Acetylene plasma polymerized surfaces for covalent immobilization of dense bioactive protein monolayers

Smooth polymerized surfaces, suitable for biochemical and biomedical applications, were deposited using a modified plasma enhanced chemical vapour deposition method with acetylene as a reaction precursor. Horseradish peroxidase (HRP) activity assays showed that the protein immobilized on the plasma polymerized surfaces maintained its biological function for a much longer period of time compared to that on uncoated surfaces. The kinetics of HRP attachment to the plasma polymerized surfaces were analyzed using quartz crystal microbalance with dissipation analysis. Spectroscopic ellipsometry and attenuated total reflection Fourier transform infrared spectroscopy were used to determine the thickness and the quantity of the attached protein. The results showed that the plasma polymerized surfaces provided a high density of attachment sites to covalently immobilize a dense monolayer of proteins.

Persistence on therapy and propensity matched outcome comparison of two subcutaneous interferon beta 1a dosages for multiple sclerosis

To compare treatment persistence between two dosages of interferon β-1a in a large observational multiple sclerosis registry and assess disease outcomes of first line MS treatment at these dosages using propensity scoring to adjust for baseline imbalance in disease characteristics. Treatment discontinuations were evaluated in all patients within the MSBase registry who commenced interferon β-1a SC thrice weekly (n = 4678). Furthermore, we assessed 2-year clinical outcomes in 1220 patients treated with interferon β-1a in either dosage (22 µg or 44 µg) as their first disease modifying agent, matched on propensity score calculated from pre-treatment demographic and clinical variables. A subgroup analysis was performed on 456 matched patients who also had baseline MRI variables recorded. Overall, 4054 treatment discontinuations were recorded in 3059 patients. The patients receiving the lower interferon dosage were more likely to discontinue treatment than those with the higher dosage (25% vs. 20% annual probability of discontinuation, respectively). This was seen in discontinuations with reasons recorded as “lack of efficacy” (3.3% vs. 1.7%), “scheduled stop” (2.2% vs. 1.3%) or without the reason recorded (16.7% vs. 13.3% annual discontinuation rate, 22 µg vs. 44 µg dosage, respectively). Propensity score was determined by treating centre and disability (score without MRI parameters) or centre, sex and number of contrast-enhancing lesions (score including MRI parameters). No differences in clinical outcomes at two years (relapse rate, time relapse-free and disability) were observed between the matched patients treated with either of the interferon dosages. Treatment discontinuations were more common in interferon β-1a 22 µg SC thrice weekly. However, 2-year clinical outcomes did not differ between patients receiving the different dosages, thus replicating in a registry dataset derived from “real-world” database the results of the pivotal randomised trial. Propensity score matching effectively minimised baseline covariate imbalance between two directly compared sub-populations from a large observational registry.

Sex as a determinant of relapse incidence and progressive course of multiple sclerosis

The aim of this work was to evaluate sex differences in the incidence of multiple sclerosis relapses; assess the relationship between sex and primary progressive disease course; and compare effects of age and disease duration on relapse incidence. Annualized relapse rates were calculated using the MSBase registry. Patients with incomplete data or <1 year of follow-up were excluded. Patients with primary progressive multiple sclerosis were only included in the sex ratio analysis. Relapse incidences over 40 years of multiple sclerosis or 70 years of age were compared between females and males with Andersen-Gill and Tweedie models. Female-to-male ratios stratified by annual relapse count were evaluated across disease duration and patient age and compared between relapse-onset and primary progressive multiple sclerosis. The study cohort consisted of 11 570 eligible patients with relapse-onset and 881 patients with primary progressive multiple sclerosis. Among the relapse-onset patients (82 552 patient-years), 48 362 relapses were recorded. Relapse frequency was 17.7% higher in females compared with males. Within the initial 5 years, the female-to-male ratio increased from 2.3:1 to 3.3:1 in patients with 0 versus ≥4 relapses per year, respectively. The magnitude of this sex effect increased at longer disease duration and older age (P < 10−12). However, the female-to-male ratio in patients with relapse-onset multiple sclerosis and zero relapses in any given year was double that of the patients with primary progressive multiple sclerosis. Patient age was a more important determinant of decline in relapse incidence than disease duration (P < 10−12). Females are predisposed to higher relapse activity than males. However, this difference does not explain the markedly lower female-to-male sex ratio in primary progressive multiple sclerosis. Decline in relapse activity over time is more closely related to patient age than disease duration.

N-acetylcysteine for therapy-resistant tobacco use disorder: a pilot study

Introduction N-Acetylcysteine (NAC) may have efficacy in treating tobacco use disorder (TUD) by reducing craving and smoking reward. This study examines whether treatment with NAC may have a clinical efficacy in the treatment of TUD. Methods A 12-week double blind randomized controlled trial was conducted to compare the clinical efficacy of NAC 3 g/day versus placebo. We recruited 34 outpatients with therapy resistant TUD concurrently treated with smoking-focused group behavioral therapy. Participants had assessments of daily cigarette use (primary outcome), exhaled carbon monoxide (COEXH) (secondary outcome), and quit rates as defined by COEXH<6 ppm. Depression was measured with the Hamilton Depression Rating Scale (HDRS). Data were analyzed using conventional and modified intention-to-treat endpoint analyses. Results NAC treatment significantly reduced the daily number of cigarettes used (Δ mean±SD = -10.9 ± 7.9 in the NAC-treated versus -3.2 ± 6.1 in the placebo group) and COEXH (Δ mean± SD = -10.4 ± 8.6 ppm in the NAC-treated versus -1.5 ± 4.5 ppm in the placebo group); 47.1% of those treated with NAC versus 21.4% of placebo-treated patients were able to quit smoking as defined by COEXH<6 ppm. NAC treatment significantly reduced the HDRS score in patients with tobacco use disorder. Conclusions These data show that treatment with NAC may have a clinical efficacy in TUD. NAC combined with appropriate psychotherapy appears to be an efficient treatment option for TUD.

Programa brasileiro de acreditação hospitalar: sua influência no credenciamento de hospitais em operadoras de plano de saúde

This dissertation presents the result of a study accomplished on the degree of use of the certificate of hospital Accreditation as one of the criteria for the accreditation of hospitals by the health insurance companies. Should be emphasized that the Accreditation Certificate represents the main final product of Hospital Accreditation Brazilian Program, being the first emitted when the hospital assists to the quality patterns specified by the Program. In that way, the study focus was, in general terms, Hospital Accreditation Brazilian Program and, more strictly, the Accreditation Certificate and it use. To reach the objectives proposed by the study, interviews were accomplished with the professionals responsible for the accreditation of the hospitals in the main health insurance companies of Brazil. In the total, five companies were consulted among the ten larger health insurance companies of Brazil, considering the number of beneficiaries. To complement the research, additional information were collected in the National Agency of Supplemental Health. It was verified, through the research, that the health insurance companies don't use the Accreditation Certificate given by the Hospital Accreditation Brazilian Program to accredit hospitals.

Aspectos sedimentológicos e petrológicos dos Beachrocks do estado do Rio Grande do Norte

A maior parte dos beachrocks distribuídos ao longo das costas oriental e setentrional do Estado do Rio Grande do Norte (53% da espessura total) foi depositada na zona de ante-praia superior, representada pelas litofácies arenitos com estratificação cruzada tabular-planar e acanalada de média escala e arenitos conglomeráticos bioturbados por Skolithos. Conglomerados e arenitos com estratificação cruzada de baixo ângulo, depositados na zona de estirâncio, representam 31% das seções descritas. Os 16% restantes são atribuídos ao colapso de material sobrejacente como resultado de solapamento basal de falésias (conglomerados maciços), de transporte como tapetes de tração (conglomerados incipientemente estratificados) e de alto grau de alteração (arenitos maciços). Uma sucessão geral de fases diagenéticas pode ser reconhecida, nos beachrocks estudados, incluindo a precipitação de esmectita autigênica, cutículas micríticas, agregados radiais, franjas isópacas de cristais prismáticos, espato equante, cimento criptocristalino de preenchimento de poros e agregados pseudo-peloidais, bem como a infiltração vadosa de sedimentos micríticos, margosos ou sílticos A ausência de estruturas orgânicas, tais como filamentos e corpos microbiais (bactérias ou fungos), dentro dos cimentos, sugere que o mecanismo por trás da cimentação é essencialmente inorgânico, muito provavelmente devido à evaporação de água do mar, em resposta às condições climáticas secas prevalecentes. Os valores de 13CVPDB máximo, mínimo e médio obtidos para os cimentos são +3.57, –7.8 e +2.34‰, respectivamente. Os valores de 18OSMOW e 18OVPDB variam de 26.32 a 31.41 (valor médio: 30.64) e de –4.41 a 0.54‰ (valor médio: –0.22‰), respectivamente. A maior parte dos valores de 18OVPDB e 13CVPDB é compatível com os de cimentos marinhos. Algumas amostras apresentam valores de 18O fortemente negativos, o que provavelmente reflete uma origem a partir de uma mistura de águas marinhas e meteóricas ou recristalização do cimento marinho através da interação com águas meteóricas. As temperaturas de precipitação assumindo 18OVPDB da água igual a 2,0 (água do mar modificada por evaporação) e -2,0 (água mista, em boa parte meteórica) variam de 23,3 a 34,9oC (valor médio: 25,8oC).