bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptome analysis of leaf and root of rice seedling to acute dehydration
Authors: Minh-Thu Pham-Thi , Hwang Duk-Ju , Jeon Jong-Seong , Nahm Baek Hie , Kim Yeon-Ki
Published: December 2013

Background

Water deficiency is one of the most serious worldwide problems for agriculture. Recently, it has become more serious and outspread, which urgently requires the production of drought-tolerant plants. Microarray experiments using mRNA from air-dried leaves and roots of rice were performed in an attempt to study genes involved in acute dehydration response.

Results

Set of 10,537 rice genes was significantly up- or down-regulated in leaves or roots under the treatment. Gene Ontology analysis highlighted gene expression during acute dehydration response depending on organ types and the duration of stress. Rice responded by down-regulating many processes which are mainly involved in inhibiting growth and development. On the other hand, phytohormones (ABA, cytokinin, brassinosteroid) and protective molecules were induced to answer to multiple stresses. Leaves induced more genes than roots but those genes were scattered in various processes, most significantly were productions of osmoprotectants and precursors for important pathways in roots. Roots up-regulated fewer genes and focused on inducing antioxidants and enhancing photosynthesis. Myb, zf-C3HC4, and NAM were most strongly affected transcription factors with the dominance of leaf over root.

Conclusions

Leaf and root tissues shared some common gene expression during stress, with the purpose of enhancing protective systems. However, these two tissues appeared to act differently in response to the different level of dehydration they experience. Besides, they can affect each other via the signaling and transportation system.
HTZ-1/H2A.z and MYS-1/MYST HAT act redundantly to maintain cell fates in somatic gonadal cells through repression of ceh-22 in C. elegans
Authors: Shibata Yukimasa , Sawa Hitoshi , Nishiwaki Kiyoji
Published: December 2013

The stable maintenance of acquired cell fates is important during development and for maintaining tissue homeostasis. Although histone modification is one of the major strategies used by cells to maintain their fates, the mechanisms by which histone variants maintain cell fates are not well understood. In C. elegans, the acetylated-histone-H4 (AcH4)-binding protein BET-1 acts downstream of the MYST family histone acetyltransferases MYS-1 and MYS-2 to establish and maintain cell fates in multiple cell lineages. Here we show that, in the bet-1 pathway, the histone H2A variant HTZ-1/H2A.z and MYS-1 are required for the maintenance of cell fates in a redundant manner. BET-1 controlled the subnuclear localization of HTZ-1. HTZ-1 and MYS-1 maintained the fates of the somatic gonadal cells (SGCs) through the repression of a target, ceh-22/Nkx2.5, which induced the formation of the leader cells of the gonad. H3K27 demethylase, UTX-1, had an antagonistic effect relative to HTZ-1 in the regulation of ceh-22. Nuclear spot assay revealed that HTZ-1 localized to the ceh-22 locus in SGCs in an utx-1-dependent manner. We propose that HTZ-1 and MYS-1 repress ceh-22 when UTX-1 removes its silencing mark, H3K27 methylation on the ceh-22 locus, thereby maintaining the fates of SGCs.
Sphingosine 1-phosphate signalling
Authors: Mendelson Karen , Evans Todd , Hla Timothy
Published: December 2013

Sphingosine 1-phosphate (S1P) is a lipid mediator formed by the metabolism of sphingomyelin. In vertebrates, S1P is secreted into the extracellular environment and signals via G protein-coupled S1P receptors to regulate cell-cell and cell-matrix adhesion, and thereby influence cell migration, differentiation and survival. The expression and localization of S1P receptors is dynamically regulated and controls vascular development, vessel stability and immune cell trafficking. In addition, crucial events during embryogenesis, such as angiogenesis, cardiogenesis, limb development and neurogenesis, are regulated by S1P signalling. Here, and in the accompanying poster, we provide an overview of S1P signalling in development and in disease.
How unique is the human neocortex?
Authors: Molnár Zoltán , Pollen Alex
Published: December 2013

The human cerebral cortex is generally considered the most complex organ, and is the structure that we hold responsible for the repertoire of behavior that distinguishes us from our closest living and extinct relatives. At a recent Company of Biologists Workshop, ‘Evolution of the Human Neocortex: How Unique Are We?’ held in September 2013, researchers considered new information from the fields of developmental biology, genetics, genomics, molecular biology and ethology to understand unique features of the human cerebral cortex and their developmental and evolutionary origin.
Identical twins and Bayes' theorem in the 21st century
Authors: Amrhein Valentin , Roth Tobias , Korner-Nievergelt Fränzi
Published: December 2013

In a recent article in Science on "Bayes' Theorem in the 21st Century", Bradley Efron uses Bayes' theorem to calculate the probability that twins are identical given that the sonogram shows twin boys. He concludes that Bayesian calculations cannot be uncritically accepted when using uninformative priors. We argue that this conclusion is problematic because Efron's example on identical twins does not use data, hence it is not Bayesian statistics; his priors are not appropriate and are not uninformative; and using the available data point and an uninformative prior actually leads to a reasonable posterior distribution.
Organization of parallel multi-agent product design of case furniture in the environment VFDO
Authors: Мешков  , Meshkov Dmitriy , Стариков  , Starikov Aleksandr
Published: December 2013

Feasibility of establishing a virtual furniture design offices (VFDO) is analyzed, whose task is to develop within the prescribed period of complex design solutions, fully describing the process of manufacturing and production technology of furniture products for client enterprises. We consider the logical structure of VFDO presented in the form of a multi-agent network model (MANM), and the mechanisms of formation and functioning of the unified of controlled work environment of design.

A number of advantages is marked over other types of MANM models of the design process of furniture.
Dynamics of forest cover and forest fund structure of the Voronezh Region
Authors: Мусиевский  , Musievskiy Aleksandr
Published: December 2013

According to the records the total forest area of the Voronezh region in 2008 was 501,689 hectares, including forest of forest fund – 463209 hectares. All the forests for their intended purpose are protective and their development can only take place in order to preserve and maintain performed ecological functions. However, the data on the dynamics of the forest cover of the Voronezh region in the period from 1585 to 2011 evidence of its regular, starting since 1993 decline, which reached in 2011, the lowest in the last 50 years value of 8.0 %.
Multi-criteria optimization of skidding process on optional fellings
Authors: Филичкина  , FilichkinaM Maria , Абрамов  , Abramov Vitaliy
Published: December 2013

The paper proposes generalized criterion for evaluating the effectiveness of the primary timber transportation, featuring simultaneous consideration of direct production costs, labor costs, and the cost of laying skid trails and the loss on their removal from the process of forest growing, as well as damage to the felling of the tree stand. The technique of leading the criteria in unequal dimensions to the dimensionless quantity for their convolution using a series of weighting coefficients to optimize the logging is shown.
Justification operation modes of column rotation mechanism of forest manipulator with energy-saving hydraulic drive
Authors: Бухтояров  , Bukhtoyarov Leonid , Долженко  , Dolzhenko Sergey , Попиков  , Popikov Petr
Published: December 2013

The analysis of the study of the dynamics of hydraulic drive of forest manipulators shows that work processes of column rotation mechanisms are accompanied by large dyna-mic loads that cause sudden changes of fluid pressure in the start-up and braking modes. The most effective are energy efficient hydro-pneumatic actuators of manipulator column that can recover energy during transient conditions and return some of the energy back into the system. A mathematical model of the operating modes was designed.
Wearing ability of soils and its effect on the durability of the working bodies of tillage machines
Authors: Поздняков  , Pozdnyakov Evgeniy
Published: December 2013

Wearing the soil´s capacity is the main factor affecting the durability of parts and compo-nents of tillage machines and the life of the machinery and tools in general. The article shows the influence of the different soil types on the degree of wear of the working bodies and it was found that the wear rate depends on the texture, moisture content, density and uniformity of the soil, the speed and shape of working bodies, the properties of the materials of which they are made. An analysis of the nature of plowshares wear, ripping tines, disc of harrows, seeders openers and knives of cutters was done.
The influence of parameters of the controlled air suspension system on the stability of the vehicle
Authors: Любавский  , Lyubavskiy Dmitriy
Published: December 2013

Installation of controlled air suspension system on the vehicle is suggested, carrying low-density cargo, such as timber or pipe, which reduces risk of tipping of the vehicle when cornering at high speeds and small radii, and will increase the speed cornering, and therefore the performance of the vehicle. In the case of train we propose control device which at the beginning of the rotation of the steering wheel while entering the turn, reduces the stiffness of the suspension of tractor-trailer wheel on the internal side.
Innovative direction of improving postharvest grain handling
Authors: Тарасенко  , Tarasenko Aleksandr , Оробинский  , Orobinskiy Vladimir , Мерчалова  , Merchalova Marina
Published: December 2013

The results of the study of treatment quality of wheat grain heap in grain cleaning machines ОЗС–50, Petkus U–80–12G, Petkus 12, 3–3,5 and Cimbria Delta 146 in cleaning mode and ОЗФ–80 in fractionation mode are given. For fractionation of grain heap on the machine ОЗФ–80 grading sieve have been established with the holes of 2.6 mm width. In the traditional treatment of grain heap, content of biologically inferior grain decreased in 1.26, crushed grain in 2.3 and contaminants in 1.9 times.
Theoretical dependences of separation of crushed grain on perforated cone surface
Authors: Дружинин  , Druzhinin Roman , Андрианов  , Andrianov Evgeniy , Труфанов  , Trufanov Viktor , Солянников  , Solyannikov Mikhail
Published: December 2013

For efficient use of the product obtained in the preparation of quality mixtures we developed a design of separation device to crushed grains to fractions. An expression for the determination of the maximum speed of the particle passed through the hole of rotating conical surface is got. Analyzing this expression, it was found that the value of the marginal rate of passage of the particles is affected by the angle at the apex of the cone.
Innovations in forestry: features of creating and prospects
Authors: Корчагин  , Korchagin Oleg , Морковина  , Morkovina Svetlana , Иванова  , Ivanova Anna
Published: December 2013

The article deals with the general approach of the existing definitions of innovation and their classification. It describes the current state of research activities in the forestry sector and the prospects for its development in priority areas. The features of the stages of the innovation process of creating product innovations in the field of forest genetics and selection are examined. The characteristics of product innovation in the forestry building on the experience of the Research Institute of Forest Genetics and Selection are investigated.
Investment area as a tool to enhance the innovation activities of business structures
Authors: Яковлева  , Yakovleva Elena , Быстрянцев  , Bystryantsev Vyacheslav , Драпалюк  , Drapalyuk Mikhail
Published: December 2013

The article defines the problems in the functioning of the innovation system, both at the national and regional levels. The observed positive dynamics of innovation development of economy is largely related to the financial component of the promotion of innovation. However modern information tools increase of innovative activity of business structures require practical application.
Features of pathology of local and introduced hardwoods within the central area of the city of Voronezh
Authors: Царалунга  , Tsaralunga Vladimir , Разинкова  , Razinkova Aleksandra , Дарковская  , Darkovskaya Aleksandra
Published: December 2013

The article presents the results of forest pathology examination of 1123 trees on 7 streets and in 2 parks in the Central district of the city of Voronezh. A comparative analysis of the pathology of native and exotic species is given, which showed that native species survive longer in group plantings, and introduced plants – in linear. A number of features of the occurrence of abnormalities in trees in urban plantings is revealed. In particular, a massive chemical burn of the horse chestnut leaf is recorded 100 % loss with powdery mildew of English oak leaves, also 100 % loss of leaf-mining insects of linden macrophylla.
On the origin of oak forests in the central forest steppe
Authors: Харченко  , Kharchenko Nikolay , Харченко  , Kharchenko Nikolay
Published: December 2013

The article contains a critical review of publications on the origin of oak forests in

Central forest steppe.The article contains a critical review of publications on the origin of oak forests in Central forest steppe.

Our hypothesis can not be considered mutually exclusive. The primacy of the steppe towards the forest is well recognized, as well as the reality of the periodic changes of plant com-munities within the natural areas in different chronological intervals of the Holocene. Sequential change of steppe vegetation formations for oak forest ones occurred depending on the global climate change. Intra-ecosystem successional processes are based on the biological characteristics of interacting tree species.
‘Instruments for Everyone’: Empowering disabled creators with tools for musical expression
Authors: Rodrigues Paulo Maria , Gehlhaar Rolf , Girao Luis Miguel , Penha Rui
Published: December 2013

This article reports a project commissioned by the Education Service of Casa da Música (CdM) in which tools were developed to allow musical expression by physically and mentally challenged people. The first phase involved defining a group of clients, identifying their capabilities and motivations and designing customized solutions involving different combinations of software and hardware. The second phase consisted of a programme of regular activities using these resources in their institutions. The third phase involved the composition of a piece of music using those resources along with others and its performance by these people in the main concert hall of CdM in April 2010. ‘Viagem’, a piece written for, and performed by, a group of about 80 people with mixed abilities proved the concept, but it was, above all, a deep artistic experience.
Twisted Hilbert transforms vs Kakeya sets of directions
Authors: Parcet Javier , Rogers Keith M.
Published: December 2013

Given a discrete group

G

${\mathrm {G}}$

and an orthogonal action

γ
:
G
→
O
(
n
)

${\gamma : \mathrm {G}\rightarrow {\rm O}(n)}$

we study Lp
-convergence of Fourier integrals which are frequency supported on the semidirect product

ℝ
n

⋊
γ

G

${\mathbb {R}^n \rtimes _\gamma \mathrm {G}}$

. Given a unit

u
∈

ℝ
n

${u \in \mathbb {R}^n}$

and

1
<
p
≠
2
<
∞

${1 < p \ne 2 < \infty }$

, our main result shows that the twisted (directional) Hilbert transform

H
u

⋊
γ

id
G

${H_u \rtimes _\gamma {\rm id}_\mathrm {G}}$

is Lp
-bounded iff the orbit

𝒪
γ

(
u
)

${\mathcal {O}_\gamma (u)}$

is finite. This is in sharp contrast with twisted Riesz transforms

R
u

⋊
γ

id
G

${R_u \rtimes _\gamma {\rm id}_\mathrm {G}}$

, which are always bounded. Our result characterizes Fourier summability in Lp
for this class of groups. We also extend de Leeuw's compactification theorem to this setting and obtain stronger estimates for functions with “lacunary” frequency support.
On semi-continuity problems for minimal log discrepancies
Authors: Nakamura Yusuke
Published: December 2013

We show the semi-continuity property of minimal log discrepancies for
varieties which have a crepant resolution in the category of Deligne–Mumford stacks.
Using this property, we also prove the ideal-adic semi-continuity problem for
toric pairs.
How far out is ‘out’? On the grammatical functions of the Estonianvälja‘out’
Authors: Huumo Tuomas , Lehismets Kersten
Published: December 2013

Among the typologically agglutinative Finno-Ugric languages, Estonian is in many ways exceptional since it has developed a long way towards the analytic type. One indicator of this is the extensive use of particles and adverbs to indicate grammatical relations such as aspect. Our paper discusses, in a Cognitive Grammar framework, the grammatical functions of the adverbvälja‘out’, which is originally an illative (‘into’) case form of the lexical nounväli‘field’. Our study shows how the meanings evolve along a continuum from concrete senses to more abstract ones, and we set out to find motivations for the development. The formväljahas developed numerous usages as an adverb and a verb particle. Its concrete spatial meaning is that of indicating a relation where a mover exits a (typically three-dimensional) container and moves from its inside to its outside. The abstract functions of this multi-functional gram include the following ones: 1) a change in the cognitive state of an animate participant (e.g., as the result of acquiring information), 2) changes-of-state metaphorically represented as motion out of a container, 3) terminative direction or distance (‘all the way to X’) and 4) perfective aspect. We argue that a crucial factor in the development of these functions is the placement of the conceptualizer's viewpoint either inside or outside the container which the mover exits. A viewpoint outside the container means that in the initial configuration the mover is hidden from the conceptualizer's view, and when exiting the container it becomes accessible to the conceptualizer. This meaning motivates abstract functions whereväljaindicates incipient availability or accessibility of the mover. On the other hand, a viewpoint situated inside the container results in the meaning where the mover (that exits the container) escapes from the conceptualizer's view, or, in abstract expressions, its cognitive dominion. This motivates the use of the gram in many expressions of a change of state, and in particular builds a link to its aspectual functions where it indicates the spatiotemporal extent of an event or an entity by measuring the distance from the starting point of such (concrete or metaphorical) motion.
The role of working memory in the comprehension of unfamiliar and familiar metaphors
Authors: Mashal Nira
Published: December 2013

Comprehension of unfamiliar metaphors (mercy blanket) is an effortful cognitive process that requires the formation of a novel metaphoric mapping between two disparate domains during which irrelevant properties have to be suppressed. The present study aims to examine the relationship between the comprehension of both unfamiliar and familiar metaphors and working memory. Three experiments were conducted: a comprehension task (Experiment 1), a recognition task (Experiments 2a and 2b), and a free recall task (Experiment 3). In the first experiment comprehension of both unfamiliar and familiar metaphors correlated with digit span backward but not with digit span forward. Results of the second experiment revealed that unfamiliar metaphors induced a higher rate of semantic errors relative to phonological errors, whereas familiar metaphors induced the same number of phonological and semantic errors. The third experiment confirmed that unfamiliar metaphors were harder to recall than were familiar metaphors. These findings show that working memory capacity may be involved in the computation of unfamiliar metaphoric interpretations, and more specifically in the process of suppressing irrelevant information via the central executive. Familiar metaphor recognition may rely on either phonological codes that are maintained in the phonological loop or on semantic processing that involves long term storage.
Grading the neuroendocrine tumors of the lung: an evidence-based proposal
Authors: Rindi G , Klersy C , Inzani F , Fellegara G , Ampollini L , Ardizzoni A , Campanini N , Carbognani P , De Pas T M , Galetta D , Granone P L , Righi L , Rusca M , Spaggiari L , Tiseo M , Viale G , Volante M , Papotti M , Pelosi G
Published: December 2013

Lung neuroendocrine tumors are catalogued in four categories by the World Health Organization (WHO 2004) classification. Its reproducibility and prognostic efficacy was disputed. The WHO 2010 classification of digestive neuroendocrine neoplasms is based on Ki67 proliferation assessment and proved prognostically effective. This study aims at comparing these two classifications and at defining a prognostic grading system for lung neuroendocrine tumors. The study included 399 patients who underwent surgery and with at least 1 year follow-up between 1989 and 2011. Data on 21 variables were collected, and performance of grading systems and their components was compared by Cox regression and multivariable analyses. All statistical tests were two-sided. At Cox analysis, WHO 2004 stratified patients into three major groups with statistically significant survival difference (typical carcinoid vs atypical carcinoid (AC),P=0.021; AC vs large-cell/small-cell lung neuroendocrine carcinomas,P<0.001). Optimal discrimination in three groups was observed by Ki67% (Ki67% cutoffs: G1 <4, G2 4–<25, G3 ≥25; G1 vs G2,P=0.021; and G2 vs G3,P≤0.001), mitotic count (G1 ≤2, G2 >2–47, G3 >47; G1 vs G2,P≤0.001; and G2 vs G3,P≤0.001), and presence of necrosis (G1 absent, G2 <10% of sample, G3 >10% of sample; G1 vs G2,P≤0.001; and G2 vs G3,P≤0.001) at uni and multivariable analyses. The combination of these three variables resulted in a simple and effective grading system. A three-tiers grading system based on Ki67 index, mitotic count, and necrosis with cutoffs specifically generated for lung neuroendocrine tumors is prognostically effective and accurate.
Accuracy of Brief Screening Tools for Identifying Postpartum Depression Among Adolescent Mothers
Authors: Venkatesh Kartik K. , Zlotnick Caron , Triche Elizabeth W. , Ware Crystal , Phipps Maureen G.
Published: December 2013

OBJECTIVE:

To evaluate the accuracy of the Edinburgh Postnatal Depression Scale (EPDS) and 3 subscales for identifying postpartum depression among primiparous adolescent mothers.

METHODS:

Mothers enrolled in a randomized controlled trial to prevent postpartum depression completed a psychiatric diagnostic interview and the 10-item EPDS at 6 weeks, 3 months, and 6 months postpartum. Three subscales of the EPDS were assessed as brief screening tools: 3-item anxiety subscale (EPDS-3), 7-item depressive symptoms subscale (EPDS-7), and 2-item subscale (EPDS-2) that resemble the Patient Health Questionnaire-2. Receiver operating characteristic curves and the areas under the curves for each tool were compared to assess accuracy. The sensitivities and specificities of each screening tool were calculated in comparison with diagnostic criteria for a major depressive disorder. Repeated-measures longitudinal analytical techniques were used.

RESULTS:

A total of 106 women contributed 289 postpartum visits; 18% of the women met criteria for incident postpartum depression by psychiatric diagnostic interview. When used as continuous measures, the full EPDS, EPDS-7, and EPDS-2 performed equally well (area under the curve >0.9). Optimal cutoff scores for a positive depression screen for the EPDS and EPDS-7 were lower (≥9 and ≥7, respectively) than currently recommended cutoff scores (≥10). At optimal cutoff scores, the EPDS and EPDS-7 both had sensitivities of 90% and specificities of >85%.

CONCLUSIONS:

The EPDS, EPDS-7, and EPDS-2 are highly accurate at identifying postpartum depression among adolescent mothers. In primary care pediatric settings, the EPDS and its shorter subscales have potential for use as effective depression screening tools.
Effects of an outpatient education program in patients with uncontrolled asthma
Authors: Rodrigues Carmen Denise Borba , Pereira Rosemary Petrik , Dalcin Paulo de Tarso Roth
Published: December 2013

OBJECTIVE: To evaluate the effects of an outpatient education program in patients with uncontrolled asthma. METHODS: This was an uncontrolled study evaluating an educational intervention and involving patients with uncontrolled asthma ≥ 14 years of age. The participants completed a questionnaire designed to assess the level of asthma control, the inhalation technique, and quality of life. All of the patients underwent pulmonary function testing, after which they participated in an education program consisting of one 45-min face-to-face session, followed by phone interviews at two, four, and eight weeks. The participants were reevaluated after three months. RESULTS: Sixty-three patients completed the study. There was a significant improvement in the level of asthma control (p < 0.001). Of the 63 patients, 28 (44.4%) and 6 (9.5%) were classified as having partially controlled asthma and controlled asthma, respectively. The mean FEV1 was 63.0 ± 20.0% and 68.5 ± 21.2% of the predicted value prior to and after the educational intervention, respectively (p = 0.002), and all of the quality of life scores improved (p < 0.05 for all). The same was true for the proportion of patients prior to and after the educational intervention using the proper inhalation technique when using metered dose inhalers (15.4% vs. 46.2%; p = 0.02) and dry powder inhalers (21.3% vs. 76.6%; p < 0.001). The logistic regression analysis revealed that an incorrect inhalation technique identified during the first evaluation was independently associated with a favorable response to the educational intervention. CONCLUSIONS: This study suggests that an outpatient education program for asthma patients improves the level of asthma control, lung function parameters, and quality of life. An incorrect inhalation technique identified during the first evaluation was predictive of a favorable response to the educational intervention.
Evaluation of atopy in patients with COPD
Authors: Neves Margarida Celia Lima Costa , Neves Yuri Costa Sarno , Mendes Carlos Mauricio Cardeal , Bastos Monalisa Nobre , Camelier Aquiles Assuncao , Queiroz Cleriston Farias , Mendoza Bernardo Fonseca , Lemos Antonio Carlos Moreira , Junior Argemiro D'Oliveira
Published: December 2013

OBJECTIVE: To determine the prevalence of atopy and to evaluate clinical, laboratory, and radiological profiles in patients with COPD. METHODS: This was a cross-sectional study involving outpatients with stable COPD (defined by the clinical history and a post-bronchodilator FEV1/FVC < 70% of the predicted value). The patients completed a questionnaire regarding clinical characteristics and atopy, after which they underwent nasal lavage cytology, skin prick testing, chest X-rays, arterial blood gas analyses, and determination of total serum IgE. RESULTS: Of the 149 subjects studied, 53 (35.6%), 49 (32.8%), and 88 (59.1%) presented with nasal eosinophilia, a positive skin prick test result, and symptoms of allergic rhinitis, respectively. Correspondence analysis confirmed these findings, showing two distinct patterns of disease expression: atopy in patients with COPD that was less severe; and no evidence of atopy in those with COPD that was more severe (reduced FEV1 and hyperinflation). There was a statistically significant association between nasal eosinophilia and a positive bronchodilator response. CONCLUSIONS: Using simple and reproducible methods, we were able to show that there is a high frequency of atopy in patients with COPD. Monitoring inflammation in the upper airways can be a useful tool for evaluating respiratory diseases in the elderly and in those with concomitant asthma and COPD, a clinical entity not yet fully understood.
Screening for F508del as a first step in the molecular diagnosis of cystic fibrosis
Authors: Marson Fernando Augusto de Lima , Bertuzzo Carmen Silvia , Ribeiro Maria Angela Goncalves de Oliveira , Ribeiro Antonio Fernando , Ribeiro Jose Dirceu
Published: December 2013

OBJECTIVE: To determine the relevance of screening for the F508del mutation of the cystic fibrosis transmembrane conductance regulator gene as a first step in the genetic diagnosis of cystic fibrosis (CF) by associating the genotype with various clinical variables. METHODS: We evaluated 180 CF patients regarding the F508del mutation. The clinical data were obtained from the medical records of the patients and from interviews with their parents or legal guardians. RESULTS: Of the 180 patients studied, 65 (36.1%) did not carry the F508del mutation (group 0 [G0]), 67 (37.2%) were F508del heterozygous (G1), and 48 (26.7%) were F508del homozygous (G2). All three groups showed associations with the clinical variables. Homozygosis was associated with younger patients, younger age at CF diagnosis, and younger age at the first isolation of Pseudomonas aeruginosa (PA), as well as with higher prevalence of pancreatic insufficiency (PI) and non-mucoid PA (NMPA) colonization. In comparison with G1+G2 patients, G0 patients were older; first experienced clinical symptoms, digestive disease, and pulmonary disease at an older age; were older at CF diagnosis and at first PA isolation; and had a lower prevalence of PI and meconium ileus, as well as of colonization by NMPA, mucoid PA, and Burkholderia cepacia. In G1 patients, values were intermediate for age at CF diagnosis; age at first PA isolation, first pulmonary symptoms, and first clinical manifestations; MPA colonization; and OR for PI. CONCLUSIONS: The identification of F508del in 63.9% of the patients studied showed that this can be a useful tool as a first step in the genetic diagnosis of CF. The F508del genotype was associated with clinical severity of the disease, especially with the variables related to CF onset.
Importance of slow vital capacity in the detection of airway obstruction
Authors: Barros Ana Raquel Goncalves de , Pires Margarida Batista , Raposo Nuno Miguel Ferreira
Published: December 2013

OBJECTIVE: To investigate the presence of airway obstruction by determining the FEV1/FVC and FEV1/slow vital capacity (SVC) ratios. METHODS: This was a quantitative, retrospective cross-sectional study. The sample comprised 1,084 individuals who underwent spirometry and plethysmography in a central hospital in Lisbon, Portugal. The study sample was stratified into six groups, by pulmonary function. RESULTS: The analysis of the FEV1/FVC ratio revealed the presence of airway obstruction in 476 individuals (43.9%), compared with 566 individuals (52.2%) for the analysis of the FEV1/SVC ratio. In the airway obstruction, airway obstruction plus lung hyperinflation, and mixed pattern groups, the difference between SVC and FVC (SVC − FVC) was statistically superior to that in the normal pulmonary function, reduced FEF, and restrictive lung disease groups. The SVC − FVC parameter showed a significant negative correlation with FEV1 (in % of the predicted value) only in the airway obstruction plus lung hyperinflation group. CONCLUSIONS: The FEV1/SVC ratio detected the presence of airway obstruction in more individuals than did the FEV1/FVC ratio; that is, the FEV1/SVC ratio is more reliable than is the FEV1/FVC ratio in the detection of obstructive pulmonary disease.
Lung cysts in chronic paracoccidioidomycosis
Authors: Costa Andre Nathan , Marchiori Edson , Benard Gil , Araujo Mariana Sponholz , Baldi Bruno Guedes , Kairalla Ronaldo Adib , Carvalho Carlos Roberto Ribeiro
Published: December 2013

On HRCT scans, lung cysts are characterized by rounded areas of low attenuation in the lung parenchyma and a well-defined interface with the normal adjacent lung. The most common cystic lung diseases are lymphangioleiomyomatosis, Langerhans cell histiocytosis, and lymphocytic interstitial pneumonia. In a retrospective analysis of the HRCT findings in 50 patients diagnosed with chronic paracoccidioidomycosis, we found lung cysts in 5 cases (10%), indicating that patients with paracoccidioidomycosis can present with lung cysts on HRCT scans. Therefore, paracoccidioidomycosis should be included in the differential diagnosis of cystic lung diseases.
Pneumothorax as a complication of lung volume recruitment
Authors: Westermann Erik J.A. , Jans Maurice , Gaytant Michael A. , Bach John R. , Kampelmacher Mike J.
Published: December 2013

Lung volume recruitment involves deep inflation techniques to achieve maximum insufflation capacity in patients with respiratory muscle weakness, in order to increase peak cough flow, thus helping to maintain airway patency and improve ventilation. One of these techniques is air stacking, in which a manual resuscitator is used in order to inflate the lungs. Although intrathoracic pressures can rise considerably, there have been no reports of respiratory complications due to air stacking. However, reaching maximum insufflation capacity is not recommended in patients with known structural abnormalities of the lungs or chronic obstructive airway disease. We report the case of a 72-year-old woman who had poliomyelitis as a child, developed torsion scoliosis and post-polio syndrome, and had periodic but infrequent asthma attacks. After performing air stacking for 3 years, the patient suddenly developed a pneumothorax, indicating that this technique should be used with caution or not at all in patients with a known pulmonary pathology
Portuguese-language version of the COPD Assessment Test: validation for use in Brazil
Authors: Silva Guilherme Pinheiro Ferreira da , Morano Maria Tereza Aguiar Pessoa , Viana Cyntia Maria Sampaio , Magalhaes Clarissa Bentes de Araujo , Pereira Eanes Delgado Barros
Published: December 2013

OBJECTIVE: To validate a Portuguese-language version of the COPD assessment test (CAT) for use in Brazil and to assess the reproducibility of this version. METHODS: This was multicenter study involving patients with stable COPD at two teaching hospitals in the city of Fortaleza, Brazil. Two independent observers (twice in one day) administered the Portuguese-language version of the CAT to 50 patients with COPD. One of those observers again administered the scale to the same patients one week later. At baseline, the patients were submitted to pulmonary function testing and the six-minute walk test (6MWT), as well as completing the previously validated Portuguese-language versions of the Saint George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (MMRC) dyspnea scale, and hospital anxiety and depression scale (HADS). RESULTS: Inter-rater and intra-rater reliability was excellent (intraclass correlation coefficient [ICC] = 0.96; 95% CI: 0.93-0.97; p < 0.001; and ICC = 0.98; 95% CI: 0.96-0.98; p < 0.001, respectively). Bland Altman plots showed good test-retest reliability. The CAT total score correlated significantly with spirometry results, 6MWT distance, SGRQ scores, MMRC dyspnea scale scores, and HADS-depression scores. CONCLUSIONS: The Portuguese-language version of the CAT is a valid, reproducible, and reliable instrument for evaluating patients with COPD in Brazil.
Adaptation to different noninvasive ventilation masks in critically ill patients
Authors: Silva Renata Matos da , Timenetsky Karina Tavares , Neves Renata Cristina Miranda , Shigemichi Liane Hirano , Kanda Sandra Sayuri , Maekawa Carla , Silva Eliezer , Eid Raquel Afonso Caserta
Published: December 2013

OBJECTIVE: To identify which noninvasive ventilation (NIV) masks are most commonly used and the problems related to the adaptation to such masks in critically ill patients admitted to a hospital in the city of São Paulo, Brazil. METHODS: An observational study involving patients ≥ 18 years of age admitted to intensive care units and submitted to NIV. The reason for NIV use, type of mask, NIV regimen, adaptation to the mask, and reasons for non-adaptation to the mask were investigated. RESULTS: We evaluated 245 patients, with a median age of 82 years. Acute respiratory failure was the most common reason for NIV use (in 71.3%). Total face masks were the most commonly used (in 74.7%), followed by full face masks and near-total face masks (in 24.5% and 0.8%, respectively). Intermittent NIV was used in 82.4% of the patients. Adequate adaptation to the mask was found in 76% of the patients. Masks had to be replaced by another type of mask in 24% of the patients. Adequate adaptation to total face masks and full face masks was found in 75.5% and 80.0% of the patients, respectively. Non-adaptation occurred in the 2 patients using near-total facial masks. The most common reason for non-adaptation was the shape of the face, in 30.5% of the patients. CONCLUSIONS: In our sample, acute respiratory failure was the most common reason for NIV use, and total face masks were the most commonly used. The most common reason for non-adaptation to the mask was the shape of the face, which was resolved by changing the type of mask employed.
Pulmonary tuberculosis and lung cancer: simultaneous and sequential occurrence
Authors: Silva Denise Rossato , Valentini Junior Dirceu Felipe , Muller Alice Manica , Almeida Carlos Podalirio Borges de , Dalcin Paulo de Tarso Roth
Published: December 2013

OBJECTIVE: Lung cancer (LC) is the leading cause of cancer-related death and represents a major public health problem worldwide. Another major cause of morbidity and mortality, especially in developing countries, is tuberculosis. The simultaneous or sequential occurrence of pulmonary tuberculosis and LC in the same patient has been reported in various case series and case-control studies. The objective of this study was to describe the characteristics of patients developing tuberculosis and LC, either simultaneously or sequentially. METHODS: This was a cross-sectional study based on the review of medical charts. RESULTS: The study involved 24 patients diagnosed with tuberculosis and LC between 2009 and 2012. The diagnoses of tuberculosis and LC occurred simultaneously in 10 patients, whereas tuberculosis was diagnosed prior to LC in 14. The median time between the two diagnoses was 5 years (interquartile range: 1-30 years). Fourteen patients (58.3%) were male, 20 (83.3%) were White, and 22 (91.7%) were smokers or former smokers. The most common histological type was adenocarcinoma, identified in 14 cases (58.3%), followed by epidermoid carcinoma, identified in 6 (25.0%). Seven patients (29.2%) presented with distant metastases at diagnosis; of those 7 patients, 5 (71%) were diagnosed with LC and tuberculosis simultaneously. CONCLUSIONS: In the present study, most of the patients with tuberculosis and LC were smokers or former smokers, and tuberculosis was diagnosed either before or simultaneously with LC. Non-small cell lung cancer, especially adenocarcinoma, was the most common histological type.
Cystic fibrosis transmembrane conductance regulator mutations at a referral center for cystic fibrosis
Authors: Coutinho Cyntia Arivabeni de Araujo Correia , Marson Fernando Augusto de Lima , Ribeiro Antonio Fernando , Ribeiro Jose Dirceu , Bertuzzo Carmen Silvia
Published: December 2013

OBJECTIVE: To determine the frequency of six mutations (F508del, G542X, G551D, R553X, R1162X, and N1303K) in patients with cystic fibrosis (CF) diagnosed, at a referral center, on the basis of abnormal results in two determinations of sweat sodium and chloride concentrations. METHODS: This was a cross-sectional study involving 70 patients with CF. The mean age of the patients was 12.38 ± 9.00 years, 51.43% were female, and 94.29% were White. Mutation screening was performed with polymerase chain reaction (for F508del), followed by enzymatic digestion (for other mutations). Clinical analysis was performed on the basis of gender, age, ethnicity, pulmonary/gastrointestinal symptoms, and Shwachman-Kulczycki (SK) score. RESULTS: All of the patients showed pulmonary symptoms, and 8 had no gastrointestinal symptoms. On the basis of the SK scores, CF was determined to be mild, moderate, and severe in 22 (42.3%), 17 (32.7%), and 13 (25.0%) of the patients, respectively. There was no association between F508del mutation and disease severity by SK score. Of the 140 alleles analyzed, F508del mutation was identified in 70 (50%). Other mutations (G542X, G551D, R553X, R1162X, and N1303K) were identified in 12 (7.93%) of the alleles studied. In F508del homozygous patients with severe disease, the OR was 0.124 (95% CI: 0.005-0.826). CONCLUSIONS: In 50% of the alleles studied, the molecular diagnosis of CF was confirmed by identifying a single mutation (F508del). If we consider the analysis of the six most common mutations in the Brazilian population (including F508del), the molecular diagnosis was confirmed in 58.57% of the alleles studied.
Diagnostic criteria and follow-up in neuroendocrine cell hyperplasia of infancy: a case series
Authors: Gomes Vivianne Calheiros Chaves , Silva Mara Cristina Coelho , Maia Filho Jose Holanda , Daltro Pedro , Ramos Simone Gusmao , Brody Alan S. , Marchiori Edson
Published: December 2013

OBJECTIVE: Neuroendocrine cell hyperplasia of infancy (NEHI) is a form of childhood interstitial lung disease characterized by tachypnea, retractions, crackles, and hypoxia. The aim of this study was to report and discuss the clinical, imaging, and histopathological findings in a series of NEHI cases at a tertiary pediatric hospital, with an emphasis on diagnostic criteria and clinical outcomes. METHODS: Between 2003 and 2011, 12 full-term infants were diagnosed with NEHI, based on clinical and tomographic findings. Those infants were followed for 1-91 months. Four infants were biopsied, and the histopathological specimens were stained with bombesin antibody. RESULTS: In this case series, symptoms appeared at birth in 6 infants and by 3 months of age in the remaining 6. In all of the cases, NEHI was associated with acute respiratory infection. The most common initial chest HRCT findings were ground-glass opacities that were in the middle lobe/lingula in 12 patients and in other medullary areas in 10. Air trapping was the second most common finding, being observed in 7 patients. Follow-up HRCT scans (performed in 10 patients) revealed normal results in 1 patient and improvement in 9. The biopsy findings were nonspecific, and the staining was positive for bombesin in all samples. Confirmation of NEHI was primarily based on clinical and tomographic findings. Symptoms improved during the follow-up period (mean, 41 months). A clinical cure was achieved in 4 patients. CONCLUSIONS: In this sample of patients, the diagnosis of NEHI was made on the basis of the clinical and tomographic findings, independent of the lung biopsy results. Most of the patients showed clinical improvement and persistent tomographic changes during the follow-up period, regardless of the initial severity of the disease or type of treatment.
The outcome of tuberculosis treatment in subjects with chronic kidney disease in Brazil: a multinomial analysis
Authors: Reis-Santos Barbara , Gomes Teresa , Horta Bernardo Lessa , Maciel Ethel Leonor Noia
Published: December 2013

OBJECTIVE: To analyze the association between clinical/epidemiological characteristics and outcomes of tuberculosis treatment in patients with concomitant tuberculosis and chronic kidney disease (CKD) in Brazil. METHODS: We used the Brazilian Ministry of Health National Case Registry Database to identify patients with tuberculosis and CKD, treated between 2007 and 2011. The tuberculosis treatment outcomes were compared with epidemiological and clinical characteristics of the subjects using a hierarchical multinomial logistic regression model, in which cure was the reference outcome. RESULTS: The prevalence of CKD among patients with tuberculosis was 0.4% (95% CI: 0.37-0.42%). The sample comprised 1,077 subjects. The outcomes were cure, in 58%; treatment abandonment, in 7%; death from tuberculosis, in 13%; and death from other causes, in 22%. The characteristics that differentiated the ORs for treatment abandonment or death were age; alcoholism; AIDS; previous noncompliance with treatment; transfer to another facility; suspected tuberculosis on chest X-ray; positive results in the first smear microscopy; and indications for/use of directly observed treatment, short-course strategy. CONCLUSIONS: Our data indicate the importance of sociodemographic characteristics for the diagnosis of tuberculosis in patients with CKD and underscore the need for tuberculosis control strategies targeting patients with chronic noncommunicable diseases, such as CKD.
Evaluation of manual resuscitators used in ICUs in Brazil
Authors: Ortiz Tatiana de Arruda , Forti Junior Germano , Volpe Marcia Souza , Beraldo Marcelo do Amaral , Amato Marcelo Britto Passos , Carvalho Carlos Roberto Ribeiro , Tucci Mauro Roberto
Published: December 2013

OBJECTIVE: To evaluate the performance of manual resuscitators (MRs) used in Brazil in accordance with international standards. METHODS: Using a respiratory system simulator, four volunteer physiotherapists employed eight MRs (five produced in Brazil and three produced abroad), which were tested for inspiratory and expiratory resistance of the patient valve; functioning of the pressure-limiting valve; and tidal volume (VT) generated when the one-handed and two-handed techniques were used. The tests were performed and analyzed in accordance with the American Society for Testing and Materials (ASTM) F920-93 criteria. RESULTS: Expiratory resistance was greater than 6 cmH2O . L−1 . s−1 in only one MR. The pressure-limiting valve, a feature of five of the MRs, opened at low pressures (< 17 cmH2O), and the maximal pressure was 32.0-55.9 cmH2O. Mean VT varied greatly among the MRs tested. The mean VT values generated with the one-handed technique were lower than the 600 mL recommended by the ASTM. In the situations studied, mean VT was generally lower from the Brazilian-made MRs that had a pressure-limiting valve. CONCLUSIONS: The resistances imposed by the patient valve met the ASTM criteria in all but one of the MRs tested. The pressure-limiting valves of the Brazilian-made MRs usually opened at low pressures, providing lower VT values in the situations studied, especially when the one-handed technique was used, suggesting that both hands should be used and that the pressure-limiting valve should be closed whenever possible.