The expanded spectrum of neuromyelitis optica: evidences for a new definition

Neuromyelitis optica (NMO) has been traditionally described as the association of recurrent or bilateral optic neuritis and longitudinally extensive transverse myelitis (LETM). Identification of aquaporin-4 antibody (AQP4-IgG) has deeply changed the concept of NMO. A spectrum of NMO disorders (NMOSD) has been formulated comprising conditions which include both AQP4-IgG seropositivity and one of the index events of the disease (recurrent or bilateral optic neuritis and LETM). Most NMO patients harbor asymptomatic brain MRI lesions, some of them considered as typical of NMO. Some patients with aquaporin-4 autoimmunity present brainstem, hypothalamic or encephalopathy symptoms either preceding an index event or occurring isolatedly with no evidence of optic nerve or spinal involvement. On the opposite way, other patients have optic neuritis or LETM in association with typical lesions of NMO on brain MRI and yet are AQP4-IgG seronegative. An expanded spectrum of NMO disorders is proposed to include these cases.

Auditory and communicative abilities in the auditory neuropathy spectrum disorder and mutation in the Otoferlin gene: clinical cases study

This study had the aim to investigate the auditory and communicative abilities of children diagnosed with Auditory Neuropathy Spectrum Disorder due to mutation in the Otoferlin gene. It is a descriptive and qualitative study in which two siblings with this diagnosis were assessed. The procedures conducted were: speech perception tests for children with profound hearing loss, and assessment of communication abilities using the Behavioral Observation Protocol. Because they were siblings, the subjects in the study shared family and communicative context. However, they developed different communication abilities, especially regarding the use of oral language. The study showed that the Auditory Neuropathy Spectrum Disorder is a heterogeneous condition in all its aspects, and it is not possible to make generalizations or assume that cases with similar clinical features will develop similar auditory and communicative abilities, even when they are siblings. It is concluded that the acquisition of communicative abilities involves subjective factors, which should be investigated based on the uniqueness of each case.

Occurrence of bipolar spectrum disorder and comorbidities in women with eating disorders

Abstract Background Eating disorder (ED) patients often have comorbidities with other psychiatric disorders, especially with mood disorders. Although recent studies suggest an intimate relationship between ED and bipolar disorder (BD), the study on a broader bipolar spectrum definition has not been done in this population. We aimed to study the occurrence of bipolar spectrum (BS) and comorbidities in eating disorder patients of a tertiary service provider. Methods Sixty-nine female patients diagnosed with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified were evaluated. The assessment comprised the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), clinical criteria for diagnosis of the Zurich bipolar spectrum. Mann–Whitney tests compared means of continuous variables. The association between categorical variables and the groups was described using contingency tables and analyzed using the chi-square or Fisher's exact test. The level of significance alpha was set at 5%. Results The results showed that 68.1% of patients had comorbidity with bipolar spectrum, and this was associated with higher family income, proportion of married people, and comorbidity with substance use. The ED with BS group showed higher rates of substance use comorbidity (40.4%) than the ED without BS group (13.6%). Discussion These results showed that the bipolar spectrum is a common comorbidity in patients with eating disorders and is associated with correlates of clinical importance, notably the comorbidity with substance use. Due to the pattern of similarity between the groups with and without comorbid bipolar spectrum in relation to various outcomes evaluated, the identification of comorbidity can be difficult. However, the precise diagnosis and careful identification of clinical correlates may contribute to future advances in treating these conditions. Further studies are necessary to evaluate the association of other clinical correlates and its possible causal association.

A theoretical study of the characterization and the absorption spectrum of Mg: Tetracycline complexes in aqueous environment.

The complex formed by the tetracycline (TC) molecule with the Mg ion is able to prevent the replication of the genetic material in the bacterial ribosome, making an excellent antibiotic. In general, the absorption and emission spectra of TC are very sensitive to the host ions and the pH of the solvent that the set is immersed. However, the theoretical absorption spectrum available in the literature is scarce and limited to simple models that do not consider the fluctuations of the liquid. Our aim is to obtain the electronic absorption spectrum of TC and the complex Mg:TC in the ratio 1:1 and 2:1. Moreover, we analyze the changes in intensity and shifts of the bands in the systems listed. We performed the simulation using the classical Monte Carlo technique with the Lennard-Jones plus Coulomb potential applied to each atom of the both TC molecule and the Mg:TC complexes in water. The electronic absorption spectrum was obtained from the time-dependent density functional theory using different solvent models. In general, we obtained a good qualitative description of the spectra when compared with the experimental results. The Mg atom shifts the first band by 4 nm in our models, in excellent agreement to the experimental result of 4 nm. The second absorption band is found here to be useful for the characterization of the position where the ion attaches to the TC.

Shape resonance spectrum of cytosine-guanine pairs.

Single and double strand breaks in DNA can be caused by low-energy electrons, the most abundant secondary products of the interaction of ionizing radiation to the biological matter. Attachment of these electrons to biomolecules lead to the formation of transient negative ions (TNIs) [1], often referred to as resonances, a process that may lead to significant vibrational excitation and dissociation. In the present study, we employ the parallel version [2] of the Schwinger Multichannel Method implemented with pseudopotentials [3] to obtain the shape resonance spectrum of cytosine-guanine (CG) pairs, with special attention to π* transient anion states. Recent experimental studies pointed out a quasi-continuum vibrational excitation spectrum for electron collisions against formic acid dimers [4], suggesting that electron attachment into π* valence orbitals could induce proton transfer in these dimers. In addition, our previous studies on the shape resonance spectra of the hydrogen-bonded complexes comprising formic acid and formamide units indicated interesting electron delocalization (localization) effects arising from the presence (absence) of inversion symmetry centers in the complexes [5]. In the present work, we extend the studies on hydrogen-bonded complexes to the CG pair, where localization of ¼¤ anions would be expected, based on the previous results. References [1]. B. Boudaïffa, P. Cloutier, D. Hunting, M. A. Huels, L. Sanche, Science 287, 1658 (2000). [2]. J. S. dos Santos, R. F. da Costa , M. T. do N. Varella, J. Chem. Phys. 136, 084307 (2012). [3]. M. H. F. Bettega, L. G. Ferreira, M. A. P. Lima, Phys. Rev. A 47, 1111 (1993). [4]. M. Allan, Phys. Rev. Lett. 98, 123201 (2007). [5]. T. C. Freitas, S. dA. Sanchez, M. T. do N. Varella, M. H. F. Bettega, Phys. Rev. A 84, 062714 (2011).

Humoral autoimmune response heterogeneity in the spectrum of primary biliary cirrhosis

Objective To compare autoantibody features in patients with primary biliary cirrhosis (PBC) and individuals presenting antimitochondria antibodies (AMAs) but no clinical or biochemical evidence of disease. Methods A total of 212 AMA-positive serum samples were classified into four groups: PBC (definite PBC, n = 93); PBC/autoimmune disease (AID; PBC plus other AID, n = 37); biochemically normal (BN) individuals (n = 61); and BN/AID (BN plus other AID, n = 21). Samples were tested by indirect immunofluorescence (IIF) on rat kidney (IIF-AMA) and ELISA [antibodies to pyruvate dehydrogenase E2-complex (PDC-E2), gp-210, Sp-100, and CENP-A/B]. AMA isotype was determined by IIF-AMA. Affinity of anti-PDC-E2 IgG was determined by 8 M urea-modified ELISA. Results High-titer IIF-AMA was more frequent in PBC and PBC/AID (57 and 70 %) than in BN and BN/AID samples (23 and 19 %) (p < 0.001). Triple isotype IIF-AMA (IgA/IgM/IgG) was more frequent in PBC and PBC/AID samples (35 and 43 %) than in BN sample (18 %; p = 0.008; p = 0.013, respectively). Anti-PDC-E2 levels were higher in PBC (mean 3.82; 95 % CI 3.36–4.29) and PBC/AID samples (3.89; 3.15–4.63) than in BN (2.43; 1.92–2.94) and BN/AID samples (2.52; 1.54–3.50) (p < 0.001). Anti-PDC-E2 avidity was higher in PBC (mean 64.5 %; 95 % CI 57.5–71.5 %) and PBC/AID samples (66.1 %; 54.4–77.8 %) than in BN samples (39.2 %; 30.9–37.5 %) (p < 0.001). PBC and PBC/AID recognized more cell domains (mitochondria, nuclear envelope, PML/sp-100 bodies, centromere) than BN (p = 0.008) and BN/AID samples (p = 0.002). Three variables were independently associated with established PBC: high-avidity anti-PDC-E2 (OR 4.121; 95 % CI 2.118–8.019); high-titer IIF-AMA (OR 4.890; 2.319–10.314); antibodies to three or more antigenic cell domains (OR 9.414; 1.924–46.060). Conclusion The autoantibody profile was quantitatively and qualitatively more robust in definite PBC as compared with AMA-positive biochemically normal individuals.

Enhancement of laser induced Au nanoparticle formation by femtosecond pulse shaping

We report the control of Au nanoparticle (NP) formation by using shaped 30 fs pulses, in a solution containing HAuCl4 and chitosan. By using a sinusoidal spectral phase, a periodic train of pulses is generated. When the period of the pulse train matches certain Raman resonances of chitosan, the reducing agent of the process, an enhancement of the Au NP formation is observed. Theoretical quantum chemical calculations indicate that the outer groups of the chitosan are mostly influenced by low Raman frequencies, which is in reasonably agreement with the experimental data and indicates an enhancement in the Au NP formation as the pulse train period increases (low frequency).

Neutronics analyses for fast spectrum nuclear systems and scenario studies for advanced nuclear fuel cycles

The present PhD thesis summarizes the three-years study about the neutronic investigation of a new concept nuclear reactor aiming at the optimization and the sustainable management of nuclear fuel in a possible European scenario. A new generation nuclear reactor for the nuclear reinassance is indeed desired by the actual industrialized world, both for the solution of the energetic question arising from the continuously growing energy demand together with the corresponding reduction of oil availability, and the environment question for a sustainable energy source free from Long Lived Radioisotopes and therefore geological repositories. Among the Generation IV candidate typologies, the Lead Fast Reactor concept has been pursued, being the one top rated in sustainability. The European Lead-cooled SYstem (ELSY) has been at first investigated. The neutronic analysis of the ELSY core has been performed via deterministic analysis by means of the ERANOS code, in order to retrieve a stable configuration for the overall design of the reactor. Further analyses have been carried out by means of the Monte Carlo general purpose transport code MCNP, in order to check the former one and to define an exact model of the system. An innovative system of absorbers has been conceptualized and designed for both the reactivity compensation and regulation of the core due to cycle swing, as well as for safety in order to guarantee the cold shutdown of the system in case of accident. Aiming at the sustainability of nuclear energy, the steady-state nuclear equilibrium has been investigated and generalized into the definition of the ``extended'' equilibrium state. According to this, the Adiabatic Reactor Theory has been developed, together with a New Paradigm for Nuclear Power: in order to design a reactor that does not exchange with the environment anything valuable (thus the term ``adiabatic''), in the sense of both Plutonium and Minor Actinides, it is required indeed to revert the logical design scheme of nuclear cores, starting from the definition of the equilibrium composition of the fuel and submitting to the latter the whole core design. The New Paradigm has been applied then to the core design of an Adiabatic Lead Fast Reactor complying with the ELSY overall system layout. A complete core characterization has been done in order to asses criticality and power flattening; a preliminary evaluation of the main safety parameters has been also done to verify the viability of the system. Burn up calculations have been then performed in order to investigate the operating cycle for the Adiabatic Lead Fast Reactor; the fuel performances have been therefore extracted and inserted in a more general analysis for an European scenario. The present nuclear reactors fleet has been modeled and its evolution simulated by means of the COSI code in order to investigate the materials fluxes to be managed in the European region. Different plausible scenarios have been identified to forecast the evolution of the European nuclear energy production, including the one involving the introduction of Adiabatic Lead Fast Reactors, and compared to better analyze the advantages introduced by the adoption of new concept reactors. At last, since both ELSY and the ALFR represent new concept systems based upon innovative solutions, the neutronic design of a demonstrator reactor has been carried out: such a system is intended to prove the viability of technology to be implemented in the First-of-a-Kind industrial power plant, with the aim at attesting the general strategy to use, to the largest extent. It was chosen then to base the DEMO design upon a compromise between demonstration of developed technology and testing of emerging technology in order to significantly subserve the purpose of reducing uncertainties about construction and licensing, both validating ELSY/ALFR main features and performances, and to qualify numerical codes and tools.

Spectrum Management and Cognitive Radios

The ever increasing demand for new services from users who want high-quality broadband services while on the move, is straining the efficiency of current spectrum allocation paradigms, leading to an overall feeling of spectrum scarcity. In order to circumvent this problem, two possible solutions are being investigated: (i) implementing new technologies capable of accessing the temporarily/locally unused bands, without interfering with the licensed services, like Cognitive Radios; (ii) release some spectrum bands thanks to new services providing higher spectral efficiency, e.g., DVB-T, and allocate them to new wireless systems. These two approaches are promising, but also pose novel coexistence and interference management challenges to deal with. In particular, the deployment of devices such as Cognitive Radio, characterized by the inherent unplanned, irregular and random locations of the network nodes, require advanced mathematical techniques in order to explicitly model their spatial distribution. In such context, the system performance and optimization are strongly dependent on this spatial configuration. On the other hand, allocating some released spectrum bands to other wireless services poses severe coexistence issues with all the pre-existing services on the same or adjacent spectrum bands. In this thesis, these methodologies for better spectrum usage are investigated. In particular, using Stochastic Geometry theory, a novel mathematical framework is introduced for cognitive networks, providing a closed-form expression for coverage probability and a single-integral form for average downlink rate and Average Symbol Error Probability. Then, focusing on more regulatory aspects, interference challenges between DVB-T and LTE systems are analysed proposing a versatile methodology for their proper coexistence. Moreover, the studies performed inside the CEPT SE43 working group on the amount of spectrum potentially available to Cognitive Radios and an analysis of the Hidden Node problem are provided. Finally, a study on the extension of cognitive technologies to Hybrid Satellite Terrestrial Systems is proposed.

The shaping of foreign policy: Vietnamese grand strategy after the Cold War

This study examines the case of Vietnam and uses the method of process tracing to explore the sources of foreign policy choice and change. Foreign policy is derived from grand strategy, which refers to the full package of a state’s domestic and foreign policies. I argue that a state’s grand strategy results from the interaction of four factors—its society’s historical experience, social motivation, international power, and political contest among domestic groups. Grand strategies emerge as a response to perceived shifts in the balance of international economic, political, and military power. However, this is not to say that international pressures and incentives are translated into foreign policy. Rather, pressures and incentives are given meaning by worldviews, which reflect a society’s historical experiences of its place in the international system at traumatic junctures of its encounter with the outside world. Strategic changes in foreign policy follow what I call the “strategic algorithm,” which incorporates four major mechanisms—balancing against threat, bandwagoning with power, learning, and survival by transformation. This case study generates hypotheses for a theory of strategic choice, a theory of foreign policy transformation, and a theory of grand strategy emergence.

Spectrum reconstruction from a scattering measurement using the adjoint Boltzmann transport equation for photons

Quality control of medical radiological systems is of fundamental importance, and requires efficient methods for accurately determine the X-ray source spectrum. Straightforward measurements of X-ray spectra in standard operating require the limitation of the high photon flux, and therefore the measure has to be performed in a laboratory. However, the optimal quality control requires frequent in situ measurements which can be only performed using a portable system. To reduce the photon flux by 3 magnitude orders an indirect technique based on the scattering of the X-ray source beam by a solid target is used. The measured spectrum presents a lack of information because of transport and detection effects. The solution is then unfolded by solving the matrix equation that represents formally the scattering problem. However, the algebraic system is ill-conditioned and, therefore, it is not possible to obtain a satisfactory solution. Special strategies are necessary to circumvent the ill-conditioning. Numerous attempts have been done to solve this problem by using purely mathematical methods. In this thesis, a more physical point of view is adopted. The proposed method uses both the forward and the adjoint solutions of the Boltzmann transport equation to generate a better conditioned linear algebraic system. The procedure has been tested first on numerical experiments, giving excellent results. Then, the method has been verified with experimental measurements performed at the Operational Unit of Health Physics of the University of Bologna. The reconstructed spectra have been compared with the ones obtained with straightforward measurements, showing very good agreement.