Short-Term Heparin Kinetics during Catheter Ablation of Atrial Fibrillation.

BACKGROUND: Percutaneous catheter ablation of atrial fibrillation (CA-AF) is a treatment option for symptomatic drug-refractory atrial fibrillation (AF). CA-AF carries a risk for thromboembolic complications that has been minimized by the use of intraprocedural intravenous unfractionated heparin (UFH). The optimal administration of UFH as well as its kinetics are not well established and need to be precisely determined. METHODS AND RESULTS: A total 102 of consecutive patients suffering from symptomatic drug-refractory AF underwent CA-AF. The mean age was 61 ± 10 years old. After transseptal puncture of the fossa ovalis, weight-adjusted UFH bolus (100 U/kg) was infused. A significant increase in activated clotting time (ACT) was observed from an average value of 100 ± 27 seconds at baseline, to 355 ± 94 seconds at 10 min (T10), to 375 ± 90 seconds at 20 min (T20). Twenty-four patients failed to reach the targeted ACT value of ≥300 seconds at T10 and more than half of these remained with subtherapeutic ACT values at T20. This subset of patients showed similar clinical characteristics and amount of UFH but were more frequently prescribed preprocedural vitamin K1 than the rest of the study population. CONCLUSIONS: In a typical intervention setting, UFH displays unexpected slow anticoagulation kinetics in a significant proportion of procedures up to 20 minutes after infusion. These findings support the infusion of UFH before transseptal puncture or any left-sided catheterization with early ACT measurements to identify patients with delayed kinetics. They are in line with recent guidelines to perform CA-AF under therapeutic anticoagulation.

Organización de la reanimación cardiopulmonar intrahospitalaria. Situación actual en España.

La parada cardiorrespiratoria (PCR) dentro del hospital es considerada una emergencia vital y está demostrado que existe una relación directa entre la respuesta asistencial y la mortalidad asociada a este evento. Los resultados del tratamiento de la PCR son un indicador de calidad de los centros sanitarios. En el caso en concreto de España, la mayoría de hospitales no disponen de un sistema organizado e integral de atención a la PCR. A pesar de los avances en medicina y tecnológicos, la tasa de supervivencia no ha variado significativamente en los últimos 30 años por lo que se ha de considerar como un problema social, económico y sanitario de gran magnitud que cabe abordar con todas las herramientas disponibles. Objetivos: Conocer cómo se organiza la reanimación cardiopulmonar (RCP) dentro del hospital y conocer los planes integrales de RCP publicados por los hospitales españoles. Metodología: Se realiza una revisión de la literatura a través de las bibliotecas indexadas Pubmed y Web of Science mediante criterios de inclusión/exclusión, uso de operadores booleanos y búsqueda bibliográfica manual. Además se realiza una entrevista a un médico referente nacional en la investigación sobre RCP. Resultados: Se han encontrado 7 planes integrales para la atención a la PCR y solo 2 de ellos están avalados por el Plan Nacional de RCP (PNRCP), miembro del Consejo Español de RCP (CERCP). Conclusiones: Existe una falta de publicaciones por parte de los hospitales españoles sobre planes integrales para la organización de la RCP que cumplan los criterios de calidad necesarios. Si bien todos los hospitales disponen de protocolos propios dirigidos a sus profesionales para la actuación en caso de PCR, estos son de uso interno y solo tienen en común entre ellos el hecho de seguir las recomendaciones de las guías del European Resuscitation Council (ERC). III Es necesario que los centros sanitarios fomenten y compartan su actividad investigadora sobre el tema. Palabras clave: parada card��aca hospitalaria, resucitación cardiopulmonar, Plan hospitalario de resucitación.

The Transatlantic Productivity Gap : Is R&D the Main Culprit?

The literature has pointed to different causes to explain the productivity gap between Europe and United States in the last decades. This paper tests the hypothesis that the lower European productivity performance in comparison with the US can be explained not only by a lower level of corporate R&D investment, but also by a lower capacity to translate R&D investment into productivity gains. The proposed microeconometric estimates are based on a unique longitudinal database covering the period 1990-2008 and comprising 1.809 US and European companies for a total of 16.079 observations. Consistent with previous literature, we find robust evidence of a significant impact of R&D on productivity, however – using different estimation techniques - the R&D coefficients for the US firms always turn out to be significantly higher. To see to what extent these transatlantic differences may be related to the different sectoral structures in the US and the EU, we differentiated the analysis by sectors. The result is that both in manufacturing, services and high-tech sectors US firms are more efficient in translating their R&D investments into productivity increases.

Cerebral oximetry and return of spontaneous circulation after cardiac arrest: A systematic review and meta-analysis.

AIM: The prediction of return of spontaneous circulation (ROSC) during resuscitation of patients suffering of cardiac arrest (CA) is particularly challenging. Regional cerebral oxygen saturation (rSO2) monitoring through near-infrared spectrometry is feasible during CA and could provide guidance during resuscitation. METHODS: We conducted a systematic review and meta-analysis on the value of rSO2 in predicting ROSC both after in-hospital (IH) or out-of-hospital (OH) CA. Our search included MEDLINE (PubMed) and EMBASE, from inception until April 4th, 2015. We included studies reporting values of rSO2 at the beginning of and/or during resuscitation, according to the achievement of ROSC. RESULTS: A total of nine studies with 315 patients (119 achieving ROSC, 37.7%) were included in the meta-analysis. The majority of those patients had an OHCA (n=225, 71.5%; IHCA: n=90, 28.5%). There was a significant association between higher values of rSO2 and ROSC, both in the overall calculation (standardized mean difference, SMD -1.03; 95%CI -1.39,-0.67; p<0.001), and in the subgroups analyses (rSO2 at the beginning of resuscitation: SMD -0.79; 95%CI -1.29,-0.30; p=0.002; averaged rSO2 value during resuscitation: SMD -1.28; 95%CI -1.74,-0.83; p<0.001). CONCLUSIONS: Higher initial and average regional cerebral oxygen saturation values are both associated with greater chances of achieving ROSC in patients suffering of CA. A note of caution should be made in interpreting these results due to the small number of patients and the heterogeneity in study design: larger studies are needed to clinically validate cut-offs for guiding cardiopulmonary resuscitation.

Evolució de les empreses a la comarca d'Osona 2007-2012

Aquest projecte tracta sobre quina evolució han tingut les empreses a la comarca d'Osona durant el període 2007-2012 agrupades per clústers. Així, pretén ser una continuació del "Pla d'Innovació d'Osona", efectuat el 2007, amb la col•laboració de diverses entitats de la comarca. Les agrupacions per clústers són realitzades a partir dels codis CNAE (Classificació Nacional d'Activitats Econòmiques). A través del processat d'aquestes dades, extretes de la base de dades SABI, s'ha observat quina tend��ncia ha experimentat el nombre d'empreses i assalariats a la comarca i quines empreses són les que tenen uns ingressos d'explotació més elevats, arribant a la conclusió principal el fet que hi ha hagut un decrement generalitzat, tant d'assalariats com de nombre d'empreses i ingressos d'explotació a causa de la crisi econòmica iniciada el 2008.

Multigenerational effects of the anticancer drug tamoxifen and its metabolite 4-hydroxy-tamoxifen on Daphnia pulex.

Tamoxifen and its metabolite 4-hydroxy-tamoxifen (4OHTam) are two potent molecules that have anticancer properties on breast cancers. Their medical use is expected to increase with the increasing global cancer rate. After consumption, patients excrete tamoxifen and the 4OHTam metabolite into wastewaters, and tamoxifen has been already detected in wastewaters and natural waters. The concentrations of 4OHTam in waters have never been reported. A single study reported 4OHTam effects on the microcrustacean Daphnia pulex. The effects of tamoxifen and 4OHTam over more than two generations are unknown in aquatic invertebrates. The main goal of this study was to assess the long-term sensitivity of the microcrustacean D. pulex over four generations, based on size, reproduction, viability and the intrinsic rate of natural increase (r). Additional experiments were carried out to observe whether the effects of tamoxifen and 4OHTam were reversible in the next generation after descendants were withdrawn from chemical stress (i.e., recovery experiment), and whether the lowest test concentration of each chemical induced toxic effects when both concentrations were combined (i.e., mixture experiments). Our results showed that tamoxifen and 4OHTam induced the adverse effects at environmentally relevant concentrations. Tamoxifen and 4OHTam impaired size, viability, reproduction and the r in four generations of treated D. pulex, but these effects were not clearly magnified over generations. Tamoxifen was more potent than 4OHTam on D. pulex. When used in a mixture, the combination of tamoxifen and 4OHTam induced effects in offspring, whereas no effects were observed when these chemicals were tested individually. In the recovery experiment, the reproduction and size were reduced in offspring withdrawn from chemical exposures. Our results suggested that tamoxifen and its metabolite may be a relevant pharmaceutical to consider in risk assessment.

Coma post-anoxique après arrêt cardiaque et hypothermie, peut-on encore prédire le pronostic en 2014 ?

L'encéphalopathie post-anoxique après arrêt cardiaque (AC) est une cause féquente d'admission pour coma en réanimation. Depuis les recommandations de 2003, l'hypothermie thérapeutique (HT) est devenue un standard de traitement après AC et est à l'origine de l'amélioration du pronostic au cours de cette derniere d��cennie. Les élements prédicteurs de pronostic valid��s par l'Académie Américaine de Neurologie avant l'ère de l'HT sont devenus moins précis. En effet, l'HT et la sédation retardent la reprise de la réponse motrice et peuvent altérer la valeur prédictive des réflexes du tronc cérébral. Une nouvelle approche est nécessaire pour établir un pronostic après AC et HT. L'enregistrement (pendant l'HTou peu après) d'une activité électroencéphalographique réactive et/ou continue est un bon prédicteur de récupération neurologique favorable après AC. Au contraire, la présence d'un tracé non réactif ou discontinu de type burst-suppression, avec une réponse N20 absente bilatérale aux potentiels évoqués somatosensoriels, sont presqu'à 100 % prédictifs d'un coma irréversible d��jà à 48 heures après AC. L'HT modifie aussi la valeur prédictive de l'énolase neuronale spécifique (NSE), principal biomarqueur sérique de la lésion cérébrale post-anoxique. Un réveil avec bonne récupération neurologique a été récemment observé par plusieurs groupes chez des patients présentant des valeurs de NSE>33 μg/L à 48-72 heures : ce seuil ne doit pas être utilisé seul pour guider le traitement. L'imagerie par résonance magnétique de diffusion peut aider à prédire les séquelles neurologiques à long terme. Un réveil chez les patients en coma post-anoxique est de plus en plus observé, malgré l'absence précoce de signes moteurs et une élévation franche des biomarqueurs neuronaux. En 2014, une nouvelle approche multimodale du pronostic est donc nécessaire, pour optimiser la prédiction d'une évolution clinique favorable après AC. Hypoxic-ischemic encephalopathy after cardiac arrest (CA) is a frequent cause of intensive care unit (ICU) admission. Incorporated in all recent guidelines, therapeutic hypothermia (TH) has become a standard of care and has contributed to improve prognosis after CA during the past decade. The accuracy of prognostic predictors validated in 2006 by the American Academy of Neurology before the era of TH is less accurate. Indeed, TH and sedation may delay the recovery of motor response and alter the predictive value of brainstem reflexes. A new approach is needed to accurately establish prognosis after CA and TH. A reactive and/or continuous electroencephalogram background (during TH or shortly thereafter) strongly predicts good outcome. On the contrary, unreactive/spontaneous burst-suppression electroencephalogram pattern, together with absent N20 on somatosensory evoked potentials, is almost 100% predictive of irreversible coma. TH also affects the predictive value of neuronspecific enolase (NSE), the main serum biomarker of postanoxic injury. A good outcome can occur despite NSE levels >33 μg/L, so this cutoff value should not be used alone to guide treatment. Diffusion magnetic resonance imagery may help predict long-term neurological sequelae. Awakening from postanoxic coma is increasingly observed, despite the absence of early motor signs and pathological elevation of NSE. In 2014, a multimodal approach to prognosis is recommended to optimize the prediction of outcome after CA.

Tastets d'economia número 2: Psicologia i Economia

Article 2 de la sèrie Tastets d'economia, adreçada al target: principiants, estudiants de batxillerat i de cicles formatius, de l'àrea de les ciències socials.

The role of alliance capabilities in alliance portfolio management

The question of why some firms perform better in managing their alliances has raised interest among scholars and managers. Whereas inter-firm factors influencing the alliance performance such as strategic fit between partners and the existence of complementarities have been studied extensively, research on firm-level antecedents is rather scarce. Therefore this study investigates the role of firm’s alliance capability in the alliance success equation. Particularly it analyses the specialized mechanisms and processes set up by firm in order to facilitate alliancerelated know-how leverage organization-wise. Evidence from a cross-industry sample of R&D intensive Finnish companies supports the fact that firms which have invested in institutionalizing alliance capabilities outperform their counterparts in alliance portfolio management. Results also suggest that firms need to adjust alliance management tools depending on the alliance portfolio size, prior experience with inter-firm partnerships and the strategic importance of alliances. Furthermore, absorptive capacity is found to be crucial for successful alliance management, its role being complementary to that of alliance capability. Finally, firms that have successful alliances also enjoy higher financial, market and innovation performance.

The state of research and development in Australia: implications for future development

The scale of research and development (R&D), and other technological activities, and the way in which the available resources are managed and organized at the enterprise and national level contribute to the rate of technological change in a country. A well organized national innovation system can be a powerful engine of progress, whereas a lack of interaction between institutions results in the slowing down of technological change, thereby diminishing its contribution to economic growth and welfare. The research object of this thesis is Australia’s national innovation system and the state of R&D in Australia. In order to establish an overall picture of the situation and to be able to make recommendations for future development, the general level of R&D activity and the main performers and funders of R&D within the system are analyzed. The framework policies supporting R&D and prevalent dynamics between different actors and sectors are of specific interest of the research. The findings reveal that the Australian culture is not a culture of research and innovation and that the main challenge is building a coherent system with strong domestic and international linkages.

En torno al cardenal Don Gil Álvarez de Albornoz y el platero sienés Andrea Petrucci: el relicario de la mano de Santa Lucía y el cáliz de San Segundo

Este artículo trata de la complicada y hasta ahora inédita historia de la llegada a España de dos obras cumbres de la orfebrería sienesa del s. XIV en plata con esmaltes translúcidos: el relicario de la mano de Santa Lucía en la catedral de Toledo y el cáliz de San Segundo en la catedral de Ávila. La importación de estos dos importantísimos objetos devocionales y litúrgicos, ambos firmados por el platero sienés Andrea Petrucci, está relacionada con la estancia en Italia del cardenal don Gil de Albornoz, arzobispo de Toledo y posteriormente cardenal de San Clemente y Santa Sabina y legado papal. El mecenazgo del cardenal castellano y de su círculo en Italia explica la comisión y adquisición de estas piezas, cuyos accidentados itinerarios desembocarían finalmente en Toledo y en Ávila.

Síntese e modifica��ões de derivados heterocíclicos de D-arabinose: potenciais inibidores de glicose-6-fosfato isomerase e de glicosamina-6-fosfato sintase

The synthesis of -5-(D-arabino-1,2,3,4-tetrahydroxybutyl)tetrazole and -2-(D-arabino-1,2,3,4-tetra-acetoxybutyl)-5-methyl-1,3,4-oxadiazole from D-arabinose is described. Attempts at removing the protecting groups of the oxadiazole derivative were unsuccessful, leading to products resulting from the opening of the oxadiazole ring. The unprotected tetrazole derivative was selectively phosphorylated at the primary hydroxyl group with diethylphosphoryl chloride. The resulting 5-[D-arabino-4-(diethylphosphoryloxy)-1,2,3-trihydroxybutyl]tetrazole is a protected form of a potential inhibitor of the enzymes glucose-6-phosphate isomerase and glucosamine synthase.

VOLATILE COMPONENTS FROM GALLS INDUCED BY Baccharopelma dracunculifoliae(Hemiptera: Psyllidae) ON LEAVES OF Baccharis dracunculifolia(Asteraceae)

The volatile components of the galls induced by the insect Baccharopelma dracunculifoliae (Hemiptera: Psyllidae) on leaves of Baccharis dracunculifolia (Asteraceae) were analyzed by gas chromatography-mass spectrometry (GC-MS) and gas chromatographyflame- ionisation detection (GC-FID), and then comparison with volatile oil samples from healthy leaves collected in the vicinity. The galls produced around 3.5% of the total organic volatiles whereas healthy leaves rendered an average yield of 0.6%. The observed higher proportions of germacrene D, bicyclogermacrene, limonene, and β-pinene in the galls suggest that all these compounds are important targets in the search for natural enemies of this Psyllid. Moreover, higher relative percentages of (E)-nerolidol and spathulenol were found in healthy leaves.

AVALIAÇÃO DE MÉTODOS DE SOLUBILIZAÇÃO PARA DETERMINAÇÃO DE METAIS EM GLICERINA PROVENIENTE DA PRODUÇÃO DE BIODIESEL POR TÉCNICAS DE ESPECTROMETRIA ATÔMICA

This paper describes the evaluation of simple and fast solubilization methods for the determination of Ca, Mg, and K in glycerin samples from biodiesel production by atomic spectrometry. The solubilization in water was compared with two other methods: solubilization in formic acid and solubilization in ethanol. Using solubilization in water, determination of the three analytes was possible; the values of limits of detection for Ca, K, Mg were 0.31, 0.06, and 0.16 mg kg−1, respectively. Because no adequate reference material was available, the accuracy was evaluated by assessing the recoveries tests with both solubilization methods; the evaluation ranged from 90% to 115%, with values of relative standard deviation >8%, indicating good accuracy of the measure. Four crude glycerin samples obtained from biodiesel plants of Rio Grande do Sul were analyzed after treatment with the different methods of solubilization, and the obtained results of Ca, Mg, and K concentration were in agreement with the values obtained from both solubilization methods. Therefore, solubilization in water is concluded to be a simpler, faster, and viable method for sample preparation of glycerin.

Magnetic and transport properties of LaMnO3+δ, La1-xCaxMnO3, La1-xCaxMn1-yFeyO3 and La1-xSrxMn1-yFeyO3

Interest to hole-doped mixed-valence manganite perovskites is connected to the ‘colossal’ magnetoresistance. This effect or huge drop of the resistivity, ρ, in external magnetic field, B, attains usually the maximum value near the ferromagnetic Curie temperature, TC. In this thesis are investigated conductivity mechanisms and magnetic properties of the manganite perovskite compounds LaMnO3+, La1-xCaxMnO3, La1-xCaxMn1-yFeyO3 and La1- xSrxMn1-yFeyO3. When the present work was started the key role of the phase separation and its influence on the properties of the colossal magnetoresistive materials were not clear. Our main results are based on temperature dependencies of the magnetoresistance and magnetothermopower, investigated in the temperature interval of 4.2 - 300 K in magnetic fields up to 10 T. The magnetization was studied in the same temperature range in weak (up to 0.1 T) magnetic fields. LaMnO3+δ is the parent compound for preparation of the hole-doped CMR materials. The dependences of such parameters as the Curie temperature, TC, the Coulomb gap, Δ, the rigid gap, γ, and the localization radius, a, on pressure, p, are observed in LaMnO3+δ. It has been established that the dependences above can be interpreted by increase of the electron bandwidth and decrease of the polaron potential well when p is increased. Generally, pressure stimulates delocalization of the electrons in LaMnO3+δ. Doping of LaMnO3 with Ca, leading to La1-xCaxMnO3, changes the Mn3+/Mn4+ ratio significantly and brings an additional disorder to the crystal lattice. Phase separation in a form of mixture of the ferromagnetic and the spin glass phases was observed and investigated in La1- xCaxMnO3 at x between 0 and 0.4. Influence of the replacement of Mn by Fe is studied in La0.7Ca0.3Mn1−yFeyO3 and La0.7Sr0.3Mn1−yFeyO3. Asymmetry of the soft Coulomb gap and of the rigid gap in the density of localized states, small shift of the centre of the gaps with respect to the Fermi level and cubic asymmetry of the density of states are obtained in La0.7Ca0.3Mn1−yFeyO3. Damping of TC with y is connected to breaking of the double-exchange interaction by doping with Fe, whereas the irreversibility and the critical behavior of the magnetic susceptibility are determined by the phase separation and the frustrated magnetic state of La0.7Sr0.3Mn1−yFeyO3.