Efficacy and Safety of Ticagrelor for Long-term Secondary Prevention of Atherothrombotic Events in Relation to Renal Function: Insights from the PEGASUS TIMI-54 trial

Aims: We evaluated the relationship of renal function and ischaemic and bleeding risk as well as the efficacy and safety of the P2Y12 platelet receptor inhibitor ticagrelor in stable patients with prior myocardial infarction (MI). Methods & Results: Patients with a history of MI 1-3 years prior from the Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin (PEGASUS)-TIMI 54 were stratified based on estimated glomerular filtration rate (eGFR), with<60 ml/min/1.73m2 prespecified for analysis of the effect of ticagrelor on the primary efficacy composite of cardiovascular death, MI, or stroke (MACE) and the primary safety endpoint of TIMI major bleeding. Of 20,898 patients, those with eGFR<60 (N=4,849, 23.2%) had a greater risk of MACE at 3 years relative to those without, which remained significant after multivariable adjustment (HRadj 1.54, 95% CI 1.27–1.85, p<0.001). The relative risk reduction in MACE with ticagrelor was similar in those with eGFR<60 (ticagrelor pooled vs. placebo: HR 0.81; 95% CI 0.68–0.96) vs. ≥60 (HR 0.88; 95% CI 0.77–1.00, pinteraction=0.44). However, due to the greater absolute risk in the former group, the absolute risk reduction with ticagrelor was higher: 2.7% vs. 0.63%. Bleeding tended to occur more frequently in patients with renal dysfunction. The absolute increase in TIMI major bleeding with ticagrelor was similar in those with and without eGFR<60 (1.19% vs. 1.43%), whereas the excess of minor bleeding tended to be more pronounced (1.93% vs. 0.69%). Conclusion: In patients with a history of MI, patients with renal dysfunction are at increased risk of MACE and consequently experience a particularly robust absolute risk reduction with long-term treatment with ticagrelor.

Fiber Bragg gratings of type I in SMF-28 and B/Ge fibre and type IIA B/Ge fibre under gamma radiation up to 0.54 MGy

The sensitivities of type I and IIA fibre Bragg gratings written to different reflectivities in SMF-28 and B/Ge fibres to ionizing radiation up to 0.54MGy are investigated. The Bragg wavelength shows a small and rapid increase at the start of irradiation followed by either a plateau (type I) or a decrease (type IIA).

A fresh look at S.54(2)

Examines the operation of the provisions of the Law of Property Act 1925 s.54(2) containing an exception to the rule that a deed is required in order to create a valid legal lease and conferring full legal status to short-term letting agreements created by parol, focusing on the requirements that the lease must take effect in possession and must be at the best rent reasonably obtainable without fine. Calls for the former of these two requirements to be amended and the latter abolished on the ground that they give rise to unnecessary complexity in the law and, in the case of the latter, uncertainty.

CASENOTES - Fitzkriston LLP v Panayi - Best Rents, Parol leases and Law of Property Act 1925 Section 54(2)

Casenote considers nature of ruling in Fitzkriston v Panayi and its implications for the interpretation of S.54(2) Law of Property Act 1925

Fiber Bragg gratings of type I in SMF-28 and B/Ge fibre and type IIA B/Ge fibre under gamma radiation up to 0.54 MGy

The sensitivities of type I and IIA fibre Bragg gratings written to different reflectivities in SMF-28 and B/Ge fibres to ionizing radiation up to 0.54MGy are investigated. The Bragg wavelength shows a small and rapid increase at the start of irradiation followed by either a plateau (type I) or a decrease (type IIA).

Medical School Donor Recognition Reception Photo 54

http://digitalcommons.fiu.edu/com_images/1059/thumbnail.jpg

Global compilation of benthic data sets I

Approaches to quantify the organic carbon accumulation on a global scale generally do not consider the small-scale variability of sedimentary and oceanographic boundary conditions along continental margins. In this study, we present a new approach to regionalize the total organic carbon (TOC) content in surface sediments (<5 cm sediment depth). It is based on a compilation of more than 5500 single measurements from various sources. Global TOC distribution was determined by the application of a combined qualitative and quantitative-geostatistical method. Overall, 33 benthic TOC-based provinces were defined and used to process the global distribution pattern of the TOC content in surface sediments in a 1°x1° grid resolution. Regional dependencies of data points within each single province are expressed by modeled semi-variograms. Measured and estimated TOC values show good correlation, emphasizing the reasonable applicability of the method. The accumulation of organic carbon in marine surface sediments is a key parameter in the control of mineralization processes and the material exchange between the sediment and the ocean water. Our approach will help to improve global budgets of nutrient and carbon cycles.

Calcium carbonate global LGM Burial rate data

Global databases of calcium carbonate concentrations and mass accumulation rates in Holocene and last glacial maximum sediments were used to estimate the deep-sea sedimentary calcium carbonate burial rate during these two time intervals. Sparse calcite mass accumulation rate data were extrapolated across regions of varying calcium carbonate concentration using a gridded map of calcium carbonate concentrations and the assumption that accumulation of noncarbonate material is uncorrelated with calcite concentration within some geographical region. Mean noncarbonate accumulation rates were estimated within each of nine regions, determined by the distribution and nature of the accumulation rate data. For core-top sediments the regions of reasonable data coverage encompass 67% of the high-calcite (>75%) sediments globally, and within these regions we estimate an accumulation rate of 55.9 ± 3.6 x 10**11 mol/yr. The same regions cover 48% of glacial high-CaCO3 sediments (the smaller fraction is due to a shift of calcite deposition to the poorly sampled South Pacific) and total 44.1 ± 6.0 x 10**11 mol/yr. Projecting both estimates to 100 % coverage yields accumulation estimates of 8.3 x 10**12 mol/yr today and 9.2 x 10**12 mol/yr during glacial time. This is little better than a guess given the incomplete data coverage, but it suggests that glacial deep sea calcite burial rate was probably not considerably faster than today in spite of a presumed decrease in shallow water burial during glacial time.

Data compilation on the biological response to ocean acidification: environmental and experimental context of data sets and related literature

The exponential growth of studies on the biological response to ocean acidification over the last few decades has generated a large amount of data. To facilitate data comparison, a data compilation hosted at the data publisher PANGAEA was initiated in 2008 and is updated on a regular basis (doi:10.1594/PANGAEA.149999). By January 2015, a total of 581 data sets (over 4 000 000 data points) from 539 papers had been archived. Here we present the developments of this data compilation five years since its first description by Nisumaa et al. (2010). Most of study sites from which data archived are still in the Northern Hemisphere and the number of archived data from studies from the Southern Hemisphere and polar oceans are still relatively low. Data from 60 studies that investigated the response of a mix of organisms or natural communities were all added after 2010, indicating a welcomed shift from the study of individual organisms to communities and ecosystems. The initial imbalance of considerably more data archived on calcification and primary production than on other processes has improved. There is also a clear tendency towards more data archived from multifactorial studies after 2010. For easier and more effective access to ocean acidification data, the ocean acidification community is strongly encouraged to contribute to the data archiving effort, and help develop standard vocabularies describing the variables and define best practices for archiving ocean acidification data.

Grain size composition of ocean and sea bottom sediments

On the basis of a long term research of the authors a database model of grain size composition of unlithified marine and ocean bottom sediments has been created. An improved method of water-mechanical analysis has been offered. Grain size parameters of main types of bottom sediments have been measured and calculated. The genetic interpretation of results and regularities of sandy, aleuritic and pelitic material in basins of sedimentation are under discussion.

Grain size and chemical composition of the surface sediment layer from the Pacific Ocean

The book is devoted to results of studies of Pacific sediment composition, regularities of their distribution and processes of sedimentation in the Pacific Ocean. Materials obtained by Soviet expeditions are the main part of the book.

Organic carbon accumulation in the South Atlantic Ocean

A compilation of 1118 surface sediment samples from the South Atlantic was used to map modern seafloor distribution of organic carbon content in this ocean basin. Using new data on Holocene sedimentation rates, we estimated the annual organic carbon accumulation in the pelagic realm (>3000 m water depth) to be approximately 1.8*10**12 g C/year. In the sediments underlying the divergence zone in the Eastern Equatorial Atlantic (EEA), only small amounts of organic carbon accumulate in spite of the high surface water productivity observed in that area. This implies that in the Eastern Equatorial Atlantic, organic carbon accumulation is strongly reduced by efficient degradation of organic matter prior to its burial. During the Last Glacial Maximum (LGM), accumulation of organic carbon was higher than during the mid-Holocene along the continental margins of Africa and South America (Brazil) as well as in the equatorial region. In the Eastern Equatorial Atlantic in particular, large relative differences between LGM and mid-Holocene accumulation rates are found. This is probably to a great extent due to better preservation of organic matter related to changes in bottom water circulation and not just a result of strongly enhanced export productivity during the glacial period. On average, a two- to three-fold increase in organic carbon accumulation during the LGM compared to mid-Holocene conditions can be deduced from our cores. However, for the deep-sea sediments this cannot be solely attributed to a glacial productivity increase, as changes in South Atlantic deep-water circulation seem to result in better organic carbon preservation during the LGM.