Sailing for Science: on board experiences for transferring knowledge on Historical Oceanography for Future Innovation

Smart, sustainable and inclusive Blue Growth means also knowing past technology and the paths followed by ancients in order to understand and monitor marine environments. In general, history of Science is a matter that is not enough explored and explained or promoted in high schools or university official programmes, and, usually, scientist do not consider it as an important part of their curricula. However, bad or good ideas, abandoned or forgotten beliefs, concepts, opinions, do still have a great potential for inspiring present and future scientists, no matter in which historical period they may have been formulated: they should be always be taken into consideration, critically examined and observed by a very close point of view, not just as part of the intellectual framework of some obsolete ‘Cabinet of Curiosities’ with limited access except for the chosen few. Moreover, history of Science should be transmitted in a more practical way, with hands-on labs showing the limits and challenges that prior generations of ocean explorers, investigators and seafarers had to face in order to answer to crucial questions as self-orientation in open sea, understanding main currents and waves, predicting meteorological conditions for a safe navigation. Oceanography is a relatively young branch of science, and still needs further approvals and knowledge (National Science Foundation, 2000). The Scientific Dissemination Group (SDG) “La Spezia Gulf of Science” – made up by Research Centres, Schools and Cultural associations located in La Spezia (Liguria, Italy) - has a decadal experience in initiatives aimed at people and groups of people of all ages, who are keen on science or who can be guided in any case to take an interest in scientific matters (Locritani et al., 2015). Amongst the SDG activities, the tight relationship with the Historical Oceanography Society, the Italian Navy and the Naval Technical Museum (that collects a rich heritage of civilization, technology and culture witnesses, related to the naval history of seamanship from the origins up to nowadays), allowed the creation of a special educational format based on Historical Oceanography, for university and high school students as an integration for their curriculum. The Historical Oceanography Society has provided the major knowledges included in the ancient volumes of its archive, thanks to the availability of its members that also held theoretical and practical lessons during the course. The present paper will describe the one-week special course (about 60 hours of theory and practice with technical visits to Research centres and Museums) that has been planned to be carried out on board of the Italian Training Navy Ship (A. Vespucci) and has been organized in order to give the hints about on board life, as well as theoretical lessons on modern and historical oceanography, hands-on labs on oceanographic instruments from public and private collections, physiology of diving techniques and astronomy. The general aim of this course has been, hence, to give to excellent students all those technological but also creative and imaginative features of our past.PublishedVienna1TM. Formazion

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402