Promising Results In Recent Studies Research Articles

Role of platelet rich plasma in management of early knee osteoarthritis pain: A retrospective observational study

IntroductionKnee joint osteoarthritis is a well-known cause of pain and disability in patients above 40 years of age. It is treated by use of non-steroidal inflammatory drugs, corticosteroids, glucosamine, chondroitin sulfate, physiotherapy with limited success. The platelet rich plasma (PRP) contains a large amount of platelet derived growth factors, cytokines and anti-inflammatory molecules which showed promising results in recent studies to relieve pain of knee joint osteoarthritis. The present study aims to determine the efficacy of intraarticular PRP for pain relief and functional improvement in patients with early knee joint osteoarthritis. MethodsIt is a retrospective observation study involving patients who underwent single intraarticular administration of PRP for knee pain with Kellgren-Lawrence (KL) grades I or II knee joint osteoarthritis. The Visual analogue scale (VAS) score and Oxford knee score (OKS) were recorded pre-procedure and at 1- and 6-month post-procedure. ResultsA total of 31 patients (20 females, 11 males) underwent PRP therapy for knee pain (16 kL grade I, 15 kL grade II). The mean age and duration of symptoms were of 53.9 years (range: 79–42 years) and 5.53 ± 2.35 years respectively. There was a significant reduction (p < 0.05) in VAS scores from pre-procedure (68.06 ± 8.33) to post procedure at 1 month (37.74 ± 11.16) and 6 months (54.52 ± 11.78). There was also significant improvement (p < 0.05) in OKS score from pre-procedure (31.1 ± 3.47) to post-procedure at 1 month (39.06 ± 3.37) and 6 months (34.10 ± 3.75). No adverse effects were reported in patients during the study period. ConclusionThis small retrospective study suggests that a single administration of intraarticular PRP may be safe and effective for pain relief and functional improvement for up to 6 months in patients of early-stage osteoarthritis.

Speech Emotion Recognition Using Convolution Neural Networks and Multi-Head Convolutional Transformer.

Speech emotion recognition (SER) is a challenging task in human-computer interaction (HCI) systems. One of the key challenges in speech emotion recognition is to extract the emotional features effectively from a speech utterance. Despite the promising results of recent studies, they generally do not leverage advanced fusion algorithms for the generation of effective representations of emotional features in speech utterances. To address this problem, we describe the fusion of spatial and temporal feature representations of speech emotion by parallelizing convolutional neural networks (CNNs) and a Transformer encoder for SER. We stack two parallel CNNs for spatial feature representation in parallel to a Transformer encoder for temporal feature representation, thereby simultaneously expanding the filter depth and reducing the feature map with an expressive hierarchical feature representation at a lower computational cost. We use the RAVDESS dataset to recognize eight different speech emotions. We augment and intensify the variations in the dataset to minimize model overfitting. Additive White Gaussian Noise (AWGN) is used to augment the RAVDESS dataset. With the spatial and sequential feature representations of CNNs and the Transformer, the SER model achieves 82.31% accuracy for eight emotions on a hold-out dataset. In addition, the SER system is evaluated with the IEMOCAP dataset and achieves 79.42% recognition accuracy for five emotions. Experimental results on the RAVDESS and IEMOCAP datasets show the success of the presented SER system and demonstrate an absolute performance improvement over the state-of-the-art (SOTA) models.

DeepCNN: Spectro‐temporal feature representation for speech emotion recognition

AbstractSpeech emotion recognition (SER) is an important research problem in human‐computer interaction systems. The representation and extraction of features are significant challenges in SER systems. Despite the promising results of recent studies, they generally do not leverage progressive fusion techniques for effective feature representation and increasing receptive fields. To mitigate this problem, this article proposes DeepCNN, which is a fusion of spectral and temporal features of emotional speech by parallelising convolutional neural networks (CNNs) and a convolution layer‐based transformer. Two parallel CNNs are applied to extract the spectral features (2D‐CNN) and temporal features (1D‐CNN) representations. A 2D‐convolution layer‐based transformer module extracts spectro‐temporal features and concatenates them with features from parallel CNNs. The learnt low‐level concatenated features are then applied to a deep framework of convolutional blocks, which retrieves high‐level feature representation and subsequently categorises the emotional states using an attention gated recurrent unit and classification layer. This fusion technique results in a deeper hierarchical feature representation at a lower computational cost while simultaneously expanding the filter depth and reducing the feature map. The Berlin Database of Emotional Speech (EMO‐BD) and Interactive Emotional Dyadic Motion Capture (IEMOCAP) datasets are used in experiments to recognise distinct speech emotions. With efficient spectral and temporal feature representation, the proposed SER model achieves 94.2% accuracy for different emotions on the EMO‐BD and 81.1% accuracy on the IEMOCAP dataset respectively. The proposed SER system, DeepCNN, outperforms the baseline SER systems in terms of emotion recognition accuracy on the EMO‐BD and IEMOCAP datasets.

Bladder-sparing (chemo)radiotherapy in elderly patients with muscle-invasive bladder cancer: a retrospective cohort study

Background Organ-sparing treatment for muscle-invasive bladder cancer by maximal transurethral removal of the tumor (TURB) followed by chemoradiation (CRT) has shown promising results in recent studies, and is therefore considered to be an acceptable alternative for the standard of radical cystectomy (RC) in selected patients. We report on outcomes in a single-center, retrospective CRT cohort in comparison to a RC and radiotherapy only (RT) cohort. Patients and methods The patient population included n = 84 CRT patients, n = 93 RC patients, and n = 95 RT patients. Primary endpoints were local control (LC) up to 2 years and overall survival (OS) up to 5 years. Cox regression was performed to determine risk factors for LC and OS in the CRT group. Acute genito-urinary (GU) and gastro-intestinal (GI) toxicity were scored with CTCAE version 4 for the RT and CRT cohort. Logistic regression was used to determine risk factors for toxicity. We followed the EQUATOR guidelines for reporting, using the STROBE checklist for observational research. Results Baseline characteristics were different between the treatment groups with in particular worse comorbidity scores and higher age in the RT cohort. The CRT schedule was completed by 96% of the patients. LC at 2 years was 83.4% (90% CI 76.0–90.8) for CRT vs. 70.9% (62.2–79.6) for RC and 67.0% (56.8–77.2) for RT. OS at 5 years was 48.9% (38.4–59.4) for CRT vs. 46.6% (36.4–56.8) for RC, and 27.6% (19.4–35.8) for RT. High T stage was significantly associated with worse LC and OS in the CRT group. GU/GI toxicity grade ≥2 occurred in 43 (48.3%) RT patients and 38 (45.2%) CRT patients. Conclusions The organ-preserving strategy with CRT was feasible and tolerable in this patient population, and the achieved LC and OS were satisfactory in comparison to the RC cohort and literature.

CARMI

Learned indexes, which use machine learning models to replace traditional index structures, have shown promising results in recent studies. However, existing learned indexes exhibit a performance gap between synthetic and real-world datasets, making them far from practical indexes. In this paper, we identify that ignoring the importance of data partitioning during model training is the main reason for this problem. Thus, we explicitly apply data partitioning to index construction and propose a new efficient and updatable cache-aware RMI framework, called CARMI. Specifically, we introduce entropy as a metric to quantify and characterize the effectiveness of data partitioning of tree nodes in learned indexes and propose a novel cost model, laying a new theoretical foundation for future research. Then, based on our novel cost model, CARMI can automatically determine tree structures and model types under various datasets and workloads by a hybrid construction algorithm without any manual tuning. Furthermore, since memory accesses limit the performance of RMIs, a new cache-aware design is also applied in CARMI, which makes full use of the characteristics of the CPU cache to effectively reduce the number of memory accesses. Our experimental study shows that CARMI performs better than baselines, achieving an average of 2.2X/1.9X speedup compared to B+ Tree/ALEX, while using only about 0.77X memory space of B+ Tree. On the SOSD platform, CARMI outperforms all baselines, with an average speedup of 1.2X over the nearest competitor RMI, which has been carefully tuned for each dataset in advance.

RNAi as a Foliar Spray: Efficiency and Challenges to Field Applications.

RNA interference (RNAi) is a powerful tool that is being increasingly utilized for crop protection against viruses, fungal pathogens, and insect pests. The non-transgenic approach of spray-induced gene silencing (SIGS), which relies on spray application of double-stranded RNA (dsRNA) to induce RNAi, has come to prominence due to its safety and environmental benefits in addition to its wide host range and high target specificity. However, along with promising results in recent studies, several factors limiting SIGS RNAi efficiency have been recognized in insects and plants. While sprayed dsRNA on the plant surface can produce a robust RNAi response in some chewing insects, plant uptake and systemic movement of dsRNA is required for delivery to many other target organisms. For example, pests such as sucking insects require the presence of dsRNA in vascular tissues, while many fungal pathogens are predominately located in internal plant tissues. Investigating the mechanisms by which sprayed dsRNA enters and moves through plant tissues and understanding the barriers that may hinder this process are essential for developing efficient ways to deliver dsRNA into plant systems. In this review, we assess current knowledge of the plant foliar and cellular uptake of dsRNA molecules. We will also identify major barriers to uptake, including leaf morphological features as well as environmental factors, and address methods to overcome these barriers.

An empirical study on the effectiveness of data resampling approaches for cross‐project software defect prediction

Cross-project defect prediction (CPDP), where data from different software projects are used to predict defects, has been proposed as a way to provide data for software projects that lack historical data. Evaluations of CPDP models using the Nearest Neighbour (NN) Filter approach have shown promising results in recent studies. A key challenge with defect-prediction datasets is class imbalance, that is, highly skewed datasets where non-buggy modules dominate the buggy modules. In the past, data resampling approaches have been applied to within-projects defect prediction models to help alleviate the negative effects of class imbalance in the datasets. To address the class imbalance issue in CPDP, the authors assess the impact of data resampling approaches on CPDP models after the NN Filter is applied. The impact on prediction performance of five oversampling approaches (MAHAKIL, SMOTE, Borderline-SMOTE, Random Oversampling and ADASYN) and three undersampling approaches (Random Undersampling, Tomek Links and One-sided selection) is investigated and results are compared to approaches without data resampling. The authors examined six defect prediction models on 34 datasets extracted from the PROMISE repository. The authors' results show that there is a significant positive effect of data resampling on CPDP performance, suggesting that software quality teams and researchers should consider applying data resampling approaches for improved recall (pd) and g-measure prediction performance. However, if the goal is to improve precision and reduce false alarm (pf) then data resampling approaches should be avoided.

ID: 3523881 ENDOSCOPIC ULTRASOUND-GUIDED RADIOFREQUENCY AND ETHANOL ABLATION FOR PANCREATIC NEUROENDOCRINE TUMORS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Endoscopic ultrasound-guided (EUS) radiofrequency (RFA) and ethanol ablation for pancreatic neuroendocrine tumors (PNETs) have been reported to have promising results in recent studies. We conducted a systematic review and meta-analysis studying the effectiveness and safety of EUS-RFA ablation as compared to EUS ethanol ablation.

Integration of Low Melting Temperature Electrolyte in Thermal Batteries

Thermal batteries usually operate at temperatures higher than 400 °C. This high operating temperature requires a complex thermal and mechanical design of the battery components and hermetically sealed casing. Reduced operating temperature thermal cells can benefit from the majority of intrinsic characterizations of thermal batteries such as safety, robustness, and infinite shelf life while mitigating the challenges related to the high operating temperature batteries such as exotic thermal insulation materials, complicated internal pyrotechnic heat source, and heavy packaging. To integrate the thermal batteries into a wider range of applications such as bore-hole probes, smart grid energy storage, and geothermal energy applications, operating temperatures of these batteries should be reduced.The most common design for thermal batteries is pellet stacks. The pellet pressing fabrication method inherently causes issues due to the fragility of the pellets, making handling and assembly of the cells arduous. Additionally, due to the liquid nature of molten salt electrolyte used in these batteries, a structure to immobilize the electrolyte layer during the operation of the battery is required. The role of the immobilizing component is also to prevent short circuiting while the battery is affected by severe physical shock or vibration. The most commonly used binder material in today’s thermal batteries is magnesium oxide (MgO). Extensive investigations were conducted on the properties and the electrochemical effect of using MgO as the binding material, besides, its fabrication process is well optimized. However, using MgO is not without its drawbacks. To prevent short-circuiting during the cell operation especially in the presence of an external shock to the system, approximately 30 vol.% of the separator layer should be dedicated to MgO, resulting in lower than desired energy density. Ceramic felts showed promising results in recent studies. High level of porosity (e.g. 96% bulk porosity), outstanding stability at elevated temperatures, and mechanical stiffness could be the key to make batteries that can operate for a longer time.Our research group has previously developed a novel eutectic electrolyte mixture using potassium bifluoride and different lithium salts such as lithium fluoride as the low melting point electrolytes. In this research, initially, the integration of this electrolyte mixture in a thermal cell was tested. Consequently, aluminum oxide (Al2O3) and yttria-stabilized zirconia (YSZ) ceramic felts were loaded with the low melting electrolyte as an alternative to the current pellet-based separator layer. Finally, (i) the assembly of the cell, (ii) the thermal analysis of the components by differential scan calorimetry (DSC) method, (iii) the new electrolyte/ceramic-felt combination’s loading level, wetting properties, infiltration, and leakage, and (iv) electrochemical behavior of the new thermal battery such as discharge capability and energy density were investigated.

Pancreatobiliary Endoscopic Interventions for Pediatric Pancreatic Pathology.

Despite the increased global recognition of pediatric pancreatic diseases, there are limited data on the utility of sophisticated endoscopic procedures such as endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in their management. Promising results of recent studies have highlighted the emerging therapeutic utility of EUS and ERCP in children. With these latest developments in mind, this article reviews the current literature regarding diagnostic and therapeutic uses, benefits, limitations, and clinical outcomes of EUS and ERCP in pediatric pancreatology.

Psilocybin occasioned mystical-type experiences.

Research into psychedelic therapy models has shown promise for the treatment of specific psychiatric conditions. Mystical-type experiences occasioned by psilocybin have been correlated with therapeutic benefits and long-term improvements in positive mental outlook and attitudes. This article aims to provide an overview of the topic, highlight strengths and weaknesses in current research, generate novel perspectives and discussion, and consider future avenues for research. This narrative review was designed to summarise and assess the state of research on psilocybin occasioned mystical-type experiences and applications for the treatment of specific psychiatric conditions. Contemporary methods on the quantification of mystical-type experiences and their acute subjective effects are discussed. Recent studies provide some understanding of the pharmacological actions of psychedelics although the neurological similarities and differences between spontaneous and psychedelic mystical-type experiences are not well described. Applicability to modern clinical settings is assessed. Potential novel therapeutic applications include use in positive psychology interventions in healthy individuals. Since 2006 significant advancements in understanding the therapeutic potential of psilocybin-assisted psychotherapy have been made; however, more work is required to understand the neuromechanistic processes and applicability in modern clinical settings. Despite promising results in recent studies, funding issues for clinical trials, legal concerns and socio-cultural resistance provide a counterpoint to experimental evidence.

Effectiveness and side effects of dimethyl fumarate in multiple sclerosis after 12 months of follow up: An Iranian clinical trial

Background: Multiple sclerosis (MS) is a neurologic disorder with a considerable global burden. During the last decades, some pharmaceutical treatments have been approved for patients with MS. Dimethyl fumarate (DMF) is one of these drugs which has been reported to have early promising results in recent studies, but the efficacy of this drug in patients with MS is still being studied in different parts of the world. In the present study, we evaluated the effectiveness of DMF therapy on reducing relapses, lesions, and disability in Iranian patients with MS. Methods: The present single-arm before-after study was approved by the Ethics Committee of Mashhad University of Medical Sciences, Mashhad, Iran [Iranian Registry of Clinical Trial (IRCT) code: IRCT20190121042439N1]. Every patient who was diagnosed with relapsing MS was considered eligible to enroll in the present clinical trial. Before receiving DMF therapy, the baseline liver function tests and complete blood count were obtained from all individuals. Also, a baseline brain magnetic resonance imaging (MRI) was obtained and Expanded Disability Status Scale (EDSS) was documented from all patients. After receiving 240 mg DMF twice daily for 12 months, the laboratory and imaging measurements as well as EDSS were repeated. Furthermore, the total number of relapses within the study period was recorded. Satisfaction with DMF treatment was determined by answering a yes-no question. Results: A total number of 50 patients enrolled in the study and most of them were female (80%). There was a significant decrease in EDSS score and gadolinium (GD)-enhancing lesions after the study period (P < 0.001 for each). Moreover, the attacks significantly dropped after the study period (P < 0.001) and 86% of patients were satisfied with their treatment. Conclusion: The findings of this study showed that 240 mg DMF administered twice daily can effectively reduce disability and provide satisfaction within the first year of therapy in patients with MS.

Evaluation of Tissue-engineered Skin on Base of Human Amniotic Membrane for Wound Healing

Background:Human amniotic membranes (hAMs) have shown promising results in recent studies aimed at improving wound healing through several mechanisms. We wanted to investigate its properties as a scaffold by adding autologous cells to treat full-thickness skin defects and hypothesized that recultivated hAM would show an even improved wound healing by accelerating the epidermal closure of the wound.Methods:In an air–liquid cell culture, we cultivated autologous keratinocytes and fibroblasts on the hAM until a mostly keratinized surface was achieved. These hAM, de-epithelialized hAM, native hAM with remaining allogenous cells, and negative controls were compared in the treatment of circular 30 × 30 mm2 full-thickness skin defects in 4 groups of 6 rats with one wound each. We evaluated the wound contraction every 10 days until wound closure, the macroscopic scar appearance on the Vancouver Scar Scale and the qualitative histological properties of the scar regarding morphology and continuity of the basement membrane.Results:Rats treated with de-epithelialized hAM showed more extent wound contraction (P < 0.001) than the other 3 groups, which did not differ significantly compared with the control group (P > 0.05). Vancouver Scar Scale showed no significantly statistical differences between the 4 groups (P = 0.46). The scar structure of all rats showed similar morphologies, the only difference being the absence of a basement membrane in the negative controls compared with the groups treated with hAM.Conclusion:The rats treated with hAM showed no improved wound healing but a tendency toward a more prominent basement membrane in the resulting scar.

The Role of Tendon Transfers for Irreparable Rotator Cuff Tears.

This review aims to describe the tendon transfer options for treating irreparable rotator cuff tears (RCTs). Options for transfer include latissimus dorsi and lower trapezius transfers for posterior-superior RCTs and pectoralis major and latissimus dorsi transfer for anterior-superior RCTs. While the latissimus dorsi tendon transfer has historically been performed for posterosuperior RCTs, the lower trapezius transfer is a more anatomic option and has demonstrated promising results in recent studies. Similarly, the pectoralis major transfer has historically been the tendon transfer of choice for anterosuperior RCTs. However, the latissimus dorsi tendon transfer has recently been shown to be a safe and anatomic tendon transfer for subscapularis insufficiency. The treatment of irreparable RCTs involves complex decision making. Tendon transfer procedures can restore the glenohumeral joint force couples, allowing restoration of near-normal shoulder kinematics. Benefits include reliable pain relief, increased function, and increased strength. Proper selection of donor tendon is crucial, and the principles of tendon transfer procedures must be adhered to for maximal benefit.

[Severe cutaneous drug reactions in children].

Among severe drug reactions in children, besides Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), aspecific form of hypersensitivity syndrome which is nowadays known as "drug reaction with eosinophilia and systemic symptoms" (DRESS) has to be mentioned. Whereas SJS/TEN is considered one reaction entity of different severity, DRESS has to be distinguished from SJS/TEN but also from other severe exanthems due to multiorgan involvement. Although SJS/TEN is generally referred to as a drug reaction, only about 75% of all cases are actually caused by medications and in children it is only about 50%. After aclear diagnosis has been made, specific therapeutic measures can follow, of which withdrawal of the inducing agent plays akey role, but further treatments differ substantially. In order to identify and withdraw the inducing agent, adetailed and thorough medication history must be obtained. Highly suspected drugs of SJS/TEN in children include, among others, antibacterial sulfonamides and various antiepileptics. DRESS in children and adolescents is also frequently induced by antiepileptics, but also by sulfonamides and minocycline. In contrast to adults, allopurinol is rarely found to be culprit in both conditions. Supportive therapy including appropriate topical treatments, pain therapy, ophthalmologic consultations, etc. is the gold standard in SJS/TEN, but ashort-term immunomodulating therapy with cyclosporineA has shown very promising results in recent studies. In DRESS, however, systemic treatment with glucocorticosteroids slowly tapered over alonger period of time is recommended.

Androgen-deprivation therapy and bone loss in prostate cancer patients: a clinical review.

Androgen-deprivation therapy (ADT) has become a standard of care in the management of advanced prostate cancer or as an adjunct therapy. However, ADT is associated with a well-known deleterious effect on bone health, resulting in a decrease in bone-mass density (BMD) and increased risk for fracture. With the longer life expectancy of prostate cancer patients, improvement of the quality of life has become increasingly important. Therefore, adequate screening, prevention and treatment of BMD loss is paramount. Zoledronic acid and denosumab have shown promising results in recent studies, which has led to the Food and Drug Administration approval of these treatment options in various settings throughout the course of the disease, including the prevention of ADT-associated bone loss. This review focuses on the various parameters that impact BMD loss in men initiating ADT, on the specific effect of ADT on bone health and on various lifestyle modifications and treatment options such as bisphosphonates, osteoclast-targeted therapy and selective estrogen-receptor modulators that have shown promising results in recent studies.

Neuroblastoma in Children Under 12 Months in Singapore—15-Year Experience and Outcomes From KKH

Background: Expectant observation of small adrenal lesions has shown promising results in recent studies. We present our 15 years outcome of managing infant neuroblastoma. Methods: All patients with neuroblastoma below the age of 1 year treated at the largest pediatric hospital in Singapore between 1998 and 2012 were identified. Results: Twenty-two patients were included in our study. Six were antenatally diagnosed. Nineteen (86%) patients had surgical resection of the tumor. Eight (36%) patients received chemotherapy as part of their treatment. Six patients were observed three of which had large adrenal tumors. Median follow-up in our series was 2.6 years. The 5 year overall survival was 90%. There were no recurrences and there were 2 deaths in our series. Conclusion: Our series shows excellent outcomes of infant neuroblastoma at our center. Careful observation of large tumors may be an option to avoid the morbidity of surgery.

Histopathology of balloon-dilation Eustachian tuboplasty.

Surgical intervention of the Eustachian tube (ET) has become increasingly common in the past decade, and balloon dilation has shown promising results in recent studies. It is unclear how balloon dilation enhances ET function. Our aim was to evaluate histological changes in the ET's mucosal lumen comparing before balloon dilation, immediately after, and postoperatively. Case series. Thirteen patients with bilateral ET dysfunction were enrolled. Biopsies of the ET mucosa were obtained just before balloon dilation; immediately after; and in three cases, 5 to 12 weeks postoperatively. Specimens were retrospectively examined under light microscopy by two pathologists blinded to the clinical information and whether specimens were pre- or postballoon dilation. Preoperative biopsies were characterized by inflammatory changes within the epithelium and submucosal layer. Immediate response to balloon dilation was thinning of the mucosa, shearing of epithelium and crush injury to the submucosa, especially to lymphocytic infiltrates. Postoperative biopsies demonstrated healthy pseudocolumnar epithelium and replacement of lymphocytic infiltrate with a thinner layer of fibrous tissue. Reduction of inflammatory epithelial changes and submucosal inflammatory infiltrate appeared to be the principal result of balloon dilation. The balloon may shear or crush portions of inflamed epithelium but usually spared the basal layer, allowing for rapid healing. Additionally, it appeared to effectively crush lymphocytes and lymphocytic follicles that may become replaced with thinner fibrous scar. Histopathology of the ET undergoing balloon dilation demonstrated effects that could reduce the overall inflammatory burden and may contribute to clinical improvement in ET function. 4.

Experimental assessment of the accuracy of genomic selection in sugarcane

Sugarcane cultivars are interspecific hybrids with an aneuploid, highly heterozygous polyploid genome. The complexity of the sugarcane genome is the main obstacle to the use of marker-assisted selection in sugarcane breeding. Given the promising results of recent studies of plant genomic selection, we explored the feasibility of genomic selection in this complex polyploid crop. Genetic values were predicted in two independent panels, each composed of 167 accessions representing sugarcane genetic diversity worldwide. Accessions were genotyped with 1,499 DArT markers. One panel was phenotyped in Reunion Island and the other in Guadeloupe. Ten traits concerning sugar and bagasse contents, digestibility and composition of the bagasse, plant morphology, and disease resistance were used. We used four statistical predictive models: bayesian LASSO, ridge regression, reproducing kernel Hilbert space, and partial least square regression. The accuracy of the predictions was assessed through the correlation between observed and predicted genetic values by cross validation within each panel and between the two panels. We observed equivalent accuracy among the four predictive models for a given trait, and marked differences were observed among traits. Depending on the trait concerned, within-panel cross validation yielded median correlations ranging from 0.29 to 0.62 in the Reunion Island panel and from 0.11 to 0.5 in the Guadeloupe panel. Cross validation between panels yielded correlations ranging from 0.13 for smut resistance to 0.55 for brix. This level of correlations is promising for future implementations. Our results provide the first validation of genomic selection in sugarcane.

Anticoagulant Therapy in Very Old Patients

Older patients are less likely than younger patients to receive anticoagulation and are more likely to be underanticoagulated. Although the use of warfarin in the elderly has been increasing, fewer than half of eligible patients take warfarin. Evidence suggests that stroke recurrence in patients on oral anticoagulation is mainly ischemic, and hemorrhagic complications that derive from oral anticoagulation would be related to overdosing. Several risk factors for developing hemorrhagic complications have been described, and clinical criteria have been designed to help clinicians in decision-making concerning the start of anticoagulation treatment. Finally, given the promising results of recent studies on new anticoagulant drugs, it is possible that vitamin K antagonists will be replaced in the coming years.