bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual Response Properties of V1 Neurons Projecting to V2 in Macaque
Authors: El-Shamayleh Yasmine , Kumbhani Romesh D. , Dhruv Neel T. , Movshon J. Anthony
Published: October 2013

Visual area V2 of the primate cortex receives the largest projection from area V1. V2 is thought to use its striate inputs as the basis for computations that are important for visual form processing, such as signaling angles, object borders, illusory contours, and relative binocular disparity. However, it remains unclear how selectivity for these stimulus properties emerges in V2, in part because the functional properties of the inputs are unknown. We used antidromic electrical stimulation to identify V1 neurons that project directly to V2 (10% of all V1 neurons recorded) and characterized their electrical and visual responses. V2-projecting neurons were concentrated in the superficial and middle layers of striate cortex, consistent with the known anatomy of this cortico-cortical circuit. Most were fast conducting and temporally precise in their electrical responses, and had broad spike waveforms consistent with pyramidal regular-spiking excitatory neurons. Overall, projection neurons were functionally diverse. Most, however, were tuned for orientation and binocular disparity and were strongly suppressed by large stimuli. Projection neurons included those selective and invariant to spatial phase, with roughly equal proportions. Projection neurons found in superficial layers had longer conduction times, broader spike waveforms, and were more responsive to chromatic stimuli; those found in middle layers were more strongly selective for motion direction and binocular disparity. Collectively, these response properties may be well suited for generating complex feature selectivity in and beyond V2.
The Neuromuscular Transform of the Lobster Cardiac System Explains the Opposing Effects of a Neuromodulator on Muscle Output
Authors: Williams Alex H. , Calkins Andrew , O'Leary Timothy , Symonds Renee , Marder Eve , Dickinson Patsy S.
Published: October 2013

Motor neuron activity is transformed into muscle movement through a cascade of complex molecular and biomechanical events. This nonlinear mapping of neural inputs to motor behaviors is called the neuromuscular transform (NMT). We examined the NMT in the cardiac system of the lobsterHomarus americanusby stimulating a cardiac motor nerve with rhythmic bursts of action potentials and measuring muscle movements in response to different stimulation patterns. The NMT was similar across preparations, which suggested that it could be used to predict muscle movement from spontaneous neural activity in the intact heart. We assessed this possibility across semi-intact heart preparations in two separate analyses. First, we performed a linear regression analysis across 122 preparations in physiological saline to predict muscle movements from neural activity. Under these conditions, the NMT was predictive of contraction duty cycle but was unable to predict contraction amplitude, likely as a result of uncontrolled interanimal variability. Second, we assessed the ability of the NMT to predict changes in motor output induced by the neuropeptide C-type allatostatin. Wiwatpanit et al. (2012) showed that bath application of C-type allatostatin produced either increases or decreases in the amplitude of the lobster heart contractions. We show that an important component of these preparation-dependent effects can arise from quantifiable differences in the basal state of each preparation and the nonlinear form of the NMT. These results illustrate how properly characterizing the relationships between neural activity and measurable physiological outputs can provide insight into seemingly idiosyncratic effects of neuromodulators across individuals.
Synapsin Function in GABA-ergic Interneurons Is Required for Short-Term Olfactory Habituation
Authors: Sadanandappa Madhumala K. , Redondo Beatriz Blanco , Michels Birgit , Rodrigues Veronica , Gerber Bertram , VijayRaghavan K. , Buchner Erich , Ramaswami Mani
Published: October 2013

InDrosophila, short-term (STH) and long-term habituation (LTH) of olfactory avoidance behavior are believed to arise from the selective potentiation of GABAergic synapses between multiglomerular local circuit interneurons (LNs) and projection neurons in the antennal lobe. However, the underlying mechanisms remain poorly understood. Here, we show thatsynapsin(syn) function is necessary for STH and thatsyn97-null mutant defects in STH can be rescued bysyn+cDNA expression solely in the LN1 subset of GABAergic local interneurons. As synapsin is a synaptic vesicle-clustering phosphoprotein, these observations identify a presynaptic mechanism for STH as well as the inhibitory interneurons in which this mechanism is deployed. Serine residues 6 and/or 533, potential kinase target sites of synapsin, are necessary for synapsin function suggesting that synapsin phosphorylation is essential for STH. Consistently, biochemical analyses using a phospho-synapsin-specific antiserum show that synapsin is a target of Ca2+calmodulin-dependent kinase II (CaMKII) phosphorylationin vivo. Additional behavioral and genetic observations demonstrate that CaMKII function is necessary in LNs for STH. Together, these data support a model in which CaMKII-mediated synapsin phosphorylation in LNs induces synaptic vesicle mobilization and thereby presynaptic facilitation of GABA release that underlies olfactory STH. Finally, the striking observation that LTH occurs normally insyn97mutants indicates that signaling pathways for STH and LTH diverge upstream of synapsin function in GABAergic interneurons.
Erg Potassium Currents of Neonatal Mouse Purkinje Cells Exhibit Fast Gating Kinetics and Are Inhibited by mGluR1 Activation
Authors: Niculescu Dragos , Hirdes Wiebke , Hornig Sönke , Pongs Olaf , Schwarz Jürgen R.
Published: October 2013

We investigated the subthreshold properties of an erg (ether-à-go-go-related gene) K+current in Purkinje cells of neonatal mice. Action potentials recorded from Purkinje cells in cerebellar slices exhibited a decreased threshold potential and increased frequency of spontaneous and repetitive activity following application of the specific erg channel blocker E-4031. Accommodation was absent before and after drug application. The erg current of these Purkinje cells activated at membrane potentials near −60 mV and exhibited fast gating kinetics. The functional importance of fast gating subthreshold erg channels in Purkinje cells was corroborated by comparing the results of action potential clamp experiments with erg1a, erg1b, erg2, and erg3 currents heterologously expressed in HEK cells. Computer simulations based on a NEURON model of Purkinje cells only reproduced the effects of the native erg current when an erg channel conductance like that of erg3 was included. Experiments with subunit-sensitive toxins (BeKm-1, APETx1) indicated that erg channels in Purkinje cells are presumably mediated by heteromeric erg1/erg3 or modified erg1 channels. Following mGluR1 activation, the native erg current was reduced by ∼70%, brought about by reduction of the maximal erg current and a shift of the activation curve to more positive potentials. The Purkinje cell erg current contributed to the sustained current component of the biphasic mGluR1 response. Activation of mGluR1 by the agonist 3,4-dihydroxyphenylglycol increased Purkinje cell excitability, similar to that induced by E-4031. The results indicated that erg currents can be modulated and may contribute to the mGluR1-induced plasticity changes in Purkinje cells.
CONTROVERSIES IN ENDOCRINOLOGY: On the need for universal thyroid screening in pregnant women
Authors: Vila Lluís , Velasco Inés , González Stella , Morales Francisco , Sánchez Emilia , Torrejón Sara , Soldevila Berta , Stagnaro-Green Alex , Puig-Domingo Manuel
Published: October 2013

There is a well-known controversy among scientific societies regarding the recommendation to screen for thyroid dysfunction (TD) during pregnancy. Although several studies have shown an association between maternal subclinical hypothyroidism and/or hypothyroxinemia with obstetric problems and/or neurocognitive impairment in the offspring, there is only limited evidence on the possible positive effects of thyroxine (T4) treatment in such cases. Despite the scarcity of this evidence, there is a widespread agreement among clinicians on the need for treatment of clinical hypothyroidism during pregnancy and the risks that could arise due to therapeutic abstention. As maternal TD is a quite prevalent condition, easily diagnosed and for which an effective and safe treatment is available, some scientific societies have proposed to assess thyroid function during the first trimester of pregnancy and ideally before week 10 of gestational age. Given the physiologic changes of thyroid function during pregnancy, hormone assessment should be performed using trimester-specific reference values ideally based on locally generated data as geographic variations have been detected. Screening of TD should be based on an initial determination of TSH performed early during the first trimester and only if abnormal should it be followed by either a free or total T4measurement. Furthermore, adequate iodine supplementation during pregnancy is critical and if feasible it should be initiated before the woman attempts to conceive.
Towards an understanding of cell-specific functions of signal-dependent transcription factors
Authors: Zhang Dawn X , Glass Christopher K
Published: October 2013

The ability to regulate gene expression in a cell-specific manner is a feature of many broadly expressed signal-dependent transcription factors (SDTFs), including nuclear hormone receptors and transcription factors that are activated by cell surface receptors for extracellular signals. As the most plastic cells of the hematopoietic system, macrophages are responsive to a wide spectrum of regulatory molecules and provide a robust model system for investigation of the basis for cell-specific transcriptional responses at a genome-wide level. Here, focusing on recent studies in macrophages, we review the evidence suggesting a model in which cell-specific actions of SDTFs are the consequence of priming functions of lineage determining transcription factors. We also discuss recent findings relating lineage-determining and SDTF activity to alterations in the epigenetic landscape as well as the production and function of enhancer RNAs. These findings have implications for the understanding of how natural genetic variation impacts cell-specific programs of gene expression and suggest new approaches for altering gene expressionin vivo.
Prolactin actions
Authors: Horseman Nelson D , Gregerson Karen A
Published: October 2013

Molecular genetics and other contemporary approaches have contributed to a better understanding of prolactin (PRL) actions at the cellular and organismal levels. In this review, several advances in knowledge of PRL actions are highlighted. Special emphasis is paid to areas of progress with consequences for understanding of human PRL actions. The impacts of these advances on future research priorities are analyzed.
Generation of neural progenitors from induced Bama miniature pig pluripotent cells
Authors: Li Xue , Shan Zhi-Yan , Wu Yan-Shuang , Shen Xing-Hui , Liu Chun-Jia , Shen Jing-Ling , Liu Zhong-Hua , Lei Lei
Published: October 2013

Pig pluripotent cells may represent an advantageous experimental tool for developing therapeutic application in the human biomedical field. However, it has previously been proven to be difficult to establish from the early embryo and its pluripotency has not been distinctly documented. In recent years, induced pluripotent stem (iPS) cell technology provides a new method of reprogramming somatic cells to pluripotent state. The generation of iPS cells together with or without certain small molecules has become a routine technique. However, the generation of iPS cells from pig embryonic tissues using viral infections together with small molecules has not been reported. Here, we reported the generation of induced pig pluripotent cells (iPPCs) using the iPS technology in combination with valproic acid (VPA). VPA treatment significantly increased the expression of pluripotent genes and played an important role in early reprogramming. We showed that iPPCs resembled pig epiblast cells in their morphology and pluripotent markers, such as OCT4, NANOG, and SSEA1. It had a normal karyotype and could form embryoid bodies, which express three germ layer markersin vitro. In addition, the iPPCs might directly differentiate into neural progenitors after being induced with the retinoic acid and extracellular matrix. Our study established a reasonable method to generate pig pluripotent cells, which might be a new donor cell source for human neural disease therapy.
Wt1 deficiency causes undifferentiated spermatogonia accumulation and meiotic progression disruption in neonatal mice
Authors: Zheng Qiao-Song , Wang Xiao-Na , Wen Qing , Zhang Yan , Chen Su-Ren , Zhang Jun , Li Xi-Xia , Sha Ri-Na , Hu Zhao-Yuan , Gao Fei , Liu Yi-Xun
Published: October 2013

Spermatogenesis is a complex process involving the regulation of multiple cell types. As the only somatic cell type in the seminiferous tubules, Sertoli cells are essential for spermatogenesis throughout the spermatogenic cycle. The Wilms tumor gene,Wt1, is specifically expressed in the Sertoli cells of the mouse testes. In this study, we demonstrated thatWt1is required for germ cell differentiation in the developing mouse testes. At 10 dayspost partum,Wt1-deficient testes exhibited clear meiotic arrest and undifferentiated spermatogonia accumulation in the seminiferous tubules. In addition, the expression of claudin11, a marker and indispensable component of Sertoli cell integrity, was impaired inWt1−/flox;Cre-ERTMtestes. This observation was confirmed inin vitrotestis cultures. However, the basal membrane of the seminiferous tubules inWt1-deficient testes was not affected. Based on these findings, we propose that Sertoli cells' status is affected inWt1-deficient mice, resulting in spermatogenesis failure.
Mycobiota evolution during storage of paddy, brown and milled rice in different genotypes
Authors: Pinciroli María , Gribaldo Alejandra , Vidal Alfonso , Bezus Rodolfo , Sisterna Marina
Published: October 2013

The rice grain is frequently infected by a series of pathogens (fungi) during its storage, producing damages to the economy and health of humans. The aim of this study was to identify the fungal genera present in different rice genotypes and to quantify their variation during storage. Paddy, brown and milled rice fractions of Nutriar, (N) H329-5(H329) and Don Ignacio genotypes were analyzed at 4, 8 and 12 months of storage. Fungi were identified based on their micromorphological characteristics and colonies. The observed genera according to their frequency were: Alternaria, Nigrospora, Epicoccum, Bipolaris, Curvularia, Cladosporium and Fusarium (field fungi) and Penicillium and Aspergillus (storage fungi). The mycobiota composition was different depending on the grain fraction and the period of storage: field fungi were located in the hulls and bran layers, while storage fungi were mainly in the endosperm. The different genotypes showed different susceptibility to contamination.
Brasil: classes sociais, neodesenvolvimentismo e política externa nos governos Lula e Dilma
Authors: Boito Jr. Armando , Berringer Tatiana
Published: October 2013

O presente artigo trata da relação entre as classes sociais e a política econômica, a política social e a política externa nos governos Lula e Dilma. Durante esses governos houve uma mudança no interior do bloco no poder: a grande burguesia interna brasileira ascendeu politicamente e passou a apoiar-se em uma ampla frente política que abarca, inclusive, classes populares. Denominamos "neodesenvolvimentismo" o programa político dessa frente - a política de desenvolvimento possível nos marcos do capitalismo neoliberal. Os governos Lula e Dilma não romperam com esse modelo de capitalismo, mas introduziram, em decorrência das classes sociais que representam e nas quais se apoiam, mudanças importantes na economia, na política e na atuação internacional do Estado brasileiro.
Las organizaciones de los industriales argentinos en la "era del desarrollo" (1955-1976)
Authors: Jauregui Aníbal
Published: October 2013

El tema son las asociaciones de interés de los industriales argentinos en el período desarrrollista. Buscamos subrayar el envolvimiento de los industriales y sus organizaciones en los conflictos políticos y a su vez estudiar como estos conflictos impactaban internamente. La investigación fue realizada en base a las revistas y documentos de las asociaciones, a la que sumamos el rastreo en periódicos y publicaciones de interés general. Los datos allí obtenidos fueron testeados mediante el método de análisis cualitativo. Se muestra que existe uma estrecha dependencia de las organizaciones en relación al sistema político y en relación a la crisis política que atraviesa a aquellos años. También hemos visto que a pesar de las diferencias políticas y organizacionales existentes entre ellas no encontramos un sector empresario favorable al desarrollo industrial y otro contrario al mismo. Nuestra idea era por tanto mostrar que no había una contraposición radical entre una UIA anti-industria vs. una CGE pro-industria, contraposición que se acepta generalmente en diversos trabajos ligados al tema. Finalmente se busca superar la tendencia a pensar en términos de contradicción absoluta de actores dentro de la historiografía política y social argentina.
Avaliação da aderência ao programa de reabilitação cardíaca em um hospital particular geral
Authors: Mair Vanessa , Breda Ana Paula , Nunes Marcos Eduardo Boquembuzo , Matos Luciana Diniz Nagem Janot de
Published: October 2013

OBJETIVO: Identificar os principais fatores que influenciaram o participante do nosso programa de reabilitação cardiovascular a faltar em suas terapias e correlacioná-los a idade, risco cardiovascular e motivação de nossa população. MÉTODOS: Realizou-se um estudo retrospectivo transversal com 42 pacientes (69,15±13,93 anos) participantes do programa de reabilitação cardíaca de um hospital geral particular de São Paulo, por meio da análise de duas escalas: a Escala de Barreiras para Reabilitação Cardíaca e a Escala de Disposição. Utilizou-se a correlação de Spearman para relacioná-las com absenteísmo, risco cardiovascular, idade e tempo de reabilitação cardíaca. RESULTADOS: A pontuação total da escala de barreiras foi 31±6 e o escore médio foi de 1,47±0,31. As principais barreiras foram relacionadas às subescalas "viagem/conflito de trabalho" e "problemas pessoais/familiares". A porcentagem de absenteísmo foi 8,4% do número de sessões possíveis de serem realizadas no mês. As faltas e os cancelamentos apresentaram correlação positiva com o risco cardiovascular (p=0,01; r=0,4) e correlações negativas com Escala de Disposição inicial (p=0,03; r=-0,35) e idade (p=0,02; r=-0,35). CONCLUSÃO: "Viagem/conflito de trabalho", "problemas pessoais/familiares" e baixa disposição inicial foram os principais fatores de absenteísmo em um programa de reabilitação cardíaca de um hospital geral particular de São Paulo.
Cirurgia robótica em Cardiologia: um procedimento seguro e efetivo
Authors: Poffo Robinson , Toschi Alisson Parrilha , Pope Renato Bastos , Celullare Alex Luiz , Benício Anderson , Fischer Claudio Henrique , Vieira Marcelo Luiz Campos , Teruya Alexandre , Hatanaka Dina Mie , Rusca Gabriel Franzin , Makdisse Marcia
Published: October 2013

OBJETIVO: Avaliar os resultados em curto e médio prazo dos pacientes submetidos à cirurgia cardíaca minimamente invasiva robô-assistida. MÉTODOS: De março de 2010 a março de 2013, 21 pacientes foram submetidos à cirurgia cardíaca robô-assistida. Os procedimentos realizados foram: plastia valvar mitral, troca valvar mitral, cirurgia de correção da fibrilação atrial, correção cirúrgica da comunicação interatrial, ressecção de tumor intracardíaco, revascularização do miocárdio totalmente endoscópica e pericardiectomia. RESULTADOS: A idade média foi de 48,39±18,05 anos. O tempo médio de circulação extracorpórea foi de 151,7±99,97 minutos, e o tempo médio de pinçamento aórtico foi de 109,94±81,34 minutos. O tempo médio de intubação orotraqueal foi de 7,52±15,2 horas, sendo que 16 (76,2%) pacientes foram extubados ainda em sala operatória, imediatamente após o procedimento. O tempo médio de permanência em unidade de terapia intensiva foi de 1,67±1,46 dias. Não houve conversões para esternotomia. Não houve óbito intra-hospitalar ou mesmo durante o seguimento em médio prazo dos pacientes. A média do tempo de acompanhamento dos pacientes foi de 684±346 dias, variando de 28 dias a 1096 dias. CONCLUSÃO: A cirurgia cardíaca robô-assistida mostrou-se exequível, segura e efetiva, podendo ser aplicada na correção de diversas patologias intra e extracardíacas.
Implantação de protocolo institucional para o uso racional de hemoderivados e seu impacto no pós-operatório de cirurgias de revascularização miocárdica
Authors: Silva Pedro Gabriel Melo de Barros e , Ikeoka Dimas Tadahiro , Fernandes Viviane Aparecida , Lasta Nilza Sandra , Silva Debora Prudencio e , Okada Mariana Yumi , Izidoro Beatriz Akinaga , Garcia José Carlos Teixeira , Baruzzi Antonio Claudio do Amaral , Furlan Valter
Published: October 2013

OBJETIVO: Cirurgias cardíacas são, por vezes, acompanhadas de perdas sanguíneas significativas, e transfusões de sangue podem ser necessárias. No entanto, o uso indiscriminado de hemoderivados pode resultar em efeitos danosos para o paciente. Neste estudo, avaliamos os efeitos imediatos da implantação de um protocolo para o uso racional de hemoderivados no perioperatório de cirurgias de revascularização miocárdica. MÉTODOS: Entre os meses de abril e junho de 2011, foi implementado um protocolo institucional em um hospital privado especializado em cardiologia com a anuência e a colaboração de sete equipes de cirurgia cardíaca, visando ao uso racional de hemoderivados. Foram verificados dados clínicos e demográficos dos pacientes, e avaliados o uso de hemoderivados e os desfechos clínicos no período intra-hospitalar, antes e após a implantação do protocolo. O protocolo consistiu em uma campanha institucional junto às equipes cirúrgicas, de anestesiologia e intensivistas, para difundir a prática do uso de hemoderivados com base em critérios clínicos objetivos (anemia com repercussões hemodinâmicas e disfunção ventricular significativa), bem como tornar rotineira a prescrição de ácido epsilon-aminocaproico no intraoperatório, que é prática recomendada por diretrizes internacionais baseadas em evidência científica. RESULTADOS: Após os 3 meses de implantação do protocolo, houve aumento do uso de ácido epsilon-aminocaproico de 31% para 100%. Antes da implantação do protocolo, 67% das cirurgias utilizaram alguma transfusão sanguínea; após a implantação, 40% das cirurgias necessitaram de alguma transfusão sanguínea nos meses subsequentes do mesmo ano (p<0,001). Não houve diferença significativa nos desfechos clínicos avaliados antes e após implantação do protocolo. CONCLUSÃO: O uso racional de hemoderivados, associado à infusão do ácido epsilon-aminocaproico, tem o potencial de reduzir o número de hemotransfusões no perioperatório de cirurgias cardíacas, o que pode ter impacto no risco de complicações.
Fatores que interferem na adesão terapêutica medicamentosa em hipertensos
Authors: Daniel Ana Carolina Queiroz Godoy , Veiga Eugenia Velludo
Published: October 2013

OBJETIVO: Caracterizar os fatores que interferem na adesão terapêutica medicamentosa de portadores de hipertensão arterial. MÉTODOS: Estudo de caráter descritivo, de natureza não experimental, que analisou uma amostra de 80 pacientes com diagnóstico de hipertensão arterial submetidos a tratamento medicamentoso e internados em um hospital universitário, no período de março a maio de 2009. Para a obtenção dos dados, foi aplicado o Instrumento para Avaliar Atitudes Frente à Tomada dos Remédios. RESULTADOS: Dentre a população estudada, 45,1% apresentaram suficiente grau de adesão à terapêutica medicamentosa. Indivíduos com pressão arterial controlada, gênero feminino, brancos, solteiros, casados ou viúvos, aposentados, de faixa etária entre 40 e 59 anos e aqueles com idade igual ou superior a 80 anos foram os entrevistados que responderam de maneira positiva ao cumprimento e seguimento da terapêutica medicamentosa. CONCLUSÃO: Apesar do número de fatores facilitadores ao processo de adesão à terapêutica medicamentosa ser maior do que o número de fatores dificultadores, observou-se que mais da metade dos pacientes entrevistados apresentou insuficiente grau de adesão à tomada de medicamentos para a hipertensão arterial. Isso demonstra a necessidade de desenvolvimento de estudos voltados à identificação desses fatores, bem como sua contribuição para a promoção de autonomia, aceitação, conhecimento e adaptação do paciente em relação à sua própria doença.
Segurança e eficácia dos stents farmacológicos eluidores de biolimus com polímero biodegradável: análise do registro EINSTEIN (Evaluation of Next-generation drug-eluting STEnt IN patients with coronary artery disease)
Authors: Souza Cristiano Freitas de , El Mouallem Anwar Mohamed , Brito Júnior Fábio Sândoli de , Abizaid Alexandre Antônio Cunha , Almeida Breno Oliveira , Almeida Amanda Gonçalves , Nascimento Teresa Cristina Dias Cunha , Perin Marco Antonio , Caixeta Adriano
Published: October 2013

OBJETIVO: Avaliar a incidência de eventos adversos cardíacos maiores (morte cardíaca, infarto agudo do miocárdio ou necessidade de nova revascularização do vaso-alvo) em 1 ano em pacientes do "mundo real". MÉTODOS: O registro EINSTEIN é um estudo observacional prospectivo, unicêntrico, que incluiu consecutivamente 103 pacientes (152 lesões) tratados com o stent BiomatrixTM, eluidor de biolimus A9 e polímero biodegradável. RESULTADOS: A média das idades foi de 65,0±12,4 anos; o gênero masculino representou 83,5% dos pacientes; e 37,9% deles eram diabéticos. Em 1 ano, eventos adversos cardíacos maiores ocorreram em 11,7% dos pacientes, incluindo 2,9% de morte cardíaca, 4,9% de infarto agudo do miocárdio sem supradesnivelamento do segmento ST e 3,9% de revascularização do vaso-alvo. Trombose de stent esteve presente em apenas 1% (1 paciente) após o seguimento clínico de 1 ano. CONCLUSÃO: O presente registro sugere que os novos stents farmacológicos eluidores de biolimus A9 com polímero biodegradável são seguros e eficazes em pacientes da prática clínica diária, com baixas taxas de eventos adversos cardíacos maiores no longo prazo.
Efeito da implementação de um protocolo assistencial de infarto agudo do miocárdio sobre os indicadores de qualidade
Authors: Makdisse Marcia , Katz Marcelo , Corrêa Alessandra da Graça , Forlenza Luciano Monte Alegre , Perin Marco Antonio , Brito Júnior Fábio Sândoli de , Nascimento Teresa Cristina Dias Cunha , Gomes Ivanise Maria , Franken Marcelo , Knobel Marcos , Pesaro Antonio Eduardo Pereira , Santos Oscar Fernando Pavão dos , Cendoroglo Neto Miguel , Lottenberg Claudio Luiz
Published: October 2013

OBJETIVO: Avaliar a adesão aos indicadores de qualidade assistencial ao longo da implementação de um protocolo assistencial de infarto agudo do miocárdio. MÉTODOS: Em 1º de março de 2005 foi implementado o protocolo assistencial de infarto agudo do miocárdio. Foram selecionados pacientes admitidos de 1ºde março de 2005 a 31 de dezembro de 2012 (n=1.431). Para comparação, utilizamos os dados de pacientes admitidos por infarto na fase pré-protocolo (n=306). Comparamos a taxa de adesão aos indicadores (taxa de prescrição de AAS na admissão hospitalar e na alta hospitalar, betabloqueador na alta e tempo porta-balão) entre as fases pré e pós-implementação do protocolo, além de tempo de permanência hospitalar e mortalidade intra-hospitalar nas diferentes fases. RESULTADOS: As taxas de prescrição de AAS na admissão e na alta hospitalar, e de betabloqueador foram maiores na fase pós versus a pré-implementação do protocolo: 99,6% versus 95,8% (p<0,001); 99,1% versus 95,8% (p<0,001) e 95,9% versus 81,7% (p<0,001), respectivamente. A taxa de prescrição de AAS aumentou ao longo da implementação do protocolo, atingindo 100% de 2009 a 2012. O tempo porta-balão pós versus pré foi de 86(32) minutos versus 93(51), respectivamente (p=0,20). O tempo de permanência hospitalar foi semelhante na fase pré versus pós-protocolo: 6(6) dias versus 6(4) dias (p=0,34). A mortalidade intra-hospitalar foi de 7,6% no pré-protocolo, 8,7% entre 2005 e 2008 e 5,3% entre 2009 e 2012 (p=0,04). CONCLUSÃO: A implementação do protocolo assistencial refletiu-se na maior adesão aos indicadores de qualidade.
Trombose muito tardia de stent coronário não farmacológico: identificando má aposição e expansão por ultrassonografia intravascular
Authors: Caixeta Adriano , Braga Vanessa Cristina Salomon Palma , Mintz Gary S
Published: October 2013

Paciente de 60 anos de idade, com histórico de implante de dois stents coronários não farmacológicos durante quadro de infarto do miocárdio com supra do segmento-ST. Dois anos após, foi admitido no pronto-socorro com quadro clínico de angina instável de início recente. O paciente fazia uso regular de inibidor da enzima de conversão da angiotensina, betabloqueador e aspirina. A aspirina foi suspensa por 10 dias antes da atual hospitalização para a retirada de um tumor de rim. O paciente foi submetido a angiografia coronária, que revelou artéria coronária direita com defeito de enchimento intraluminal sugestivo de trombo intra-stent. A ultrassonografia intravascular demonstrou má aposição e expansão dos stents, além da presença de trombo. Neste caso, o mecanismo de trombose muito tardia de stent coronário não farmacológico deveu-se possivelmente a uma combinação de fatores mecânicos (implante de stents subdimensionados durante o procedimento índice) e farmacológico (descontinuação da aspirina).
Calcificação caseosa do anel mitral: relato de caso
Authors: França Lucas Arraes de , Rodrigues Ana Clara Tude , Vieira Marcelo Luiz Campos , Oliveira Wércules Antônio Alves de , Azevedo Rudyney Eduardo Uchôa de , Cordovil Adriana , Lira-Filho Edgar Bezerra de , Fischer Claudio Henrique , Morhy Samira Saady
Published: October 2013

Relatamos um caso raro de provável calcificação caseosa do anel mitral. Essa patologia é mais frequentemente encontrada em mulheres assintomáticas e com idade acima de 70 anos. O reconhecimento dessa imagem é importante, primeiramente devido à ecocardiografia ser a forma mais fácil para elucidação diagnóstica e também por ela ser comumente confundida com outras massas, como tumores, trombos e vegetações, entidades mais comuns. Habitualmente, apresenta evolução benigna e seu correto diagnóstico é fundamental para evitar intervenções cirúrgicas desnecessárias.
Ecocardiografia com contraste no infarto do miocárdio
Authors: Trindade Maria Luciana Zacarias Hannouche da , Vieira Marcelo Luiz Campos , Rodrigues Ana Clara Tude , Francisco Neto Miguel José , Fischer Claudio Henrique , Morhy Samira Saady
Published: October 2013

Os contrastes ecocardiográficos à base de microbolhas estão aprovados para várias situações da prática clínica. Novos softwares, como a imagem em segunda harmônica e o power pulse inversion, podem melhorar a visualização do contraste no exame ecocardiográfico. Neste artigo, discutem-se o início da prática da ecocardiografia com contraste, as novas tecnologias que ajudam na aquisição e melhora da imagem, e seu uso no infarto do miocárdio.
Sinking failure of scour protection at wind turbine foundation
Authors: Sumer B. Mutlu , Nielsen Anders W.
Published: October 2013

This paper summarises the results of an experimental study on scour protection around offshore wind turbine foundations, with special emphasis on the sinking failure of the scour protection work in Horns Rev 1 offshore wind farm (Denmark). The paper reviews previous results obtained by the author (AN), and is organised as follows. Section 2 addresses flow around a pile with a scour protection. Section 3 looks at the initiation of sand motion beneath scour protection. Section 4 discusses sediment motion beneath scour protection and resulting sinking. Section 5 investigates the Horns Rev 1 case. A brief account is also given of filter criteria and their application to the Horns Rev 1 case, whereby the present results and the filter criteria results are linked.
Capacitive sensors for offshore scour monitoring
Authors: Michalis Panagiotis , Saafi Mohamed , Judd Martin
Published: October 2013

One of the main challenges in the design and operation of offshore wind turbines arises from the uncertainty about maximum scour depth around their foundations. Scour action can lead to excessive excavation of the surrounding seabed and is being considered as a major risk for offshore wind farm developments. An ability to gather information concerning the evolution of scouring will enable the validation of models derived from laboratory-based studies, the assessment of different engineering designs and the development of improved scour countermeasure techniques. However, real-time scour data are not being collected due to a lack of available instrumentation techniques. This paper proposes a new scour monitoring technology for offshore wind turbine installations. The monitoring system consists of arrays of small capacitive scour probes installed around the foundation structure and linked to a wireless network to enable remote data acquisition. Based on this research, it is concluded that the sensor is capable of exhibiting high sensitivity to scour and sediment deposition processes for common sea floor mediums under different temperature conditions in saline water. The proposed monitoring system has considerable potential for field applications that will contribute to improving the resilience and sustainability of offshore structures.
Offshore wind-turbine structures: a review
Authors: Arshad Muhammad , O’Kelly Brendan C.
Published: October 2013

This paper reviews various issues related to wind-power generation, one of the more popular forms of renewable energy, including attractions and challenges of electric power generation through onshore and offshore resources. Significant increases in wind-turbine dimensions, rated power-generation capacity and size of wind farm developments over the past two decades are projected to continue. Offshore wind-power generation presents many engineering challenges including: limited guidelines available for analysis and design of foundation/support structures; inadequate logistics for construction/fabrication; and comparatively expensive operation and maintenance costs, which combined result in current levelised cost of energy approximately double that for onshore wind-power generation. Different offshore foundation options are discussed in terms of general layout, loading characteristics and related fundamental natural frequency. Outlooks for some new approaches/developments and areas for further research are identified that may go towards reducing the levelised cost of energy for wind-power generation more in line with that from other energy resources, thereby enhancing the attractiveness of this industry for potential investors.
Railway bridge failure during flooding in the UK and Ireland
Authors: Benn Jeremy
Published: October 2013

A review of accident reports and other sources has shown there have been 15 fatalities, and perhaps 4–5 times that number of injuries, which can be attributed to structural failure during flooding on the railway system in Britain since the 1840s. The resulting present-day economic damage is estimated to be at least £300 million. Bridge failure due to flooding is most commonly associated with ‘extreme’ but not necessarily ‘very rare’ floods; the average event rarity associated with catastrophic failure is 1 in 160-year return period, but the range of 200–250 years includes most flood-related failures. Undermining of abutments and piers by scour is the most common form of failure of bridges. The remaining failures can be attributed to six other failure sequences which are currently not adequately addressed within the existing procedures. Of these six, debris collection resulting in enhanced local scour and the location of structures in rapidly responding catchments are considered the most significant. It is recommended that the design flood for scour assessment and protection design should be based on a 200-year return period flood event. A higher value (of 1000 years) may be appropriate for structures with a particularly high consequence of failure.
Innovations in vascular device surface engineering: a clinical review
Authors: Aggarwal Ankur , Jenkins Christina S. , Mangla Jimmi , Shanley Charles J. , Long Graham W.
Published: October 2013

Atherosclerosis and its consequential disease processes are major causes of morbidity, mortality and healthcare expenditures. New medical therapies have allowed us to better combat this disease. Surgical options for treating coronary and peripheral vessel disease include angioplasty, stenting and bypass grafting. Technological advances in stents and surgical conduits have revolutionized the approach to coronary artery disease and peripheral vascular disease. However, while these modalities do increase life expectancy, they are associated with their own complications. This article reviews and summarizes the literature regarding the history of the formulation of coronary stents and synthetic conduits, the current state of coronary and small-peripheral vessel stents and prosthetic bypass grafts, and ongoing research to modify and improve stents and prosthetic conduits for bypass grafts with the goal of improving long-term patency rates. An extensive literature review was performed through PubMed. Extensive research efforts are still ongoing in surface modifications to make new endovascular and open surgical devices more effective. The goal of this biomedical research is to develop novel scaffolds that will continue to improve long-term patency rates and provide surgeons with the ideal prosthetic conduit or stent.
Plastic response to a proxy cue of predation risk when direct cues are unreliable
Authors: Miehls Andrea L. J. , McAdam Andrew G. , Bourdeau Paul E. , Peacor Scott D.
Published: October 2013

Responses to proximate cues that directly affect fitness or cues directly released by selective agents are well‐documented forms of phenotypic plasticity. For example, to reduce predation risk, prey change phenotype in response to light level (e.g., moon phase) when light affects predation risk from visual predators, and to chemical cues (kairomones) released by predators. Less well understood is the potential for organisms to perceive predation risk through “proxy cues”: proximate cues that correlate with, but do not directly affect predation risk. Previous field studies indicate that body and spine length of an invasive cladoceran in Lake Michigan,Bythotrephes longimanus(the spiny water flea), increase during the growing season, coincident with a decrease in clutch size. Although the cause of seasonal trait changes is not known, changes are associated with warmer water temperature and increased predation risk from gape‐limited fish (i.e., fish whose ability to consumeBythotrephesis limited by mouth size). Using a laboratory experiment, we found no effect of fish (Perca flavescens) kairomones onBythotrephesmorphology or life history. In contrast, higher water temperature led to longer absolute spine and body length, increased investment in morphological defense of offspring (measured as the ratio of spine‐to‐body length), and decreased clutch size and age at reproduction. These plastic responses are unlikely to be adaptive to temperature per se, but rather our findings indicate that temperature serves as a proxy cue of fish predation risk. Temperature correlates with risk of gape‐limited fish predation due to growth of fish from larval stages incapable of consumingBythotrephesearly in the season, to larger sizes by midseason increasingly capable of consumingBythotrephes, but limited by gape size to consuming smaller individuals. We argue that forBythotrephes, temperature is a more reliable cue of predation risk than fish kairomones, because fish kairomones are present throughout the season due to continual presence of non‐gape‐limited adult fish, to which plastic response would have little effect. Organisms may, therefore, not only respond to changes in an environmental factor because the factor directly affects risk, but also when the environmental factor serves as a proxy signaling change in predation risk.
Is there any empirical support for biodiversity offset policy?
Authors: Curran Michael , Hellweg Stefanie , Beck Jan
Published: October 2013

Biodiversity offsets are seen as a policy mechanism to balance development and conservation goals. Many offset schemes employ habitat restoration in one area to recreate biodiversity value that is destroyed elsewhere, assuming that recovery is timely and predictable. Recent research has challenged these assumptions on the grounds that restoration implies long time delays and a low certainty of success. To investigate these assertions, and to assess the strength of empirical support for offset policy, we used a meta‐analytic approach to analyze data from 108 comparative studies of secondary growth (SG) and old‐growth (OG) habitat (a total of 1228 SG sites and 716 OG reference sites). We extracted species checklists and calculated standardized response ratios for species richness, Fisher's alpha, Sorenson similarity, and Morisita‐Horn similarity. We modeled diversity change with habitat age using generalized linear models and multi‐model averaging, correcting for a number of potential explanatory variables. We tested whether (1) diversity of passively and actively restored habitat converges to OG values over time, (2) active restoration significantly accelerates this process, and (3) current offset policies are appropriate to the predicted uncertainties and time lags associated with restoration. The results indicate that in the best case, species richness converges to OG reference values within a century, species similarity (Sorenson) takes about twice as long, and assemblage composition (Morisita‐Horn) up to an order of magnitude longer (hundreds to thousands of years). Active restoration significantly accelerates the process for all indices, but the inherently large time lags, uncertainty, and risk of restoration failure require offset ratios that far exceed what is currently applied in practice. Restoration offset policy therefore leads to a net loss of biodiversity, and represents an inappropriate use of the otherwise valuable tool of ecosystem restoration.
Taking the Guesswork Out of Assessing Individual Contributions to Group Work Assignments
Authors: Lambert Susan C. , Carter Amanda J. , Lightbody Margaret
Published: October 2013

This paper demonstrates how a wiki can be used to deliver greater justice in the form of a fairer grade to students who report that not all members of their group made a reasonable contribution to an assignment. While group assessment has many pedagogical and professional benefits, it is fraught with potentially unjust outcomes in terms of the marks assigned to individual students. Free-riders can unjustly receive marks for work that they have not contributed to and they may even drag down the group marks due to their non-performance. We describe how a wiki was used in an auditing group assignment to provide evidence of individual student contributions following reports of unequal contributions by group members. It was found that the wiki provided a relatively more objective basis than traditional document-based assignments to inform the decision as to whether or not all students in the group would receive the same grade and if not, how the grades should be modified.
Insulin Regulates the Unfolded Protein Response in Human Adipose Tissue
Authors: Boden Guenther , Cheung Peter , Salehi Sajad , Homko Carol , Loveland-Jones Catherine , Jayarajan Senthil , Stein T. Peter , Williams Kevin Jon , Liu Ming-Lin , Barrero Carlos A. , Merali Salim
Published: October 2013

Endoplasmic reticulum (ER) stress is increased in obesity and is postulated to be a major contributor to many obesity-related pathologies. Little is known about what causes ER stress in obese people. Here, we show that insulin upregulated the unfolded protein response (UPR), an adaptive reaction to ER stress, in vitro in 3T3-L1 adipocytes and in vivo, in subcutaneous (sc) adipose tissue of nondiabetic subjects, where it increased the UPR dose dependently over the entire physiologic insulin range (from ∼35 to ∼1,450 pmol/L). The insulin-induced UPR was not due to increased glucose uptake/metabolism and oxidative stress. It was associated, however, with increased protein synthesis, with accumulation of ubiquitination associated proteins, and with multiple posttranslational protein modifications (acetylations, methylations, nitrosylations, succinylation, and ubiquitinations), some of which are potential causes for ER stress. These results reveal a new physiologic role of insulin and provide a putative mechanism for the development of ER stress in obesity. They may also have clinical and therapeutic implications, e.g., in diabetic patients treated with high doses of insulin.
FTOGenotype, Vitamin D Status, and Weight Gain During Childhood
Authors: Lourenço Barbara H. , Qi Lu , Willett Walter C. , Cardoso Marly A. ,   for the ACTION Study Team
Published: October 2013

Previous evidence suggests that variants in the fat mass and obesity-associated gene (FTO) affect adiposity in an age-dependent fashion in children, and nutritional factors may modify genotype effects. We assessed the effect of FTO rs9939609 on BMI and BMI-for-age Z score changes during childhood in a population-based longitudinal study in the Brazilian Amazon and investigated whether these effects were modified by vitamin D status, an important nutritional factor related to adiposity. At baseline, 1,088 children aged <10 years had complete genotypic and anthropometric data; 796 were followed up over a median 4.6 years. Baseline vitamin D insufficiency was defined as <75 nmol/L. We observed a 0.07 kg/m2/year increase in BMI and a 0.03 Z/year increase in BMI-for-age Z score per rs9939609 risk allele over follow-up (P = 0.01). Vitamin D status significantly modified FTO effects (P for interaction = 0.02). The rs9939609 risk allele was associated with a 0.05 Z/year increase in BMI-for-age Z score among vitamin D–insufficient children (P = 0.003), while no significant genetic effects were observed among vitamin D–sufficient children. Our data suggest that FTO rs9939609 affects child weight gain, and genotype effects are more pronounced among children with insufficient vitamin D levels.
A 10-s Sprint Performed After Moderate-Intensity Exercise Neither Increases nor Decreases the Glucose Requirement to Prevent Late-Onset Hypoglycemia in Individuals With Type 1 Diabetes
Authors: Davey Raymond J. , Bussau Vanessa A. , Paramalingam Nirubasini , Ferreira Luis D. , Lim Ee Mun , Davis Elizabeth A. , Jones Timothy W. , Fournier Paul A.
Published: October 2013

OBJECTIVE

To determine whether performing a 10-s sprint after moderate-intensity exercise increases the amount of carbohydrate required to maintain euglycemia and prevent late-onset postexercise hypoglycemia relative to moderate-intensity exercise alone.

RESEARCH DESIGN AND METHODS

Seven individuals with type 1 diabetes underwent a hyperinsulinemic-euglycemic clamp and performed 30 min of moderate-intensity exercise on two separate occasions followed by either a 10-s maximal sprint effort or no sprint. During the following 8 h, glucose infusion rate to maintain euglycemia and rates of glucose appearance and disappearance were measured continuously.

RESULTS

In response to exercise and throughout the 8-h recovery period, there were no differences in glucose infusion rate, blood glucose levels, plasma insulin concentrations, and rates of glucose appearance and disappearance between the two experimental conditions (P > 0.05).

CONCLUSIONS

A 10-s sprint performed after 30 min of moderate-intensity exercise does not affect the amount of carbohydrate required to maintain euglycemia postexercise in individuals with type 1 diabetes.