Paragon

Variation in tropical forest management directly affects biodiversity and provisioning of ecosystem services on a global scale, thus it is necessary to compare forests under different conservation approaches such as protected areas, payments for ecosystem services programs (PES), and ecotourism, as well as forests lacking any formal conservation plan. To examine the effectiveness of specific conservation approaches, we examined differences in forest structure and tree recruitment, including canopy cover; canopy height; seedling, sapling, and adult tree density; and average and total diameter at breast height (DBH) across 78 plots in 18 forests across Costa Rica representing protected areas, private forests utilizing PES and/or ecotourism, and private forests not utilizing these economic incentives...

In this research, we propose a novel approach for constructing a sensitive and selective electrochemical sensor utilizing high-quality multi-walled carbon nanotubes functionalized with amino groups (MWCNT-NH2 ) for the detection of Talazoparib (TLZ), a poly (ADP-ribose) polymerase (PARP) enzyme inhibitor, in real samples. The MWCNT-NH2 -based sensor exhibited remarkable performance characteristics, including excellent repeatability, reproducibility, and high selectivity against various interferences. Under optimized conditions, the sensor demonstrated a wide linear concentration range of 1...

BACKGROUND: Data on the occurrence times of multiple outcomes, reflecting the temporal profile of disease burden/progression, have been used to estimate treatment effects in various recent randomized trials. Most procedures for analyzing these data require specific model assumptions. When the assumptions are not met, the results may be misleading. Robust, model-free procedures for study design and analysis that enable clinically meaningful interpretations are warranted. METHODS: For each treatment group, we constructed and summarized the estimated mean cumulative count of events over time by the area under the curve (AUC), which can be interpreted as the mean total event-free time lost from multiple undesirable outcomes...

PREMISE: The HybPiper pipeline has become one of the most widely used tools for the assembly of target capture data for phylogenomic analysis. After the production of locus sequences and before phylogenetic analysis, the identification of paralogs is a critical step for ensuring the accurate inference of evolutionary relationships. Algorithmic approaches using gene tree topologies for the inference of ortholog groups are computationally efficient and broadly applicable to non-model organisms, especially in the absence of a known species tree...

The prevalence of heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of the total heart failure population, and with the aging of the population and the increasing prevalence of hypertension, obesity, and type 2 diabetes (T2DM), the incidence of HFpEF continues to rise and has become the most common subtype of heart failure. Compared with heart failure with reduced ejection fraction, HFpEF has a more complex pathophysiology and is more often associated with hypertension, T2DM, obesity, atrial fibrillation, renal insufficiency, pulmonary hypertension, obstructive sleep apnea, and other comorbidities...

Pivotal outcome trials targeting heart failure with preserved (HFpEF) and mildly-reduced ejection fraction (HFmrEF) may have excluded patients at highest risk of poor outcomes. We aimed to assess eligibility for HFpEF/HFmrEF outcome trials in an unselected heart failure cohort and its association with all-cause mortality. Among 32.028 patients presenting to a tertiary care center emergency unit for any reason between August 2018 and July 2019, we identified 407 admissions with evident HFpEF and HFmrEF. Eligibility criteria for pivotal trials CHARM-Preserved, I-PRESERVE, TOPCAT, PARAGON-HF, EMPEROR-Preserved and DELIVER were assessed by chart review...

Coronavirus disease-2019 (COVID-19) emerged in the last months of 2019 and caused a pandemic effecting the whole world. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19 has changed by various mutations since the day it was first identified, causing the pandemic to continue. Age, male gender, obesity, and comorbidity, which are general risk factors for COVID-19, can also cause prolonged PCR positivity. In this report, a case of 37-year-old male who is working in the hospital's COVID-19 molecular diagnostics laboratory was presented...

INTRODUCTION: While many professional associations within clinical and counseling psychology have made an aspirational call for clinician awareness of social position, there is a lack of research into how socially-conferred privilege impacts psychotherapy. Specifically of interest is the differences in race and gender within the therapeutic dyad, in which there is a BIPOC (Black, Indigenous, and Persons of Color)/white or male/female-identified dynamic. METHOD: The authors utilized a Grounded Theory approach to analyze qualitative interviews with practicing psychologists to construct a process model regarding how socially-conferred privileged identity domains impact the therapeutic relationship and the participants' professionalization process...

Background PARAGON-HF (Efficacy and Safety of LCZ696 Compared to Valsartan, on Morbidity and Mortality in Heart Failure Patients With Preserved Ejection Fraction) suggested a potential benefit of sacubitril-valsartan in women with preserved ejection fraction. Among patients with heart failure previously treated with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), we studied whether effectiveness of treatment with sacubitril-valsartan compared with ACEI/ARB monotherapy differed between men and women for both preserved and reduced ejection fraction...

BACKGROUND: Anemia is common in patients with heart failure with reduced ejection fraction and is associated with poor clinical outcomes. Renin-angiotensin system blockers lower hemoglobin and may induce anemia. OBJECTIVES: The authors investigated whether concomitant neprilysin inhibition might ameliorate this effect of renin-angiotensin system blockers in PARADIGM-HF (Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure)...

BACKGROUND: Patients with heart failure (HF) often suffer from a range of comorbidities, which may affect their health status. OBJECTIVES: To assess the impact of different comorbidities on health status in patients with HF and reduced and preserved ejection fraction (HFrEF and HFpEF). METHODS: Using individual patient data from HFrEF (ATMOSPHERE, PARADIGM-HF, DAPA-HF) and HFpEF (TOPCAT, PARAGON-HF) trials, we examined the Kansas City Cardiomyopathy Questionnaire (KCCQ) domain scores and Overall Summary Score (KCCQ-OSS) across a range of cardio-respiratory (angina, AF, stroke, COPD) and other comorbidities (obesity, DM, CKD, anaemia)...

BACKGROUND: The rate of stroke in patients with heart failure (HF) and preserved ejection fraction but without atrial fibrillation (AF), is uncertain as is whether it is possible to reliably predict the risk of stroke in these patients. METHODS: We validated a previously developed simple risk model for stroke among patients enrolled in the I-Preserve trial (Irbesartan in Heart Failure With Preserved Systolic Function) and PARAGON-HF trial (Efficacy and Safety of LCZ696 Compared to Valsartan, on Morbidity and Mortality in Heart Failure Patients With Preserved Ejection Fraction)...

The Poynting effect is a paragon of nonlinear soft matter mechanics. It is the tendency (found in all incompressible, isotropic, hyperelastic solids) exhibited by a soft block to expand vertically when sheared horizontally. It can be observed whenever the length of the cuboid is at least four times its thickness. Here we show that the Poynting effect can be easily reversed and the cuboid can shrink vertically, simply by reducing this aspect ratio. In principle, this discovery means that for a given solid, say one used as a seismic wave absorber under a building, an optimal ratio exists where vertical displacements and vibrations can be completely eliminated...

To prevent yield losses caused by climate change, it is important to identify naturally tolerant genotypes with traits and related pathways that can be targeted for crop improvement. Here we report on the characterization of contrasting vegetative heat tolerance in two UK bread wheat varieties. Under chronic heat stress, the heat-tolerant cultivar Cadenza produced an excessive number of tillers which translated into more spikes and higher grain yield compared to heat-sensitive Paragon. RNAseq and metabolomics analyses revealed that over 5000 genotype-specific genes were differentially expressed, including photosynthesis-related genes, which might explain the observed ability of Cadenza to maintain photosynthetic rate under heat stress...

BACKGROUND: Limited data exist to characterize novel measures of right ventricular (RV) function and the coupling to pulmonary circulation in patients with heart failure and preserved left ventricular ejection fraction (HFpEF). OBJECTIVES: This study sought to assess the clinical implications of RV function, the association with N-terminal pro-B-type natriuretic peptide, and the risk for adverse events among patients with HFpEF. METHODS: This study analyzed measures of RV function by assessing absolute RV free wall longitudinal strain (RVFWLS) and its ratio to estimated pulmonary artery systolic pressure (PASP) (RVFWLS/PASP ratio) in 528 patients (mean age 74 ± 8 years, 56% female) with adequate echocardiographic images quality enrolled in the PARAGON-HF trial...

AIMS: In this post hoc analysis of the PARAGON-HF trial, we evaluated clinical outcomes and response to sacubitril/valsartan by duration of heart failure (HF) with left ventricular ejection fraction ≥45% from initial diagnosis. METHODS AND RESULTS: The primary outcome was a composite of total HF hospitalizations and cardiovascular death, analyzed using a semiparametric proportional rates method, stratified by geographic region. Among 4,784 (99.7%) randomized PARAGON-HF participants for whom baseline HF duration was captured, 1,359 (28%) had a HF duration of <6 months, 1,295 (27%) 6 months-2 years, and 2,130 (45%) >2 years...

AIMS: The PARAGLIDE-HF trial demonstrated reductions in natriuretic peptides with sacubitril/valsartan compared with valsartan in patients with heart failure (HF) with mildly reduced or preserved ejection fraction who had a recent worsening HF event, but was not adequately powered to examine clinical outcomes. PARAGON-HF included a subset of PARAGLIDE-HF-like patients who were recently hospitalized for HF. Participant-level data from PARAGLIDE-HF and PARAGON-HF were pooled to better estimate the efficacy and safety of sacubitril/valsartan in reducing cardiovascular and renal events in HF with mildly reduced or preserved ejection fraction...

OBJECTIVE: To estimate the original corneal curvature after orthokeratology by applying a machine learning-based algorithm. METHODS: A total of 497 right eyes of 497 patients undergoing overnight orthokeratology for myopia for more than 1 year were enrolled in this retrospective study. All patients were fitted with lenses from Paragon CRT. Corneal topography was obtained by a Sirius corneal topography system (CSO, Italy). Original flat K (K1) and original steep K (K2) were set as the targets of calculation...

DNA-editing enzymes perform chemical reactions on DNA nucleobases. These reactions can change the genetic identity of the modified base or modulate gene expression. Interest in DNA-editing enzymes has burgeoned in recent years due to the advent of clustered regularly interspaced short palindromic repeat-associated (CRISPR-Cas) systems, which can be used to direct their DNA-editing activity to specific genomic loci of interest. In this review, we showcase DNA-editing enzymes that have been repurposed or redesigned and developed into programmable base editors...

AIMS: Heart failure (HF) therapy trials usually exclude cancer patients. We examined the association between cancer history and outcomes in trial participants with HF and reduced (HFrEF) or preserved ejection fraction (HFpEF). METHODS AND RESULTS: We combined PARADIGM-HF and ATMOSPHERE, which enrolled HFrEF patients (n = 15 415) and we pooled HFpEF patients (ejection fraction ≥45%) enrolled in PARAGON-HF and CHARM-Preserved (n = 7363)...