When Is the Best Moment to Assess the Ankle Brachial Index: Pre- or Post-Hemodialysis?

Background: Cardiovascular disease is an important cause of death in patients on dialysis. Peripheral arterial disease (PAD) is a prognostic factor for cardiovascular disease. The ankle brachial index (ABI) is a noninvasive method used for the diagnosis of PAD. The difference between ABI pre- and post-dialysis had not yet been formally tested, and it was the main objective of this study. Methods:The ABI was assessed using an automated oscillometric device in incident patients on hemodialysis. All blood pressure readings were taken in triplicate pre- and post-dialysis in three consecutive dialysis sessions (times 1, 2, and 3). Results: One hundred and twenty-three patients (85 men) aged 53 +/- 19 years were enrolled. We found no difference in ABI pre- and post-dialysis on the right or left side, and there was no difference in times 1, 2, and 3. In patients with a history of PAD, the ABI pre- versus post-dialysis were of borderline significance on the right side (p = 0.088). Conclusion: ABI measured pre- and post-dialysis presented low variability. The ABI in patients with a history of PAD should be evaluated with caution. The applicability of the current method in predicting mortality among patients on hemodialysis therefore needs further investigation. Copyright (C) 2012 S. Karger AG, Basel

From the terrible loneliness to the wonderful agreement of human beings

What would be the ""terrible loneliness"" and what would be the ""wonderful agreement"" in the present paper? The ""terrible loneliness"" is the only reality that a person perceives and/or thinks during the now going on. For the person, an enormous quantity of occurrences is in the present moment absent. A very small quantity of occurrences is present. The person is the only being in having this. And, this is only during a little moment. The person never thinks about his loneliness in this moment. On the contrary, he thinks he is plenty of people and full of occurrences. But, if he were thinking about reality, he would live in a terrible loneliness. How does he escape himself from this loneliness? He thinks that the probable occurrences are real occurrences. He may be right in a plenty of times. Going through what I call opening hypotheses-basic hypotheses and non-basic but important hypotheses-and going through what I call simply hypotheses he is able to sanction a wonderful agreement of human beings about the known parts of the Universe. However, they are hypotheses, not absolute realities.

Analytic perturbation theory for bound states in the transfer matrix spectrum of weakly correlated lattice ferromagnetic spin systems

We consider general d-dimensional lattice ferromagnetic spin systems with nearest neighbor interactions in the high temperature region ('beta' << 1). Each model is characterized by a single site apriori spin distribution taken to be even. We also take the parameter 'alfa' = ('S POT.4') - 3 '(S POT.2') POT.2' > 0, i.e. in the region which we call Gaussian subjugation, where ('S POT.K') denotes the kth moment of the apriori distribution. Associated with the model is a lattice quantum field theory known to contain a particle of asymptotic mass -ln 'beta' and a bound state below the two-particle threshold. We develop a 'beta' analytic perturbation theory for the binding energy of this bound state. As a key ingredient in obtaining our result we show that the Fourier transform of the two-point function is a meromorphic function, with a simple pole, in a suitable complex spectral parameter and the coefficients of its Laurent expansion are analytic in 'beta'.

Signatures of quantum phase transitions in parallel quantum dots: Crossover from local moment to underscreened spin-1 Kondo physics

We study a strongly interacting "quantum dot 1" and a weakly interacting "dot 2" connected in parallel to metallic leads. Gate voltages can drive the system between Kondo-quenched and non-Kondo free-moment phases separated by Kosterlitz-Thouless quantum phase transitions. Away from the immediate vicinity of the quantum phase transitions, the physical properties retain signatures of first-order transitions found previously to arise when dot 2 is strictly noninteracting. As interactions in dot 2 become stronger relative to the dot-lead coupling, the free moment in the non-Kondo phase evolves smoothly from an isolated spin-one-half in dot 1 to a many-body doublet arising from the incomplete Kondo compensation by the leads of a combined dot spin-one. These limits, which feature very different spin correlations between dot and lead electrons, can be distinguished by weak-bias conductance measurements performed at finite temperatures.

Targeting the Transposase Domain of the DNA Repair Component Metnase to Enhance Chemotherapy

Previous studies have shown that the DNA repair component Metnase (SETMAR) mediates resistance to DNA damaging cancer chemotherapy. Metnase has a nuclease domain that shares homology with the Transposase family. We therefore virtually screened the tertiary Metnase structure against the 550,000 compound ChemDiv library to identify small molecules that might dock in the active site of the transposase nuclease domain of Metnase. We identified eight compounds as possible Metnase inhibitors. Interestingly, among these candidate inhibitors were quinolone antibiotics and HIV integrase inhibitors, which share common structural features. Previous reports have described possible activity of quinolones as antineoplastic agents. Therefore, we chose the quinolone ciprofloxacin for further study, based on its wide clinical availability and low toxicity. We found that ciprofloxacin inhibits the ability of Metnase to cleave DNA and inhibits Metnase-dependent DNA repair. Ciprofloxacin on its own did not induce DNA damage, but it did reduce repair of chemotherapy-induced DNA damage. Ciprofloxacin increased the sensitivity of cancer cell lines and a xenograft tumor model to clinically relevant chemotherapy. These studies provide a mechanism for the previously postulated antineoplastic activity of quinolones, and suggest that ciprofloxacin might be a simple yet effective adjunct to cancer chemotherapy. Cancer Res; 72(23); 6200-8. (C) 2012 AACR.

Previous exposure to musical auditory stimulation immediately influences the cardiac autonomic responses to the postural change maneuver in women

Background Chronic exposure to musical auditory stimulation has been reported to improve cardiac autonomic regulation. However, it is not clear if music acutely influences it in response to autonomic tests. We evaluated the acute effects of music on heart rate variability (HRV) responses to the postural change maneuver (PCM) in women. Method We evaluated 12 healthy women between 18 and 28 years old and HRV was analyzed in the time (SDNN, RMSSD, NN50 and pNN50) and frequency (LF, HF and LF/HF ratio) domains. In the control protocol, the women remained at seated rest for 10 minutes and quickly stood up within three seconds and remained standing still for 15 minutes. In the music protocol, the women remained at seated rest for 10 minutes, were exposed to music for 10 minutes and quickly stood up within three seconds and remained standing still for 15 minutes. HRV was recorded at the following time: rest, music (music protocol) 0–5, 5–10 and 10–15 min during standing. Results In the control protocol the SDNN, RMSSD and pNN50 indexes were reduced at 10–15 minutes after the volunteers stood up, while the LF (nu) index was increased at the same moment compared to seated rest. In the protocol with music, the indexes were not different from control but the RMSSD, pNN50 and LF (nu) were different from the music period. Conclusion Musical auditory stimulation attenuates the cardiac autonomic responses to the PCM.

Properties of nanoparticles prepared from NdFeB-based compound for magnetic hyperthermia application

Nanoparticles were prepared from a NdFeB-based alloy using the hydrogen decrepitation process together with high-energy ball milling and tested as heating agent for magnetic hyperthermia. In the milling time range evaluated (up to 10 h), the magnetic moment per mass at H = 1.59 MA m(-1) is superior than 70 A m(2) kg(-1); however, the intrinsic coercivity might be inferior than 20 kA m(-1). The material presents both ferromagnetic and superparamagnetic particles constituted by a mixture of phases due to the incomplete disproportionation reaction of Nd2Fe14BHx during milling. Solutions prepared with deionized water and magnetic particles exposed to an AC magnetic field (H-max similar to 3.7 kA m(-1) and f = 228 kHz) exhibited 26 K <= Delta T-max <= 44 K with a maximum estimated specific absorption rate (SAR) of 225 W kg(-1). For the pure magnetic material milled for the longest period of time (10 h), the SAR was estimated as similar to 2500 W kg(-1). In vitro tests indicated that the powders have acceptable cytotoxicity over a wide range of concentration (0.1-100 mu g ml(-1)) due to the coating applied during milling.

A TRAINING COURSE ON BIOETHICS FOR FAMILY HEALTH STRATEGY PROFESSIONALS IN SANTO ANDRE, SP

This case report presents the experience of a training course on bioethics for nurses and physicians of the Family Health Strategy in Santo Andre, SP. This study is based on problem-based learning and deliberative bioethics, and aimed at presenting the deliberation procedure as a means of handling ethical issues. Contents were addressed in a cross-section manner through five sequential activity sessions at two different moments of concentration with one dispersion interval. In the first moment of concentration, key concepts and deliberative bioethics contents were developed. The second involved deliberation sessions on moral conflicts, which were selected and prepared during the dispersion interval. Participants evaluated the deliberation as an appropriate instrument to deal with the ethical issues they are faced with. Problem-based learning was an effective educational strategy for continuing education in deliberative bioethics.

Treatment-resistant depression increases health costs and resource utilization

Objective: Major Depressive Disorder (MDD) is a debilitating condition with a marked social impact. The impact of MDD and Treatment-Resistant Depression (TRD+) within the Brazilian health system is largely unknown. The goal of this study was to compare resource utilization and costs of care for treatment-resistant MDD relative to non-treatment-resistant depression (TRD-). Methods: We retrospectively analyzed the records of 212 patients who had been diagnosed with MDD according to the ICD-10 criteria. Specific criteria were used to identify patients with TRD+. Resource utilization was estimated, and the consumption of medication was annualized. We obtained information on medical visits, procedures, hospitalizations, emergency department visits and medication use related or not to MDD. Results: The sample consisted of 90 TRD+ and 122 TRD-patients. TRD+ patients used significantly more resources from the psychiatric service, but not from non-psychiatric clinics, compared to TRD-patients. Furthermore, TRD+ patients were significantly more likely to require hospitalizations. Overall, TRD+ patients imposed significantly higher (81.5%) annual costs compared to TRD-patients (R$ 5,520.85; US$ 3,075.34 vs. R$ 3,042.14; US$ 1,694.60). These findings demonstrate the burden of MDD, and especially of TRD+ patients, to the tertiary public health system. Our study should raise awareness of the impact of TRD+ and should be considered by policy makers when implementing public mental health initiatives.

Structural, morphological, and magnetic characterization of In1-xMnxAs quantum dots grown by molecular beam epitaxy

In this paper, we present a method to order low temperature (LT) self-assembled ferromagnetic In1-xMnxAs quantum dots (QDs) grown by molecular beam epitaxy (MBE). The ordered In1-xMnxAs QDs were grown on top of a non-magnetic In0.4Ga0.6As/GaAs(100) QDs multi-layered structure. The modulation of the chemical potential, due to the stacking, provides a nucleation center for the LT In1-xMnxAs QDs. For particular conditions, such as surface morphology and growth conditions, the In1-xMnxAs QDs align along lines like chains. This work also reports the characterization of QDs grown on plain GaAs(100) substrates, as well as of the ordered structures, as function of Mn content and growth temperature. The substitutional Mn incorporation in the InAs lattice and the conditions for obtaining coherent and incoherent structures are discussed from comparison between Raman spectroscopy and x-ray analysis. Ferromagnetic behavior was observed for all structures at 2K. We found that the magnetic moment axis changes from [110] in In1-xMnxAs over GaAs to [1-10] for the ordered In1-xMnxAs grown over GaAs template. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4745904]

Alzheimer random walk model: Two previously overlooked diffusion regimes

A non-Markovian one-dimensional random walk model is studied with emphasis on the phase-diagram, showing all the diffusion regimes, along with the exactly determined critical lines. The model, known as the Alzheimer walk, is endowed with memory-controlled diffusion, responsible for the model's long-range correlations, and is characterized by a rich variety of diffusive regimes. The importance of this model is that superdiffusion arises due not to memory per se, but rather also due to loss of memory. The recently reported numerically and analytically estimated values for the Hurst exponent are hereby reviewed. We report the finding of two, previously overlooked, phases, namely, evanescent log-periodic diffusion and log-periodic diffusion with escape, both with Hurst exponent H = 1/2. In the former, the log-periodicity gets damped, whereas in the latter the first moment diverges. These phases further enrich the already intricate phase diagram. The results are discussed in the context of phase transitions, aging phenomena, and symmetry breaking.

A representação gráfica na Revista Projeto & Design.

Esta pesquisa inicia-se pelo estudo das diferentes maneiras de representação de um projeto arquitetônico: desenhos analógicos e digitais, desenhos naturais e técnicos, desenhos auxiliados por computador, maquetes físicas e modelos digitais. Teve como objetivo analisar a representação gráfica utilizada nas publicações de obras arquitetônicas em mídias impressas especializadas, tendo sido selecionada a Revista Projeto & Design como estudo de caso. Com este estudo foi possível, por meio de bibliometria gráfica, verificar as contribuições das representações na compreensão e leitura dos projetos arquitetônicos, elencando-se e exemplificando-se as tipologias de imagens utilizadas nas últimas décadas, bem como relacionar os resultados com o momento histórico em que foram projetadas ou publicadas.