Bivalirudin Versus Heparin Anticoagulation in Transcatheter Aortic Valve Replacement: The Randomized BRAVO-3 Trial.

BACKGROUND Anticoagulation is required during transcatheter aortic valve replacement (TAVR) procedures. Although an optimal regimen has not been determined, heparin is mainly used. Direct thrombin inhibition with bivalirudin may be an effective alternative to heparin as the procedural anticoagulant agent in this setting. OBJECTIVES The goal of this study was to determine whether bivalirudin offers an alternative to heparin as the procedural anticoagulant agent in patients undergoing TAVR. METHODS A total of 802 patients with aortic stenosis were randomized to undergo transfemoral TAVR with bivalirudin versus unfractionated heparin during the procedure. The 2 primary endpoints were major bleeding within 48 h or before hospital discharge (whichever occurred first) and 30-day net adverse clinical events, defined as the combination of major adverse cardiovascular events (all-cause mortality, myocardial infarction, or stroke) and major bleeding. RESULTS Anticoagulation with bivalirudin versus heparin did not meet superiority because it did not result in significantly lower rates of major bleeding at 48 h (6.9% vs. 9.0%; relative risk: 0.77; 95% confidence interval [CI]: 0.48 to 1.23; p = 0.27) or net adverse cardiovascular events at 30 days (14.4% vs. 16.1%; relative risk: 0.89; 95% CI: 0.64 to 1.24; risk difference: -1.72; 95% CI: -6.70 to 3.25; p = 0.50); regarding the latter, the prespecified noninferiority hypothesis was met (pnoninferiority < 0.01). Rates of major adverse cardiovascular events at 48 h were not significantly different (3.5% vs. 4.8%; relative risk: 0.73; 95% CI: 0.37 to 1.43; p = 0.35). At 48 h, the bivalirudin group had significantly fewer myocardial infarctions but more acute kidney injury events than the heparin group; at 30 days, these differences were no longer significant. CONCLUSIONS In this randomized trial of TAVR procedural pharmacotherapy, bivalirudin did not reduce rates of major bleeding at 48 h or net adverse cardiovascular events within 30 days compared with heparin. Although superiority was not shown, the noninferiority hypothesis was met with respect to the latter factor. Given the lower cost, heparin should remain the standard of care, and bivalirudin can be an alternative anticoagulant option in patients unable to receive heparin in TAVR. (International, Multi-center, Open-label, Randomized Controlled Trial in Patients Undergoing TAVR to Determine the Treatment Effect [Both Safety and Efficacy] of Using Bivalirudin Instead of UFH [BRAVO-2/3]; NCT01651780).

Rituximab Maintenance for a Maximum of 5 Years After Single-Agent Rituximab Induction in Follicular Lymphoma: Results of the Randomized Controlled Phase III Trial SAKK 35/03.

PURPOSE Rituximab maintenance therapy has been shown to improve progression-free survival in patients with follicular lymphoma; however, the optimal duration of maintenance treatment remains unknown. PATIENTS AND METHODS Two hundred seventy patients with untreated, relapsed, stable, or chemotherapy-resistant follicular lymphoma were treated with four doses of rituximab monotherapy in weekly intervals (375 mg/m(2)). Patients achieving at least a partial response were randomly assigned to receive maintenance therapy with one infusion of rituximab every 2 months, either on a short-term schedule (four administrations) or a long-term schedule (maximum of 5 years or until disease progression or unacceptable toxicity). The primary end point was event-free survival (EFS). Progression-free survival, overall survival (OS), and toxicity were secondary end points. Comparisons between the two arms were performed using the log-rank test for survival end points. RESULTS One hundred sixty-five patients were randomly assigned to the short-term (n = 82) or long-term (n = 83) maintenance arms. Because of the low event rate, the final analysis was performed after 95 events had occurred, which was before the targeted event number of 99 had been reached. At a median follow-up period of 6.4 years, the median EFS was 3.4 years (95% CI, 2.1 to 5.3) in the short-term arm and 5.3 years (95% CI, 3.5 to not available) in the long-term arm (P = .14). Patients in the long-term arm experienced more adverse effects than did those in the short-term arm, with 76% v 50% of patients with at least one adverse event (P < .001), five versus one patient with grade 3 and 4 infections, and three versus zero patients discontinuing treatment because of unacceptable toxicity, respectively. There was no difference in OS between the two groups. CONCLUSION Long-term rituximab maintenance therapy does not improve EFS, which was the primary end point of this trial, or OS, and was associated with increased toxicity.

Reduced foveal vision enhances peripheral monitoring and peripheral event detection

Introduction: Although it seems plausible that sports performance relies on high-acuity foveal vision, it could be empirically shown that myoptic blur (up to +2 diopters) does not harm performance in sport tasks that require foveal information pick-up like golf putting (Bulson, Ciuffreda, & Hung, 2008). How myoptic blur affects peripheral performance is yet unknown. Attention might be less needed for processing visual cues foveally and lead to better performance because peripheral cues are better processed as a function of reduced foveal vision, which will be tested in the current experiment. Methods: 18 sport science students with self-reported myopia volunteered as participants, all of them regularly wearing contact lenses. Exclusion criteria comprised visual correction other than myopic, correction of astigmatism and use of contact lenses out of Swiss delivery area. For each of the participants, three pairs of additional contact lenses (besides their regular lenses; used in the “plano” condition) were manufactured with an individual overcorrection to a retinal defocus of +1 to +3 diopters (referred to as “+1.00 D”, “+2.00 D”, and “+3.00 D” condition, respectively). Gaze data were acquired while participants had to perform a multiple object tracking (MOT) task that required to track 4 out of 10 moving stimuli. In addition, in 66.7 % of all trials, one of the 4 targets suddenly stopped during the motion phase for a period of 0.5 s. Stimuli moved in front of a picture of a sports hall to allow for foveal processing. Due to the directional hypotheses, the level of significance for one-tailed tests on differences was set at α = .05 and posteriori effect sizes were computed as partial eta squares (ηρ2). Results: Due to problems with the gaze-data collection, 3 participants had to be excluded from further analyses. The expectation of a centroid strategy was confirmed because gaze was closer to the centroid than the target (all p < .01). In comparison to the plano baseline, participants more often recalled all 4 targets under defocus conditions, F(1,14) = 26.13, p < .01, ηρ2 = .65. The three defocus conditions differed significantly, F(2,28) = 2.56, p = .05, ηρ2 = .16, with a higher accuracy as a function of a defocus increase and significant contrasts between conditions +1.00 D and +2.00 D (p = .03) and +1.00 D and +3.00 D (p = .03). For stop trials, significant differences could neither be found between plano baseline and defocus conditions, F(1,14) = .19, p = .67, ηρ2 = .01, nor between the three defocus conditions, F(2,28) = 1.09, p = .18, ηρ2 = .07. Participants reacted faster in “4 correct+button” trials under defocus than under plano-baseline conditions, F(1,14) = 10.77, p < .01, ηρ2 = .44. The defocus conditions differed significantly, F(2,28) = 6.16, p < .01, ηρ2 = .31, with shorter response times as a function of a defocus increase and significant contrasts between +1.00 D and +2.00 D (p = .01) and +1.00 D and +3.00 D (p < .01). Discussion: The results show that gaze behaviour in MOT is not affected to a relevant degree by a visual overcorrection up to +3 diopters. Hence, it can be taken for granted that peripheral event detection was investigated in the present study. This overcorrection, however, does not harm the capability to peripherally track objects. Moreover, if an event has to be detected peripherally, neither response accuracy nor response time is negatively affected. Findings could claim considerable relevance for all sport situations in which peripheral vision is required which now needs applied studies on this topic. References: Bulson, R. C., Ciuffreda, K. J., & Hung, G. K. (2008). The effect of retinal defocus on golf putting. Ophthalmic and Physiological Optics, 28, 334-344.

Enhanced Cold Tolerance in Transgenic Tobacco Expressing a Chloroplast Omega-3 Fatty Acid Desaturase Gene under the Control of a Cold-inducible Promoter

A new cold-inducible genetic construct was cloned using a chloroplast-specific omega-3-fatty acid desaturase gene (FAD7) under the control of a cold-inducible promoter (cor15a) from Arabidopsis thaliana. RT-PCR confirmed a marked increase in FAD7 expression, in young Nicotiana tabacum (cv. Havana) plants harboring cor15a-FAD7, after a short-term exposure to cold. When young, cold-induced tobacco seedlings were exposed to low-temperature (0.5, 2 or 3.5 degrees C) for up to 44 days, survival within independent cor15a-FAD7 transgenic lines (40.2-96%) was far superior to the wild type (6.7-10.2%). In addition, the major trienoic fatty acid species remained stable in cold-induced cor15a-FAD7 N. tabacum plants under prolonged cold storage while the levels of hexadecatrienoic acid (16:3) and octadecatrienoic acid (18:3) declined in wild type plants under the same conditions (79 and 20.7% respectively). Electron microscopy showed that chloroplast membrane ultrastructure in cor15a-FAD7 transgenic plants was unaffected by prolonged exposure to cold temperatures. In contrast, wild type plants experienced a loss of granal stacking and disorganization of the thylakoid membrane under the same conditions. Changes in membrane integrity coincided with a precipitous decline in leaf chlorophyll concentration and low survival rates in wild type plants. Cold-induced double transgenic N. alata (cv. Domino Mix) plants, harboring both the cor15a-FAD7 cold-tolerance gene and a cor15a-IPT dark-tolerance gene, exhibited dramatically higher survival rates (89-90%) than wild type plants (2%) under prolonged cold storage under dark conditions (2 degrees C for 50 days).

Fragm. lat. III 5 - Inventar

Trägerband: Ms. Barth. 129; Vorbesitzer: Bartholomaeusstift Frankfurt am Main

Grain size analysis of sediment coring site CRP-2 from the Ross Sea, Antarctica

The purpose of this note is to present results of grain size analyses from 118 samples of the CRP-2/2A core using sieve and Sedigraph techniques. The samples were selected to represent the range of facies encountered, and tend to become more widely spaced with depth. Fifteen came from the upper 27 m of Quaternary and Pliocene sediments, 62 from the early Miocene-late Oligocene strata (27 to 307 mbsf), and 41 from the early Oligocene strata beneath (307 to 624 mbsf). The results are intended to provide reference data for lithological descriptions in the core logs (Cape Roberts Science Team, 1999), and to help with facies interpretation. The analytical technique used for determining size frequency of the sand fraction in our samples (sieving) is simple, physical and widely practised for over a century. Thus it provides a useful reference point for analyses produced by other faster and more sophisticated techniques, such as the Malvern laser particle size analysis system (Woolfe et al., 2000), and estimates derived from measurements taken with down-hole logging tools (Bücker, pers. com., 1999).

El impacto de la asignación universal por hijo en la provincia de Mendoza

La universalización de las asignaciones familiares a través de la implementación de la Asignación Universal por Hijo (en adelante AUH), teniendo en cuenta el número de menores que se ven beneficiados por esta política (más de 3,5 millones), generó un amplio debate por diferentes investigadores, periodistas y referentes políticos, en relación a los efectos que se producirán en el corto y largo plazo en nuestra sociedad. Los investigadores del CIFRA (Centro de Investigación y Formación de la República Argentina), indican que “frente a la falta de una política clara tendiente a garantizar la demanda agregada interna, la implementación de la AUH implica un cambio importante". De este análisis se desprende la posibilidad y necesidad de conjugar la equidad social con el crecimiento económico. En el mismo sentido, resaltan “más allá de combatir la pobreza y la indigencia de forma directa, la transferencia de ingresos hacia los sectores más desprotegidos implica un fuerte impulso al consumo, generando un efecto multiplicador positivo". Existen diferentes investigaciones, a nivel nacional, que analizan el impacto de la AUH sobre los niveles de pobreza, indigencia, consumo, entre otros. El objetivo de este documento es presentar un análisis de la asignación universal por hijo y su potencial impacto sobre la Provincia de Mendoza. Para ello, en los dos primeros capítulos se describe 5 el sistema contributivo de asignaciones familiares por hijo y la nueva asignación universal no contributiva. En el capítulo tres se describen los programas asistenciales similares a la AUH, referentes a siete países de América Latina. En el capítulo cuatro se presenta la estimación del impacto potencial de la AUH en la pobreza e indigencia de nuestra provincia, como así también el impacto sobre la demanda agregada. Para finalizar se abordarán las conclusiones y recomendaciones.

(Table 1) Stable isotope data of chemoherm carbonates at Hydrate Ridge on the Cascadia continental margin

Two active chemoherm build-ups growing freely up into the oceanic water column, the Pinnacle and the South East-Knoll Chemoherms, have been discovered at Hydrate Ridge on the Cascadia continental margin. These microbially-mediated carbonate formations rise above the seafloor by several tens of meters and display a pinnacle-shaped morphology with steep flanks. The recovered rocks are pure carbonates dominated by aragonite. Based on fabric and mineralogic composition different varieties of authigenic aragonite can be distinguished. Detailed visual and petrographic investigations unambiguously reveal the involvement of microbes during the formation of the carbonates. The fabric of the cryptocrystalline and fibrous aragonite can be described as thrombolitic. Fossilized microbial filaments in the microcrystalline aragonite indicate the intimate relationship between microbes and carbonates. The strongly 13C-depleted carbon isotope values of the samples (as low as -48.1 per mill PDB) are characteristic of methane as the major carbon source for the carbonate formation. The methane-rich fluids from which the carbonates are precipitated originate most probably from a gas reservoir below the bottom-simulating reflector (BSR) and rise through fault systems. The d18O values of the aragonitic chemoherm carbonates are substantially higher (as high as 5.0 per mill PDB) than the expected equilibrium value for an aragonite forming from ambient seawater (3.5 per mill PDB). As a first approximation this indicates formation from glacial ocean water but other factors are considered as well. A conceptual model is presented for the precipitation of these chemoherm carbonates based on in situ observations and the detailed petrographic investigation of the carbonates. This model explains the function of the consortium of archaea and sulfate-reducing bacteria that grows on the carbonates performing anaerobic oxidation of methane (AOM) and enabling the precipitation of the chemoherms above the seafloor surrounded by oxic seawater. Beggiatoa mats growing on the surface of the chemoherms oxidize the sulfide provided by sulfate-dependent anaerobic oxidation of methane within an oxic environment. The contact between Beggiatoa and the underlying microbial consortium represents the interface between the overlying oxic water column and an anoxic micro-environment where carbonate formation takes place.

(Table 3) Sedimentation rates of stage 1 and last glacial maximum from different Holes during cruises of RRS Discovery in 1984-1985 and 1987-1988, and RRS James Clark Ross in 1992-1993

Within the Scotia Sea, the axis of the Antarctic Circumpolar Current (ACC) is geographically confined, and sediments therefore contain a record of palaeo-flow speed uncomplicated by ACC axis migration. We outline Holocene and Last Glacial Maximum (LGM) current-controlled sedimentation using data from 3.5-kHz profiles, cores and current meter moorings. Geophysical surveys show areas of erosion and deposition controlled by Neogene basement topography. Deposition occurs in mounded sediment drifts or flatter areas, where 500-1000 m of sediment overlies acoustic basement. 3.5-kHz profiles show parallel, continuous sub-bottom reflectors with highest sedimentation rates in the centre of the drifts, and reflectors converging towards marginal zones of non-deposition. Locally, on the flanks of continental blocks (e.g. South Georgia), downslope processes are dominant. The absence of mudwaves on the sediment drifts may result from the unsteadiness of ACC flow. A core transect from the ACC axis south to the boundary with the Weddell Gyre shows a southward decrease in biogenic content, controlled by the Polar Front and the spring sea-ice edge. Both these features lay farther north at LGM. The cores have been dated by relative abundance of the radiolarian Cycladophora davisiana, and by changes in the biogenic Ba content, a palaeoproductivity indicator. Sedimentation rates range from 3 to 17 cm/ka. The grain size of Holocene sediments shows a coarsening trend from south to north, consistent with strongest bottom-current flow near the ACC axis, though interpretation is complicated by the presence of biogenic grains. Year-long current meter records indicate mean speeds from 7 cm/s in the south to 12 cm/s in the north, with benthic storm frequency increasing northwards. LGM sediments are predominantly terrigenous and show a clearer northward-coarsening trend, with well-sorted silts in the northern Scotia Sea. Assuming a constant terrigenous source, this implies stronger ACC flow at the LGM, contrasting with weaker Weddell Gyre flow deduced from earlier work.

Indicadores para evaluar el vocabulario y la estructura sistemática de un tesauro

Se proponen siete indicadores para evaluar la calidad del vocabulario y la estructura sistemática del tesauro, considerando que las especificaciones incluidas en las normas para su diseño y desarrollo, así como los principios de la teoría de la clasificación son los requisitos de calidad que deben alcanzar las características inherentes de los tesauros. Las características que no cumplen con dichos requisitos se consideran no conformidades. Los indicadores fueron probados en tres tesauros en español (DeCS, Spines y Tesauro de la Unesco). Los resultados fueron: a) Términos preferentes que representan más de un concepto (ideal 0): DeCS 10,8, Spines 7,3, Unesco 10,9. b) Media de palabras por término preferente (ideal menor o igual a 3): DeCS 2,3 más/menos 1,6, Spines 1,9 más/menos 0,9, Unesco 2,0 más/menos 1,1. c) Términos preferentes con formas gramaticales no aceptadas (ideal 0): DeCS 19,8, Spines 10,0, Unesco 15,8. d) Términos preferentes con formas de singular y plural no aceptadas (ideal 0): DeCS 4,7,Spines 2,2, Unesco 40,5. e) Términos preferentes que carecen de relación jerárquica (ideal 0): DeCS 0, Spines 1,4y Unesco 1,1. f) Términos preferentes con dos o más términos genéricos (ideal 0): DeCS 53,8, Spines 14,9, Unesco 0. g) Términos preferentes con un solo término específico (ideal 0): DeCS 13,5, Spines 3,5, Unesco 10,3. Se concluye que estos indicadores cumplen con los criterios de un buen indicador y pueden ser útiles para la evaluación de la calidad del tesauro durante el proceso de diseño y desarrollo.

Análisis de las características antropométricas del plantel de sub 15 del Club Atlético Juventud de Las Piedras

El objetivo de este trabajo de investigación fue describir y analizar las características antropométricas del plantel sub 15 del Club Atlético Juventud de Las Piedras y relacionarlas con sus posiciones dentro del campo de juego. Para llevar adelante este estudio se tomó una muestra de 24 jugadores de entre 14 y 15 años, ésta estuvo compuesta por 1 arquero, 9 defensas, 10 volantes y 5 delanteros. Las características antropométricas descritas y analizadas fueron las 5 masas del cuerpo: masa muscular, masa de tejido adiposo, masa ósea, masa residual y piel (protocolo de Kerr y Ross), el somatotipo (protocolo de Heat y Carter), además del peso y la talla. Para llevar adelante estos protocolos se necesitó recolectar datos de pliegues, perímetros, diámetros, peso y talla. El paradigma que sustenta esta investigación es el positivista y el modelo de investigación es el cuantitativo. El nivel que alcanza este trabajo es de tipo exploratorio. El somatotipo medio del equipo fue 2,5 - 3,9 - 2,9, que corresponde a la categoría mesomorfo balanceado. Para el puesto de arquero el somatotipo fue 4,3 - 5 - 2,5, endo mesomorfico. Para los defensas 2,6 - 4,1 - 3,2, meso ectomorfico. Para los volantes 2,5 - 3,9 - 3,8, ectomorfo mesomorfo y para los delanteros 2,6 - 4,6 - 2,7, mesomorfo balanceado. El porcentaje de tejido adiposo medio del equipo fue del 29,8 , para el puesto de arquero 34,1, para los defensas 29,1, para los volantes 30,18 y para los delanteros 26,65 . El tejido muscular medio fue de 40, para el puesto de arquero 39,2, para los defensas 41,6, para los volantes 39,4 y para los delanteros 43,1. El peso y la talla media del plantel fueron 58,1 kg. Y 169,1 cm. respectivamente. Para el puesto de arquero 58,8 kg. y 165 cm., para los defensas 61,5 kg. Y 171,3 cm., para los volantes 56,4 kg. Y 169,6 cm. y por último para los delanteros 55,6 kg. Y 163,3 cm. Como conclusiones podemos afirmar que el porcentaje de masa muscular encontrado en el plantel estuvo por debajo de la media si los comparamos con equipos de igual edad de la República Argentina, no se encontraron grandes diferencias en cuanto al peso y la talla entre las distintas 3 posiciones dentro del campo de juego, a no ser por los defensas que presenta mayor estatura y mayor peso. El puesto de arquero presenta mayor porcentaje de masa grasa. Como recomendaciones finales para futuras investigaciones se proponen entre otras indagar acerca de posibles causas que influyen en el perfil antropométrico actual de los deportistas evaluados y plantear aspectos dirigidos a optimizar el mismo, realizar un perfil completo de los deportistas y llevar adelante un estudio acerca del estado nutricional de los deportistas