Extended thromboprophylaxis with betrixaban in acutely ill medical patients

BACKGROUND: Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. METHODS: Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. We performed sequential analyses in three prespecified, progressively inclusive cohorts: patients with an elevated d-dimer level (cohort 1), patients with an elevated d-dimer level or an age of at least 75 years (cohort 2), and all the enrolled patients (overall population cohort). The statistical analysis plan specified that if the between-group difference in any analysis in this sequence was not significant, the other analyses would be considered exploratory. The primary efficacy outcome was a composite of asymptomatic proximal deep-vein thrombosis and symptomatic venous thromboembolism. The principal safety outcome was major bleeding. RESULTS: A total of 7513 patients underwent randomization. In cohort 1, the primary efficacy outcome occurred in 6.9% of patients receiving betrixaban and 8.5% receiving enoxaparin (relative risk in the betrixaban group, 0.81; 95% confidence interval [CI], 0.65 to 1.00; P=0.054). The rates were 5.6% and 7.1%, respectively (relative risk, 0.80; 95% CI, 0.66 to 0.98; P=0.03) in cohort 2 and 5.3% and 7.0% (relative risk, 0.76; 95% CI, 0.63 to 0.92; P=0.006) in the overall population. (The last two analyses were considered to be exploratory owing to the result in cohort 1.) In the overall population, major bleeding occurred in 0.7% of the betrixaban group and 0.6% of the enoxaparin group (relative risk, 1.19; 95% CI, 0.67 to 2.12; P=0.55). CONCLUSIONS: Among acutely ill medical patients with an elevated d-dimer level, there was no significant difference between extended-duration betrixaban and a standard regimen of enoxaparin in the prespecified primary efficacy outcome. However, prespecified exploratory analyses provided evidence suggesting a benefit for betrixaban in the two larger cohorts. (Funded by Portola Pharmaceuticals; APEX ClinicalTrials.gov number, NCT01583218.)

The Sino-Japanese Economic Relations under the Koizumi Administration

departmental bulletin pape

Introduction: historical institutionalist perspectives on European spatial planning

In a context where European integration is put into question, under the weight of external (migration, safety issues, economic) and centrifugal forces (Brexit, growing Euroscepticism), European spatial planning has been somewhat sidelined in the debates on the European Union’s goals, cohesion and future. This special issue aims to contribute to a deeper understanding of these dynamics by revisiting the history of European spatial planning – from its origins, gradual institutionalization to its current rolling back – by exploring it both at the European and the national level, stressing its difficulties and idiosyncrasies. The conceptual framework of historical institutionalism is used across the papers in an attempt to shed more light on this processes, through the analysis of critical junctures and path dependency of planning and cohesion agendas, transnational networks as well as changes to the national institutions and planning systems. This tightly woven collection of papers touches upon not only the underlying arguments for European cohesion, but also the questions about the future of European spatial planning as an ‘EU microcosm’ in light of current discussions concerning democratic credentials and legitimacy of the EU project as a whole.Accepted Author ManuscriptSpatial Planning and Strateg

The Construction of Gauge-Links in Arbitrary Hard Processes

Transverse momentum dependent parton distribution and fragmentation functions are described by hadronic matrix elements of bilocal products of field operators off the light-cone. These bilocal products contain gauge-links, as required by gauge-invariance. The gauge-links are path-ordered exponentials connecting the field operators along a certain integration path. This integration path is process-dependent, depending specifically on the short-distance partonic subprocess. In this paper we present the technical details needed in the calculation of the gauge-links and a calculational scheme is provided to obtain the gauge-invariant distribution and fragmentation correlators corresponding to a given partonic subprocess

Ion irradiation in liquid of μm3 region for cell surgery

We present here a cell surgery scheme involving selective inactivation or disruption of cellular structures. Energetic ions are injected into a cell through a tapered glass capillary like a microinjection method. A slight but essential difference from microinjection is that a thin window is prepared at the outlet so that no liquid material can flow in or back through the outlet while still allowing energetic ions to penetrate into the cell. An ∼ MeV He ion beam from such a capillary having 10 μm outlet diameter inactivated a selected volume ( ∼ μm3) of fluorescent molecules located in a HeLa cell nucleus

The Political Changes and Leagal Changes in Investment and Company Related to Asian Infrastructure Investment Bank（ AIIB） in Asian Countries： Towards Achiving Peace and Justice, Reducing Inequality and SDGs

departmental bulletin pape

Log-transformed B-type natriuretic peptide as a prognostic predictor in patients undergoing cardiovascular surgery

金沢医科大学博士（医学）2018thesi

Preparation of Silica-Gel Film with pH Indicators by the Sol-Gel Method

application/pdfGel films with various pH indicators were prepared by the sol-gel method without catalysts. The obtained gel films showed good response for various pH solutions as optical pH sensors and no leaching of the indicators was observed. The feature of absorption spectra of the indicators in the gel films was almost the same as that in the aqueous solutions. pKa of the indicators in the gel films was shifted with the increase of the TMOS content in the starting solutions. These results suggest that the pH indicators in the gel films were trapped in similar environment as in the solutions.journal articl

Claim of Chickasaw Nation. Letter from the Acting Secretary of the Interior, relative to the claim of the Chickasaw Nation for interest due on certain state stocks belonging to the Chickasaw Nation fund

42-2AppropriationsL-C of the Chickasaw Nation. [1515] For interest due on stocks held in their trust fund.1872-9

On Stability and Boundedness of Solutions of a System of Some Functional Differential Equations

19KJ00003571919論文Articledepartmental bulletin pape