Left main stenting: do we need another study?

Coronary artery bypass graft (CABG) surgery has long been adopted as the treatment of choice for patients with left main (LM) coronary obstructions. In the past, randomised trials and observational studies have shown an advantage in survival of CABG against medical treatment. Recent studies comparing CABG with percutaneous coronary intervention (PCI) suggested that angioplasty may play a role as an alternative choice. However, well designed randomised trials to evaluate the relative merits of both therapeutic approaches are lacking. In this article, we review the current scientific evidences and outline issues that currently still need to be addressed in comparing CABG versus PCI for the treatment of LM disease.

The Provisional Paediatric Rheumatology International Trials Organisation/American College of Rheumatology/European League Against Rheumatism disease activity core set for the evaluation of response to therapy in juvenile dermatomyositis: A prospective validation study

Objective. To validate a core set of outcome measures for the evaluation of response to treatment in patients with juvenile dermatomyositis (DM). Methods. In 2001, a preliminary consensus-derived core set for evaluating response to therapy in juvenile DM was established. In the present study, the core set was validated through an evidence-based, large-scale data collection that led to the enrollment of 294 patients from 36 countries. Consecutive patients with active disease were assessed at baseline and after 6 months. The validation procedures included assessment of feasibility, responsiveness, discriminant and construct ability, concordce in the evaluation of response to therapy between physicians and parents, redundancy, internal consistency, and ability to predict a therapeutic response. Results. The following clinical measures were found to be feasible, and to have good construct validity, discriminative ability, and internal consistency; furthermore, they were not redundant, proved responsive to clinically important changes in disease activity, and were associated strongly with treatment outcome and thus were included in the final core set: 1) physician`s global assessment of disease activity, 2) muscle strength, 3) global disease activity measure, 4) parent`s global assessment of patient`s well-being, 5) functional ability, and 6) health-related quality of life. Conclusion. The members of the Paediatric Rheumatology International Trials Organisation, with the endorsement of the American College of Rheumatology and the European Leauge Against Rheumatism, propose a core set of criteria for the evaluation of response of therapy that is scientifically and clinically relevant and statistically validated. The core set will help standardize the conduct and reporting of clinical trials and assist practitioners in deciding whether a child with juvenile DM has responded adequately to therapy.

Maned wolf survival rate in central Brazil

Although many carnivores are of conservation concern, most are poorly studied. The maned wolf Chrysocyon brachyurus Illiger, 1811 is the largest South American canid with a broad distribution; however, the largest portion of its range is in the Brazilian Cerrado savannah, where due to intensive agricultural expansion, it is threatened by habitat loss. Maned wolf population trends are virtually unknown. We analyzed radio telemetry data from a 13-year study in Emas National Park, central Brazil, with Burnham`s live recapture/dead recovery models in the program MARK to obtain the first analytically sound estimate of the apparent maned wolf survival rate. We constructed 16 candidate models including variation in survival rate and resighting probability associated with an individual`s sex or age and year of study. Apparent adult survival rate throughout the study ranged from 0.28 (se=0.08) to 0.97 (se=0.06). There was no evidence for sex specificity but strong support for time variation. Model weights supported an age effect and the subadult survival rate was 0.63 (se=0.15). Results indicate similar life patterns for male and female maned wolves and similar mortality risks for adults and subadults in the study area. The observed temporal fluctuations of adult survival rate are important for population dynamics as they decrease average population growth rates. Population dynamics are central for conservation planning and our results are an important step towards a better understanding of the maned wolf`s ecology.

Mutations in the human ortholog of Aristaless cause X-linked mental retardation and epilepsy

Mental retardation and epilepsy often occur together. They are both heterogeneous conditions with acquired and genetic causes. Where causes are primarily genetic, major advances have been made in unraveling their molecular basis. The human X chromosome alone is estimated to harbor more than 100 genes that, when mutated, cause mental retardation(1). At least eight autosomal genes involved in idiopathic epilepsy have been identified(2), and many more have been implicated in conditions where epilepsy is a feature. We have identified mutations in an X chromosome-linked, Aristaless-related, homeobox gene (ARX), in nine families with mental retardation (syndromic and nonspecific), various forms of epilepsy, including infantile spasms and myoclonic seizures, and dystonia. Two recurrent mutations, present in seven families, result in expansion of polyalanine tracts of the ARX protein. These probably cause protein aggregation, similar to other polyalanine(3) and polyglutamine(4) disorders. In addition, we have identified a missense mutation within the ARX homeodomain and a truncation mutation. Thus, it would seem that mutation of ARX is a major contributor to X-linked mental retardation and epilepsy.

Administrando o estado: a experi??ncia dos gestores governamentais

A implanta????o da carreira de Especialistas em Pol??ticas P??blicas e Gest??o Governamental destinou-se a prover o Estado brasileiro de um corpo de funcion??rios com perfil generalista, ampla mobilidade funcional, e alta qualifica????o, para ocupa????o de cargos nos escal??es superiores da administra????o p??blica federal. Este artigo recupera a hist??ria do recrutamento, forma????o e inser????o na m??quina administrativa da primeira turma de Gestores Governamentais. O perfil profissional delineado no recrutamento e no curso de forma????o encontrou ampla receptividade na administra????o federal, mas o ??xito da experi??ncia n??o asegurou a sua consolida????o, constatando-se a debilita????o da carreira e a evas??o de seus quadros, motivada pela interrup????o do projeto, que at?? o presente realizou apenas um concurso recrutamento.

Efeito da privação de sono paradoxal e do bloqueio da síntese da corticosterona sobre os limiares da reação de defesa induzida pela estimulação elétrica da matéria cinzenta periaquedutal e colículo superior

O Transtorno do pânico (TP) é um transtorno mental comum que afeta até 5% da população em algum momento da vida, sendo caracterizada pela presença de ataques de pânico (AP) recorrentes. Constitui uma psicopatologia que pode ser afetada pela privação do sono (PS), relação que ainda é pouco compreendida. Neste contexto, modelos experimentais de AP e de PS são ferramentas úteis na investigação dessa possível correlação, especialmente motivado pela crescente condição de privação de sono, que tem se tornado cada vez mais frequente na sociedade moderna. Assim, este estudo avaliou os efeitos da privação de sono paradoxal (PSP) sobre os limiares dos comportamentos defensivos induzidos por estimulação intracraniana (EI) da MCPD e CS de ratos num modelo experimental de AP, assim como verificou a influência da corticosterona sobre esses limiares. Foram utilizados 160 ratos Wistar machos (300g), organizados em 4 grupos com 40 animais cada, como se segue: Grupo Controle (CTR) submetido à EI, porém sem PSP; Grupo Privação (PRV), submetido à EI e privado por 96 horas; Grupo Privação + Bloqueio da corticosterona (PRB), submetido ao tratamento com metirapona, EI, e privado por 96 horas, e Grupo Controle + Bloqueio da corticosterona (CTB), submetido ao tratamento com metirapona e EI, porém sem privação de sono. Após 10 dias do implante cirúrgico intracraniano de eletrodo na MCPD e CS, os animais passaram por 5 sessões de estimulação, como se segue: 1ª (TRI) considerada triagem - imediatamente antes da privação, 2ª (P48) após 48h de privação, 3ª (P96) após 96h de privação, 4ª (R48) após 48h de retirada da privação e 5ª (R96) após 96h de retirada da privação. As curvas de limiares das respostas individuais de defesa obtidas nas várias sessões de estimulação da MCPD e CS (TRI, P48, P96, R48 e R96) dos ratos foram comparadas entre si, bem como as curvas de limiares de uma dada resposta nos diferentes grupos (CTR, PRV, CTB e PRB). Além disso, os níveis de corticosterona (CORT) foram dosados nas diferentes sessões de EI, e comparadas num mesmo grupo, bem como nos diferentes grupos. No grupo CTR, todos os comportamentos foram iguais em todas as sessões quando comparados à TRI, entretanto, nos animais privados (PRV), o limiar do galope (GLP) reduziu significativamente em R48 e R96, não ocorrendo xix alterações nos demais comportamentos. Em contraste, no grupo PRB, o Trote (TRT) aumentou a partir de P48, enquanto o GLP não foi alterado em nenhuma sessão de EI. Na comparação entre os grupos, em Salto (SLT), Micção (MIC), Exoftalmia (EXO), Imobilidade (IMO), Defecação (DEF), TRT e GLP, não sofreram alterações decorrentes da CORT produzida decorrente da PSP, sugerindo que a corticosterona não altera os comportamentos defensivos característicos do Ataque de Pânico. Em adição, tais resultados sugerem que os efeitos tardios da PSP sobre os limiares de GLP possivelmente se devam a mecanismos neuroquímicos tempo-dependente.

Modification of MOR by desilication treatments: Structural, textural and acidic characterization

The effect of several desilication experimental parameters (base concentration, temperature and time) on the characteristics of MOR zeolite was studied. The samples were characterized by X-ray diffraction, Al-27 and Si-29 MAS-NMR, chemical analysis, and FTIR (framework vibration region). The textural characterization was made by N-2 adsorption and the acidity was evaluated by pyridine adsorption followed by FTIR and by the catalytic model reaction of n-heptane cracking. The alkaline treatments promoted the Si extraction from the zeolite framework, without considerable loss of crystallinity and, as it was envisaged, an important increase of the mesoporous structure was attained. A linear correlation between the number of framework Si per unit cell. N-Si and the asymmetric stretching wavenumber, nu(i), was observed. The acidity characterization shows that the desilicated samples exhibit practically the same acid properties than the parent HMOR zeolite. The optimum desilication conditions were those used to obtain sample M/0.2/85/2, i.e., sample treated with 0.2 M NaOH solution at 85 degrees C for 2 h.

Quantificação da difusão na ressonância magnética da mama: ADC e Kurtosis

Mestrado em Radiações Aplicadas às Tecnologias da Saúde. Área de especialização: Ressonância Magnética

O piano (bem) informado : processos de interiorização e crescimento

Este livro debruça-se sobre questões ligadas à metodologia do piano, incluindo aspectos técnicos, musicais e artísticos, num enquadramento que engloba algumas das principais reflexões éticas, estéticas e filosóficas de referência. O objetivo deste trabalho é a partilha de uma visão baseada na experiência pessoal e profissional na área do piano. Este texto assume uma certa continuidade com as grandes contribuições de autores tais como Ludwig Deppe, Matthay Tobias, Grigory Kogan, Heinrich Neuhaus e George Kochevitsky publicado. Ao mesmo tempo que se integra e complementa alguma dessa literatura especializada, aponta ideias, sugestões e pontos de vista caracterizados pela inovação e aplicabilidade racional e científica.

Incorporation of niobium in SAPO-11 materials: Synthesis and characterization

The present work concerns a new synthesis approach to prepare niobium based SAPO materials with AEL structure and the characterization ofNb species incorporated within the inorganic matrixes. The SAPO-11 materials were synthesized with or without the help of a small amine, methylamine (MA) as co-template, while Nb was added directly during the preparation of the initial gel. Structural, textural and acidic properties of the different supports were evaluated by XRD, TPR, UV-Vis spectroscopy, pyridine adsorption followed by IR spectroscopy and thermal analyses. Pure and well crystalline Nb based SAPO-11 materials were obtained, either with or without MA, using in the initial gel a low Si content of about 0.6. Increasing the Si content of the gel up to 0.9 led to an important decrease of the samples crystallinity. Niobium was found to incorporate the AEL pores support as small Nb2O5 oxide particles and also as extra framework cationic species (Nb5+), compensating the negative charges from the matrix and generating new Lewis acid sites. (C) 2011 Elsevier Inc. All rights reserved.

Accounting logic and new professional in healthcare: a case study

The central place hospitals occupy in health systems transforms them into prime target of healthcare reforms. This study aims to identify current trends in organizational structure change in public hospitals and explore the role of accounting in attempts to develop controls over professionals within public hospitals. The analytical framework we proposed crosses the concept of “new professionalism” (Evetts, 2010), with the concept of “accounting logic” for controlling professionals (Broadbent and Laughlin, 1995). Looking for a more holistic overview, we developed a qualitative and exploratory study. The data were collected trough semi-structured interviews with doctors of a clinical hospital unit. Content analysis suggests that, although we cannot say that there is a complete and generalized integration of accounting information in the clinical decisions, important improvement has been made in that area. Despite the extensive literature developed on this topic, there is any empirical studies of authors are aware that allow us to realize how real doctors in reals day-to-day work integrated these trends of change in theirs clinical decisions.

A Queda de Ícaro, de Brueghel e Schimmernde Inselchen im Meer, de Robert Walser – uma viagem ao mundo da tradução intersemiótica

O tema sobre o qual me proponho escrever insere-se no âmbito da 'tradução intersemiótica', já que se trata de uma análise comparativa da obra Der Sturz des Ikarus, de Pieter Brueghel, e do poema Schimmernde Inselchen im Meer, de Robert Walser, em que estamos perante um exemplo flagrante de transposição de uma obra pictórica para a escrita. No artigo, darei, ainda, especial enfoque à questão de aquele quadro representar, também ele, um exemplo de 'tradução intersemiótica' (neste caso, uma passagem da palavra às artes plásticas), uma vez que Brueghel faz, nele, uma recontextualização do mito de Ícaro, ao transpor para a tela um poema de Ovídio (estamos, assim, mais uma vez, perante um exemplo de mudança de medium). Dado que a questão da 'tradução intersemiótica' se inscreve numa outra, mais vasta ainda, que éa da intertextualidade, tentarei enquadrar uma na outra, tecendo, na introdução do artigo e, sempre que oportuno, ao longo do mesmo, algumas considerações breves sobre a função significante do mitema, as metamorfoses do mito e o papel do mito no 'diálogo intermedial das artes' ao longo dos tempos. Nesta análise comparativa, parto do pressuposto de estarmos, em qualquer tradução, face a um acto de re-escrita, pelo que há que reflectir, particularmente no caso da 'tradução intersemiótica', sobre a (nova) dimensão interpretativa conferida pelo processo de transposição mediática

Copper(II) aza-bis(oxazoline) complex immobilized onto ITQ-2 and MCM-22 based materials as heterogeneous catalysts for the cyclopropanation of styrene

A copper(II) chiral aza-bis(oxazoline) homogeneous catalyst (CuazaBox) was anchored onto the external surface of MCM-22 and ITQ-2 structures, as well as encapsulated into hierarchical MCM-22. The transition metal complex loading onto the porous solids was determined by ICP-AES and the materials were also characterized by elemental analysis (C, N, H, S), FTIR, XPS, TG and low temperature N-2 adsorption isotherms. The materials were tested as heterogeneous catalysts in the benchmark reaction of cyclopropanation of styrene to check the effect of the immobilization procedure on the catalytic parameters, as well as on their reutilization in several catalytic cycles. Catalyst CuazaBox anchored onto the external surface of MCM-22 and ITQ-2 materials were more active and enantioselective in the cyclopropanation of styrene than the corresponding homogeneous phase reaction run under similar experimental conditions. This is due to the propylation of the acidic aza-Box nitrogen. HMCM-22 was nevertheless the best heterogeneous catalyst. Encapsulation of CuazaBox on post-synthesis modified MCM-22 materials led to low activities and enantioselectivities. But reversal on the stereochemical course of the reaction was observed, probably due to confinement effect. (C) 2013 Elsevier Inc. All rights reserved.

Electroanalytical study of the pesticide asulam

The electrochemical behaviour of the herbicide Asulam was studied by cyclic and square wave voltammetry. Asulam may be irreversibly oxidised at a glassy carbon electrode. Maximum currents were obtained at pH=1.9 in aqueous electrolyte solution. Based on the electrochemical behaviour of Asulam, two analytical methodologies were developed for its determination in water samples, using square wave voltammetry (SWV) and flow injection analysis (FIA) coupled with an amperometric detector. Limits of detection of 7.1x10-6 mol L-1 and 1.2x10-8 mol L-1 for SWV and FIA respectively, were achieved. Repeatability was calculated by assessing the relative standard deviation (%) for 10 consecutive determinations of one sample. The found values were 2.1% for SWV and 5.0% for FIA. Validation of the results provided by SWV and FIA methodologies was performed by comparison with results from an HPLC-DAD technique. Good relative deviations were found (<5%). Recovery trials were performed to assess the accuracy of the results and the obtained values were between 84% and 107% for both methods.

Os periódicos portugueses de emigração (1808-1822)

Esta dissertação analisa e compara os periódicos com uma componente de divulgação científica, editados por refugiados políticos em Londres e Paris, sendo o núcleo investigado composto por quatro títulos: o Correio Braziliense (1808-1822) e O Investigador Portuguez em Inglaterra (1811-1819), publicados em Londres, O Observador Lusitano em Pariz (1815) e os Annaes das Sciencias, das Artes, e das Letras (1818-1822), ambos com origem na capital francesa. Este estudo comporta uma discussão sobre questões historiográficas levantadas pelo estudo de periódicos de divulgação científica, nomeadamente num país com as particularidades de Portugal, a caracterização do período histórico em que decorreu a vida destas publicações, um panorama breve do estado das diversas ciências no plano internacional que nelas encontraram eco, seguidos da análise propriamente dita do núcleo de periódicos seleccionados. No âmbito desta última, deu-se particular destaque aos editores e ao seu percurso, ao lugar das ciências entre as matérias apresentadas por cada periódico, e aos temas e personalidades focadas. Foram identificadas as principais fontes citadas e analisou-se a participação dos leitores em cada periódico. Ressaltam como traços fundamentais destes periódicos o esforço desenvolvido pelos seus editores no sentido de sensibilizarem os governantes para a importância de alterarem práticas tradicionais e estruturas ultrapassadas, abrindo o país à informação proveniente do exterior e, em particular, ao desenvolvimento científico e económico.