Comparison between MDCT and Grayscale IVUS in a Quantitative Analysis of Coronary Lumen in Segments with or without Atherosclerotic Plaques

Background: The diagnostic accuracy of 64-slice MDCT in comparison with IVUS has been poorly described and is mainly restricted to reports analyzing segments with documented atherosclerotic plaques. Objectives: We compared 64-slice multidetector computed tomography (MDCT) with gray scale intravascular ultrasound (IVUS) for the evaluation of coronary lumen dimensions in the context of a comprehensive analysis, including segments with absent or mild disease. Methods: The 64-slice MDCT was performed within 72 h before the IVUS imaging, which was obtained for at least one coronary, regardless of the presence of luminal stenosis at angiography. A total of 21 patients were included, with 70 imaged vessels (total length 114.6 ± 38.3 mm per patient). A coronary plaque was diagnosed in segments with plaque burden > 40%. Results: At patient, vessel, and segment levels, average lumen area, minimal lumen area, and minimal lumen diameter were highly correlated between IVUS and 64-slice MDCT (p < 0.01). However, 64-slice MDCT tended to underestimate the lumen size with a relatively wide dispersion of the differences. The comparison between 64-slice MDCT and IVUS lumen measurements was not substantially affected by the presence or absence of an underlying plaque. In addition, 64-slice MDCT showed good global accuracy for the detection of IVUS parameters associated with flow-limiting lesions. Conclusions: In a comprehensive, multi-territory, and whole-artery analysis, the assessment of coronary lumen by 64-slice MDCT compared with coronary IVUS showed a good overall diagnostic ability, regardless of the presence or absence of underlying atherosclerotic plaques.

Galectin-3: A Link between Myocardial and Arterial Stiffening in Patients with Acute Decompensated Heart Failure?

Abstract Background: Heart failure is accompanied by abnormalities in ventricular-vascular interaction due to increased myocardial and arterial stiffness. Galectin-3 is a recently discovered biomarker that plays an important role in myocardial and vascular fibrosis and heart failure progression. Objectives: The aim of this study was to determine whether galectin-3 is correlated with arterial stiffening markers and impaired ventricular-arterial coupling in decompensated heart failure patients. Methods: A total of 79 inpatients with acute decompensated heart failure were evaluated. Serum galectin-3 was determined at baseline, and during admission, transthoracic echocardiography and measurements of vascular indices by Doppler ultrasonography were performed. Results: Elevated pulse wave velocity and low arterial carotid distensibility are associated with heart failure in patients with preserved ejection fraction (p = 0.04, p = 0.009). Pulse wave velocity, carotid distensibility and Young’s modulus did not correlate with serum galectin-3 levels. Conversely, raised galectin-3 levels correlated with an increased ventricular-arterial coupling ratio (Ea/Elv) p = 0.047, OR = 1.9, 95% CI (1.0‑3.6). Increased galectin-3 levels were associated with lower rates of left ventricular pressure rise in early systole (dp/dt) (p=0.018) and raised pulmonary artery pressure (p = 0.046). High galectin-3 levels (p = 0.038, HR = 3.07) and arterial pulmonary pressure (p = 0.007, HR = 1.06) were found to be independent risk factors for all-cause mortality and readmissions. Conclusions: This study showed no significant correlation between serum galectin-3 levels and arterial stiffening markers. Instead, high galectin-3 levels predicted impaired ventricular-arterial coupling. Galectin-3 may be predictive of raised pulmonary artery pressures. Elevated galectin-3 levels correlate with severe systolic dysfunction and together with pulmonary hypertension are independent markers of outcome.

Association between Spirituality and Adherence to Management in Outpatients with Heart Failure

Abstract Background: Spirituality may influence how patients cope with their illness. Objectives: We assessed whether spirituality may influence adherence to management of outpatients with heart failure. Methods: Cross sectional study enrolling consecutive ambulatory heart failure patients in whom adherence to multidisciplinary treatment was evaluated. Patients were assessed for quality of life, depression, religiosity and spirituality utilizing validated questionnaires. Correlations between adherence and psychosocial variables of interest were obtained. Logistic regression models explored independent predictors of adherence. Results: One hundred and thirty patients (age 60 ± 13 years; 67% male) were interviewed. Adequate adherence score was observed in 38.5% of the patients. Neither depression nor religiosity was correlated to adherence, when assessed separately. Interestingly, spirituality, when assessed by both total score sum (r = 0.26; p = 0.003) and by all specific domains, was positively correlated to adherence. Finally, the combination of spirituality, religiosity and personal beliefs was an independent predictor of adherence when adjusted for demographics, clinical characteristics and psychosocial instruments. Conclusion: Spirituality, religiosity and personal beliefs were the only variables consistently associated with compliance to medication in a cohort of outpatients with heart failure. Our data suggest that adequately addressing these aspects on patient’s care may lead to an improvement in adherence patterns in the complex heart failure management.

Birds from Liberia, with a discussion of barriers between Upper and Lower Guinea subspecies, by Austin L. Rand.

v.32:no.9(1951)

A new central Brazilian genus and species of sigmodontine rodent (Sigmodontinae) transitional between akodonts and oryzomyines : with a discussion of muroid molar morphology and evolution / Philip Hershkovitz.

n.s. no.75(1993)

Soil invertebrates in southern Brazilian Araucaria forest - grassland mosaic: differences between disturbed and undisturbed areas

Soil invertebrate distribution in Araucaria forest, grassland and edge habitats was studied in both disturbed and undisturbed areas in southern Brazil. Mean-density and taxa compositions were verified. Invertebrate densities differed between grassland and the other two habitats in the undisturbed area but not across the disturbed one. At the disturbed area taxa differed between the grassland and the other two habitats. The undisturbed area, on the other hand, presented taxa differences only between the grassland and the forest habitats. Acari, Arachnida and Collembola were the most sensitive taxa for detecting differences across habitats in both areas. At the disturbed area, these taxa presented densities lowering from the forest to the grassland. At the undisturbed area the same taxa increased from the forest to the grassland. Coleoptera and Formicidae (Insecta) presented no difference between habitats at the studied taxonomic level.

Trophic relationships between macroinvertebrates and fish in a pampean lowland stream (Argentina)

The diet and trophic relationships between the macroinvertebrates Phyllogomphoides joaquini Rodrigues Capítulo, 1992 and Coenagrionidae (Odonata), Chironomidae (Diptera), Diplodon delodontus (Lamarck, 1919) (Bivalvia: Hyriidae), and Pomacea canaliculata (Lamarck, 1822) (Gastropoda: Ampulariidae) and the fishes Pimelodella laticeps Eigenmann, 1917 (Heptapteridae) and Bryconamericus iheringii (Boulenger, 1887) (Characidae) in a temperate lowland lotic system in Argentina were assessed on the basis of gut contents and stable-isotope analyses. The feeding strategies were analyzed by the AMUNDSEN method. Relative food items contribution for the taxa studied indicated a generalist-type trophic strategy. In macroinvertebrates, in general, the values of stable isotope confirmed the result of the analysis of gut contents. With the fish, stable-isotope analysis demonstrated that both species are predators, although B. iheringii exhibited a more omnivorous behaviour. These feeding studies allowed us to determine the trophic relationships among taxa studied. Detritus and diatoms were a principal source of food for all the macroinvertebrates studied. In La Choza stream the particulate organic matter is a major no limited food resource, has a significant influence upon the community.

Collaboration strategies and technological innovation: a contractual perspective of the relationship between firms and techonological centers

In this paper, a theoretical framework for analyzing the selection of governance structures for implementing collaboration agreements between firms and Technological Centers is presented and empirically discussed. This framework includes Transaction Costs and Property Rights’ theoretical assumptions, though complemented with several proposals coming from the Transactional Value Theory. This last theory is used for adding some dynamism in the governance structure selection. As empirical evidence of this theoretical explanation, we analyse four real experiences of collaboration between firms and one Technological Center. These experiences are aimed to represent the typology of relationships which Technological Centers usually face. Among others, a key interesting result is obtained: R&D collaboration activities do not need to always be organized through hierarchical solutions. In those cases where future expected benefits and/or reputation issues could play an important role, the traditional more static theories could not fully explain the selected governance structure for managing the R&D relationship. As a consequence, these results justify further research about the adequacy of the theoretical framework presented in this paper in other contexts, for example, R&D collaborations between firms and/or between Universities or Public Research Centers and firms.

Societal metabolism of societies: the bifurcation between Spain and Ecuador

This paper presents an application of the Multiple-Scale Integrated Assessment of Societal Metabolism to the recent economic history of Ecuador and Spain. Understanding the relationship between the Gross Domestic Product (GDP) and the throughput of matter and energy over time in modern societies is crucial for understanding the sustainability predicament as it is linked to economic growth. When considering the dynamics of economic development, Spain was able to take a different path than Ecuador thanks to the different characteristics of its energy budget and other key variables. This and other changes are described using economic and biophysical variables (both extensive and intensive referring to different hierarchical levels). The representation of these parallel changes (on different levels and describable only using different variables) can be kept in coherence by adopting the frame provided by MSIASM.

Stakeholder activism, managerial entrenchment, and the congruence of interests between shareholders and stakeholders

We argue that when stakeholder protection is left to the voluntary initiative of managers, concessions to social activists and pressure groups can turn into a self-entrenchment strategy for incumbent CEOs. Stakeholders other than shareholders thus benefit from corporate governance rules putting managers under a tough replacement threat. We show that a minimal amount of formal stakeholder protection, or the introduction of explicit covenants protecting stakeholder rights in the firm charter, may deprive CEOs of the alliance with powerful social activists, thus increasing managerial turnover and shareholder value. These results rationalize a recent trend whereby well-known social activists like Friends of the Earth and active shareholders like CalPERS are showing a growing support for each other's agendas.

Interactions between product and labour market reforms

Labour market reforms face very often opposition from the employed workers, because it normally reduces their wages. Also product market regulations are regularly biased towards too much benefitting the firms. As a result there remain many frictions in both the labour and product markets that hinder an optimal functioning of the economy. These issues have recently received a lot of attention in the economics literature and scholars have been looking for politically viable reforms in both markets. However, despite its potential importance, there has been done virtually no research on the interaction between reforms in product and labour markets. We find that when combining reforms, the opposition for reforms decreases considerably. This is because there exist complementarities and the gains in total welfare can be more evenly distributed over the interest groups. Moreover, the interaction of reforms offers a way out for the so-called 'sclerosis' effect.

Between specialization and globalization. The marketing of agrarian products and its environmental impacts seen from a historical perspective: the province of Barcelona in the mid-nineteenth century

Ecological economics has five good reasons to consider that economic globalisation, spurred by commercial and financial fluxes, to be one of the main driving forces responsible for causing environmental degradation to our planet. The first, is the energy consumption and the socio-environmental impacts which long-distance haulage entails. The second, is the ever-increasing flow of goods to far-away destinations which renders their recycling practically impossible. This is particularly significant, because it prevents the metabolic lock of the nutrients present in food and other agrarian products from taking place. The third, is that the high degree of specialization attained in agriculture, forestry, cattle, mining and industry in each region, generates deleterious effects not only on the eco-landscape structure of the uses of the soil, but on the capability to provide habitat and environmental functions to maintain biodiversity as well