Aflatoxin Exposure May Contribute to Chronic Hepatomegaly in Kenyan School Children

BACKGROUND: Presentation with a firm type of chronic hepatomegaly of multifactorial etiology is common among school-age children in sub-Saharan Africa.

OBJECTIVE: Aflatoxin is a liver toxin and carcinogen contaminating staple maize food. In this study we examined its role in chronic hepatomegaly.

METHODS: Plasma samples collected in 2002 and again in 2004 from 218 children attending two schools in neighboring villages were assayed for aflatoxin exposure using the aflatoxin-albumin adduct (AF-alb) biomarker. Data were previously examined for associations among hepatomegaly, malaria, and schistosomiasis.

RESULTS: AF-alb levels were high in children from both schools, but the geometric mean (95% confidence interval) in year 2002 was significantly higher in Matangini [206.5 (175.5, 243.0) pg/mg albumin] than in Yumbuni [73.2 (61.6, 87.0) pg/mg; p < 0.001]. AF-alb levels also were higher in children with firm hepatomegaly [176.6 (129.6, 240.7) pg/mg] than in normal children [79.9 (49.6, 128.7) pg/mg; p = 0.029]. After adjusting for Schistosoma mansoni and Plasmodium infection, we estimated a significant 43% increase in the prevalence of hepatomegaly/hepatosplenomegaly for every natural-log-unit increase in AF-alb. In 2004, AF-alb levels were markedly higher than in 2002 [539.7 (463.3, 628.7) vs. 114.5 (99.7, 131.4) pg/mg; p < 0.001] but with no significant difference between the villages or between hepatomegaly and normal groups [539.7 (436.7, 666.9) vs. 512.6 (297.3, 883.8) pg/mg], possibly because acute exposures during an aflatoxicosis outbreak in 2004 may have masked any potential underlying relationship.

CONCLUSIONS: Exposure to aflatoxin was associated with childhood chronic hepatomegaly in 2002. These preliminary data suggest an additional health risk that may be related to aflatoxin exposure in children, a hypothesis that merits further testing.

Plateau iris syndrome associated with multiple ciliary body cysts:Report of 3 cases

Objective: To describe plateau iris syndrome associated with multiple neuroepithelial cysts of the pars plicata. Methods: Case reports of 3 patients with plateau iris syndrome who were found to have multiple bilateral ciliary body cysts on ultrasound biomicroscopic examination. Results: Ultrasound biomicroscopy revealed classic features of plateau iris syndrome in each patient but also showed multiple neuroepithelial cysts of the ciliary body in each eye. Conclusion: Plateau iris syndrome may be associated with multiple ciliary body cysts.

Glycation does not alter LDL-induced secretion of tissue plasminogen activator and plasminogen activator inhibitor-1 from human aortic endothelial cells

Diabetes may induce both quantitative and qualitative changes in lipoproteins, especially low-density lipoprotein (LDL). Effects of LDL glycation on endothelial cell secretion of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) have not been fully elucidated. Human aortic endothelial cell (HAEC) tPA and PAI-1 production were determined after incubation with LDL (50 to 500 microg/mL protein, 24 h) from three sources: (1) nondiabetic LDL (N-LDL) modified in vitro to form six preparations: native, nonmodified (N); glycated (G); minimally oxidized (MO); minimally oxidized and glycated (MOG); heavily oxidized (HO); and heavily oxidized and glycated (HOG); (2) in vivo glycated and relatively nonglycated LDL subfractions from type 1 diabetic patients; (3) LDL from type 1 diabetic patients and matched controls, which was subfractionated using density gradient ultracentrifugation. In experiments using LDL modified in vitro, the rate of tPA release by HAECs incubated with N-LDL (83 +/- 4 ng/mg cell protein/24 h) did not differ significantly from those incubated with G-LDL (73 +/- 7), MO-LDL (74 +/- 13), or MOG-LDL (66 +/- 15) and was not influenced by LDL concentration. The rate of PAI-1 release was similar in HAECs incubated with N-LDL (5.7 +/- 0.6 mug/mg cell protein/24 h), G-LDL (5.7 +/- 0.7), MO-LDL (5.5 +/- 0.8), or MOG-LDL (5.7 +/- 0.9) and was not influenced by LDL concentration. In contrast, tPA release was significantly decreased in cells incubated with LDL (10 microg/mL) modified extensively by oxidation, and averaged 45.2 +/- 5.0 and 43.7 +/- 9.9 ng/mg/24 h for HO-LDL and HOG-LDL, respectively, and was further decreased with increasing concentrations of the heavily oxidized LDL preparations. PAI-1 release was not significantly decreased relative to N-LDL in cells incubated with low concentrations (5 to 50 microg/mL) of HO-LDL and HOG-LDL, but was decreased to 3.2 +/- 0.5 and 3.1 +/- 0.7 microg/mg/24 h for HO-LDL and HOG-LDL at 200 microg/mL, respectively. Results using in vivo glycated versus nonglycated LDL showed that tPA and PAI-1 release did not differ between subfractions. Release of tPA averaged 5.11 +/- 0.6 and 5.12 +/- 0.7 ng/mg/24 h, whereas release of PAI-1 averaged 666 +/- 27 ng/mg/24 h and 705 +/- 30 ng/mg/24 h for nonglycated and glycated LDL subfractions, respectively. Using LDL of different density subclasses, tPA and PAI-1 release in response to LDL from diabetic patients compared with control subjects did not differ when HAECs were incubated with LDLs of increasing density isolated from each subject pair. We conclude that oxidation of LDL, but not glycation, may contribute to the altered fibrinolysis observed in diabetes.

Association between the 5q31.1 gene neurogenin1 and schizophrenia

Multiple lines of evidence suggest that schizophrenia results from aberrant neurodevelopment. The neurogenin1 gene (neurog1) consists of a single 1,666 bp exon that encodes a basic helix-loop-helix (bHLH) transcription factor that causes neuronal differentiation and induces cortical and glutamatergic differentiation programs. Because of its function and its location in 5q31.1, which has been linked to schizophrenia in multiple samples, we tested it for association with the disorder. We sequenced neurog1 in 25 affected subjects from the Irish Study of High-Density Schizophrenia Families. We observed a 5'-UTR SNP at position -60, already present in databases as rs8192558, and tested it along with rs2344485, rs8192559, and rs2344484. Narrow, intermediate, and broad diagnostic definitions were used. The major alleles of rs8192558 and rs2344484 were over-transmitted to affected subjects using both Pedigree Disequilibrium Test (PDT) (0.01 <or = P <or = 0.06) and FBAT (0.02 <or = P <or = 0.07). A haplotype consisting of the major alleles of all four SNPs was significantly over-transmitted in FBAT to the broad definition (P = 0.049), with trend significance to the narrow and intermediate definitions, and with trend significance in PDT. In confirmatory tests using 657 cases and 411 controls, this haplotype was slightly but not significantly over-represented in cases (81% vs. 77%, P = 0.21). These results, along with a priori evidence for the involvement of neurog1 in neurodevelopment, suggest that variants in neurog1 might have a small effect on susceptibility to schizophrenia. This gene should be tested in additional and larger samples.

Ambient Temperature Hydrocarbon Selective Catalytic Reduction of NOx Using Atmospheric Pressure Nonthermal Plasma Activation of a Ag/Al2O3 Catalyst

Atmospheric pressure nonthermal-plasma-activated catalysis for the removal of NOx using hydrocarbon selective catalytic reduction has been studied utilizing toluene and n-octane as the hydrocarbon reductant. When the plasma was combined with a Ag/Al2O3 catalyst, a strong enhancement in activity was observed when compared with conventional thermal activation with high conversions of both. NOx and hydrocarbons obtained at temperature at temperature ≤250 °C, where the silver catalyst is normally inactive. Importantly, even in the absence of an external heat source, significant activity was obtained. This low temperature activity provides the basis for applying nonthermal plasmas to activate emission control catalysts during cold start conditions, which remains an important issue for mobile and stationary applications.

Statin Use and Risk of Delirium in the Critically Ill

Rationale: Delirium is common in intensive care unit (ICU) patients and is a predictor of worse outcomes and neuroinflammation is a possible mechanism. The antiinflammatory actions of statins may reduce delirium.

Objectives: To determine whether critically ill patients receiving statin therapy had a reduced risk of delirium than those not on statins.

Methods: A prospective cohort analysis of data from consecutive ICU patients admitted to a UK mixed medical and surgical critical care unit between August 2011 and February 2012; the Confusion Assessment Method for ICU was used to determine the days each patient was assessed as being free of delirium during ICU admission.

Measurements and Main Results: Delirium-free days, daily administration of statins, and serum C-reactive protein (CRP) were recorded. Four hundred and seventy consecutive critical care patients were followed, of whom 151 patients received statins. Using randomeffects multivariable logistic regression, statin administration the previous evening was associated with the patient being assessed as free of delirium (odds ratio, 2.28; confidence interval, 1.01-5.13; P , 0.05) and with lower CRP (b = 20.52; P , 0.01) the following day. When the association between statin and being assessed as free of delirium was controlled for CRP, the effect size became nonsignificant (odds ratio, 1.56; confidence interval, 0.64-3.79; P = 0.32).

Conclusions: Ongoing statin therapy is associated with a lower daily risk of delirium in critically ill patients. An ongoing clinical trial, informed by this study, is investigating if statins are a potential therapy for delirium in the critically ill.Copyright © 2014 by the American Thoracic Society.

Kuznetsov independence for interval-valued expectations and sets of probability distributions: Properties and algorithms

Kuznetsov independence of variables X and Y means that, for any pair of bounded functions f(X) and g(Y), E[f(X)g(Y)]=E[f(X)] *times* E[g(Y)], where E[.] denotes interval-valued expectation and *times* denotes interval multiplication. We present properties of Kuznetsov independence for several variables, and connect it with other concepts of independence in the literature; in particular we show that strong extensions are always included in sets of probability distributions whose lower and upper expectations satisfy Kuznetsov independence. We introduce an algorithm that computes lower expectations subject to judgments of Kuznetsov independence by mixing column generation techniques with nonlinear programming. Finally, we define a concept of conditional Kuznetsov independence, and study its graphoid properties.

Saúde mental e comportamentos de risco em estudantes universitários

A saúde dos estudantes do ensino superior é uma importante questão de saúde pública, com impacto não só a nível pessoal e social, como também institucional. Nesse sentido, a presente investigação teve como objectivos: 1) caracterizar a saúde mental dos estudantes universitários, ao nível de sintomas depressivos, stress e bem-estar; 2) identificar os seus padrões de consumo de álcool, em termos de quantidade e frequência de consumo, ingestão esporádica excessiva e tipos de bebidas mais ingeridas; 3) conhecer a prevalência de dois comportamentos de risco ligados ao álcool, os comportamentos sexuais de risco e a condução sob o efeito de álcool; 4) analisar a relação entre saúde mental e consumo de álcool no ensino superior. Para esse efeito, realizou-se um estudo transversal com 666 alunos do 1º ciclo da Universidade de Aveiro. Os instrumentos utilizados foram: Ficha de Caracterização Sociodemográfica e Académica; Medida de Saúde Comportamental-20; Inventário da Depressão em Estudantes Universitários; Inventário de Stress em Estudantes Universitários; Questionário de Comportamentos de Risco em Estudantes Universitários. Os resultados mostraram que 32% dos estudantes se encontravam num patamar disfuncional quanto à sua saúde mental, 15% apresentavam sintomatologia depressiva e 26% sofriam de níveis elevados de stress, mas que apenas uma minoria destes alunos estava a receber apoio psicológico profissional. Os níveis de saúde mental foram inferiores nas mulheres, nos alunos do 1º e do 3º ano, da área de Saúde e de estatuto socioeconómico baixo. Para além disso, a maioria dos estudantes consumia álcool e 41% tiveram episódios de ingestão excessiva no último mês. Durante as festas académicas, um quarto dos estudantes ingeriu cinco ou mais bebidas por noite. O consumo de álcool foi superior nos homens, nos estudantes da área de Engenharias, de estatuto socioeconómico elevado e nos deslocados. Quanto a problemas ligados ao álcool, 13% dos estudantes sexualmente activos admitiram ter tido relações sexuais decorrentes do consumo de álcool, no último ano, e 29% praticaram condução sob o efeito de álcool no último mês. Estes comportamentos foram mais frequentes em estudantes do sexo masculino e naqueles que tiveram episódios de ingestão excessiva. Não se encontrou, de um modo geral, uma relação entre saúde mental e consumo de álcool, tendo sido detectadas apenas correlações, fracas, do stress e do bem-estar com o consumo de álcool. Ao contrário do que era esperado, verificou-se que à medida que o consumo de álcool aumentava, o stress diminuía e o bem-estar aumentava ligeiramente. Estes dados salientam a necessidade de as instituições do ensino superior reforçarem a identificação e o tratamento de problemas existentes e apostarem na prevenção, tanto através de estratégias dirigidas a toda a comunidade, no âmbito da educação para a saúde e da literacia em saúde mental, como através de iniciativas destinadas aos grupos de risco aqui identificados.

Identificação de indicadores moleculares de bem-estar durante o cultivo de dourada (Sparus aurata, Linnaeus 1758), utilizando técnicas de proteómica

Dissertação de Mestrado, Biologia Marinha, Especialização em Biotecnologia Marinha, Faculdade de Ciências do Mar e do Ambiente, Universidade do Algarve, 2008

Influence of the Human Head in the Radiation of a Mobile Antenna

The big proliferation of mobile communication systems has caused an increased concern about the interaction between the human body and the antennas of mobile handsets. In order to study the problem, a multiband antenna was designed, fabricated and measured to operate over two frequency sub bands 900 and 1800 MHz. After that, we simulated the same antenna, but now, in the presence of a human head model to analyze the head's influence. First, the influence of the human head on the radiation efficiency of the antenna has been investigated as a function of the distance between the head and the antenna and with the inclination of the antenna. Furthermore, the relative amount of the electromagnetic power absorbed in the head has been obtained. In this study the electromagnetic analysis has been performed via FDTD (Finite Difference Time Domain).

American Society of Anesthesiologists Score: Still Useful After 60 Years? Results of the EuSOS Study

OBJECTIVE: The European Surgical Outcomes Study described mortality following in-patient surgery. Several factors were identified that were able to predict poor outcomes in a multivariate analysis. These included age, procedure urgency, severity and type and the American Association of Anaesthesia score. This study describes in greater detail the relationship between the American Association of Anaesthesia score and postoperative mortality. METHODS: Patients in this 7-day cohort study were enrolled in April 2011. Consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery with a recorded American Association of Anaesthesia score in 498 hospitals across 28 European nations were included and followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Decision tree analysis with the CHAID (SPSS) system was used to delineate nodes associated with mortality. RESULTS: The study enrolled 46,539 patients. Due to missing values, 873 patients were excluded, resulting in the analysis of 45,666 patients. Increasing American Association of Anaesthesia scores were associated with increased admission rates to intensive care and higher mortality rates. Despite a progressive relationship with mortality, discrimination was poor, with an area under the ROC curve of 0.658 (95% CI 0.642 - 0.6775). Using regression trees (CHAID), we identified four discrete American Association of Anaesthesia nodes associated with mortality, with American Association of Anaesthesia 1 and American Association of Anaesthesia 2 compressed into the same node. CONCLUSION: The American Association of Anaesthesia score can be used to determine higher risk groups of surgical patients, but clinicians cannot use the score to discriminate between grades 1 and 2. Overall, the discriminatory power of the model was less than acceptable for widespread use.

O impacto do perfil do utente da USF durante o seu internamento

RESUMO - Introdução: Através da elaboração do presente projeto de investigação pretendeu-se analisar o que poderá influenciar o custo total de um utente internado, inscrito numa USF, que foi seguidamente internado no setor hospitalar. Recorreu-se à base de dados de uma USF e de um hospital, ambos pertencentes à ARS Alentejo do ano de 2010. O objetivo central consiste em estudar a relação do volume de consultas da USF e se o tipo de admissão no hospital, sendo ela programada ou não programada, explica a variância o custo do internamento. Metodologia: Foi efetuado o cruzamento entre os dados dos utentes inscritos na USF e o total de internamento hospitalar, utilizando a sua data de nascimento e respetivo sexo. Após efetuado o cruzamento, através de um procedimento estatístico com base em SPSS, foram estipuladas pressupostos de forma a encontrar uma associação entre o custo do utente internado com as variáveis da base de dados da USF. De seguida, foi verificado se o tipo de admissão do internamento pode ou não influenciar o custo do internamento. Para efetuar tais correlações, optei por separar a amostra consoante alguns dos seus grupos mais frequentes, em que foi desagregado os internamentos referentes ao GCD 14 – Gravidez, Parto e Puerpério e dos utentes pertencentes ao escalão etários dos idosos (mais de 64 anos). Resultados: A variável da idade do utente é a que mais poderá explicar a variância do custo do internamento, apresentando sempre valores significativos para tal relação. As restantes pouco ou nada podem explicar a variância do custo do internamento. Quanto à tipologia de admissão, o facto de ser programado poderá explicar a diminuição dos dias de internamento, que concomitantemente poderá diminuir o custo do internamento, devido a forte correlação existente entre elas (r=0,666). Conclusão: A introdução da integração dos cuidados de saúde a nível primário e secundário poderá ser a solução base para a redução dos gastos desnecessários na saúde. Um maior acompanhamento do utente nos CSP poderá reduzir a frequência hospitalar, como verificamos que as variáveis da USF e o facto de a consulta ser programada podem explicar tal variância.

L'Écho de Paris

1886/01/07 (Numéro 666).

Œuvres manuscrites de Gustave Flaubert (manuscrits définitifs, avec copies annotées, brouillons et notes). VIII Trois contes. Second volume

F. 407-513. La Légende de saint Julien l’Hospitalier. F. 407-480. Brouillons foliotés par l’auteur (alternance de chiffres arabes, ou romains, de lettres) : page de titre portant « St Julien l’hospitalier/Brouillons » (f. 407). Les feuillets sont utilisés recto-verso, les versos étant rédigés tête bêche (sauf f. 414v, 451v, 480v). Les rectos et les versos peuvent se rapporter à des chapitres différents. F. 481-513. La Légende de saint Julien l’Hospitalier. Notes, plan, scénario. F. 481-486, 490, 495-513. Notes et plan de 1856 : notes sur l’architecture militaire (f. 481-486) ; notes sur la chevalerie, extraites de Jean-Baptiste de La Curne de Sainte Palaye, Mémoires sur l’ancienne chevalerie (f. 495-496) ; notes sur la chasse (f. 497) ; notes extraites du Mesnagier de Paris (f. 498-501, 503bis-504) ; notes extraites de Jean-Baptiste-Jacques Le Verrier de la Conterie, L’Ecole de la chasse au chien courant (f. 502-503) ; notes extraites de Jacques Du Fouilloux, La Vénerie (505-510v) ; notes et dessins de bois de cerfs et de « fumées » d’après Jacques Du Fouilloux (f. 511-512) ; notes sur la vénerie (f. 513) ; plan en cinq parties (f. 490). F. 487-489, 491-494. Notes et scénario de 1875 : « Cerf » (f. 487) ; « Vol » (f. 488) ; « Vautrait » (f. 489) ; « Pièges » (f. 491) ; « Chiens » (f. 491v) ; scénario de 1875, chapitre I (f. 492), chapitre II (f. 493), chapitre III (f. 494). F. 514-759. Hérodias. F. 514-536v. Manuscrit de travail incomplet d’une grande partie du chapitre I, foliotée 7-29 par l’auteur : page de titre portant : « Herodias/Ms incomplet. » (f. 514) ; fin du chapitre I (f. 515-516) ; chapitre II (f. 517-526) ; chapitre III (f. 527-536) ; au f. 536v, brouillon, rédigé tête-bêche, d’un passage du chapitre I. F. 537-656. Brouillons foliotés par l’auteur (alternance de chiffres arabes, ou romains, de lettres) : page de titre portant « Herodias/brouillons » (f. 537) ; chapitre I (f. 538-551) ; chapitre II (f. 552-615) ; chapitre III (f. 616-656) daté : « mercredi soir 31 janvier 1877/ 10h 10m » (f. 656). Les feuillets sont utilisés recto-verso, les versos étant rédigés tête bêche ; les rectos et les versos peuvent se rapporter à des chapitres différents. F. 657-759. Hérodias. Notes et scénarios parfois foliotés par l’auteur (alternance de chiffres arabes, ou romains, de lettres) : page de titre portant « Herodias./notes. » (f. 657). F. 658-701. Notes de lecture et de travail : notes de lecture extraites de Etienne-Marc Quatremère, Mémoire sur les Nabatéens (f. 658) ; notes de lecture extraites de Henry-Baker Tristram, The Land of Moab (f. 659) ; notes de lecture extraites d’Auguste Parent, Machaerous (f. 660-661) ; notes de lecture sur Jérusalem (f. 662) ; notes de lecture extraites de Joseph Derenbourg, Essai sur l’histoire et la géographie de la Palestine (f. 663-664) ; notes de lecture extraites de Champagny, Rome et la Judée au temps de la chute de Néron (f. 665) ; notes sur l’histoire biblique (f. 666) ; « Romains » (f. 667-668) ; notes extraites de Suétone sur Auguste, Tibère et Vitellius (f. 669) ; « Mœurs romano-orientales » (f. 670) ; notes de lecture extraites de Flavius Josèphe, la Guerre des Juifs (f. 671-674, 692) ; « Parthes » (f. 675-676) ; « Arabes » (f. 677) ; « Religions orientales et romaines » (f. 678) ; notes sur la magie (f. 679) ; « Doctrines religieuses des juifs » (f. 680) ; « St Jean Baptiste » (f. 681) ; « Jean Baptiste/évangiles » (f. 682) ; « Juifs » (f. 683-684) ; « Prophètes » (f. 685-686) ; « Psaumes » (f. 687) ; notes sur l’histoire biblique (f. 688) ; « Apocryphes » (f. 689-690) ; « Juifs » (f. 691) ; « Festins » (f. 693) ; notes de lecture extraites de Smith, Dictionnary of the Bible (f. 694) ; « Machabées » (f. 695) ; notes de lecture extraites de Félicien de Saulcy, Histoire d’Hérode (f. 696-697) ; « Administration militaire et religieuse » (f. 698) ; « Paysages, notes de voyage » (f. 699) ; « Festin » (f. 700) ; « Personnages » (f. 701). F. 701v-759. Scénarios et brouillons. Quelques feuillets portent des notes diverses : « Personnages » (f. 702) ; « Festin » (f. 703) ; « Résumé » en trois parties (f. 704) ; « Machaerous » (f. 705) ; « Sens du mot messie »(f. 706) ; « Messie (f. 707) ; notes pour la scène du festin (f.740, 744v) ; notes de lecture extraites de Saulcy et de Renan (f. 741-743v) ; « St jean » (f. 747) ; notes sur l’histoire biblique (f. 756).