An Aquaculture-Based Method for Calibrated Bivalve Isotope Paleothermometry

To quantify species- specific relationships between bivalve carbonate isotope geochemistry ( delta O-18(c)) and water conditions ( temperature and salinity, related to water isotopic composition [delta O-18(w)]), an aquaculture-based methodology was developed and applied to Mytilus edulis ( blue mussel). The four- by- three factorial design consisted of four circulating temperature baths ( 7, 11, 15, and 19 degrees C) and three salinity ranges ( 23, 28, and 32 parts per thousand ( ppt); monitored for delta O-18(w) weekly). In mid- July of 2003, 4800 juvenile mussels were collected in Salt Bay, Damariscotta, Maine, and were placed in each configuration. The size distribution of harvested mussels, based on 105 specimens, ranged from 10.9 mm to 29.5 mm with a mean size of 19.8 mm. The mussels were grown in controlled conditions for up to 8.5 months, and a paleotemperature relationship based on juvenile M. edulis from Maine was developed from animals harvested at months 4, 5, and 8.5. This relationship [ T degrees C = 16.19 (+/- 0.14) - 4.69 (+/- 0.21) {delta O-18(c) VPBD - delta O-18(w) VSMOW} + 0.17 (+/- 0.13) {delta O-18(c) VPBD - delta O-18(w) VSMOW}(2); r(2) = 0.99; N = 105; P < 0.0001] is nearly identical to the Kim and O'Neil ( 1997) abiogenic calcite equation over the entire temperature range ( 7 - 19 degrees C), and it closely resembles the commonly used paleotemperature equations of Epstein et al. ( 1953) and Horibe and Oba ( 1972). Further, the comparison of the M. edulis paleotemperature equation with the Kim and O'Neil ( 1997) equilibrium- based equation indicates that M. edulis specimens used in this study precipitated their shell in isotopic equilibrium with ambient water within the experimental uncertainties of both studies. The aquaculture- based methodology described here allows similar species- specific isotope paleothermometer calibrations to be performed with other bivalve species and thus provides improved quantitative paleoenvironmental reconstructions.

Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents.

BACKGROUND Dual antiplatelet therapy is recommended after coronary stenting to prevent thrombotic complications, yet the benefits and risks of treatment beyond 1 year are uncertain. METHODS Patients were enrolled after they had undergone a coronary stent procedure in which a drug-eluting stent was placed. After 12 months of treatment with a thienopyridine drug (clopidogrel or prasugrel) and aspirin, patients were randomly assigned to continue receiving thienopyridine treatment or to receive placebo for another 18 months; all patients continued receiving aspirin. The coprimary efficacy end points were stent thrombosis and major adverse cardiovascular and cerebrovascular events (a composite of death, myocardial infarction, or stroke) during the period from 12 to 30 months. The primary safety end point was moderate or severe bleeding. RESULTS A total of 9961 patients were randomly assigned to continue thienopyridine treatment or to receive placebo. Continued treatment with thienopyridine, as compared with placebo, reduced the rates of stent thrombosis (0.4% vs. 1.4%; hazard ratio, 0.29 [95% confidence interval {CI}, 0.17 to 0.48]; P<0.001) and major adverse cardiovascular and cerebrovascular events (4.3% vs. 5.9%; hazard ratio, 0.71 [95% CI, 0.59 to 0.85]; P<0.001). The rate of myocardial infarction was lower with thienopyridine treatment than with placebo (2.1% vs. 4.1%; hazard ratio, 0.47; P<0.001). The rate of death from any cause was 2.0% in the group that continued thienopyridine therapy and 1.5% in the placebo group (hazard ratio, 1.36 [95% CI, 1.00 to 1.85]; P=0.05). The rate of moderate or severe bleeding was increased with continued thienopyridine treatment (2.5% vs. 1.6%, P=0.001). An elevated risk of stent thrombosis and myocardial infarction was observed in both groups during the 3 months after discontinuation of thienopyridine treatment. CONCLUSIONS Dual antiplatelet therapy beyond 1 year after placement of a drug-eluting stent, as compared with aspirin therapy alone, significantly reduced the risks of stent thrombosis and major adverse cardiovascular and cerebrovascular events but was associated with an increased risk of bleeding. (Funded by a consortium of eight device and drug manufacturers and others; DAPT ClinicalTrials.gov number, NCT00977938.).

Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization

The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain ∼8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD.

Adjuvant ovarian suppression in premenopausal breast cancer.

BACKGROUND Suppression of ovarian estrogen production reduces the recurrence of hormone-receptor-positive early breast cancer in premenopausal women, but its value when added to tamoxifen is uncertain. METHODS We randomly assigned 3066 premenopausal women, stratified according to prior receipt or nonreceipt of chemotherapy, to receive 5 years of tamoxifen, tamoxifen plus ovarian suppression, or exemestane plus ovarian suppression. The primary analysis tested the hypothesis that tamoxifen plus ovarian suppression would improve disease-free survival, as compared with tamoxifen alone. In the primary analysis, 46.7% of the patients had not received chemotherapy previously, and 53.3% had received chemotherapy and remained premenopausal. RESULTS After a median follow-up of 67 months, the estimated disease-free survival rate at 5 years was 86.6% in the tamoxifen-ovarian suppression group and 84.7% in the tamoxifen group (hazard ratio for disease recurrence, second invasive cancer, or death, 0.83; 95% confidence interval [CI], 0.66 to 1.04; P=0.10). Multivariable allowance for prognostic factors suggested a greater treatment effect with tamoxifen plus ovarian suppression than with tamoxifen alone (hazard ratio, 0.78; 95% CI, 0.62 to 0.98). Most recurrences occurred in patients who had received prior chemotherapy, among whom the rate of freedom from breast cancer at 5 years was 82.5% in the tamoxifen-ovarian suppression group and 78.0% in the tamoxifen group (hazard ratio for recurrence, 0.78; 95% CI, 0.60 to 1.02). At 5 years, the rate of freedom from breast cancer was 85.7% in the exemestane-ovarian suppression group (hazard ratio for recurrence vs. tamoxifen, 0.65; 95% CI, 0.49 to 0.87). CONCLUSIONS Adding ovarian suppression to tamoxifen did not provide a significant benefit in the overall study population. However, for women who were at sufficient risk for recurrence to warrant adjuvant chemotherapy and who remained premenopausal, the addition of ovarian suppression improved disease outcomes. Further improvement was seen with the use of exemestane plus ovarian suppression. (Funded by Pfizer and others; SOFT ClinicalTrials.gov number, NCT00066690.).

Worlds that passed

by A. S. Sachs. [Transl. by Harold Berman]

Irisin – a myth rather than an exercise-inducible myokine

The myokine irisin is supposed to be cleaved from a transmembrane precursor, FNDC5 (fibronectin type III domain containing 5), and to mediate beneficial effects of exercise on human metabolism. However, evidence for irisin circulating in blood is largely based on commercial ELISA kits which are based on polyclonal antibodies (pAbs) not previously tested for cross-reacting serum proteins. We have analyzed four commercial pAbs by Western blotting, which revealed prominent cross-reactivity with non-specific proteins in human and animal sera. Using recombinant glycosylated and non-glycosylated irisin as positive controls, we found no immune-reactive bands of the expected size in any biological samples. A FNDC5 signature was identified at ~20 kDa by mass spectrometry in human serum but was not detected by the commercial pAbs tested. Our results call into question all previous data obtained with commercial ELISA kits for irisin, and provide evidence against a physiological role for irisin in humans and other species.

Juden und Griechen im römischen Alexandreia : eine historische Skizze des alexandrinischen Antisemitismus

von H. I. Bell

Adjuvant exemestane with ovarian suppression in premenopausal breast cancer.

BACKGROUND Adjuvant therapy with an aromatase inhibitor improves outcomes, as compared with tamoxifen, in postmenopausal women with hormone-receptor-positive breast cancer. METHODS In two phase 3 trials, we randomly assigned premenopausal women with hormone-receptor-positive early breast cancer to the aromatase inhibitor exemestane plus ovarian suppression or tamoxifen plus ovarian suppression for a period of 5 years. Suppression of ovarian estrogen production was achieved with the use of the gonadotropin-releasing-hormone agonist triptorelin, oophorectomy, or ovarian irradiation. The primary analysis combined data from 4690 patients in the two trials. RESULTS After a median follow-up of 68 months, disease-free survival at 5 years was 91.1% in the exemestane-ovarian suppression group and 87.3% in the tamoxifen-ovarian suppression group (hazard ratio for disease recurrence, second invasive cancer, or death, 0.72; 95% confidence interval [CI], 0.60 to 0.85; P<0.001). The rate of freedom from breast cancer at 5 years was 92.8% in the exemestane-ovarian suppression group, as compared with 88.8% in the tamoxifen-ovarian suppression group (hazard ratio for recurrence, 0.66; 95% CI, 0.55 to 0.80; P<0.001). With 194 deaths (4.1% of the patients), overall survival did not differ significantly between the two groups (hazard ratio for death in the exemestane-ovarian suppression group, 1.14; 95% CI, 0.86 to 1.51; P=0.37). Selected adverse events of grade 3 or 4 were reported for 30.6% of the patients in the exemestane-ovarian suppression group and 29.4% of those in the tamoxifen-ovarian suppression group, with profiles similar to those for postmenopausal women. CONCLUSIONS In premenopausal women with hormone-receptor-positive early breast cancer, adjuvant treatment with exemestane plus ovarian suppression, as compared with tamoxifen plus ovarian suppression, significantly reduced recurrence. (Funded by Pfizer and others; TEXT and SOFT ClinicalTrials.gov numbers, NCT00066703 and NCT00066690, respectively.).

A deep crust–mantle boundary in the asteroid 4 Vesta

The asteroid 4 Vesta was recently found to have two large impact craters near its south pole, exposing subsurface material. Modelling suggested that surface material in the northern hemisphere of Vesta came from a depth of about 20 kilometres, whereas the exposed southern material comes from a depth of 60 to 100 kilometres. Large amounts of olivine from the mantle were not seen, suggesting that the outer 100 kilometres or so is mainly igneous crust. Here we analyse the data on Vesta and conclude that the crust–mantle boundary (or Moho) is deeper than 80 kilometres.

Todesfall eines Patienten mit Herzunterstützungssystem

Herzunterstützungssysteme werden bei Patienten mit terminalem Herzversagen und im kardiogenen Schock verwendet. Therapieziele sind die Überbrückung bis zur Transplantation bzw. zur Organerholung. Berichtet wird über den Todesfall eines 69 Jahre alt gewordenen Mannes, dem 2 Jahre vor Todeseintritt ein Linksherzunterstützungssystem implantiert worden war. Mit diesem Herzunterstützungssystem konnte er über einen Zeitraum von 2 Jahren zufriedenstellend leben. Er starb an einem auch laborchemisch gesicherten akuten Myokardinfarkt bei Funktionsfähigkeit des Unterstützungssystems und der Schrittmachereinheit.

The Aramaic of the Old Testament : a grammatical and lexical study of its relations with other early Aramaic dialects

by H. H. Rowley

Sport clubs in Europe. A cross-national comparative perspective

​This book presents an up-to-date portrait of the characteristics of sport clubs in various European countries and their role in society and the national sport system. Furthermore, it offers a cross-national comparative perspective of sport clubs in twenty European countries. Containing both empirical data and information on the political and historical backgrounds of sport clubs, the book is organized in three parts. First, the authors provide an overview of the theoretical approach of the book and a description of the framework used for the country chapters. Second, the country chapters, written by experts within the field, provide a systematic overview of the available information on sport clubs in each country. These chapters are structured to answer the following questions: (1) What is the position of sport clubs within the national sport structure? (2) Which role do they fulfil in policy and society? (3) What are their basic characteristics and what factors influence the development of sport clubs? The book is concluded with a systematic comparison of the participating countries with the purpose of forging a clear link between the functioning of policy systems, observed problems, and possible solutions, and with a future research agenda on sport clubs. In an era of increased collaboration between European states, sport provides a natural vehicle through which to compare changes in culture, economics, and policy across nations. Sport Clubs in Europe will appeal to scholars of nonprofit management, sports management and sports sociology as well as administrators and policy makers in the international sports community.