Bivalirudin started during emergency transport for primary PCI.

BACKGROUND: Bivalirudin, as compared with heparin and glycoprotein IIb/IIIa inhibitors, has been shown to reduce rates of bleeding and death in patients undergoing primary percutaneous coronary intervention (PCI). Whether these benefits persist in contemporary practice characterized by prehospital initiation of treatment, optional use of glycoprotein IIb/IIIa inhibitors and novel P2Y12 inhibitors, and radial-artery PCI access use is unknown. METHODS: We randomly assigned 2218 patients with ST-segment elevation myocardial infarction (STEMI) who were being transported for primary PCI to receive either bivalirudin or unfractionated or low-molecular-weight heparin with optional glycoprotein IIb/IIIa inhibitors (control group). The primary outcome at 30 days was a composite of death or major bleeding not associated with coronary-artery bypass grafting (CABG), and the principal secondary outcome was a composite of death, reinfarction, or non-CABG major bleeding. RESULTS: Bivalirudin, as compared with the control intervention, reduced the risk of the primary outcome (5.1% vs. 8.5%; relative risk, 0.60; 95% confidence interval [CI], 0.43 to 0.82; P=0.001) and the principal secondary outcome (6.6% vs. 9.2%; relative risk, 0.72; 95% CI, 0.54 to 0.96; P=0.02). Bivalirudin also reduced the risk of major bleeding (2.6% vs. 6.0%; relative risk, 0.43; 95% CI, 0.28 to 0.66; P<0.001). The risk of acute stent thrombosis was higher with bivalirudin (1.1% vs. 0.2%; relative risk, 6.11; 95% CI, 1.37 to 27.24; P=0.007). There was no significant difference in rates of death (2.9% vs. 3.1%) or reinfarction (1.7% vs. 0.9%). Results were consistent across subgroups of patients. CONCLUSIONS: Bivalirudin, started during transport for primary PCI, improved 30-day clinical outcomes with a reduction in major bleeding but with an increase in acute stent thrombosis. (Funded by the Medicines Company; EUROMAX ClinicalTrials.gov number, NCT01087723.)

A formally verified compiler back-end

This article describes the development and formal verification (proof of semantic preservation) of a compiler back-end from Cminor (a simple imperative intermediate language) to PowerPC assembly code, using the Coq proof assistant both for programming the compiler and for proving its correctness. Such a verified compiler is useful in the context of formal methods applied to the certification of critical software: the verification of the compiler guarantees that the safety properties proved on the source code hold for the executable compiled code as well

Post-glacial mass flow and associated deposits preserved in palaeovalleys: the Late Precambrian Morænesø Formation, North Greenland

The Morænesø Formation is of Late Proterozoic age and is preserved as the fills of a series of palaeovalleys. The formation is made up of conglomerates and sandstones of fluvial and aeolian origin and of a series of breccias which resulted almost entirely from gravitational mass movement down the sides of the palaeovalleys. At the most extensive exposure, examples of local rock-fall, rock-slide and matrix-poor breccia flows are observed close to the valley side. Their movement was probably favoured by freeze-thaw mechanisms. More widespread diamictites overlie valley-floor sands and were deposited under water-saturated conditions as a series of mass flows apparently from the sides of the palaeovalleys. The diamictites contain far-travelled clasts, some of which show striated surfaces suggesting a phase of glacial transport prior to final emplacement. Only at one locality does diamictite directly overlie the basal unconformity and suggest possible in situ till. The diamictite sheets are overlain by a widespread but thin dolomite unit which shows spectacular stromatolitic domes. At other localities in the area, valley fills show evidence of floating lake ice with dropstone pebbles occurring in thin bedded sandstones and mudstones. The palaeovalleys are thought to have been eroded by valley glaciers which, on retreat, left substantial volumes of till on the valley sides and possibly in tributary valleys. Any moraine deposited on the valley floor was eroded by fluvial activity priorto a phase of alluvial and aeolian aggradation which coincided with local mass movement in cold conditions. Catastrophic rainfall, probably related to a generally wetter palaeoclimate, remobilised lateral moraines and other deposits and emplaced them on the valley floor. Deep weathering of dolerites at the unconformity suggests an ameliorated climate and a substantial time gap prior to these mass flows. A body of shallow water, established on the valley floor soon after these events, led to deposition of stromatolitic dolomite. The Morænesø Formation represents remarkable preservation of a complex series of local glacial and post-glacial deposits in an upland setting compared with the more widespread lowland or marine tillites of Late Proterozoic age in other areas

The next generation fungal diversity researcher

Fungi are more important to our lives than is assumed by the general public. They can comprise both devastating pathogens and plant-associated mutualists in nature, and several species have also become important workhorses of biotechnology. Fungal diversity research has in a short time transcended from a low-tech research area to a method-intensive high-tech discipline. With the advent of the new genomic and post-genomic methodologies, large quantities of new fungal data are currently becoming available each year. Whilst these new data and methodologies may help modern fungal diversity researchers to explore and discover the yet hidden diversity within a context of biological processes and organismal diversity, they need to be reconciled with the traditional approaches. Such a synthesis is actually difficult to accomplish given the current discouraging situation of fungal biology education, especially in the areas of biodiversity and taxonomic research. The number of fungal diversity researchers and taxonomists in academic institutions is decreasing, as are opportunities for mycological education in international curricula. How can we educate and stimulate students to pursue a career in fungal diversity research and taxonomy and avoid the situation whereby only those few institutions with strong financial support are able to conduct excellent research? Our short answer is that we need a combination of increased specialization and increased collaboration, i.e. that scientists with specialized expertise (e.g., in data generation, compilation, interpretation, and communication) consistently work together to generate and deliver new fungal knowledge in a more integrative manner – closing the gap between both traditional and modern approaches and academic and non-academic environments. Here we discuss how this perspective could be implemented in the training of the ‘next generation fungal diversity researcher’

Fair Soft Clustering

Scholars in the machine learning community have recently focused on analyzing the fairness of learning models, including clustering algorithms. In this work we study fair clustering in a probabilistic (soft) setting, where observations may belong to several clusters determined by probabilities. We introduce new probabilistic fairness metrics, which generalize and extend existing non-probabilistic fairness frameworks and propose an algorithm for obtaining a fair probabilistic cluster solution from a data representation known as a fairlet decomposition. Finally, we demonstrate our proposed fairness metrics and algorithm by constructing a fair Gaussian mixture model on three real-world datasets. We achieve this by identifying balanced micro-clusters which minimize the distances induced by the model, and on which traditional clustering can be performed while ensuring the fairness of the solution.publishedVersio

Holocene sea level fluctuations and coastal evolution in the central Algarve (southern Portugal)

In Armação de Pêra Bay, southern Portugal, environmental changes during the Holocene can be interpreted based on the morphological and sedimentological similarities between older geomorphic features (cemented beach and dune rocks) and present coastal features. Using knowledge of the present beach and dune processes, we propose a two-step model for the evolution of Armação de Pêra Bay. First, during the rapid sea level rise between about 8800 and 6600 yr cal BP, the bay changed from a positive to a negative budget littoral cell and transgressive dunes formed, favoured by drought conditions. At about 5000 yr cal BP, during a sea level maximum, beach width was less than the critical fetch and dunes stabilized and underwent cementation during the wetter Atlantic climatic event. The second phase of dune accumulation started at about 3200 yr cal BP, due to a regression of sea level during which the bay changed back to a positive budget littoral cell in which beach width was greater than the critical fetch. Currently, the beach width is less than the critical fetch, dunes are inactive, and the sedimentary budget is negative due to sediment storage in local river systems.Fundação para a Ciência e a Tecnologia. FEDER, and OE (Project POCTI/CTA/34162/2000

Dissimilar responses of fungal and bacterial communities to soil transplantation simulating abrupt climate changes.

Both fungi and bacteria play essential roles in regulating soil carbon cycling. To predict future carbon stability, it is imperative to understand their responses to environmental changes, which is subject to large uncertainty. As current global warming is causing range shifts toward higher latitudes, we conducted three reciprocal soil transplantation experiments over large transects in 2005 to simulate abrupt climate changes. Six years after soil transplantation, fungal biomass of transplanted soils showed a general pattern of changes from donor sites to destination, which were more obvious in bare fallow soils than in maize cropped soils. Strikingly, fungal community compositions were clustered by sites, demonstrating that fungi of transplanted soils acclimatized to the destination environment. Several fungal taxa displayed sharp changes in relative abundance, including Podospora, Chaetomium, Mortierella and Phialemonium. In contrast, bacterial communities remained largely unchanged. Consistent with the important role of fungi in affecting soil carbon cycling, 8.1%-10.0% of fungal genes encoding carbon-decomposing enzymes were significantly (p &lt; 0.01) increased as compared with those from bacteria (5.7%-8.4%). To explain these observations, we found that fungal occupancy across samples was mainly determined by annual average air temperature and rainfall, whereas bacterial occupancy was more closely related to soil conditions, which remained stable 6 years after soil transplantation. Together, these results demonstrate dissimilar response patterns and resource partitioning between fungi and bacteria, which may have considerable consequences for ecosystem-scale carbon cycling

Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmö, Sweden on 23–24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and quality of life for the HOME core outcome set for atopic eczema (AE). Following presentations, which included data from systematic reviews, consensus discussions were held in a mixture of whole group and small group discussions. Small groups were allocated a priori to ensure representation of different stakeholders and countries. Decisions were voted on using electronic keypads. For the patient-reported symptoms, the group agreed by vote that itch, sleep loss, dryness, redness/inflamed skin and irritated skin were all considered essential aspects of AE symptoms. Many instruments for capturing patient-reported symptoms were discussed [including the Patient-Oriented SCOring Atopic Dermatitis index, Patient-Oriented Eczema Measure (POEM), Self-Administered Eczema Area and Severity Index, Itch Severity Scale, Atopic Dermatitis Quickscore and the Nottingham Eczema Severity Score] and, by consensus, POEM was selected as the preferred instrument to measure patient-reported symptoms. Further work is needed to determine the reliability and measurement error of POEM. Further work is also required to establish the importance of pain/soreness and the importance of collecting information regarding the intensity of symptoms in addition to their frequency. Much of the discussion on quality of life concerned the Dermatology Life Quality Index and Quality of Life Index for Atopic Dermatitis; however, consensus on a preferred instrument for measuring this domain could not be reached. In summary, POEM is recommended as the HOME core outcome instrument for measuring AE symptoms