Depressive symptoms as a novel risk factor for recurrent venous thromboembolism: a longitudinal observational study in patients referred for thrombophilia investigation.

BACKGROUND Increasing evidence suggests that psychosocial factors, including depression predict incident venous thromboembolism (VTE) against a background of genetic and acquired risk factors. The role of psychosocial factors for the risk of recurrent VTE has not previously been examined. We hypothesized that depressive symptoms in patients with prior VTE are associated with an increased risk of recurrent VTE. METHODS In this longitudinal observational study, we investigated 271 consecutive patients, aged 18 years or older, referred for thrombophilia investigation with an objectively diagnosed episode of VTE. Patients completed the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). During the observation period, they were contacted by phone and information on recurrent VTE, anticoagulation therapy, and thromboprophylaxis in risk situations was collected. RESULTS Clinically relevant depressive symptoms (HADS-D score ≥ 8) were present in 10% of patients. During a median observation period of 13 months (range 5-48), 27 (10%) patients experienced recurrent VTE. After controlling for sociodemographic and clinical factors, a 3-point increase on the HADS-D score was associated with a 44% greater risk of recurrent VTE (OR 1.44, 95% CI 1.02, 2.06). Compared to patients with lower levels of depressive symptoms (HADS-D score: range 0-2), those with higher levels (HADS-D score: range 3-16) had a 4.1-times greater risk of recurrent VTE (OR 4.07, 95% CI 1.55, 10.66). CONCLUSIONS The findings suggest that depressive symptoms might contribute to an increased risk of recurrent VTE independent of other prognostic factors. An increased risk might already be present at subclinical levels of depressive symptoms.

Investigation of sediment core PS2556 from Bellingshausen Sea, Antarctica

Die Rekonstruktion der glaziomarinen Sedimentationsprozesse am antarktischen Kontinentalrand des westlichen Bellingshausenmeeres erfolgte durch die sedimentologische Auswertung eines 962 cm langen Schwerelotkernes aus 3594 m Wassertiefe. Der Kern wurde während des Fahrtabschnittes ANT-XI/3 mit dem FS "Polarstern" vom Scheitel einer Sediment- "Drift" gezogen. An dem Sedimentkern wurde eine lithologische Beschreibung, sowie sedimentologische Untersuchungen und sedimentphysikalische Messungen durchgeführt. Anhand der Ergebnisse konnten signifikante Änderungen in der Zusammensetzung und Struktur der Sedimente erkannt, und drei Faziestypen unterschieden werden. Die Faziestypen charakterisieren jeweils glaziale oder interglaziale Zeiträume. Der größte Teil der Sedimentabfolge gehört der Laminitfazies an. Dabei handelt es sich um feinlaminierte Sedimentabschnitte, die vorwiegend aus feinkörnigen, terrigenen Komponenten zusammengesetzt sind. In die feinlaminierten Abschnitte sind vereinzelte, wenige Milimeter bis Zentimeter mächtige Siltlagen eingeschaltet. Die biogenen Anteile sind gering, Anzeichen für Bodenleben fehlen völlig. Die Manganfazies wird von authigen gebildeten Mangankonkretionen dominiert, die jeweils diskrete Lagen bilden. Dabei handelt es sich zum einen um Mikromanganknollen und -krusten und zum andern um manganhaltige Gangfüllungen. Biogene und terrigene Anteile sind in diesem Faziestyp unbedeutend. Die Biogenfazies ist von strukturlosen und stark bioturbierten Sedimenten gekennzeichnet. In diesen Sedimentabschnitten ist der hohe Anteil an Eisfracht (IRD) und die erhöhten Gehalte an Kalziumkarbonat und Opal in der Sandfraktion markant. Die stratigraphische Einordnung des Sedimentkernes erfolgte über die von Grobe & Mackensen (1992) entwickelte Lithostratigraphie, mit deren Einheiten die Faziestypen des Sedimentkernes korreliert werden konnten. Dabei ergaben sich zwei mögliche Altersmodelle und ein Basisalter von ca. 250.000 Jahren. Anhand der stratigraphischen Fixpunkte wurden Sedimentationsraten des Gesamtsedimentes und Akkumulationsraten des Kalziumkarbonates, des Biogenopals und des organisch gebundenen Kohlenstoffes berechnet. Dabei wurde gezeigt, daß lediglich das Kalziumkarbonat und der Biogenopal als Anzeiger für biologische Produktion dienen können, wobei Lösungsprozesse in der Wassersäule und im Sediment eine große Rolle spielen. Der Gehalt an organisch gebundenem Kohlenstoff ist in dem Sedimentkern nur erhaltungsbedingt zu erklären. Die Sedimentationsprozesse der einzelnen Faziestypen sind von den Eisverhältnissen, der biologischen Produktion, dem gravitativen Transport und der Umlagerung durch Meeresströmungen abhängig. Die Auswirkung der einzelnen Faktoren ist jeweils unterschiedlich ausgeprägt und wirkt sich spezifisch auf die einzelnen Parameter aus. In den Glazialen hatte ein Vorstoß des Schelfeises über die Schelfkante zur Anlieferung großer Sedimentmassen geführt, die über gravitativen Transport den Kontinentalhang hinunter transportiert wurden. Die Feinfracht wurde über parallel zum Kontinentalhang laufende Konturströme westwärts transportiert und in der Larninitfazies der Driftkörper abgelagert. Am Ende der Glaziale kam es zur Sedimentation der Manganfazies. Die geringen Sedimentationsraten am Kamm der Sedimentdrift kamen aufgrund reduzierter Intensität der Konturströme und fehlender Umlagerung von Schelfsedimenten in Folge rückschreitender Schelfeisrnassen zustande. In den Interglazialen kam es durch den aufsteigenden Meeresspiegel zum Aufschwimmen des Schelfeises. Der damit verbundene Abbau der Eisrnassen über dem Schelf, hatte eine hohe Sedimentation von IRD zur Folge. Mit fortschreitendem Interglazial kam es in Zeiten nur saisonaler Meereisbedeckung zu verstärkter biologischer Produktion und zur Sedimentation biogenen Materials.

A qualitative investigation into leader behavioural flexibility

Purpose – The current research aims to determine to what extent Australian managers are behaviourally flexible and to identify what factors are associated with the development of leader behavioural flexibility (LBF) and its contribution to positive organisational outcomes. Design/methodology/approach – Because of the exploratory nature of the questions to be addressed, a qualitative approach to data collection was selected. In particular, the grounded theory methodology was utilised due to its ability to aid with the theory building process. Semi-structured interviews based on the critical incident interview technique were used as the data source. Findings – The findings illustrate that the Australian managers who participated in this study exhibited significant degrees of LBF. The results also suggest that education level and group size may be antecedents to LBF. In addition, it appears that leader-member exchange may mediate the relationship between LBF and positive organisational outcomes, while social intelligence may moderate this relationship. Research limitations/implications – The current research makes several contributions in terms of theoretical development and reveals a richer insight into the underlying processes associated with the relationship between LBF and positive organisational outcomes. Practical implications – As the current research was conducted in the field with 20 practising organisational managers, the findings also highlight some important practical applications regarding LBF. Originality/value – Although previous studies have been able to establish a relationship between LBF and positive organisational outcomes, they have explained very little about the processes associated with this relationship. The present study attempted to uncover some of these processes.

Design and development of a time of flight fast scattering spectrometer : a quantitative surface analysis technique and a new approach towards the experimental investigation of the surface particle interactions

A new surface analysis technique has been developed which has a number of benefits compared to conventional Low Energy Ion Scattering Spectrometry (LEISS). A major potential advantage arising from the absence of charge exchange complications is the possibility of quantification. The instrumentation that has been developed also offers the possibility of unique studies concerning the interaction between low energy ions and atoms and solid surfaces. From these studies it may also be possible, in principle, to generate sensitivity factors to quantify LEISS data. The instrumentation, which is referred to as a Time-of-Flight Fast Atom Scattering Spectrometer has been developed to investigate these conjecture in practice. The development, involved a number of modifications to an existing instrument, and allowed samples to be bombarded with a monoenergetic pulsed beam of either atoms or ions, and provided the capability to analyse the spectra of scattered atoms and ions separately. Further to this a system was designed and constructed to allow incident, exit and azimuthal angles of the particle beam to be varied independently. The key development was that of a pulsed, and mass filtered atom source; which was developed by a cyclic process of design, modelling and experimentation. Although it was possible to demonstrate the unique capabilities of the instrument, problems relating to surface contamination prevented the measurement of the neutralisation probabilities. However, these problems appear to be technical rather than scientific in nature, and could be readily resolved given the appropriate resources. Experimental spectra obtained from a number of samples demonstrate some fundamental differences between the scattered ion and neutral spectra. For practical non-ordered surfaces the ToF spectra are more complex than their LEISS counterparts. This is particularly true for helium scattering where it appears, in the absence of detailed computer simulation, that quantitative analysis is limited to ordered surfaces. Despite this limitation the ToFFASS instrument opens the way for quantitative analysis of the 'true' surface region to a wider range of surface materials.

Experimental investigation and CFD simulation of insulation debris transport phenomena in water flow

The investigation of insulation debris generation, transport and sedimentation becomes important with regard to reactor safety research for PWR and BWR, when considering the long-term behavior of emergency core cooling systems during all types of loss of coolant accidents (LOCA). The insulation debris released near the break during a LOCA incident consists of a mixture of disparate particle population that varies with size, shape, consistency and other properties. Some fractions of the released insulation debris can be transported into the reactor sump, where it may perturb/impinge on the emergency core cooling systems. Open questions of generic interest are the sedimentation of the insulation debris in a water pool, its possible re-suspension and transport in the sump water flow and the particle load on strainers and corresponding pressure drop. A joint research project on such questions is being performed in cooperation between the University of Applied Sciences Zittau/Görlitz and the Forschungszentrum Dresden-Rossendorf. The project deals with the experimental investigation of particle transport phenomena in coolant flow and the development of CFD models for its description. While the experiments are performed at the University at Zittau/Görlitz, the theoretical modeling efforts are concentrated at Forschungszentrum Dresden-Rossendorf. In the presentation the basic concepts for CFD modeling are described and feasibility studies including the conceptual design of the experiments are presented.

Experimental investigation and CFD simulation of the behaviour of mineral wool in the reactor sump

The investigation of insulation debris generation, transport and sedimentation becomes important with regard to reactor safety research for PWR and BWR, when considering the long-term behavior of emergency core cooling systems during all types of loss of coolant accidents (LOCA). The insulation debris released near the break during a LOCA incident consists of a mixture of disparate particle population that varies with size, shape, consistency and other properties. Some fractions of the released insulation debris can be transported into the reactor sump, where it may perturb/impinge on the emergency core cooling systems. Open questions of generic interest are the sedimentation of the insulation debris in a water pool, its possible re-suspension and transport in the sump water flow and the particle load on strainers and corresponding pressure drop. A joint research project on such questions is being performed in cooperation between the University of Applied Sciences Zittau/Gorlitz and the Forschungszentrum Dresden-Rossendorf. The project deals with the experimental investigation of particle transport phenomena in coolant flow and the development of CFD models for its description. While the experiments are performed at the University at Zittau/Gorlitz, the theoretical modeling efforts are concentrated at Forschungszentrum Dresden-Rossendorf. In the current paper the basic concepts for CFD modeling are described and feasibility studies including the conceptual design of the experiments are presented. Copyright © 2008 by ASME.

Post Hoc Analysis Of The Patricia Randomized Trial Of The Efficacy Of Human Papillomavirus Type 16 (hpv-16)/hpv-18 As04-adjuvanted Vaccine Against Incident And Persistent Infection With Nonvaccine Oncogenic Hpv Types Using An Alternative Multiplex Type-specific Pcr Assay For Hpv Dna.

The efficacy of the human papillomavirus type 16 (HPV-16)/HPV-18 AS04-adjuvanted vaccine against cervical infections with HPV in the Papilloma Trial against Cancer in Young Adults (PATRICIA) was evaluated using a combination of the broad-spectrum L1-based SPF10 PCR-DNA enzyme immunoassay (DEIA)/line probe assay (LiPA25) system with type-specific PCRs for HPV-16 and -18. Broad-spectrum PCR assays may underestimate the presence of HPV genotypes present at relatively low concentrations in multiple infections, due to competition between genotypes. Therefore, samples were retrospectively reanalyzed using a testing algorithm incorporating the SPF10 PCR-DEIA/LiPA25 plus a novel E6-based multiplex type-specific PCR and reverse hybridization assay (MPTS12 RHA), which permits detection of a panel of nine oncogenic HPV genotypes (types 16, 18, 31, 33, 35, 45, 52, 58, and 59). For the vaccine against HPV types 16 and 18, there was no major impact on estimates of vaccine efficacy (VE) for incident or 6-month or 12-month persistent infections when the MPTS12 RHA was included in the testing algorithm versus estimates with the protocol-specified algorithm. However, the alternative testing algorithm showed greater sensitivity than the protocol-specified algorithm for detection of some nonvaccine oncogenic HPV types. More cases were gained in the control group than in the vaccine group, leading to higher point estimates of VE for 6-month and 12-month persistent infections for the nonvaccine oncogenic types included in the MPTS12 RHA assay (types 31, 33, 35, 45, 52, 58, and 59). This post hoc analysis indicates that the per-protocol testing algorithm used in PATRICIA underestimated the VE against some nonvaccine oncogenic HPV types and that the choice of the HPV DNA testing methodology is important for the evaluation of VE in clinical trials. (This study has been registered at ClinicalTrials.gov under registration no. NCT00122681.).

Investigation Of Genetic Factors Underlying Typical Orofacial Clefts: Mutational Screening And Copy Number Variation.

Typical orofacial clefts (OFCs) comprise cleft lip, cleft palate and cleft lip and palate. The complex etiology has been postulated to involve chromosome rearrangements, gene mutations and environmental factors. A group of genes including IRF6, FOXE1, GLI2, MSX2, SKI, SATB2, MSX1 and FGF has been implicated in the etiology of OFCs. Recently, the role of the copy number variations (CNVs) has been studied in genetic defects and diseases. CNVs act by modifying gene expression, disrupting gene sequence or altering gene dosage. The aims of this study were to screen the above-mentioned genes and to investigate CNVs in patients with OFCs. The sample was composed of 23 unrelated individuals who were grouped according to phenotype (associated with other anomalies or isolated) and familial recurrence. New sequence variants in GLI2, MSX1 and FGF8 were detected in patients, but not in their parents, as well as in 200 control chromosomes, indicating that these were rare variants. CNV screening identified new genes that can influence OFC pathogenesis, particularly highlighting TCEB3 and KIF7, that could be further analyzed. The findings of the present study suggest that the mechanism underlying CNV associated with sequence variants may play a role in the etiology of OFC.

Lesão muscular : estudo a partir da equipe brasileira de atletismo que participou dos jogos olimpicos de Atlanta - 1996

Universidade Estadual de Campinas . Faculdade de Educação Física

Numerical investigation of the three-dimensional secondary instabilities in the time-developing compressible mixing layer

Mixing layers are present in very different types of physical situations such as atmospheric flows, aerodynamics and combustion. It is, therefore, a well researched subject, but there are aspects that require further studies. Here the instability of two-and three-dimensional perturbations in the compressible mixing layer was investigated by numerical simulations. In the numerical code, the derivatives were discretized using high-order compact finite-difference schemes. A stretching in the normal direction was implemented with both the objective of reducing the sound waves generated by the shear region and improving the resolution near the center. The compact schemes were modified to work with non-uniform grids. Numerical tests started with an analysis of the growth rate in the linear regime to verify the code implementation. Tests were also performed in the non-linear regime and it was possible to reproduce the vortex roll-up and pairing, both in two-and three-dimensional situations. Amplification rate analysis was also performed for the secondary instability of this flow. It was found that, for essentially incompressible flow, maximum growth rates occurred for a spanwise wavelength of approximately 2/3 of the streamwise spacing of the vortices. The result demonstrated the applicability of the theory developed by Pierrehumbet and Widnall. Compressibility effects were then considered and the maximum growth rates obtained for relatively high Mach numbers (typically under 0.8) were also presented.

Spectroscopic characterization and investigation of the dynamic of charge compensation process of supramolecular films derived from tetra-2-pyridyl-1,4-pyrazine ligand

This work describes the infrared spectroscopy characterization and the charge compensation dynamics in supramolecular film FeTPPZFeCN derived from tetra-2-pyridyl-1,4-pyrazine (TPPZ) with hexacyanoferrate, as well as the hybrid film formed by FeTPPZFeCN and polypyrrole (PPy). For supramolecular film, it was found that anion flux is greater in a K+ containing solution than in Li+ solution, which seems to be due to the larger crystalline ionic radius of K+. The electroneutralization process is discussed in terms of electrostatic interactions between cations and metallic centers in the hosting matrix. The nature of the charge compensation process differs from others modified electrodes based on Prussian blue films, where only cations such as K+ participate in the electroneutralization process. In the case of FeTPPZFeCN/PPy hybrid film, the magnitude of the anions’s flux is also dependent on the identity of the anion of the supporting electrolyte.

Investigation of measles IgM-seropositive cases of febrile rash illnesses in the absence of documented measles virus transmission, State of São Paulo, Brazil, 2000-2004

Introdução: Revisar os casos de doenças febris exantemáticas com IgM reagente contra o sarampo, no estado de São Paulo, Brasil, durante os cinco anos seguidos a interrupção da transmissão do vírus do sarampo. Métodos: Nós revisamos 463 casos de doenças febris exantemáticas com IgM reagente contra o sarampo, no estado de São Paulo, Brasil, de 2000 a 2004. Indivíduos vacinados contra o sarampo 56 dias antes da coleta de amostra foram considerados expostos à vacina. Soros da fase aguda e de convalescença foram testados para a evidência de infecção de sarampo, rubéola, parvovírus B19 e herpes vírus 6. Na ausência de soroconversão para imunoglobulina G contra o sarampo, casos com IgM reagente contra o sarampo foram considerados falsos positivos em pessoas com evidência de outras infecções virais. Resultados: Entre as 463 pessoas com doenças febris exantemáticas que testaram positivo para anticorpos IgM contra o sarampo durante o período, 297 (64 por cento) pessoas foram classificadas como expostas à vacina. Entre os 166 casos não expostos à vacina, 109 (66 por cento) foram considerados falsos positivos baseado na ausência de soroconversão, dos quais 21 (13 por cento) tiveram evidência de infecção por vírus da rubéola, 49 (30 por cento) parvovírus B19 e 28 (17 por cento) infecção por herpes vírus humano 6. Conclusões: Após a interrupção da transmissão do vírus do sarampo é necessária exaustiva investigação dos casos com IgM reagente contra o sarampo, especialmente dos casos não expostos à vacina. Testes laboratoriais para etiologias das doenças febris exantemáticas ajudam na interpretação destes casos

Preliminary biocompatibility investigation of magnetic albumin nanosphere designed as a potential versatile drug delivery system

Background: The magnetic albumin nanosphere (MAN), encapsulating maghemite nanoparticles, was designed as a magnetic drug delivery system (MDDS) able to perform a variety of biomedical applications. It is noteworthy that MAN was efficient in treating Ehrlich's tumors by the magnetohyperthermia procedure. Methods and materials: In this study, several nanotoxicity tests were systematically carried out in mice from 30 minutes until 30 days after MAN injection to investigate their biocompatibility status. Cytometry analysis, viability tests, micronucleus assay, and histological analysis were performed. Results: Cytometry analysis and viability tests revealed MAN promotes only slight and temporary alterations in the frequency of both leukocyte populations and viable peritoneal cells, respectively. Micronucleus assay showed absolutely no genotoxicity or cytotoxicity effects and histological analysis showed no alterations or even nanoparticle clusters in several investigated organs but, interestingly, revealed the presence of MAN clusters in the central nervous system (CNS). Conclusion: The results showed that MAN has desirable in vivo biocompatibility, presenting potential for use as a MDDS, especially in CNS disease therapy.

Investigation of a magnetohyperthermia system efficacy

This study reports on the successful use of magnetic albumin nanosphere (MAN) with in vivo magnetohyperthermia (MHT) in a mouse Ehrlich tumor. Maghemite nanoparticles (8.9 nm average diameter) were encapsulated within MAN (73.0 nm average diameter). Ehrlich tumor obtained after implantation of tumor cells in the subcutaneous tissue of mice was used as a model throughout this study. MHT was performed with MAN (40 mu L) containing 1.2 x 10(15) particle/mL and 40 Oe amplitude ac magnetic field oscillating at 1 MHz. Animals not treated, treated with MAN, or exposed to the ac field were used as controls. Histopathological analysis was carried out after 2, 5, or 11 days of tumor implantation. We found that the MHT most efficient condition was obtained while applying the ac field protocol twice a day during three consecutive days. Further, in this ac field-treated group no proliferation cells were detected. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3559498]

Genetic Variants of Diabetes Risk and Incident Cardiovascular Events in Chronic Coronary Artery Disease

Objective: To determine whether information from genetic risk variants for diabetes is associated with cardiovascular events incidence. Methods: From the about 30 known genes associated with diabetes, we genotyped single-nucleotide polymorphisms at the 10 loci most associated with type-2 diabetes in 425 subjects from the MASS-II Study, a randomized study in patients with multi-vessel coronary artery disease. The combined genetic information was evaluated by number of risk alleles for diabetes. Performance of genetic models relative to major cardiovascular events incidence was analyzed through Kaplan-Meier curve comparison and Cox Hazard Models and the discriminatory ability of models was assessed for cardiovascular events by calculating the area under the ROC curve. Results: Genetic information was able to predict 5-year incidence of major cardiovascular events and overall-mortality in non-diabetic individuals, even after adjustment for potential confounders including fasting glycemia. Non-diabetic individuals with high genetic risk had a similar incidence of events then diabetic individuals (cumulative hazard of 33.0 versus 35.1% of diabetic subjects). The addition of combined genetic information to clinical predictors significantly improved the AUC for cardiovascular events incidence (AUC = 0.641 versus 0.610). Conclusions: Combined information of genetic variants for diabetes risk is associated to major cardiovascular events incidence, including overall mortality, in non-diabetic individuals with coronary artery disease.