Colour Doppler ultrasound of the ocular circulation in patients with systemic lupus erythematosus identifies altered microcirculatory haemodynamics

We assessed whether quantitative analysis of Doppler flow velocity waveforms is able to identify subclinical microvascular abnormalities in SLE and whether eigenvector analysis can detect changes not detectable using the resistive index (RI). Fifty-four SLE patients with no conventional cardiovascular risk factors, major organ involvement or retinopathy were compared to 32 controls. Flow velocity waveforms were obtained from the ophthalmic artery (OA), central retinal artery (CRA) and common carotid artery (CA). The waveforms were analysed using eigenvector decomposition and compared between groups at each arterial site. The RI was also determined. The RI was comparable between groups. In the OA and CRA, there were significant differences in the lower frequency sinusoidal components (P <0.05 for each component). No differences were apparent in the CA between groups. Eigenvector analysis of Doppler flow waveforms, recorded in proximity of the terminal vascular bed, identified altered ocular microvascular haemodynamics in SLE. Altered waveform structure could not be identified by changes in RI, the traditional measure of downstream vascular resistance. This analytical approach to waveform analysis is more sensitive in detecting preclinical microvascular abnormalities in SLE. It may hold potential as a useful tool for assessing disease activity, response to treatment, and predicting future vascular complications.

Burkholderia cenocepacia disrupts host cell actin cytoskeleton by inactivating Rac and Cdc42

Burkholderia cenocepacia, a member of the Burkholderia cepacia complex, is an opportunistic pathogen that causes devastating infections in patients with cystic fibrosis. The ability of B. cenocepacia to survive within host cells could contribute significantly to its virulence in immunocompromised patients. In this study, we explored the mechanisms that enable B. cenocepacia to survive inside macrophages. We found that B. cenocepacia disrupts the actin cytoskeleton of infected macrophages, drastically altering their morphology. Submembranous actin undergoes depolymerization, leading to cell retraction. The bacteria perturb actin architecture by inactivating Rho family GTPases, particularly Rac1 and Cdc42. GTPase inactivation follows internalization of viable B. cenocepacia and compromises phagocyte function: macropinocytosis and phagocytosis are markedly inhibited, likely impairing the microbicidal and antigen-presenting capability of infected macrophages. The type VI secretion system is essential for the bacteria to elicit these changes. This is the first report demonstrating inactivation of Rho family GTPases by a member of the B. cepacia complex.

Inactivation of macrophage Rab7 by Burkholderia cenocepacia

Strains of the Burkholderia cepacia complex can survive within macrophages by arresting the maturation of phagocytic vacuoles. The bacteria preclude fusion of the phagosome with lysosomes by a process that is poorly understood. Using murine macrophages, we investigated the stage at which maturation is arrested and analyzed the underlying mechanism. Vacuoles containing B. cenocepacia strain J2315, an isolate of the transmissible ET12 clone, recruited Rab5 and synthesized phosphatidylinositol-3-phosphate, indicating progression to the early phagosomal stage. Despite the fact that the B. cenocepacia-containing vacuoles rarely fused with lysosomes, they could nevertheless acquire the late phagosomal markers CD63 and Rab7. Fluorescence recovery after photobleaching and use of a probe that detects Rab7-guanosine triphosphate indicated that activation of Rab7 was impaired by B. cenocepacia, accounting at least in part for the inability of the vacuole to merge with lysosomes. The Rab7 defect was not due to excessive cholesterol accumulation and was confined to the infected vacuoles. Jointly, these experiments indicate that B. cenocepacia express virulence factors capable of interfering with Rab7 function and thereby with membrane traffic.

Metais em águas e sedimentos da plataforma dos Açores

A presente tese tem por objetivo principal contribuir para o conhecimento da geoquímica sedimentar da zona oceânica da crista da Terceira e montanhas submarinas a sul (região entre 29-39ºN e 27-32ºW), integrando também a caraterização dos metais e nutrientes na coluna de água e propondo concentrações para servirem de referência nesta região do Atlântico Central. Para o efeito foram realizadas amostragens na coluna de água em sete locais e de sedimento em cinco locais, durante a campanha oceanográfica designada por EMEPC/AÇORES/G3/2007 a bordo do navio SV Kommandor Jack, no âmbito do projeto da Estrutura de Missão para a Extensão da Plataforma Continental (EMEPC). Os perfis de CTD da coluna de água na região estudada revelam a presença de massas de água distintas: a Western North Atlantic Central Water (WNACW), a Eastern North Atlantic Central Water tropical (ENACWt), a Eastern North Atlantic Central Water polar (ENACWp), a Mediterranean Overflow Water (MOW), a Deep Mediterranean Water (DMW) e a North Eastern Atlantic Deep Water (NEADW). Observou-se nos perfis de temperatura e salinidade, referentes aos primeiros 200 m da coluna de água, um gradiente meridional negativo entre as estações localizadas na crista da Terceira e as estações localizadas mais a sul. Observou-se nas águas superficiais valores de oxigénio dissolvido de 93% e de pH de 8,1, assim como que as concentrações dos nutrientes NOx, PO4 e SiO2 variam de acordo com a atividade biológica, tendo-se registado concentrações medianas mais baixas, respetivamente de 6,5, 0,23 e 1,3 mol L-1, que aumentam com a profundidade devido à ausência de produção primária (respetivamente 31, 1,4 e 22 mol L-1). As concentrações de NH4 e de SO4 não variam significativamente nas massas de água, sendo os valores medianos mínimos e máximos de 0,69 a 0,79 mol L-1 para o NH4 e de 30 a 32 mol L-1 para o SO4. São propostas concentrações de referência para as massas de água, para os elementos cobre, cádmio, chumbo e arsénio. Os perfis de sedimento analisados permitem distinguir os sedimentos na crista da Terceira (core A) dos restantes (cores B a E). A grande variabilidade textural encontrada no core A, que contrasta com os outros cores analisados, deve-se a importantes contribuições terrígenas, originadas pela erosão sub-aérea e pela atividade vulcânica das ilhas próximas. iv resumo (continuação) A análise mineralógica, efetuada à fração areia e à fração fina (< 63 μm), confirma que os sedimentos do core A derivam de rochas vulcânicas formadas maioritariamente por piroxenas, olivinas, anfíbolas, biotite, alterites e ainda calcite, plagióclase e magnetite, tendo-se identificado ao microscópio a glauconite e o vidro vulcânico. De acordo com a composição química destes minerais o core A apresenta valores mais elevados de Al, Fe, K, P, Mg, Si, Na, Zn, V, Cr e Mn relativamente aos cores B a E. Os cores B a E apresentam grandes quantidades de calcite (>80%) formada maioritariamente por foraminíferos e nanoplâncton calcário (cocolitóforos). A fração areia confirma a composição maioritariamente carbonatada com grande abundância de material biogénico formado por oozes de foraminíferos (planctónicos e bentónicos) com raras espículas de espongiários e restos de conchas. Os cores B a E apresentam valores muito mais elevados que o core A para os elementos Ca e Sr. Os resultados para o Al, Fe, K, P, Si, Na, As, Cu, Ni, Zn, V, Cr, Li, Pb, Cd e Co presentes nos locais B, C, D e E sugerem que estes cores são comparáveis aos sedimentos de fundo carbonatados. Propõe-se concentrações de referência para a região do Atlântico compreendida entre 29-39ºN e 27-32ºW considerando a primeira camada colhida em cada core. Para o core A as concentrações são normalizadas a 5% de Al e CaCO3, enquanto que para os cores B a E são normalizadas a 2% de Al e CaCO3. Assim as concentrações de referência para o core A são: As – 18 mg kg-1, Cr – 91 mg kg-1, Cu – 127 mg kg-1, Ni – 84 mg kg-1, Pb – 41 mg kg-1, Hg – 41 ng g-1 e Zn – 482 mg kg-1. Para os cores B a E as concentrações de referência são: As – 3 mg kg-1, Cr – 10 mg kg-1, Cu – 36 mg kg-1 Ni – 12 mg kg -1, Hg – 3 ng g-1 e Zn – 20 mg kg-1. Para os restantes metais as concentrações de referência para o core A são: Al – 9%, Si – 25%, Fe – 6%, Ca – 13%, K – 2%, Mg – 2%, Na – 3%, P – 0,4%, Sr – 900 mg kg-1, Li – 10 mg kg-1, Mn – 1200 mg kg-1, Ba – 700 mg kg-1 e V – 140 mg kg-1. Para os cores B a E as concentrações de referência são: Al – 0,9%, Si – 2%, Fe – 0,2%, Ca – 95%, K – 0,3%, Mg – 0,4%, Na – 0,3%, P – 0,04%, Sr – 2600 mg kg-1, Li – 5 mg kg-1, Mn – 240 mg kg-1, Ba – 345 mg kg-1, Co – 2 mg kg-1 e V – 6 mg kg-1. Os resultados da presente tese constituem um contributo para a caraterização geoquímica da região e podem servir de referência à monitorização futura do mar dos Açores e montes submarinos a sul.

Una aproximación teórico-práctica para el costeo de cápitas de paquetes de salud

Metodología para la estimación de cápitas de planes de salud. Se propone un método de cuantificación de insumos a emplear, la estimación de costos indirectos asociados a las intervenciones y un método de anualización para los costos fijos que generalmente trascienden en su vida útil al período de duración de una cápita. Finalmente, a través de un ejercicio práctico de estimación de la cápita del Componente de Salud del Programa Oportunidades de México se ilustra la aplicación del desarrollo metodológico expuesto en la parte inicial.

Calidad de atención percibida y calidad de vida relacionada con la salud en pacientes participantes de estudios clínicos de la ips idearg sas.

La presente investigación surge en el programa de Bienestar y Calidad de Vida suscrito a la Línea de Liderazgo en la Escuela de Administración de la Universidad del Rosario, con el objetivo de describir si las subdimensiones de la calidad de la atención percibida guardan relación con la calidad de vida relacionada con la salud en los pacientes participantes en Estudios Clínicos en la Institución Prestadora de Servicios de Salud IDEARG SAS, considerando si los factores sociodemográficos se constituyen en mediadores de esta relación. Esta investigación plantea un estudio descriptivo correlacional, en el que a partir de la utilización de los cuestionarios PECASUSS, Percepción de la Calidad según Usuarios del Servicio de Salud, y SF36 de Calidad de Vida Relacionada con la Salud, se lleve a cabo un procesamiento estadístico descriptivo en el software SPSS 21, y con ello se evidencie la correlación entre la calidad de atención percibida y la calidad de vida en salud. Para su desarrollo se abordaran cinco capítulos. El primero engloba el proyecto de trabajo de grado propuesto, el segundo capítulo refiere a la descripción de las subdimensiones que componen la Calidad de la Atención Percibida y de los índices y dominios que a la Calidad de Vida relacionada con la Salud atañen; en el tercer capítulo se evidencia la relación entre los datos sociodemográficos de los participantes y, por un lado, la Calidad de la Atención Percibida y, por otro lado, la Calidad de Vida Relacionada con la Salud; enseguida en el cuarto capítulo se describen las relaciones emergentes entre los dominios de la calidad de vida relacionados con la salud y las subdimensiones de la calidad de la atención en salud percibida; en un quinto capítulo se discuten las correlaciones que describen la existencia de relación entre la Calidad de la Atención Percibida y la Calidad de Vida Relacionada con la Salud; y finalmente se da cierre al trabajo con las conclusiones y recomendaciones.

Dificultades en la integración y cooperación de los cuerpos policiales de América Latina en la lucha contra el narcotráfico. Estudio de caso: AMERIPOL

La presente investigación analiza los principales retos que afectan la cooperación e integración de los cuerpos policiales latinoamericanos en la lucha contra el narcotráfico. Para realizar dicho análisis se toma como caso de estudio AMERIPOL, organización creada en el año 2007 y que actualmente constituye el único mecanismo de cooperación policial en el hemisferio americano. Se considera que la cooperación e integración de los cuerpos policiales en la lucha contra el narcotráfico en la región enfrentan dos retos principales: la disparidad de los marcos jurídicos entre los Estados y la descoordinación política. Estos retos suponen la existencia de factores que impiden una política de cooperación conjunta contra las drogas y por tanto, el desarrollo de actitudes aislacionistas que limitan la cooperación en contra de éste flagelo

Impact of Tibetan Orography and Heating on the Summer Flow over Asia

The influence on the summer flow over Asia of both the orographic and thermal forcing of the Tibetan Plateau is investigated using a sequence of idealised experiments with a global primitive equation model. The zonally averaged flow is prescribed and both realistic and idealised orography and heating are used. There is some similarity between the responses to the two forcings when applied separately. The upper tropospheric Tibetan anticyclone is predominantly forced by the heating but also weakly by the orography. Below this, both forcings tend to give air descending in an equatorward anticyclonic circulation down the isentropes to the west and rising in a similar poleward circulation to the east. However the heating-only response has a strong ascending southwesterly flow that is guided around the south and south-east of the orography when it is included. On the northern side, the westerly flow over the orography gives ascent on the upslope and descent on the downslope. It is found that heating over the Plateau leads to a potential vorticity (PV) minimum and that if it is sufficiently strong the flow is unstable, producing a quasi-biweekly oscillation. During this oscillation the Tibetan anticyclone changes between a single centre over the southwestern side of the Plateau and a split/double structure with centres over China and the Middle East. These characteristics are similar to observed variability in the region. Associated with this quasi-biweekly oscillation are significant variations in the strength of the ascent over the Plateau and the Rossby wave pattern over the North Pacific. The origin of the variability is instability associated with the zonally extended potential vorticity PV minimum on a θ-surface, as proposed by Hsu and Plumb (2000). This minimum is due to the tendency to reduce the PV above the heating over the Plateau and to advection by the consequent anticyclone of high PV around from the east and low PV to the west. The deep convection to the south and southeast of the Plateau tends to suppress the quasi-biweekly oscillation because the low PV produced above it acts to reduce the meridional PV gradient reversal. The occurrence of the oscillation depends on the relative magnitude of the heating in the two regions.

Interactions between the grasses Phalaris arundinacea, Miscanthus sinensis and Echinochloa crus-galli, and barley and cereal yellow dwarf virusus

The grass species Miscanthus sinensis, Echinochloa crus-galli and Phalaris arundinacea may be useful biomass crops. In glasshouse inoculations with two isolates of Barley yellow dwarf virus (BYDV)-MAV and BYDV-PAV and one of Cereal yellow dwarf virus (CYVD)-RPV , E. crus galli was infected by all three virus isolates, P. arundinacea by BYDV-MAV and CYDV-RPV, but M. sinensis only by BYDV-MAV. All three hosts became very difficult to infect after several weeks’ growth. Symptoms were inconspicuous; dry matter yield losses ranged from c. 20–40%. Aphids acquired all three virus isolates from E. crus-galli, but more efficiently from 5 than 26-week-old plants. Only BYDV-MAV was acquired from P. arundinacea and M. sinensis. Plants of each species and of Avena sativa were grown outdoors between May and July in 1994 and 1995. Young plants of each species were exposed for successive 2-week intervals during the same periods. Vector populations were higher on A. sativa and P. arundinacea than on E. crus-galli and M. sinensis, and more plants of these species became infected. In 1994 only BYDV-MAV was detected. In 1995 BYDV-MAV, BYDV-PAV and CYDV-RPV were all detected; BYDV-MAV was again the virus isolate most frequently found.

Antarctic ocean and sea ice response to ozone depletion: a two timescale problem

The response of the Southern Ocean to a repeating seasonal cycle of ozone loss is studied in two coupled climate models and found to comprise both fast and slow processes. The fast response is similar to the inter-annual signature of the Southern Annular Mode (SAM) on Sea Surface Temperature (SST), on to which the ozone-hole forcing projects in the summer. It comprises enhanced northward Ekman drift inducing negative summertime SST anomalies around Antarctica, earlier sea ice freeze-up the following winter, and northward expansion of the sea ice edge year-round. The enhanced northward Ekman drift, however, results in upwelling of warm waters from below the mixed layer in the region of seasonal sea ice. With sustained bursts of westerly winds induced by ozone-hole depletion, this warming from below eventually dominates over the cooling from anomalous Ekman drift. The resulting slow-timescale response (years to decades) leads to warming of SSTs around Antarctica and ultimately a reduction in sea-ice cover year-round. This two-timescale behavior - rapid cooling followed by slow but persistent warming - is found in the two coupled models analysed, one with an idealized geometry, the other a complex global climate model with realistic geometry. Processes that control the timescale of the transition from cooling to warming, and their uncertainties are described. Finally we discuss the implications of our results for rationalizing previous studies of the effect of the ozone-hole on SST and sea-ice extent. %Interannual variability in the Southern Annular Mode (SAM) and sea ice covary such that an increase and southward shift in the surface westerlies (a positive phase of the SAM) coincides with a cooling of Sea Surface Temperature (SST) around 70-50$^\circ$S and an expansion of the sea ice cover, as seen in observations and models alike. Yet, in modeling studies, the Southern Ocean warms and sea ice extent decreases in response to sustained, multi-decadal positive SAM-like wind anomalies driven by 20th century ozone depletion. Why does the Southern Ocean appear to have disparate responses to SAM-like variability on interannual and multidecadal timescales? Here it is demonstrated that the response of the Southern Ocean to ozone depletion has a fast and a slow response. The fast response is similar to the interannual variability signature of the SAM. It is dominated by an enhanced northward Ekman drift, which transports heat northward and causes negative SST anomalies in summertime, earlier sea ice freeze-up the following winter, and northward expansion of the sea ice edge year round. The enhanced northward Ekman drift causes a region of Ekman divergence around 70-50$^\circ$S, which results in upwelling of warmer waters from below the mixed layer. With sustained westerly wind enhancement in that latitudinal band, the warming due to the anomalous upwelling of warm waters eventually dominates over the cooling from the anomalous Ekman drift. Hence, the slow response ultimately results in a positive SST anomaly and a reduction in the sea ice cover year round. We demonstrate this behavior in two models: one with an idealized geometry and another, more detailed, global climate model. However, the models disagree on the timescale of transition from the fast (cooling) to the slow (warming) response. Processes that controls this transition and their uncertainties are discussed.

Annular modes and apparent eddy feedbacks in the Southern Hemisphere

Lagged correlation analysis is often used to infer intraseasonal dynamical effects but is known to be affected by non-stationarity. We highlight a pronounced quasi-two-year peak in the anomalous zonal wind and eddy momentum flux convergence power spectra in the Southern Hemisphere, which is prima facie evidence for non-stationarity. We then investigate the consequences of this non-stationarity for the Southern Annular Mode and for eddy momentum flux convergence. We argue that positive lagged correlations previously attributed to the existence of an eddy feedback are more plausibly attributed to non-stationary interannual variability external to any potential feedback process in the mid-latitude troposphere. The findings have implications for the diagnosis of feedbacks in both models and re-analysis data as well as for understanding the mechanisms underlying variations in the zonal wind.