Drug-eluting stents compared to bare-metal stents improve short-term survival in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention: a nationwide prospective analysis of the AMIS Plus registry.

BACKGROUND: Recently, it has been suggested that the type of stent used in primary percutaneous coronary interventions (pPCI) might impact upon the outcomes of patients with acute myocardial infarction (AMI). Indeed, drug-eluting stents (DES) reduce neointimal hyperplasia compared to bare-metal stents (BMS). Moreover, the later generation DES, due to its biocompatible polymer coatings and stent design, allows for greater deliverability, improved endothelial healing and therefore less restenosis and thrombus generation. However, data on the safety and performance of DES in large cohorts of AMI is still limited. AIM: To compare the early outcome of DES vs. BMS in AMI patients. METHODS: This was a prospective, multicentre analysis containing patients from 64 hospitals in Switzerland with AMI undergoing pPCI between 2005 and 2013. The primary endpoint was in-hospital all-cause death, whereas the secondary endpoint included a composite measure of major adverse cardiac and cerebrovascular events (MACCE) of death, reinfarction, and cerebrovascular event. RESULTS: Of 20,464 patients with a primary diagnosis of AMI and enrolled to the AMIS Plus registry, 15,026 were referred for pPCI and 13,442 received stent implantation. 10,094 patients were implanted with DES and 2,260 with BMS. The overall in-hospital mortality was significantly lower in patients with DES compared to those with BMS implantation (2.6% vs. 7.1%,p < 0.001). The overall in-hospital MACCE after DES was similarly lower compared to BMS (3.5% vs. 7.6%, p < 0.001). After adjusting for all confounding covariables, DES remained an independent predictor for lower in-hospital mortality (OR 0.51,95% CI 0.40-0.67, p < 0.001). Since groups differed as regards to baseline characteristics and pharmacological treatment, we performed a propensity score matching (PSM) to limit potential biases. Even after the PSM, DES implantation remained independently associated with a reduced risk of in-hospital mortality (adjusted OR 0.54, 95% CI 0.39-0.76, p < 0.001). CONCLUSIONS: In unselected patients from a nationwide, real-world cohort, we found DES, compared to BMS, was associated with lower in-hospital mortality and MACCE. The identification of optimal treatment strategies of patients with AMI needs further randomised evaluation; however, our findings suggest a potential benefit with DES.

Meta-analysis of the influence of bonding parameters on the clinical outcome of tooth-colored cervical restorations

PURPOSE: To meta-analyze the literature on the clinical performance of Class V restorations to assess the factors that influence retention, marginal integrity, and marginal discoloration of cervical lesions restored with composite resins, glass-ionomer-cement-based materials [glass-ionomer cement (GIC) and resin-modified glass ionomers (RMGICs)], and polyacid-modified resin composites (PMRC). MATERIALS AND METHODS: The English literature was searched (MEDLINE and SCOPUS) for prospective clinical trials on cervical restorations with an observation period of at least 18 months. The studies had to report about retention, marginal discoloration, marginal integrity, and marginal caries and include a description of the operative technique (beveling of enamel, roughening of dentin, type of isolation). Eighty-one studies involving 185 experiments for 47 adhesives matched the inclusion criteria. The statistical analysis was carried out by using the following linear mixed model: log (-log (Y /100)) = β + α log(T ) + error with β = log(λ), where β is a summary measure of the non-linear deterioration occurring in each experiment, including a random study effect. RESULTS: On average, 12.3% of the cervical restorations were lost, 27.9% exhibited marginal discoloration, and 34.6% exhibited deterioration of marginal integrity after 5 years. The calculation of the clinical index was 17.4% of failures after 5 years and 32.3% after 8 years. A higher variability was found for retention loss and marginal discoloration. Hardly any secondary caries lesions were detected, even in the experiments with a follow-up time longer than 8 years. Restorations placed using rubber-dam in teeth whose dentin was roughened showed a statistically significantly higher retention rate than those placed in teeth with unprepared dentin or without rubber-dam (p < 0.05). However, enamel beveling had no influence on any of the examined variables. Significant differences were found between pairs of adhesive systems and also between pairs of classes of adhesive systems. One-step self-etching had a significantly worse clinically index than two-step self-etching and three-step etch-and-rinse (p = 0.026 and p = 0.002, respectively). CONCLUSION: The clinical performance is significantly influenced by the type of adhesive system and/or the adhesive class to which the system belongs. Whether the dentin/enamel is roughened or not and whether rubberdam isolation is used or not also significantly influenced the clinical performance. Composite resin restorations placed with two-step self-etching and three-step etch-and-rinse adhesive systems should be preferred over onestep self-etching adhesive systems, GIC-based materials, and PMRCs.

Avancées sur la source, la taille et la nature des particules microbiennes aéroportées présentes dans l'environnement intérieur

L'exposition à certaines particules fongiques et bactéries présentes dans les aérosols de l'environnement intérieur a été associée au développement ou à l'exacerbation d'affections respiratoires telles que l'asthme, la rhinite allergique ou encore l'aspergillose (1-4). Le réservoir principal identifié dans cet environnement pour les bactéries aéroportées est constitué par les habitants eux-mêmes, alors que celui des particules fongiques est l'environnement extérieur, ou, lorsque les conditions sont réunies, l'environnement intérieur (5-7). Néanmoins, la nature et la taille de ces particules fongiques, ainsi que l'impact de l'occupation humaine sur ces paramètres n'ont été que peu explorés. Les articles de cette note s'intéressent justement à ces aspects et illustrent l'importance de leur prise en compte dans l'évaluation du risque d'exposition aux microorganismes dans l'environnement intérieur. L'étude de Hospodsky et coll. (2014) apporte une information quantitative sur le niveau d'émission de bactéries et particules fongiques résultant d'une occupation humaine dans des environnements intérieurs sains. Alors que l'étude de Afanou et coll. (2014) montre la complexité des particules fongiques qui peuvent être générées dans l'environnement intérieur, différentes espèces de moisissures pouvant participer en proportions différentes au nombre de particules submicroniques1 grâce à leurs fragments de spores ou hyphes.

Thoracic fat volume is independently associated with coronary vasomotion.

PURPOSE: Thoracic fat has been associated with an increased risk of coronary artery disease (CAD). As endothelium-dependent vasoreactivity is a surrogate of cardiovascular events and is impaired early in atherosclerosis, we aimed at assessing the possible relationship between thoracic fat volume (TFV) and endothelium-dependent coronary vasomotion. METHODS: Fifty healthy volunteers without known CAD or major cardiovascular risk factors (CRFs) prospectively underwent a (82)Rb cardiac PET/CT to quantify myocardial blood flow (MBF) at rest, and MBF response to cold pressor testing (CPT-MBF) and adenosine (i.e., stress-MBF). TFV was measured by a 2D volumetric CT method and common laboratory blood tests (glucose and insulin levels, HOMA-IR, cholesterol, triglyceride, hsCRP) were performed. Relationships between CPT-MBF, TFV and other CRFs were assessed using non-parametric Spearman rank correlation testing and multivariate linear regression analysis. RESULTS: All of the 50 participants (58 ± 10y) had normal stress-MBF (2.7 ± 0.6 mL/min/g; 95 % CI: 2.6-2.9) and myocardial flow reserve (2.8 ± 0.8; 95 % CI: 2.6-3.0) excluding underlying CAD. Univariate analysis revealed a significant inverse relation between absolute CPT-MBF and sex (ρ = -0.47, p = 0.0006), triglyceride (ρ = -0.32, p = 0.024) and insulin levels (ρ = -0.43, p = 0.0024), HOMA-IR (ρ = -0.39, p = 0.007), BMI (ρ = -0.51, p = 0.0002) and TFV (ρ = -0.52, p = 0.0001). MBF response to adenosine was also correlated with TFV (ρ = -0.32, p = 0.026). On multivariate analysis, TFV emerged as the only significant predictor of MBF response to CPT (p = 0.014). CONCLUSIONS: TFV is significantly correlated with endothelium-dependent and -independent coronary vasomotion. High TF burden might negatively influence MBF response to CPT and to adenosine stress, even in persons without CAD, suggesting a link between thoracic fat and future cardiovascular events.

Sex Determination: Separate Sexes Are a Double Turnoff in Melons.

Flowers with only one sexual function typically result from the developmental suppression of the other. A recent study that shows how this is achieved has important implications for models of the evolution of separate sexes in plants.

AltitudeOmics : Resetting of Cerebrovascular CO2 Reactivity Following Acclimatization to High Altitude.

Previous studies reported enhanced cerebrovascular CO2 reactivity upon ascent to high altitude using linear models. However, there is evidence that this response may be sigmoidal in nature. Moreover, it was speculated that these changes at high altitude are mediated by alterations in acid-base buffering. Accordingly, we reanalyzed previously published data to assess middle cerebral blood flow velocity (MCAv) responses to modified rebreathing at sea level (SL), upon ascent (ALT1) and following 16 days of acclimatization (ALT16) to 5260 m in 21 lowlanders. Using sigmoid curve fitting of the MCAv responses to CO2, we found the amplitude (95 vs. 129%, SL vs. ALT1, 95% confidence intervals (CI) [77, 112], [111, 145], respectively, P = 0.024) and the slope of the sigmoid response (4.5 vs. 7.5%/mmHg, SL vs. ALT1, 95% CIs [3.1, 5.9], [6.0, 9.0], respectively, P = 0.026) to be enhanced at ALT1, which persisted with acclimatization at ALT16 (amplitude: 177, 95% CI [139, 215], P < 0.001; slope: 10.3%/mmHg, 95% CI [8.2, 12.5], P = 0.003) compared to SL. Meanwhile, the sigmoidal response midpoint was unchanged at ALT1 (SL: 36.5 mmHg; ALT1: 35.4 mmHg, 95% CIs [34.0, 39.0], [33.1, 37.7], respectively, P = 0.982), while it was reduced by ~7 mmHg at ALT16 (28.6 mmHg, 95% CI [26.4, 30.8], P = 0.001 vs. SL), indicating leftward shift of the cerebrovascular CO2 response to a lower arterial partial pressure of CO2 (PaCO2) following acclimatization to altitude. Sigmoid fitting revealed a leftward shift in the midpoint of the cerebrovascular response curve which could not be observed with linear fitting. These findings demonstrate that there is resetting of the cerebrovascular CO2 reactivity operating point to a lower PaCO2 following acclimatization to high altitude. This cerebrovascular resetting is likely the result of an altered acid-base buffer status resulting from prolonged exposure to the severe hypocapnia associated with ventilatory acclimatization to high altitude.

Metsäpolttoaineiden vesitiekuljetus proomukalustolla

Metsäpolttoaineiden käyttö kasvaa lämpö- ja voimalaitoksissa ja mahdollisissa biojalostamoissa. Metsäpolttoaineilla voidaan saavuttaa päästövähennyksiä korvaamalla päästöintensiivisempiä polttoaineita. Metsäpolttoaineen kysynnän kasvu suurkäyttöpaikoilla luo uusia vaatimuksia metsäbiomassan hankintaan. Metsäpolttoaineiden vesitiekuljetuksen sisältämiä logistiikkajärjestelmiä kehittämällä toimitusvarmuutta pystytään parantamaan ja hankintaa laajentamaan kustannustehokkaasti ja ympäristöystävällisesti. Kuljetuskokeilut antoivat uutta tietoa vesitiekuljetuksen sisältämästä hankinnasta. Lastikapasiteetti nykyisen kaltaisessa Eurooppa IIa -suurproomussa vaihtelee 1200 tonnista jopa 1800 tonniin (kosteus 40 %) riippuen tiivistymisestä ja proomun modifiointiasteesta. Metsähakkeen energiatiheys oli suurproomukuljetuksissa keskimäärin 1 MWh/i-m3, joka oli 25 % parempi kuin vertailun hakerekkakuljetuksissa. Vesitiekuljetuksen kustannukset olivat kuljetuskokeiluissa lastauksineen ja purkuineen 0,02 €/MWh/km, ollen noin 20 % ketjun kokonaiskustannuksista. Simuloinnin edullisimpien vesitiekuljetusvaihtoehtojen vaihteluvälin kustannukset olivat vastaavasti 0,013 - 0,026 €/MWh/km. Lastauksen ja purun kustannus oli 0,4 - 0,6 €/MWh ja vesitiekuljetus 0,9 - 2,0 €/MWh (100 km). Ketjun kokonaiskustannukset hakkuutähdehakkeelle vaihtelivat simuloinnin edullisimpien vaihtoehtojen perusteella välillä 10,8 - 12,1 €/MWh (30 km rekka, 100 km proomu). Kuljetusketjujen simuloinnin kustannukset osoittivat proomukuljetusketjun olevan kilpailukykyinen vaihtoehto hakerekkakuljetusketjulle kalustosta ja vuosittaisista käyttötunneista riippuen kuljetusetäisyyden ylittäessä 100 km. Kustannustehokkain ratkaisu vesitiekuljetuksessa saavutettiin pienen aluksen ja suuren kokoluokan proomuyksikön kytkyeellä. Haketus kannattaa toteuttaa ennen proomukuljetuksen osuutta metsähakkeen paremman tiiviyden ja käsiteltävyyden perusteella. Logistiikkajärjestelmiä pitää kehittää tapauskohtaisesti käyttöpaikan tarpeet ja olosuhteet huomioon ottaen. Metsäpolttoaineiden vesitiekuljetuksen sisältämän logistiikan liiketoimintamallien vertailussa arvioitiin vaihtoehtoiset ulkoistetut toimintamallit paremmaksi kuin nykyinen urakointimalli. Tämä mahdollistaa paremman metsähakkeen saatavuuden ja logistiikan tehokkuuden lastausterminaaleissa. Terminaalitoiminnot ja proomukuljetukset lisäävät uusia liiketoimintamahdollisuuksia ja mahdollistavat metsäpolttoaineiden

Aplicação da CLAE para determinação do ácido 10-Hidróxi-2-decenóico (10-HDA) em geléia real pura e adicionada a mel brasileiro

The aim of this paper was to determine the 10-HDA in pure royal jelly and products containing royal jelly, using HPLC methodology. 10-HDA is the natural indicator of the presence of royal jelly in products and also gives the authenticity of pure royal jelly. The chromatographic conditions used were: isocratic system, C18-H column, auto sampler, diode array UV-VIS detector (225 nm), mobile phase with methanol/water (45:55), pH= 2.5 and a-naphtol as internal standard. The results obtained using laboratory samples for pure royal jelly were 2.37%, varying from 0.15% for honey with 10% of royal jelly to 2.10% for honey with 90% of royal jelly respectivelly. For commercial products, the 10-HDA content varied from no detectable to 0.026%. The recovery test presented a minumum of 100.44% The detection limit was 45.92 ng/mL and the quantification limit was 76.53 ng/mL.

Predictors of remission in the treatment of major depressive disorder: real-world evidence from a 6-month prospective observational study

BACKGROUND: This study examined potential predictors of remission among patients treated for major depressive disorder (MDD) in a naturalistic clinical setting, mostly in the Middle East, East Asia, and Mexico. METHODS: Data for this post hoc analysis were taken from a 6-month prospective, noninterventional, observational study that involved 1,549 MDD patients without sexual dysfunction at baseline in 12 countries worldwide. Depression severity was measured using the Clinical Global Impression of Severity and the 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). Depression-related pain was measured using the pain-related items of the Somatic Symptom Inventory. Remission was defined as a QIDS-SR16 score ≤5. Generalized estimating equation regression models were used to examine baseline factors associated with remission during follow-up. RESULTS: Being from East Asia (odds ratio [OR] 0.48 versus Mexico; P<0.001), a higher level of depression severity at baseline (OR 0.77, P=0.003, for Clinical Global Impression of Severity; OR 0.92, P<0.001, for QIDS-SR16), more previous MDD episodes (OR 0.92, P=0.007), previous treatments/therapies for depression (OR 0.78, P=0.030), and having any significant psychiatric and medical comorbidity at baseline (OR 0.60, P<0.001) were negatively associated with remission, whereas being male (OR 1.29, P=0.026) and treatment with duloxetine (OR 2.38 versus selective serotonin reuptake inhibitors, P<0.001) were positively associated with remission. However, the association between Somatic Symptom Inventory pain scores and remission no longer appeared to be significant in this multiple regression (P=0.580), (P=0.008 in descriptive statistics), although it remained significant in a subgroup of patients treated with selective serotonin reuptake inhibitors (OR 0.97, P=0.023), but not in those treated with duloxetine (P=0.182). CONCLUSION: These findings are largely consistent with previous reports from the USA and Europe. They also highlight the potential mediating role of treatment with duloxetine on the negative relationship between depression-related pain and outcomes of depression.

Prevalence of Problematic Mobile Phone Use in British Adolescents

The problematic use of mobile phones among adolescents has not been widely studied. There are very few instruments for assessing potential technological addiction to mobile phones, or for categorizing different types of users or uses. The most widely used scale is the Mobile Phone Problem Use Scale (MPPUS), which is used to study adult populations, and has been applied in various forms in international contexts. The aims of this study were to adapt the Spanish version of this scale (MPPUSA) to British adolescents, and then to estimate the prevalence of possible problematic users. A questionnaire was administered to a sample of 1,529 secondary school pupils aged between 11 and 18 years, with 1,026 completed questionnaires being collected. The analysis showed that the factor and construct validity and reliability were comparable to those obtained in previous studies. The prevalence of problematic users among the students was 10%, and the typical problematic user tended to be an adolescent between 11 and 14 years old, studying in a public school, who considered themselves to be an expert user of this technology, who made extensive use of his/her mobile phone, and who attributed the same problem of use among their peers. These users presented notable scores in all the symptoms covered by the scale used to assess problematic use. In conclusion, the adaptation of the MPPUSA as a screening scale for British adolescents presents good sensitivity and specificity for detecting the main addictive symptoms proposed in this validated version.

Determinação de olanzapina em formulações farmacêuticas por espectrofotometria: desenvolvimento e validação

Spectrophotometric methods of zero order, first and second derived order had been developed for olanzapine determination in tablets using ethanol and isopropanol as solvent. The two solvents revealed to be adequate. For the three methods the calibration curve coefficient of correlation had been greater than 0.9998 with limit of detection varying from 0.068 to 0.190 mg L-1, in ethanol, and 0.026 to 0.205 mg L-1, in isopropanol. The inter-day precision was inferior to 1.1 and 1.9 mg L-1 for ethanol and isopropanol, respectively. The average recoveries varied from 98 to 101%, in ethanol and 99 to 103% in isopropanol.

Produção e caracterização de polihidroxialcanoatos obtidos por fermentação da glicerina bruta residual do biodiesel

The aim of this study was to evaluate the production of polyhydroxyalkanoates (PHAs) by fermentation of Crude Glycerin, a byproduct of the biodiesel industry, by Cupriavidus necator IPT 026, 027 and 028. The influence of fermentation time and temperature in shake flasks were evaluated. The highest PHA production (2.82 g L-1) occurred at 35 ºC for 72 h of fermentation. The melting and initial thermal degradation temperatures of this PHA were 177.9 ºC and 306.33 ºC, respectively, with 55% crystallinity. FTIR spectrum was similar to those reported in literature. The polymer obtained presented three different methyl esters of hydroxyalkanoates in its composition, with molecular weight of 630 kDa. Bacteria can use Crude Glycerin as an inexpensive substrate to produce value-added biodegradable products, such as PHA.

Otimização e validação de uma metodologia analítica para determinação de 1-hidroxipireno em urina de cortadores de cana-de-açúcar

Este trabalho teve como objetivo otimizar e validar uma metodologia analítica para determinação de 1-hidróxipireno em urina de trabalhadores envolvidos na colheita da cana-de-açúcar. O método utilizado para determinação de 1-hidroxipireno em urina humana utilizado consiste na hidrólise enzimática, extração e clean-up por extração em fase sólida (SPE) e quantificação por cromatografia líquida de alta eficiência com detector de fluorescência (CLAE/Flu). Quatro tipos de cartuchos foram testados para verificação da porcentagem de recuperação. Urina de cortadores de cana-de-açúcar (não-fumantes e de ambos os sexos) foram coletadas no período da safra (n=39) e entressafra (n=34) da cana-de-açúcar. Os melhores resultados de recuperação foram atribuídos aos cartuchos C18. Os mesmos apresentaram recuperação entre 79% e 108%, com coeficiente de variação entre 5% e 10%. O limite de quantificação do método foi de 74 ng de 1-hidroxipireno por litro de urina. A metodologia otimizada e validada foi utilizada para determinação de amostras reais. Os resultados encontrados na urina dos trabalhadores no período da safra variaram de 0,026 a 2,3 μmol de 1-hidroxipireno por mol de creatinina. No período da entressafra os resultados variaram de 0,0023 a 0,38 μmol de 1-hidroxipireno por mol de creatinina. A metodologia validada mostrou-se adequada para determinação de 1-hidroxipireno em urina humana. Os dados obtidos permitem concluir que há forte correlação entre excreção de 1-hidroxipireno e os períodos de safra e entressafra da cana de açúcar.

On convergence of transforms based on parabolic scaling

This thesis studies properties of transforms based on parabolic scaling, like Curvelet-, Contourlet-, Shearlet- and Hart-Smith-transform. Essentially, two di erent questions are considered: How these transforms can characterize H older regularity and how non-linear approximation of a piecewise smooth function converges. In study of Hölder regularities, several theorems that relate regularity of a function f : R2 → R to decay properties of its transform are presented. Of particular interest is the case where a function has lower regularity along some line segment than elsewhere. Theorems that give estimates for direction and location of this line, and regularity of the function are presented. Numerical demonstrations suggest also that similar theorems would hold for more general shape of segment of low regularity. Theorems related to uniform and pointwise Hölder regularity are presented as well. Although none of the theorems presented give full characterization of regularity, the su cient and necessary conditions are very similar. Another theme of the thesis is the study of convergence of non-linear M ─term approximation of functions that have discontinuous on some curves and otherwise are smooth. With particular smoothness assumptions, it is well known that squared L2 approximation error is O(M-2(logM)3) for curvelet, shearlet or contourlet bases. Here it is shown that assuming higher smoothness properties, the log-factor can be removed, even if the function still is discontinuous.

Caracterização do dossel e do estrato de regeneração natural no sub-bosque e em clareiras de uma florestal estacional semidecidual no município de Viçosa, MG

Este estudo foi desenvolvido na Reserva Mata do Paraíso, pertencente à Universidade Federal de Viçosa. Foram selecionadas 10 clareiras naturais com diferentes tamanhos. No centro das clareiras e numa faixa de 5 m de sub-bosque (entorno) ao redor destas foram obtidas fotografias hemisféricas digitais. Através dessas fotografias, foram calculadas as áreas das clareiras e a sua correspondente abertura de dossel e dos seus entornos. No interior das clareiras e nos seus entornos foram amostrados todos os indivíduos com altura > 1,00 m e diâmetro na altura de 1,30 m do solo (DAP) inferior a 5,00 cm. Constatou-se a predominância de pequenas clareiras com áreas inferiores a 100 m² e com pequena abertura do dossel nas quais predominam as mesmas espécies típicas dos estádios finais de sucessão tolerantes à sombra e abundantes no sub-bosque ao redor dessas clareiras. No conjunto das clareiras foram amostrados 759 indivíduos, distribuídos em 69 espécies pertencentes a 28 famílias botânicas. O índice de diversidade de Shannon (H') das clareiras variou de 1,026 a 3,011. Coffea arabica e Picramnia regnelli foram as espécies mais abundantes tanto no conjunto das clareiras quanto no conjunto dos entornos (sub-bosque). A similaridade florística entre o conjunto das clareiras e o conjunto dos entornos foi alta (Ij = 69%), indicando que as mesmas espécies que regeneram no sub-bosque estão conseguindo fazer o mesmo também no ambiente de clareira. A dominância ecológica de Coffea arabica nos dois ambientes pode, no longo prazo, comprometer a conservação das espécies autóctones desse trecho da floresta.