Extensive Rhodolith Beds Cover the Summits of Southwestern Atlantic Ocean Seamounts

Calcium carbonate production by marine organisms is an essential process in the global budget of CO32-, and coralline reefs are the most important benthic carbonate producers. Crustose coralline algae (CCA) are well recognized as the most important carbonate builders in the tropical Brazilian continental shelf, forming structural reefs and extensive rhodolith beds. However, the distribution of CCA beds, as well as their role in CO32- mineralization in mesophotic communities and isolated carbonate banks, is still poorly known. To characterize the bottom features of several seamount summits in the Southwestern Atlantic (SWA), side-scan sonar records, remotely operated vehicle imagery, and benthic samples with mixed-gas scuba diving were acquired during two recent research cruises (March 2009 and February 2011). The tops of several seamounts within this region are relatively shallow (similar to 60 m), flat, and dominated by rhodolith beds (Vitoria, Almirante Saldanha, Davis, and Jaseur seamounts, as well as the Trindade Island shelf). On the basis of abundance, dimensions, vitality, and growth rates of CCA nodules, a mean CaCO3 production was estimated, ranging from 0.4 to 1.8 kg m(-2) y(-1) with a total production reaching 1.5 x 10(-3) Gt y(-1). Our results indicate that these SWA seamount summits provide extensive areas of shallow reef area and represent 0.3% of the world's carbonate banks. The importance of this habitat has been highly neglected, and immediate management needs must be fulfilled in the short term to ensure long-term persistence of the ecosystem services provided by these offshore carbonate realms.Brazilian Research Council (CNPq)Brazilian Research Council (CNPq

Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients

Bococizumab is a humanized monoclonal antibody that inhibits proprotein convertase subtilisin- kexin type 9 (PCSK9) and reduces levels of low-density lipoprotein (LDL) cholesterol. We sought to evaluate the efficacy of bococizumab in patients at high cardiovascular risk. METHODS In two parallel, multinational trials with different entry criteria for LDL cholesterol levels, we randomly assigned the 27,438 patients in the combined trials to receive bococizumab (at a dose of 150 mg) subcutaneously every 2 weeks or placebo. The primary end point was nonfatal myocardial infarction, nonfatal stroke, hospitalization for unstable angina requiring urgent revascularization, or cardiovascular death; 93% of the patients were receiving statin therapy at baseline. The trials were stopped early after the sponsor elected to discontinue the development of bococizumab owing in part to the development of high rates of antidrug antibodies, as seen in data from other studies in the program. The median follow-up was 10 months. RESULTS At 14 weeks, patients in the combined trials had a mean change from baseline in LDL cholesterol levels of -56.0% in the bococizumab group and +2.9% in the placebo group, for a between-group difference of -59.0 percentage points (P<0.001) and a median reduction from baseline of 64.2% (P<0.001). In the lower-risk, shorter-duration trial (in which the patients had a baseline LDL cholesterol level of ≥70 mg per deciliter [1.8 mmol per liter] and the median follow-up was 7 months), major cardiovascular events occurred in 173 patients each in the bococizumab group and the placebo group (hazard ratio, 0.99; 95% confidence interval [CI], 0.80 to 1.22; P = 0.94). In the higher-risk, longer-duration trial (in which the patients had a baseline LDL cholesterol level of ≥100 mg per deciliter [2.6 mmol per liter] and the median follow-up was 12 months), major cardiovascular events occurred in 179 and 224 patients, respectively (hazard ratio, 0.79; 95% CI, 0.65 to 0.97; P = 0.02). The hazard ratio for the primary end point in the combined trials was 0.88 (95% CI, 0.76 to 1.02; P = 0.08). Injection-site reactions were more common in the bococizumab group than in the placebo group (10.4% vs. 1.3%, P<0.001). CONCLUSIONS In two randomized trials comparing the PCSK9 inhibitor bococizumab with placebo, bococizumab had no benefit with respect to major adverse cardiovascular events in the trial involving lower-risk patients but did have a significant benefit in the trial involving higher-risk patients

Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients

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