Riviste scientifiche

Dwarf planet Ceres has a water cycle but it’s not like Earth’s

New Scientist - Me, 14/03/2018 - 19:00
Ceres, a distant dwarf planet, hosts sheets of ice just under its surface. In the summer, some of this ice may sublimate and coat shadowy crater walls in frost

AI drones are controlling self-driving diggers on building sites

New Scientist - Me, 14/03/2018 - 16:15
At thousands of sites around Japan, drones are learning to direct autonomous trucks from above – heralding a revolution in the construction industry

A quarter of people have bad reactions to fragranced products

New Scientist - Me, 14/03/2018 - 13:35
Growing numbers of people say they get asthma, migraines or skin problems when they’re exposed to chemicals in products like deodorants and air fresheners

Ten connected miniature organs are best human-on-a-chip yet

New Scientist - Me, 14/03/2018 - 11:00
Ten miniature organs have been connected together to create the closest we’ve come yet to a human-on-a-chip – a system that may one day replace animal testing

A brief history of Stephen Hawking: A legacy of paradox

New Scientist - Me, 14/03/2018 - 10:44
He was an icon for many reasons, but as we remember Stephen Hawking, his remarkable contribution to science is undoubtedly his greatest legacy

Stephen Hawking: Tributes pour in as physicist dies aged 76

New Scientist - Me, 14/03/2018 - 10:43
World-famous theoretical physicist Stephen Hawking died on Wednesday morning, and tributes are flowing in

The importance and challenges of shared decision making in older people with multimorbidity

PLoS Medicine - Ma, 13/03/2018 - 22:00

by Tammy Hoffmann, Jesse Jansen, Paul Glasziou

In a Perspective, Tammy Hoffmann and colleagues discuss medical decision making for elderly patients with multimorbidity.

A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AF study)

PLoS Medicine - Ma, 13/03/2018 - 22:00

by Lars O. Karlsson, Staffan Nilsson, Magnus Bång, Lennart Nilsson, Emmanouil Charitakis, Magnus Janzon


Atrial fibrillation (AF) is associated with substantial morbidity, in particular stroke. Despite good evidence for the reduction of stroke risk with anticoagulant therapy, there remains significant undertreatment. The main aim of the current study was to investigate whether a clinical decision support tool (CDS) for stroke prevention integrated in the electronic health record could improve adherence to guidelines for stroke prevention in patients with AF.

Methods and findings

We conducted a cluster-randomized trial where all 43 primary care clinics in the county of Östergötland, Sweden (population 444,347), were randomized to be part of the CDS intervention or to serve as controls. The CDS produced an alert for physicians responsible for patients with AF and at increased risk for thromboembolism (according to the CHA2DS2-VASc algorithm) without anticoagulant therapy. The primary endpoint was adherence to guidelines after 1 year. After randomization, there were 22 and 21 primary care clinics in the CDS and control groups, respectively. There were no significant differences in baseline adherence to guidelines regarding anticoagulant therapy between the 2 groups (CDS group 70.3% [5,186/7,370; 95% CI 62.9%–77.7%], control group 70.0% [4,187/6,009; 95% CI 60.4%–79.6%], p = 0.83). After 12 months, analysis with linear regression with adjustment for primary care clinic size and adherence to guidelines at baseline revealed a significant increase in guideline adherence in the CDS (73.0%, 95% CI 64.6%–81.4%) versus the control group (71.2%, 95% CI 60.8%–81.6%, p = 0.013, with a treatment effect estimate of 0.016 [95% CI 0.003–0.028]; number of patients with AF included in the final analysis 8,292 and 6,508 in the CDS and control group, respectively). Over the study period, there was no difference in the incidence of stroke, transient ischemic attack, or systemic thromboembolism in the CDS group versus the control group (49 [95% CI 43–55] per 1,000 patients with AF in the CDS group compared to 47 [95% CI 39–55] per 1,000 patients with AF in the control group, p = 0.64). Regarding safety, the CDS group had a lower incidence of significant bleeding, with events in 12 (95% CI 9–15) per 1,000 patients with AF compared to 16 (95% CI 12–20) per 1,000 patients with AF in the control group (p = 0.04). Limitations of the study design include that the analysis was carried out in a catchment area with a high baseline adherence rate, and issues regarding reproducibility to other regions.


The present study demonstrates that a CDS can increase guideline adherence for anticoagulant therapy in patients with AF. Even though the observed difference was small, this is the first randomized study to our knowledge indicating beneficial effects with a CDS in patients with AF.

Trial registration

ClinicalTrials.gov NCT02635685

Validation of a genetic risk score for atrial fibrillation: A prospective multicenter cohort study

PLoS Medicine - Ma, 13/03/2018 - 22:00

by Evan D. Muse, Nathan E. Wineinger, Emily G. Spencer, Melissa Peters, Riley Henderson, Yunyue Zhang, Paddy M. Barrett, Steven P. Rivera, Jay G. Wohlgemuth, James J. Devlin, Dov Shiffman, Eric J. Topol


Atrial fibrillation (AF) is the most commonly encountered arrhythmia and is associated with an elevated risk of stroke. Improving the identification of patients with the highest risk for AF to enable appropriate surveillance and treatment, if necessary, is critical to reducing AF-associated morbidity and mortality. Multiple common single nucleotide polymorphisms (SNPs) are unequivocally associated with the lifetime risk of AF. In the current study we aimed to prospectively validate an AF genetic risk score (GRS) in previously undiagnosed patients at risk for AF.

Methods and findings

Individuals 40 years of age or older with 1 clinical risk factor for AF, presenting with symptoms of AF, or with a first diagnosis of AF, were enrolled for genetic testing and ambulatory cardiac rhythm monitoring with an adhesive patch monitor or a long-term Holter monitor (mean wear time 10 days 21 hours and 13 days 18 hours, respectively). An AF event was the first diagnosis of AF by ECG, patch monitor, or long-term Holter monitor. The AF GRS was determined for each participant based on the weighted contribution of 12 genetic risk loci. Of 904 participants, 85 manifested AF. Their mean age was 66.2 (SD 11.8) years; 38% of participants were male. Participants in the highest quintile of AF GRS were more likely (odds ratio 3.11; 95% CI 1.27–7.58; p = 0.01) to have had an AF event than participants in the lowest quintile after adjusting for age, sex, smoking status, BMI, hypertension, diabetes mellitus, heart failure, and prior myocardial infarction. Study limitations included an ethnically homogenous population, a restricted rhythm monitoring period, and the evolving discovery of SNPs associated with AF.


Prospective assessment of a GRS for AF identified participants with elevated risk of AF beyond established clinical criteria. Accordingly, a GRS for AF could be incorporated into overall risk assessment to better identify patients at the highest risk of developing AF, although further testing in larger populations is needed to confirm these findings.

Trial registration

ClinicalTrials.gov NCT01970969

Progression of diabetes, heart disease, and stroke multimorbidity in middle-aged women: A 20-year cohort study

PLoS Medicine - Ma, 13/03/2018 - 22:00

by Xiaolin Xu, Gita D. Mishra, Annette J. Dobson, Mark Jones


The prevalence of diabetes, heart disease, and stroke multimorbidity (co-occurrence of two or three of these conditions) has increased rapidly. Little is known about how the three conditions progress from one to another sequentially through the life course. We aimed to delineate this progression in middle-aged women and to determine the roles of common risk factors in the accumulation of diabetes, heart disease, and stroke multimorbidity.

Methods and findings

We used data from 13,714 women aged 45–50 years without a history of any of the three conditions. They were participants in the Australian Longitudinal Study on Women's Health (ALSWH), enrolled in 1996, and surveyed approximately every 3 years to 2016. We characterized the longitudinal progression of the three conditions and multimorbidity. We estimated the accumulation of multimorbidity over 20 years of follow-up and investigated their association with both baseline and time-varying predictors (sociodemographic factors, lifestyle factors, and other chronic conditions).Over 20 years, 2,511 (18.3%) of the women progressed to at least one condition, of whom 1,420 (56.6%) had diabetes, 1,277 (50.9%) had heart disease, and 308 (12.3%) had stroke; 423 (16.8%) had two or three of these conditions. Over a 3-year period, the age-adjusted odds of two or more conditions was approximately twice that of developing one new condition compared to women who did not develop any new conditions. For example, the odds for developing one new condition between Surveys 7 and 8 were 2.29 (95% confidence interval [CI], 1.93–2.72), whereas the odds for developing two or more conditions was 6.51 (95% CI, 3.95–10.75). The onset of stroke was more strongly associated with the progression to the other conditions (i.e., 23.4% [95% CI, 16.3%–32.2%] of women after first onset of stroke progressed to other conditions, whereas the percentages for diabetes and heart disease were 9.9% [95% CI, 7.9%–12.4%] and 11.4% [95% CI, 9.1%–14.4%], respectively). Being separated, divorced, or widowed; being born outside Australia; having difficulty managing on their available income; being overweight or obese; having hypertension; being physically inactive; being a current smoker; and having prior chronic conditions (i.e., mental disorders, asthma, cancer, osteoporosis, and arthritis) were significantly associated with increased odds of accumulation of diabetes, heart disease, and stroke multimorbidity. The main limitations of this study were the use of self-reported data and the low number of events.


Stroke was associated with increased risk of progression to diabetes or heart disease. Social inequality, obesity, hypertension, physical inactivity, smoking, or having other chronic conditions were also significantly associated with increased odds of accumulating multimorbidity. Our findings highlight the importance of awareness of the role of diabetes, heart disease, and stroke multimorbidity among middle-aged women for clinicians and health-promotion agencies.

Malfunctioning fertility clinic tanks may put eggs at risk

New Scientist - Ma, 13/03/2018 - 17:55
Thousands of frozen eggs and embryos may have been damaged after temperatures rose in two malfunctioning tanks at fertility clinics in California and Ohio

Weird crystals could grow on Titan and help alien life thrive

New Scientist - Ma, 13/03/2018 - 17:28
The surface of Saturn’s largest moon Titan might be covered, salt-like crystals that could be among the ingredients for nitrogen-based alien life

Dinobird Archaeopteryx only flew in short bursts like a pheasant

New Scientist - Ma, 13/03/2018 - 17:00
The bird-like dinosaur Archaeopteryx could flap its wings to fly, but only for short bursts – like a modern pheasant flapping to escape danger

The sun’s mysteriously hot corona may be due to invisible plasma

New Scientist - Ma, 13/03/2018 - 16:29
The surface of Saturn's largest moon Titan might be covered in salt-like crystals that could be among the ingredients for nitrogen-based microbes

Polar melt may shut down the Atlantic current that warms Europe

New Scientist - Ma, 13/03/2018 - 16:20
Melting Arctic ice flooding into the Atlantic could put the ocean circulation that warms Europe in danger, triggering dramatic sea-level rise and drought

Chemistry bots collude on Twitter to speed up their experiments

New Scientist - Ma, 13/03/2018 - 12:50
Communicating on social media has allowed a pair of robots to conduct chemistry experiments together and get faster results

US climate report warns nation will lose out if it doesn’t act

New Scientist - Ma, 13/03/2018 - 12:20
A draft of a US government report argues that the country could reap huge economic and health benefits by cutting greenhouse gas emissions

What are Novichok nerve agents and did Russia do it?

New Scientist - Ma, 13/03/2018 - 10:43
The poison used to target ex-Russian spy Sergei Skripal and his daughter was a Novichok nerve agent, UK prime minister Theresa May revealed yesterday

We’ve just spotted the brightest mystery radio burst from space

New Scientist - Lu, 12/03/2018 - 21:16
Fast radio bursts are some of the weirdest, most elusive phenomena in the cosmos. We just found three new ones, one of which is the brightest we’ve ever seen

Psychopaths pay less attention to what other people are thinking

New Scientist - Lu, 12/03/2018 - 20:00
Psychopaths in films and TV are often masters of manipulation, but in real life they’re not so good at subconsciously registering other people’s perspectives
Condividi contenuti