Analyses of coronary graft patency after aprotinin use: results from the International Multicenter Aprotinin Graft Patency Experience (IMAGE) trial

OBJECTIVE: We examined the effects of aprotinin on graft patency, prevalence of myocardial infarction, and blood loss in patients undergoing primary coronary surgery with cardiopulmonary bypass. METHODS: Patients from 13 international sites were randomized to receive intraoperative aprotinin (n = 436) or placebo (n = 434). Graft angiography was obtained a mean of 10.8 days after the operation. Electrocardiograms, cardiac enzymes, and blood loss and replacement were evaluated. RESULTS: In 796 assessable patients, aprotinin reduced thoracic drainage volume by 43% (P < .0001) and requirement for red blood cell administration by 49% (P < .0001). Among 703 patients with assessable saphenous vein grafts, occlusions occurred in 15.4% of aprotinin-treated patients and 10.9% of patients receiving placebo (P = .03). After we had adjusted for risk factors associated with vein graft occlusion, the aprotinin versus placebo risk ratio decreased from 1.7 to 1.05 (90% confidence interval, 0.6 to 1.8). These factors included female gender, lack of prior aspirin therapy, small and poor distal vessel quality, and possibly use of aprotinin-treated blood as excised vein perfusate. At United States sites, patients had characteristics more favorable for graft patency, and occlusions occurred in 9.4% of the aprotinin group and 9.5% of the placebo group (P = .72). At Danish and Israeli sites, where patients had more adverse characteristics, occlusions occurred in 23.0% of aprotinin- and 12.4% of placebo-treated patients (P = .01). Aprotinin did not affect the occurrence of myocardial infarction (aprotinin: 2.9%; placebo: 3.8%) or mortality (aprotinin: 1.4%; placebo: 1.6%). CONCLUSIONS: In this study, the probability of early vein graft occlusion was increased by aprotinin, but this outcome was promoted by multiple risk factors for graft occlusion.     

Tributary use and large-scale movements of grass carp in Lake Erie

Infrequent captures of invasive, non-native grass carp (Ctenopharyngodon idella) have occurred in Lake Erie over the last 30+ years, with recent evidence suggesting wild reproduction in the lake’s western basin (WB) is occurring. Information on grass carp movements in the Laurentian Great Lakes is lacking, but an improved understanding of large-scale movements and potential areas of aggregation will help inform control strategies and risk assessment if grass carp spread to other parts of Lake Erie and other Great Lakes. Twenty-three grass carp captured in Lake Erie’s WB were implanted with acoustic transmitters and released. Movements were monitored with acoustic receivers deployed throughout Lake Erie and elsewhere in the Great Lakes. Grass carp dispersed up to 236 km, with approximately 25% of fish dispersing greater than 100 km from their release location. Mean daily movements ranged from <0.01 to 2.49 km/day, with the highest daily averages occurring in the spring and summer. The Sandusky, Detroit, and Maumee Rivers, and Plum Creek were the most heavily used WB tributaries. Seventeen percent of grass carp moved into Lake Erie’s central or eastern basins, although all fish eventually returned to the WB. One fish emigrated from Lake Erie through the Huron-Erie Corridor and into Lake Huron. Based on our results, past assessments may have underestimated the potential for grass carp to spread in the Great Lakes. We recommend focusing grass carp control efforts on Sandusky River and Plum Creek given their high use by tagged fish, and secondarily on Maumee and Detroit Rivers.     

In Situ EXAFS Study on the Chemical State of Arsenic Deposited on a NiMoP/Al2O3 Hydrotreating Catalyst

The chemical state of arsenic deposited on a NiMoP/Al₂O₃ hydrotreating catalyst exposed to ppb levels of arsenic over several years in a refinery reactor has been studied by in situ EXAFS. In the as-received As-NiMoP catalyst, arsenic is exclusively coordinated to oxygen atoms. Upon sulfiding the sample in 2%H₂S/2%H₂/96%He, the As atoms become surrounded by approximately two sulfur atoms. No evidence was found for Ni–As bond formation. A possible model for the As local environment is suggested on the basis of combined EXAFS results, STM data and FEFF8.0 simulations (program for ab initio calculations on multiple scattering XAFS and XANES). The FEFF8.0 simulations of the proposed model are in accord with the experimental data measured at the As K edge. In this model, an As atom is located at the edge of a hexagonally truncated Ni-MoS₂ slab and is blocking the active NiMoS site.     

Nickel Activation for Hydrogenolysis Reaction on USY Zeolite

The effects of the SAR (14 and 38) and of the methodology of introduction of nickel (wetness impregnation and ion exchange) on catalyst activation were investigated in Ni/USY model catalysts submitted to two activation treatments: reduction (A) and reduction/calcination/reduction, successively (B). the catalysts prepared by wetness impregnation, a marked increase in the catalytic activity after treatment B was observed. On the basis of the catalyst efficiency toward ethane hydrogenolysis, the lower SAR catalyst presents a threefold higher activity. On the contrary, the catalysts prepared by ion exchange, as well as a model catalyst prepared by wetness impregnation over a USY exhaustively exchanged with nickel ions, do not present measurable increasing of the catalytic activity under the same activation conditions. Monitoring the catalyst activation by EXAFS indicates the formation of nickel clusters in the impregnated catalysts after activation treatment B, which should be responsible for the high catalytic activity. However, TEM images reveal a bimodal particle size distribution, with large (ca. 20 nm) and small nickel particles. Temperature-programmed reduction performed under the same conditions of catalyst activation suggests that only the small nickel particles are activated under the experimental conditions adopted in this work.     

Crystal structures and phase transformation of deuterated lithium imide, Li2ND

Half-Heusler compounds of Sn-doped TiCoSb “TiCoSn_xSb_1−x (x = 0.0, 0.01, and 0.05)” were prepared and their thermoelectric properties were measured above room temperature. From the EDX analysis, all the samples have three phases: the TiCoSn_xSb_1−x, Co-rich, and Ti-rich phases. The values of the thermoelectric power increase with Sn doping, and a positive thermoelectric power is obtained in the sample of TiCoSn_0.05Sb_0.95. The thermal conductivity decreases both with increasing temperature and with Sn content. The maximum value of ZT for p-type material is 0.030 at 988 K in the sample of TiCoSn_0.05Sb_0.95.     

On preconditioning for a parallel solution of the Richards equation

In this paper, we present a class of preconditioning methods for a parallel solution of the three-dimensional Richards equation. The preconditioning methods Jacobi scaling, block-Jacobi, incomplete lower–upper, incomplete Cholesky and algebraic multigrid were applied in combination with a parallel conjugate gradient solver and tested for robustness and convergence using two model scenarios. The first scenario was an infiltration into initially dry, sandy soil discretised in 500,000 nodes. The second scenario comprised spatially distributed soil properties using 275,706 numerical nodes and atmospheric boundary conditions. Computational results showed a high efficiency of the nonlinear parallel solution procedure for both scenarios using up to 64 processors. Using 32 processors for the first scenario reduced the wall clock time to slightly more than 1% of the single processor run. For scenario 2 the use of 64 processors reduces the wall clock time to slightly more than 20% of the 8 processors wall clock time. The difference in the efficiency of the various preconditioning methods is moderate but not negligible. The use of the multigrid preconditioning algorithm is recommended, since on average it performed best for both scenarios.     

An energy model of interframe interval effects in single-step apparent motion

A computational model was developed to explain the effects of an interframe interval (IFI) in single-step apparent motion experiments. In these experiments a stimulus appears in one position, disappears, and then reappears in a shifted position after a short or long IFI. If the luminance during the IFI matches the mean luminance of the stimulus frames, long IFIs result in perceived motion opposite the short-IFI conditions. Brighter or darker IFIs, however, do not support the reversed motion effect. The model possess the following defining characteristics: (1) a biphasic ("transient") channel whose signalled direction of motion reverses with changes of IFI duration; (2) a combined direction-opponent output which is the sum of directional responses developed in two channels--biphasic ("transient") and monophasic ("sustained"); (3) a signal/noise weighting of the contributions of the two channels to the final directional output of the system. Predictions of the model about the effects of IFI intensity and viewing eccentricity were tested and confirmed in two new psychophysical experiments. The interpretations of past studies which included a role for second-order motion mechanisms in explaining IFI duration effects were reexamined. Further empirical tests of the model were outlined.     

Arthroscopic Bankart repair with the Suretac device. Part I: Clinical observations

Although arthroscopic Bankart repair has become an accepted surgical stabilization technique for anterior shoulder instability, the failure rate remains unacceptably high. Little information is available concerning healing of the Bankart repair. The purpose of this article is to clarify this issue by analyzing a cohort of 15 patients who underwent a "second-look" arthroscopy to evaluate and treat pain or recurrent instability following arthroscopic Bankart repair with the Suretac device (Acufex Microsurgical, Mansfield, MA). "Second-look" arthroscopy was performed at an average of 9 months following the index surgical procedure. The reasons for this second surgery were recurrent instability in 7, pain in 6, and pain and stiffness in 2. In the 7 patients with recurrent instability, the Bankart repair was found to be completely healed in 3 (43%), partially healed in 1 (14%), and had recurred in 3 (43%); however, 6 of 7 were observed to have lax capsular tissue. In 4 of these cases, retrospective review of the index surgical procedure showed that a technical error had been made during the repair. Two cases had biopsy of the repair site on "second-look" at 6 to 8 months, and this showed residual polyglyconate polymer debris surrounded by a histiocytic infiltrate. In the remaining 8 cases with stable shoulders, the Bankart repair had completely healed in 5 cases (62.5%) and partially healed in 3 cases (37.5%). The higher failure rate with this approach compared with open approaches appears to result from improper patient selection and errors in surgical technique. There is some question concerning healing strength of the Bankart repair, although complete healing of the Bankart does not seem to be a prerequesite for shoulder stability. Success of the procedure might be expected to improve by selecting only patients with unidirectional, posttraumatic, anterior instability who are found to have a discrete Bankart lesion and well-developed ligamentous tissue.