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By means of massive (more than 1.2 · 106 molecules) molecular dynamics simulations at 300 K we have disentangled self- and cross-dipolar contributions to the dielectric relaxation of liquid water that cannot be experimentally resolved. We have demonstrated that cross dipolar correlations are of paramount importance. They amount for almost a 60% of the total dielectric amplitude. The corresponding relaxation function is a one-step Debye-like function with a characteristic time, τcross, of the order of the phenomenological Debye time, τD. In contrast, the relaxation function corresponding to the self-contribution is rather complex and contains a fast decay related to dipolar librations and a second relaxation step that can be well described by two exponentials: a low-amplitude fast process (τ0 = 0.31 ps) and a main slow process (τself = 5.4 ps) that fully randomizes the dipolar orientation. In addition to dipolar relaxation functions, we have also calculated scattering-like magnitudes characterizing translation and rotation of water molecules. Although these processes can be considered as "jump" processes in the short time range, at the time scale of about τD-τcross, at which the cross-dipolar correlations decay to zero, the observed behavior cannot be distinguished from that corresponding to uncoupled Brownian translational and rotational diffusion. We propose that this is the reason why the Debye model, which does not consider intermolecular dipolar interactions, seems to work at time t â³ τD.
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By using time-of-flight neutron spectroscopy with polarization analysis, we have separated coherent and incoherent contributions to the scattering of deuterated tetrahydrofuran in a wide scattering vector (Q)-range from meso- to inter-molecular length scales. The results are compared with those recently reported for water to address the influence of the nature of inter-molecular interactions (van der Waals vs hydrogen bond) on the dynamics. The phenomenology found is qualitatively similar in both systems. Both collective and self-scattering functions are satisfactorily described in terms of a convolution model that considers vibrations, diffusion, and a Q-independent mode. We observe a crossover in the structural relaxation from being dominated by the Q-independent mode at the mesoscale to being dominated by diffusion at inter-molecular length scales. The characteristic time of the Q-independent mode is the same for collective and self-motions and, contrary to water, faster and with a lower activation energy (≈1.4 Kcal/mol) than the structural relaxation time at inter-molecular length scales. This follows the macroscopic viscosity behavior. The collective diffusive time is well described by the de Gennes narrowing relation proposed for simple monoatomic liquids in a wide Q-range entering the intermediate length scales, in contraposition to the case of water.
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Congenitally corrected transposition of the great arteries is a rare clinical entity, which usually presents during adulthood with associated defects; atrioventricular block, heart failure, systemic valve failure, and arrhythmias usually complicate the clinical course. Even rarer is associated hypertrophic cardiomyopathy, which complicates the disease course and clinical decision-making. Herein, we present a patient with this condition who underwent heart transplantation, with adequate clinical resolution.
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Cardiomiopatia Hipertrófica , Insuficiência Cardíaca , Transposição dos Grandes Vasos , Humanos , Adulto , Transposição das Grandes Artérias Corrigida Congenitamente/complicações , Transposição dos Grandes Vasos/complicações , Transposição dos Grandes Vasos/diagnóstico por imagem , Transposição dos Grandes Vasos/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Insuficiência Cardíaca/complicações , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico por imagemRESUMO
PURPOSE: The aim of the study was to analyze the surgical outcome of patients with total anomalous pulmonary venous connection (TAPVC) who underwent cardiac surgery. METHODS: A retrospective study was carried out. Patients with diagnosis of TAPVC undergoing cardiac surgery at the National Institute of Cardiology Ignacio Chávez, from January 1, 2003 and June 30, 2019 were included. Descriptive statistics were calculated, as well as a bivariate analysis of the variables associated with mortality. A logistic regression model was included to determine risk factors associated with the main outcome and survival was analyzed using the Kaplan-Meier method. RESULTS: A total of 5314 patients diagnosed with congenital heart disease (CHD) underwent surgery, 414 (7.8%) were patients with TAPVC, with an average age of 17.1 ± 34.6 months, 58.2% were male. It was frequent in infants (61.6%) and preschool (19.6%). Predominant type was supracardiac TAPVC (47.4%). Pulmonary venous obstruction (PVO) occurred in 32.1%. Risk factors associated with mortality were infracardiac TAPVC (odds ratio [OR]: 3.26; 95% confidence interval [CI]: 1.17-9.03; p = .02), PVO (OR: 2.56; 95% CI: 1.05-6.22; p = .03) and postoperative mechanical ventilation (OR: 1.005; 95% CI: 1.002-1.008; p = .01). Overall survival was 87.2%, with better outcomes in adolescents (100%), children (94.1%), mixed TAPVC (96%), and cardiac TAPVC (91.9%; p < .001). CONCLUSIONS: The survival of our institution after surgical correction of TAPVC is similar to that of other referral centers, where patients with infracardiac TAPVC and newborns worse outcomes. All patients must undergo a rigorous evaluation to determine an adequate repair strategy.
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Procedimentos Cirúrgicos Cardíacos , Veias Pulmonares , Pneumopatia Veno-Oclusiva , Síndrome de Cimitarra , Adolescente , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Veias Pulmonares/anormalidades , Veias Pulmonares/cirurgia , Pneumopatia Veno-Oclusiva/diagnóstico , Pneumopatia Veno-Oclusiva/etiologia , Pneumopatia Veno-Oclusiva/cirurgia , Estudos Retrospectivos , Síndrome de Cimitarra/complicações , Resultado do TratamentoRESUMO
PURPOSE: To evaluate the clinical and surgical outcomes among children with bicuspid aortic valve who underwent cardiac surgery. METHODS: This observational and retrospective study included patients with a diagnosis of bicuspid aortic valve who underwent cardiac surgery between January 1, 2003, and March 31, 2020. Demographic characteristics and perioperative conditions were described. RESULTS: One hundred and sixteen patients were included, with a mean age of 12.4 ± 4.2 years; 63.2% were male. The most frequent diagnosis was congenital aortic stenosis (23.5%), followed by connective tissue disorders (16%). Mechanical aortic prostheses were used in 87.7% of cases, with a mean size of 21 ± 2.6 mm. The main factors associated with mortality were valve prosthesis dysfunction (odds ratio [OR]: 12.44; 95% confidence interval [CI]: 1.05-147.48; p = .04) and reoperation (OR: 24.29; 95% CI: 1.03-570.08; p = .04). The overall survival was 87.9%, with better outcomes among those who did not undergo reoperation (Log Rank, p = .01). CONCLUSIONS: Outcomes after aortic valve replacement in children with bicuspid aortic valve are excellent in the short and long term, regardless of using mechanical or biological prostheses.
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Estenose da Valva Aórtica , Doença da Válvula Aórtica Bicúspide , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Criança , Adolescente , Feminino , Doença da Válvula Aórtica Bicúspide/cirurgia , Estudos Retrospectivos , México/epidemiologia , Valva Aórtica/anormalidades , Estenose da Valva Aórtica/cirurgia , Reoperação , Resultado do TratamentoRESUMO
The existence of an ideal glass and the resolution to the Kauzmann paradox is a long-standing open question in materials science. To address this problem, we exploit the ability of glasses with large interfacial area to access low energy states. We submit aggregates of spheres of a polymeric glass former to aging well below their glass transition temperature, T_{g}; and characterize their thermodynamic state by calorimetry, and the vibrational density of state (VDOS) by inelastic neutron scattering (INS). We show that, when aged at appropriate temperatures, glassy spheres attain a thermodynamic state corresponding to an ideal glass in time scales of about one day. In this state, the boson peak, underlying the deviation from the Debye level of the VDOS, is essentially suppressed. Our results are discussed in the framework of the link between the macroscopic thermodynamic state of glasses and their vibrational properties.
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We present an investigation by molecular dynamics (MD)-simulations of the coherent dynamic structure factor, S(Q, t) (Q: momentum transfer), of liquid water at the mesoscale (0.1 Å-1 ≤ Q ≤ Qmax) [Qmax ≈ 2 Å-1: Q-value of the first maximum of the static structure factor, S(Q), of water]. The simulation cell-large enough to address the collective properties at the mesoscale-is validated by direct comparison with recent results on the dynamic structure factor in the frequency domain obtained by neutron spectroscopy with polarization analysis [Arbe et al., Phys. Rev. Res. 2, 022015 (2020)]. We have not only focused on the acoustic excitations but also on the relaxational contributions to S(Q, t). The analysis of the MD-simulation results-including the self- and distinct contributions to the diffusive part of S(Q, t)-nicely explains why the relaxation process hardly depends on Q in the low Q-range (Q ≤ 0.4 Å-1) and how it crosses over to a diffusion-driven process at Q ≈ Qmax. Our simulations also give support to the main assumptions of the model used to fit the experimental data in the above mentioned paper. The application of such a model to the simulation S(Q, t) data delivers (i) results for the relaxation component of S(Q, t) in agreement with those obtained from neutron experiments and (ii) longitudinal and transverse hydrodynamic-like components with similar features than those identified in previous simulations of the longitudinal and transverse current spectra directly. On the other hand, in general, our MD-simulations results of S(Q, t) qualitatively agree with the viscoelastic transition framework habitually used to describe inelastic x-ray scattering results.
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BACKGROUND: Unilateral abscence of pulmonary artery is a rare congenital heart disease. If these anomaly is unrecognized and treated the risk of pulmonary hypertension in the contralateral lung can be lethal for the patients. AIMS: To report the successful sequential hybrid-surgical approach of two cases of rescue of pulmonary branches only fed by ductus arteriosus. MATERIALS & METHODS: Description of two rare cases of absence of a unilateral pulmonary branch successfully treated in our institution. RESULTS, DISCUSSSIION AND CONCLUSION: The timely identification of these cases and the strategic planning of interventional and surgical hybrid sequential treatment of these rare cases is effective.
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Permeabilidade do Canal Arterial , Canal Arterial , Cardiopatias Congênitas , Hipertensão Pulmonar , Humanos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgiaRESUMO
PURPOSE: The aim of the study was to identify, determine, and analyze the clinical and surgical outcomes of patients with atrial isomerism (AI) undergoing cardiac surgery. METHODS: A retrospective study was carried out. Patients with diagnosis of AI undergoing cardiac surgery at the National Institute of Cardiology Ignacio Chávez, from January 1, 2010 and March 31, 2020 were included; demographic characteristics and perioperative conditions of the patients were considered. RESULTS: Sixty-five patients were included, with an average age of 6.4 ± 4.9 years, 50.8% males. Thirty-eight (58.5%) had right atrial isomerism (RAI) and 27 (41.5%) had left atrial isomerism (LAI); univentricular physiology (78.5%) predominated. Atrioventricular septal defect (AVSD) in RAI and septal defects in LAI were identified as the main associated defects. The most common surgical procedures performed were modified Blalock-Taussig shunt (MBTS) (27.6%), MBTS with total anomalous pulmonary venous connection (TAPVC) repair (15.3%) and total cavopulmonary connection (TCPC) with an extracardiac conduit fenestrated (10.8%); 100% RAI required a univentricular approach, while in LAI it was 48.1%. Overall survival was 92.3%, with 100% survival in LAI with biventricular physiology and 86.8% in RAI with univentricular physiology. CONCLUSIONS: The survival of our institution is similar to that of other referral centers, where patients with LAI had a better evolution than RAI; in addition, the univentricular approach was required in all with RAI. Patients with AI must undergo a rigorous evaluation to determine an adequate repair strategy, considering univentricular RAI with a high possibility of morbidity and mortality.
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Procedimentos Cirúrgicos Cardíacos , Defeitos dos Septos Cardíacos , Síndrome de Heterotaxia , Criança , Pré-Escolar , Feminino , Síndrome de Heterotaxia/cirurgia , Humanos , Lactente , Isomerismo , Masculino , Estudos RetrospectivosRESUMO
The clinical presentation of brucellosis in humans is variable and unspecific, and thus, laboratory corroboration of the diagnosis is essential for the patient's proper treatment. The diagnosis of brucellar infections can be made by culture, serological tests, and nucleic acid amplification assays. Modern automated blood culture systems enable detection of acute cases of brucellosis within the routine 5- to 7-day incubation protocol employed in clinical microbiology laboratories, although a longer incubation and performance of blind subcultures may be needed for protracted cases. Serological tests, though they lack specificity and provide results that may be difficult to interpret in individuals repeatedly exposed to Brucella organisms, nevertheless remain a diagnostic cornerstone in resource-poor countries. Nucleic acid amplification assays combine exquisite sensitivity, specificity, and safety and enable rapid diagnosis of the disease. However, long-term persistence of positive molecular test results in patients that have apparently fully recovered is common and has unclear clinical significance and therapeutic implications. Therefore, as long as there are no sufficiently validated commercial tests or studies that demonstrate an adequate interlaboratory reproducibility of the different homemade PCR assays, cultures and serological methods will remain the primary tools for the diagnosis and posttherapeutic follow-up of human brucellosis.
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Brucella , Brucelose/diagnóstico , Brucelose/microbiologia , Brucella/classificação , Brucella/genética , Técnicas de Laboratório Clínico , Humanos , Técnicas de Diagnóstico Molecular , Técnicas de Amplificação de Ácido Nucleico , Testes SorológicosRESUMO
Toll-like receptor 2 (TLR2) plays a key role in innate immune response recognizing molecular patterns expressed by pathogens. rs111200466 is a TLR2 promoter insertion/deletion polymorphism with contradictory data about its role in human immunodeficiency virus type 1 (HIV-1) infection. We analyzed rs111200466 in HIV-1 disease progression and showed a correlation with a faster progression to the CD4+ < 200 cells/µL outcome for deletion allele carriers (Cox regression analysis: hazard ratio, 2.4 [95% confidence interval, 1.4-4]; P = .001). When naive patients with CD4+ < 200 cells/µL started antiretroviral treatment, rs111200466-deletion carriers showed a trend toward a slower, recovery rate (time required to reach CD4+ > 350 cells/µL; Cox Pâ =â .36). Our data suggest rs111200466 as a prognosis factor for HIV-1 disease progression.
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Contagem de Linfócito CD4 , Infecções por HIV/genética , Polimorfismo Genético , Receptor 2 Toll-Like/genética , Estudos de Coortes , Progressão da Doença , Feminino , HIV-1 , Humanos , Masculino , Prognóstico , Regiões Promotoras Genéticas , Análise de SobrevidaRESUMO
Single-chain polymer nanoparticles (SCNPs) are soft nano-objects consisting of uni-macromolecular chains collapsed to a certain degree by intramolecular crosslinking. The similarities between the behaviour of SCNPs and that of intrinsically disordered proteins suggest that SCNPs in concentrated solutions can be used as models to design artificial micro-environments, which mimic many of the general aspects of cellular environments. In this work, the self-assembly into SCNPs of an amphiphilic random copolymer, composed by oligo(ethylene glycol)methyl ether methacrylate (OEGMA) and 2-acetoacetoxy ethyl methacrylate (AEMA), has been investigated by means of the dielectric relaxation of water. Direct evidence of segregation of the AEMA repeating units is provided by comparison with the dielectric relaxation of water in similar solutions of the linear hydrophilic polymer, P(OEGMA). Furthermore, the results of comparative studies with similar water solutions of an amphiphilic block copolymer forming multi-chain micelles support the single-chain character of the self-assembly of the random copolymer. The overall obtained results highlight the suitability of the dielectric spectroscopy to confirm the self-assembly of the amphiphilic random copolymers into globular like core-shell single-chain nanoparticles at a concentration well above the overlap concentration.
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Nanopartículas , Água , Interações Hidrofóbicas e Hidrofílicas , Micelas , PolímerosRESUMO
We report a microscopic observation of the time-dependent dynamic tube dilation process on isofrictional bidisperse melts. By applying neutron spin echo (NSE) and dielectric techniques on blends of long polyisoprene (PI) chains with short PI additives with different topology, we access the dynamics of the tube dilation process on a molecular scale. The time-dependent tube dilation is directly revealed by NSE as an additional time dependence of the dynamic structure factor in the local reptation regime. We identify the characteristic time of tube dilation as the terminal time of the additive.
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Access to completely deuterated single-chain nanoparticles (dSCNPs) has remained an unresolved issue. Herein, the first facile and efficient procedure to produce dSCNPs is reported, which comprises: i) the use of commercially available perdeuterated cyclic ether monomers as starting reagents, ii) a ring-opening copolymerization process performed in bulk to produce a neat dSCNP precursor, iii) a standard azidation reaction to decorate this precursor with azide moieties, and iv) a facile intramolecular azide photodecomposition step carried out under UV irradiation at high dilution providing with highly valuable, completely deuterated soft nano-objects from the precursor. dSCNPs are used to investigate by means of neutron-scattering measurements the form factor (radius of gyration, scaling exponent) of polyethylene oxide (PEO) chains in nanocomposites with different amounts of dSCNPs. Moreover, to illustrate the possibilities offered by the synthetic route disclosed in this communication for potential applications, the significant reduction in viscosity observed in a pure melt of polyether-based single-chain nanoparticles when compared to a melt of the corresponding linear polymer chains is shown.
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Azidas/química , Deutério/química , Nanopartículas/química , NêutronsRESUMO
Searching for the ideal glass transition, we exploit the ability of glassy polymer films to explore low energy states in remarkably short time scales. We use 30 nm thick polystyrene (PS) films, which in the supercooled state basically display the bulk polymer equilibrium thermodynamics and dynamics. We show that in the glassy state, this system exhibits two mechanisms of equilibrium recovery. The faster one, active well below the kinetic glass transition temperature (Tg), allows massive enthalpy recovery. This implies that the 'fictive' temperature (Tf) reaches values as low as the predicted Kauzmann temperature (TK) for PS. Once the thermodynamic state corresponding to Tf = TK is reached, no further decrease of enthalpy is observed. This is interpreted as a signature of the ideal glass transition.
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We applied quasielastic neutron scattering (QENS) techniques to samples with two different contrasts (deuterated solute/hydrogenated solvent and the opposite label) to selectively study the component dynamics of proline/water solutions. Results on diluted and concentrated solutions (31 and 6 water molecules/proline molecule, respectively) were analyzed in terms of the susceptibility and considering a recently proposed model for water dynamics [Arbe et al., Phys. Rev. Lett., 2016, 117, 185501] which includes vibrations and the convolution of localized motions and diffusion. We found that proline molecules not only reduce the average diffusion coefficient of water but also extend the time/frequency range of the crossover region ('cage') between the vibrations and purely diffusive behavior. For the high proline concentration we also found experimental evidence of water heterogeneous dynamics and a distribution of diffusion coefficients. Complementary molecular dynamics simulations show that water molecules start to perform rotational diffusion when they escape the cage regime but before the purely diffusive behavior is established. The rotational diffusion regime is also retarded by the presence of proline molecules. On the other hand, a strong coupling between proline and water diffusive dynamics which persists with decreasing temperature is directly observed using QENS. Not only are the temperature dependences of the diffusion coefficients of both components the same, but their absolute values also approach each other with increasing proline concentration. We compared our results with those reported using other techniques, in particular using dielectric spectroscopy (DS). A simple approach based on molecular hydrodynamics and a molecular treatment of DS allows rationalizing the a priori puzzling inconsistency between QENS and dielectric results regarding the dynamic coupling of the two components. The interpretation proposed is based on general grounds and therefore should be applicable to other biomolecular solutions.
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We investigate the kinetics of enthalpy recovery in stacked glassy polystyrene (PS) films with thickness from 30 to 95 nm over a wide temperature range below the glass transition temperature (Tg). We show that the time evolution toward equilibrium exhibits two mechanisms of recovery, in ways analogous to bulk PS. The fast mechanism, allowing partial enthalpy recovery toward equilibrium, displays Arrhenius temperature dependence with low activation energy, whereas the slow mechanism follows pronounced super-Arrhenius temperature dependence. In comparison to bulk PS, the time scales of the two mechanisms of recovery are considerably shorter and decreasing with the film thickness. Scaling of the equilibration times at various thicknesses indicates that the fast mechanism of recovery is compatible with the free volume holes diffusion model. Conversely, the slow mechanism of recovery appears to be accelerated with decreasing thickness more than predicted by the model and, therefore, its description requires additional ingredients. The implications, from both a fundamental and technological viewpoint, of the ability of thin polymer films to densify in relatively short time scales are discussed.
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A 10-month-old girl with type I Loeys-Dietz syndrome developed a conspicuous aortic root aneurysm that was well demonstrated on chest X-ray/CT reconstruction. She underwent successful valve-spare repair of the ascending aorta.
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Aorta/diagnóstico por imagem , Aneurisma da Aorta Torácica/complicações , Implante de Prótese Vascular/métodos , Síndrome de Loeys-Dietz/complicações , Aorta/cirurgia , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/cirurgia , Feminino , Seguimentos , Humanos , Lactente , Síndrome de Loeys-Dietz/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
In this article we review the recent polymer literature where dielectric spectroscopy has been used to investigate the segmental dynamics of polymers under the constraints produced by self-structuring. Specifically, we consider three cases: (i) semicrystalline polymers, (ii) segregated block-copolymers, and (iii) asymmetric miscible polymer blends. In these three situations the characteristics of the dielectric relaxation associated with the polymer segmental dynamics are markedly affected by the constraints imposed by the corresponding structural features. After reviewing in detail each of the polymer systems, the most common aspects are discussed in the context of the use of dielectric relaxation as a sensitive tool for analyzing structural features in nanostructured polymer systems.
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By means of extensive simulations, we investigate concentrated solutions of globular single-chain nanoparticles (SCNPs), an emergent class of synthetic soft nano-objects. By increasing the concentration, the SCNPs show flattening, and even reentrant behaviour, in the density dependence of their structural and dynamic correlations, as well as a soft caging regime and weak dynamic heterogeneity. The latter is confirmed by validation of the Stokes-Einstein relation up to concentrations far beyond the overlap density. Therefore SCNPs arise as a new class of soft colloids, exhibiting slow dynamics and actualizing in a real system the structural and dynamic anomalies proposed by models of ultrasoft particles. Quantitative differences in the dynamic behaviour depend on the SCNP deformability, which can be tuned through the degree of internal cross-linking.