The Aging Process of the Heart: Obesity Is the Main Risk Factor for Left Atrial Enlargement During Aging The MONICA/KORA (Monitoring of Trends and Determinations in Cardiovascular Disease/Cooperative Research in the Region of Augsburg) Study

Objectives This prospective study evaluated the association of obesity and hypertension with left atrial (LA) volume over 10 years. Background Although left atrial enlargement (LAE) is an independent risk factor for atrial fibrillation, stroke, and death, little information is available about determinants of LA size in the general population. Methods Participants (1,212 men and women, age 25 to 74 years) originated from a sex-and age-stratified random sample of German residents of the Augsburg area (MONICA S3). Left atrial volume was determined by standardized echocardiography at baseline and again after 10 years. Left atrial volume was indexed to body height (iLA). Left atrial enlargement was defined as iLA >= 35.7 and >= 33.7 ml/m in men and women, respectively. Results At baseline, the prevalence of LAE was 9.8%. Both obesity and hypertension were independent predictors of LAE, obesity (odds ratio [OR]: 2.4; p < 0.001) being numerically stronger than hypertension (OR: 2.2; p < 0.001). Adjusted mean values for iLA were significantly lower in normal-weight hypertensive patients (25.4 ml/m) than in obese normotensive individuals (27.3 ml/m; p = 0.016). The highest iLA was found in the obese hypertensive subgroup (30.0 ml/m; p < 0.001 vs. all other groups). This group also presented with the highest increase in iLA (+6.0 ml/m) and the highest incidence (31.6%) of LAE upon follow-up. Conclusions In the general population, obesity appears to be the most important risk factor for LAE. Given the increasing prevalence of obesity, early interventions, especially in young obese individuals, are essential to prevent premature onset of cardiac remodeling at the atrial level. (J Am Coll Cardiol 2009; 54: 1982-9) (C) 2009 by the American College of Cardiology Foundation

Association between degenerative aortic valve disease and long-term exposure to cardiovascular risk factors: results of the longitudinal population-based KORA/MONICA survey

Degenerative aortic valve disease (DAVD), a common finding in the elderly, is associated with an increased risk of death due to cardiovascular causes. Taking advantage of its longitudinal design, this study evaluates the prevalence of DAVD and its temporal associations with long-term exposure to cardiovascular risk factors in the general population. We studied 953 subjects (aged 25-74 years) from a random sample of German residents. Risk factors had been determined at a baseline investigation in 1994/95. At a follow-up investigation, 10 years later, standardized echocardiography determined aortic valve morphology and aortic valve area (AVA) as well as left ventricular geometry and function. At the follow-up study, the overall prevalence of DAVD was 28%. In logistic regression models adjusting for traditional cardiovascular risk factors at baseline age (OR 2.0 [1.7-2.3] per 10 years, P < 0.001), active smoking (OR 1.7 [1.1-2.4], P = 0.009) and elevated total cholesterol levels (OR 1.2 [1.1-1.3] per increase of 20 mg/dL, P < 0.001) were significantly related to DAVD at follow-up. Furthermore, age, baseline status of smoking, and total cholesterol level were significant predictors of a smaller AVA at follow-up study. In contrast, hypertension and obesity had no detectable relationship with long-term changes of aortic valve structure. In the general population we observed a high prevalence of DAVD that is associated with long-term exposure to elevated cholesterol levels and active smoking. These findings strengthen the notion that smoking cessation and cholesterol lowering are promising treatment targets for prevention of DAVD.

Intraorbital polyacrylamide gel injection for the treatment of anophthalmic enophthalmos

Purpose: To evaluate the use of orbital polyacrylamide gel injection for the correction of anophthalmic enophthalmos. Methods: Noncontrolled clinical trial of 21 patients (14 with ocular implants, 5 with phthisis bulbi, and 2 with dermis-fat graft). Orbital CT was performed to estimate the volume of polyacrylamide gel needed to restore orbital volume. Polyacrylamide gel was injected using a 22-gauge (30 x 0.7 min) needle transcutaneously inserted in the lateral third of the lower eyelid, directed to the orbital muscle cone. A second injection was administered 15 days later. if necessary. CT was repeated 30 days after the last procedure. Exophthalmometry was performed before Bind 90 days after file procedure. Results: The mean total volume injected per orbit was 2.4 +/- 0.7 ml (range 1-3.5 ml). The volume of the enophthalmic orbit increased front 26.9 +/- 5.0 ml to 29.3 +/- 4.9 ml (p < 0.001). The mean difference in exophthalmometry readings was 3.3 +/- 1.6 mm (range, 1.5-8.0 mm) before the procedure and 1.0 +/- 0.9 mm (range, 0.0-3.0 mm) after 3 months (p < 0.001). Adjustment of the ocular prosthesis or fabrication of a new one was necessary in 11 patients (52.4%), and the mean volume of the ocular prosthesis was reduced front 2.0 +/- 0.6 ml to 1.6 +/- 0.6 ml (p = 0.003). All patients were satisfied with the aesthetic results. No serious adverse events were observed. The initial results were maintained 1 year after the procedure. Conclusions: Polyacrylamide gel injection in the orbital space effectively reduces enophthalmos in ocular prosthesis wearers.

European 1: A globally important clonal complex of Mycobacterium bovis

We have identified a globally important clonal complex of Mycobacterium bovis by deletion analysis of over one thousand strains from over 30 countries. We initially show that over 99% of the strains of M. bovis, the cause of bovine tuberculosis, isolated from cattle in the Republic of Ireland and the UK are closely related and are members of a single clonal complex marked by the deletion of chromosomal region RDEu1 and we named this clonal complex European 1 (Eu1). Eu1 strains were present at less than 14% of French, Portuguese and Spanish isolates of M. bovis but are rare in other mainland European countries and Iran. However, strains of the Eu1 clonal complex were found at high frequency in former trading partners of the UK (USA, South Africa, New Zealand, Australia and Canada). The Americas, with the exception of Brazil, are dominated by the Eu1 clonal complex which was at high frequency in Argentina, Chile, Ecuador and Mexico as well as North America. Eu1 was rare or absent in the African countries surveyed except South Africa. A small sample of strains from Taiwan were non-Eu1 but, surprisingly, isolates from Korea and Kazakhstan were members of the Eu1 clonal complex. The simplest explanation for much of the current distribution of the Eu1 clonal complex is that it was spread in infected cattle, such as Herefords, from the UK to former trading partners, although there is evidence of secondary dispersion since. This is the first identification of a globally dispersed clonal complex M. bovis and indicates that much of the current global distribution of this important veterinary pathogen has resulted from relatively recent International trade in cattle. Crown Copyright (C) 2011 Published by Elsevier B.V. All rights reserved.

MRI based diffusion and perfusion predictive model to estimate stroke evolution

In this study we present a novel automated strategy for predicting infarct evolution, based on MR diffusion and perfusion images acquired in the acute stage of stroke. The validity of this methodology was tested on novel patient data including data acquired from an independent stroke clinic. Regions-of-interest (ROIs) defining the initial diffusion lesion and tissue with abnormal hemodynamic function as defined by the mean transit time (MTT) abnormality were automatically extracted from DWI/PI maps. Quantitative measures of cerebral blood flow (CBF) and volume (CBV) along with ratio measures defined relative to the contralateral hemisphere (r(a)CBF and r(a)CBV) were calculated for the MTT ROIs. A parametric normal classifier algorithm incorporating these measures was used to predict infarct growth. The mean r(a)CBF and r(a)CBV values for eventually infarcted MTT tissue were 0.70 +/-0.19 and 1.20 +/-0.36. For recovered tissue the mean values were 0.99 +/-0.25 and 1.87 +/-0.71, respectively. There was a significant difference between these two regions for both measures (P

Behaviour of the black flying fox Pteropus alecto: 1. An ethogram of behaviour, and preliminary characterisation of mother-infant interactions

The black flying fox Pteropus alecto is one of four species of flying fox found on the Australian mainland. Little information exists about the specific behaviour of this species, and no framework for the study of its behaviour has yet been constructed. In the study reported here, two P alecto colonies were observed at two day roosts in South East Queensland, Australia, between 1998-2000. Observations focused on solitary and social actions in general and on mother-infant interactions in some detail and led to the construction of an ethogram that defines each action structurally and functionally, describing accompanying vocalisations where appropriate. Diurnal activity patterns of P. alecto throughout the year consisted predominantly of roosting, grooming and sleeping, and involved little social activity. Social interactions were largely restricted to the seasonal contexts of the birthing/rearing period of October to March and the subsequent courtship/mating season of February to April. In all, 74 behavioural units were defined with the aim of facilitating further research and the implementation of effective conservation strategies for the species.

Behaviour of the black flying fox Pteropus alecto: 2. Territoriality and courtship

Flying foxes are commonly thought of as highly social mammals, yet little is known about the dynamics of their social interactions at a day roost. The aim of the present study was to examine the nature of the seasonal activities of territoriality and courtship amongst wild flying foxes in Australia. Focal observations were conducted at two permanent roosts of black flying foxes Pteropus alecto during periods of peak social interaction in the summers of 1999 and 2000 in urban Brisbane, Queensland. Observations of male territoriality were conducted at dawn and began eight weeks prior to the commencement of mating. The majority of defense bouts (87%) consisted of ritualised pursuit, while 13% of bouts involved physical contact expressed as either wrestling or hooking. One male with an unusually large territory took significantly longer to defend it than other males with less territory to defend. Observations of courtship revealed repetitive courtship sequences, including pre-copulatory approaches by the males, copulation attempts and grooming/resting periods. Thirty-four complete courtship sequences incorporating 135 copulation attempts were recorded over two seasons. Females actively resisted courtship approaches by males, forcing males to display a continuous determination to mate over time where determination can be considered an indicator of 'fitness'. The courtship bout length of females with suckling young was significantly longer ((x) over bar +/- SE; 230.9 +/- 22.16 s) than that of females unencumbered by large pups (158.5 +/- 9.69 s), although the length of copulations within those courtships was not (45.6 +/- 5.19 versus 36.2 +/- 3.43 s).

Thermomechanical environment characterisation in injection moulding and its relation to the mechanical properties of talc-filled polypropylene

This study is focused on the establishment of relationships between the injection moulding processing conditions, the applied thermomechanical environment (TME) and the tensile properties of talc-filled polypropylene,adopting a new extended concept of thermomechanical indices (TMI). In this approach, TMI are calculated from computational simulations of the moulding process that characterise the TME during processing, which are then related to the mechanical properties of the mouldings. In this study, this concept is extended to both the filling and the packing phases, with new TMI defined related to the morphology developed during these phases. A design of experiments approach based on Taguchi orthogonal arrays was adopted to vary the injection moulding parameters (injection flow rate, injection temperature, mould wall temperature and holding pressure), and thus, the TME. Results from analysis of variance for injection-moulded tensile specimens have shown that among the considered processing conditions, the flow rate is the most significant parameter for the Young’s modulus; the flow rate and melt temperature are the most significant for the strain at break; and the holding pressure and flow rate are the most significant for the stress at yield. The yield stress and Young’s modulus were found to be governed mostly by the thermostress index (TSI, related to the orientation of the skin layer), whilst the strain at break depends on both the TSI and the cooling index (CI, associated to the crystallinity degree of the core region). The proposed TMI approach provides predictive capabilities of the mechanical response of injection-moulded components, which is a valuable input during their design stage.

Effect of the Impact Conditions on the Mechanical Properties of Injection-Molded Parts

This work focused on the study of the impact event on molded parts in the framework of automotive components. The influence of the impact conditions and processing parameters on the mechanical behavior of talc-filled polypropylene specimens was analyzed. The specimens were lateral-gate discs produced by injection molding, and the mechanical characterization was performed through instrumented falling weight impact tests concomitantly assisted with high-speed videography. Results analyzed using the analysis of variance (ANOVA) method have shown that from the considered parameters, only the dart diameter and test temperature have significant influence on the falling weight impact properties. Higher dart diameter leads to higher peak force and peak energy results. Conversely, higher levels of test temperatures lead to lower values of peak force and peak energy. By means of high-speed videography, a more brittle fracture was observed for experiments with higher levels of test velocity and dart diameter and lower levels of test temperature. The injection-molding process conditions assessed in this study have an influence on the impact response of moldings, mainly on the deformation capabilities of the moldings.

Estimating Local Part Thickness in Midplane Meshes for Finite Element Analysis

Within the development of motor vehicles, crash safety (e.g. occupant protection, pedestrian protection, low speed damageability), is one of the most important attributes. In order to be able to fulfill the increased requirements in the framework of shorter cycle times and rising pressure to reduce costs, car manufacturers keep intensifying the use of virtual development tools such as those in the domain of Computer Aided Engineering (CAE). For crash simulations, the explicit finite element method (FEM) is applied. The accuracy of the simulation process is highly dependent on the accuracy of the simulation model, including the midplane mesh. One of the roughest approximations typically made is the actual part thickness which, in reality, can vary locally. However, almost always a constant thickness value is defined throughout the entire part due to complexity reasons. On the other hand, for precise fracture analysis within FEM, the correct thickness consideration is one key enabler. Thus, availability of per element thickness information, which does not exist explicitly in the FEM model, can significantly contribute to an improved crash simulation quality, especially regarding fracture prediction. Even though the thickness is not explicitly available from the FEM model, it can be inferred from the original CAD geometric model through geometric calculations. This paper proposes and compares two thickness estimation algorithms based on ray tracing and nearest neighbour 3D range searches. A systematic quantitative analysis of the accuracy of both algorithms is presented, as well as a thorough identification of particular geometric arrangements under which their accuracy can be compared. These results enable the identification of each technique’s weaknesses and hint towards a new, integrated, approach to the problem that linearly combines the estimates produced by each algorithm.

Vencendo a complexidade: um conceito de fitness organizacional

Os enfoques da administração de empresas baseados em uma perspectiva meramente econômica carecem de um fundamento teórico capaz de sustentar um management dirigido à viabilidade e ao desenvolvimento organizacional. O autor propõe um quadro analítico novo para o design e o (auto)controle de empresas, baseado na cibernética organizacional e voltado para um fitness organizacional abrangente. Esse quadro focaliza um management de complexidade, que implica uma (auto)pilotagem integral, recorrendo às noções de pré-controle e de viabilidade além da sobrevivência. A argumentação é corroborada mediante evidência empírica.

Inovação na gestão pública subnacional: reflexões sobre a estratégia de desenvolvimento do Acre

Revisões periódicas das tendências da inovação na gestão pública subnacional desde a redemocratização reiteram a necessidade de ampliação dos estudos nesta área. Além dessa demanda por estudos quanto a novos serviços, procedimentos inovadores e modernização da gestão, o presente artigo busca reforçar a necessidade de estudos sobre a qualidade da governança. Utilizamos para tanto a descrição da estratégia de desenvolvimento do Acre como estudo de caso, evidenciando o papel relevante da gestão pública na melhoria da qualidade de vida naquele estado, e sua preparação aos impactos das mudanças climáticas. A análise permite refletir sobre a importância do contexto político e social do qual surgem inovações, para além da replicação de receituários, sendo a gestão de conhecimento indutora a inovações.

Prevalência de tabagismo e fatores associados em área metropolitana da região Sul do Brasil

Com o objetivo de avaliar a prevalência de tabagismo em Porto Alegre, RS, Brasil, e os fatores associados, executou-se estudo observacional, de delineamento transversal e base populacional. Através de amostragem aleatória proporcional, por estágios múltiplos e conglomerados, selecionaram-se 1.091 indivíduos, a partir de 18 anos, que responderam a um questionário, em entrevista domiciliar. Aferiu-se o hábito de fumar através de perguntas dirigidas ao tipo de fumo, freqüência e tempo de exposição. A prevalência foi de 34,9% (IC 31,9 - 37,8), sendo de 41,5% (IC 38,5 - 44,4) entre os homens e 29,5% (IC 26,8 - 32,2) entre as mulheres. O início foi, em média, aos 16 (±5,6) e 17,8 (±6,7) anos, com moda de 15 e 14 anos, respectivamente. Os homens fumavam 19,0 ± 14,0 cigarros por dia e as mulheres 14,5 ± 10,3. Analisaram-se as associações através de regressão logística, incluindo-se no modelo sexo, idade, educação, renda, qualificação profissional e consumo de álcool. O hábito de fumar foi mais freqüente entre os homens, indivíduos de menor nível socioeconômico, dos 30 aos 39 anos, e entre os usuários de bebidas alcoólicas. Conclui-se que o tabagismo é freqüente em Porto Alegre, constituindo-se problema de saúde pública similar ao referido pela literatura. O consumo de álcool deve estar associado ao fumo por serem ambos comportamentos de risco, com determinantes comuns.

Comportamentos de risco, auto-avaliação do nível de saúde e percepção de estresse entre trabalhadores da indústria

OBJETIVO: Identificar a prevalência e analisar a associação entre comportamentos de risco à saúde, percepção de estresse e auto-avaliação do nível de saúde, em trabalhadores da indústria. MÉTODOS: Estudo epidemiológico transversal, utilizando questionário previamente testado em estudo-piloto realizado em Santa Catarina, Brasil. Foram coletados dados sobre fumo, abuso de álcool, consumo de frutas e verduras, atividades físicas, percepção de estresse e auto-avaliação do nível de saúde de 4.225 trabalhadores (67,5% homens e 32,5% mulheres). Os sujeitos foram recrutados por meio de amostragem por conglomerados em três estágios (erro de 5%). A análise estatística incluiu o teste de qui-quadrado e a análise de regressão logística, para um nível de significância de p<0,05. RESULTADOS: A média de idade dos sujeitos foi de 29,7 anos (DP=8,6). A prevalência de fumantes foi de 20,6%, maior entre os homens (23,1%) que entre as mulheres (15,6%). A proporção de trabalhadores que abusaram de álcool foi alta (57,2% entre os homens e 18,8% entre as mulheres). Dos sujeitos, 46,2% não realizaram atividades físicas no lazer (67% das mulheres e 34,8% dos homens), e 13,9% referiram níveis elevados de estresse e dificuldade para enfrentar a vida. Aproximadamente 15% dos trabalhadores relataram nível de saúde regular ou ruim. Sexo, idade, estado civil, número de filhos, nível educacional e econômico estiveram significativamente associados à prevalência de comportamentos de risco. CONCLUSÕES: Mesmo considerando as limitações inerentes aos estudos transversais, e baseados em medidas auto-relatadas, os resultados sugerem elevada prevalência de abuso de bebidas alcoólicas e inatividade física de lazer. A associação observada entre sexo e comportamento de risco definiu um perfil bidimensional: nos homens os comportamentos de risco mais prevalentes tomaram a forma de risco direto/ativo (fumar, abuso de bebidas alcoólicas), e nas mulheres tomaram a forma de risco indireto/passivo (inatividade física, estresse).