Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Author Correction: A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic

In the version of this article initially published, the following authors were omitted from the author list and the Author contributions section for “investigation” and “writing and editing”: Nandor Hajdu (Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary), Jordane Boudesseul (Facultad de Psicología, Instituto de Investigación Científica, Universidad de Lima, Lima, Perú), Rafał Muda (Faculty of Economics, Maria Curie-Sklodowska University, Lublin, Poland) and Sandersan Onie (Black Dog Institute, UNSW Sydney, Sydney, Australia & Emotional Health for All Foundation, Jakarta, Indonesia). In addition, Saeideh FatahModares’ name was originally misspelled as Saiedeh FatahModarres in the author list. Further, affiliations have been corrected for Maria Terskova (National Research University Higher School of Economics, Moscow, Russia), Susana Ruiz Fernandez (FOM University of Applied Sciences, Essen; Leibniz-Institut für Wissensmedien, Tübingen, and LEAD Research Network, Eberhard Karls University, Tübingen, Germany), Hendrik Godbersen (FOM University of Applied Sciences, Essen, Germany), Gulnaz Anjum (Department of Psychology, Simon Fraser University, Burnaby, Canada, and Department of Economics & Social Sciences, Institute of Business Administration, Karachi, Pakistan). The changes have been made to the HTML and PDF versions of the article

A global experiment on motivating social distancing during the COVID-19 pandemic

Significance Communicating in ways that motivate engagement in social distancing remains a critical global public health priority during the COVID-19 pandemic. This study tested motivational qualities of messages about social distancing (those that promoted choice and agency vs. those that were forceful and shaming) in 25,718 people in 89 countries. The autonomy-supportive message decreased feelings of defying social distancing recommendations relative to the controlling message, and the controlling message increased controlled motivation, a less effective form of motivation, relative to no message. Message type did not impact intentions to socially distance, but people’s existing motivations were related to intentions. Findings were generalizable across a geographically diverse sample and may inform public health communication strategies in this and future global health emergencies. Abstract Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

Response

South Summit High School, activities for yearbookKendall Webb Collectio

Atmosfera controlada para o armazenamento de goiaba cultivar 'Paluma'

A goiaba é uma fruta que apresenta alta perecibilidade, sendo o armazenamento em Atmosfera Controlada (AC) uma técnica que pode prolongar a vida pós-colheita, mantendo sua qualidade. O objetivo deste trabalho foi determinar a melhor condição de armazenamento em AC para a conservação da qualidade da goiaba, cultivar 'Paluma'. O experimento foi conduzido no Delineamento em Blocos ao Acaso, com os tratamentos: [1] 20,9 kPa O2 + 0,03 kPa CO2 (AR - testemunha); [2] 1,0 kPa O2 + 2,0 kPa CO2; [3] 2,0 kPa O2 + 2,0 kPa CO2; [4] 3,0 kPa O2 + 2,0 kPa CO2; e [5] 3,0 kPa O2 + 4,0 kPa CO2. Todos os frutos foram armazenados à temperatura de 8°C (±0,2) sob umidade relativa de 95% (±2,0). Após 28 dias de armazenamento, os frutos foram avaliados quanto às suas características físico-químicas. A melhor conservação da goiaba cultivar 'Paluma' em AC foi obtida com O2 entre 1 e 2 kPa, combinado com 2 kPa de CO2. Estas condições reduziram a degradação da coloração verde da epiderme, a perda de firmeza e de acidez e mantiveram a coloração da polpa com mais eficiência; porém, a alta ocorrência de podridões durante a vida de prateleira é o fator que limita o período de conservação desta goiaba