Bivalirudin for patients with acute coronary syndromes

Background: Current guidelines for patients with moderate- or high-risk acute coronary syndromes recommend an early invasive approach with concomitant antithrombotic therapy, including aspirin, clopidogrel, unfractionated or low-molecular-weight heparin, and glycoprotein IIb/IIIa inhibitors. We evaluated the role of thrombin-specific anticoagulation with bivalirudin in such patients. Methods: We assigned 13,819 patients with acute coronary syndromes to one of three antithrombotic regimens: unfractionated heparin or enoxaparin plus a glycoprotein IIb/IIIa inhibitor, bivalirudin plus a glycoprotein IIb/IIIa inhibitor, or bivalirudin alone. The primary end points were a composite ischemia end point (death, myocardial infarction, or unplanned revascularization for ischemia), major bleeding, and the net clinical outcome, defined as the combination of composite ischemia or major bleeding. Results: Bivalirudin plus a glycoprotein IIb/IIIa inhibitor, as compared with heparin plus a glycoprotein IIb/IIIa inhibitor, was associated with noninferior 30-day rates of the composite ischemia end point (7.7% and 7.3%, respectively), major bleeding (5.3% and 5.7%), and the net clinical outcome end point (11.8% and 11.7%). Bivalirudin alone, as compared with heparin plus a glycoprotein IIb/IIIa inhibitor, was associated with a noninferior rate of the composite ischemia end point (7.8% and 7.3%, respectively; P = 0.32; relative risk, 1.08; 95% confidence interval [CI], 0.93 to 1.24) and significantly reduced rates of major bleeding (3.0% vs. 5.7%; P<0.001; relative risk, 0.53; 95% CI, 0.43 to 0.65) and the net clinical outcome end point (10.1% vs. 11.7%; P = 0.02; relative risk, 0.86; 95% CI, 0.77 to 0.97). Conclusions: In patients with moderate- or high-risk acute coronary syndromes who were undergoing invasive treatment with glycoprotein IIb/IIIa inhibitors, bivalirudin was associated with rates of ischemia and bleeding that were similar to those with heparin. Bivalirudin alone was associated with similar rates of ischemia and significantly lower rates of bleeding. (ClinicalTrials.gov number, NCT00093158.)

Percolation of spatially constrained Erdos-R enyi networks with degree correlations

Motivated by experiments on activity in neuronal cultures [J. Soriano, M. Rodr ́ıguez Mart́ınez, T. Tlusty, and E. Moses, Proc. Natl. Acad. Sci. 105, 13758 (2008)], we investigate the percolation transition and critical exponents of spatially embedded Erd̋os-Ŕenyi networks with degree correlations. In our model networks, nodes are randomly distributed in a two-dimensional spatial domain, and the connection probability depends on Euclidian link length by a power law as well as on the degrees of linked nodes. Generally, spatial constraints lead to higher percolation thresholds in the sense that more links are needed to achieve global connectivity. However, degree correlations favor or do not favor percolation depending on the connectivity rules. We employ two construction methods to introduce degree correlations. In the first one, nodes stay homogeneously distributed and are connected via a distance- and degree-dependent probability. We observe that assortativity in the resulting network leads to a decrease of the percolation threshold. In the second construction methods, nodes are first spatially segregated depending on their degree and afterwards connected with a distance-dependent probability. In this segregated model, we find a threshold increase that accompanies the rising assortativity. Additionally, when the network is constructed in a disassortative way, we observe that this property has little effect on the percolation transition.

Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: a literature review and meta-analysis of individual patient data.

BACKGROUND: Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. This study was designed to establish the baseline values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treated with artemisinin-based combination therapies (ACTs). METHODS: A literature review in PubMed was conducted in March 2013 to identify all prospective clinical trials (uncontrolled trials, controlled trials and randomized controlled trials), including ACTs conducted in Sub-Saharan Africa, between 1960 and 2012. Individual patient data from these studies were shared with the WorldWide Antimalarial Resistance Network (WWARN) and pooled using an a priori statistical analytical plan. Factors affecting early parasitological response were investigated using logistic regression with study sites fitted as a random effect. The risk of bias in included studies was evaluated based on study design, methodology and missing data. RESULTS: In total, 29,493 patients from 84 clinical trials were included in the analysis, treated with artemether-lumefantrine (n = 13,664), artesunate-amodiaquine (n = 11,337) and dihydroartemisinin-piperaquine (n = 4,492). The overall parasite clearance rate was rapid. The parasite positivity rate (PPR) decreased from 59.7 % (95 % CI: 54.5-64.9) on day 1 to 6.7 % (95 % CI: 4.8-8.7) on day 2 and 0.9 % (95 % CI: 0.5-1.2) on day 3. The 95th percentile of observed day 3 PPR was 5.3 %. Independent risk factors predictive of day 3 positivity were: high baseline parasitaemia (adjusted odds ratio (AOR) = 1.16 (95 % CI: 1.08-1.25); per 2-fold increase in parasite density, P <0.001); fever (>37.5 °C) (AOR = 1.50 (95 % CI: 1.06-2.13), P = 0.022); severe anaemia (AOR = 2.04 (95 % CI: 1.21-3.44), P = 0.008); areas of low/moderate transmission setting (AOR = 2.71 (95 % CI: 1.38-5.36), P = 0.004); and treatment with the loose formulation of artesunate-amodiaquine (AOR = 2.27 (95 % CI: 1.14-4.51), P = 0.020, compared to dihydroartemisinin-piperaquine). CONCLUSIONS: The three ACTs assessed in this analysis continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.

La fureur divine et son détournement en Nb 25

The story Numbers of 25 which reports the incident of Baal Peor is one among several texts in the book of Numbers focusing on divine wrath, its cause and its consequences. The present article offers a detailed analysis of the account which is difficult to understand because of certain jumps in the plot and because of its allusive style. Scholars mostly agree with the idea that the story grew in two or three stages. A lot of commentators believe that the original story contains only the apostasy of Peor caused by the Moabites (vv. 1-5). A subsequent story would focus on Pinchas' action against Zimri and Kospi, and a third layer is linked to the story of the war between Israel and Midian (Numbers 31). The problem of this theory however is that it seems impossible to reconstruct an original story about the matter of Peor; one does not find a satisfying end within vv. 1-5. Furthermore, v. 5, which belongs to the first, "Moabite", section, is already linked to the theme of Midian which dominates the second and the third passage. Moreover, the assemblage of different themes and motifs seem having been done with care: Regarding the two abuses of Israel reported in the story--idolatry and intermarriage--, they often go together in late polemical Deuteronomistic and post-Deuteronomistic layers (Ezra-Nehemiah). The double focus on Midian and Moab could both be polemically directed against certain Moses traditions found in the books of Exodus and Deuteronomy (concerning Moses' marriage with a Midianite women on the one hand and his stay and death and burial in Moab - in the vicinity of Beth Peor - on the other hand). As in several ANE traditions also in the Hebrew Bible the motif of "divine wrath" serves to interpret fatal historical events; in Num 25 as in other Biblical stories however it is doubtful whether the alleged incident (the plague) really have taken place and the story's plot is anchored in ancient Israel's history.

Vanha juutalainen musiikki Helsingissä : historiallis-lingvistinen katsaus

Johdanto ; Jiddišinkielinen kansanlauluperinne ; Klezmer-musiikki ; Liturgiset sävelmät ja paraliturgiset laulut ; Lopuksi.

Digital Preservation Tools, Practices, and Policies in Islandora

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

A Distributed Microservices Framework Integrating Taverna

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Typus generalis Ukrainae, sive, Palatinatuum Podoliae, Kioviensis et Braczlaviensis terras nova delineatione exhibens

Kartta kuuluu A. E. Nordenskiöldin kokoelmaan

Magnus ducatus Finlandiae nova et accurata delineatio.

[N. 1:2000000].

Novissima Russiae tabula Authore Isaaco Massa. Doctrina et humanitate praedito d. Isaaco Bernart, rerum quae per Moscoviam maxime trahuntur mercatori peritissimo, hanc Moscoviae tabula dedicat affinis finis Hen. Hondius.

Janamittakaavat: Wirst, seu Milliaria Russica ; Miliaria Germanica.

Variation of some chemical and functional properties of Bambara groundnut (Voandzeia Subterranean L. Thouars) during sort time storage

Abstract The storage susceptibility of Bambara groundnut (B. G.) (Voandzeia Subterranean (L.) Thouars) to Callosobruchus maculatus and chemical and functional properties of 11 varieties form Far-North of Cameroon were investigate using standard analytical methods. Storage susceptibility shown that, after five months within treatment, C. maculatus destroy 10 to 50% of grains. The chemical characteristics of none attack grains of 11 varieties were range to 18.64 at 21.08%, 6.85 at 7.44%, 49.75 at 52.68% and to 6.05 at 7.55% respectively for protein, fat, starch and free carbohydrate. These chemical characteristics significantly (p < 0.05) decreases form attacks varieties. For the functional parameters, the none attacks grains was range of 130 at 135%, 19.15 at 20.91%, 18.20 at 21.13%, 2.76 at 3.21% and of 8.54 at 10.14% respectively for water capacity absorption, solubility index, gel length, ash and humidity. The results of this study indicated that storage susceptibility, chemical and functional properties of B. G. be dependant to the varieties.

Canadian Niagara Power Company fonds

Power at the Falls: The first recorded harnessing of Niagara Falls power was in 1759 by Daniel Joncairs. On the American side of the Falls he dug a small ditch and drew water to turn a wheel which powered a sawmill. In 1805 brothers Augustus and Peter Porter expanded on Joncairs idea. They bought the American Falls from New York State at public auction. Using Joncairs old site they built a gristmill and tannery which stayed in business for twenty years. The next attempt at using the Falls came in 1860 when construction of the hydraulic canal began by the Niagara Falls Hydraulic Power and Manufacturing Co. The canal was complete in 1861 and brought water from the Niagara river, above the falls, to the mills below. By 1881 the Niagara Falls Hydraulic Power and Manufacturing Co. had a small generating station which provided some electricity to the village of Niagara Falls and the Mills. This lasted only four years and then the company sold its assets at public auction due to bankruptcy. Jacob Schoellkopf arrived at the Falls in 1877 with the purchase of the hydraulic canal land and water and power rights. In 1879 Schoellkopf teamed up with Charles Brush (of Euclid Ohio) and powered Brush’s generator and carbon arc lights with the power from his water turbines, to illuminate the Falls electrically for the first time. The year 1895 marked the opening of the Adam No. 1 generating station on the American side. The station was the beginnings of modern electrical utility operations. The design and operations of the generating station came from worldwide competitions held by panels of experts. Some who were involved in the project include; George Westinghouse, J. Pierpont Morgan, Lord Kelvin and Nikoli Tesla. The plants were operated by the Niagara Falls Power Company until 1961, when the Robert Moses Plant began operation in Lewiston, NY. The Adams plants were demolished that same year and the site used as a sewage treatment plant. The Canadian side of the Falls began generating their own power on January 1, 1905. This power came from the William Birch Rankine Power Station located 500 yards above the Horseshoe Falls. This power station provided the village of Fort Erie with its first electricity in 1907, using its two 10,000 electrical horsepower generators. Today 11 generators produce 100,000 horsepower (75 megawatts) and operate as part of the Niagara Mohawk and Fortis Incorporated Power Group.

Letter to Mr. Henry H. Collier, 1837

Henry Haight Collier, was born in Howard, Steuben County, N. Y., November 28, 1818. His father, Richard Collier, was from Green County, in the same State. His grandfather, Isaac Collier, and his great-grandfather were originally from England. His mother, Mary Haight, was of Dutch origin. In 1835, Henry went to St. Catharines, where his elder brother, Richard Collier, resided. He spent two years at Grantham Academy, and then returned to Steuben County, to read law in Bath, with Edward Howell, and subsequently with Hammond and Campbell. Mr. Collier never opened a law office. He studied law for two years and in 1839 he went to Texas where he was connected with the State and Treasury Departments. In 1845 Mr. Collier returned to St. Catharines and opened a general store called St. Catharines Agricultural Works with his brother. The store remained open until May, 1877. He added the manufacturing of lumber in 1850, and manufacturing of agricultural implements in 1869. He built one of the first saw mills on the canal, on Lock No. 5, in St. Catharines. In July, 1877, he was appointed Collector of Customs. He became a Village Councilor for St. Paul’s Ward in 1859, and held that office from fifteen to twenty years. He was Deputy Reeve and member of the County Council for two terms. He was the Mayor of St. Catharines in 1872 and 1873. He was also Chairman of the Board of Water Commissioners of the city, during the time that the works were being built. He was a Justice of the Peace for twenty years or more. Mr. Collier was affiliated with the Reform Party and he was a Knight Templar in the Masonic fraternity and an Odd Fellow. He was also active in the Methodist Church. On June 1, 1858, he married Cornelia, daughter of Moses Cook, of "Westchester Place," St. Catharines, and had a daughter and son. Mary J. (married name: Mrs. Frank Camp) was a graduate of the Female Seminary at Hamilton, and Henry Herbert was a student in the University of Toronto. Henry H. Collier died on July 15, 1895 and is buried in Victoria Lawn Cemetery, St. Catharines, Ontario. Sources: www.accessgeneology.com "Historical Profiles from Victoria Lawn Cemetery" by Paul E. Lewis "Sincerely Lamented St. Catharines Obituaries 1817-1918" by Paul Hutchison

Aboriginal Parental Involvement/Engagement for Student Success

An increasing body of knowledge links parental involvement with student success but few studies address Aboriginal parental involvement in urban settings. While some critics argue traditional Aboriginal knowledge is best delivered at home, Aboriginal children who share parents’ stories in the classroom benefit other children who draw connections to these stories. Moreover, Aboriginal learners need to function in mainstream Western society and in public school settings in which educators often have a difficult time engaging Aboriginal parents. Consequently, this research sought to explore the perceptions and sense of engagement of parents/caregivers in the Aboriginal Student Program (ASP) in a publicly funded secondary school in Ontario. The study was an extension of the researcher’s existing work and focused specifically on a sample of parents/caregivers taking part in an Aboriginal feast at an Ontario secondary school. Nine individuals accepted an invitation to participate in a Talking Circle and shared perceptions of their children’s educational experiences. Data were collected and coded, and findings indicated that parental involvement in children’s educational journeys contributed significantly to a sense of parental engagement in the school and in Aboriginal programs. Results also suggest that Eurocentric pedagogy can be modified in mainstream secondary schools to directly involve Aboriginal parents/caregivers. Although many participants’ stories revealed they experienced racism during their own schooling, study findings demonstrate that the parents/caregivers want to be involved in their children’s education nonetheless. This thesis discusses the data that were grounded in the participants’ voices that in turn led to several key recommendations.