Lupus anticoagulant: a marker for stroke and venous thrombosis in primary Sjogren's syndrome

Antiphospholipid antibodies (aPL) and antiphospholipid syndrome (APS) have been described in primary Sjogren's syndrome (pSS) with controversial findings regarding aPL prevalence and their association with thrombotic events. We evaluated 100 consecutive pSS patients (American-European criteria) and 89 age-gender-ethnicity-matched healthy controls for IgG/IgM anticardiolipin (aCL), IgG/IgM anti-beta2-glycoprotein-I (a beta 2GPI), and lupus anticoagulant (LA) (positivity according to APS Sydney's criteria). Clinical analysis followed standardized interview and physical examination assessing thrombotic and nonthrombotic APS manifestations and thrombosis risk factors. aPLs were detected in 16 % patients and 5.6 % controls (p = 0.035). LA was the most common aPL in patients (9 %), followed by a beta 2GPI (5 %) and aCL (4 %). Thrombotic events occurred in five patients [stroke in two, myocardial infarction in one and deep-vein thrombosis (DVT) in four], but in none of controls (p = 0.061). Mean age at time of stroke was 35 years. Three patients with thrombotic events (including the two with stroke) had APS (Sydney's criteria) and were positive exclusively for LA. Comparison of patients with (n = 16) and without (n = 84) aPL revealed similar mean age, female predominance, and ethnicity (p > =0.387). Frequencies of livedo reticularis (25 vs. 4.8 %, p = 0.021), stroke (12.5 vs. 0 %, p = 0.024), and DVT (18.8 vs. 1.2 %, p = 0.013) were significantly higher in APL + patients. Conversely, frequencies of hypertension, dyslipidemia, diabetes, obesity, smoking, sedentarism, and hormonal contraception were similar in patients with or without aPL (p a parts per thousand yenaEuro parts per thousand 0.253). Our study identified LA as an important marker for APS in pSS, particularly for stroke in young patients, warranting routine evaluation of these antibodies and rigorous intervention in modifiable risk factors.

INTERACTION BETWEEN THE CARBON MONOXIDE AND NITRIC OXIDE PATHWAYS IN THE LOCUS COERULEUS DURING FEVER

FAPESP [2010/50882-1]

Age influences outcomes in 70-year or older patients undergoing isolated coronary artery bypass graft surgery

Objective: To analyze the results of isolated on-pump coronary artery bypass graft surgery (CABG) in patients >= 70 years old in comparison to patients <70 years old. Methods: Patients undergoing isolated CABG were selected for the study. The patients were assigned into two groups: G1 (age >= 70 years old) and G2 (age <70 years old). The endpoints were in-hospital mortality, acute myocardial infarction (AMI), stroke, re-exploration for bleeding, intraaortic balloon pump for circulatory shock, respiratory complications, acute renal failure, mediastinitis, sepsis, atrial fibrillation, and complete atrioventricular block (CAVB). Results: A total of 1,033 were included in the study: G1 comprised 257 (24.8%) patients G2 776 (75.2%). Patients in G1 were more likely to have in-hospital mortality than in G2 (8.9% vs. 3.6%, respectively; P=0.001), while the incidence of AMI was similar (5.8% vs. 5.5%; P=0.87) in G2. More patients in G1 had re-exploration for bleeding (12.1% vs. 6.1%; P=0.003). Compared to G2, G1 had more incidences of respiratory complications (21.4% vs. 9.1%; P<0.001), mediastinitis (5.1% vs. 1.9%; P=0.013), stroke (3.9% vs. 1.3%; P=0.016), acute renal failure (7.8% vs. 1.3%; P<0.001), sepsis (3.9% vs. 1.9%; P=0.003), atrial fibrillation (15.6% vs. 9.8%; P=0.016), and CAVB (3.5% vs. 1.2%; P=0.023). There was no significant difference in the use of the intraaortic balloon pump. In the forward stepwise multivariate logistic regression analysis, age >= 70 years was an independent predictive factor for higher in-hospital mortality (P=0.004), re-exploration for bleeding (P=0.002), sepsis (P=0.002), respiratory complications (P<0.001), mediastinitis (P=0.016), stroke (P=0.029), acute renal failure (P<0.001), atrial fibrillation (P=0.021), and CAVB (P=0.031). Conclusion: This study suggests that patients of age >= 70 years were at increased risk of death and other complications in the CABG's postoperative period in comparison to younger patients.

VVV DR1: The first data release of the Milky Way bulge and southern plane from the near-infrared ESO public survey VISTA variables in the Via Lactea

Context. The ESO public survey VISTA variables in the Via Lactea (VVV) started in 2010. VVV targets 562 sq. deg in the Galactic bulge and an adjacent plane region and is expected to run for about five years. Aims. We describe the progress of the survey observations in the first observing season, the observing strategy, and quality of the data obtained. Methods. The observations are carried out on the 4-m VISTA telescope in the ZYJHK(s) filters. In addition to the multi-band imaging the variability monitoring campaign in the K-s filter has started. Data reduction is carried out using the pipeline at the Cambridge Astronomical Survey Unit. The photometric and astrometric calibration is performed via the numerous 2MASS sources observed in each pointing. Results. The first data release contains the aperture photometry and astrometric catalogues for 348 individual pointings in the ZYJHK(s) filters taken in the 2010 observing season. The typical image quality is similar to 0 ''.9-1 ''.0. The stringent photometric and image quality requirements of the survey are satisfied in 100% of the JHK(s) images in the disk area and 90% of the JHK(s) images in the bulge area. The completeness in the Z and Y images is 84% in the disk, and 40% in the bulge. The first season catalogues contain 1.28 x 10(8) stellar sources in the bulge and 1.68 x 10(8) in the disk area detected in at least one of the photometric bands. The combined, multi-band catalogues contain more than 1.63 x 10(8) stellar sources. About 10% of these are double detections because of overlapping adjacent pointings. These overlapping multiple detections are used to characterise the quality of the data. The images in the JHK(s) bands extend typically similar to 4 mag deeper than 2MASS. The magnitude limit and photometric quality depend strongly on crowding in the inner Galactic regions. The astrometry for K-s = 15-18 mag has rms similar to 35-175 mas. Conclusions. The VVV Survey data products offer a unique dataset to map the stellar populations in the Galactic bulge and the adjacent plane and provide an exciting new tool for the study of the structure, content, and star-formation history of our Galaxy, as well as for investigations of the newly discovered star clusters, star-forming regions in the disk, high proper motion stars, asteroids, planetary nebulae, and other interesting objects.

A theoretical contribution characterizing a potentially new molecular species: MgAs

A new molecular species, MgAs, is investigated theoretically for the first time at the CASSCF/MRCI level using quintuple-zeta quality basis sets. Potential energy curves for the lowest-lying electronic states are presented as well as the associated spectroscopic constants. Dipole and transition moment functions for selected states complement this characterization. Estimates of transition probabilities and radiative life-times for the most important transitions are also reported. The effect of spin-orbit interactions is clearly reflected on the potential energy curves. Comparisons with BeAs, BeN, and BeP are made where pertinent. (C) 2011 Elsevier B.V. All rights reserved.

Continuous enzymatic interesterification of lard and soybean oil blend: Effects of different flow rates on physical properties and acyl migration

Continuous enzymatic interesterification is an alternative to chemical interesterification for lipid modification technology which is economically viable for large scale use. A blend of 70% lard and 30% soybean oil was submitted to continuous enzymatic interesterification in a glass tubular bioreactor at flow rate ranging from 0.5 to 4.5 mL/min. The original mixture and the reaction products obtained were examined to determine melting and crystallization behavior by DSC, and analyzed for regiospecific fatty acid distribution. Continuous enzymatic interesterification changed the mixture, forming a new triacylglycerol composition, verified by DSC curves and variation in enthalpy of melting values. The regiospecific distribution of fatty acids was changed by flow variations in the reactor. In the continuous enzymatic interesterification reaction the flow rate of 4.5 mL/min, was more advantageous than slower flow rates, reducing acyl migration and increasing process productivity. (C) 2011 Elsevier B.V. All rights reserved.

GALAXIES BEHIND THE GALACTIC PLANE: FIRST RESULTS AND PERSPECTIVES FROM THE VVV SURVEY

VISTA Variables in the Via Lactea (VVV) is an ESO variability survey that is performing observations in near-infrared bands (ZY JHK(s)) toward the Galactic bulge and part of the disk with the completeness limits at least 3 mag deeper than Two Micron All Sky Survey. In the present work, we searched in the VVV survey data for background galaxies near the Galactic plane using ZY JHK(s) photometry that covers 1.636 deg(2). We identified 204 new galaxy candidates by analyzing colors, sizes, and visual inspection of multi-band (ZY JHK(s)) images. The galaxy candidate colors were also compared with the predicted ones by star count models considering a more realistic extinction model at the same completeness limits observed by VVV. A comparison of the galaxy candidates with the expected one by Millennium simulations is also presented. Our results increase the number density of known galaxies behind the Milky Way by more than one order of magnitude. A catalog with galaxy properties including ellipticity, Petrosian radii, and ZY JHK(s) magnitudes is provided, as well as comparisons of the results with other surveys of galaxies toward the Galactic plane.

Global health competencies for nurses in the Americas

This article reports the findings from an online survey of nursing faculty from the United States, Canada, Latin America, and Caribbean countries to identify their perceptions about global health competencies for undergraduate nursing students. A list of global health competencies for medical students developed by the Association of Faculties of Medicine of Canada Resource Group on Global Health and the Global Health Education Consortium was adapted for nurses and translated from English to Spanish and Portuguese. The competencies were divided into six subscales, and respondents rated each competency on a 4-point Likert scale, with high scores reflecting strong agreement that the competency was essential for undergraduate nursing students. E-mail invitations and links to the online survey were distributed using a nonprobability convenience sampling strategy. This article reports findings only from the respondents to the English and Spanish surveys. The final sample included 542 responses to the English survey and 51 responses to the Spanish survey. Cronbach's alpha reliability coefficients for the subscales ranged from .78 to .96. The mean values for all 6 subscales and for each of the 30 items were greater than 3.0 for the respondents to the Spanish survey, and the mean values for 27 of the items were greater than 3.0 for the respondents to the English survey. These findings suggest that respondents perceived the competencies as essential global health competencies for undergraduate nursing students in the Americas. Narrative comments written by respondents indicate additional competencies and specific concerns about adding additional content to an already full curricula. Results of this study can be used to guide faculty deliberations about global health competencies that should be incorporated in the nursing curricula.

Generalized non-commutative inflation

Non-commutative geometry indicates a deformation of the energy-momentum dispersion relation f (E) = E/pc (not equal 1) for massless particles. This distorted energy-momentum relation can affect the radiation-dominated phase of the universe at sufficiently high temperature. This prompted the idea of non-commutative inflation by Alexander et al (2003 Phys. Rev. D 67 081301) and Koh and Brandenberger (2007 JCAP06(2007) 021 and JCAP11(2007) 013). These authors studied a one-parameter family of a non-relativistic dispersion relation that leads to inflation: the a family of curves f (E) = 1 + (lambda E)(alpha). We show here how the conceptually different structure of symmetries of non-commutative spaces can lead, in a mathematically consistent way, to the fundamental equations of non-commutative inflation driven by radiation. We describe how this structure can be considered independently of (but including) the idea of non-commutative spaces as a starting point of the general inflationary deformation of SL(2, C). We analyze the conditions on the dispersion relation that leads to inflation as a set of inequalities which plays the same role as the slow-roll conditions on the potential of a scalar field. We study conditions for a possible numerical approach to obtain a general one-parameter family of dispersion relations that lead to successful inflation.

KRONBERGER 49: A NEW LOW-MASS GLOBULAR CLUSTER OR AN UNPRECEDENTED BULGE WINDOW?

We employ optical and near-infrared photometry to study the stars in the direction of the star cluster candidate Kronberger 49. The optical color-magnitude diagrams (V, I, and Gunn z photometry obtained with the Galileo Telescope) are tight and present evidence of a main-sequence turnoff. We may be dealing with a low-mass, metal-rich globular cluster located in the bulge at a distance from the Sun of d(circle dot) = 8 +/- 1 kpc. Alternatively, it may be a dust hole through which we are sampling the bulge stellar population affected by a very low amount of differential reddening.

Comparison of 3 modes of automated weaning from mechanical ventilation: A bench study

Purpose: Automated weaning modes are available in some mechanical ventilators, but no studies compared them hitherto. We compared the performance of 3 automated modes under standard and challenging situations. Methods: We used a lung simulator to compare 3 automated modes, adaptive support ventilation (ASV), mandatory rate ventilation (MRV), and Smartcare, in 6 situations, weaning success, weaning failure, weaning success with extreme anxiety, weaning success with Cheyne-Stokes, weaning success with irregular breathing, and weaning failure with ineffective efforts. Results: The 3 modes correctly recognized the situations of weaning success and failure, even when anxiety or irregular breathing were present but incorrectly recognized weaning success with Cheyne-Stokes. MRV incorrectly recognized weaning failure with ineffective efforts. Time to pressure support (PS) stabilization was shorter for ASV (1-2 minutes for all situations) and MRV (1-7 minutes) than for Smartcare (8-78 minutes). ASV had higher rates of PS oscillations per 5 minutes (4-15), compared with Smartcare (0-1) and MRV (0-12), except when extreme anxiety was present. Conclusions: Smartcare, ASV, and MRV were equally able to recognize weaning success and failure, despite the presence of anxiety or irregular breathing but performed incorrectly in the presence of Cheyne-Stokes. PS behavior over the time differs among modes, with ASV showing larger and more frequent PS oscillations over the time. Clinical studies are needed to confirm our results. (C) 2012 Elsevier Inc. All rights reserved.

ANTERIOR SHOULDER INSTABILITY: CORRELATION BETWEEN MAGNETIC RESONANCE ARTHROGRAPHY, ULTRASOUND ARTHROGRAPHY AND INTRAOPERATIVE FINDINGS

The purpose of the present study was to determine ultrasound (US) arthrography diagnostic accuracy in patients with recurrent shoulder dislocation by comparing US arthrography and magnetic resonance arthrography (MRA) with intraoperative findings. Fifty-six consecutive patients with diagnosis of chronic anterior instability of the shoulder were evaluated for assessment of bone and soft tissue lesions by three radiologists. Twenty-five cases were confirmed by surgery. Sensitivity, specificity, inter-and intraobserver agreement were calculated. Ultrasound sensitivity ranged from 20% to 100% and specificity from 25% to 90%. MRA sensitivity ranged from 80% to 100% and specificity from 50% to 100%. Interobserver agreement was good for MRA (0.54-0.70) and fair for US arthrography (0.19-0.40). Despite a higher interobserver variability for US arthrography than for MRA, our results indicate that US is capable of demonstrating bone and soft tissue lesions related to chronic instability of the shoulder in the presence of intra-articular fluid. (E-mail: marcelo_simao@hotmail.com) (C) 2012 World Federation for Ultrasound in Medicine & Biology.

A modified Primal-Dual Logarithmic-Barrier Method for solving the Optimal Power Flow problem with discrete and continuous control variables

The aim of solving the Optimal Power Flow problem is to determine the optimal state of an electric power transmission system, that is, the voltage magnitude and phase angles and the tap ratios of the transformers that optimize the performance of a given system, while satisfying its physical and operating constraints. The Optimal Power Flow problem is modeled as a large-scale mixed-discrete nonlinear programming problem. This paper proposes a method for handling the discrete variables of the Optimal Power Flow problem. A penalty function is presented. Due to the inclusion of the penalty function into the objective function, a sequence of nonlinear programming problems with only continuous variables is obtained and the solutions of these problems converge to a solution of the mixed problem. The obtained nonlinear programming problems are solved by a Primal-Dual Logarithmic-Barrier Method. Numerical tests using the IEEE 14, 30, 118 and 300-Bus test systems indicate that the method is efficient. (C) 2012 Elsevier B.V. All rights reserved.

Crotoxin and phospholipases A(2) from Crotalus durissus terrificus showed antiviral activity against dengue and yellow fever viruses

Dengue is the most important arbovirus in the world with an estimated of 50 million dengue infections occurring annually and approximately 2.5 billion people living in dengue endemic countries. Yellow fever is a viral hemorrhagic fever with high mortality that is transmitted by mosquitoes. Effective vaccines against yellow fever have been available for almost 70 years and are responsible for a significant reduction of occurrences of the disease worldwide; however, approximately 200,000 cases of yellow fever still occur annually, principally in Africa. Therefore, it is a public health priority to develop antiviral agents for treatment of these virus infections. Crotalus durissus terrificus snake, a South American rattlesnake, presents venom with several biologically actives molecules. In this study, we evaluated the antiviral activity of crude venom and isolated toxins from Crotalus durissus terrificus and found that phospholipases A(2) showed a high inhibition of Yellow fever and dengue viruses in VERO E6 cells. (C) 2011 Elsevier Ltd. All rights reserved.

Modeling and identification of freeplay nonlinearity

A nonlinear analysis is performed for the purpose of identification of the pitch freeplay nonlinearity and its effect on the type of bifurcation of a two degree-of-freedom aeroelastic system. The databases for the identification are generated from experimental investigations of a pitch-plunge rigid airfoil supported by a nonlinear torsional spring. Experimental data and linear analysis are performed to validate the parameters of the linearized equations. Based on the periodic responses of the experimental data which included the flutter frequency and its third harmonics, the freeplay nonlinearity is approximated by a polynomial expansion up to the third order. This representation allows us to use the normal form of the Hopf bifurcation to characterize the type of instability. Based on numerical integrations, the coefficients of the polynomial expansion representing the freeplay nonlinearity are identified. Published by Elsevier Ltd.