Massa muscular de idosos do município de São Paulo - Estudo SABE: Saúde, Bem-estar e Envelhecimento

A análise da massa muscular (MM) em idosos, seja total (MMT) ou apendicular (MMA), é importante para o acompanhamento deste componente ao longo do envelhecimento, sendo que estes valores são mais associados à incapacidade funcional quando ajustados pela estatura, possibilitando, assim, a análise dos índices de massa muscular total (IMMT) e apendicular (IMMA). O objetivo deste estudo foi apresentar valores normativos, expressos em médias e percentis, de MMT, MMA, IMMT e IMMA, de idosos do município de São Paulo, segundo sexo e grupos etários. A amostra foi composta por 1203 idosos de ambos os sexos, da coorte de 2006 do Estudo SABE: Saúde, Bem-estar e Envelhecimento, realizado no município de São Paulo, Brasil. As variáveis MMT e MMA foram identificadas a partir de equações preditivas, enquanto os respectivos índices, pela razão entre os valores de MM e altura, ao quadrado (em kg.m-2). Os valores médios e os desvios-padrão de MMT, de mulheres e homens, com menos de 80 e 80 anos e mais, foram, em kg, 17,7±3,6, 14,4±3,2, 26,9±3,8 e 24,1±2,9, respectivamente, enquanto os valores de MMA foram 14,4±2,1, 13,0±2,0, 21,0±2,8 e 19,4±2,3, respectivamente. Quando ajustados pela altura, os valores de IMMT foram, em kg.m-2, 7,6±1,4, 6,3±1,2, 9,8±1,1 e 8,9±0,9, e os valores de IMMA foram, 6,1±0,7, 5,7±0,7, 7,6±0,8 e 7,2±0,7, respectivamente. Todas as variáveis apresentaram alta correlação entre si (r>0,84). Homens e idosos mais jovens apresentaram maiores valores, com significância estatística, em relação aos seus pares e as diferenças entre os grupos etários são maiores entre as mulheres.

Theoretical Study of the Absorption Spectra of Photosynthetic Pigments

The first stage of the photosynthetic process is the extraordinary efficiency of sunlight absorption in the visible region [1]. This region corresponds to the maximum of the spectral radiance of the solar emission. The efficient absorption of visible light is one of the most important characteristics of photosynthetic pigments. In chlorophylls, for example, the absorptions are seen as a strong absorption in the region 400-450 nm in connection with other absorptions with small intensities in the region of 500-600 nm. This work aims at understanding the essential features of the absorption spectrum of photosynthetic pigments, in line with several theoretical studies in the literature [2, 3]. The absorption spectra were calculated for H2-Porphyrin, Mg-Porphyrin, and Zn-Porphyrin, and for H2-Phthalocyanine and Mg-Phthalocyanine with and without the four peripheral eugenol substituents. The geometries were optimized using the B3LYP/6-31+G(d) theoretical model. For the calculation of the absorption spectra different TD-DFT calculations were performed (B3LYP, CAM-B3LYP, O3LYP, M06-2X and BP86) along with CIS (D). For the spectra the basis set 6-311++G (d, p) was used for porphyrins and 6-31+G (d) was used for the other systems. At this stage the solvent effects were considered using the simplified continuum model (PCM). First a comparison between the results using the different methods was made. For the porphyrins the best results compared to experiment (both in position and intensities) are obtained with M06-2X and CIS (D). We also analyze the compatibility of the four-orbital model of Gouterman [4] that states that transitions could be well described by the HOMO-1, HOMO, LUMO, and LUMO+1 molecular orbitals. Our results for H2-Porphyrin shows an agreement with other theoretical results and experimental data [5]. For the phthalocyanines (including the four peripheral eugenol substituents) the results are also in good agreement compared with the experimental results given in ref [6]. Finally, the results show that the inclusion of solvent eÆects gives corrections for the spectral shift in the correct direction but numerically small. References [1] R.E. Blankenship; “Molecular Mechanisms of Photosynthesis", Blackwell Science (2002). [2] P. Jaramillo, K. Coutinho, B.J.C. Cabral and S. Canuto; Chem. Phys. Lett., 516, 250(2011). [3] L. Petit, A. Quartarolo, C. Adamo and N. Russo; J. Phys. Chem. B, 110, 2398(2006). [4] M. J. Gouterman; Mol. Spectr., 6, 138(1961). [5] M. Palummo, C. Hogan, F. Sottile, P. Bagal∂a and A. Rubio; J. Chem. Phys., 131, 084102(2009). [6] E. Agar, S. Sasmaz and A. Agar; Turk. J. Chem., 23, 131(1999).

Immunogenicity and Reactogenicity of 2009 Influenza A (H1N1) Inactivated Monovalent Non-Adjuvanted Vaccine in Elderly and Immunocompromised Patients

Background Immunosuppressed individuals present serious morbidity and mortality from influenza, therefore it is important to understand the safety and immunogenicity of influenza vaccination among them. Methods This multicenter cohort study evaluated the immunogenicity and reactogenicity of an inactivated, monovalent, non-adjuvanted pandemic (H1N1) 2009 vaccine among the elderly, HIV-infected, rheumatoid arthritis (RA), cancer, kidney transplant, and juvenile idiopathic arthritis (JIA) patients. Participants were included during routine clinical visits, and vaccinated according to conventional influenza vaccination schedules. Antibody response was measured by the hemagglutination-inhibition assay, before and 21 days after vaccination. Results 319 patients with cancer, 260 with RA, 256 HIV-infected, 149 elderly individuals, 85 kidney transplant recipients, and 83 with JIA were included. The proportions of seroprotection, seroconversion, and the geometric mean titer ratios postvaccination were, respectively: 37.6%, 31.8%, and 3.2 among kidney transplant recipients, 61.5%, 53.1%, and 7.5 among RA patients, 63.1%, 55.7%, and 5.7 among the elderly, 59.0%, 54.7%, and 5.9 among HIV-infected patients, 52.4%, 49.2%, and 5.3 among cancer patients, 85.5%, 78.3%, and 16.5 among JIA patients. The vaccine was well tolerated, with no reported severe adverse events. Conclusions The vaccine was safe among all groups, with an acceptable immunogenicity among the elderly and JIA patients, however new vaccination strategies should be explored to improve the immune response of immunocompromised adult patients. (ClinicalTrials.gov, NCT01218685)

Development and characterization of non-oxide ceramic composites for mechanical and tribological applications

The main reasons for the attention focused on ceramics as possible structural materials are their wear resistance and the ability to operate with limited oxidation and ablation at temperatures above 2000°C. Hence, this work is devoted to the study of two classes of materials which can satisfy these requirements: silicon carbide -based ceramics (SiC) for wear applications and borides and carbides of transition metals for ultra-high temperatures applications (UHTCs). SiC-based materials: Silicon carbide is a hard ceramic, which finds applications in many industrial sectors, from heat production, to automotive engineering and metals processing. In view of new fields of uses, SiC-based ceramics were produced with addition of 10-30 vol% of MoSi2, in order to obtain electro conductive ceramics. MoSi2, indeed, is an intermetallic compound which possesses high temperature oxidation resistance, high electrical conductivity (21·10-6 Ω·cm), relatively low density (6.31 g/cm3), high melting point (2030°C) and high stiffness (440 GPa). The SiC-based ceramics were hot pressed at 1900°C with addition of Al2O3-Y2O3 or Y2O3-AlN as sintering additives. The microstructure of the composites and of the reference materials, SiC and MoSi2, were studied by means of conventional analytical techniques, such as X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy dispersive spectroscopy (SEM-EDS). The composites showed a homogeneous microstructure, with good dispersion of the secondary phases and low residual porosity. The following thermo-mechanical properties of the SiC-based materials were measured: Vickers hardness (HV), Young’s modulus (E), fracture toughness (KIc) and room to high temperature flexural strength (σ). The mechanical properties of the composites were compared to those of two monolithic SiC and MoSi2 materials and resulted in a higher stiffness, fracture toughness and slightly higher flexural resistance. Tribological tests were also performed in two configurations disco-on-pin and slideron cylinder, aiming at studying the wear behaviour of SiC-MoSi2 composites with Al2O3 as counterfacing materials. The tests pointed out that the addition of MoSi2 was detrimental owing to a lower hardness in comparison with the pure SiC matrix. On the contrary, electrical measurements revealed that the addition of 30 vol% of MoSi2, rendered the composite electroconductive, lowering the electrical resistance of three orders of magnitude. Ultra High Temperature Ceramics: Carbides, borides and nitrides of transition metals (Ti, Zr, Hf, Ta, Nb, Mo) possess very high melting points and interesting engineering properties, such as high hardness (20-25 GPa), high stiffness (400-500 GPa), flexural strengths which remain unaltered from room temperature to 1500°C and excellent corrosion resistance in aggressive environment. All these properties place the UHTCs as potential candidates for the development of manoeuvrable hypersonic flight vehicles with sharp leading edges. To this scope Zr- and Hf- carbide and boride materials were produced with addition of 5-20 vol% of MoSi2. This secondary phase enabled the achievement of full dense composites at temperature lower than 2000°C and without the application of pressure. Besides the conventional microstructure analyses XRD and SEM-EDS, transmission electron microscopy (TEM) was employed to explore the microstructure on a small length scale to disclose the effective densification mechanisms. A thorough literature analysis revealed that neither detailed TEM work nor reports on densification mechanisms are available for this class of materials, which however are essential to optimize the sintering aids utilized and the processing parameters applied. Microstructural analyses, along with thermodynamics and crystallographic considerations, led to disclose of the effective role of MoSi2 during sintering of Zrand Hf- carbides and borides. Among the investigated mechanical properties (HV, E, KIc, σ from room temperature to 1500°C), the high temperature flexural strength was improved due to the protective and sealing effect of a silica-based glassy phase, especially for the borides. Nanoindentation tests were also performed on HfC-MoSi2 composites in order to extract hardness and elastic modulus of the single phases. Finally, arc jet tests on HfC- and HfB2-based composites confirmed the excellent oxidation behaviour of these materials under temperature exceeding 2000°C; no cracking or spallation occurred and the modified layer was only 80-90 μm thick.

Stima del sequestro e immagazzinamento di CO2 nelle praterie di Posidonia oceanica

Ogni anno, a causa dell’utilizzo di combustibili fossili e della produzione di cemento, vengono rilasciate in atmosfera 35,7 × 109 tonnellate di CO2, il principale dei gas serra. Durante l’ultima Conferenza delle Parti della UNFCCC, tenutasi a Parigi e nota come COP-21, gli Stati membri hanno posto come obiettivo il raggiungimento delle “emissioni zero” entro la seconda metà del XXI secolo. Secondo le previsioni fornite dall’IPCC il raggiungimento di tale obiettivo porterebbe comunque la concentrazione atmosferica di CO2 a 430 – 530 ppm con un conseguente aumento di temperatura di 1.5-2°C. Se non si riuscisse a rispettare questo traguardo potrebbe rendersi necessaria la rimozione forzata di CO2 dall’atmosfera. Negli ultimi anni è stata riconosciuta ad alcuni ecosistemi, tra cui le praterie di fanerogame marine, la capacità naturale di sottrarre elevate quantità di CO2, e rimuoverle dall’ambiente sotto forma di carbonio organico, chiamato “Blue Carbon”, per lunghi periodi di tempo. Il principale obiettivo di questo lavoro è quello di stimare i quantitativi di “Blue Carbon” contenuto all’interno dei sedimenti e nella biomassa vegetale di una prateria di Posidonia oceanica. I risultati hanno permesso di quantificare, al variare della densità dei fasci fogliari della pianta, la percentuale di carbonio organico contenuta nei primi 40 cm di sedimento e quello contenuto nella biomassa vegetale. Queste percentuali sono state utilizzate per stimare i quantitativi totali di carbonio all’interno di una ristretta area della prateria, quella attorno allo scoglio di Molarotto. Per quest’area il contenuto in carbonio organico stimato per i sedimenti è risultato essere compreso tra 104,4 e 122,7 t C ha-1, mentre quello contenuto nelle fronde tra 3,65 e 6,31 t C ha-1. Utilizzando il software QGIS è stato infine possibile stimare la quantità totale (fronde + sedimento) di carbonio contenuto all’interno della prateria in generale. Questo è risultato essere di 716 tonnellate.

PSGL-1 is dispensible for the development of active experimental autoimmune encephalomyelitis in SJL/J mice

The adhesion molecule P-selectin glycoprotein ligand (PSGL)-1 has been suggested to be involved in the immunopathogenesis of multiple sclerosis (MS). However, in C57BL/6 mice PSGL-1 was found to be dispensible for the development of MOG(aa35-55)-induced experimental autoimmune encephalomyelitis (EAE), an animal model for MS. To study, if involvement of PSGL-1 to EAE pathogenesis can be observed in another common mouse model, we backcrossed PSGL-1(-/-) mice for at least 12 generations into the SJL/J background and compared PLP(aa139-151) induced EAE in PSGL-1(-/-) SJL/J mice versus wild-type SJL/J mice. Here, we demonstrate that PSGL-1(-/-) SJL/J mice exhibited EAE pathogenesis indistinguishable from wild-type SJL/J mice. Our present study underscores and emphasizes previous observations that PSGL-1 is dispensible for EAE pathogenesis.

Accurate relative pKa calculations for carboxylic acids using complete basis set and Gaussian-n models combined with continuum solvation methods

The complete basis set methods CBS-4, CBS-QB3, and CBS-APNO, and the Gaussian methods G2 and G3 were used to calculate the gas phase energy differences between six different carboxylic acids and their respective anions. Two different continuum methods, SM5.42R and CPCM, were used to calculate the free energy differences of solvation for the acids and their anions. Relative pKa values were calculated for each acid using one of the acids as a reference point. The CBS-QB3 and CBS-APNO gas phase calculations, combined with the CPCM/HF/6-31+G(d)//HF/6-31G(d) or CPCM/HF/6-31+G(d)//HF/6-31+G(d) continuum solvation calculations on the lowest energy gas phase conformer, and with the conformationally averaged values, give results accurate to ½ pKa unit. © 2001 American Institute of Physics.

Choice of Initial Combination Antiretroviral Therapy in Individuals With HIV Infection: Determinants and Outcomes

BACKGROUND Current guidelines give recommendations for preferred combination antiretroviral therapy (cART). We investigated factors influencing the choice of initial cART in clinical practice and its outcome. METHODS We analyzed treatment-naive adults with human immunodeficiency virus (HIV) infection participating in the Swiss HIV Cohort Study and starting cART from January 1, 2005, through December 31, 2009. The primary end point was the choice of the initial antiretroviral regimen. Secondary end points were virologic suppression, the increase in CD4 cell counts from baseline, and treatment modification within 12 months after starting treatment. RESULTS A total of 1957 patients were analyzed. Tenofovir-emtricitabine (TDF-FTC)-efavirenz was the most frequently prescribed cART (29.9%), followed by TDF-FTC-lopinavir/r (16.9%), TDF-FTC-atazanavir/r (12.9%), zidovudine-lamivudine (ZDV-3TC)-lopinavir/r (12.8%), and abacavir/lamivudine (ABC-3TC)-efavirenz (5.7%). Differences in prescription were noted among different Swiss HIV Cohort Study sites (P < .001). In multivariate analysis, compared with TDF-FTC-efavirenz, starting TDF-FTC-lopinavir/r was associated with prior AIDS (relative risk ratio, 2.78; 95% CI, 1.78-4.35), HIV-RNA greater than 100 000 copies/mL (1.53; 1.07-2.18), and CD4 greater than 350 cells/μL (1.67; 1.04-2.70); TDF-FTC-atazanavir/r with a depressive disorder (1.77; 1.04-3.01), HIV-RNA greater than 100 000 copies/mL (1.54; 1.05-2.25), and an opiate substitution program (2.76; 1.09-7.00); and ZDV-3TC-lopinavir/r with female sex (3.89; 2.39-6.31) and CD4 cell counts greater than 350 cells/μL (4.50; 2.58-7.86). At 12 months, 1715 patients (87.6%) achieved viral load less than 50 copies/mL and CD4 cell counts increased by a median (interquartile range) of 173 (89-269) cells/μL. Virologic suppression was more likely with TDF-FTC-efavirenz, and CD4 increase was higher with ZDV-3TC-lopinavir/r. No differences in outcome were observed among Swiss HIV Cohort Study sites. CONCLUSIONS Large differences in prescription but not in outcome were observed among study sites. A trend toward individualized cART was noted suggesting that initial cART is significantly influenced by physician's preference and patient characteristics. Our study highlights the need for evidence-based data for determining the best initial regimen for different HIV-infected persons.

In vivo biochemical 7.0 Tesla magnetic resonance: preliminary results of dGEMRIC, zonal T2, and T2* mapping of articular cartilage

INTRODUCTION: Ultra-high-field whole-body systems (7.0 T) have a high potential for future human in vivo magnetic resonance imaging (MRI). In musculoskeletal MRI, biochemical imaging of articular cartilage may benefit, in particular. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) and T2 mapping have shown potential at 3.0 T. Although dGEMRIC, allows the determination of the glycosaminoglycan content of articular cartilage, T2 mapping is a promising tool for the evaluation of water and collagen content. In addition, the evaluation of zonal variation, based on tissue anisotropy, provides an indicator of the nature of cartilage ie, hyaline or hyaline-like articular cartilage.Thus, the aim of our study was to show the feasibility of in vivo dGEMRIC, and T2 and T2* relaxation measurements, at 7.0 T MRI; and to evaluate the potential of T2 and T2* measurements in an initial patient study after matrix-associated autologous chondrocyte transplantation (MACT) in the knee. MATERIALS AND METHODS: MRI was performed on a whole-body 7.0 T MR scanner using a dedicated circular polarization knee coil. The protocol consisted of an inversion recovery sequence for dGEMRIC, a multiecho spin-echo sequence for standard T2 mapping, a gradient-echo sequence for T2* mapping and a morphologic PD SPACE sequence. Twelve healthy volunteers (mean age, 26.7 +/- 3.4 years) and 4 patients (mean age, 38.0 +/- 14.0 years) were enrolled 29.5 +/- 15.1 months after MACT. For dGEMRIC, 5 healthy volunteers (mean age, 32.4 +/- 11.2 years) were included. T1 maps were calculated using a nonlinear, 2-parameter, least squares fit analysis. Using a region-of-interest analysis, mean cartilage relaxation rate was determined as T1 (0) for precontrast measurements and T1 (Gd) for postcontrast gadopentate dimeglumine [Gd-DTPA(2-)] measurements. T2 and T2* maps were obtained using a pixelwise, monoexponential, non-negative least squares fit analysis; region-of-interest analysis was carried out for deep and superficial cartilage aspects. Statistical evaluation was performed by analyses of variance. RESULTS: Mean T1 (dGEMRIC) values for healthy volunteers showed slightly different results for femoral [T1 (0): 1259 +/- 277 ms; T1 (Gd): 683 +/- 141 ms] compared with tibial cartilage [T1 (0): 1093 +/- 281 ms; T1 (Gd): 769 +/- 150 ms]. Global mean T2 relaxation for healthy volunteers showed comparable results for femoral (T2: 56.3 +/- 15.2 ms; T2*: 19.7 +/- 6.4 ms) and patellar (T2: 54.6 +/- 13.0 ms; T2*: 19.6 +/- 5.2 ms) cartilage, but lower values for tibial cartilage (T2: 43.6 +/- 8.5 ms; T2*: 16.6 +/- 5.6 ms). All healthy cartilage sites showed a significant increase from deep to superficial cartilage (P < 0.001). Within healthy cartilage sites in MACT patients, adequate values could be found for T2 (56.6 +/- 13.2 ms) and T2* (18.6 +/- 5.3 ms), which also showed a significant stratification. Within cartilage repair tissue, global mean values showed no difference, with 55.9 +/- 4.9 ms for T2 and 16.2 +/- 6.3 ms for T2*. However, zonal assessment showed only a slight and not significant increase from deep to superficial cartilage (T2: P = 0.174; T2*: P = 0.150). CONCLUSION: In vivo T1 dGEMRIC assessment in healthy cartilage, and T2 and T2* mapping in healthy and reparative articular cartilage, seems to be possible at 7.0 T MRI. For T2 and T2*, zonal variation of articular cartilage could also be evaluated at 7.0 T. This zonal assessment of deep and superficial cartilage aspects shows promising results for the differentiation of healthy and affected articular cartilage. In future studies, optimized protocol selection, and sophisticated coil technology, together with increased signal at ultra-high-field MRI, may lead to advanced biochemical cartilage imaging.

Bronchial circulation after experimental lung transplantation: the effect of direct revascularization of a bronchial artery

Direct revascularization of a bronchial artery has been proposed as a measure to alleviate the problem of bronchial ischemia after lung transplantation. To assess the effect of restoration of arterial blood flow to the transplanted bronchus, bronchial mucosal blood flow was measured in a model of modified unilateral lung transplantation in pigs. Laser Doppler velocimetry (LDV) and radioisotope studies using radio-labeled erythrocytes (RI) were used to measure blood flow at the donor main carina (DC) and upper lobe carina (DUC) after 3 h of reperfusion. The recipient carina was used as a reference point; values obtained by LDV and RI were expressed as percentage of blood flow at the recipient carina. Two groups of animals were studied. In group 1 (n = 6) standard unilateral transplantation was performed; in group 2 (n = 6) a left bronchial artery was reimplanted into the descending thoracic aorta of the recipient. No differences were observed between the two groups with respect to preoperative or postoperative gas exchange or hemodynamics. In group 1, bronchial blood flow at the DC was 37.6 +/- 2.2% (LDV) and 44.1 +/- 14.8% (RI) of reference blood flow. At the DUC, blood flow was 54.9 +/- 7.7% (LDV) and 61.6 +/- 25.7% (RI) of normal flow. In group 2, blood flow was increased at the DC as measured by LDV (55.3 +/- 17.1%; p less than 0.05) and by RI (60.8 +/- 25.3%; p less than 0.2). A similar increase was found at the DUC (LDV: 81.8 +/- 19.3%; p less than 0.05; RI: 88.6 +/- 31.0%; p less than 0.2). It is concluded that there is a significant gradient of blood flow from intra- to extrapulmonary airways after lung transplantation. Reimplantation of a bronchial artery results in significant improvement of graft bronchial blood flow. Restoration of bronchial perfusion to normal levels, however, cannot be achieved, suggesting a possible defect in the microcirculation of the donor airways.

Does hyoid bone resection according to Sistrunk influence normal craniofacial growth? A cephalometric study

PURPOSE: To retrospectively evaluate the influence of hyoid bone resection according to Sistrunk in early age due to a thyroglossal duct cyst on craniofacial growth. MATERIALS AND METHODS: We retrospectively examined 10 patients (2 females and 8 males) having had hyoid bone resection according to Sistrunk due to thyroglossal duct cysts by lateral cephalograms taken before orthodontic treatment (mean, 17.1 years; range, 8.6-31.9 years). Surgery was carried out at a mean age of 4.4 years (range, 0.37-9.8 years). All lateral cephalograms were evaluated and traced by hand. Descriptive statistics were calculated, and data from each patient were compared individually with corresponding standard values (age and gender) from Bathia and Leighton. RESULTS: With regard to sagittal parameters, the SNB angles were by trend too small and the ANB angles were too large. However, the ratio of mandibular to maxillary length showed that the patients had a mandible that was too large or maxilla that was too small. With regard to vertical parameters, large deviations from normal values in both directions (hyperdivergent to hypodivergent pattern) could be detected when we analyzed NSL/ML', NL/ML', and NSL/NL. With regard to dental parameters, the majority of the patients had retroclined upper (IsL/NL, IsL/N-A) and lower (IiL/ML, IiL/N-B) incisors. CONCLUSIONS: Several vertical and horizontal skeletal and dental cephalometric parameters were shown to be different by trend when compared with control values. A possible negative impact on craniofacial growth potential and direction as a result of hyoid resection in early age according to Sistrunk cannot be excluded.

Correlations between severity of clinical signs and histopathological changes in 60 dogs with spinal cord injury associated with acute thoracolumbar intervertebral disc disease

The outcome of spinal surgery in dogs with absent voluntary motor function and nociception following intervertebral disc (IVD) herniation is highly variable, which likely attests to differences in the severity of spinal cord damage. This retrospective study evaluated the extent to which neurological signs correlated with histologically detected spinal cord damage in 60 dogs that were euthanased because of thoracolumbar IVD herniation. Clinical neurological grades correlated significantly with the extent of white matter damage (P<0.001). However, loss of nociception also occurred in 6/31 (19%) dogs with relatively mild histological changes. The duration of clinical signs, Schiff-Sherrington posture, loss of reflexes and pain on spinal palpation were not significantly associated with the severity of spinal cord damage. Although clinical-pathological correlation was generally good, some clinical signs frequently thought to indicate severe cord injury did not always correlate with the degree of cord damage, suggesting functional rather than structural impairment in some cases.

Incidence of hypo- and hyper-capnia in a cross-sectional European cohort of ventilated newborn infants

OBJECTIVE To determine the incidence of hypo- and hyper-capnia in a European cohort of ventilated newborn infants. DESIGN AND SETTING Two-point cross-sectional prospective study in 173 European neonatal intensive care units. PATIENTS AND METHODS Patient characteristics, ventilator settings and measurements, and blood gas analyses were collected for endotracheally ventilated newborn infants on two separate dates. RESULTS A total of 1569 blood gas analyses were performed in 508 included patients with a mean±SD Pco2 of 48±12 mm Hg or 6.4±1.6 kPa (range 17-104 mm Hg or 2.3-13.9 kPa). Hypocapnia (Pco2<30 mm Hg or 4 kPa) and hypercapnia (Pco2>52 mm Hg or 7 kPa) was present in, respectively, 69 (4%) and 492 (31%) of the blood gases. Hypocapnia was most common in the first 3 days of life (7.3%) and hypercapnia after the first week of life (42.6%). Pco2 was significantly higher in preterm infants (49 mm Hg or 6.5 kPa) than term infants (43 mm Hg or 5.7 kPa) and significantly lower during pressure-limited ventilation (47 mm Hg or 6.3±1.6 kPa) compared with volume-targeted ventilation (51 mm Hg or 6.8±1.7 kPa) and high-frequency ventilation (50 mm Hg or 6.7±1.7 kPa). CONCLUSIONS This study shows that hypocapnia is a relatively uncommon finding during neonatal ventilation. The higher incidence of hypercapnia may suggest that permissive hypercapnia has found its way into daily clinical practice.

Up, down, strange and charm quark masses with Nf = 2+1+1 twisted mass lattice QCD

We present a lattice QCD calculation of the up, down, strange and charm quark masses performed using the gauge configurations produced by the European Twisted Mass Collaboration with Nf=2+1+1 dynamical quarks, which include in the sea, besides two light mass degenerate quarks, also the strange and charm quarks with masses close to their physical values. The simulations are based on a unitary setup for the two light quarks and on a mixed action approach for the strange and charm quarks. The analysis uses data at three values of the lattice spacing and pion masses in the range 210–450 MeV, allowing for accurate continuum limit and controlled chiral extrapolation. The quark mass renormalization is carried out non-perturbatively using the RI′-MOM method. The results for the quark masses converted to the scheme are: mud(2 GeV)=3.70(17) MeV, ms(2 GeV)=99.6(4.3) MeV and mc(mc)=1.348(46) GeV. We obtain also the quark mass ratios ms/mud=26.66(32) and mc/ms=11.62(16). By studying the mass splitting between the neutral and charged kaons and using available lattice results for the electromagnetic contributions, we evaluate mu/md=0.470(56), leading to mu=2.36(24) MeV and md=5.03(26) MeV.