Early allergen exposure and atopic eczema

Background The relationship between exposure to indoor aeroallergens in early life and subsequent eczema is unclear. We have previously failed to show any significant associations between early life exposure to house dust mite and cat fur allergens and either sensitization to these allergens or wheeze. We have also previously reported a lower prevalence of parent-reported, doctor-diagnosed eczema by age 2 years for children exposed to higher concentrations of house dust mite, but no other associations with other definitions of eczema or for exposure to cat allergen. Objectives To extend the exposure–response analysis of allergen exposure and eczema outcomes measured up to age 8 years, and to investigate the role of other genetic and environmental determinants. Methods A total of 593 children (92Æ4% of those eligible) born to all newly pregnant women attending one of three general practitioner surgeries in Ashford, Kent, were followed from birth to age 8 years. Concentrations of house dust mite and cat allergen were measured in dust samples collected from the home at 8 weeks after birth. The risk of subsequent eczema as defined by the U.K. diagnostic criteria was determined according to different levels (quintiles) of allergen exposure at birth. Results By age 8 years, 150 (25Æ3%) children had met the diagnostic criteria for eczema at least once. Visible flexural dermatitis was recorded at least once for 129 (28Æ0%). As in other studies, parental allergic history was positively associated with most eczema outcomes, as were higher maternal education and less crowded homes. No clear linear associations between early exposure to house dust mite or cat allergen were found, regardless of the definition of eczema used. The risk of eczema appeared to increase for the three lowest quintiles of house dust mite allergen exposure (odds ratio, OR 1Æ37 for third quintile compared with first), and then to fall for the two highest quintiles (OR 0Æ66 and 0Æ71) even after controlling for confounding factors. Conclusions The lack of any clear exposure–disease relationship between allergens in early life and subsequent eczema argues against allergen exposure being a major factor causing eczema. If the lower levels of eczema at higher levels of house dust mite are confirmed, then interventions aimed at reducing house dust mite in early infancy could paradoxically increase the risk of subsequent eczema.

Causas de descompensación glicémica en pacientes con diabetes tipo 2 en la clínica metabólica de llopango del Instituto Salvadoreño del Seguro Social.

A pesar de los beneficios ya demostrados de un buen control glicémico, la evidencia sugiere que la hemoglobina glicosilada de la mayoría de pacientes diabéticos tipo 2 no se encuentra dentro de metas. Se estima que en Estados Unidos solamente un tercio de los pacientes con diabetes mellitus tipo 2 (DM2) tienen una hemoglobina glicosilada menor de 7% que es lo que sugieren la mayoría de guías actuales. La población con diabetes mellitus tipo2 (DM2) es heterogénea, y múltiples factores afectan el control glicémico. La adherencia a conductas de autocuidado por parte del paciente, la asistencia de forma regular a sesiones educacionales de autocuidado, el auto monitoreo de la glicemia, y la asistencia a controles médicos se ha demostrado que tienen un efecto positivo en el resultado del tratamiento de la DM2. Mantener el peso corporal, la reducción de peso y el consumo de alimentos con bajo índice glucémico también causa mejoría en los parámetros metabólicos. Los agentes hipoglicemiantes orales son uno de los tratamientos más prescritos para un control intensivo de la glucosa. Sin embargo la no adherencia a estos es una de las principales causas de un mal control glicémico, por lo que se han realizado múltiples estudios tratando de dilucidar porque el paciente descontinúa su tratamiento encontrando que el 42.9% olvida tomar el medicamento, el 30.6% no entiende la importancia de tomar el medicamento y 26.5% lo hace por presentar hipoglicemia asociada. Este estudio es de tipo observacional, analítico de casos y controles definiendo al Control: pacientes con hemoglobina mayor de 7% durante su último control en el año 2013 y Caso: pacientes con hemoglobina menor de 7% durante su último control en el año 2013. La Población en estudio son los pacientes diabéticos tipo 2 de clínica metabólica de Ilopango. Tomando como muestra a todos los pacientes con diagnóstico de Diabetes Mellitus tipo 2 que cumplan con los criterios de inclusión. La información fue obtenida de la revisión de los expedientes de las clínicas metabólicas de la unidad médica de Ilopango en donde tienen un registro de aproximadamente 6000 pacientes de los cuales 2500 padecen de diabetes mellitus tipo 2, pero únicamente 825 pacientes cuentan con hemoglobina glicosilada de seguimiento, que fue la muestra. Se evaluaron algunos factores como determinantes en el control o descompensación de la AIc cuando se utiliza la medición de la variable del índice de masa corporal, el tener un IMC por arriba de 25 significo que el 90% de los pacientes estuvieron descompensados (OR: 8.797, IC 5.924, 13.18) con un valor de p=<0.0000001 comparada con aquellos pacientes que su IMC es por debajo de 25. Otro hallazgo encontrado fue el tener una patología asociada, como variable de descompensación de A1c (OR=6.996 IC=4.881, 10.16 p <0.0000001) incrementando en un 37% veces más la descompensación en esta variable no se consideró la severidad de la infección ni tampoco la etiología. Además se analizó como determinante de hemoglobina glicosilada mayor de 7%, el cumplimiento de la terapia que se indica a los pacientes, obteniéndose que para aquellos pacientes que cumplen la terapia indicada están más propensos a tener una hemoglobina glicosilada menor de 7% con una fracción prevenible del 4.34% (OR= 0.8229 IC= 0.6256- 1.082 p= 0.08111 ), como un factor protector asociado a los pacientes con DM, aunque estadísticamente no es significativo ya que tiene un valor de p= 0.08.

Discrete breathers in a two-dimensional hexagonal Fermi-Pasta-Ulam lattice

We consider a two-dimensional Fermi-Pasta-Ulam (FPU) lattice with hexagonal symmetry. Using asymptotic methods based on small amplitude ansatz, at third order we obtain a eduction to a cubic nonlinear Schr{\"o}dinger equation (NLS) for the breather envelope. However, this does not support stable soliton solutions, so we pursue a higher-order analysis yielding a generalised NLS, which includes known stabilising terms. We present numerical results which suggest that long-lived stationary and moving breathers are supported by the lattice. We find breather solutions which move in an arbitrary direction, an ellipticity criterion for the wavenumbers of the carrier wave, symptotic estimates for the breather energy, and a minimum threshold energy below which breathers cannot be found. This energy threshold is maximised for stationary breathers, and becomes vanishingly small near the boundary of the elliptic domain where breathers attain a maximum speed. Several of the results obtained are similar to those obtained for the square FPU lattice (Butt \& Wattis, {\em J Phys A}, {\bf 39}, 4955, (2006)), though we find that the square and hexagonal lattices exhibit different properties in regard to the generation of harmonics, and the isotropy of the generalised NLS equation.

Prevalence of asthma among school children in Gaborone, Botswana.

Background: Asthma prevalence is high (>10%) in developed countries and although data is still missing for most of Africa, rates are increasing in developing regions as they become more westernized. We investigated the prevalence of asthma in school children in Gaborone, Botswana. Methods: This was a cross sectional descriptive study. ISAAC methodology was used. A representative proportionate size random sample of two age groups of children (13-14 year olds and 6-7 year olds) was consecutively enrolled from 10 schools. The schools were selected using a table of random numbers. A minimum sample size of 924 individuals (462 from each group) was adequate to achieve a precision of 3 % around our estimated prevalence of asthma of 10% with 95% confidence assuming a non-response rate of 20%. Data was collected using the validated International study of Asthma and Allergies in children (ISAAC) questionnaire. In accordance with the ISAAC criteria, Asthma was defined as wheezing in the previous 12 months. Data was captured in microsoft excel and analysed using SPSS version 23. Results: The prevalence of asthma (wheezing in the previous 12 months) was 16.5% (194/1175). Among the 6-7 year olds, the prevalence of asthma (wheezing in the previous 12 months) was 15.9%, while among the 13-14 years olds it was 16.8 %. The prevalence school type was 22.3 % in private schools versus 14.5 % in public schools. More severe asthma was associated with older children, 13 -14 years. The older children reported more limited speech due to wheezing (OR= 2.0, 95% CI =1.034, 3.9, p-value=0.043), ever had asthma (OR= 1.5, 95% CI=1.031, 2.3, p-value=0.034) and wheezing during exercise (OR=3.4, 95% CI= 2.5, 4.9, p-value= <0.001) compared to the younger children 6-7 years. Children from private schools had more wheezing symptoms. They were more likely to have ever wheezed (OR=2.2, .95% CI=1.7,2.9, p-value < 0.0001), wheezed in the previous twelve months (have asthma) (OR=1.7,95%CI=1.2,2.4, p-value = 0.001), ever had asthma (OR=2.4, 95% CI=1.7,3.5, pvalue< 0.0001), and wheezed during exercise (OR=1.8, 95% CI=1.4,2.4, p-value < 0.0001). Conclusion: The prevalence of asthma amongst school children in Gaborone, Botswana is high with older children experiencing more severe symptoms of asthma.

The goal orientations scale (GOS): Validation for portuguese students

Current research on achievement goals acknowledges that students can manifest different goal patterns. This study aimed to adapt and validate a self-report scale to assess the goal orientations of Portuguese students. A total of 2675 (age range 9–24 years) Portuguese students completed the Goal Orientations Scale (GOS). Through a cross-validation procedure, confirmatory factor analysis and descriptive statistics supports the existence of four different goal orientations: task, self-enhancing, self-defeating and avoidance orientations. The reliability and the internal validity estimates confirm that the GOS is an adequate instrument in assessing student goal orientations.

Contributos para a construção de um texto foneticamente equilibrado para o português-europeu.

Objectivo: o objectivo deste estudo consiste na criação de um Texto Foneticamente Equilibrado para o Português-Europeu (PE) designado “O Sol”. Método: quatro sujeitos da região de Setúbal, entre [21-49] anos (dois do sexo feminino e dois do masculino) leram em voz alta o texto “O Sol”. As gravações realizadas com Olympus (VN- 240PC e VN- 2100PC com microfones integrados) serviram para a contabilização dos fonemas produzidos. Os procedimentos foram: 1) a comparação entre as frequências relativas dos fonemas do “O Sol” e as frequências relativas descritas no PF_fone, através do coeficiente de correlação de Pearson e do teste de Mann-Whitney; 2) a comparação entre a transcrição larga e a estreita, verificando-se os fenómenos de coarticulação; e 3) a análise dos formatos silábicos. Resultados: a análise estatística demonstrou que as frequências relativas de ocorrência dos fonemas do texto “O Sol” têm uma correlação forte com as do PF_fone (r = 0,924). As medianas das frequências relativas de ocorrência dos fonemas do texto foram significativamente iguais às do PF_fone (p<.05). Conclusão: o texto “O Sol” está próximo de um texto foneticamente equilibrado ideal, uma vez que se verificaram os pressupostos pré-definidos. Fonologicamente, apresenta os formatos silábicos mais frequentes no PE, verificou-se ainda uma diminuição na frequência relativa de fonemas na transcrição estreita, devido a fenómenos de coarticulação. Futuros trabalhos incidirão no aumento da amostra.

Catalytic Asymmetric Transfer Hydrogenation of Imines: Recent Advances

In this review article recent developments in the asymmetric transfer hydrogenation of imines from 2008 up to today are presented. The main methodology involves either metal-catalyzed procedures in the presence of a chiral ligand or organocatalyzed technologies using a Hantzsch ester and a chiral BINOL-derived phosphoric acid. The most important procedures are collected, paying special attention to the application of this methodology in synthetic organic chemistry.

Estimativa da pegada hídrica cinza de fertilizante nitrogenado no polo de produção de grãos, Paragominas - Pará, Amazônia.

Estimativas apontam que até o ano de 2050 o planeta irá presenciar uma crise em quantidade e qualidade hídrica, decorrente principalmente do crescimento populacional nos grandes centros urbanos e do incremento econômico. No Brasil segundo dados da Organização das Nações Unidas (ONU), em 2030 a população nacional chegará a 232 milhões de habitantes, indicando comprometimentos em qualidade e disponibilidade de água às populações. Na Amazônia, a partir de 2004 houve uma mudança no perfil agrícola com a expansão da fronteira, principalmente nos estados de Mato Grosso, Maranhão e Pará. Na microrregião nordeste paraense, onde está inserido o município de Paragominas, a agricultura é a atividade mais expressiva, onde a soja (Glycine max) e o milho (Zea may) são as principais culturas. No ano 2000 a área plantada era de 24.440 hectares, em 2012 passou para 104.924 hectares cultivados com soja e milho. Todavia, o desafio na Amazônia é produzir apontando indicadores de sustentabilidade (econômicos, sociais e ambientais). Assim, objetivou-se neste trabalho estimar a pegada hídrica cinza de composto nitrogenado utilizado na adubação de culturas, para subsidiar ações de planejamento agrícola. No cálculo foram consideradas dosagens recomendadas nas literaturas técnicas e os parâmetros da legislação nacional

Optical Access Engine Setup and Validation

The optical access engine integrated with the diagnostic and optical measurement techniques is a great platform for engine research because it provides clear visual access to the combustion chamber inside the engines. An optical access engine customized based on a 4-cylinder spark ignited direct injection (SIDI) production engine is located in the Advanced Power Systems Laboratories (APS LABS) at Michigan Technological University. This optical access engine inside the test cell has been set up for different engine research. In this report, two SAE papers in engine research utilizing the optical access engine are reviewed to gain basic understanding of the methodology. Though the optical engine in APS LABS is a little bit different from the engines used in the literature, the methodology in the papers provides guidelines for engine research through optical access engines. In addition, the optical access engine instrumentation including the test cell setup and the optical engine setup is described in detail in the report providing a solid record for later troubleshooting and reference. Finally, the motoring tests, firing tests and optical imaging experiment on the optical engine have been performed to validate the instrumentation. This report only describes so far the instrumentation of the optical engine in the APS LABS by April 2015.

Effect of the Supplemental Nutrition Assistance Program (SNAP) and Nutrition Education on Nutrition and Health Outcomes of HIV+ Individuals

Factors associated with and barriers to participation in Supplemental Nutrition Assistance Program (SNAP) and the effect participation has on food security, nutrition status, disease status and quality of life was investigated in a cross-sectional study including 175 HIV infected individuals. In addition, the effect of a targeted nutrition education on nutrition knowledge, readiness to dietary behavior change, nutrition status, disease status and quality of life was also investigated among a subset of the population (N = 45) in a randomized clinical control trial. SNAP participation rate was 70.3%, similar to the State of Florida and national participation rates. SNAP participation was positively and independently associated with being born in the US (P < 0.001), having monthly income less than $1000 (P = 0.006), and receiving antiretroviral treatment (P < 0.001). Participation barriers include denial of participation by program, recent incarceration, living in a shelter where participation is not allowed and unawareness of eligibility status. In regression analyses, SNAP participation was not significantly associated with improved food security, nutrition status, disease status and health related quality of life (HRQOL). Over half (56%) of the population experienced food insecurity and had inadequate intakes of half of the nutrients assessed. Illicit drug, alcohol and cigarette use were high in this population (31%, 55% and 63% respectively), and affected food security, nutrients intake, disease status and HRQOL. The nutrition education intervention resulted in a trend towards improvements nutrition knowledge, self-efficacy, and readiness to change without impacting nutrition status, disease state and quality of life. Food insecurity and other nutrition related issues, with implications for treatment, management and cost of HIV disease, continue to plague infected individuals living in poverty. More resources, including food and nutrition programs, specifically targeted towards this population are needed to address these issues.

Skeletal maturation, fundamental motor skills and motor coordination in children 7–10 years

info:eu-repo/semantics/publishedVersion

Skeletal maturation, fundamental motor skills and motor coordination in children 7–10 years

info:eu-repo/semantics/publishedVersion

Efectos jurídicos de prohibir minería en ecosistemas de páramos con títulos mineros preexistentes

A raíz del impacto ambiental que produce la actividad minera sobre la biodiversidad y los recursos naturales, el sistema jurídico colombiano sustrajo de esta actividad, zonas de especial importancia ecológica y ambiental, que podrían llegar a deteriorarse en su totalidad. Sin embargo, si bien es clara la importancia de proteger estas zonas de la actividad extractiva, lo cierto es que en la actualidad se presenta un alto porcentaje de estas zonas que se superponen con títulos mineros. Circunstancia que conlleva a que entren en tensión intereses constitucionales protegidos. Por un lado, el interés general de proteger el medio ambiente y los recursos naturales y por el otro, el interés público de desarrollar la actividad minera. De acuerdo a lo anterior, a través de este trabajo de investigación, se busca describir y analizar las consecuencias en el ámbito jurídico, que se generan, al prohibir la actividad minera en zonas sobre las cuales el Estado había autorizado la realización de actividades de exploración y /o explotación minera con anterioridad al cambio regulatorio. En consecuencia, se expondrán los escenarios en que se puede encontrar un contrato de concesión, con la prohibición legal de desarrollar actividades mineras en ecosistemas de páramos. Específicamente, se analizará la situación de los títulos mineros que cuenten con licencia ambiental, títulos mineros que se encuentren en etapa de exploración y los títulos que habiendo terminado la etapa de exploración su licencia ambiental se encuentre en trámite.

El rol de las redes de apoyo transnacional en la evolución del régimen de trata de personas en la región del mekong, 2004-2015

Con el fin de la unipolaridad no sólo se fortalecieron mecanismos de gobernanza global como los Regímenes Internacionales, sino también se fortalecieron actores no estatales. A pesar de la importancia que tomaron estos dos elementos aún no existe una teoría que explique exhaustivamente la relación que existe entre ellos. Es por lo anterior que, la investigación busca responder de qué manera el rol de las Redes de Apoyo Transnacional ha incidido en la evolución del régimen de tráfico de personas en la Región del Mekong. Asimismo tiene como objetivo comprender las relación entre el Régimen y las Redes de Apoyo Transnacional a través de la formulación de un caso de estudio basado en metodologías cualitativas, específicamente, en el análisis teórico-constructivista y el análisis de contenido de documentos producidos por actores estatales y no estatales.

Guía de práctica clínica para la enfermedad hepática grasa no alcohólica

Objetivo: Brindar una guía de práctica clínica basada con la evidencia más reciente para el diagnóstico y tratamiento de la Enfermedad Hepática Grasa No alcohólica teniendo en cuenta la efectividad y seguridad de las intervenciones dirigidas a pacientes, personal asistencial, administrativo y entes gubernamentales de cualquier servicio de atención en Colombia. Materiales y métodos: Esta guía fue desarrollada por un equipo multidisciplinario con apoyo de la Asociación Colombiana de Gastroenterología, el Grupo Cochrane ITS y el Instituto de Investigaciones Clínicas de la Universidad Nacional de Colombia. Se desarrollaron preguntas clínicas relevantes y se realizó la búsqueda de guías nacionales e internacionales en bases de datos especializadas. Las guías existentes fueron evaluadas en términos de calidad y aplicabilidad. Una guía cumplió los criterios de adaptación, por lo que se decidió adaptar 3 preguntas clínicas. El Grupo Cochrane realizó la búsqueda sistemática de la literatura. Las tablas de evidencia y recomendaciones fueron realizadas con base a la metodología GRADE. Las recomendaciones de la guía fueron socializadas en una reunión de expertos con entes gubernamentales y pacientes. Resultados: Se desarrolló una guía de práctica clínica basada en la evidencia para el diagnóstico y tratamiento de la Enfermedad Hepática Grasa No alcohólica en Colombia Conclusiones: El diagnóstico y manejo oportuno de la Enfermedad Hepática Grasa No alcohólica contribuirá a disminuir la carga de la enfermedad en Colombia y las enfermedades asociadas