Safety of Prasugrel Loading Doses in Patients Pre-Loaded With Clopidogrel in the Setting of Primary Percutaneous Coronary Intervention: Results of a Nonrandomized Observational Study.

OBJECTIVES: The aim of this study was to assess the safety of the concurrent administration of a clopidogrel and prasugrel loading dose in patients undergoing primary percutaneous coronary intervention. BACKGROUND: Prasugrel is one of the preferred P2Y12 platelet receptor antagonists for ST-segment elevation myocardial infarction patients. The use of prasugrel was evaluated clinically in clopidogrel-naive patients. METHODS: Between September 2009 and October 2012, a total of 2,023 STEMI patients were enrolled in the COMFORTABLE (Comparison of Biomatrix Versus Gazelle in ST-Elevation Myocardial Infarction [STEMI]) and the SPUM-ACS (Inflammation and Acute Coronary Syndromes) studies. Patients receiving a prasugrel loading dose were divided into 2 groups: 1) clopidogrel and a subsequent prasugrel loading dose; and 2) a prasugrel loading dose. The primary safety endpoint was Bleeding Academic Research Consortium types 3 to 5 bleeding in hospital at 30 days. RESULTS: Of 2,023 patients undergoing primary percutaneous coronary intervention, 427 (21.1%) received clopidogrel and a subsequent prasugrel loading dose, 447 (22.1%) received a prasugrel loading dose alone, and the remaining received clopidogrel only. At 30 days, the primary safety endpoint was observed in 1.9% of those receiving clopidogrel and a subsequent prasugrel loading dose and 3.4% of those receiving a prasugrel loading dose alone (adjusted hazard ratio [HR]: 0.57; 95% confidence interval [CI]: 0.25 to 1.30, p = 0.18). The HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly) bleeding score tended to be higher in prasugrel-treated patients (p = 0.076). The primary safety endpoint results, however, remained unchanged after adjustment for these differences (clopidogrel and a subsequent prasugrel loading dose vs. prasugrel only; HR: 0.54 [95% CI: 0.23 to 1.27], p = 0.16). No differences in the composite of cardiac death, myocardial infarction, or stroke were observed at 30 days (adjusted HR: 0.66, 95% CI: 0.27 to 1.62, p = 0.36). CONCLUSIONS: This observational, nonrandomized study of ST-segment elevation myocardial infarction patients suggests that the administration of a loading dose of prasugrel in patients pre-treated with a loading dose of clopidogrel is not associated with an excess of major bleeding events. (Comparison of Biomatrix Versus Gazelle in ST-Elevation Myocardial Infarction [STEMI] [COMFORTABLE]; NCT00962416; and Inflammation and Acute Coronary Syndromes [SPUM-ACS]; NCT01000701).

Analysis of the process of inspection in recreational craft in Spain. Suggestions for safety improvement

Inspections of pleasure boats in Spain can be carried out by collaborating entities of inspection, entities that must be authorized by the Maritime Administration. This authorization allows to perform effective inspections and technical controls of recreational crafts. Recreational crafts are subjected to surveys that are based on the registration list and on the material used in the hull. In addition, required safety equipment of the recreational boat depends on the distance that the recreational boat is authorized to navigate. Following data obtained from inspections of recreational craft, this paper aims to analyze information about hulls within dry and afloat conditions, about the equipment for rescue and safety, and about other nautical equipment; as well as to perform and improve different verifications during the inspections. All this information points to several aspects relevant for the optimization of the inspection process, the ultimate target being increasing efficiency and effectiveness, and ensuring more safety in recreational craft.

Safety and immunogenicity of a chimpanzee adenovirus-vectored Ebola vaccine in healthy adults: a randomised, double-blind, placebo-controlled, dose-finding, phase 1/2a study.

BACKGROUND: The ongoing Ebola outbreak led to accelerated efforts to test vaccine candidates. On the basis of a request by WHO, we aimed to assess the safety and immunogenicity of the monovalent, recombinant, chimpanzee adenovirus type-3 vector-based Ebola Zaire vaccine (ChAd3-EBO-Z). METHODS: We did this randomised, double-blind, placebo-controlled, dose-finding, phase 1/2a trial at the Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Participants (aged 18-65 years) were randomly assigned (2:2:1), via two computer-generated randomisation lists for individuals potentially deployed in endemic areas and those not deployed, to receive a single intramuscular dose of high-dose vaccine (5 × 10(10) viral particles), low-dose vaccine (2·5 × 10(10) viral particles), or placebo. Deployed participants were allocated to only the vaccine groups. Group allocation was concealed from non-deployed participants, investigators, and outcome assessors. The safety evaluation was not masked for potentially deployed participants, who were therefore not included in the safety analysis for comparison between the vaccine doses and placebo, but were pooled with the non-deployed group to compare immunogenicity. The main objectives were safety and immunogenicity of ChAd3-EBO-Z. We did analysis by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02289027. FINDINGS: Between Oct 24, 2014, and June 22, 2015, we randomly assigned 120 participants, of whom 18 (15%) were potentially deployed and 102 (85%) were non-deployed, to receive high-dose vaccine (n=49), low-dose vaccine (n=51), or placebo (n=20). Participants were followed up for 6 months. No vaccine-related serious adverse events were reported. We recorded local adverse events in 30 (75%) of 40 participants in the high-dose group, 33 (79%) of 42 participants in the low-dose group, and five (25%) of 20 participants in the placebo group. Fatigue or malaise was the most common systemic adverse event, reported in 25 (62%) participants in the high-dose group, 25 (60%) participants in the low-dose group, and five (25%) participants in the placebo group, followed by headache, reported in 23 (57%), 25 (60%), and three (15%) participants, respectively. Fever occurred 24 h after injection in 12 (30%) participants in the high-dose group and 11 (26%) participants in the low-dose group versus one (5%) participant in the placebo group. Geometric mean concentrations of IgG antibodies against Ebola glycoprotein peaked on day 28 at 51 μg/mL (95% CI 41·1-63·3) in the high-dose group, 44·9 μg/mL (25·8-56·3) in the low-dose group, and 5·2 μg/mL (3·5-7·6) in the placebo group, with respective response rates of 96% (95% CI 85·7-99·5), 96% (86·5-99·5), and 5% (0·1-24·9). Geometric mean concentrations decreased by day 180 to 25·5 μg/mL (95% CI 20·6-31·5) in the high-dose group, 22·1 μg/mL (19·3-28·6) in the low-dose group, and 3·2 μg/mL (2·4-4·9) in the placebo group. 28 (57%) participants given high-dose vaccine and 31 (61%) participants given low-dose vaccine developed glycoprotein-specific CD4 cell responses, and 33 (67%) and 35 (69%), respectively, developed CD8 responses. INTERPRETATION: ChAd3-EBO-Z was safe and well tolerated, although mild to moderate systemic adverse events were common. A single dose was immunogenic in almost all vaccine recipients. Antibody responses were still significantly present at 6 months. There was no significant difference between doses for safety and immunogenicity outcomes. This acceptable safety profile provides a reliable basis to proceed with phase 2 and phase 3 efficacy trials in Africa. FUNDING: Swiss State Secretariat for Education, Research and Innovation (SERI), through the EU Horizon 2020 Research and Innovation Programme.

Seguiment d'extremitats de ratolins en experiments optogenètics

L'objectiu principal d'aquest treball és aplicar tècniques de visió articial per aconseguir localitzar i fer el seguiment de les extremitats dels ratolins dins l'entorn de prova de les investigacions d'optogenètica del grup de recerca del Neuroscience Institute de la Universitat de Princeton, Nova Jersey.

Fischer-Tropsch Slurry Bubble Column Reactor Modeling

The literature part of the work reviews overall Fischer-Tropsch process, Fischer-Tropsch reactors and catalysts. Fundamentals of Fischer-Tropsch modeling are also presented. The emphasis is on the reactor unit. Comparison of the reactors and the catalysts is carried out to choose the suitable reactor setup for the modeling work. The effects of the operation conditions are also investigated. Slurry bubble column reactor model operating with cobalt catalyst is developed by taking into account the mass transfer of the reacting components (CO and H2) and the consumption of the reactants in the liquid phase. The effect of hydrostatic pressure and the change in total mole flow rate in gas phase are taken into account in calculation of the solubilities. The hydrodynamics, reaction kinetics and product composition are determined according to literature. The cooling system and furthermore the required heat transfer area and number of cooling tubes are also determined. The model is implemented in Matlab software. Commercial scale reactor setup is modeled and the behavior of the model is investigated. The possible inaccuraries are evaluated and the suggestions for the future work are presented. The model is also integrated to Aspen Plus process simulation software, which enables the usage of the model in more extensive Fischer-Tropsch process simulations. Commercial scale reactor of diameter of 7 m and height of 30 m was modeled. The capacity of the reactor was calculated to be about 9 800 barrels/day with CO conversion of 75 %. The behavior of the model was realistic and results were in the right range. The highest uncertainty to model was estimated to be caused by the determination of the kinetic rate.

Ydinreaktorin painesäiliön ulkoisen jäähdytyksen lämmönsiirtokokeita

The purpose of this work was to design and carry out thermal-hydraulic experiments dealing with overcooling transients of a VVER-440-type nuclear reactor pressure vessel. Sudden overcooling accident could have negative effect on the mechanical strength of the pressure vessel. If part of the pressure vessel is compromised, the intense pressure inside a pressurized water reactor could cause the wall to fracture. Information on the heat transfer along the outside of the pressure vessel wall is necessary for stress analysis. Basic knowledge of the overcooling accident and heat transfer types on the outside of the pressure vessel is presented as background information. Test facility was designed and built based to study and measure heat transfer during specific overcooling scenarios. Two test series were conducted with the first one concentrating on the very beginning of the transient and the second one concentrating on steady state heat transfer. Heat transfer coefficients are calculated from the test data using an inverse method, which yields better results in fast transients than direct calculation from the measurement results. The results show that heat transfer rate varies considerably during the transient, being very high in the beginning and dropping to steady state in a few minutes. The test results show that appropriate correlations can be used in future analysis.

Coolant Flow and Heat Transfer in Pebble-Bed Reactor Core

This thesis gathers knowledge about ongoing high-temperature reactor projects around the world. Methods for calculating coolant flow and heat transfer inside a pebble-bed reactor core are also developed. The thesis begins with the introduction of high-temperature reactors including the current state of the technology. Process heat applications that could use the heat from a high-temperature reactor are also introduced. A suitable reactor design with data available in literature is selected for the calculation part of the thesis. Commercial computational fluid dynamics software Fluent is used for the calculations. The pebble-bed is approximated as a packed-bed, which causes sink terms to the momentum equations of the gas flowing through it. A position dependent value is used for the packing fraction. Two different models are used to calculate heat transfer. First a local thermal equilibrium is assumed between the gas and solid phases and a single energy equation is used. In the second approach, separate energy equations are used for the phases. Information about steady state flow behavior, pressure loss, and temperature distribution in the core is obtained as results of the calculations. The effect of inlet mass flow rate to pressure loss is also investigated. Data found in literature and the results correspond each other quite well, considered the amount of simplifications in the calculations. The models developed in this thesis can be used to solve coolant flow and heat transfer in a pebble-bed reactor, although additional development and model validation is needed for better accuracy and reliability.

Química orgânica experimental: integração de teoria, experimento e análise

A new approach for teaching in basic experimental organic chemistry is presented. Experimental work goes on parallel to theoretical lectures leading to an immediate application of theoretical concepts transmitted therein. One day/week is dedicated exclusively to the organic laboratory. Reactions are proposed as problems to be solved; the student has to deduce the structure of the product on the basis of his observations, the analytical data and his mechanistical knowledge. 70 different experiments, divided in 7 thematical chapters, are presented. All experiments require the analysis and discussion of 1H and 13C NMR, IR and UV spectra. Additional questions about each reaction have to be answered by the student in his written report. Laboratory safety is garanteed by the exclusion or substitution of hazardous and toxic reagents. Microscale preparations are adopted in most cases to lower the cost of materials and the amount of waste. Recycling of many reaction products as starting materials in other experiments reduces the need for commercial reagents and allows the execution of longer reaction sequences. Only unexpensive standard laboratory equipment and simple glassware are required. All experiments include instructions for the save treatment or disposal of chemical waste.

Transforming Maritime Safety Culture. Evaluation of the impacts of the ISM Code on maritime safety culture in Finland

The purpose of the METKU Project (Development of Maritime Safety Culture) is to study how the ISM Code has influenced the safety culture in the maritime industry. This literature review is written as a part of the Work Package 2 which is conducted by the University of Turku, Centre for Maritime Studies. The maritime traffic is rapidly growing in the Baltic Sea which leads to a growing risk of maritime accidents. Particularly in the Gulf of Finland, the high volume of traffic causes a high risk of maritime accidents. The growing risks give us good reasons for implementing the research project concerning maritime safety and the effectiveness of the safety measures, such as the safety management systems. In order to reduce maritime safety risks, the safety management systems should be further developed. The METKU Project has been launched to examine the improvements which can be done to the safety management systems. Human errors are considered as the most important reason for maritime accidents. The international safety management code (the ISM Code) has been established to cut down the occurrence of human errors by creating a safety-oriented organizational culture for the maritime industry. The ISM Code requires that a company should provide safe practices in ship operation and a safe working environment and establish safeguards against all identified risk. The fundamental idea of the ISM Code is that companies should continuously improve safety. The commitment of the top management is essential for implementing a safety-oriented culture in a company. The ISM Code has brought a significant contribution to the progress of maritime safety in recent years. Shipping companies and ships’ crews are more environmentally friendly and more safety-oriented than 12 years ago. This has been showed by several studies which have been analysed for this literature research. Nevertheless, the direct effect and influence of the ISM Code on maritime safety could not be isolated very well. No quantitative measurement (statistics/hard data) could be found in order to present the impacts of the ISM Code on maritime safety. In this study it has been discovered that safety culture has emerged and it is developing in the maritime industry. Even though the roots of the safety culture have been established there are still serious barriers to the breakthrough of the safety management. These barriers could be envisaged as cultural factors preventing the safety process. Even though the ISM Code has been effective over a decade, the old-established behaviour which is based on the old day’s maritime culture still occurs. In the next phase of this research project, these cultural factors shall be analysed in regard to the present safety culture of the maritime industry in Finland.

Descoloração e degradação de poluentes orgânicos em soluções aquosas através do processo fotoeletroquímico

Organic compounds responsible for the color of wastewaters are usually refractory to biological digestion. In this paper the photo-assisted electrolysis process is used for color removal from three of the most colored wastewaters, which are daily generated in large amounts: the E1 bleach Kraft mill effluent, a textile reactive dye effluent and a landfill leachate. Electrolysis was carried out at 26,5 mA cm-2 in a flow reactor in which the anode surface was illuminated by a 400 W high pressure Hg bulb. In all experiments 70-75% of color reduction was observed which was also followed by a net organic load oxidation.

Laite- ja työturvallisuus H2S-tiloissa

Tässä työssä selvitettiin, millä tavoin räjähdysvaarallisten työtilojen työturvallisuuteen voidaan vaikuttaa ja miten turvallisuutta pidetään yllä. Työssä selvitettiin, mitä vaatimuksia räjähdysvaaralliset tilat asettavat laite- ja työturvallisuudelle. Työn lähtökohdaksi otettiin ilmanvaihdon vaikutus sisäilman olosuhteisiin ja samalla selvitettiin, mitä muutoksia räjähdysvaarallisten aineiden käyttö teollisuuden tuotantoprosesseissa aiheuttaa ilmanvaihdossa. Räjähdysvaarallisten tilojen suunnittelua ohjailevat säädökset, lait ja direktiivit. Johdonmukaisen suunnittelulla ja säädöksiä noudattamalla pystytään toteuttamaan turvallinen työympäristö. Räjähdysvaarallista tilaa päästiin tarkastelemaan Talvivaaran Kaivososakeyhtiö Oyj:n metallien talteenottolaitoksella. Työssä haluttiin tutkia rakennuksen työturvallisuutta ja työskentelyolosuhteita. Tutkimuskohteena olleessa reaktorihallissa tehtiin ilmanvaihdon suorituskyvyn mittauksia. Tarkoituksena oli myös tehdä rikkivedyn pitoisuus mittauksia, mutta Talvivaaran tuotannon viivästyessä, pitoisuus mittaukset jätettiin tämän diplomityön ulkopuolelle. Talvivaaraan reaktorirakennuksen olosuhteita ja turvallisuutta tarkasteltiin lähemmin teoreettisten laskelmien avulla. Laskelmien ja mittaustulosten perusteella reaktorirakennuksen ilmanvaihdon suorituskyky todettiin riittäväksi ja toiminta työturvalliseksi. Riskin arvioinnin perusteella reaktorirakennuksen riskitason katsotaan olevan siedettävä.

The use of non-animal alternatives in the safety evaluations of cosmetics ingredients by the Scientific Committee on Consumer Safety (SCCS)

In Europe, the safety evaluation of cosmetics is based on the safety evaluation of each individual ingredient. Article 3 of the Cosmetics Regulation specifies that a cosmetic product made available on the market is to be safe for human health when used normally or under reasonably foreseeable conditions. For substances that cause some concern with respect to human health (e.g. colorants, preservatives, UV-filters), safety is evaluated at the Commission level by a scientific committee, presently called the Scientific Committee on Consumer Safety (SCCS). According to the Cosmetics Regulations, in the EU, the marketing of cosmetics products and their ingredients that have been tested on animals for most of their human health effects, including acute toxicity, is prohibited. Nevertheless, any study dating from before this prohibition took effect is accepted for the safety assessment of cosmetics ingredients. The in vitro methods reported in the dossiers summited to the SCCS are here evaluated from the published reports issued by the scientific committee of the Directorate General of Health and Consumers (DG SANCO); responsible for the safety of cosmetics ingredients. The number of studies submitted to the SCCS that do not involve animals is still low and in general the safety of cosmetics ingredients is based on in vivo studies performed before the prohibition.

Catalytic gasification of glycerol in supercritical water

The conversion of glycerol in supercritical water (SCW) was studied at 510-550 °C and a pressure of 350 bars using both a bed of inert and non-porous ZrO2 particles (hydrothermal experiments), and a bed of a 1% Ru/ZrO2 catalyst. Experiments were conducted with a glycerol concentration of 5 wt% in a continuous isothermal fixed-bed reactor at a residence time between 2 and 10 s. Hydrothermolysis of glycerol formed water-soluble products such as acetaldehyde, acetic acid, hydroxyacetone and acrolein, and gases like H2, CO and CO2. The catalyst enhanced the formation of acetic acid, inhibited the formation of acrolein, and promoted gasification of the glycerol decomposition products. Hydrogen and carbon oxides were the main gases produced in the catalytic experiments, with minor amounts of methane and ethylene. Complete glycerol conversion was achieved at a residence time of 8.5 s at 510 °C, and at around 5 s at 550 °C with the 1 wt% Ru/ZrO2 catalyst. The catalyst was not active enough to achieve complete gasification since high yields of primary products like acetic acid and acetaldehyde were still present. Carbon balances were between 80 and 60% in the catalytic experiments, decreasing continuously as the residence time was increased. This was attributed partially to the formation of methanol and acetaldehyde, which were not recovered and analyzed efficiently in our set-up, but also to the formation of carbon deposits. Carbon deposition was not observed on the catalyst particles but on the surface of the inert zirconia particles, especially at high residence time. This was related to the higher concentration of acetic acid and other acidic species in the catalytic experiments, which may polymerize to form tar-like carbon precursors. Because of carbon deposition, hydrogen yields were significantly lower than expected; for instance at 550 °C the hydrogen yield potential was only 50% of the stoichiometric value.

Proposição de um reator fotocatalítico para destruição de microrganismos em ambientes interiores

The TiO2/UV photocatalytic reactor was investigated as an alternative system to inactivate airborne microorganisms. The experiments performed in the absence of the catalyst showed that direct photolysis was not efficient to destruct microorganisms, with only 30% of inactivation. Similar inactivation percentage was obtained using TiO2 in absence of UV radiation. The destruction of microorganisms present in a contaminated indoor atmosphere, using the combination of TiO2/UV was very efficient, reaching more than 98% of destruction.