First-episode psychosis in a 15 year-old female with clinical presentation of anti-NMDA receptor encephalitis: a case report and review of the literature

BACKGROUND: Anti-NMDA receptor encephalitis is an autoimmune disease that was identified in 2007, and manifests in a stepwise manner with psychiatric, neurological and autonomic symptoms. The disease is caused by autoantibodies against NMDA receptors. It can have a paraneoplastic origin, mainly secondary to ovarian teratomas, but it can also be unrelated to the tumor. This disease can affect both sexes and all ages. CASE PRESENTATION: Here, we present a case of a 15 year-old female adolescent with first-episode psychosis with anti-NMDA receptor encephalitis not related to tumor, which manifested with delusion, hallucinations, panic attacks, agitation, and neurological symptoms, and later with autonomic instability. She was treated with immunotherapy and psychiatric medication resulting in improvement of her main psychiatric and neurological symptoms. CONCLUSION: Our main objective in presenting this case is to alert clinicians to this challenging and recent disease that has a clinical presentation that might resemble a functional psychiatric condition and can be underdiagnosed in the context of child and adolescent psychiatry

Safety and risk factors for difficult endoscopist-directed ERCP sedation in daily practice: a hospital-based case-control study

Background: There are limited data concerning endoscopist-directed endoscopic retrograde cholangiopancreatography deep sedation. The aim of this study was to establish the safety and risk factors for difficult sedation in daily practice. Patients and methods: Hospital-based, frequency matched case-control study. All patients were identified from a database of 1,008 patients between 2014 and 2015. The cases were those with difficult sedations. This concept was defined based on the combination of the receipt of high-doses of midazolam or propofol, poor tolerance, use of reversal agents or sedation-related adverse events. The presence of different factors was evaluated to determine whether they predicted difficult sedation. Results: One-hundred and eighty-nine patients (63 cases, 126 controls) were included. Cases were classified in terms of high-dose requirements (n = 35, 55.56%), sedation-related adverse events (n = 14, 22.22%), the use of reversal agents (n = 13, 20.63%) and agitation/discomfort (n = 8, 12.7%). Concerning adverse events, the total rate was 1.39%, including clinically relevant hypoxemia (n = 11), severe hypotension (n = 2) and paradoxical reactions to midazolam (n = 1). The rate of hypoxemia was higher in patients under propofol combined with midazolam than in patients with propofol alone (2.56% vs. 0.8%, p < 0.001). Alcohol consumption (OR: 2.674 [CI 95%: 1.098-6.515], p = 0.030), opioid consumption (OR: 2.713 [CI 95%: 1.096-6.716], p = 0.031) and the consumption of other psychoactive drugs (OR: 2.015 [CI 95%: 1.017-3.991], p = 0.045) were confirmed to be independent risk factors for difficult sedation. Conclusions: Endoscopist-directed deep sedation during endoscopic retrograde cholangiopancreatography is safe. The presence of certain factors should be assessed before the procedure to identify patients who are high-risk for difficult sedation.

A Irrequietude motora como expressão de uma função materna comprometida: Método Rorschach

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica.

Obtenção de polímeros de LCC para aplicação como antioxidante de biodiesel de soja

Biodiesel is a fuel obtained from vegetable oils, such as soy, castorbean, among others. The monoester of fatty acid of these oils have chains with mono, di and tri double connections. The presence of these insaturations are susceptible to oxidization. Antioxidants are substances able to prevent oxidization from oils, fats, fat foods, as well as esters of Alquila( biodiesel). The objective of this work is to summarize a new antioxidant from the Cashew Nut Shell Liquid (CNSL) using the electrolysis technique. A current of 2 amperes was used in a single cell of only one group and two eletrodos of stainless steel 304 in a solution of methanol, together with the eletrolits: acetic acid, sodium chloride and sodium hydroxide, for two hours of agitation. The electrolysis products are characterized by the techniques of cromatography in a thin layer, spectroscopy of infrared and gravimetric analysis. The material was submitted to tests of oxidative stability made by the techniques of spectropy of impendancy and Rancimat (EN 14112). The analyses of characterization suggest that the polimerization of the electrolytic material ocurred. The application results of these materials as antioxidants of soy biodiesel showed that the order of the oxidative stability was obtained by both techniques used

Síntese de zeólitas e argilas ácidas pilarizadas a partir de matérias primas naturais

Structural changes in waste for zeolites synthesis are subject of many studies carried out in the synthesis of molecular sieves. These materials are named molecular sieves because they have well defined pore sizes and they have the capacity of select molecules by its size. In this work, it was studied the synthesis processes of two types of molecular sieves: pillared acid clays using as starting material one natural montmorillonite clay and the synthesis of zeolites from a silico-aluminous residue. This residue is a byproduct of the extraction of lithium -spodumene. The preparation of pillared acid clays was performed in two steps: 1° acid treatment of clay samples (time and temperature studies) and 2°pilarization of them with Al13 (Keggin ion). The temperature and acid concentration affect the removal of cations in the structure and porosity of the material obtained. The analysis of X-ray diffraction (XRD) and infrared spectroscopy (IR), showed that increasing the severity of the acid treatment compromises the structural material. Also the pore size distribution is approximately uniform. Despite presenting a structural disorganization, the samples were pillared. As evidenced by XRD increasing the basal spacing, specific area and uniform porosity by adsorption of N2. Regarding the microporous molecular sieves were synthesized zeolites A and NaP1 from a silico-aluminous residue, a byproduct of extracting lithium. The temperature and time of agitation during the synthesis were the most important factors for obtaining zeolite A. The aging of the gel and the highest crystallization time promoted the formation of zeolite NaP1 using a Si / Al ratio = 3.2

Uso de argilominerais e diatomita como adsorvente de fenóis em águas produzidas na indústria de petróleo

The oil production in Brazil has been increasing each year. Consequently, increasing volumes of water produced are generated with large quantities of contaminants, which brings many problems in disposing of these waters. The concern that the concentrations of contaminants in water produced meet existing laws for disposal of effluents, has been extremely important for the development of different techniques for treatment of water produced. The study of clay minerals as adsorbents of organic contaminants has grown considerably so in order to combine the low cost with the efficiency of environmental preservation and health issues. Thus, this study aims to understand the characteristics of vermiculite clay, sodium bentonite, calcium bentonite and diatomite and evaluate their performance as adsorbents for phenol in the water produced. Through adsorption isotherms it was possible to observe the behavior of these adsorptive clay and diatomite for adsorption of phenol, the main phenolic compound found in water produced. Different concentrations of synthetic solutions of phenol were put in touch with these adsorbents under same conditions of agitation and temperature. The adsorbents were composted adsorptive favorable, but the vermiculite and diatomite showed little capacity for absorption, being suggested for absorbs small concentrations of phenol in the balance isothermal

Dispersive liquid–liquid microextraction for metals enrichment: A useful strategy for improving sensitivity of laser-induced breakdown spectroscopy in liquid samples analysis

A rapid and efficient Dispersive Liquid–Liquid Microextraction (DLLME) followed by Laser-Induced Breakdown Spectroscopy detection (LIBS) was evaluated for simultaneous determination of Cr, Cu, Mn, Ni and Zn in water samples. Metals in the samples were extracted with tetrachloromethane as pyrrolidinedithiocarbamate (APDC) complexes, using vortex agitation to achieve dispersion of the extractant solvent. Several DLLME experimental factors affecting extraction efficiency were optimized with a multivariate approach. Under optimum DLLME conditions, DLLME-LIBS method was found to be of about 4.0–5.5 times more sensitive than LIBS, achieving limits of detection of about 3.7–5.6 times lower. To assess accuracy of the proposed DLLME-LIBS procedure, a certified reference material of estuarine water was analyzed.

Production of Recombinant Trichoderma Reesei Endoglucanase Protein CEL7B by Using Kluyveromyces Lactis

This research is about producing recombinant Trichoderma reesei endoglucanase Cel7B by using Kluyveromyces lactis, transformed with chromosomally integrated Cel7B cDNA, as a host cell (K. lactis Cel7B). Cel7B is one of the glycoside hydrolyze family of proteins that are produced by T. reesei. Cel7B together with other endoglucanases, exoglucanases, and â-glucosidases hydrolyze cellulose to glucose, which can then be fermented to biofuels or other value-added products. The research objective of this MS project is to examine favorable fermentation conditions for recombinant Cel7B enzyme production and improved activity. Production of enzyme on different types of media was examined, and the activity of the enzyme was measured by using different tools or procedures. The first condition tested for was using different concentrations of galactose as a carbon and energy source; however galactose also acts as a potent promoter of recombinant Cel7B expression in K. lactis Cel7B. The purpose of this method is to determine the relationship between production of enzyme with increasing sugar concentration. The second culture condition test was using different types of media: a complex medium-yeast extract, peptone, galactose (YPGal); a minimal medium-yeast nitrogen base (YNB) with galactose; and a minimal medium with supplement-yeast nitrogen base with casamino acid (YBC), a nitrogen source, with galactose. The third condition was using different types of reactors or fermenters: a small reactor (shake flask) and a larger automated bioreactor (BioFlo 3000 fermenter). The purpose of this method is to determine the quantity of the protein produced by using different environments of production. Different tools to determine the presence and activity of Cel7B enzyme were used. For the presence of enzyme, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) was used. Secondly, to detect enzyme activity, the carboxymethyl cellulose- 3,5-dinitrosalicylic acid (CMC- DNS) assay was employed. SDS-PAGE showed that the enzyme band was at 67 kDa, which is larger than native Cel7B (52 kDa.), likely due to over glycolylation during post-translational processing in K. lactis. For the different types of media used in our fermentation, recombinant Cel7B was produced from yeast extract peptone galactose (YPGal), and yeast nitrogen base with casamino acid (YBC), but was not produced and no activity was detected from yeast nitrogen base (YNB). This experiment concluded that the Cel7B production requires the amino acid resources as part of fermentation medium. In experiments where recombinant Cel7B net activity was measured at 1% galactose initial concentration in YPGal and YBC media, higher enzyme activity was detected for the complex medium YPGal. Higher activity of recombinant Cel7B was detected for flask culture in 2% galactose compared to 1% galactose for YBC medium. Two bioreactor experiments were conducted under these culture conditions at 30°C, pH 7.0, dissolved oxygen of 50% of saturation, and 250 rpm agitation (variable depending on DO control) K. lactis-Cel7B yeast growth curves were quite reproducible with maximum optical density (O.D) at 600 nm of between 7 and 8 (when factoring dilution of 10:1). Galactose was consumed rapidly during the first 15 hours of bioreactor culture and recombinant Cel7B started to appear in the culture at 10-15 hours and increased thereafter up to a maximum of between 0.9 and 1.6 mg/mL/hr in these experiments. These bioreactor enzyme activity results are much higher than comparable experiments conducted with flask-scale culture (0.5 mg/mL/hr). In order to achieve the highest recombinant Cel7B activity from batch culture of K. lactis-Cel7B, based on this research it is best to use a complex medium, 2% initial galactose concentration, and an automated bioreactor where good control of temperature, pH, and dissolved oxygen can be achieved.

"To Hold the World in Contempt": The British Empire, War, and the Irish and Indian Nationalist Press, 1899-1914

The era between the close of the nineteenth century and the onset of the First World War witnessed a marked increase in radical agitation among Indian and Irish nationalists. The most outspoken political leaders of the day founded a series of widely circulated newspapers in India and Ireland, placing these editors in the enviable position of both reporting and creating the news. Nationalist journalists were in the vanguard of those pressing vocally for an independent India and Ireland, and together constituted an increasingly problematic contingent for the British Empire. The advanced-nationalist press in Ireland and the nationalist press in India took the lead in facilitating the exchange of provocative ideas—raising awareness of perceived imperial injustices, offering strategic advice, and cementing international solidarity. Irish and Indian press coverage of Britain’s imperial wars constituted one of the premier weapons in the nationalists’ arsenal, permitting them to build support for their ideology and forward their agenda in a manner both rapid and definitive. Directing their readers’ attention to conflicts overseas proved instructive in how the Empire dealt with those who resisted its policies, and also showcased how it conducted its affairs with its allies. As such, critical press coverage of the Boxer Rebellion, Boer War, Russo-Japanese War, and World War I bred disaffection for the Empire, while attempts by the Empire to suppress the critiques further alienated the public. This dissertation offers the first comparative analysis of the major nationalist press organs in India and Ireland, using the prism of war to illustrate the increasingly persuasive role of the press in promoting resistance to the Empire. It focuses on how the leading Indian and Irish editors not only fostered a nationalist agenda within their own countries, but also worked in concert to construct a global anti-imperialist platform. By highlighting the anti-imperial rhetoric of the nationalist press in India and Ireland and illuminating their strategies for attaining self-government, this study deepens understanding of the seeds of nationalism, making a contribution to comparative imperial scholarship, and demonstrating the power of the media to alter imperial dynamics and effect political change.

Évaluation d'un protocole pour mieux intervenir auprès des enfants ayant un déficit d'attention /hyperactivité et leur famille dans une perspective scolaire

Ces enfants qui bougent sans arrêt captent l'attention d'un nombre important d'intervenants et de chercheurs. À cet effet, des programmes de recherches et d'interventions destinés à décrire la problématique de déficit d'attention hyperactivité (DAH) chez les enfants, à contrecarrer les déficits à la maison de même qu'à l'école sont réalisés. Le manque d'attention, un excès d'agitation de même qu'un comportement impulsif, comportements propres au DAH, sont des facteurs de risques non négligeables dans le développement des problèmes de comportement associés. Il devient donc primordial de centrer nos efforts de recherche et d'intervention sur l'école, lieu où l'enfant vivra plusieurs réussites et/ou échecs pouvant influencer l'estime qu'il a de lui-même. Il est établi que l'estime de soi est un facteur marquant pour le développement de l'enfant. Sans compter que parents et enseignants ont besoin de beaucoup d'énergie afin d'intervenir auprès de ces enfants. Nombre de programmes sont destinés aux habilités parentales et d'autres favorisent l'apprentissage de nouvelles méthodes pédagogiques pour mieux enseigner aux enfants en difficulté. Cependant, peu de programmes sont destinés à favoriser la collaboration entre le milieu scolaire et le milieu familiale afin de maximiser l'aide à apporter à l'enfant. Le but visé par ce travail est de présenter brièvement un contexte théorique sous-jacent à la problématique du DAH, de présenter un protocole d'intervention destiné aux enseignants afin qu'ils initient une collaboration avec les parents et d'étudier le processus d'implantation du protocole dans six écoles de la commission scolaire des Draveurs de Gatineau. Il y a trois parties qui seront décrites et évaluées lors de la présentation du protocole : 1) le dépistage des enfants ayant des comportements propres au DAH ; 2) le partage d'informations avec l'équipe école, le jeune et ses parents ; 3) le choix de moyens à mettre en place à la maison, à l'école et lors des périodes de leçons et devoirs incluant une sensibilisation à la consultation médicale et la médication. L'évaluation de l'utilisation du protocole «pour mieux intervenir auprès du jeune ayant un DAH et de sa famille dans une perspective scolaire » s'est déroulée de janvier 1999 à juin de cette même année dans les écoles primaires. Le but de l'étude est de valider l'utilisation du protocole afin de le perfectionner et le distribuer aux Commissions Scolaires intéressées dans un avenir rapproché. Ce présent travail, effectué dans le cadre d'un essai en psychoéducation à l'Université du Québec à Hull, a pour objectif d'évaluer l'utilisation d'un protocole, qui s'appuie sur une compréhension de la problématique du déficit d'attention/hyperactivité en milieu scolaire. Un contexte théorique faisant un bref survol de diverses thématiques se rapportant au DAH est élaboré. Cette sensibilisation à la réalité qui entoure le DAH nous amène à dégager la problématique spécifique qui concerne la nécessité d'adapter une démarche progressive et systémique réalisée par des intervenants conscients des besoins des différents acteurs dans une perspective scolaire. C'est dans ce contexte que le protocole d'intervention est présenté et évalué : celui-ci vise essentiellement à améliorer l'approche entre l'école et les parents de manière à établir une relation basée sur la confiance et une collaboration qui se traduit par l'efficacité des interventions auprès de l'enfant. Une évaluation descriptive du protocole par les différentes directions ainsi qu'une analyse de contenu en suit. L'élaboration ainsi que l'utilisation des instruments utilisés lors de l'étude sont décrits de même que l'échantillon ayant participé à l'étude. Le document se termine par une synthèse des points importants et des critiques apportées à l'étude.

Sensor psychrometric approaches to mitigating aflatoxins in maize dried on farms in Kenya

Kenia liegt in den Äquatorialtropen von Ostafrika und ist als ein weltweiter Hot-Spot für Aflatoxinbelastung insbesondere bei Mais bekannt. Diese toxischen und karzinogenen Verbindungen sind Stoffwechselprodukte von Pilzen und so insbesondere von der Wasseraktivität abhängig. Diese beeinflusst sowohl die Trocknung als auch die Lagerfähigkeit von Nahrungsmitteln und ist somit ein wichtiger Faktor bei der Entwicklung von energieeffizienten und qualitätsorientierten Verarbeitungsprozessen. Die vorliegende Arbeit hat sich zum Ziel gesetzt, die Veränderung der Wasseraktivität während der konvektiven Trocknung von Mais zu untersuchen. Mittels einer Optimierungssoftware (MS Excel Solver) wurde basierend auf sensorerfassten thermo-hygrometrischen Daten der gravimetrische Feuchteverlust von Maiskolben bei 37°C, 43°C und 53°C vorausberechnet. Dieser Bereich stellt den Übergang zwischen Niedrig- und Hochtemperaturtrocknung dar. Die Ergebnisse zeigen deutliche Unterschiede im Verhalten der Körner und der Spindel. Die Trocknung im Bereich von 35°C bis 45°C kombiniert mit hohen Strömungsgeschwindigkeiten (> 1,5 m / s) begünstigte die Trocknung der Körner gegenüber der Spindel und kann daher für eine energieeffiziente Trocknung von Kolben mit hohem Anfangsfeuchtegehalt empfohlen werden. Weitere Untersuchungen wurden zum Verhalten unterschiedlicher Schüttungen bei der bei Mais üblichen Satztrocknung durchgeführt. Entlieschter und gedroschener Mais führte zu einem vergrößerten Luftwiderstand in der Schüttung und sowohl zu einem höheren Energiebedarf als auch zu ungleichmäßigerer Trocknung, was nur durch einen erhöhten technischen Aufwand etwa durch Mischeinrichtungen oder Luftumkehr behoben werden könnte. Aufgrund des geringeren Aufwandes für die Belüftung und die Kontrolle kann für kleine landwirtschaftliche Praxisbetriebe in Kenia daher insbesondere die Trocknung ganzer Kolben in ungestörten Schüttungen empfohlen werden. Weiterhin wurde in der Arbeit die Entfeuchtung mittels eines Trockenmittels (Silikagel) kombiniert mit einer Heizquelle und abgegrenztem Luftvolumen untersucht und der konventionellen Trocknung gegenüber gestellt. Die Ergebnisse zeigten vergleichbare Entfeuchtungsraten während der ersten 5 Stunden der Trocknung. Der jeweilige Luftzustand bei Verwendung von Silikagel wurde insbesondere durch das eingeschlossene Luftvolumen und die Temperatur beeinflusst. Granulierte Trockenmittel sind bei der Maistrocknung unter hygienischen Gesichtspunkten vorteilhaft und können beispielsweise mit einfachen Öfen regeneriert werden, so dass Qualitätsbeeinträchtigungen wie bei Hochtemperatur- oder auch Freilufttrocknung vermieden werden können. Eine hochwertige Maistrocknungstechnik ist sehr kapitalintensiv. Aus der vorliegenden Arbeit kann aber abgeleitet werden, dass einfache Verbesserungen wie eine sensorgestützte Belüftung von Satztrocknern, der Einsatz von Trockenmitteln und eine angepasste Schüttungshöhe praktikable Lösungen für Kleinbauern in Kenia sein können. Hierzu besteht, ggf. auch zum Aspekt der Verwendung regenerativer Energien, weiterer Forschungsbedarf.

AMBIVALENCES IDENTITY IN THE BROTHERS, MILTON HATOUM

This article presents a reading of the novel The Brothers, by Milton Hatoum, focused on the narrator’s condition and his identity implications. Nael, the protagonist narrator, grew blended to a family of his own and random at the same time, without knowing his space amongst the group. The uncertainty of his origins have shaped a floating identity between the position of the son/grandson and the position of the employee aggregated to the group. The ambivalences of this identity are narrated searching for answers, the stabilization of Nael’s identity space. To this end, the main instrument is the memory, the only mean to resignify the past and fulfill the lack of wholeness which accompanies Nael: the wholeness is achieved with the agitation of the past, the memories and especially, the silences and the family forgetfulness. The reflections about the possible identity positions of the narrator find support in the theoretical concepts of memory and identity from a sociological and anthropological perspective. Key words: memory; identity; The Brothers.