The Stability of the Blood Oxygenation Level-Dependent Functional MRI Response to Motor Tasks Is Altered in Patients With Chronic Ischemic Stroke

Background and Purpose-Functional MRI is a powerful tool to investigate recovery of brain function in patients with stroke. An inherent assumption in functional MRI data analysis is that the blood oxygenation level-dependent (BOLD) signal is stable over the course of the examination. In this study, we evaluated the validity of such assumption in patients with chronic stroke. Methods-Fifteen patients performed a simple motor task with repeated epochs using the paretic and the unaffected hand in separate runs. The corresponding BOLD signal time courses were extracted from the primary and supplementary motor areas of both hemispheres. Statistical maps were obtained by the conventional General Linear Model and by a parametric General Linear Model. Results-Stable BOLD amplitude was observed when the task was executed with the unaffected hand. Conversely, the BOLD signal amplitude in both primary and supplementary motor areas was progressively attenuated in every patient when the task was executed with the paretic hand. The conventional General Linear Model analysis failed to detect brain activation during movement of the paretic hand. However, the proposed parametric General Linear Model corrected the misdetection problem and showed robust activation in both primary and supplementary motor areas. Conclusions-The use of data analysis tools that are built on the premise of a stable BOLD signal may lead to misdetection of functional regions and underestimation of brain activity in patients with stroke. The present data urge the use of caution when relying on the BOLD response as a marker of brain reorganization in patients with stroke. (Stroke. 2010; 41:1921-1926.)

Absolute and relative abundance estimates of Australian east cost humpback whales (Megaptera novaeangliae)

The humpback whales that migrate along the east coast of Australia were hunted to near-extinction in the 1950s and early 1960s. Two independent series of land-based surveys conducted over the last 25 years during the whales’ northward migration along the Australian coastline have demonstrated a rapid increase in the size of the population. In 2004 we conducted a survey of the migratory population as a continuation of these series of surveys. Two methods of data analysis were used in line with the previous surveys, both for calculation of absolute and relative abundance. We consider the best estimates for 2004 to be 7,090 ± 660 (95% CI) whales with an annual rate of increase of 10.6 ± 0.5% (95% CI) for 1987 – 2004. The rate of increase agrees with those previously obtained for this population and demonstrates the continuation of a strong post-exploitation recovery. While there are still some uncertainties concerning the absolute abundance estimate and structure of this population, the rate of annual increase should be independent of these and highly robust.

A nanometre-scale non-periodic structural variation in high temperature superconducting ceramics and the implications for properties

Non-periodic structural variation has been found in the high T-c cuprates, YBa2Cu3O7-x and Hg0.67Pb0.33Ba2Ca2Cu3O8+delta, by image analysis of high resolution transmission electron microscope (HRTEM) images. We use two methods for analysis of the HRTEM images. The first method is a means for measuring the bending of lattice fringes at twin planes. The second method is a low-pass filter technique which enhances information contained by diffuse-scattered electrons and reveals what appears to be an interference effect between domains of differing lattice parameter in the top and bottom of the thin foil. We believe that these methods of image analysis could be usefully applied to the many thousands of HRTEM images that have been collected by other workers in the high temperature superconductor field. This work provides direct structural evidence for phase separation in high T-c cuprates, and gives support to recent stripes models that have been proposed to explain various angle resolved photoelectron spectroscopy and nuclear magnetic resonance data. We believe that the structural variation is a response to an opening of an electronic solubility gap where holes are not uniformly distributed in the material but are confined to metallic stripes. Optimum doping may occur as a consequence of the diffuse boundaries between stripes which arise from spinodal decomposition. Theoretical ideas about the high T-c cuprates which treat the cuprates as homogeneous may need to be modified in order to take account of this type of structural variation.

Body size and ovarian cancer: case-control study and systematic review (Australia)

Objective: Although increased body mass is an established risk factor for a variety of cancers, its relation with cancer of the ovary is unclear. We therefore investigated the association between measures of body mass index (BMI) and ovarian cancer risk. Methods: Data from an Australian case-control study of 775 ovarian cancer cases and 846 controls were used to examine the association with BMI. We have also summarized the results from a number of other studies that have examined this association. Results: There was a significant increased risk of ovarian cancer with increasing BMI, with women in the top 15% of the BMI range having an odds ratio (OR) of 1.9 (95% confidence interval (CI), 1.3-2.6) compared with those in the middle 30%. Stratifying by physical activity showed a stronger effect among inactive women (OR = 3.0, 95% CI 1.3-6.9). The overall effect was consistent with the findings of most prior population-based case-control studies, while cohort studies reported positive effects closer to the null. Hospital-based studies gave variable results. Conclusions: Taken together, the evidence is in favor of a small to moderate positive relation between high BMI and occurrence of ovarian cancer.

Self-reported calcium intake and bone mineral content in children and adolescents

Objective: We examined the relationship between self-reported calcium (Cal intake and bone mineral content (BMC) in children and adolescents. We hypothesized that an expression of Ca adjusted for energy intake (El), i.e., Ca density, would be a better predictor of BMC than unadjusted Ca because of underreporting of EI. Methods: Data were obtained on dietary intakes (repeated 24-hour recalls) and BMC (by DEXA) in a cross-section of 227 children aged 8 to 17 years. Bivariate and multivariate analyses were used to examine die relationship between Ca, Ca density, and the dependent variables total body BMC and lumbar spine BMC. Covariates included were height, weight, bone area, maturity age, activity score and El. Results: Reported El compared to estimated basal metabolic rate suggested underreporting of El. Total body and lumbar spine BMC were significantly associated with El, but not Ca or Ca density, in bivariate analyses. After controlling for size and maturity, multiple linear regression analysis revealed unadjusted Ca to be a predictor of BMC in males in the total body (p = 0.08) and lumbar spine (p = 0.01). Unadjusted Ca was not a predictor of BMC at either site in females. Ca density was not a better predictor of BMC at either site in males or females. Conclusions: The relationship observed in male adolescents in this study between Ca intake and BMC is similar to that seen in clinical trials. Ca density did not enable us to see a relationship between Ca intake and BMC in females, which may reflect systematic reporting errors or that diet is not a limiting factor in this group of healthy adolescents.

The application of statistical process control charts to the detection and monitoring of hospital-acquired infections

The monitoring of infection control indicators including hospital-acquired infections is an established part of quality maintenance programmes in many health-care facilities. However, surveillance data use can be frustrated by the infrequent nature of many infections. Traditional methods of analysis often provide delayed identification of increasing infection occurrence, placing patients at preventable risk. The application of Shewhart, Cumulative Sum (CUSUM) and Exponentially Weighted Moving Average (EWMA) statistical process control charts to the monitoring of indicator infections allows continuous real-time assessment. The Shewhart chart will detect large changes, while CUSUM and EWMA methods are more suited to recognition of small to moderate sustained change. When used together, Shewhart and EWMA methods are ideal for monitoring bacteraemia and multiresistant organism rates. Shewhart and CUSUM charts are suitable for surgical infection surveillance.

Population pharmacokinetics of tacrolimus in adult kidney transplant recipients

Objectives: The aims of this study were to investigate the population pharmacokinetics of tacrolimus in adult kidney transplant recipients and to identify factors that explain variability. Methods: Population analysis was performed on retrospective data from 70 patients who received oral tacrolimus twice daily. Morning blood trough concentrations were measured by liquid chromatography-tandem mass spectrometry. Maximum likelihood estimates were sought for apparent clearance (CL/F) and apparent volume of distribution (V/F), with the use of NONMEM (GloboMax LLC, Hanover, Md). Factors screened for influence on these parameters were weight, age, gender, postoperative day, days of tacrolimus therapy, liver function tests, creatinine clearance, hematocrit fraction, corticosteroid dose, and potential interacting drugs. Results. CL/F was greater in patients with abnormally low hematocrit fraction (data from 21 patients only), and it decreased with increasing days of therapy and AST concentrations (P

Allowance for thermodynamic non-ideality in the characterization of protein self-association by frontal exclusion chromatography: hemoglobin revisited

This investigation re-examines theoretical aspects of the allowance for effects of thermodynamic non-ideality on the characterization of protein self-association by frontal exclusion chromatography, and thereby provides methods of analysis with greater thermodynamic rigor than those used previously. Their application is illustrated by reappraisal of published exclusion chromatography data for hemoglobin on the controlled-pore-glass matrix CPG-120. The equilibrium constant of 100/M that is obtained for dimerization of the (02 species by this means is also deduced from re-examination of published studies of concentrated hemoglobin solutions by osmotic pressure and sedimentation equilibrium methods. (C) 2003 Elsevier Science B.V. All rights reserved.

Phylogeny and classification of the Digenea (Platyhelminthes : Trematoda)

Complete small subunit ribosomal RNA gene (ssrDNA) and partial (D1-D3) large subunit ribosomal RNA gene (lsrDNA) sequences were used to estimate the phylogeny of the Digenea via maximum parsimony and Bayesian inference. Here we contribute 80 new ssrDNA and 124 new lsrDNA sequences. Fully complementary data sets of the two genes were assembled from newly generated and previously published sequences and comprised 163 digenean taxa representing 77 nominal families and seven aspidogastrean outgroup taxa representing three families. Analyses were conducted on the genes independently as well as combined and separate analyses including only the higher plagiorchiidan taxa were performed using a reduced-taxon alignment including additional characters that could not be otherwise unambiguously aligned. The combined data analyses yielded the most strongly supported results and differences between the two methods of analysis were primarily in their degree of resolution. The Bayesian analysis including all taxa and characters, and incorporating a model of nucleotide substitution (general-time-reversible with among-site rate heterogeneity), was considered the best estimate of the phylogeny and was used to evaluate their classification and evolution. In broad terms, the Digenea forms a dichotomy that is split between a lineage leading to the Brachylaimoidea, Diplostomoidea and Schistosomatoidea (collectively the Diplostomida nomen novum (nom. nov.)) and the remainder of the Digenea (the Plagiorchiida), in which the Bivesiculata nom. nov. and Transversotremata nom. nov. form the two most basal lineages, followed by the Hemiurata. The remainder of the Plagiorchiida forms a large number of independent lineages leading to the crown clade Xiphidiata nom. nov. that comprises the Allocreadioidea, Gorgoderoidea, Microphalloidea and Plagiorchioidea, which are united by the presence of a penetrating stylet in their cercariae. Although a majority of families and to a lesser degree, superfamilies are supported as currently defined, the traditional divisions of the Echinostomida, Plagiorchiida and Strigeida were found to comprise non-natural assemblages. Therefore, the membership of established higher taxa are emended, new taxa erected and a revised, phylogenetically based classification proposed and discussed in light of ontogeny, morphology and taxonomic history. (C) 2003 Australian Society for Parasitology Inc. Published by Elsevier Science Ltd. All rights reserved.

Model-based analysis of anaerobic acetate uptake by a mixed culture of polyphosphate-accumulating and glycogen-accumulating organisms

An increasing number of studies shows that the glycogen-accumulating organisms (GAOs) can survive and may indeed proliferate under the alternating anaerobic/aerobic conditions found in EBPR systems, thus forming a strong competitor of the polyphosphate-accumulating organisms (PAOs). Understanding their behaviors in a mixed PAO and GAO culture under various operational conditions is essential for developing operating strategies that disadvantage the growth of this group of unwanted organisms. A model-based data analysis method is developed in this paper for the study of the anaerobic PAO and GAO activities in a mixed PAO and GAO culture. The method primarily makes use of the hydrogen ion production rate and the carbon dioxide transfer rate resulting from the acetate uptake processes by PAOs and GAOs, measured with a recently developed titration and off-gas analysis (TOGA) sensor. The method is demonstrated using the data from a laboratory-scale sequencing batch reactor (SBR) operated under alternating anaerobic and aerobic conditions. The data analysis using the proposed method strongly indicates a coexistence of PAOs and GAOs in the system, which was independently confirmed by fluorescent in situ hybridization (FISH) measurement. The model-based analysis also allowed the identification of the respective acetate uptake rates by PAOs and GAOs, along with a number of kinetic and stoichiometric parameters involved in the PAO and GAO models. The excellent fit between the model predictions and the experimental data not involved in parameter identification shows that the parameter values found are reliable and accurate. It also demonstrates that the current anaerobic PAO and GAO models are able to accurately characterize the PAO/GAO mixed culture obtained in this study. This is of major importance as no pure culture of either PAOs or GAOs has been reported to date, and hence the current PAO and GAO models were developed for the interpretation of experimental results of mixed cultures. The proposed method is readily applicable for detailed investigations of the competition between PAOs and GAOs in enriched cultures. However, the fermentation of organic substrates carried out by ordinary heterotrophs needs to be accounted for when the method is applied to the study of PAO and GAO competition in full-scale sludges. (C) 2003 Wiley Periodicals, Inc.

C??maras setoriais no Governo do Estado do Par??

O artigo apresenta o in??cio da implanta????o das c??maras setoriais no Governo do Estado do Par??, introduzindo um novo desenho para a gest??o das pol??ticas p??blicas no estado. A pesquisa foi realizada por meio de an??lise documental junto a diversas inst??ncias do governo paraense, tendo sido o autor participante da implanta????o e da coordena????o da C??mara Setorial de Gest??o at?? 2007. Primeiramente, faz-se uma an??lise sobre os novos modelos de gest??o p??blica no Brasil e a dissolu????o dos antigos padr??es. Em seguida, apresenta-se a proposta de c??maras setoriais, seus m??todos e conceitos, partindo para avan??os e desafios impostos pela implementa????o do novo modelo, conclui-se com uma an??lise sobre o futuro do modelo na gest??o p??blica estadual, bem como a aproxima????o com ferramentas contempor??neas da administra????o, interagindo com as diversas ??reas do governo estadual.

Caracterização físico química, perfil sensorial e aceitação de morangos submetidos à irradiação

A irradiação de alimentos é um método de conservação não térmico utilizado em diferentes alimentos e em diferentes doses. Sabe-se que, dependendo da dose aplicada, esse método pode ocasionar alterações nas características físico-químicas e sensoriais, que afetam a qualidade do produto. Portanto, um dos objetivos deste estudo foi analisar o efeito da irradiação nas características físico-químicas e sensoriais de morangos irradiados. A irradiação das amostras de morango ocorreu um dia após a colheita e foi realizada no Laboratório de Radiação Gama do Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), em Belo Horizonte-MG. As doses utilizadas foram 1 kGy, 2 kGy, 3 kGy e 4 kGy e a amostra controle (0 kGy). Foram avaliados pH, acidez total titulável, sólidos solúveis, ratio (relação entre teor de sólidos solúveis e acidez total titulável), açúcares redutores, totais e não redutores, pectina, ácido ascórbico, firmeza, cor, antocianinas, compostos fenólicos e capacidade antioxidante. Para a caracterização sensorial das amostras, foi utilizado o método Perfil Descritivo Otimizado (PDO), sendo avaliados os atributos sensoriais cor, sabor adocicado, gosto ácido, firmeza e suculência, por 15 julgadores previamente selecionados. Além da caracterização sensorial, foi realizada a análise de aceitação sensorial por 60 consumidores de morango em duas sessões. A irradiação não alterou significativamente a maioria das características físico-químicas analisadas, ao comparar todas as doses empregadas, incluindo o morango controle (não irradiado); apenas a firmeza apresentou valores diferentes estatisticamente: com o aumento da dose, houve diminuição da firmeza do fruto. No PDO, as amostras diferiram quanto à cor, sabor adocicado, firmeza e suculência, sendo que a amostra controle e a amostra irradiada com 1 kGy tiveram maiores valores de firmeza e menores de suculência e sabor adocicado. Em relação à aceitação, a amostra controle e a amostra irradiada com 1 kGy não diferiram estatisticamente pelo teste Tukey a 5%, mas diferiram das amostras irradiadas com doses de 3 kGy e de 4 kGy; no entanto, a amostra irradiada a 2 kGy não diferiu de nenhuma outra dose. Foram realizados estudos de correlações entre os dados físico-químicos de pH, acidez total titulável (ATT), sólidos solúveis (SS), açúcares totais e açúcares não redutores, antocianina (método pH diferencial), pectina, firmeza instrumental, relação entre SS/ATT (ratio) e alguns parâmetros de cor (a*, b*, c* e L), e os dados do teste sensorial descritivo, ou seja, os atributos de firmeza, suculência, sabor adocicado e gosto ácido. Os resultados obtidos foram correlações significativamente positivas entre pH e ratio, sólidos solúveis e pectina, antocianinas e parâmetros de cor (a* e c*), açúcares e parâmetros de cor (b* e c*), firmeza sensorial e firmeza instrumental, suculência e sabor xvi adocicado e firmeza sensorial e gosto ácido. Já as correlações negativas foram entre acidez e ratio, sólidos solúveis e firmeza, antocianina e L*, firmeza sensorial e sabor adocicado e suculência com: firmeza instrumental, firmeza sensorial e gosto ácido. Neste trabalho, também foi realizada a caracterização físico-química e sensorial de morangos irradiados nas doses determinadas por Lima Filho et al. (2014) como sendo correspondentes ao limiar de detecção (LD) sensorial (0,405 kGy) e ao limiar de rejeição (LR) sensorial (3,6 kGy) para morangos irradiados. Além disso, foi verificada a influência da embalagem na aceitação sensorial de morangos irradiados na dose 3,6 kGy. Todas as medidas físico-químicas apresentaram pequena variação entre as amostras controle (0 kGy) e o LD e o LR. Não houve diferença significativa em relação à aceitação da amostra irradiada na ausência e na presença da embalagem, provavelmente devido ao grau de conhecimento do painel de consumidores em relação ao processo de irradiação de alimentos. Conclui-se que a irradiação é um método de conservação que pode ser utilizado em morangos, uma vez que exerce pouca influência, no período de tempo estudado, nas suas características físico-químicas e sensoriais.

Padrões espaço-temporais da mortalidade por câncer de mama em mulheres no Estado do Espírito Santo - um estudo ecológico

O câncer de mama é a principal neoplasia maligna que acomete o sexo feminino no Brasil. O câncer de mama é hoje uma doença de extrema importância para a saúde pública nacional, motivando ampla discussão em torno das medidas que promova o seu diagnóstico precoce, a redução em sua morbidade e mortalidade. A presente pesquisa possui três objetivos, cujos resultados encontram-se organizados em artigos. O primeiro objetivo buscou analisar a completude dos dados do Sistema de Informação de Mortalidade sobre os óbitos por câncer de mama em mulheres no Espírito Santo, Sudeste e Brasil (1998 a 2007). Realizou-se um estudo descritivo analítico baseado em dados secundários, onde foi analisado o número absoluto e percentual de não preenchimento das variáveis nas declarações de óbitos. Adotou-se escore para avaliar os graus de não completude. Os resultados para as variáveis sexo e idade foram excelentes tanto para o Espírito Santo, Sudeste e Brasil. O preenchimento das variáveis raça/cor, grau de escolaridade e estado civil apresentam problemas no Espírito Santo. Enquanto no Sudeste e Brasil as variáveis raça/cor e escolaridade têm tendência decrescente para a não completude, no Espírito Santo a tendência se mantém estável. Para a variável estado civil, a não completude tem tendência crescente no Estado do Espírito Santo. O segundo objetivo foi analisar a evolução das taxas de mortalidade por câncer de mama, em mulheres no Espírito Santo no período de 1980 a 2007. Estudo de série temporal, cujos dados sobre óbitos foram obtidos do Sistema de Informação de Mortalidade e as estimativas populacionais segundo idade e anos-calendário, do Instituto Brasileiro Geografia e Estatística. Os coeficientes específicos 9 de mortalidade, segundo faixa etária, foram calculados anualmente. A análise de tendência foi realizada por meio da padronização das taxas de mortalidade pelo método direto, em que a população do senso IBGE-2000, foi considerada padrão. No período de estudo, ocorreram 2.736 óbitos por câncer de mama. O coeficiente de mortalidade neste período variou de 3,41 a 10,99 por 100.000 mulheres. Os resultados indicam que há tendência de mortalidade por câncer de mama ao longo da série (p=0,001 com crescimento de 75,42%). Todas as faixas etárias a partir de 30 anos apresentaram tendência de crescimento da mortalidade estatisticamente significante (p=0,001). Os percentuais de crescimento foram aumentando, segundo as idades mais avançadas, sendo 48,4% na faixa de 40 a 49 anos, chegando a 92,3%, na faixa de 80 anos e mais. O terceiro objetivo foi realizar a análise espacial dos óbitos em mulheres por câncer de mama no estado do Espírito Santo, nos anos de 2003 a 2007, com análise das correlações espaciais dessa mortalidade e componentes do município. O cenário foi o Estado do Espírito Santo, composto por 78 municípios. Para análise dos dados, utilizou-se a abordagem bayesiana (métodos EBest Global e EBest Local) para correção de taxas epidemiológicas. Calculou-se o índice I de Moran, para dependência espacial em nível global e a estatística Moran Local. As maiores taxas estão concentradas em 19 municípios pertencentes às Microrregiões: Metropolitana (Fundão, Vitória, Vila Velha, Viana, Cariacica e Guarapari), Metrópole Expandida Sul (Anchieta, Alfredo Chaves), Pólo Cachoeiro (Vargem Alta, Rio Novo do Sul, Mimoso do Sul, Cachoeiro de Itapemirim, Castelo, Jerônimo Monteiro, Bom Jesus do Norte, Apiacá e Muqui) e Caparaó (Alegre e São José do Calçado). Os resultados da Estimação Bayesiana (Índice de Moran) dos óbitos por câncer de mama em mulheres ocorridos no estado do Espírito Santo, segundo os dados brutos e 10 ajustados indicam a existência de correlação espacial significativa para o mapa Local (I = 0,573; p = 0,001) e Global (I = 0,118; p = 0,039). Os dados brutos não apresentam correlação espacial (I = 0,075; p = 0,142).

Assessing morbidity in the paediatric community

INTRODUCTION: Morbidity information is easily available from medical records but its scope is limited to the population attended by the health services. Information on the prevalence of diseases requires community surveys, which are not always feasible. These two sources of information represent two alternative assessments of disease occurrence, namely demand morbidity and perceived morbidity. The present study was conceived so as to elicit a potential relationship between them so that the former could be used in the absence of the latter. METHODS: A community of 13,365 families on the outskirts of S. Paulo, Brazil, was studied during the period from 15/Nov/1994 to 15/Jan/1995. Data regarding children less than 5 years old were collected from a household survey and from the 2 basic health units in the area. Prevalence of diseases was ascertained from perceived morbidity and compared to estimates computed from demand morbidity. RESULTS: Data analysis distinguished 2 age groups, infants less than 1 year old and children 1 to less than 5. The most important groups of diseases were respiratory diseases, diarrhoea, skin problems and infectious & parasitical diseases. Basic health units presented a better coverage for infants. Though disease frequencies were not different within or outside these units, a better coverage was found for diarrhoea and infectious & parasitical diseases in the infant group, and for diarrhoea in the older age group. Equivalence between the two types of morbidity was found to be limited to the infant group and concerned only the best covered diseases. The odds of a disease being seen at the health service should be of at least 4:10 to ensure this equivalence. CONCLUSION: It was concluded that, provided that health service coverage is good, demand morbidity can be taken as a reliable estimate of community morbidity.

Comparação entre coronariografia efectuada via artéria radial e via artéria femoral

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular. Área de especialização: Intervenção Cardiovascular.