Late Adverse Effects of the Coadministration of Valproate and Lamotrigine

Individuals treated with combined valproate-lamotrigine rarely present late adverse effects (unrelated to introduction and titration). We describe four patients in whom such effects occurred after continuous, long-term use of valproate-lamotrigine (at 9 months to 2 years after final antiepileptic drug adjustment). The patients presented heterogeneous disturbances, including ataxia, vertigo, and headache, and rare movement disorders, such as tics and abnormal eye movements. Although these effects are heterogeneous in their occurrence and timing, they can alert physicians to the possibility of late neurologic disturbances, and must be considered in order to avoid unnecessary ancillary tests. Treatment discontinuation is unnecessary, given that a small decrease in dose led to remission of these adverse effects. (c) 2012 Elsevier Inc. All rights reserved.

Analysis of elastic functionally graded materials under large displacements via high-order tetrahedral elements

The purpose of this study is to present a position based tetrahedral finite element method of any order to accurately predict the mechanical behavior of solids constituted by functionally graded elastic materials and subjected to large displacements. The application of high-order elements makes it possible to overcome the volumetric and shear locking that appears in usual homogeneous isotropic situations or even in non-homogeneous cases developing small or large displacements. The use of parallel processing to improve the computational efficiency, allows employing high-order elements instead of low-order ones with reduced integration techniques or strain enhancements. The Green-Lagrange strain is adopted and the constitutive relation is the functionally graded Saint Venant-Kirchhoff law. The equilibrium is achieved by the minimum total potential energy principle. Examples of large displacement problems are presented and results confirm the locking free behavior of high-order elements for non-homogeneous materials. (C) 2011 Elsevier B.V. All rights reserved.

Temporomandibular disorders, otologic symptoms and depression levels in tinnitus patients

The aim of this study was to determine the prevalence of signs and symptoms of temporomandibular disorders (TMD) and otologic symptoms in patients with and without tinnitus. The influence of the level of depression was also addressed. The tinnitus group was comprised of 100 patients with tinnitus, and control group was comprised of 100 individuals without tinnitus. All subjects were evaluated using the research diagnostic criteria for temporomandibular disorders (RDC/TMD) to determine the presence of TMD and depression level. Chi-square, Spearman Correlation and Mann-Whitney tests were used in statistical analysis, with a 5% significance level. TMD signs and symptoms were detected in 85% of patients with tinnitus and in 55% of controls (P = 0.001). The severity of pain and higher depression levels were positively associated with tinnitus (P = 0.001). It was concluded that tinnitus is associated with TMD and with otalgia, dizziness/vertigo, stuffy sensations, hypoacusis sensation and hyperacusis, as well as with higher depression levels.

Continuous enzymatic interesterification of lard and soybean oil blend: Effects of different flow rates on physical properties and acyl migration

Continuous enzymatic interesterification is an alternative to chemical interesterification for lipid modification technology which is economically viable for large scale use. A blend of 70% lard and 30% soybean oil was submitted to continuous enzymatic interesterification in a glass tubular bioreactor at flow rate ranging from 0.5 to 4.5 mL/min. The original mixture and the reaction products obtained were examined to determine melting and crystallization behavior by DSC, and analyzed for regiospecific fatty acid distribution. Continuous enzymatic interesterification changed the mixture, forming a new triacylglycerol composition, verified by DSC curves and variation in enthalpy of melting values. The regiospecific distribution of fatty acids was changed by flow variations in the reactor. In the continuous enzymatic interesterification reaction the flow rate of 4.5 mL/min, was more advantageous than slower flow rates, reducing acyl migration and increasing process productivity. (C) 2011 Elsevier B.V. All rights reserved.

STATE INSTITUTIONS, POWER, AND SOCIAL NETWORKS IN BRAZILIAN URBAN POLICIES

A large historiographic tradition has studied the Brazilian state, yet we know relatively little about its internal dynamics and particularities. The role of informal, personal, and unintentional ties has remained underexplored in most policy network studies, mainly because of the pluralist origin of that tradition. It is possible to use network analysis to expand this knowledge by developing mesolevel analysis of those processes. This article proposes an analytical framework for studying networks inside policy communities. This framework considers the stable and resilient patterns that characterize state institutions, especially in contexts of low institutionalization, particularly those found in Latin America and Brazil. The article builds on research on urban policies in Brazil to suggest that networks made of institutional and personal ties structure state organizations internally and insert them,into broader political scenarios. These networks, which I call state fabric, frame politics, influence public policies, and introduce more stability and predictability than the majority of the literature usually considers. They also form a specific power resource-positional power, associated with the positions that political actors occupy-that influences politics inside and around the state.

Impact of benign childhood epilepsy with centrotemporal spikes (BECTS) on school performance

BECTS represents the vast majority of childhood focal epilepsy. Owing to the age peculiarity of children who suffer from this disease, i.e., school-going age of between 6 and 9 years, the condition is often referred to as a school disorder by parents and teachers. Objective: The aim of this study was to evaluate the academic performance of children with BED'S, according to the clinical and electroencephalographic ILAE criteria, and compare the results of neuropsychological tests of language and attention to the frequency of epileptic discharges. Methods: The performances of 40 school children with BED'S were evaluated by applying a school performance test (SBT), neuropsychological tests (WISC and Trail-Making), and language tests (Illinois Test Psycholinguistic Abilities - ITPA - and Staggered Spondaic Word - SSW). The same tests were applied in the control group. Results: Children with BED'S, when compared to those in the control group, showed lower scores in academic performance (SPT), digits and similarities subtests of WISC, auditory processing subtest of SSW, and ITPA - representational and automatic level. The study showed that epileptic discharges did not influence the results. Conclusion: Children with BED'S scored significantly lower scores in tests on academic performance, when compared with those in the control group probably due to executive dysfunction. (C) 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Huckebein is part of a combinatorial repression code in the anterior blastoderm

The hierarchy of the segmentation cascade responsible for establishing the Drosophila body plan is composed by gap, pair-rule and segment polarity genes. However, no pair-rule stripes are formed in the anterior regions of the embryo. This lack of stripe formation, as well as other evidence from the literature that is further investigated here, led us to the hypothesis that anterior gap genes might be involved in a combinatorial mechanism responsible for repressing the cis-regulatory modules (CRMs) of hairy (h), even-skipped (eve), runt (run), and fushi-tarazu (ftz) anterior-most stripes. In this study, we investigated huckebein (hkb), which has a gap expression domain at the anterior tip of the embryo. Using genetic methods we were able to detect deviations from the wild-type patterns of the anterior-most pair-rule stripes in different genetic backgrounds, which were consistent with Hkb-mediated repression. Moreover, we developed an image processing tool that, for the most part, confirmed our assumptions. Using an hkb misexpression system, we further detected specific repression on anterior stripes. Furthermore, bioinformatics analysis predicted an increased significance of binding site clusters in the CRMs of h 1, eve 1, run 1 and ftz 1 when Hkb was incorporated in the analysis, indicating that Hkb plays a direct role in these CRMs. We further discuss that Hkb and Slp1, which is the other previously identified common repressor of anterior stripes, might participate in a combinatorial repression mechanism controlling stripe CRMs in the anterior parts of the embryo and define the borders of these anterior stripes. (C) 2011 Elsevier Inc. All rights reserved.

Pre-procambial cells are niches for pluripotent and totipotent stem-like cells for organogenesis and somatic embryogenesis in the peach palm: a histological study

The direct induction of adventitious buds and somatic embryos from explants is a morphogenetic process that is under the influence of exogenous plant growth regulators and its interactions with endogenous phytohormones. We performed an in vitro histological analysis in peach palm (Bactris gasipaes Kunth) shoot apexes and determined that the positioning of competent cells and their interaction with neighboring cells, under the influence of combinations of exogenously applied growth regulators (NAA/BAP and NAA/TDZ), allows the pre-procambial cells (PPCs) to act in different morphogenic pathways to establish niche competent cells. It is likely that there has been a habituation phenomenon during the regeneration and development of the microplants. This includes promoting the tillering of primary or secondary buds due to culturing in the absence of NAA/BAP or NAA/TDZ after a period in the presence of these growth regulators. Histological analyses determined that the adventitious roots were derived from the dedifferentiation of the parenchymal cells located in the basal region of the adventitious buds, with the establishment of rooting pole, due to an auxin gradient. Furthermore, histological and histochemical analyses allowed us to characterize how the PPCs provide niches for multipotent, pluripotent and totipotent stem-like cells for vascular differentiation, organogenesis and somatic embryogenesis in the peach palm. The histological and histochemical analyses also allowed us to detect the unicellular or multicellular origin of somatic embryogenesis. Therefore, our results indicate that the use of growth regulators in microplants can lead to habituation and to different morphogenic pathways leading to potential niche establishment, depending on the positioning of the competent cells and their interaction with neighboring cells. Key message Our results indicate that the use of growth regulators in microplants can lead to habituation and to different morphogenic pathways leading to potential niche establishment, depending on the positioning of the competent cells and their interaction with neighboring cells.

Conjugated Linoleic Acid: good or bad nutrient

Conjugated linoleic acid (CLA) is a class of 28 positional and geometric isomers of linoleic acid octadecadienoic.Currently, it has been described many benefits related to the supplementation of CLA in animals and humans, as in the treatment of cancer, oxidative stress, in atherosclerosis, in bone formation and composition in obesity, in diabetes and the immune system. However, our results show that, CLA appears to be not a good supplement in patients with cachexia.

Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study

Abstract Background Dizziness is a common complaint among older adults and has been linked to a wide range of health conditions, psychological and social characteristics in this population. However a profile of dizziness is still uncertain which hampers clinical decision-making. We therefore sought to explore the relationship between dizziness and a comprehensive range of demographic data, diseases, health and geriatric conditions, and geriatric syndromes in a representative sample of community-dwelling older people. Methods This is a cross-sectional, population-based study derived from FIBRA (Network for the Study of Frailty in Brazilian Elderly Adults), with 391 elderly adults, both men and women, aged 65 years and older. Elderly participants living at home in an urban area were enrolled through a process of random cluster sampling of census regions. The outcome variable was the self-report of dizziness in the last year. Several feelings of dizziness were investigated including vertigo, spinning, light or heavy headedness, floating, fuzziness, giddiness and instability. A multivariate logistic regression analysis was conducted to estimate the adjusted odds ratios and build the probability model for dizziness. Results The complaint of dizziness was reported by 45% of elderly adults, from which 71.6% were women (p=0.004). The multivariate regression analysis revealed that dizziness is associated with depressive symptoms (OR = 2.08; 95% CI 1.29–3.35), perceived fatigue (OR = 1.93; 95% CI 1.21-3.10), recurring falls (OR = 2.01; 95% CI 1.11-3.62) and excessive drowsiness (OR = 1.91; 95% CI 1.11–3.29). The discrimination of the final model was AUC = 0.673 (95% CI 0.619-0.727) (p< 0.001). Conclusions The prevalence of dizziness in community-dwelling elderly adults is substantial. It is associated with other common geriatric conditions usually neglected in elderly adults, such as fatigue and drowsiness, supporting its possible multifactorial manifestation. Our findings demonstrate the need to expand the design in future studies, aiming to estimate risk and identify possible causal relations.

Wavelet analysis of heart rate variability related to nocturnal frontal lobe epilepsy seizures

Introduction: Nocturnal frontal lobe epilepsy (NFLE) is a distinct syndrome of partial epilepsy whose clinical features comprise a spectrum of paroxysmal motor manifestations of variable duration and complexity, arising from sleep. Cardiovascular changes during NFLE seizures have previously been observed, however the extent of these modifications and their relationship with seizure onset has not been analyzed in detail. Objective: Aim of present study is to evaluate NFLE seizure related changes in heart rate (HR) and in sympathetic/parasympathetic balance through wavelet analysis of HR variability (HRV). Methods: We evaluated the whole night digitally recorded video-polysomnography (VPSG) of 9 patients diagnosed with NFLE with no history of cardiac disorders and normal cardiac examinations. Events with features of NFLE seizures were selected independently by three examiners and included in the study only if a consensus was reached. Heart rate was evaluated by measuring the interval between two consecutive R-waves of QRS complexes (RRi). RRi series were digitally calculated for a period of 20 minutes, including the seizures and resampled at 10 Hz using cubic spline interpolation. A multiresolution analysis was performed (Daubechies-16 form), and the squared level specific amplitude coefficients were summed across appropriate decomposition levels in order to compute total band powers in bands of interest (LF: 0.039062 - 0.156248, HF: 0.156248 - 0.624992). A general linear model was then applied to estimate changes in RRi, LF and HF powers during three different period (Basal) (30 sec, at least 30 sec before seizure onset, during which no movements occurred and autonomic conditions resulted stationary); pre-seizure period (preSP) (10 sec preceding seizure onset) and seizure period (SP) corresponding to the clinical manifestations. For one of the patients (patient 9) three seizures associated with ictal asystole were recorded, hence he was treated separately. Results: Group analysis performed on 8 patients (41 seizures) showed that RRi remained unchanged during the preSP, while a significant tachycardia was observed in the SP. A significant increase in the LF component was instead observed during both the preSP and the SP (p<0.001) while HF component decreased only in the SP (p<0.001). For patient 9 during the preSP and in the first part of SP a significant tachycardia was observed associated with an increased sympathetic activity (increased LF absolute values and LF%). In the second part of the SP a progressive decrease in HR that gradually exceeded basal values occurred before IA. Bradycardia was associated with an increase in parasympathetic activity (increased HF absolute values and HF%) contrasted by a further increase in LF until the occurrence of IA. Conclusions: These data suggest that changes in autonomic balance toward a sympathetic prevalence always preceded clinical seizure onset in NFLE, even when HR changes were not yet evident, confirming that wavelet analysis is a sensitive technique to detect sudden variations of autonomic balance occurring during transient phenomena. Finally we demonstrated that epileptic asystole is associated with a parasympathetic hypertonus counteracted by a marked sympathetic activation.

Computer simulations of two-dimensional colloidal crystals in confinement

Monte Carlo simulations are used to study the effect of confinement on a crystal of point particles interacting with an inverse power law potential in d=2 dimensions. This system can describe colloidal particles at the air-water interface, a model system for experimental study of two-dimensional melting. It is shown that the state of the system (a strip of width D) depends very sensitively on the precise boundary conditions at the two ``walls'' providing the confinement. If one uses a corrugated boundary commensurate with the order of the bulk triangular crystalline structure, both orientational order and positional order is enhanced, and such surface-induced order persists near the boundaries also at temperatures where the system in the bulk is in its fluid state. However, using smooth repulsive boundaries as walls providing the confinement, only the orientational order is enhanced, but positional (quasi-) long range order is destroyed: The mean-square displacement of two particles n lattice parameters apart in the y-direction along the walls then crosses over from the logarithmic increase (characteristic for $d=2$) to a linear increase (characteristic for d=1). The strip then exhibits a vanishing shear modulus. These results are interpreted in terms of a phenomenological harmonic theory. Also the effect of incommensurability of the strip width D with the triangular lattice structure is discussed, and a comparison with surface effects on phase transitions in simple Ising- and XY-models is made

The bursting behavior of gas slugs: laboratory and analytical insights into Strombolian volcanic eruptions.

The aim of this thesis is to study how explosive behavior and geophysical signals in a volcanic conduit are related to the development of overpressure in slug-driven eruptions. A first suite of laboratory experiments of gas slugs ascending in analogue conduits was performed. Slugs ascended into a range of analogue liquids and conduit diameters to allow proper scaling to the natural volcanoes. The geometrical variation of the slug in response to the explored variables was parameterised. Volume of gas slug and rheology of the liquid phase revealed the key parameters in controlling slug overpressure at bursting. Founded on these results, a theoretical model to calculate burst overpressure for slug-driven eruptions was developed. The dimensionless approach adopted allowed to apply the model to predict bursting pressure of slugs at Stromboli. Comparison of predicted values with measured data from Stromboli volcano showed that the model can explain the entire spectrum of observed eruptive styles at Stromboli – from low-energy puffing, through normal Strombolian eruptions, up to paroxysmal explosions – as manifestations of a single underlying physical process. Finally, another suite of laboratory experiments was performed to observe oscillatory pressure and forces variations generated during the expansion and bursting of gas slugs ascending in a conduit. Two end-member boundary conditions were imposed at the base of the pipe, simulating slug ascent in closed base (zero magma flux) and open base (constant flux) conduit. At the top of the pipe, a range of boundary conditions that are relevant at a volcanic vent were imposed, going from open to plugged vent. The results obtained illustrate that a change in boundary conditions in the conduit concur to affect the dynamic of slug expansion and burst: an upward flux at the base of the conduit attenuates the magnitude of the pressure transients, while a rheological stiffening in the top-most region of conduit changes dramatically the magnitude of the observed pressure transients, favoring a sudden, and more energetic pressure release into the overlying atmosphere. Finally, a discussion on the implication of changing boundary on the oscillatory processes generated at the volcanic scale is also given.

Statistische Betrachtungen und mößbauerspektroskopische Untersuchungen von Ordnungszuständen in Biotiten

Im Mittelpunkt der vorliegenden Arbeit standen Untersuchungen zu strukturellen Ordnungs- und Unordnungsphänomenen an natürlichen, substitutionellen Mischkristallen. Aufgrund der enormen Vielfalt an potentiellen Austauschpartnern wurden hierfür Vertreter der Biotit-Mischkristallreihe "Phlogopit-Annit" ausgewählt. Ihr modulartiger Aufbau ermöglichte die gezielte Beschreibung von Verteilungsmustern anionischer und kationischer Merkmalsträger innerhalb der Oktaederschicht der Biotit-Mischkristalle. Basierend auf der postulierten Bindungsaffinität zwischen Mg2+ und F- einerseits und Fe2+ und OH- andererseits, wurde die strukturelle Separation einer Fluor-Phlogopit-Komponente als primäre Ausprägungsform des Mg/F-Ordnungsprinzips abgeleitet. Im Rahmen dieser Modellvorstellung koexistieren im makroskopisch homogenen Biotit-Mischkristall Domänen zweier chemisch divergenter Phasen nebeneinander: Eine rein Mg2+/F- - führende Phlogopit-Phase und eine Wirtskristallphase, die mit fortschreitender Separation bzw. Entmischung der erstgenannten Phase sukzessive reicher an einer hydroxylführenden eisenreichen Annit-Komponente wird. Zwecks numerischer Beschreibung diverser Stadien der Entmischungsreaktion wurden die Begriffe der "Relativen" und "Absoluten Domänengröße" eingeführt. Sie stellen ein quantitatives Maß zur Beurteilung der diskutierten Ordnungsphänomene dar. Basierend auf einem sich stetig ändernden Chemismus der Wirtskristallphase kann jeder Übergangszustand zwischen statistischer Verteilung und vollständiger Ordnung durch das korrespondierende Verteilungsmuster der interessierenden Merkmalsträger ( = Nahordnungskonfiguration und Besetzungswahrscheinlichkeit) charakterisiert und beschrieben werden. Durch mößbauerspektroskopische Untersuchungen konnten die anhand der entwickelten Modelle vorhergesagten Ausprägungsformen von Ordnungs-/Unordnungsphänomenen qualitativ und quantitativ verifiziert werden. Es liessen sich hierbei zwei Gruppen von Biotit-Mischkristallen unterscheiden. Eine erste Gruppe, deren Mößbauer-Spektren durch den OH/F-Chemismus als dominierendes Differenzierungsmerkmal geprägt wird, und eine zweite Gruppe, deren Mößbauer-Spektren durch Gruppierungen von höherwertigen Kationen und Vakanzen ( = Defektchemie) geprägt wird. Auf der Basis von Korrelationsdiagrammen, die einen numerischen und graphischen Bezug zwischen absoluter und relativer Domänengröße einerseits und experimentell zugänglichem Mößbauer-Parameter A (= relativer Flächenanteil, korrespondierend mit der Besetzungswahrscheinlichkeit einer bestimmten Nahordnungs-konstellation) andererseits herstellen, konnten für die erste Gruppe die Volumina der beiden miteinander koexistierenden Komponenten "Hydroxyl-Annit reicher Wirtskristall" und "Fluor-Phlogopit" exakt quantifiziert werden. Das Spektrum der untersuchten Proben umfasste hierbei Kristallspezies, die einerseits durch geringe bis mittlere Mg2+/F- - bzw. Fe2+/OH- -Ordnungsgrade gekennzeichnet sind, andererseits eine nahezu vollständige Ordnung der interessierenden Merkmalsträger Mg2+, Fe2+, OH- und F- widerspiegeln. Desweiteren konnte der Nachweis geführt werden, dass für ausgewählte Proben eine quantitative Bestimmung der Defektvolumina möglich ist.

Crystal phases and glassy dynamics in monodisperse hard ellipsoids

We have performed Monte Carlo and molecular dynamics simulations of suspensions of monodisperse, hard ellipsoids of revolution. Hard-particle models play a key role in statistical mechanics. They are conceptually and computationally simple, and they offer insight into systems in which particle shape is important, including atomic, molecular, colloidal, and granular systems. In the high density phase diagram of prolate hard ellipsoids we have found a new crystal, which is more stable than the stretched FCC structure proposed previously . The new phase, SM2, has a simple monoclinic unit cell containing a basis of two ellipsoids with unequal orientations. The angle of inclination is very soft for length-to-width (aspect) ratio l/w=3, while the other angles are not. A symmetric state of the unit cell exists, related to the densest-known packings of ellipsoids; it is not always the stable one. Our results remove the stretched FCC structure for aspect ratio l/w=3 from the phase diagram of hard, uni-axial ellipsoids. We provide evidence that this holds between aspect ratios 3 and 6, and possibly beyond. Finally, ellipsoids in SM2 at l/w=1.55 exhibit end-over-end flipping, warranting studies of the cross-over to where this dynamics is not possible. Secondly, we studied the dynamics of nearly spherical ellipsoids. In equilibrium, they show a first-order transition from an isotropic phase to a rotator phase, where positions are crystalline but orientations are free. When over-compressing the isotropic phase into the rotator regime, we observed super-Arrhenius slowing down of diffusion and relaxation, and signatures of the cage effect. These features of glassy dynamics are sufficiently strong that asymptotic scaling laws of the Mode-Coupling Theory of the glass transition (MCT) could be tested, and were found to apply. We found strong coupling of positional and orientational degrees of freedom, leading to a common value for the MCT glass-transition volume fraction. Flipping modes were not slowed down significantly. We demonstrated that the results are independent of simulation method, as predicted by MCT. Further, we determined that even intra-cage motion is cooperative. We confirmed the presence of dynamical heterogeneities associated with the cage effect. The transit between cages was seen to occur on short time scales, compared to the time spent in cages; but the transit was shown not to involve displacements distinguishable in character from intra-cage motion. The presence of glassy dynamics was predicted by molecular MCT (MMCT). However, as MMCT disregards crystallization, a test by simulation was required. Glassy dynamics is unusual in monodisperse systems. Crystallization typically intervenes unless polydispersity, network-forming bonds or other asymmetries are introduced. We argue that particle anisometry acts as a sufficient source of disorder to prevent crystallization. This sheds new light on the question of which ingredients are required for glass formation.