by the seed shelter but was reduced to one-sixth in the NI treatment (5% vs 30% in SL), so we obtained the lowest overall predation rates in the combined NI + seed shelter treatment (5%). We thus corroborated our hypothesis that combining large-scale management with an acorn-scale protection can greatly increase the success of sowing. We expect these outcomes to increase the effectiveness of direct sowing and to raise the share of this practice in reforestation, especially for species that develop best with direct sowing such as oaks.

Surgical Intervention for Non–Small-Cell Lung Cancer Patients with Pleural Carcinomatosis: Results From the Japanese Lung Cancer Registry in 2004

A subset of non-small-cell lung cancer (NSCLC) patients with malignant pleural effusion and/or malignant pleural nodules is now classified as stage IV and is generally considered a contraindication to surgery. However, several reports have demonstrated that the prognosis of patients with pleural carcinomatosis first detected at thoracotomy is relatively favorable. The aim of this study was to describe the results of surgical intervention in NSCLC patients with pleural carcinomatosis in Japan. In 2010, the Japanese Joint Committee of Lung Cancer Registry conducted a nationwide registration of lung cancer patients who underwent surgery in 2004. Using this database, we performed a retrospective study focused on pleural carcinomatosis. We examined the clinicopathological features, the current status of therapy, and surgical outcomes in patients with pleural carcinomatosis. Among the 11,420 registered NSCLC patients, 329 (2.9%) patients had pleural carcinomatosis. The median survival time and 5-year survival rate of 313 patients without other metastatic disease were 34.0 months and 29.3%, respectively. Primary tumor resection was performed in 256 (81.8%) patients, and macroscopic complete resection was achieved in 152 (48.6%) patients, with 5-year survival rates of 33.1% and 37.1%, respectively. Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status (p < 0.001), best stage nodal status (p = 0.002), and the presence or absence of gross residual tumor (p = 0.013) were independent predictors of survival. In our surgical registry for NSCLC, patients with pleural carcinomatosis accounted for 2.9%, and macroscopic complete resection for them was associated with better survival.

Activated clotting time and outcomes during percutaneous coronary intervention for non-ST-segment-elevation myocardial infarction: insights from the FUTURA/OASIS-8 Trial.

Activated clotting time (ACT) is widely used to guide unfractionated heparin dosing during percutaneous coronary intervention. However, its value in predicting complications is controversial in the modern era. We sought to examine the relationship between ACT and outcomes in non-ST-segment-elevation acute coronary syndrome patients. In the Fondaparinux With Unfractionated Heparin During Revascularization in Acute Coronary Syndromes (FUTURA/OASIS-8) trial, 2026 patients with non-ST-segment-elevation acute coronary syndrome treated with fondaparinux 2.5 mg/d and undergoing percutaneous coronary intervention were randomized to low-dose unfractionated heparin (50 U/kg) or standard-dose unfractionated heparin (85 U/kg or 60 U/kg with glycoprotein IIb/IIIa inhibitors, with ACT guidance). No difference was shown for major bleeding and there was a trend toward a reduction in ischemic events with standard-dose unfractionated heparin. To clarify the additional value of ACT guidance, we analyzed with logistic modeling peri-percutaneous coronary intervention outcomes according to peak ACT as a linear function. A threshold effect was then investigated. No linear correlation was found between ACT and thrombotic or bleeding events. In patients not receiving planned glycoprotein IIb/IIIa inhibitors, a significant increase in rates of death, myocardial infarction, and target vessel revascularization was identified in patients with an ACT≤300 s (4.86% versus 2.78%; adjusted odds ratio, 1.84; 95% confidence interval, 1.06-3.21; P=0.03). No threshold was found for hemorrhagic complications in patients with or without glycoprotein IIb/IIIa inhibitors. Non-ST-segment-elevation acute coronary syndrome patients undergoing percutaneous coronary intervention with an ACT≤300 s are at increased risk of thrombotic complications. ACT, however, does not predict hemorrhagic complications. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00790907.

The Impact of Processing Instruction on the Recognition and Production of English Derivational Affixes Among EFL Learners

1. Sasan Baleghizadeh[1][1] 2. Arash Saharkhiz[1][1] 1. 1Shahid Beheshti University (G.C.), Tehran, Iran 1. Sasan Baleghizadeh, Shahid Beheshti University, G.C., Evin, Tehran 198396 9411, Iran. Email: sasanbaleghizadeh{at}yahoo.com In this study, we investigated the effectiveness of processing instruction (PI) as opposed to traditional deductive exercise-based intervention (TI) in teaching English derivational affixes. There was also a comparison non-intervention (NI) group, and the groups were posttested. To teach the target affixes via PI, new structured input tasks were developed. In all, 101 adult male and female lower-intermediate participants initially took part in the study, but this was later reduced to 71 as a result of the pretest, and so on. The results were analyzed through MANOVA and paired t test. In recognition, PI and TI outperformed non-intervention, while PI and TI did not outperform one another. In production, TI outperformed the other groups, while the other groups did not outperform one another. More studies must be carried out before drawing any conclusions about the transferability of PI to output activities for teaching derivational affixes. The students were also interviewed to survey their attitudes. Affectively, PI created self-confidence and an enjoyable atmosphere among the learners. Also cognitively, PI was the only group that satisfied the participants in their ability to recognize and produce derivational affixes. We found PI a highly effective and positive approach for teaching recognizing derivational affixes. We also believe it to possess a high potential for teaching their production, as it gave the participants a good sense of self-confidence for the production of the affixes. [1]: #aff-1

Collagen Plug Vascular Closure Devices and Reduced Risk of Bleeding with Bivalirudin Versus Heparin Plus Abciximab in Patients Undergoing Percutaneous Coronary Intervention for Non ST‐Segment Elevation Myocardial Infarction

In ISAR-REACT-4 (abciximab and heparin vs. bivalirudin for non-ST-elevation myocardial infarction [NSTEMI]), bivalirudin reduced the risk of bleeding after percutaneous coronary intervention (PCI) compared with unfractionated heparin plus abciximab (UFH + abciximab). Vascular closure devices (VCDs) may also prevent bleeding complications, and thus attenuate the benefit of bivalirudin. This analysis examined whether there exists an interaction on bleeding between VCDs and bivalirudin versus UFH + abciximab after PCI. Patients with NSTEMI were randomly assigned to either receive UFH + abciximab or bivalirudin for PCI. The use of a VCD after femoral access was left to the operator's discretion. The effect of randomized treatment in patients who received a VCD was compared to that in patients with manual compression of the femoral access site. The primary end-point of this analysis was the 30-day incidence of ISAR-REACT-4 major bleeding. A total of 1,711 patients were enrolled in this analysis. Among the 365 (21.3%) patients receiving a VCD, 188 (51.5%) were treated with UFH + abciximab and 177 (48.5%) with bivalirudin. ISAR- REACT-4 major bleeding was higher with UFH + abciximab than with bivalirudin, independent of whether a VCD was used (4.8% vs. 2.3% with VCD and 4.6% vs. 2.7% without VCD, Pint = 0.76). There were also no interactions between randomized treatment and VCDs with respect to any of the ischemic end-points or net clinical outcome (Pint > 0.56). In patients undergoing PCI for NSTEMI, the reduction of major bleeding by bivalirudin compared with UFH + abciximab was not affected whether a VCD was used.

Interdisciplinary Palliative Care Intervention in Metastatic Non–Small-Cell Lung Cancer

ObjectiveChallenges and barriers continue to hinder the integration of palliative care models into comprehensive, ambulatory oncology care. This article aims to describe how symptoms, distress, and quality of life (QOL) data from the usual care phase of a National Cancer Institute–supported Program Project informed the development of an interdisciplinary, tailored palliative care intervention for patients with metastatic non–small-cell lung cancer (NSCLC). MethodsPatients receiving usual care for metastatic NSCLC were recruited into this prospective longitudinal study over a 1-year period. A total of 130 patients with stage IV NSCLC were accrued, and 114 patients had evaluable data. Research nurses assisted patients in completing the clinical section of the data forms, and patients completed surveys and self-reports at baseline and 6, 12, and 24 weeks. ResultsPatients ranged in age from 40 to 84 years, and 61% were Caucasian non-Hispanic. Sixty-six former (N = 59) and current smokers had an average of 38 pack-year history of smoking. The Karnofsky Performance Status, Instrumental Activities of Daily Living, and Cognitive scores deteriorated significantly (P = .001, .009, and .042, respectively). Social Activity was stable, whereas Social Support increased significantly. Overall symptom distress score and Total symptom score both significantly increased at 24 weeks (P = .003 and .017, respectively). Physical Well-Being decreased significantly (P = .036), whereas the Functional Assessment of Cancer Therapy-Lung, Functional Assessment of Chronic Illness Therapy-Spirituality Subscale, and Distress scores remained statistically stable over time. ConclusionsPatients with metastatic NSCLC continue to experience high symptom burden and diminished physical well-being over time while receiving cancer treatments. An interdisciplinary palliative care intervention is currently being tested to improve symptom burden and overall QOL.

Effects of the P-Selectin Antagonist Inclacumab on Myocardial Damage After Percutaneous Coronary Intervention for Non–ST-Segment Elevation Myocardial Infarction: Results of the SELECT-ACS Trial

The study aimed to evaluate inclacumab for the reduction of myocardial damage during a percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction. P-selectin is an adhesion molecule involved in interactions between endothelial cells, platelets, and leukocytes. Inclacumab is a recombinant monoclonal antibody against P-selectin, with potential anti-inflammatory, antithrombotic, and antiatherogenic properties. Patients (N = 544) with non-ST-segment elevation myocardial infarction scheduled for coronary angiography and possible ad hoc PCI were randomized to receive 1 pre-procedural infusion of inclacumab 5 or 20 mg/kg or placebo. The primary endpoint, evaluated in patients who underwent PCI, received study medication, and had available efficacy data (n = 322), was the change in troponin I from baseline at 16 and 24 h after PCI. There was no effect of inclacumab 5 mg/kg. Placebo-adjusted geometric mean percent changes in troponin I with inclacumab 20 mg/kg were -24.4% at 24 h (p = 0.05) and -22.4% at 16 h (p = 0.07). Peak troponin I was reduced by 23.8% (p = 0.05) and area under the curve over 24 h by 33.9% (p = 0.08). Creatine kinase-myocardial band yielded similar results, with changes of -17.4% at 24 h (p = 0.06) and -16.3% at 16 h (p = 0.09). The incidence of creatine kinase-myocardial band increases >3 times the upper limit of normal within 24 h was 18.3% and 8.9% in the placebo and inclacumab 20-mg/kg groups, respectively (p = 0.05). Placebo-adjusted changes in soluble P-selectin level were -9.5% (p = 0.25) and -22.0% (p < 0.01) with inclacumab 5 and 20 mg/kg. There was no significant difference in adverse events between groups. Inclacumab appears to reduce myocardial damage after PCI in patients with non-ST-segment elevation myocardial infarction. (A Study of RO4905417 in Patients With Non ST-Elevation Myocardial Infarction [Non-STEMI] Undergoing Percutaneous Coronary Intervention; NCT01327183).

Suitability of the management of habitat complexity, acorn burial depth, and a chemical repellent for post-fire reforestation of oaks

Acorn sowing is a reforestation technique that can potentially render high-quality oak seedlings and high seedling survival, although it is often discarded due to high rates of seed predation. Predator activity can be modified by habitat complexity due to its effects on accessibility and protection for different predators. In this study we analysed how habitat complexity generated by different post-fire management treatments, sowing depth, and capsaicin (a chemical repellent) affect acorn predation by two guilds of post-dispersal predators that differ in size and foraging behaviour. We carried out two acorn predation experiments. In Experiment #1 we buried acorns at two depths (2 and 8cm) in two post-fire burnt-wood management treatments of different habitat complexity, namely: (1) Salvage Logging (SL), where the burnt trunks were cut and piled and the branches were masticated (lower habitat complexity), and (2) Non-Intervention (NI), with no action after the fire and 100% of the trees naturally fallen by 2009, thus leaving a habitat with lying burnt logs and branches (higher habitat complexity). In Experiment #2 we repeated Experiment #1, with the addition of capsaicin as a mammal repellent treatment. Most acorns were consumed in both years (ca. 90%), mainly by rodents. In Experiment #1 predation by boars accounted for 4.1% of overall predation, and it was about twice as high in SL than in NI, likely due to the physical difficulty for large mammals to forage in an area with a complex structure created by lying logs and branches. In contrast, rodents consumed ca. 1.4 times more acorns in NI than in SL, which led to overall greater predation in NI in both experiments. This was likely due to the protection provided by the branches for the rodent community. Deeper burial reduced predation by small percentages, although in Experiment #1 it had a negligible effect in NI. Capsaicin did not reduce predation, and it reduced seedling emergence to half. This study suggests that habitat complexity created by trunks and branches reduced predation by wild boars, but favoured rodent acorn predation. We conclude that other methods for the protection of individual acorns need to be identified to increase the success of oak reforestation via seeding.