| 1. |
- Solomon, S. D., et al.
(författare)
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Effect of candesartan on cause-specific mortality in heart failure patients: the Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) program
- 2004
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Ingår i: Circulation. - 1524-4539. ; 110:15, s. 2180-3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with heart failure are at increased risk of sudden death and death attributed to progressive pump failure. We assessed the effect of candesartan on cause-specific mortality in patients enrolled in the Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) program. METHODS AND RESULTS: The CHARM program consisted of 3 component trials that enrolled patients with symptomatic heart failure: CHARM-Alternative (n=2028; LVEF<=40% [corrected] and ACE intolerant), CHARM-Added (n=2548; LVEF<=40%, [corrected] already on ACE inhibitors), and CHARM-Preserved (n=3023; LVEF >40%). Patients were randomized to candesartan, titrated to 32 mg QD, or placebo and were followed up for a median of 37.7 months. All deaths were reviewed by a blinded adjudication committee and categorized according to prespecified definitions on the basis of a narrative and source documentation. The number and rate of deaths by cause were calculated for each of the component trials and the overall program. Of all the patients, 8.5% died suddenly, and 6.2% died of progressive heart failure. Candesartan reduced both sudden death (HR 0.85 [0.73 to 0.99], P=0.036) and death from worsening heart failure (HR 0.78 [0.65 to 0.94], P=0.008). These reductions were most apparent in the patients with LVEF<=40% [corrected]. CONCLUSIONS: Candesartan reduced sudden death and death from worsening heart failure in patients with symptomatic heart failure, although this reduction was most apparent in patients with systolic dysfunction.
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| 2. |
- Young, J. B., et al.
(författare)
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Mortality and morbidity reduction with Candesartan in patients with chronic heart failure and left ventricular systolic dysfunction: results of the CHARM low-left ventricular ejection fraction trials
- 2004
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Ingår i: Circulation. - 1524-4539. ; 110:17, s. 2618-26
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with symptomatic chronic heart failure (CHF) and reduced left ventricular ejection fraction (LVEF) have a high risk of death and hospitalization for CHF deterioration despite therapies with angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and even an aldosterone antagonist. To determine whether the angiotensin-receptor blocker (ARB) candesartan decreases cardiovascular mortality, morbidity, and all-cause mortality in patients with CHF and depressed LVEF, a prespecified analysis of the combined Candesartan in Heart Failure Assessment of Reduction in Mortality and morbidity (CHARM) low LVEF trials was performed. CHARM is a randomized, double-blind, placebo-controlled, multicenter, international trial program. METHODS AND RESULTS: New York Heart Association (NYHA) class II through IV CHF patients with an LVEF of < or =40% were randomized to candesartan or placebo in 2 complementary parallel trials (CHARM-Alternative, for patients who cannot tolerate ACE inhibitors, and CHARM-Added, for patients who were receiving ACE inhibitors). Mortality and morbidity were determined in 4576 low LVEF patients (2289 candesartan and 2287 placebo), titrated as tolerated to a target dose of 32 mg once daily, and observed for 2 to 4 years (median, 40 months). The primary outcome (time to first event by intention to treat) was cardiovascular death or CHF hospitalization for each trial, with all-cause mortality a secondary end point in the pooled analysis of the low LVEF trials. Of the patients in the candesartan group, 817 (35.7%) experienced cardiovascular death or a CHF hospitalization as compared with 944 (41.3%) in the placebo group (HR 0.82; 95% CI 0.74 to 0.90; P<0.001) with reduced risk for both cardiovascular deaths (521 [22.8%] versus 599 [26.2%]; HR 0.84 [95% CI 0.75 to 0.95]; P=0.005) and CHF hospitalizations (516 [22.5%] versus 642 [28.1%]; HR 0.76 [95% CI 0.68 to 0.85]; P<0.001). It is important to note that all-cause mortality also was significantly reduced by candesartan (642 [28.0%] versus 708 [31.0%]; HR 0.88 [95% CI 0.79 to 0.98]; P=0.018). No significant heterogeneity for the beneficial effects of candesartan was found across prespecified and subsequently identified subgroups including treatment with ACE inhibitors, beta-blockers, an aldosterone antagonist, or their combinations. The study drug was discontinued because of adverse effects by 23.1% of patients in the candesartan group and 18.8% in the placebo group; the reasons included increased creatinine (7.1% versus 3.5%), hypotension (4.2% versus 2.1%), and hyperkalemia (2.8% versus 0.5%), respectively (all P<0.001). CONCLUSIONS: Candesartan significantly reduces all-cause mortality, cardiovascular death, and heart failure hospitalizations in patients with CHF and LVEF < or =40% when added to standard therapies including ACE inhibitors, beta-blockers, and an aldosterone antagonist. Routine monitoring of blood pressure, serum creatinine, and serum potassium is warranted.
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| 3. |
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| 4. |
- O'Meara, E., et al.
(författare)
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Effect of candesartan on New York Heart Association functional class. Results of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme
- 2004
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 0195-668X. ; 25:21, s. 1920-6
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To evaluate the effect of the angiotensin receptor blocker candesartan on New York Heart Association (NYHA) functional class in a broad spectrum of patients with chronic heart failure (CHF). METHODS AND RESULTS: Patients in the CHARM Programme with symptomatic CHF were randomized to placebo (n=3796) or candesartan (n=3803) and followed for a median of 38 months. NYHA class was assessed at baseline, at two weekly intervals during dose titration and 4 monthly thereafter. Patients were classified as "better", "unchanged" or "worse" at the end of the study compared to baseline. Both a simple "last visit carried forward" (LVCF) analysis and "worst rank carried forward" (WRCF) analysis (where patients who died were allocated NYHA class V) were used. In the LVCF analysis, compared to placebo, more candesartan patients improved (35.4% versus 32.5%) and fewer worsened (9.0% versus 10.3%) in NYHA class (p=0.003). The WRCF analysis also showed a better overall change in NYHA class with candesartan compared to placebo. There was no heterogeneity in the response to candesartan between the CHARM component trials. CONCLUSIONS: Candesartan improves NYHA functional class to a similar extent to other proven treatments for CHF when added to these other treatments.
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| 5. |
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| 6. |
- Cardona, R., et al.
(författare)
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High-spin structure of normal-deformed bands in 84Zr
- 2003
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Ingår i: Physical Review C - Nuclear Physics. - 0556-2813. ; 68, s. 1-024303
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Tidskriftsartikel (refereegranskat)abstract
- The reaction 58Ni(32S, α2p) at E lab= 135 MeV was used to populate high-spin states in 84Zr. The complete GAMMASPHERE and MICROBALL arrays were used to obtain clean γ- γ- γ line shapes to be analyzed by the Doppler shift attenuation method and to determine 27 lifetimes in the ground-state band and in two excited bands. Side-feeding times were also measured by comparing the line shapes gated with transitions above and below the state under study. The deduced electric quadrupole moments for the ground-state band are consistent with a very slow reduction with frequency with values ranging between 2.4(3) and 2.0(1)e b. The negative-parity bands feature also an approximate constancy of quadrupole moment with values similar to those in the ground-state band. Cranking calculations agree with this behavior in both parity bands and suggest an interpretation of the upper states in the ground-state band as part of a very slowly terminating band. Shell-dependent cranked Nilsson calculations explain a fourth γ cascade as pertaining to a noncollective structure terminating at I = 20+.
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| 7. |
- Döring, J., et al.
(författare)
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Band terminations in the valence space of 86Zr
- 2000
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Ingår i: Physical Review C - Nuclear Physics. - 0556-2813. ; 61:3, s. 343101-343106
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Tidskriftsartikel (refereegranskat)abstract
- High-spin states in 86Zr up to 30+ and 27- were observed via the 58Ni(32S,4p) reaction at 135 MeV beam energy using the combined GAMMASPHERE and MICROBALL systems. Calculations performed with the configuration-dependent shell-correction approach show that these states are built from six g9/2 neutrons and at most four protons excited from the p1/2,p3/2,f5/2 subshells to the g9/2 subshell at small deformation. The highest observed states at 27- and 30+ are interpreted as band-terminating states with the latter having the highest spin available in the valence space for 86Zr.
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| 8. |
- Hara, N., et al.
(författare)
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An emerging view of scientific collaboration : Scientists' perspectives on factors that impact collaboration
- 2003
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Ingår i: Journal of the American Society of Information Science and Technology. ; 54:10, s. 952-
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Tidskriftsartikel (refereegranskat)abstract
- Collaboration is often a critical component in today's research that is dominated by complex problems, rapidly changing technology, dynamic growth of information and highly specialized areas of expertise. An individual scientist can seldom provide all of the expertise and resources necessary to address complex research problems. This paper describes collaboration among a group of scientists and discusses how their experiences are socially shaped. The scientists were members of a newly formed distributed, multi-disciplinary academic research center that was organized into four multi-disciplinary research groups. Each group had 14 to 34 members, including faculty, postdoctoral fellows and students, at four geographically dispersed universities. To investigate challenges that emerge in establishing scientific collaboration, data were collected about members' previous and current collaborative experiences, perceptions regarding collaboration, and work practices during the center's first year of operation. Interviews with members of one group and a center-wide sociometric survey were conducted. Data analysis has led to the development of a proposed framework that identifies multiple forms, or types, of collaboration that emerge among scientists (e.g., complementary and integrative collaboration) and their associated factors including personal compatibility, interrelationship of work, incentives and infrastructure. These results may help inform social and organizational practices needed to establish collaboration in distributed, multi-disciplinary research centers.
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| 9. |
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| 10. |
- Wiedeking, M., et al.
(författare)
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Transition strengths and band terminations in 86Zr
- 2003
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Ingår i: Physical Review C - Nuclear Physics. - 0556-2813. ; 67, s. 1-034320
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Tidskriftsartikel (refereegranskat)abstract
- High angular momentum states in 86Zr were populated through the 58Ni(32S,4p) reaction at 135 MeV using the 88-In. Cyclotron at Lawrence Berkeley National Laboratory. Recoiling 86Zr nuclei were stopped in a thick Ta backing. Prompt multi-γ coincidences with evaporated charged particles were detected using the full array of GAMMASPHERE and the MICROBALL. Mean lifetimes of 36 levels in 86Zr were measured using the Doppler-shift attenuation method. Transition quadrupole moments Qt were found in the range of about 0.3-1.5 e b in the positive-parity bands. The negative-parity bands show Qt values from about 0.25 to 1.2 e b. In the yrast positive-parity band, a sharp drop in collectivity approaching the 30+ state supports the interpretation of band termination in this configuration. Decreasing Qt values approaching the 24+ and 27- states also provide an indication of terminating structures.
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