Clinical Profile, Predictors of Mortality, and Treatment of Patients after Myocardial Infarction, in an Academic Medical Center Hospital

OBJECTIVE: To evaluate clinical profiles, predictors of 30-day mortality, and the adherence to international recommendations for the treatment of myocardial infarction in an academic medical center hospital. METHODS: We retrospectively studied 172 patients with acute myocardial infarction, admitted in the intensive care unit from January 1992 to December 1997. RESULTS: Most patients were male (68%), white (97%), and over 60 years old (59%). The main risk factor for coronary atherosclerotic disease was systemic blood hypertension (63%). Among all the variables studied, reperfusion therapy, smoking, hypertension, cardiogenic shock, and age were the predictors of 30-day mortality. Most commonly used medications were: acetylsalicylic acid (71%), nitrates (61%), diuretics (51%), angiotensin-converting enzyme inhibitors (46%), thrombolytic therapy (39%), and beta-blockers (35%). CONCLUSION: The absence of reperfusion therapy, smoking status, hypertension, cardiogenic shock, and advanced age are predictors of 30-day mortality in patients with acute myocardial infarction. In addition, some medications that are undoubtedly beneficial have been under-used after acute myocardial infarction.

Teaching the Rational Use of Medicines to medical students: a qualitative research

Background: Prescribing is a complex and challenging task that must be part of a logical deductive process based on accurate and objective information and not an automated action, without critical thinking or a response to commercial pressure. The objectives of this study were 1) develop and implement a discipline based on the WHO's Guide to Good Prescribing; 2) evaluate the course acceptance by students; 3) assess the impact that the Rational Use of Medicines (RUM) knowledge had on the students habits of prescribing medication in the University Hospital.Methods: In 2003, the RUM principal, based in the WHO's Guide to Good Prescribing, was included in the official curriculum of the Botucatu School of Medicine, Brazil, to be taught over a total of 24 hours to students in the 4th year. We analyzed the students' feedback forms about content and teaching methodology filled out immediately after the end of the discipline from 2003 to 2010. In 2010, the use of RUM by past students in their medical practice was assessed through a qualitative approach by a questionnaire with closed-ended rank scaling questions distributed at random and a single semistructured interview for content analysis.Results: The discipline teaches future prescribers to use a logical deductive process, based on accurate and objective information, to adopt strict criteria (efficacy, safety, convenience and cost) on selecting drugs and to write a complete prescription. At the end of it, most students considered the discipline very good due to the opportunity to reflect on different actions involved in the prescribing process and liked the teaching methodology. However, former students report that although they are aware of the RUM concepts they cannot regularly use this knowledge in their daily practice because they are not stimulated or even allowed to do so by neither older residents nor senior medical staff.Conclusions: This discipline is useful to teach RUM to medical students who become aware of the importance of this subject, but the assimilation of the RUM principles in the institution seems to be a long-term process which requires the involvement of a greater number of the academic members.

Early social environment and the fighting behaviour of young Oreochromis niloticus (Pisces, Cichlidae)

This study examines the influence of early experience with different forms of aggressive behaviour on the fighting behaviour of young fish. Fry of the cichlid fish, Oreochromis niloticus, were raised from hatching in small groups consisting of a normal individual (the test fish) and either mutant conspecifics lacking the dorsal fin and thereby the ability to perform fin displays, or normal ones. Following a 63-day period of development in groups the test fish were confronted in their home tanks with an unfamiliar normal fish for 10 min. The fighting behaviour of the test fish was analyzed considering their previous group type (mutant or normal) and rank (alpha or beta). There was no difference between test fish in the rate and sequence of behaviour patterns used in fighting. However, test fish that had developed in mutant groups were rarely the first to bite in contests and had a longer latency to biting following the first bite of the stimulus fish than rest fish with normal experience. This finding is attributable to the form of aggressive behaviour experienced by the test fish during development but not to existing differences in the amount of aggression previously experienced, nor to previous rank, sex, or size relative to the stimulus fish. The results suggest that early experience influenced decision making by the test fish during the fight. The involvement of the fin displays and the possible mechanism of this influence are discussed.

Eye color as an indicator of social rank in the fish Nile tilapia

We investigated the association of eye color with the dominant-subordinate relationship in the fish Nile tilapia, Oreochromis niloticus. Eye color pattern was also examined in relation to the intensity of attacks. We paired 20 size-matched fish (intruder: 73.69 ± 11.49 g; resident: 75.42 ± 8.83 g) and evaluated eye color and fights. These fish were isolated in individual aquaria for 10 days and then their eye color was measured 5 min before pairing (basal values). Twenty minutes after pairing, eye color and fights were quantified for 10 min. Clear establishment of social hierarchy was observed in 7 of 10 pairs of fish. Number of attacks ranged from 1 to 168 among pairs. The quartile was calculated for these data and the pairs were then divided into two classes: low-attack (1 to 111 attacks - 2 lower quartiles) or high-attack (112 to 168 attacks - 2 higher quartiles). Dominance decreased the eye-darkening patterns of the fish after pairing, while subordinance increased darkening compared to dominance. Subordinate fish in low-attack confrontations presented a darker eye compared to dominant fish and to the basal condition. We also observed a paler eye pattern in dominants that shared low-attack interactions after pairing compared to the subordinates and within the group. However, we found no differences in the darkening pattern between dominants and subordinates from the high-attack groups. We conclude that eye color is associated with social rank in this species. Moreover, the association between eye color and social rank in the low-attack pairs may function to reduce aggression.

NDIM achievements: massive, arbitrary tensor rank and N-loop insertions in Feynman integrals

One of the main difficulties in studying quantum field theory, in the perturbative regime, is the calculation of D-dimensional Feynman integrals. In general, one introduces the so-called Feynman parameters and, associated with them, the cumbersome parametric integrals. Solving these integrals beyond the one-loop level can be a difficult task. The negative-dimensional integration method (NDIM) is a technique whereby such a problem is dramatically reduced. We present the calculation of two-loop integrals in three different cases: scalar ones with three different masses, massless with arbitrary tensor rank, with and N insertions of a two-loop diagram.

STUDIES ON THE RELATIONSHIP BETWEEN THE PATHOGENICITY OF PARACOCCIDIOIDES-BRASILIENSIS IN MICE AND ITS GROWTH-RATE UNDER DIFFERENT OXYGEN ATMOSPHERES

We performed comparative studies of the pathogenicity of six strains of Paracoccidioides brasiliensis (Bt-9, Bt-4, Pb-9, Pb-18, Bt-7 and B-1183) for young adult male ddY mice and growth rate of each strain under different oxygen atmospheres (aerobic, micro-aerobic and anaerobic atmospheres) at 37-degrees-C. 10(6) units of yeast cells were intravenously injected into each mouse. The pathogenicity of each isolate was determined by a scoring system based on organ culture and histopathological findings. The growth rates under different oxygen atmospheres were determined by a scoring system in which 300 fungal units per strain were counted. The strain Bt-9 showed the greatest pathogenicity, followed by Bt-4. Pb-9 and Pb-18 had on intermediate rank of pathogenicity. Bt-7 and B-1183 were the least pathogenic of the strains tested. Except for strain Bt-7 all strains showed an excellent growth under an aerobic atmosphere. Bt-4 and Bt-9 also showed excellent growth under a micro-aerobic atmosphere, followed by Pb-9, whereas the growth of Pb-18, Bt-7 and B-1183 was limited. There was a correlation between the growth rate under a micro-aerobic atmosphere and the pathogenicity of a strain. The growth rate of P. brasiliensis under a micro-aerobic atmosphere strongly correlated to its pathogenicity.

Predicting academic success of engineering students in technical drawing from working memory

Tests on spatial aptitude, in particular Visualization, have been shown to be efficient predictors of the academic performance of Technical Drawing stu-dents. It has recently been found that Spatial Working Memory (a construct defined as the ability to perform tasks with a figurative content that require si-multaneous storage and transformation of information) is strongly associated with Visualization. In the present study we analyze the predictive efficiency of a bat-tery of tests that included tests on Visualization, SpatialWorking Memory, Spatial Short-term Memory and Executive Function on a sample of first year engineering students. The results show that Spatial Working Memory (SWM) is the most important predictor of academic success in Technical Drawing. In our view, SWM tests can be useful for detecting as early as possible those students who will require more attention and support in the teaching-learning process.

Expression of opg, rank, and rankl proteins in tooth repair processes after immediate and delayed tooth

This study evaluated the immunohistochemical expression of OPG, RANK, and RANKL proteins in the repair after immediate and delayed replantation of rat teeth. Fifty-six Wistar rats (Rattus norvegicus albinus) had their maxillary right lateral incisor extracted and then replanted, according to the following conditions: group I (control; n = 8), teeth were not extracted; group II (n = 16), immediate replantation; group III (n = 16), delayed replantation without treatment; and group IV (n = 16), delayed replantation after root surface treatment (periodontal ligament removal and immersion in 2% acidulated-phosphate sodium fluoride) and calcium hydroxide intracanal dressing. Rats in group I were euthanized on the first day of the experiment, while the animals in the other groups were euthanized 10 and 60 days after replantation (n = 8/period). Hematoxylin and eosin-stained sections were obtained for histological analysis. The immunohistochemical analysis revealed expression of OPG and RANKL proteins in all groups and both postreplantation times, except for group II at 60 days. In the experimental groups, RANK expression was observed only at 10 days. In conclusion, there was strong immunostaining for the OPG-RANK-RANKL system at the earlier postreplantation time, suggesting a more effective participation of these proteins at the start of the healing process, as their expression decreased at 60 days. Copyright © 2013 by Mutaz B. Habal, MD.

Stable singularities of co-rank one quasi homogeneous map germs from (ℂn+1, 0) to (ℂn, 0), n = 2, 3

In this article, we investigate the geometry of quasi homogeneous corank one finitely determined map germs from (ℂn+1, 0) to (ℂn, 0) with n = 2, 3. We give a complete description, in terms of the weights and degrees, of the invariants that are associated to all stable singularities which appear in the discriminant of such map germs. The first class of invariants which we study are the isolated singularities, called 0-stable singularities because they are the 0-dimensional singularities. First, we give a formula to compute the number of An points which appear in any stable deformation of a quasi homogeneous co-rank one map germ from (ℂn+1, 0) to (ℂn, 0) with n = 2, 3. To get such a formula, we apply the Hilbert's syzygy theorem to determine the graded free resolution given by the syzygy modules of the associated iterated Jacobian ideal. Then we show how to obtain the other 0-stable singularities, these isolated singularities are formed by multiple points and here we use the relation among them and the Fitting ideals of the discriminant. For n = 2, there exists only the germ of double points set and for n = 3 there are the triple points, named points A1,1,1 and the normal crossing between a germ of a cuspidal edge and a germ of a plane, named A2,1. For n = 3, there appear also the one-dimensional singularities, which are of two types: germs of cuspidal edges or germs of double points curves. For these singularities, we show how to compute the polar multiplicities and also the local Euler obstruction at the origin in terms of the weights and degrees. © 2013 Pushpa Publishing House.

Massive spin-2 particle from a rank-2 tensor

Here we obtain all possible second-order theories for a rank-2 tensor which describe a massive spin-2 particle. We start with a general second-order Lagrangian with ten real parameters. The absence of lower-spin modes and the existence of two local field redefinitions leads us to only one free parameter. The solutions are split into three one-parameter classes according to the local symmetries of the massless limit. In the class which contains the usual massive Fierz-Pauli theory, the subset of spin-1 massless symmetries is maximal. In another class where the subset of spin-0 symmetries is maximal, the massless theory is invariant under Weyl transformations and the mass term does not need to fit into the form of the Fierz-Pauli mass term. In the remaining third class neither the spin-1 nor the spin-0 symmetry is maximal and we have a new family of spin-2 massive theories. © 2013 American Physical Society.

Cysteine proteinase inhibitors regulate human and mouse osteoclastogenesis by interfering with RANK signaling

The cysteine proteinase inhibitor cystatin C inhibited RANKL-stimulated osteoclast formation in mouse bone marrow macrophage cultures, an effect associated with decreased mRNA expression of Acp5, Calcr, Ctsk, Mmp9, Itgb3, and Atp6i, without effect on proliferation or apoptosis. The effects were concentration dependent with half-maximal inhibition at 0.3 μM. Cystatin C also inhibited osteoclast formation when RANKL-stimulated osteoclasts were cultured on bone, leading to decreased formation of resorption pits. RANKL-stimulated cells retained characteristics of phagocytotic macrophages when cotreated with cystatin C. Three other cysteine proteinase inhibitors, cystatin D, Z-RLVG-CHN2 (IC50 0.1 μM), and E-64 (IC 50 3 μM), also inhibited osteoclast formation in RANKL-stimulated macrophages. In addition, cystatin C, Z-RLVG-CHN2, and E-64 inhibited osteoclastic differentiation of RANKL-stimulated CD14+ human monocytes. The effect by cystatin C on differentiation of bone marrow macrophages was exerted at an early stage after RANKL stimulation and was associated with early (4 h) inhibition of c-Fos expression and decreased protein and nuclear translocation of c-Fos. Subsequently, p52, p65, IκBα, and Nfatc1 mRNA were decreased. Cystatin C was internalized in osteoclast progenitors, a process requiring RANKL stimulation. These data show that cystatin C inhibits osteoclast differentiation and formation by interfering intracellularly with signaling pathways downstream RANK. © FASEB.

A rank aggregation framework for video multimodal geocoding

This paper proposes a rank aggregation framework for video multimodal geocoding. Textual and visual descriptions associated with videos are used to define ranked lists. These ranked lists are later combined, and the resulting ranked list is used to define appropriate locations for videos. An architecture that implements the proposed framework is designed. In this architecture, there are specific modules for each modality (e.g, textual and visual) that can be developed and evolved independently. Another component is a data fusion module responsible for combining seamlessly the ranked lists defined for each modality. We have validated the proposed framework in the context of the MediaEval 2012 Placing Task, whose objective is to automatically assign geographical coordinates to videos. Obtained results show how our multimodal approach improves the geocoding results when compared to methods that rely on a single modality (either textual or visual descriptors). We also show that the proposed multimodal approach yields comparable results to the best submissions to the Placing Task in 2012 using no extra information besides the available development/training data. Another contribution of this work is related to the proposal of a new effectiveness evaluation measure. The proposed measure is based on distance scores that summarize how effective a designed/tested approach is, considering its overall result for a test dataset. © 2013 Springer Science+Business Media New York.

Comparison of factor-analytic and reduced rank models for test-day milk yield in Gyr dairy cattle (Bos indicus)

We analyzed 46,161 monthly test-day records of milk production from 7453 first lactations of crossbred dairy Gyr (Bos indicus) x Holstein cows. The following seven models were compared: standard multivariate model (M10), three reduced rank models fitting the first 2, 3, or 4 genetic principal components, and three models considering a 2-, 3-, or 4-factor structure for the genetic covariance matrix. Full rank residual covariance matrices were considered for all models. The model fitting the first two principal components (PC2) was the best according to the model selection criteria. Similar phenotypic, genetic, and residual variances were obtained with models M10 and PC2. The heritability estimates ranged from 0.14 to 0.21 and from 0.13 to 0.21 for models M10 and PC2, respectively. The genetic correlations obtained with model PC2 were slightly higher than those estimated with model M10. PC2 markedly reduced the number of parameters estimated and the time spent to reach convergence. We concluded that two principal components are sufficient to model the structure of genetic covariances between test-day milk yields. © FUNPEC-RP.