First generation versus second generation drug-eluting stents for the treatment of bifurcations: 5-year follow-up of the LEADERS all-comers randomized trial.

BACKGROUND Historically, percutaneous coronary intervention (PCI) of bifurcation lesions was associated with worse procedural and clinical outcomes when compared with PCI of non-bifurcation lesions. Newer generation drug-eluting stents (DES) might improve long-term clinical outcomes after bifurcation PCI. METHODS AND RESULTS The LEADERS trial was a 10-center, assessor-blind, non-inferiority, all-comers trial, randomizing 1,707 patients to treatment with a biolimus A9(TM) -eluting stent (BES) with an abluminal biodegradable polymer or a sirolimus-eluting stent (SES) with a durable polymer (ClinicalTrials.gov Identifier: NCT00389220). Five-year clinical outcomes were compared between patients with and without bifurcation lesions and between BES and SES in the bifurcation lesion subgroup. There were 497 (29%) patients with at least 1 bifurcation lesion (BES = 258; SES = 239). At 5-year follow-up, the composite endpoint of cardiac death, myocardial infarction (MI) and clinically-indicated (CI) target vessel revascularization (TVR) was observed more frequently in the bifurcation group (26.6% vs. 22.4%, P = 0.049). Within the bifurcation lesion subgroup, no differences were observed in (cardiac) death or MI rates between BES and SES. However, CI target lesion revascularization (TLR) (10.1% vs. 15.9%, P = 0.0495), and CI TVR (12.0% vs. 19.2%, P = 0.023) rates were significantly lower in the BES group. Definite/probable stent thrombosis (ST) rate was numerically lower in the BES group (3.1% vs. 5.9%, P = 0.15). Very late (>1 year) definite/probable ST rates trended to be lower with BES (0.4% vs. 3.1%, P = 0.057). CONCLUSIONS In the treatment of bifurcation lesions, use of BES led to superior long-term efficacy compared with SES. Safety outcomes were comparable between BES and SES, with an observed trend toward a lower rate of very late definite/probable ST between 1 and 5 years with the BES. © 2015 Wiley Periodicals, Inc.

Future water quality monitoring--adapting tools to deal with mixtures of pollutants in water resource management.

Environmental quality monitoring of water resources is challenged with providing the basis for safeguarding the environment against adverse biological effects of anthropogenic chemical contamination from diffuse and point sources. While current regulatory efforts focus on monitoring and assessing a few legacy chemicals, many more anthropogenic chemicals can be detected simultaneously in our aquatic resources. However, exposure to chemical mixtures does not necessarily translate into adverse biological effects nor clearly shows whether mitigation measures are needed. Thus, the question which mixtures are present and which have associated combined effects becomes central for defining adequate monitoring and assessment strategies. Here we describe the vision of the international, EU-funded project SOLUTIONS, where three routes are explored to link the occurrence of chemical mixtures at specific sites to the assessment of adverse biological combination effects. First of all, multi-residue target and non-target screening techniques covering a broader range of anticipated chemicals co-occurring in the environment are being developed. By improving sensitivity and detection limits for known bioactive compounds of concern, new analytical chemistry data for multiple components can be obtained and used to characterise priority mixtures. This information on chemical occurrence will be used to predict mixture toxicity and to derive combined effect estimates suitable for advancing environmental quality standards. Secondly, bioanalytical tools will be explored to provide aggregate bioactivity measures integrating all components that produce common (adverse) outcomes even for mixtures of varying compositions. The ambition is to provide comprehensive arrays of effect-based tools and trait-based field observations that link multiple chemical exposures to various environmental protection goals more directly and to provide improved in situ observations for impact assessment of mixtures. Thirdly, effect-directed analysis (EDA) will be applied to identify major drivers of mixture toxicity. Refinements of EDA include the use of statistical approaches with monitoring information for guidance of experimental EDA studies. These three approaches will be explored using case studies at the Danube and Rhine river basins as well as rivers of the Iberian Peninsula. The synthesis of findings will be organised to provide guidance for future solution-oriented environmental monitoring and explore more systematic ways to assess mixture exposures and combination effects in future water quality monitoring.

Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis.

BACKGROUND Non-steroidal anti-inflammatory drugs (NSAIDs) are the backbone of osteoarthritis pain management. We aimed to assess the effectiveness of different preparations and doses of NSAIDs on osteoarthritis pain in a network meta-analysis. METHODS For this network meta-analysis, we considered randomised trials comparing any of the following interventions: NSAIDs, paracetamol, or placebo, for the treatment of osteoarthritis pain. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the reference lists of relevant articles for trials published between Jan 1, 1980, and Feb 24, 2015, with at least 100 patients per group. The prespecified primary and secondary outcomes were pain and physical function, and were extracted in duplicate for up to seven timepoints after the start of treatment. We used an extension of multivariable Bayesian random effects models for mixed multiple treatment comparisons with a random effect at the level of trials. For the primary analysis, a random walk of first order was used to account for multiple follow-up outcome data within a trial. Preparations that used different total daily dose were considered separately in the analysis. To assess a potential dose-response relation, we used preparation-specific covariates assuming linearity on log relative dose. FINDINGS We identified 8973 manuscripts from our search, of which 74 randomised trials with a total of 58 556 patients were included in this analysis. 23 nodes concerning seven different NSAIDs or paracetamol with specific daily dose of administration or placebo were considered. All preparations, irrespective of dose, improved point estimates of pain symptoms when compared with placebo. For six interventions (diclofenac 150 mg/day, etoricoxib 30 mg/day, 60 mg/day, and 90 mg/day, and rofecoxib 25 mg/day and 50 mg/day), the probability that the difference to placebo is at or below a prespecified minimum clinically important effect for pain reduction (effect size [ES] -0·37) was at least 95%. Among maximally approved daily doses, diclofenac 150 mg/day (ES -0·57, 95% credibility interval [CrI] -0·69 to -0·46) and etoricoxib 60 mg/day (ES -0·58, -0·73 to -0·43) had the highest probability to be the best intervention, both with 100% probability to reach the minimum clinically important difference. Treatment effects increased as drug dose increased, but corresponding tests for a linear dose effect were significant only for celecoxib (p=0·030), diclofenac (p=0·031), and naproxen (p=0·026). We found no evidence that treatment effects varied over the duration of treatment. Model fit was good, and between-trial heterogeneity and inconsistency were low in all analyses. All trials were deemed to have a low risk of bias for blinding of patients. Effect estimates did not change in sensitivity analyses with two additional statistical models and accounting for methodological quality criteria in meta-regression analysis. INTERPRETATION On the basis of the available data, we see no role for single-agent paracetamol for the treatment of patients with osteoarthritis irrespective of dose. We provide sound evidence that diclofenac 150 mg/day is the most effective NSAID available at present, in terms of improving both pain and function. Nevertheless, in view of the safety profile of these drugs, physicians need to consider our results together with all known safety information when selecting the preparation and dose for individual patients. FUNDING Swiss National Science Foundation (grant number 405340-104762) and Arco Foundation, Switzerland.

Zonal playfield attributes – A stochastic approach to subjective passing affordances in football

Introduction: According to the ecological view, coordination establishes byvirtueof social context. Affordances thought of as situational opportunities to interact are assumed to represent the guiding principles underlying decisions involved in interpersonal coordination. It’s generally agreed that affordances are not an objective part of the (social) environment but that they depend on the constructive perception of involved subjects. Theory and empirical data hold that cognitive operations enabling domain-specific efficacy beliefs are involved in the perception of affordances. The aim of the present study was to test the effects of these cognitive concepts in the subjective construction of local affordances and their influence on decision making in football. Methods: 71 football players (M = 24.3 years, SD = 3.3, 21 % women) from different divisions participated in the study. Participants were presented scenarios of offensive game situations. They were asked to take the perspective of the person on the ball and to indicate where they would pass the ball from within each situation. The participants stated their decisions in two conditions with different game score (1:0 vs. 0:1). The playing fields of all scenarios were then divided into ten zones. For each zone, participants were asked to rate their confidence in being able to pass the ball there (self-efficacy), the likelihood of the group staying in ball possession if the ball were passed into the zone (group-efficacy I), the likelihood of the ball being covered safely by a team member (pass control / group-efficacy II), and whether a pass would establish a better initial position to attack the opponents’ goal (offensive convenience). Answers were reported on visual analog scales ranging from 1 to 10. Data were analyzed specifying general linear models for binomially distributed data (Mplus). Maximum likelihood with non-normality robust standard errors was chosen to estimate parameters. Results: Analyses showed that zone- and domain-specific efficacy beliefs significantly affected passing decisions. Because of collinearity with self-efficacy and group-efficacy I, group-efficacy II was excluded from the models to ease interpretation of the results. Generally, zones with high values in the subjective ratings had a higher probability to be chosen as passing destination (βself-efficacy = 0.133, p < .001, OR = 1.142; βgroup-efficacy I = 0.128, p < .001, OR = 1.137; βoffensive convenience = 0.057, p < .01, OR = 1.059). There were, however, characteristic differences in the two score conditions. While group-efficacy I was the only significant predictor in condition 1 (βgroup-efficacy I = 0.379, p < .001), only self-efficacy and offensive convenience contributed to passing decisions in condition 2 (βself-efficacy = 0.135, p < .01; βoffensive convenience = 0.120, p < .001). Discussion: The results indicate that subjectively distinct attributes projected to playfield zones affect passing decisions. The study proposes a probabilistic alternative to Lewin’s (1951) hodological and deterministic field theory and enables insight into how dimensions of the psychological landscape afford passing behavior. Being part of a team, this psychological landscape is not only constituted by probabilities that refer to the potential and consequences of individual behavior, but also to that of the group system of which individuals are part of. Hence, in regulating action decisions in group settings, informers are extended to aspects referring to the group-level. References: Lewin, K. (1951). In D. Cartwright (Ed.), Field theory in social sciences: Selected theoretical papers by Kurt Lewin. New York: Harper & Brothers.

Sportmotorische Leistungsfähigkeit und schulische Leistung – Zum mediierenden Effekt der exekutiven Funktionen

Introduction: Da die exekutiven Funktionen in enger Verbindung mit schulischer Leistung stehen (Diamond, 2007) interessiert aus sportwissenschaftlicher Sicht, welchen Beitrag Sport und Bewegung zu dessen Erhöhung leisten kann. Direkte Zusammenhänge zwischen den Konstrukten sportmotorische Leistungsfähigkeit, exekutive Funktionen und schulische Leistung scheinen empirisch hinreichend belegt. Offen bleibt hingegen wie sich der Zusammenhang gestaltet wobei des Öfteren Mediations- und Moderationseffekte diskutiert (Alfermann & Linde, 2012), selten jedoch statistisch getestet werden. Ob die exekutiven Funktionen als potentieller Mediator zwischen sportmotorischer Leistungsfähigkeit und schulischer Leistung fungiert, ist Gegenstand des vorliegenden Beitrags. Methods: Im Rahmen der Studie „Sport und Kognition“ (SpuK) wurden insgesamt 110 Schülerinnen und Schüler (56.8% ♀; 7.90±0.43 Jahre) in ihren exekutiven Funktionen (EF) getestet. Zusätzlich wurde die sportmotorische Leistungsfähigkeit (SMLF) und die schulische Leistung (SL) durch Einschätzung der Lehrperson erhoben. Um die Annahme zu prüfen, ob die schulische Leistung vorwiegend mediiert über die exekutiven Funktionen durch die sportmotorische Leistung vorhergesagt werden kann, wurde eine Mediatoranalyse (Fairchild & McQuillin, 2010) berechnet. Results: Das Strukturgleichungsmodell mit 2(7, N=95)=3.057, p=.880; CFI>.99 weist eine hohe Anpassungsgüte auf. Erwartungsgemäss gibt es innerhalb des Mediationsmodells keinen signifikanten Zusammenhang zwischen SMLF und SL (Sprache) (β=-.12, p=.869). Während der Zusammenhang von SMLF auf EF signifikant ausfällt (β=.69, p= .026), zeigt sich der Zusammenhang von EF auf SL (Sprache) als nicht signifikant (β=.68, p=.515). Daher zeigt sich weder der direkte Effekt (p=.124) von SMLF auf SL noch der indirekte Effekte (p=.472) von SMLF auf SL über EF signifikant. Die geprüfte Mediation muss somit verworfen werden. Discussion/Conclusion: Obwohl starke Zusammenhänge von SMLF und EF als auch von EF und SL (Sprache) und gleichzeitig ein schwacher direkter Zusammenhang von SMLF und SL die theoretische Annahme der Mediation stützen, kann der indirekte Effekt keine Signifikanz ausweisen, was zu einer Ablehnung der Mediationshypothese führt. Erklären lässt sich dieser Befund durch eine zu geringfügige Stichprobe einerseits und durch eine unzureichende Datenqualität aufgrund inadäquat operationalisierter Messmethoden zur Einschätzung der schulischen Leistung andererseits. Zukünftige Studien sollten zur Messung der schulischen Leistung auf objektive Messmethoden zurückgreifen. References: Alfermann, D., & Linde, K. (2012). Physische Aktivität und kognitive Leistungsfähigkeit. In R. Fuchs & W. Schlicht (Hrsg.), Seelische Gesundheit und sportliche Aktivität (S.294-314). Göttingen: Hogrefe. Diamond, A., Barnett, W. S., Thomas, J., & Munro, S. (2007). Preschool program improves cognitive control. Science, 318, 1387-1388. Fairchild, A. J., & McQuillin, S. D. (2010). Evaluating mediation and moderation effects in school psychology: A presentation of methods and review of current practice. Journal of School Psychology, 48, 53-84.

Global patterns of DNA polymorphism in noncoding regions in human populations

DNA sequence variation is currently a major source of data for studying human origins, evolution, and demographic history, and for detecting linkage association of complex diseases. In this dissertation, I investigated DNA variation in worldwide populations from two ∼10 kb autosomal regions on 22q11.2 (noncoding) and 1q24 (introns). A total of 75 variant sites were found among 128 human sequences in the 22q11.2 region, yielding an estimate of 0.088% for nucleotide diversity (π), and a total of 52 variant sites were found among 122 human sequences in the 1q24 region with an estimated π value of 0.057%. The data from these two regions and a 10 kb noncoding region on Xq13.3 all show a strong excess of low-frequency variants in comparison to that expected from an equilibrium population, indicating a relatively recent population expansion. The effective population sizes estimated from the three regions were 11,000, 12,700, and 8,600, respectively, which are close to the commonly used value of 10,000. In each of the two autosomal regions, the age of the most recent common ancestor (MRCA) was estimated to be older than 1 million years among all the sequences and ∼600,000 years among non-African sequences, providing first evidence from autosomal noncoding or intronic regions for a genetic history of humans much more ancient than the emergence of modern humans. The ancient genetic history of humans indicates no severe bottleneck during the evolution of humans in the last half million years; otherwise, much of the ancient genetic history would have been lost during a severe bottleneck. This study strongly suggests that both the “out of Africa” and the multiregional models are too simple for explaining the evolution of modern humans. A compilation of genome-wide data revealed that nucleotide diversity is highest in autosomal regions, intermediate in X-linked regions, and lowest in Y-linked regions. The data suggest the existence of background selection or selective sweep on Y-linked loci. In general, the nucleotide diversity in humans is low compared to that in chimpanzee and Drosophila populations. ^

Granulometry of two sediment cores from Maxwell Bay, South Shetland Islands, West Antarctica

The climate evolution of the South Shetland Islands during the last c. 2000 years is inferred from the multiproxy analyses of a long (928 cm) sediment core retrieved from Maxwell Bay off King George Island. The vertical sediment flux at the core location is controlled by summer melting processes that cause sediment-laden meltwater plumes to form. These leave a characteristic signature in the sediments of NE Maxwell Bay. We use this signature to distinguish summer and winter-dominated periods. During the Medieval Warm Period, sediments are generally finer which indicates summer-type conditions. In contrast, during the Little Ice Age (LIA) sediments are generally coarser and are indicative of winter-dominated conditions. Comparison with Northern and Southern Hemisphere, Antarctic, and global temperature reconstructions reveals that the mean grain-size curve from Maxwell Bay closely resembles the curve of the global temperature reconstruction. We show that the medieval warming occurred earlier in the Southern than in the Northern Hemisphere, which might indicate that the warming was driven by processes occurring in the south. The beginning of the LIA appears to be almost synchronous in both hemispheres. The warming after the LIA closely resembles the Northern Hemisphere record which might indicate this phase of cooling was driven by processes occurring in the north. Although the recent rapid regional warming is clearly visible, the Maxwell Bay record does not show the dominance of summer-type sediments until the 1970s. Continued warming in this area will likely affect the marine ecosystem through meltwater induced turbidity of the surface waters as well as an extension of the vegetation period due to the predicted decrease of sea ice in this area.

Experiencias de escritura en los umbrales académicos. 16H266

Este proyecto conjuga la investigación bibliográfica o de campo con formas singulares de investigación-acción. En este sentido se aboca a un trabajo sostenido con experiencias de escritura en el umbral de ingreso académico a partir de la problemática que visualizamos en los primeros años universitarios en cátedras de las Carreras de Letras (Licenciatura y Profesorado) a las cuales una importante porción de la población estudiantil accede con limitadas, escasas -y en ocasiones ausentes- competencias para la lecto - comprensión y la producción escrita avanzada. Advertimos dichas limitaciones o ausencias en situaciones concretas prototípicas (por ejemplo, elaboración de trabajos prácticos individuales y grupales, realización de parciales domiciliarios o presenciales) e incluso, en situaciones menos estandarizadas en el ámbito académico, como la redacción espontánea a partir de consignas desencadenantes de una escritura más íntima o autográfica. Para abordar esta problemática, hemos propuesto desde este proyecto: 1) Trabajar en talleres de producción de textos académicos y en tutorías de escritura (personalizadas y/o en pequeños grupos), con situaciones de lecto - escritura capaces de provocar experiencias enriquecidas con interacciones entre pares, desencadenantes de intensa y sistemática reflexión metadiscursiva sobre procesos de escritura, géneros y formatos usuales, logros y dificultades que se evidencian en producciones propias y ajenas. 2) Diseñar propuestas metodológicas innovadoras para desarrollar competencias discursivas mediante intervenciones docentes basadas en investigaciones y experiencias consistentes.

Programas de salud sexual y reproductiva y maternidad adolescente en La Plata (Buenos Aires, Argentina). En: Avá, nº 15

La mirada estigmatizante de la maternidad en la adolescencia y el interés por controlar la sexualidad por parte del sector sanitario, es reciente y diferente para hombres y mujeres. Sabemos que las categorías género y edad en tanto construcciones culturales que aluden a relaciones básicas de desigualdad- atravesadas por las estructuras económico-políticas particulares-, están cargadas de significados que se dirimen en un campo social predispuesto a reforzar estereotipos naturalizantes y relaciones de dominación. El estudio se ubica en la problemática general del reconocimiento de derechos presente en los programas de salud sexual y reproductiva que tienen como destinatarias a mujeres adolescentes pobres. El recorte pone en foco el contraste entre el marco normativo y el significado que asume la maternidad para las adolescentes. Para ello, se analizan programas de salud nacionales, de la Provincia de Buenos Aires y de la municipalidad de La Plata y discursos obtenidos en entrevistas realizadas a veinte adolescentes residentes en barrios pobres de la ciudad de La Plata. El análisis de los programas explora la incorporación del enfoque de género y la interpretación de los problemas de sexualidad/reproducción de las adolescentes en el marco de los derechos humanos y el de los discursos de las entrevistadas indaga su interpelación.

La participación de las poblaciones locales, colonas y mbya-guaraní, en la constitución de una arena ambientalista de la provincia de Misiones, Argentina. 16H299

Actividades desarrolladas durante el período: análisis de datos y elaboración de tres presentaciones a reuniones científicas realizadas durante el año 2010 y 2011 por parte del Director de proyecto y la Auxiliar de Investigación; escritura de siete artículos sobre temas relativos al proyecto de investigación publicados en libros y publicaciones periódicas de Argentina y Estados Unidos; realización de estudios de Posdoctorado en el CICR-University of Georgia desde septiembre 2010 a septiembre 2011 por parte del Director de investigación, trabajando temas relativos a políticas de conservación y comunidades locales; realización de trabajo de campo en la zona de norte de la Provincia de Misiones, destinada a la obtener datos relativos al presente proyecto de investigación. Durante el primer semestre de 2010 el Director y durante el segundo semestre de 2010 la Auxiliar de Investigación.