Serodiagnosis of staphylococcal sepsis

The coagulase-negative staphylococci are the most frequent cause of sepsis associated with indwelling intravascular catheters. Current microbiological investigations to support the diagnosis of catheter-related sepsis (CRS) include the culture of blood and catheter tips, however positive results may reflect specimen contamination, or colonisation of the catheter rather than true sepsis. Previous serological approaches to assist in the diagnosis of CRS based on cellular staphylococcal antigens have been of limited value. In this current study, the serodiagnostic potential of an exocellular antigen produced by 7 strains of coagulase-negative staphylococci cultured in brain heart infusion broth was investigated. Antigenic material isolated by gel permeation from liquid culture was characterised by immunological techniques and chemical analysis. Characterisation of the exocellular antigen revealed a novel glycerophosphoglycolipid, termed lipid S. which shared antigenic determinants with lipoteichoic acid, but differed by comprising a glycerophosphate chain length of only 6 units. In addition, lipid S was immunologically distinct from diphosphatidyl glycerol, a constituent cell membrane phospho lipid. An indirect enzyme linked immunosorbent assay (ELISA) based on lipid S was subsequently developed and used to determine serum antibody levels (IgM and IgG) in 67 patients with CRS due to staphylococci, and 67 patients with a central venous catheter (CVC) in situ who exhibited no evidence of sepsis. The sensitivity and specificity of the lipid S IgG ELISA was 75% and 90% respectively whilst the IgM assay had sensitivity and specificity of 52% and 85%. The addition of GullSORereagent to the EL1SA procedure to remove competing serum IgG and rheumatoid factor did not significantly improve the performance of the IgM assay. The serological response in serial serum samples of 13 patients with CRS due to staphylococci was investigated. Elevated levels of antibody were detected at an early stage of infection, prior to the isolation of microorganisms by standard culture methods, and before the clinical presentation of sepsis in 3 patients. The lipid S ELISA was later optimised and a rapid 4-hour assay developed for the serodiagnosis of CRS. Serum IgG levels were determined in 40 patients with CRS due to staphylococci and 40 patients with a CVC in situ who exhibited no evidence of sepsis. The sensitivity and specificity of the rapid IgG assay was 70% and 100% respectively. Elevated serum antibody levels in patients with endocarditis, prosthetic joint infection and pyogenic spondylodiscitis due to Gram-positive cocci were also detected with the lipid S ELISA suggesting that the assay may facilitate the diagnosis of these infections. Unexpected increased levels of anti-lipid S IgG in 31% of control patients with sciatica suggested a possible microbial aetiology of this condition. Further investigation of some of these patients by culture of microdiscectomy tissue removed at operation, revealed the presence of low-virulent microorganisms in 37% of patients of which Propionibacterium aeries accounted for 85% of the positive culture isolates. The results suggested a previously unrecognised association between P. acnes and sciatica, which may have implications for the future management of the condition.

Improving envelopment in Data Envelopment Analysis under variable returns to scale

In a Data Envelopment Analysis model, some of the weights used to compute the efficiency of a unit can have zero or negligible value despite of the importance of the corresponding input or output. This paper offers an approach to preventing inputs and outputs from being ignored in the DEA assessment under the multiple input and output VRS environment, building on an approach introduced in Allen and Thanassoulis (2004) for single input multiple output CRS cases. The proposed method is based on the idea of introducing unobserved DMUs created by adjusting input and output levels of certain observed relatively efficient DMUs, in a manner which reflects a combination of technical information and the decision maker's value judgements. In contrast to many alternative techniques used to constrain weights and/or improve envelopment in DEA, this approach allows one to impose local information on production trade-offs, which are in line with the general VRS technology. The suggested procedure is illustrated using real data. © 2011 Elsevier B.V. All rights reserved.

Advances in data envelopment analysis

Since its introduction in 1978, data envelopment analysis (DEA) has become one of the preeminent nonparametric methods for measuring efficiency and productivity of decision making units (DMUs). Charnes et al. (1978) provided the original DEA constant returns to scale (CRS) model, later extended to variable returns to scale (VRS) by Banker et al. (1984). These ‘standard’ models are known by the acronyms CCR and BCC, respectively, and are now employed routinely in areas that range from assessment of public sectors, such as hospitals and health care systems, schools, and universities, to private sectors, such as banks and financial institutions (Emrouznejad et al. 2008; Emrouznejad and De Witte 2010). The main objective of this volume is to publish original studies that are beyond the two standard CCR and BCC models with both theoretical and practical applications using advanced models in DEA.

Airline Deregulation, Computerized Reservation Systems, and Travel Agents

With the beginning of airline deregulations in 1978, U.S. domestic operations were in for a period of turmoil, adjustment, vibrancy, entrepreneurship, and change. A great deal has been written about the effects of deregulation on airlines and their personnel, and on the public at large. Less attention has been paid to the effects on travel agents and on the seminal role of computerized reservations systems (CRSs) in the flowering of travel agencies. This article examines both of these phenomena.

Pore water and solid-phase data from site Scharendijke (Lake Grevelingen, NL)

Will be submitted by the author

Physiological energetics of the thick shell mussel Mytilus coruscus exposed to seawater acidification and thermal stress

Anthropogenic CO2 emissions have caused seawater temperature elevation and ocean acidification. In view of both phenomena are occurring simultaneously, their combined effects on marine species must be experimentally evaluated. The purpose of this study was to estimate the combined effects of seawater acidification and temperature increase on the energy budget of the thick shell mussel Mytilus coruscus. Juvenile mussels were exposed to six combined treatments with three pH levels (8.1, 7.7 and 7.3) * two temperatures (25 °C and 30 °C) for 14 d. We found that clearance rates (CRs), food absorption efficiencies (AEs), respiration rates (RRs), ammonium excretion rates (ER), scope for growth (SFG) and O:N ratios were significantly reduced by elevated temperature sometimes during the whole experiments. Low pH showed significant negative effects on RR and ER, and significantly increased O:N ratios, but showed almost no effects on CR, AE and SFG of M. coruscus. Nevertheless, their interactive effects were observed in RR, ER and O:N ratios. PCA revealed positive relationships among most physiological indicators, especially between SFG and CR under normal temperatures compared to high temperatures. PCA also showed that the high RR was closely correlated to an increasing ER with increasing pH levels. These results suggest that physiological energetics of juvenile M. coruscus are able to acclimate to CO2 acidification with a little physiological effect, but not increased temperatures. Therefore, the negative effects of a temperature increase could potentially impact the ecophysiological responses of M. coruscus and have significant ecological consequences, mainly in those habitats where this species is dominant in terms of abundance and biomass.

Espessura da zona de transição do manto sob a Província Borborema, NE Brasil, através de conversões Ps telessísmicas

The mantle transition zone is defined by two seismic discontinuities, nominally at 410 and 660 km depth, which result from transformations in the mineral olivine. The topography of these discontinuities provides information about lateral temperature changes in the transition zone. In this work, P-to-S conversions from teleseismic events recorded at 32 broadband stations in the Borborema Province were used to determine the transition zone thickness beneath this region and to investigate whether there are lateral temperature changes within this depth range. For this analysis, stacking and migration of receiver functions was performed. In the Borborema Province, geophysical studies have revealed a geoid anomaly which could reflect the presence of a thermal anomaly related to the origin of intraplate volcanism and uplift that marked the evolution of the Province in the Cenozoic. Several models have been proposed to explain these phenomena, which include those invoking the presence of a deep-seated mantle plume and those invoking shallower sources, such as small-scale convection cells. The results of this work show that no thermal anomalies are present at transition zone depths, as significant variations in the transition zone thickness were not observed. However, regions of depressed topography for both discontinuities (410 and 660 km) that approximately overlap in space were identified, suggesting that lower-thanaverage, lateral variations in seismic velocity above 410 km depth may exist below the the Borborema Province. This is consistent with the presence of a thermally-induced, low-density body independently inferred from analysis of geoid anomalies. Therefore, the magma source responsible for the Cenozoic intraplate volcanism and related uplift in the Province, is likely to be confined above the upper mantle transition zone.

Avaliação do controle da diagênese na qualidade de reservatório siliciclástico do cenomaniano superior da formação Açu, sudoeste da bacia potiguar

The distribution of diagenetic alterations in Late Cenomanian siliciclastic reservoirs from Potiguar Basin was influenced by the stratigraphic framework and the depositional system. Seismic sections and geophysical logs of two wells drilled in the SW portion of the mentioned basin above register regional stratigraphic surfaces representing maximum floods related to a transgressive event. The sequential analysis of 80 m of drill core (~450 m deep) recognized nine depositional facies with an upwards granodecrescent standard piling that limits cycles with an erosional conglomeratic base (lag) overlain by intercalations of medium to very fine sandstones showing cross bedding (channel, planar and low angled) and horizontal bedding (plane-parallel , wave and flaser). The top of the cycles is marked by the deposition of pelites and the development of paleosoils and lagoons. The correlation of genetically related facies reveals associations of channel fillings, crevasse, and flood plains deposited in a transgressive system. Detailed descriptions of seventy nine thin sections aided by MEV-EBSD/EDS, DRX and stable isotope analyses in sandstones revealed an arcosian composition and complex textural arrays with abundant smectite fringes continuously covering primary components, mechanically infiltrated cuticles and moldic and intragrain pores. K-feldspar epitaxial overgrowth covers microcline and orthoclase grains before any other phase. Abundant pseudomatrix due to the compactation of mud intraclasts concentrate along the stratification planes, locally replaced by macrocristalline calcite and microcrystalline and framboidal pyrite. Kaolinite (booklets and vermicular), microcrystalline smectite, microcrystalline titanium minerals and pyrite replace the primary components. The intergrain porosity prevails over the moldic, intragrain and contraction porosities. The pores are poorly connected due to the presence of intergranular smectite, k-feldspar overgrowth, infiltrated mud and pseudomatrix. The sandstones were subjected to eodiagenetic conditions next to the surface and shallow burial mesodiagenetic conditions. The diagenetic alterations reduced the porosity and the permeability mainly due to the precipitation of smectite fringes, compactation of mud intraclasts onto the pseudomatrix and cementing by poikilotopic calcite characterizing different reservoir petrofacies. These diagenetic products acted as barriers and detours to the flow of fluids thus reducing the quality of the reservoir.

Avaliação imunoistoquímica de CD34 e triptase em cistos odontogênicos radiculares e cistos dentígeros inflamados

Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq

Avaliação imunoistoquímica de CD34 e triptase em cistos odontogênicos radiculares e cistos dentígeros inflamados

Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq

Chemical and mineral composition of rocks from the Philippine Sea

The book is devoted to geology of the Philippine Sea floor. This region is studied most extensively among other marginal seas of the Pacific Ocean. Rocks of the sedimentary and basalt layers within this sea have been studied during five legs of D/S Glomar Challenger. International geological expedition on board R/V Dmitry Mendeleev carried out according to the Project ''Ophiolites of Continents and Comparable Rocks of the Ocean Floor''obtained unique collection of rocks from the second and third layers of the ocean crust in the Philippine Sea. The book provides detailed petrographic and geochemical description of igneous and sedimentary formations from the Philippine Sea and compares them with rocks of the continental ophiolite association. An analysis of structure and history of the ocean crust formation in the region is based on all known geological information. The main periods of tectonic movement activation and nature of their manifestations within the sea are shown.

Chemical composition and stable sulfur isotope record of Black Sea sediments

The main terminal processes of organic matter mineralization in anoxic Black Sea sediments underlying the sulfidic water column are sulfate reduction in the upper 2-4 m and methanogenesis below the sulfate zone. The modern marine deposits comprise a ca. 1-m-deep layer of coccolith ooze and underlying sapropel, below which sea water ions penetrate deep down into the limnic Pleistocene deposits from >9000 years BP. Sulfate reduction rates have a subsurface maximum at the SO4[2-]-CH4 transition where H2S reaches maximum concentration. Because of an excess of reactive iron in the deep limnic deposits, most of the methane-derived H2S is drawn downward to a sulfidization front where it reacts with Fe(III) and with Fe2+ diffusing up from below. The H2S-Fe2+ transition is marked by a black band of amorphous iron sulfide above which distinct horizons of greigite and pyrite formation occur. The pore water gradients respond dynamically to environmental changes in the Black Sea with relatively short time constants of ca. 500 yr for SO4[2-] and 10 yr for H2S, whereas the FeS in the black band has taken ca. 3000 yr to accumulate. The dual diffusion interfaces of SO4[2-]-CH4 and H2S-Fe2+ cause the trapping of isotopically heavy iron sulfide with delta34S = +15 to +33 per mil at the sulfidization front. A diffusion model for sulfur isotopes shows that the SO4[2-] diffusing downward into the SO4[2-]-CH4 transition has an isotopic composition of +19 per mil, close to the +23 per mil of H2S diffusing upward. These isotopic compositions are, however, very different from the porewater SO4[2-] (+43 per mil) and H2S (-15 per mil) at the same depth. The model explains how methane-driven sulfate reduction combined with a deep H2S sink leads to isotopically heavy pyrite in a sediment open to diffusion. These results have general implications for the marine sulfur cycle and for the interpretation of sulfur isotopic data in modern sediments and in sedimentary rocks throughout earth's history.

Pore water and solid-phase measurements on sediment cores from the Black Sea

The surface sediments in the Black Sea are underlain by extensive deposits of iron (Fe) oxide-rich lake sediments that were deposited prior to the inflow of marine Mediterranean Sea waters ca. 9000 years ago. The subsequent downward diffusion of marine sulfate into the methane-bearing lake sediments has led to a multitude of diagenetic reactions in the sulfate-methane transition zone (SMTZ), including anaerobic oxidation of methane (AOM) with sulfate. While the sedimentary cycles of sulfur (S), methane and Fe in the SMTZ have been extensively studied, relatively little is known about the diagenetic alterations of the sediment record occurring below the SMTZ. Here we combine detailed geochemical analyses of the sediment and pore water with multicomponent diagenetic modeling to study the diagenetic alterations below the SMTZ at two sites in the western Black Sea. We focus on the dynamics of Fe, S and phosphorus (P) and demonstrate that diagenesis has strongly overprinted the sedimentary burial records of these elements. Our results show that sulfate-mediated AOM substantially enhances the downward diffusive flux of sulfide into the deep limnic deposits. During this downward sulfidization, Fe oxides, Fe carbonates and Fe phosphates (e.g. vivianite) are converted to sulfide phases, leading to an enrichment in solid phase S and the release of phosphate to the pore water. Below the sulfidization front, high concentrations of dissolved ferrous Fe (Fe2+) lead to sequestration of downward diffusing phosphate as authigenic vivianite, resulting in a transient accumulation of total P directly below the sulfidization front. Our model results further demonstrate that downward migrating sulfide becomes partly re-oxidized to sulfate due to reactions with oxidized Fe minerals, fueling a cryptic S cycle and thus stimulating slow rates of sulfate-driven AOM (~ 1-100 pmol/cm**3/d) in the sulfate-depleted limnic deposits. However, this process is unlikely to explain the observed release of dissolved Fe2+ below the SMTZ. Instead, we suggest that besides organoclastic Fe oxide reduction, AOM coupled to the reduction of Fe oxides may also provide a possible mechanism for the high concentrations of Fe2+ in the pore water at depth. Our results reveal that methane plays a key role in the diagenetic alterations of Fe, S and P records in Black Sea sediments. The downward sulfidization into the limnic deposits is enhanced through sulfate-driven AOM with sulfate and AOM with Fe oxides may provide a deep source of dissolved Fe2+ that drives the sequestration of P in vivianite below the sulfidization front.

Prevalência da síndrome metabólica em receptores de transplante renal de acordo com o gênero e tempo pós-transplante /

Metabolic syndrome (MS) is defined as a set of cardiovascular risk factors including obesity, systemic high blood pressure (SHBP), changes in glucose metabolism and dyslipidemia. The prevalence of MS in renal transplant recipients (RTR) ranges from 15% to 65%, increasing the risk of cardiovascular disease (CVD) and reducing renal allograft survival in the long term. The objectives of this study were to determine the prevalence and frequency of MS in renal transplant patients according to gender and time of transplantation and to evaluate renal function in patients with and without MS. Patients and Methods: Crosssectional study conducted from August 2012 to September 2013 involving 153 renal transplant recipients. MS was defined according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). The sample was divided into two groups: patients with metabolic syndrome (WMS patients) and patients without metabolic syndrome (WoMS patients) and according to gender. The WMS patients were stratified into quartiles according to the renal transplantation period (RTP), and variables related to MS were analyzed for both sexes. Results: MS was diagnosed in 58.1% of the studied population, specifically in MS was found 58.4% of men and 41.6% of women (P ˂ 0.05). The male and female with MS were 48.8 ± 11.6 years old vs. 47.1 ± 12.7 years old and the time of post transplantation was 76.1 ± 76.5 months vs. 84.7 ± 65.4 months, respectively (P >0,05). When we compared the sexes in the WMS group, systolic blood pressure (SBP) was higher in men (137.0 ± 18.1 vs. 128.9 ± 13.6 mmHg, P= 0.029), while the other components of MS did not exhibit significant differences. With respect to renal function, when we compared the sexes in the WMS group, the serum creatinine (sCr) was higher in men (1.73 ± 0.69 vs. 1.31 ± 0.47 mg/dL, P= 0.0012), while the urinary protein/creatinine ratio was higher in women (0.48 ± 0.69 vs. 0.37 ± 0.48 mg/dL, P=0.0150). We found no significant difference in the estimated glomerular filtration rate (eGFR) between WMS and WoMS patients for women and men (50.6 ± 19.1 vs. 50.1 ± 18.3 mL/min/1.73 m², P=0.909). We found a significant positive association between eGFR and HDL-c levels (r=0.3371; P=0.0145) for WMS men. The MS components showed no significant differences in RTP for different interquartile ranges, except for diastolic blood pressure (DBP) in women, where there was a significant variation among the quartiles evaluated (P=0.0009). Conclusion: the prevalence of MS was similar in the different quartiles in both sexes, in relation to time post TX. There was no significant difference in eGFR in patients WMS and WoMS, in both sexes. Concluding that the MS did not vary in relation to time post transplant.

Émergence et développement de l’oncologie au Québec : collaboration, compétition et défis organisationnels, 1900-2005

Objectifs : le principal objectif de notre projet doctoral consiste à mettre en relief les transformations qui ont marqué le développement de l’oncologie et de la lutte contre le cancer au Québec au 20e siècle. Pour ce faire, nous nous sommes penchées sur trois niveaux d’analyse : 1) le niveau micro aborde l’organisation des services médicaux au sein d’une organisation hospitalière, soit l’Hôtel-Dieu de Québec. 2) Le niveau méso analyse une lutte professionnelle, soit la lutte entre les hématologues et les oncologues médicaux pour la reconnaissance de l’oncologie médicale. 3) Le niveau macro s’intéresse à l’organisation de la lutte contre le cancer à travers la province de Québec et aux différents modèles organisationnels créés. Principale hypothèse : l’émergence et la transformation de l’oncologie et de la lutte contre le cancer ont été influencées des rapports de collaboration et de compétition entre les acteurs impliqués en oncologie. En effet, il apparaît que ce champ se trouve en tension entre l’obligation de collaborer pour offrir des services de qualité aux patients et les dynamiques professionnelles et/ou organisationnelles. Cadre théorique : un cadre théorique a été développé pour chacun des niveaux d’analyse. Le niveau micro s’inspire des travaux de Frickel, Abbott et Strauss et s’intéresse plus particulièrement aux négociations entourant l’ordre social au sein d’un hôpital universitaire; le niveau méso emploie les travaux de Bourdieu et Abbott pour analyser la lutte entre deux spécialités médicales pour le contrôle des agents de chimiothérapie; et le niveau macro, de la sociologie des organisations et de la théorie néo-institutionnaliste pour mettre en relief l’émergence et la transformation de la lutte contre le cancer au Québec au 20e siècle. Méthodologie : l’approche de l’étude de cas a été adoptée et chaque niveau d’analyse constitue une étude de cas à part entière. Le corpus de données se compose de données archivistiques recueillies dans 10 centres d’archives canadiens, et de données d’entrevues. Une soixantaine d’entrevues avec des oncologues, des professionnels de la santé, des gestionnaires, des chercheurs et des fonctionnaires ont été réalisées. Conclusion : les différents niveaux d’analyse offrent différentes contributions qui leurs sont propres, mais l’ensemble de la thèse tend à mettre en relief la complexité du changement organisationnel à travers un perpétuel processus de définition et de redéfinition des frontières professionnelles et des organisations en raison du développement des connaissances scientifiques, des technologies, des expertises professionnelles et de l’environnement social, politique et économique.