Survival Prediction of Initial Blood pH for Nontraumatic Out-of-hospital Cardiac Arrest Patients in the Emergency Department

SummaryBackgroundMost nontraumatic out-of-hospital cardiac arrest (NTOHCA) patients who fail in prehospital resuscitation receive continued cardiopulmonary resuscitation in the emergency department (ED). Initial blood pH, which can be assessed rapidly in the ED, was examined to see whether it is a strong survival predictor for these patients.MethodsA 1-year retrospective study included consecutive 225 NTOHCA patients at a medical center in northern Taiwan who presented through the emergency medical services system. On arrival at the ED, these patients received continued cardiopulmonary resuscitation, and their initial blood pH data were assessed.ResultsThe pH value was positively correlated with variables such as return of spontaneous circulation, witnessed arrest, short prehospital time (≤20 minutes), and survival. The best cut-off value of initial blood pH, revealed by the receiver operating characteristic curve, was 7.068. The lowest pH value of the survivors was 6.856. The results of logistic regression model analysis shows that the odds ratios of survival was 10.0 (95% confidence interval [CI], 2.1–47.7) for patients with initial blood pH ≥ 7.068, 5.3 (95% CI, 1.48–18.9) for those with nonasystole rhythm, 4.0 (95% CI, 1.1–14.8) for those with prehospital time ≤20 minutes, and 9.1 (95% CI, 2.3–35.2) for those without NaHCO3 administration during resuscitation, respectively.ConclusionA cut-off value of an initial blood pH of 7.068 can serve as a predictor for survival among NTOHCA patients. In addition, patients whose initial blood pH is lower than 6.85 in the ED may not survive until hospital discharge

Shell-model calculations and realistic effective interactions

A review is presented of the development and current status of nuclear shell-model calculations in which the two-body effective interaction is derived from the free nucleon-nucleon potential. The significant progress made in this field within the last decade is emphasized, in particular as regards the so-called V-low-k approach to the renormalization of the bare nucleon-nucleon interaction. In the last part of the review we first give a survey of realistic shell-model calculations from early to present days. Then, we report recent results for neutron-rich nuclei near doubly magic 132Sn and for the whole even-mass N=82 isotonic chain. These illustrate how shell-model effective interactions derived from modern nucleon-nucleon potentials are able to provide an accurate description of nuclear structure properties.Comment: 71 pages, to be published in Progress in Particle and Nuclear Physic

A comparative study of chemical composition, antioxidant and antimicrobial properties of Morchella esculenta (L.) Pers. from Portugal and Serbia

A comparative study on chemical composition (nutritional value, primary and secondary metabolites), antioxidant properties (scavenging activity, reducing power and inhibition of lipid peroxidation), and antimicrobial activity (antibacterial and demelanizing properties) of two samples of Morchella esculenta (morel) from different countries (Portugal and Serbia) was performed. This species was chosen for being one of the most highly prized edible mushrooms in the world. Both samples are rich in carbohydrates (including free sugars) and proteins, and contain several bioactive compounds such as organic acids, phenolic compounds and tocopherols. Polyunsaturated fatty acids were the most abundant compounds followed by mono or saturated fatty acids. Sample from Portugal (SP) gave higher radical scavenging activity and reducing power, while sample from Serbia (SS) showed higher lipid peroxidation inhibition. Both samples gave antibacterial activity against five bacteria (in some cases even better than standard antibiotics) and demelanizing activity against four micromycetes, showing SS higher activities. As far as we know, this is the first study reporting chemical compounds and bioactivity of morel samples from Portugal and Serbia. Furthermore, a novel method for evaluation of demelanizing activity was presented.The authors are grateful to Fundacao para a Ciencia e a Tecnologia (FCT, Portugal) and COMPETE/QREN/EU (research project PTDC/AGR-ALI/110062/2009; bilateral cooperation action Portugal/Serbia 2011; strategic projects PEst-OE/AGR/UI0690/2011 and PEst-C/QUI/UI0686/2011), and to Serbian Ministry of Education and Science (grant number 173032) for financial support. S.A. Heleno (BD/70304/2010) and L. Barros (BPD/4609/2008) also thank FCT, POPH-QREN and FSE

Perspectives and Integration in SOLAS Science

Why a chapter on Perspectives and Integration in SOLAS Science in this book? SOLAS science by its nature deals with interactions that occur: across a wide spectrum of time and space scales, involve gases and particles, between the ocean and the atmosphere, across many disciplines including chemistry, biology, optics, physics, mathematics, computing, socio-economics and consequently interactions between many different scientists and across scientific generations. This chapter provides a guide through the remarkable diversity of cross-cutting approaches and tools in the gigantic puzzle of the SOLAS realm. Here we overview the existing prime components of atmospheric and oceanic observing systems, with the acquisition of ocean–atmosphere observables either from in situ or from satellites, the rich hierarchy of models to test our knowledge of Earth System functioning, and the tremendous efforts accomplished over the last decade within the COST Action 735 and SOLAS Integration project frameworks to understand, as best we can, the current physical and biogeochemical state of the atmosphere and ocean commons. A few SOLAS integrative studies illustrate the full meaning of interactions, paving the way for even tighter connections between thematic fields. Ultimately, SOLAS research will also develop with an enhanced consideration of societal demand while preserving fundamental research coherency. The exchange of energy, gases and particles across the air-sea interface is controlled by a variety of biological, chemical and physical processes that operate across broad spatial and temporal scales. These processes influence the composition, biogeochemical and chemical properties of both the oceanic and atmospheric boundary layers and ultimately shape the Earth system response to climate and environmental change, as detailed in the previous four chapters. In this cross-cutting chapter we present some of the SOLAS achievements over the last decade in terms of integration, upscaling observational information from process-oriented studies and expeditionary research with key tools such as remote sensing and modelling. Here we do not pretend to encompass the entire legacy of SOLAS efforts but rather offer a selective view of some of the major integrative SOLAS studies that combined available pieces of the immense jigsaw puzzle. These include, for instance, COST efforts to build up global climatologies of SOLAS relevant parameters such as dimethyl sulphide, interconnection between volcanic ash and ecosystem response in the eastern subarctic North Pacific, optimal strategy to derive basin-scale CO2 uptake with good precision, or significant reduction of the uncertainties in sea-salt aerosol source functions. Predicting the future trajectory of Earth’s climate and habitability is the main task ahead. Some possible routes for the SOLAS scientific community to reach this overarching goal conclude the chapter

First evidence for the two-body charmless baryonic decay B0→pp−

The results of a search for the rare two-body charmless baryonic decays B0→pp− and B0s→pp− are reported. The analysis uses a data sample, corresponding to an integrated luminosity of 0.9 fb−1, of pp collision data collected by the LHCb experiment at a centre-of-mass energy of 7 TeV. An excess of B0→pp− candidates with respect to background expectations is seen with a statistical significance of 3.3 standard deviations. This is the first evidence for a two-body charmless baryonic B 0 decay. No significant B0s→pp− signal is observed, leading to an improvement of three orders of magnitude over previous bounds. If the excess events are interpreted as signal, the 68.3% confidence level intervals on the branching fractions are B(B0→pp−)=1.47+0.62+0.35−0.51−0.14×10−8,\hfillB(Bs→pp−)=2.84+2.03+0.85−1.68−0.18×10−8,\hfill where the first uncertainty is statistical and the second is systematic

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

Study of eta-eta ' mixing from measurement of B-(s)(0) -&gt; J/psi eta((')) decay rates

A study of B and Bs meson decays into J/ψ η and J/ψ η′ final states is performed using a data set of proton-proton collisions at centre-of-mass energies of 7 and 8 TeV, collected by the LCHb experiment and corresponding to 3.0 fb−1 of integrated luminosity. The decay B0 → J/ψ η′ is observed for the first time. The following ratios of branching fractions are measured: B(B0→J/ψη′)B(B0s→ J/ψη′)=(2.28±0.65 (stat)±0.10 (syst)±0.13 (fs/fd))×10−2,B(B0→ J/ψη)B(B0s→ J/ψη)=(1.85±0.61 (stat)±0.09 (syst)±0.11 (fs/fd))×10−2, where the third uncertainty is related to the present knowledge of fs/fd, the ratio between the probabilities for a b quark to form a Bs or a B0 meson. The branching fraction ratios are used to determine the parameters of η − η′ meson mixing. In addition, the first evidence for the decay Bs → ψ(2S)η′ is reported, and the relative branching fraction is measured, B(B0s→ ψ(2S)η′)B(B0s→ J/ψη′)=(38.7±9.0 (stat)±1.3 (syst)±0.9(B))×10−2, where the third uncertainty is due to the limited knowledge of the branching fractions of J/ψ and ψ(2S) mesons

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

The Transfer Problem in the Servicing of Foreign Capital by the Underdeveloped Countries

136 page