Safety and Effectiveness of two treatment regimes with tranexamic acid to minimize inflammatory response in elective cardiopulmonary bypass patients: a randomized double-blind, dose-dependent, phase IV clinical trial

Background. In cardiopulmonary bypass (CPB) patients, fibrinolysis may enhance postoperative inflammatory response. We aimed to determine whether an additional postoperative dose of antifibrinolytic tranexamic acid (TA) reduced CPB-mediated inflammatory response (IR). Methods. We performed a randomized, double-blind, dose-dependent, parallel-groups study of elective CPB patients receiving TA. Patients were randomly assigned to either the single-dose group (40 mg/Kg TA before CPB and placebo after CPB) or the double-dose group (40 mg/Kg TA before and after CPB). Results. 160 patients were included, 80 in each group. The incident rate of IR was significantly lower in the double-dose-group TA2 (7.5% vs. 18.8% in the single-dose group TA1; P = 0.030). After adjusting for hypertension, total protamine dose and temperature after CPB, TA2 showed a lower risk of IR compared with TA1 [OR: 0.29 (95% CI: 0.10-0.83), (P = 0.013)]. Relative risk for IR was 2.5 for TA1 (95% CI: 1.02 to 6.12). The double-dose group had significantly lower chest tube bleeding at 24 hours [671 (95% CI 549-793 vs. 826 (95% CI 704-949) mL; P = 0.01 corrected-P significant] and lower D-dimer levels at 24 hours [489 (95% CI 437-540) vs. 621(95% CI: 563-679) ng/mL; P = 0.01 corrected-P significant]. TA2 required lower levels of norepinephrine at 24 h [0.06 (95% CI: 0.03-0.09) vs. 0.20(95 CI: 0.05-0.35) after adjusting for dobutamine [F = 6.6; P = 0.014 corrected-P significant]. We found a significant direct relationship between IL-6 and temperature (rho = 0.26; P < 0.01), D-dimer (rho = 0.24; P < 0.01), norepinephrine (rho = 0.33; P < 0.01), troponin I (rho = 0.37; P < 0.01), Creatine-Kinase (rho = 0.37; P < 0.01), Creatine Kinase-MB (rho = 0.33; P < 0.01) and lactic acid (rho = 0.46; P < 0.01) at ICU arrival. Two patients (1.3%) had seizure, 3 patients (1.9%) had stroke, 14 (8.8%) had acute kidney failure, 7 (4.4%) needed dialysis, 3 (1.9%) suffered myocardial infarction and 9 (5.6%) patients died. We found no significant differences between groups regarding these events. Conclusions. Prolonged inhibition of fibrinolysis, using an additional postoperative dose of tranexamic acid reduces inflammatory response and postoperative bleeding (but not transfusion requirements) in CPB patients. A question which remains unanswered is whether the dose used was ideal in terms of safety, but not in terms of effectiveness.

International regimes as knowledge syndicates? Energy and trends of global governance

El poder de l'Estat i la sobirania tradicional s'està deteriorant de manera constant, sobretot en termes de la provisió de certs béns públics fonamentals. Els Estats, en particular, són incapaços de manejar el coneixement i la informació que és essencial per mantenir la competitivitat i la sostenibilitat en una economia interdependent. Estructures fiables de la governança mundial i la cooperació internacional estan lluny de ser establertes. Energia com a problema a les agendes p dels governs, les empreses privades i la societat civil és un exemple manifest d'aquesta dinàmica.. L'actual sistema de governança mundial d'energia implica accions polítiques disperses per actors divers. L'Agència Internacional de l'Energia té un paper destacat, però està debilitat per la seva composició limitada i basada en el coneixement- epistèmic en lloc del material o executiu. Aquest treball sosté que ni la mida ni nombre de membres disponibles estan dificultant la governabilitat mundial d'energia. Més aviat, l'energia és una sèrie de béns públics que es troben als llimbs, on els estats no poden pagar la seva disposició, així com els diversos interessos impedir l'establiment d'una autoritat internacional. Després de la introducció de la teoria del règim internacional i el concepte de coneixement basats en les comunitats epistèmiques, l'article revisa l'estat actual de la governabilitat de l'energia mundia. A continuació es presenta una comparació d'aquesta estructura amb els règims de govern nacional i regional, d'una banda, i amb règims globals ambientals i de salut, de l'altra

Institutional regimes for sustainable collective housing stocks

The influence of public policy, property rights and contracts on the sustainability of residential buildings remains largely unknown. This research will use the analytical framework of the housing institutional regime to study the sustainability over time of the housing stock. We aim to produce an inventory of the housing institutional regime in Switzerland, a comparison with the German and Catalan regimes, and policy suggestions to achieve a better sustainability of the housing stock.

Per-antenna rate and power control for MIMO layered architectures in the low- and high-power regimes

In a MIMO layered architecture, several codewordsare transmitted from a multiplicity of antennas. Although thespectral efficiency is maximized if the rates of these codewordsare separately controlled, the feedback rate within the linkadaptation loop is reduced if they are constrained to be identical.This poses a direct tradeoff between performance andfeedback overhead. This paper provides analytical expressionsthat quantify the difference in spectral efficiency between bothapproaches for arbitrary numbers of antennas. Specifically, thecharacterization takes place in the realm of the low- and highpowerregimes via expansions that are shown to have a widerange of validity.In addition, the possibility of adjusting the transmit powerof each codeword individually is considered as an alternative tothe separate control of their rates. Power allocation, however,turns out to be inferior to rate control within the context of thisproblem.

Inoculação de Azospirillum amazonense em dois genótipos de milho sob diferentes regimes de nitrogênio

A adaptabilidade de genótipos de milho a ambientes onde os nutrientes não estejam prontamente disponíveis pode ser relacionada com a adaptação à predominância, nos solos, das formas de N nítrica e amoniacal e à associação com microrganismos benéficos como as bactérias diazotróficas e, ou, promotoras de crescimento de plantas. O objetivo deste trabalho foi verificar o comportamento de dois híbridos intervarietais de milho sob diferentes doses e formas de N, assim como o efeito da inoculação com Azospirillum amazonense, em um ensaio em casa de vegetação, utilizando vasos preenchidos com vermiculita e solução nutritiva de Hoagland como fonte de nutrientes. O delineamento experimental foi de blocos ao acaso em esquema fatorial, constituindo os tratamentos em: dois híbridos intervarietais, H1 (Carioca x Eldorado) e H2 (Palha Roxa ES x Sol da Manhã); plantas inoculadas ou não inoculadas com A. amazonense, e três regimes de N, conforme doses e proporções seguintes: 126 mg semana-1 de N (75 % NH4+ : 25 % NO3-); 126 mg semana-1 de N (25 % NH4+ : 75 % NO3-), e 12,6 mg semana-1 de N (50 % NH4+ : 50 % NO3-). Vinte e cinco dias após o plantio, as plantas foram separadas em raiz e parte aérea para determinação da matéria seca, conteúdos totais de N e P, atividade das enzimas nitrato redutase e glutamina sintetase e açúcares solúveis totais. O híbrido H1, mais eficiente em avaliações preliminares em campo, produziu mais matéria seca e apresentou maior eficiência na utilização de N e P. Plantas que receberam a maior dose de N, independentemente do predomínio da forma nítrica ou amoniacal, apresentaram maior acúmulo de N (nas raízes e parte aérea) e P (na parte aérea) e maior índice de utilização de P. Com o predomínio da forma amoniacal, observou-se incremento na produção de matéria seca da parte aérea e na atividade da glutamina sintetase, bem como decréscimo na concentração de açúcares solúveis totais nas raízes. A inoculação com A. amazonense promoveu maior produção de matéria seca e acúmulo de N nas raízes.

Kinetic parameters of soil β-glucosidase response to environmental temperature and moisture regimes

Soil β-glucosidase participates in the final step of cellulose biodegradation. It is significant in the soil C cycle and is used as an indicator of the biological fertility of soil. However, the response of its kinetic parameters to environmental temperature and moisture regimes is not well understood. This study tested the β-glucosidase response in the main agricultural soils (black soil, albic soil, brown soil, and cinnamon soil) of Northeast China. Incubation tests were conducted to measure the kinetic parameters Km, Vmax or Vmax/Km of soil β-glucosidase at environmental temperatures of 10, 20 and 30 ºC and at 10, 20 and 30 % soil moisture content. The insensitive response of the kinetic parameters to temperature changes indicates that soil β-glucosidase was present primarily in immobilized form. The significant response of the kinetic parameters of soil β-glucosidase to soil moisture rather than to environmental temperatures suggests that the catalytic ability of soil β-glucosidase was sensitive to changing soil moisture regimes.

Soil temperature regimes in Finland

Selostus: Maan lämpötila Suomessa

Microbiological properties and oxidizable organic carbon fractions of an oxisol under coffee with split phosphorus applications and irrigation regimes

Phosphorus fertilization and irrigation increase coffee production, but little is known about the effect of these practices on soil organic matter and soil microbiota in the Cerrado. The objective of this study was to evaluate the microbiological and oxidizable organic carbon fractions of a dystrophic Red Latossol under coffee and split phosphorus (P) applications and different irrigation regimes. The experiment was arranged in a randomized block design in a 3 x 2 factorial design with three split P applications (P1: 300 kg ha-1 P2O5, recommended for the crop year, of which two thirds were applied in September and the third part in December; P2: 600 kg ha-1 P2O5, applied at planting and then every two years, and P3: 1,800 kg ha-1 P2O5, the requirement for six years, applied at once at planting), two irrigation regimes (rainfed and year-round irrigation), with three replications. The layers 0-5 and 5-10 cm were sampled to determine microbial biomass carbon (MBC), basal respiration (BR), enzyme activity of acid phosphatase, the oxidizable organic carbon fractions (F1, F2, F3, and F4), and total organic carbon (TOC). The irrigation regimes increased the levels of MBC, microbial activity and acid phosphatase, TOC and oxidizable fractions of soil organic matter under coffee. In general, the form of dividing P had little influence on the soil microbial properties and OC. Only P3 under irrigation increased the levels of MBC and acid phosphatase activity.

Three-dimensional aspects of fluid flows in channels. II. Effects of meniscus and thin film regimes on viscous fingers

We perform a three-dimensional study of steady state viscous fingers that develop in linear channels. By means of a three-dimensional lattice-Boltzmann scheme that mimics the full macroscopic equations of motion of the fluid momentum and order parameter, we study the effect of the thickness of the channel in two cases. First, for total displacement of the fluids in the channel thickness direction, we find that the steady state finger is effectively two-dimensional and that previous two-dimensional results can be recovered by taking into account the effect of a curved meniscus across the channel thickness as a contribution to surface stresses. Second, when a thin film develops in the channel thickness direction, the finger narrows with increasing channel aspect ratio in agreement with experimental results. The effect of the thin film renders the problem three-dimensional and results deviate from the two-dimensional prediction.

Three-dimensional aspects of fluid flows in channels. I. Meniscus and thin film regimes

We study the forced displacement of a fluid-fluid interface in a three-dimensional channel formed by two parallel solid plates. Using a lattice-Boltzmann method, we study situations in which a slip velocity arises from diffusion effects near the contact line. The difference between the slip and channel velocities determines whether the interface advances as a meniscus or a thin film of fluid is left adhered to the plates. We find that this effect is controlled by the capillary and Péclet numbers. We estimate the crossover from a meniscus to a thin film and find good agreement with numerical results. The penetration regime is examined in the steady state. We find that the occupation fraction of the advancing finger relative to the channel thickness is controlled by the capillary number and the viscosity contrast between the fluids. For high viscosity contrast, lattice-Boltzmann results agree with previous results. For zero viscosity contrast, we observe remarkably narrow fingers. The shape of the finger is found to be universal.

Three-dimensional aspects of fluid flows in channels. II. Effects of meniscus and thin film regimes on viscous fingers

We perform a three-dimensional study of steady state viscous fingers that develop in linear channels. By means of a three-dimensional lattice-Boltzmann scheme that mimics the full macroscopic equations of motion of the fluid momentum and order parameter, we study the effect of the thickness of the channel in two cases. First, for total displacement of the fluids in the channel thickness direction, we find that the steady state finger is effectively two-dimensional and that previous two-dimensional results can be recovered by taking into account the effect of a curved meniscus across the channel thickness as a contribution to surface stresses. Second, when a thin film develops in the channel thickness direction, the finger narrows with increasing channel aspect ratio in agreement with experimental results. The effect of the thin film renders the problem three-dimensional and results deviate from the two-dimensional prediction.

Three-dimensional aspects of fluid flows in channels. I. Meniscus and thin film regimes

We study the forced displacement of a fluid-fluid interface in a three-dimensional channel formed by two parallel solid plates. Using a lattice-Boltzmann method, we study situations in which a slip velocity arises from diffusion effects near the contact line. The difference between the slip and channel velocities determines whether the interface advances as a meniscus or a thin film of fluid is left adhered to the plates. We find that this effect is controlled by the capillary and Péclet numbers. We estimate the crossover from a meniscus to a thin film and find good agreement with numerical results. The penetration regime is examined in the steady state. We find that the occupation fraction of the advancing finger relative to the channel thickness is controlled by the capillary number and the viscosity contrast between the fluids. For high viscosity contrast, lattice-Boltzmann results agree with previous results. For zero viscosity contrast, we observe remarkably narrow fingers. The shape of the finger is found to be universal.