Exploring race/ethnicity as a risk factor for mortality in newborns following congenital heart surgery at a center of excellence

The purpose of this study was to determine if race/ethnicity was a significant risk factor for hospital mortality in children following congenital heart surgery in a contemporary sample of newborns with congenital heart disease. Unlike previous studies that utilized administrative databases, this study utilized clinical data collected at the point of care to examine racial/ethnic outcome differences in the context of the patients' clinical condition and their overall perioperative experience. A retrospective cohort design was used. The study sample consisted of 316 newborns (<31 days of age) who underwent congenital heart surgery between January 2007 through December 2009. A multivariate logistic regression model was used to determine the impact of race/ethnicity, insurance status, presence of a spatial anomaly, prenatal diagnosis, postoperative sepsis, cardiac arrest, respiratory failure, unplanned reoperation, and total length of stay in the intensive care unit on outcomes following congenital heart surgery in newborns. The study findings showed that the strongest predictors of hospital mortality following congenital heart surgery in this cohort were postoperative cardiac arrest, postoperative respiratory failure, having a spatial anomaly, and total ICU LOS. Race/ethnicity and insurance status were not significant risk factors. The institution where this study was conducted is designated as a center of excellence for congenital heart disease. These centers have state-of-the-art facilities, extensive experience in caring for children with congenital heart disease, and superior outcomes. This study suggests that optimal care delivery for newborns requiring congenital heart surgery at a center of excellence portends exceptional outcomes and this benefit is conferred upon the entire patient population despite the race/ethnicity of the patients. From a public health and health services view, this study also contributes to the overall body of knowledge on racial/ethnic disparities in children with congenital heart defects and puts forward the possibility of a relationship between quality of care and racial/ethnic disparities. Further study is required to examine the impact of race/ethnicity on the long-term outcomes of these children as they encounter the disparate components of the health care delivery system. There is also opportunity to study the role of race/ethnicity on the hospital morbidity in these patients considering current expectations for hospital survival are very high, and much of the current focus for quality improvement rests in minimizing the development of patient morbidities.^

Border Industry in Myanmar: Turning the Periphery into the Center of Growth

The Myanmar economy has not been deeply integrated into East Asia’s production and distribution networks, despite its location advantages and notably abundant, reasonably well-educated, cheap labor force. Underdeveloped infrastructure, logistics in particular, and an unfavorable business and investment environment hinder it from participating in such networks in East Asia. Service link costs, for connecting production sites in Myanmar and other remote fragmented production blocks or markets, have not fallen sufficiently low to enable firms, including multi-national corporations to reduce total costs, and so the Myanmar economy has failed to attract foreign direct investments. Border industry offers a solution. The Myanmar economy can be connected to the regional and global economy through its borders with neighboring countries, Thailand in particular, which already have logistic hubs such as deep-sea ports, airports and trunk roads. This paper examines the source of competitiveness of border industry by considering an example of the garment industry located in the Myanmar-Thai border area. Based on such analysis, we recognize the prospects of border industry and propose some policy measures to promote this on Myanmar soil.

Is South Sulawesi a Center of Growth in Eastern Indonesia? : Japanese ODA Strategy Revisited

Japanese ODA, especially that undertaken by JICA, has targeted South Sulawesi Province as a core area of development in eastern Indonesia, with hope that the economic growth of South Sulawesi will bring about spillover effects in other regions. This paper tests the validity of the strategy using a framework of Vector Autoregressive model. The results show that South Sulawesi’s economy Granger causes other regions in eastern Indonesia, but not vice versa, implying that South Sulawesi drives the development of other regions in eastern Indonesia. Further analysis shows that the development of the agricultural sector in South Sulawesi potentially has the highest spillover effects than other sectors and that the magnitude of spillover effect from South Sulawesi on eastern Indonesia is higher than other economically important regions, such as Eastern Java and Kalimantan.

Traditional Building Adaptation to New Requirements: Historic Center of Arequipa, Perú

The traditional buildings in the historic center of the city of Arequipa, Perú, recently declared of human heritage, are of volcanic tuff both in walls and in vaulted roofs on the ground floor. Having been built in the 18th century and up to the beginning of the 20th century, they have suffered many damages from the seismic movements registered in this region. Due to this, many of them have had to be rebuilt. In this presentation, the different changes to adapt the city of Spanish colonial origin to the present tertiary use are analyzed.

Flujos de gases de efecto invernadero en suelos forestales y agroforestales del centro de la Península Ibérica=Greenhouse gas flows in forest and agroforestry soils in the center of the Iberian Peninsula

Debido a la complejidad de los procesos que controlan el intercambio de gases de carbono (C) y nitrógeno (N) entre el suelo y la atmósfera, en los sistemas forestales y agroforestales, son comprensibles las incógnitas existentes respecto a la estimación de los flujos de los gases de efecto invernadero (GEI) y la capacidad como reservorios de carbono de los suelos, bajo diferentes formas de uso y regímenes de alteración a escala regional y global. Esta escasez de información justifica la necesidad de caracterizar la dinámica de intercambio de GEI en los ecosistemas Mediterráneos, en especial en el contexto actual de cambio climático, y el incremento asociado de temperatura y periodos de sequía, alteración de los patrones de precipitación, y el riesgo de incendios forestales; cuyas consecuencias afectarán tanto a los compartimentos de C y de N del suelo como a la capacidad de secuestro de C de estos ecosistemas. Dentro de este contexto se enmarca la presente tesis doctoral cuyo objetivo ha sido cuantificar y caracterizar los flujos de dióxido de carbono (CO2), de oxido nitroso (N2O) y de metano (CH4), junto con los stocks de C y N, en suelos forestales de Quercus ilex, Quercus pyrenaica y Pinus sylvestris afectados por incendios forestales; así como el estudiar el efecto de la gestión y la cubierta arbórea en la respiración del suelo y los stocks de C y N en una dehesa situada en el centro de la Península Ibérica. De manera que los flujos de CO2, N2O y CH4; y los parámetros físico-químicos y biológicos del suelo fueron estudiados en los diferentes tratamientos y ecosistemas a lo largo del trabajo que se presenta. Los resultados obtenidos muestran la existencia de variaciones temporales y espaciales de la respiración del suelo dentro de una escala geográfica pequeña, controladas principalmente por la temperatura y la humedad del suelo; y por los contenidos de C y N del suelo en un bosque de Pinus sylvestris en la vertiente norte de la Sierra de Guadarrama , en España. El análisis de los efectos de los incendios forestales a largo plazo (6-8 años) revela que las pérdidas anuales de C a través de la respiración del suelo en las zonas quemadas de Quercus ilex, Quercus pyrenaica y Pinus sylvestris fueron 450 gCm-2yr-1, 790 gCm-2yr-1 y 1220 gCm-2yr-1, respectivamente; lo que representa una reducción del 43%, 22% y 11% en comparación con las zonas no quemadas de dichas especies, debido a la destrucción de la masa arbórea. El efecto del fuego también alteró los flujos N2O y CH4 del suelo, de una forma diferente en los distintos ecosistemas y estacionalidades estudiadas. De tal modo, que los suelos quemados mostraron una mayor oxidación del CH4 en las masas de Q. ilex, y una menor oxidación en las de P. sylvestris; además de una disminución de los flujos de N2O en Q. pyrenaica. Los incendios también afectaron los parámetros microclimáticos de los suelos forestales, observándose un incremento de la temperatura del suelo y una disminución de la humedad en los emplazamientos quemados que en los no quemados. Los cationes intercambiables, el pH, el cociente C/N, el contenido en raicillas y la biomasa microbiana también disminuyeron en las zonas quemadas. Aunque el C orgánico del suelo no se alteró de manera significativa, si lo hizo la calidad de la materia orgánica, disminuyendo el carbono lábil y aumentando las formas recalcitrantes lo que se tradujo en menor sensibilidad de la respiración del suelo a la temperatura (valores de Q10) en las zonas quemadas. Los resultados del estudio realizado en la Dehesa muestran que las actividades silvopastorales estudiadas afectaron levemente y de forma no constante a la respiración del suelo y las condiciones microclimáticas del suelo. Se observó una reducción 12% de la respiración del suelo por efecto del pastoreo no intensivo. Sin embargo, se observaron incrementos de 3Mg/ha en los stocks de C y de 0.3 Mg/ha en los stocks de N en los suelos pastoreados en comparación con los no pastoreados. Aunque, no se observó un claro efecto de la labranza sobre la respiración del suelo en nuestro experimento, sin embargo si se observó una disminución de 3.5 Mg/ha en las reservas de C y de 0.3 Mg/ ha en las de N en los suelos labrados comparados con los no labrados. La copa del arbolado influyó de forma positiva tanto en la respiración del suelo, como en los stocks de C y N de los suelos. La humedad del suelo jugó un papel relevante en la sensibilidad de la respiración a la temperatura del suelo. Nuestros resultados ponen de manifiesto la sensibilidad de la respiración del suelo a cambios en la humedad y los parámetros edáficos, y sugieren que la aplicación de modelos estándar para estimar la respiración del suelo en áreas geográficas pequeñas puede no ser adecuada a menos que otros factores sean considerados en combinación con la temperatura del suelo. Además, las diferentes respuestas de los flujos de gases de efecto invernadero a los cambios, años después de la ocurrencia de incendios forestales, destaca la necesidad de incluir estos cambios en las futuras investigaciones de la dinámica del carbono en los ecosistemas mediterráneos. Por otra parte, las respuestas divergentes en los valores de respiración del suelo y en los contenidos de C y N del suelo observados en la dehesa, además de la contribución de la copa de los árboles en los nutrientes del suelo ilustran la importancia de mantener la gestión tradicional aplicada en beneficio de la capacidad de almacenar C en la dehesa estudiada. La información obtenida en este trabajo pretende contribuir a la mejora del conocimiento de la dinámica y el balance de C en los sistemas mediterráneos, además de ayudar a predecir el impacto del cambio climático en el intercambio de C entre los ecosistemas forestales y agroforestales y la atmósfera. ABSTRACT Due to the complexity of the processes that control the exchange of carbon (C) and nitrogen (N) gasses between soils and the atmosphere in forest and agroforestry ecosystems, understandable uncertainties exist as regards the estimation of greenhouse gas (GHG) fluxes and the soil sink capacity at regional and global scale under different forms of land use and disturbance regimes. These uncertainties justify the need to characterize the exchange dynamics of GHG between the atmosphere and soils in Mediterranean terrestrial ecosystems, particularly in the current context of climate change and the associated increase in temperature, drought periods, heavy rainfall events, and increased risk of wildfires, which affect not only the C and N pools but also the soil C sink capacity of these ecosystems. Within this context, the aims of the present thesis were, firstly, to quantify and characterize the fluxes of carbon dioxide (CO2), nitrous oxide (N2O) and methane (CH4) as well as the C and N stocks in Quercus ilex, Quercus pyrenaica and Pinus sylvestris stands affected by wildfires, and secondly, to study the effects of Quercus ilex canopy and management on both soil respiration and C and N pools in dehesa systems in the center of Iberian Peninsula. Soil CO2, N2O and CH4 fluxes, and soil physical-chemical and biological parameters were studied under the different treatments and ecosystems considered in this study. The results showed seasonal and spatial variations in soil respiration within small geographic areas, mainly controlled by soil temperature and moisture in addition to soil carbon and nitrogen stocks in mixed pine–oak forest ecosystems on the north facing slopes of the Sierra de Guadarrama in Spain. The analysis of long term effects of wildfires (6–8 years) revealed that annual carbon losses through soil respiration from burned sites in Quercus ilex, Quercus pyrenaica and Pinus sylvestris stands were 450 gCm-2yr-1, 790 gCm-2yr-1 and 1220 gCm-2yr-1, respectively; with burned sites emitting 43%, 22% and 11% less in burned as opposed to non-burned sites due the loss of trees. Fire may alter both N2O and CH4 fluxes although the magnitude of such variation depends on the site, soil characteristics and seasonal climatic conditions. The burned sites showed higher CH4 oxidation in Q.ilex stands, and lower oxidation rates in P. sylvestris stands. A reduction in N2O fluxes in Q. pyrenaica stands was detected at burned sites along with changes in soil microclimate; higher soil temperature and lower soil moisture content. Exchangeable cations, the C/N ratio, pH, fine root and microbial biomass were also found to decrease at burned sites. Although the soil organic carbon was not significantly altered, the quality of the organic matter changed, displaying a decrease in labile carbon and a relative increase in refractory forms, leading to lower sensitivity of soil respiration to temperature (Q10 values) at burned sites. The results from the dehesa study show that light grazing and superficial tilling practices used in the studied dehesa system in Spain had a slight but non-consistent impact on soil respiration and soil microclimate over the study period. The reduction in soil respiration in the dehesa system due to the effects of grazing was around 12 %. However, increments of 3Mg/ha in C stocks and 0.3 Mg/ha in N stocks in grazed soils were observed. Although no clear effect of tilling on soil respiration was found, a decrease of 3.5 Mg/ha in C stocks and 0.3 Mg/ha in N stocks was detected for tilled soils. The presence of a tree canopy induced increases in soil respiration, soil C and N stocks, while soil moisture was found to play an important role in soil respiration temperature response. Our results suggest that the use of standard models to estimate soil respiration in small geographical areas may not be adequate unless other factors are considered in addition to soil temperature. Furthermore, the different responses of GHG flux to climatic shifts, many years after the occurrence of wildfire, highlight the need to include these shifts in C dynamics in future research undertaken in Mediterranean ecosystems. Furthermore, divergent responses in soil respiration and soil C and N stocks to grazing or tilling practices in Dehesa systems, and the influence of tree canopy on soil respiration and soil nutrient content, illustrate the importance of maintaining beneficial management practices. Moreover, the carbon sequestration capacity of the Dehesa system studied may be enhanced through improvements in the management applied. It is hoped that the information obtained through this research will contribute towards improving our understanding of the dynamics and balance of C in Mediterranean systems, and help predict the impact of climate change on the exchange of C between forest and agroforestry ecosystems and the atmosphere.

A model of economic management of cultural heritage: the rehabilitation of fort christmas as an interpretation center of defensive architecture of the Mediterranean in Cartagena (Spain)

The Cultural Heritage constitutes a way to generate social identities and play an important role in the development of the Spanish Mediterranean cities that opt to sustainable quality tourism. The reflection on the necessity of intervention on this heritage, in addition to establishing what should be done, brings up the need to define the reasons for taking action, why and what-for. These decisions are essential to establish if its maintenance and recovery are economically sustainable. The Project "Cartagena Port of Cultures", with support from the European Union, is an example of effective instrument for ensuring the sustainability of our built heritage conservation. Its main objective was to enable sustainable development of tourism in Cartagena based on sustainability and seasonality. This was achieved through a process of recovery of heritage resources and their optimum promotion and marketing.

Pararotor dynamics: center of mass displacement from the blade plane—analytical approach

The pararotor is a biology-inspired decelerator device based on the autorotation of a rotary wing whose main purpose is to guide a load descent into a certain atmosphere. This paper focuses on a practical approach to the general dynamic stability of a pararotor whose center of mass is displaced from the blade plane. The analytical study departs from the motion equations of pararotor flight, considering the center of mass displacement from the blade plane, studied over a number of simplifying hypotheses that allows determining the most important influences to flight behavior near equilibrium. Two practical indexes are developed to characterize the stability of a pararotor in terms of geometry, inertia, and the aerodynamic characteristics of the device. Based on these two parameters, a stability diagram can be defined upon which stability regions can be identified. It was concluded that the ability to reach stability conditions depends mainly on a limited number of parameters associated with the pararotor configuration: the relationship between moments of inertia, the position of the blades, the planform shape (associated with the blade aerodynamic coefficients and blade area), and the vertical distance between the center of mass and the blade plane. These parameters can be evaluated by computing practical indexes to determine stability behavior.

A glutamate residue in the catalytic center of the yeast chorismate mutase restricts enzyme activity to acidic conditions

Chorismate mutase acts at the first branchpoint of aromatic amino acid biosynthesis and catalyzes the conversion of chorismate to prephenate. Comparison of the x-ray structures of allosteric chorismate mutase from the yeast Saccharomyces cerevisiae with Escherichia coli chorismate mutase/prephenate dehydratase suggested conserved active sites between both enzymes. We have replaced all critical amino acid residues, Arg-16, Arg-157, Lys-168, Glu-198, Thr-242, and Glu-246, of yeast chorismate mutase by aliphatic amino acid residues. The resulting enzymes exhibit the necessity of these residues for catalytic function and provide evidence of their localization at the active site. Unlike some bacterial enzymes, yeast chorismate mutase has highest activity at acidic pH values. Replacement of Glu-246 in the yeast chorismate mutase by glutamine changes the pH optimum for activity of the enzyme from a narrow to a broad pH range. These data suggest that Glu-246 in the catalytic center must be protonated for maximum catalysis and restricts optimal activity of the enzyme to low pH.

Induction of resistance to diabetes in non-obese diabetic mice by targeting CD44 with a specific monoclonal antibody

Inflammatory destruction of insulin-producing β cells in the pancreatic islets is the hallmark of insulin-dependent diabetes mellitus, a spontaneous autoimmune disease of non-obese diabetic mice resembling human juvenile (type I) diabetes. Histochemical analysis of diabetic pancreata revealed that mononuclear cells infiltrating the islets and causing autoimmune insulitis, as well as local islet cells, express the CD44 receptor; hyaluronic acid, the principal ligand of CD44, is detected in the islet periphery and islet endothelium. Injection of anti-CD44 mAb 1 hr before cell transfer of diabetogenic splenocytes and subsequently on alternate days for 4 weeks induced considerable resistance to diabetes in recipient mice, reflected by reduced insulitis. Contact sensitivity to oxazolone was not influenced by this treatment. A similar antidiabetic effect was observed even when the anti-CD44 mAb administration was initiated at the time of disease onset: i.e., 4–7 weeks after cell transfer. Administration of the enzyme hyaluronidase also induced appreciable resistance to insulin-dependent diabetes mellitus, suggesting that the CD44–hyaluronic acid interaction is involved in the development of the disease. These findings demonstrate that CD44-positive inflammatory cells may be a potential therapeutic target in insulin-dependent diabetes.

Multiple pathways for ultrafast transduction of light energy in the photosynthetic reaction center of Rhodobacter sphaeroides

A pathway of electron transfer is described that operates in the wild-type reaction center (RC) of the photosynthetic bacterium Rhodobacter sphaeroides. The pathway does not involve the excited state of the special pair dimer of bacteriochlorophylls (P*), but instead is driven by the excited state of the monomeric bacteriochlorophyll (BA*) present in the active branch of pigments along which electron transfer occurs. Pump-probe experiments were performed at 77 K on membrane-bound RCs by using different excitation wavelengths, to investigate the formation of the charge separated state P+HA−. In experiments in which P or BA was selectively excited at 880 nm or 796 nm, respectively, the formation of P+HA− was associated with similar time constants of 1.5 ps and 1.7 ps. However, the spectral changes associated with the two time constants are very different. Global analysis of the transient spectra shows that a mixture of P+BA− and P* is formed in parallel from BA* on a subpicosecond time scale. In contrast, excitation of the inactive branch monomeric bacteriochlorophyll (BB) and the high exciton component of P (P+) resulted in electron transfer only after relaxation to P*. The multiple pathways for primary electron transfer in the bacterial RC are discussed with regard to the mechanism of charge separation in the RC of photosystem II from higher plants.

Genetic control of resistance to experimental infection with virulent Mycobacterium tuberculosis

Over 2 billion people are estimated to be infected with virulent Mycobacterium tuberculosis, yet fewer than 10% progress to clinical tuberculosis within their lifetime. Twin studies and variations in the outcome of tuberculosis infection after exposure to similar environmental risks suggest genetic heterogeneity among individuals in their susceptibility to disease. In a mouse model of tuberculosis, we have established that resistance and susceptibility to virulent M. tuberculosis is a complex genetic trait. A new locus with a major effect on tuberculosis susceptibility, designated sst1 (susceptibility to tuberculosis 1), was mapped to a 9-centimorgan (cM) interval on mouse chromosome 1. It is located 10–19 cM distal to a previously identified gene, Nramp1, that controls the innate resistance of mice to the attenuated bacillus Calmette–Guérin vaccine strain. The phenotypic expression of the newly identified locus is distinct from that of Nramp1 in that sst1 controls progression of tuberculosis infection in a lung-specific manner. Mice segregating at the sst1 locus exhibit marked differences in the growth rates of virulent tubercle bacilli in the lungs. Lung lesions in congenic sst1-susceptible mice are characterized by extensive necrosis and unrestricted extracellular multiplication of virulent mycobacteria, whereas sst1-resistant mice develop interstitial granulomas and effectively control multiplication of the bacilli. The resistant allele of sst1, although powerful in controlling infection, is not sufficient to confer full protection against virulent M. tuberculosis, indicating that other genes located outside of the sst1 locus are likely also to be important for controlling tuberculosis infection.

Frequency of resistance to Bacillus thuringiensis in field populations of pink bollworm

Strategies for delaying pest resistance to genetically modified crops that produce Bacillus thuringiensis (Bt) toxins are based primarily on theoretical models. One key assumption of such models is that genes conferring resistance are rare. Previous estimates for lepidopteran pests targeted by Bt crops seem to meet this assumption. We report here that the estimated frequency of a recessive allele conferring resistance to Bt toxin Cry1Ac was 0.16 (95% confidence interval = 0.05–0.26) in strains of pink bollworm (Pectinophora gossypiella) derived from 10 Arizona cotton fields during 1997. Unexpectedly, the estimated resistance allele frequency did not increase from 1997 to 1999 and Bt cotton remained extremely effective against pink bollworm. These results demonstrate that the assumptions and predictions of resistance management models must be reexamined.

The nature of the excited state of the reaction center of photosystem II of green plants: A high-resolution fluorescence spectroscopy study

We studied the electronically excited state of the isolated reaction center of photosystem II with high-resolution fluorescence spectroscopy at 5 K and compared the obtained spectral features with those obtained earlier for the primary electron donor. The results show that there is a striking resemblance between the emitting and charge-separating states in the photosystem II reaction center, such as a very similar shape of the phonon wing with characteristic features at 19 and 80 cm−1, almost identical frequencies of a number of vibrational modes, a very similar double-Gaussian shape of the inhomogeneous distribution function, and relatively strong electron-phonon coupling for both states. We suggest that the emission at 5 K originates either from an exciton state delocalized over the inactive branch of the photosystem or from a fraction of the primary electron donor that is long-lived at 5 K. The latter possibility can be explained by a distribution of the free energy difference of the primary charge separation reaction around zero. Both possibilities are in line with the idea that the state that drives primary charge separation in the reaction center of photosystem II is a collective state, with contributions from all chlorophyll molecules in the central part of the complex.