Aetiologies of pulseless electrical activity in out-of-hospital cardiac arrests:A retrospective study and analysis of specific causes

Background: Pulseless electrical activity (PEA) cardiac arrest is defined as a cardiac arrest (CA) presenting with a residual organized electrical activity on the electrocardiogram. In the last decades, the incidence of PEA has regularly increased, compared to other types of CA like ventricular fibrillation or pulseless ventricular tachycardia. PEA is frequently induced by reversible conditions. The "4 (or 5) H" & "4 (or 5) T" are proposed as a mnemonic to asses for Hypoxia, Hypovolemia, Hypo- /Hyperkalaemia, Hypothermia, Thrombosis (cardiac or pulmonary), cardiac Tamponade, Toxins, and Tension pneumothorax. Other pathologies (intracranial haemorrhage, severe sepsis, myocardial contraction dysfunction) have been identified as potential causes for PEA, but their respective probability and frequencies are unclear and they are not yet included into the resuscitation guidelines. The aim of this study was to analyse the aetiologies of PEA out-of-hospital CA, in order to evaluate the relative frequencies of each cause and therefore to improve the management of patients suffering a PEA cardiac arrest. Method: This retrospective study was based on data routinely and prospectively collected for each PEMS intervention. All adult patients treated from January 1st 2002 to December 2012 31st by the PEMS for out-of-hospital cardiac arrest, with PEA as the first recorded rhythm, and admitted to the emergency department (ED) of the Lausanne University Hospital were included. The aetiologies of PEA cardiac arrest were classified into subgroups, based on the classical H&T's classification, supplemented by four other subgroups analysis: trauma, intra-cranial haemorrhage (ICH), non-ischemic cardiomyopathy (NIC) and undetermined cause. Results: 1866 OHCA were treated by the PEMS. PEA was the first recorded rhythm in 240 adult patients (13.8 %). After exclusion of 96 patients, 144 patients with a PEA cardiac arrest admitted to the ED were included in the analysis. The mean age was 63.8 ± 20.0 years, 58.3% were men and the survival rate at 48 hours was 29%. 32 different causes of OHCA PEA were established for 119 patients. For 25 patients (17.4 %), we were unable to attribute a specific cause for the PEA cardiac arrest. Hypoxia (23.6 %), acute coronary syndrome (12.5%) and trauma (12.5 %) were the three most frequent causes. Pulmonary embolism, Hypovolemia, Intoxication and Hyperkaliemia occurs in less than 10% of the cases (7.6 %, 5.6 %, 3.5%, respectively 2.1 %). Non ischemic cardiomyopathy and intra-cranial haemorrhage occur in 8.3 % and 6.9 %, respectively. Conclusions: According to our results, intra-cranial haemorrhage and non-ischemic cardiomyopathy represent noticeable causes of PEA in OHCA, with a prevalence equalling or exceeding the frequency of classical 4 H's and 4 T's aetiologies. These two pathologies are potentially accessible to simple diagnostic procedures (native CT-scan or echocardiography) and should be included into the 4 H's and 4 T's mnemonic.

Distribution and population genetic variation of cryptic species of the Alpine mayfly Baetis alpinus (Ephemeroptera: Baetidae) in the Central Alps.

BACKGROUND: Many species contain evolutionarily distinct groups that are genetically highly differentiated but morphologically difficult to distinguish (i.e., cryptic species). The presence of cryptic species poses significant challenges for the accurate assessment of biodiversity and, if unrecognized, may lead to erroneous inferences in many fields of biological research and conservation. RESULTS: We tested for cryptic genetic variation within the broadly distributed alpine mayfly Baetis alpinus across several major European drainages in the central Alps. Bayesian clustering and multivariate analyses of nuclear microsatellite loci, combined with phylogenetic analyses of mitochondrial DNA, were used to assess population genetic structure and diversity. We identified two genetically highly differentiated lineages (A and B) that had no obvious differences in regional distribution patterns, and occurred in local sympatry. Furthermore, the two lineages differed in relative abundance, overall levels of genetic diversity as well as patterns of population structure: lineage A was abundant, widely distributed and had a higher level of genetic variation, whereas lineage B was less abundant, more prevalent in spring-fed tributaries than glacier-fed streams and restricted to high elevations. Subsequent morphological analyses revealed that traits previously acknowledged as intraspecific variation of B. alpinus in fact segregated these two lineages. CONCLUSIONS: Taken together, our findings indicate that even common and apparently ecologically well-studied species may consist of reproductively isolated units, with distinct evolutionary histories and likely different ecology and evolutionary potential. These findings emphasize the need to investigate hidden diversity even in well-known species to allow for appropriate assessment of biological diversity and conservation measures.

Sexual dimorphism of sonic apparatus and extreme intersexual variation of sounds in Ophidion rochei (Ophidiidae): first evidence of a tight relationship between morphology and sound characteristics in Ophidiidae

Many Ophidiidae are active in dark environments and display complex sonic apparatus morphologies. However, sound recordings are scarce and little is known about acoustic communication in this family. This paper focuses on Ophidion rochei which is known to display an important sexual dimorphism in swimbladder and anterior skeleton. The aims of this study were to compare the sound producing morphology, and the resulting sounds in juveniles, females and males of O. rochei.Results: Males, females, and juveniles possessed different morphotypes. Females and juveniles contrasted with males because they possessed dramatic differences in morphology of their sonic muscles, swimbladder, supraoccipital crest, and first vertebrae and associated ribs. Further, they lacked the ‘rocker bone’ typically found in males. Sounds from each morphotype were highly divergent. Males generally produced non harmonic, multiple-pulsed sounds that lasted for several seconds (3.5 ± 1.3 s) with a pulse period of ca. 100 ms. Juvenile and female sounds were recorded for the first time in ophidiids. Female sounds were harmonic, had shorter pulse period (±3.7 ms), and never exceeded a few dozen milliseconds (18 ± 11 ms). Moreover, unlike male sounds, female sounds did not have alternating long and short pulse periods. Juvenile sounds were weaker but appear to be similar to female sounds.Conclusions: Although it is not possible to distinguish externally male from female in O. rochei, they show a sonic apparatus and sounds that are dramatically different. This difference is likely due to their nocturnal habits that may have favored the evolution of internal secondary sexual characters that help to distinguish males from females and that could facilitate mate choice by females. Moreover, the comparison of different morphotypes in this study shows that these morphological differences result from a peramorphosis that takes place during the development of the gonads

Seasonal variation of the major secondary metabolites present in the extract of Eremanthus mattogrossensis Less (Asteraceae: Vernonieae) leaves

The species Eremanthus mattogrossensis, known as "veludo do cerrado" (cerrado velvet), is native to the Brazilian Cerrado. Because the amount of metabolites present in plants may be influenced by biological and environmental factors, here we conducted an HPLC-DAD-MS/MS investigation of the metabolite concentrations found in the MeOH/H2O extract of the leaves of this species. The main compounds were identified and quantified, and the metabolites were grouped by chemical class (caffeoylquinic acids, flavonoids, and sesquiterpene lactone). Statistical analysis indicated a straight correlation between the quantity of metabolites and seasonality, suggesting that environmental properties elicit important metabolic responses.

Variation of essential oil composition of Tapirira guianensis Aubl. (Anacardiaceae) from two sandbank forests, north of Brazil

Tapirira guianensis (Anacardiaceae) is used in traditional medicine and is important for the recovery of degraded areas and riparian forests because the T. guianensis fruits are highly consumed by wildlife. Volatile components from dried leaves and branches of five individual plants of T. guianensis were collected in two sandbank forests of the State of Pará (Extractive Reserve Maracanã and Area of Environmental Protection Algodoal/Maiandeua), extracted by hydrodistillation using a Clevenger-type apparatus, and analyzed by GC/MS. The ten oils obtained are comprised mostly of sesquiterpene hydrocarbons (58.49 to 100%), with (E)-caryophyllene, β-selinene, α-selinene, β-sesquiphellandrene, and α-zingiberene being the most prominent. The results of the oil compositions were processed by Hierarchical Component Analysis (HCA) allowing the establishment of three groups of essential oils for T. guianensis differentiated by the content of β-selinene/α-selinene (Type I), (E)-caryophyllene (Type II), and β-sesquiphellandrene/α-zingiberene (Type III).

Immersion enthalpy variation of surface-modified mineral activated carbon in lead (II) aqueous solution adsorption: the relation between immersion enthalpy and adsorption capacity

An activated carbon was obtained by chemical activation with phosphoric acid, CM, from a mineral carbon. Afterwards, the carbon was modified with 2 and 5 molL-1, CMox2 and CMox5 nitric acid solutions to increase the surface acid group contents. Immersion enthalpy at pH 4 values and Pb2+ adsorption isotherms were determined by immersing activated carbons in aqueous solution. The surface area values of the adsorbents and total pore volume were approximately 560 m².g-1 and 0.36 cm³g-1, respectively. As regards chemical characteristics, activated carbons had higher acid sites content, 0.92-2.42 meq g-1, than basic sites, 0.63-0.12 meq g-1. pH values were between 7.4 and 4.5 at the point of zero charge, pH PZC. The adsorbed quantity of Pb2+ and the immersion enthalpy in solution of different pH values for CM activated carbon showed that the values are the highest for pH 4, 15.7 mgg-1 and 27.6 Jg-1 respectively. Pb2+ adsorption isotherms and immersion enthalpy were determined for modified activated carbons and the highest values were obtained for the activated carbon that showed the highest content of total acid sites on the surface.

Factors associated with depressive symptoms in a sample of Brazilian medical students

OBJECTIVES: 1 - Verify the prevalence of depressive symptoms in first to fourth-year medical students using the Beck Depression Inventory (BDI). 2 - Establish correlations between target factors and higher or lower BDI scores. 3 - Investigate the relationship between the prevalence of depressive symptoms and the demand for psychological care offered by the Centro Universitário Lusíada. METHOD: Cross-sectional study of 290 first to fourth-year medical students; implementation of the BDI, socio-demographic survey, and evaluation of satisfaction with progress. RESULTS: The study sample was 59% female and 41% male. Mean BDI was 6.3 (SD 5.8). Overall prevalence of depressive symptoms was 23.1%. The following associations were statistically significant (p<0.05): among students for whom the course failed to meet original expectations, who were dissatisfied with the course, or who came from the interior of the State (20.5%, 12.5%, and 24.4% of the total sample, respectively), for 40%, 36.1% and 36.4%, respectively, the BDI was consistent with some degree of depression. CONCLUSION: The study showed that there is higher prevalence of depressive symptoms in medical students than in the general population

Of pearls and pigs : a conceptual-semantic Tiernet approach to formal representation of structure and variation of phraseological units

"Helmiä sioille", pärlor för svin, säger man på finska om någonting bra och fint som tas emot av en mottagare som inte vill eller har ingen förmåga att förstå, uppskatta eller utnyttja hela den potential som finns hos det mottagna föremålet, är ointresserad av den eller gillar den inte. För sådana relativt stabila flerordiga uttryck, som är lagrade i språkbrukarnas minnen och som demonstrerar olika slags oregelbundna drag i sin struktur använder man inom lingvistiken bl.a. termerna "idiom" eller "fraseologiska enheter". Som en oregelbundenhet kan man t.ex. beskriva det faktum att betydelsen hos uttrycket inte är densamma som man skulle komma till ifall man betraktade det som en vanlig regelbunden fras. En annan oregelbundenhet, som idiomforskare har observerat, ligger i den begränsade förmågan att varieras i form och betydelse, som många idiom har jämfört med regelbundna fraser. Därför talas det ofta om "grundform" och "grundbetydelse" hos idiom och variationen avses som avvikelse från dessa. Men när man tittar på ett stort antal förekomstexempel av idiom i språkbruk, märker man att många av dem tillåter variation, t.o.m. i sådan utsträckning att gränserna mellan en variant och en "grundform" suddas ut, och istället för ett idiom råkar vi plötsligt på en "familj" av flera besläktade uttryck. Allt detta väcker frågan om hur dessa uttryck egentligen ska vara representerade i språket. I avhandlingen utförs en kritisk granskning av olika tidigare tillvägagångssätt att beskriva fraseologiska enheter i syfte att klargöra vilka svårigheter deras struktur och variation erbjuder för den lingvistiska teorin. Samtidigt presenteras ett alternativt sätt att beskriva dessa uttryck. En systematisk och formell modell som utvecklas i denna avhandling integrerar en beskrivning av idiom på många olika språkliga nivåer och skildrar deras variation i form av ett nätverk och som ett resultat av samspel mellan idiomets struktur och kontexter där det förekommer, samt av interaktion med andra fasta uttryck. Modellen bygger på en fördjupande, språkbrukbaserad analys av det finska idiomet "X HEITTÄÄ HELMIÄ SIOILLE" (X kastar pärlor för svin).

VARIATION OF MICROFIBRIL ANGLE OF Pinus radiata D. Don IN RELATION TO TREE SPACING IN CHILEAN PLANTATIONS

ABSTRACTFour stands of 28-year-old radiata pine (Pinus radiata D. Don) grown in the eighth region (Biobio) of Chile were sampled to determine the effect of tree spacing on the microfibril angle. The samples were taken at two different stem levels of the tree, 2.5 m and 7.5 m, with increment strip taken in the Nothern direction. The four experimental stands were characterized by the following spacing 2x2, 2x3, 3x4 and 4x4. The microfibril angle was measured by X-ray diffraction with the SilviScan technology at the FP-Innovation-Paprican Division in Vancouver, Canada. The results showed a significant effect of tree spacing on the microfibril angle in both juvenile wood and mature wood as well as at the two stem levels considered. The minimum (9.42º) was reached in 2x2 stand at 7.5 m in mature wood, while maximum microfibril angle (24.54º) was obtained in 2x3 stand at 2.5 m in juvenile wood. Regarding the effect of tree spacing, 4x4 stand had the lowest microfibril angle,except in mature wood at 7.5 m where 4x4 had the highest microfibril angle (11°) of the four stands.

Determination of the influence of the variation of reducing and non-reducing sugars on coffee quality with use of artificial neural network

The present study aimed at evaluating the use of Artificial Neural Network to correlate the values resulting from chemical analyses of samples of coffee with the values of their sensory analyses. The coffee samples used were from the Coffea arabica L., cultivars Acaiá do Cerrado, Topázio, Acaiá 474-19 and Bourbon, collected in the southern region of the state of Minas Gerais. The chemical analyses were carried out for reducing and non-reducing sugars. The quality of the beverage was evaluated by sensory analysis. The Artificial Neural Network method used values from chemical analyses as input variables and values from sensory analysis as output values. The multiple linear regression of sensory analysis values, according to the values from chemical analyses, presented a determination coefficient of 0.3106, while the Artificial Neural Network achieved a level of 80.00% of success in the classification of values from the sensory analysis.

Floristic and structural variation of weeds in eucalyptus plantations as influenced by relief and time of year

The objective of this work was to analyze the floristic variation and phytosociological structure of weeds as influenced by relief and time of year in eucalyptus plantations in Santana do Paraíso and Guanhães - MG. The total area sampled for each locality was approximately 10 ± 3 hectares, comprising three types of relief: lowland, slope, and upper area. In each type of relief, 10 plots of 1 m² were sampled, corresponding to 30 plots per locality, where they were randomly allocated in a zigzag. The taxonomic identification was performed in four assessments, corresponding to the months of November and March, comprising two ratings each season, always at the same points, and geo-referenced using the Global Positioning System (GPS). A total of 3,893 individuals, 18 families and 61 species, were identified in Santana do Paraiso and a total of 1,166 individuals, 13 families and 58 species, in Guanhães. In both localities, the most representative families in terms of wealth were: Poaceae, Asteraceae, and Fabaceae. Galinsoga parviflora was the most abundant species. The Vernonia polyantes was identified only in the lowlands, while Arrabida florida was identified in the slope and upper area. On the other hand, Emilia coccinea, Sida rhombifolia, S. paniculatum and Spermacoce latifolia were common to all three environments. Commelina benghalensis was present only in the month of March, while G. parviflora was present only in the month of November. It was concluded that the floristic and phytosociological variation of weeds in eucalyptus plantations is influenced by the type of relief and time of year, which should guide the management practices used in the culture.

Industrialized cashew juices: variation of ascorbic acid and other physicochemical parameters

Commercial cashew apple juice is widely accepted in the Brazilian market. Cashew apple has high content of ascorbic acid, an important nutrient to human beings. Ascorbic acid content in food can be affected by processing and storage conditions. Commercial cashew apple juice samples, ready-to-drink and concentrated, were analyzed. The ascorbic acid content, total titratable acidity, total soluble solids, and pH of the juices were determined during storage at 4 °C after the containers were opened. The ascorbic acid content presented a great variability among the samples analyzed ranging from 37.3 to 46.3 mg.100 mL-1 in ready-to-drink juices and from 75.7 to 152 mg.100 mL-1 in concentrated juices. The storage of commercial cashew apple juices for 48 hours at 4 °C resulted in ascorbic acid losses of up to 8.8% for concentrated and 6.4% for ready-to-drink juices. The other parameters remained stable during storage. The results of this study point to the importance of considering ascorbic acid losses in commercial cashew apple juices which occurs after opening but before the expiration date expires.