Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Shamanistic Shakespeare: Korea's Colonization of Hamlet

"Shamanistic Shakespeare: Korea's Colonization of Hamlet" offers a timely reminder about the dangers of imposing a reformulated national myth on international Shakespeare productions. Focusing on a London performance of Korea’s Yohangza Theatre Company’s shamanized Hamlet, this case study invites far broader consideration of the readability of global Shakespeares, and the cultural competence required by Western audiences to appreciate their political, historical, and local complexity. The Korean theatre industry’s colonizing of Hamlet is traced to a Seoul-based nationalist intellectual agenda to reinvent Korea’s mythic identity after a century of cultural oppression. The chapter demonstrates how this concretizing of shamanic symbolism, packaged for Westernized theatregoing consumption, has created a supposedly authentic Koreanized Shakespeare genre that is confusing to local and global audiences alike

¿Ángeles en la batalla?: Representaciones de la enfermera en Champourcin y Urraca Pastor durante la guerra civil española

Durante la Guerra Civil Espanola (1936-39), tanto en el bando republicano como en el sublevado numerosas mujeres se ofrecieron como voluntarias para cuidar a los heridos, incluso careciendo de experiencia previa en cuestiones sanitarias. En palabras de Mary Nash, en la retaguardia y en las trincheras la enfermería era uno de los ámbitos más importantes de la movilización femenina (Rojas 215). Esto explica que desde el inicio del conflicto bélico la figura de la enfermera se mitificara, creándose romances y carteles en torno a ella (Greene 128). En opinión de Miriam Basilio, la imagen de la enfermera en h España republicana, junto con otras figuras femeninas tradicionales como las madres o las costureras, sirvió para contrarrestar las ansiedades masculinas producidas por la presencia de mujeres en el frente o en las fábricas (34)

B Physics at the Tevatron: Run II and Beyond

This report provides a comprehensive overview of the prospects for B physics at the Tevatron. The work was carried out during a series of workshops starting in September 1999. There were four working groups: 1) CP Violation, 2) Rare and Semileptonic Decays, 3) Mixing and Lifetimes, 4) Production, Fragmentation and Spectroscopy. The report also includes introductory chapters on theoretical and experimental tools emphasizing aspects of B physics specific to hadron colliders, as well as overviews of the CDF, D0, and BTeV detectors, and a Summary