Epidemiology and Immediate Indirect Effects of Respiratory Viruses in Lung Transplant Recipients: A 5-Year Prospective Study.

The epidemiology of respiratory viruses (RVs) in lung transplant recipients (LTRs) and the relationship of RVs to lung function, acute rejection (AR) and opportunistic infections in these patients are not well known. We performed a prospective cohort study (2009-2014) by collecting nasopharyngeal swabs (NPSs) from asymptomatic LTRs during seasonal changes and from LTRs with upper respiratory tract infectious disease (URTID), lower respiratory tract infectious disease (LRTID) and AR. NPSs were analyzed by multiplex polymerase chain reaction. Overall, 1094 NPSs were collected from 98 patients with a 23.6% positivity rate and mean follow-up of 3.4 years (interquartile range 2.5-4.0 years). Approximately half of URTIDs (47 of 97, 48.5%) and tracheobronchitis cases (22 of 56, 39.3%) were caused by picornavirus, whereas pneumonia was caused mainly by paramyxovirus (four of nine, 44.4%) and influenza (two of nine, 22.2%). In LTRs with LRTID, lung function changed significantly at 1 mo (p = 0.03) and 3 mo (p = 0.04). In a nested case-control analysis, AR was associated with RVs (hazard ratio [HR] 6.54), Pseudomonas aeruginosa was associated with LRTID (HR 8.54), and cytomegalovirus (CMV) replication or disease was associated with URTID (HR 2.53) in the previous 3 mo. There was no association between RVs and Aspergillus spp. colonization or infection (HR 0.71). In conclusion, we documented a high incidence of RV infections in LTRs. LRTID produced significant lung function abnormalities. Associations were observed between AR and RVs, between P. aeruginosa colonization or infection and LRTID, and between CMV replication or disease and URTID.

Immunogenicity of pandemic influenza A H1N1/2009 adjuvanted vaccine in pediatric solid organ transplant recipients.

The aim of this study was to assess the immunogenicity of a vaccine against this virus in a prospective cohort of transplanted pediatric patients without previous influenza infection who received one dose of MF59®-adjuvanted pandemic H1N1/2009 vaccine. Seventeen patients who were being regularly followed up at the Outpatient Clinic of the Children's Transplant Unit (liver and kidney transplantation) in Hospital Universitari Vall d'Hebron (Barcelona) were included. Seroconversion was demonstrated in 15 of 17 (88.2%) vaccinated children. There were no rejection episodes or major adverse events. The MF59(®) -adjuvanted pandemic H1N1/2009 vaccine was safe and elicited an adequate response.

Pterodon pubescens oil: characterisation, certification of origin and quality control via mass spectrometry fingerprinting analysis.

INTRODUCTION: The oil obtained from Pterodon pubescens (Leguminosae) seeds are known to display anti-cancer, anti-dermatogenic and anti-nociceptive activitiy. Phytochemical studies have demonstrated that its main constituents are diterpenoids with voucapan skeletons. Considering the potential biological activities of the oil, rapid and efficient methods for assessing its quality would facilitate certification and quality control. OBJECTIVE: To develop a direct mass spectrometric fingerprinting method for the P. pubescens seed oil that would focus on the major diterpenoids constituents, enabling quality control, origin certification and recognition of marker species in commercially available products. METHOD: Two techniques were used: (i) direct infusion electrospray ionisation (ESI) mass spectrometry after solvent extraction and dilution and (ii) ambient desorption/ionisation via easy ambient sonic-spray ionisation, EASI(+)-MS, performed directly on the seed surface or at a paper surface imprinted with the oil. RESULTS: From a combination of ESI-MS, HRESI-MS and ESI-MS/MS data, 12 diterpenes were characterised, and typical profiles were obtained for the oil extract or the crude oil via both ESI-MS and EASI-MS. These techniques require no or very simple sample preparation protocols and the whole analytical processes with spectra acquisition take just a few minutes. CONCLUSION: Both techniques, but particularly EASI-MS, provide simple, fast and efficient MS fingerprinting methodologies to characterise the P. pubescens oil with typical (di)terpene profiles being applicable to quality control and certification of authenticity and origin.

Influenza A H1N1/2009 infection in pediatric solid organ transplant recipients.

AIM AND METHOD: The aim of this study was to describe the clinical characteristics and outcome of pandemic influenza A H1N1/2009 (pH1N1) infection, in a retrospective cohort of pediatric patients with kidney and/or liver transplant and confirmed pH1N1 infection from June to December 2009, diagnosed in 2 Spanish teaching hospitals. RESULTS: Forty-nine patients were included. Pneumonia was diagnosed in 4 patients (8.2%), and 3 of them required respiratory support. There were no related deaths. CONCLUSION: Antiviral treatment within 48 h was associated with a lower likelihood of pneumonia (0/38, 0%) than treatment started after 48 h (4/11, 36.3%) (P < 0.01).

Family resources and school performance: an analysis of associated factors in middle school adolescents. / Recursos do ambiente familiar e desempenho escolar: análise de fatores associados em adolescentes do ensino fundamental.

PURPOSE: To verify the association between family resources, sociodemographic aspects, and school performance in middle school students. METHODS: Observational, analytical, cross-sectional study with a probabilistic sample stratified by sex, age, and grade in school. A total of 124 adolescents of both sexes, aged 11 to 14 years, enrolled in a private middle school participated in the study. We sent to their parents/guardians an online form with the Home Environment Resources Scale (HER), Brazilian Economic Classification Criteria (CCEB), and sociodemographic questions. The school performance was furnished by the institution. We used frequency distribution analysis of categorical variables and measures of central tendency and dispersion of the continuous ones. We used the Mann-Whitney, Kruskal-Wallis, and Spearman correlation coefficient tests and set the significance level at p ≤ 0.05. RESULTS: Most of the sample was 11 years old, females, sixth graders, with very good school performance, belonging to social class A, and whose householder had a bachelor's degree. Age and grade in school were associated with interaction with the parents, "family-school connection", and total HER score. The "proximal processes" had a moderate positive correlation with outings and toys. There was a moderate positive correlation between total HER score and "predictable activities that indicate stability". The "proximal processes" had a strong positive correlation with "family-school connection". There was a weak positive correlation between books available at home and school performance. CONCLUSION: The family resources were related to the adolescents' school performance.

OBJETIVO: Verificar a associação entre recursos do ambiente familiar, aspectos sociodemográficos e desempenho escolar de estudantes do Ensino Fundamental. MÉTODO: Estudo observacional analítico transversal, com amostra probabilística estratificada por sexo, idade e ano escolar. Participaram 124 adolescentes, de ambos os sexos, entre 11 e 14 anos, matriculados no Ensino Fundamental II de uma instituição particular. Os responsáveis receberam um formulário online contendo: Inventário dos Recursos do Ambiente Familiar (RAF), Critério de Classificação Econômica Brasil (CCEB) e questões sociodemográficas. O desempenho escolar foi fornecido pela instituição. Realizou-se distribuição de frequência das variáveis categóricas e medidas de tendência central e de dispersão para as contínuas. Utilizou-se os testes Mann-Whitney, Kruskal-Wallis e coeficiente de correlação de Spearman, sendo considerados significantes os que apresentaram valor de p≤0,05. RESULTADOS: A maioria da amostra possuía 11 anos, do sexo feminino, cursava o 6º ano do Ensino Fundamental, obteve desempenho escolar muito bom, apresentava classificação A e declarou que a/o chefe de família possuía Ensino Superior completo. Houve associação entre idade e ano escolar com a interação com os pais, ligação família-escola e RAF total. Os processos proximais demonstraram correlação positiva de magnitude moderada com passeios e brinquedos. Houve correlação positiva moderada entre total do RAF e atividades previsíveis que sinalizam estabilidade. Os processos proximais se correlacionaram de maneira positiva forte com a ligação família-escola. Ter livros em casa revelou correlação positiva fraca com o desempenho escolar. CONCLUSÃO: Os recursos do ambiente familiar apresentaram relação com o desempenho escolar dos adolescentes.

Therapy with m-TOR inhibitors decreases the response to the pandemic influenza A H1N1 vaccine in solid organ transplant recipients.

Concern has been raised regarding the response to vaccination in solid organ transplant recipients (SOTR) undergoing immunosuppressant regimens and the possibility of rejection related to the immune response associated with pandemic influenza H1N1-2009 vaccination. The goal of this study was to assess the immunogenicity, efficacy and safety of the pandemic vaccine in SOTR. We performed a multicenter prospective study in SOTR receiving the pandemic vaccine. Immunological response was determined in serum 5 weeks after vaccination by microneutralization assays, and immunoglobulins were measured by ELISA. Three hundred and forty-six SOTR were included. Preexisting seroprotection was detected in 13.6% of cases and rates of seroconversion and seroprotection after vaccination were 73.1% and 82.9%, respectively. Patients with baseline antibody titers had better geometric mean titers (GMT)-post after pandemic vaccination (339.4 vs. 121.4, p < 0.001). Younger age, liver disease and m-TOR inhibitor therapy were independently associated with lower seroprotection and GMT-post. There were no major adverse effects or rejection episodes. Pandemic vaccine was safe in SOTR and elicited an adequate response, although lower than in healthy individuals. This is the first study describing a decreased response after vaccination in patients receiving mTOR inhibitors who presented lower seroprotection rates and lower GMT-post.

Recursos do ambiente familiar e desempenho escolar: análise de fatores associados em adolescentes do ensino fundamental / Family resources and school performance: an analysis of associated factors in middle school adolescents

Resumo Objetivo Verificar a associação entre recursos do ambiente familiar, aspectos sociodemográficos e desempenho escolar de estudantes do Ensino Fundamental. Método Estudo observacional analítico transversal, com amostra probabilística estratificada por sexo, idade e ano escolar. Participaram 124 adolescentes, de ambos os sexos, entre 11 e 14 anos, matriculados no Ensino Fundamental II de uma instituição particular. Os responsáveis receberam um formulário online contendo: Inventário dos Recursos do Ambiente Familiar (RAF), Critério de Classificação Econômica Brasil (CCEB) e questões sociodemográficas. O desempenho escolar foi fornecido pela instituição. Realizou-se distribuição de frequência das variáveis categóricas e medidas de tendência central e de dispersão para as contínuas. Utilizou-se os testes Mann-Whitney, Kruskal-Wallis e coeficiente de correlação de Spearman, sendo considerados significantes os que apresentaram valor de p≤0,05. Resultados A maioria da amostra possuía 11 anos, do sexo feminino, cursava o 6º ano do Ensino Fundamental, obteve desempenho escolar muito bom, apresentava classificação A e declarou que a/o chefe de família possuía Ensino Superior completo. Houve associação entre idade e ano escolar com a interação com os pais, ligação família-escola e RAF total. Os processos proximais demonstraram correlação positiva de magnitude moderada com passeios e brinquedos. Houve correlação positiva moderada entre total do RAF e atividades previsíveis que sinalizam estabilidade. Os processos proximais se correlacionaram de maneira positiva forte com a ligação família-escola. Ter livros em casa revelou correlação positiva fraca com o desempenho escolar. Conclusão Os recursos do ambiente familiar apresentaram relação com o desempenho escolar dos adolescentes.

ABSTRACT Purpose To verify the association between family resources, sociodemographic aspects, and school performance in middle school students. Methods Observational, analytical, cross-sectional study with a probabilistic sample stratified by sex, age, and grade in school. A total of 124 adolescents of both sexes, aged 11 to 14 years, enrolled in a private middle school participated in the study. We sent to their parents/guardians an online form with the Home Environment Resources Scale (HER), Brazilian Economic Classification Criteria (CCEB), and sociodemographic questions. The school performance was furnished by the institution. We used frequency distribution analysis of categorical variables and measures of central tendency and dispersion of the continuous ones. We used the Mann-Whitney, Kruskal-Wallis, and Spearman correlation coefficient tests and set the significance level at p ≤ 0.05. Results Most of the sample was 11 years old, females, sixth graders, with very good school performance, belonging to social class A, and whose householder had a bachelor's degree. Age and grade in school were associated with interaction with the parents, "family-school connection", and total HER score. The "proximal processes" had a moderate positive correlation with outings and toys. There was a moderate positive correlation between total HER score and "predictable activities that indicate stability". The "proximal processes" had a strong positive correlation with "family-school connection". There was a weak positive correlation between books available at home and school performance. Conclusion The family resources were related to the adolescents' school performance.

Vascular reactivity to angiotensin II and to norepinephrine in diabetic subjects.

Vascular responsiveness to infused angiotensin II and to norepinephrine was determined in 14 normal subjects and two groups of diabetic subjects, 16 with no clinically detectable diabetic complications and 14 with diabetic retinopathy but no clinical evidence of nephropathy. All were maintained on a 100-mEq. -Na- 100-mEq. -K diet. Serum electrolytes, 24-hour urinary sodium, creatinine clearance, and plasma renin activity did not differ significantly among the groups. Group mean baseline diastolic pressure in those with retinopathy was higher than in normal subjects but no significantly different from that of uncomplicated diabetics. The pressor dose of angiotensin II (ng./kg./min. to increase diastolic blood pressure 20 mm. Hg) for each group respectively was 11.5 +/-0.9, 12.9+/- 1.3, and 8.3 +/- 1.3, and the slope of the dose-response curve (mm. Hg rise in blood pressure resulting from the infusion of 1 ng./kg./min. following the initial increment in blood pressure) was 2.0 +/-0.2, 1.6+/-0.2, 3.3+/- 0.6. For norepinephrine, the pressor doses were 163 +/- 24, 212+/-21, and123 +/- 11 and slopes were 0.17 +/- 0.03, 0.13 +/- 0.02, and 0.20 +/-0.02. Neither diabetic group differed significantly from normal subjects. Diabetics with retinopathy were more sensitive to angiotensin II, pressor dose (P less than 0.059) and slope (P less than 0.02), and to norepinephrine, pressor dose (P less than 0.006) and slope (P =0.05) than those without complications. These data suggest that vascular reactivity is enhanced in diabetics with retinopathy.

Improved embryonic cryosurvival observed after in vitro supplementation with conjugated linoleic acid is related to changes in the membrane lipid profile.

The aim of this study was to evaluate the effect of supplementing serum-containing media with a mixture of cis- and trans-9,11- and -10,12-conjugated isomers of linoleic acid (CLA) during different steps of the in vitro production (IVM, IVC, or IVM + IVC) of bovine embryos on their embryonic development, cryotolerance, and lipid profile. To evaluate the impact of the CLA on membrane lipids, such as phosphatidylcholine (PC) and sphingomyelin (SM), the embryos' lipid profiles were obtained using matrix-assisted laser desorption ionization mass spectrometry. The cleavage rates (78.6%-84.8%) and blastocyst development (44.8%-51.2%) remained unaltered. The postthawing reexpansion rates were higher (P < 0.05) when the CLA was added to the IVM medium (82.6%) or to the IVM + IVC medium (83.8%) than the control (69.3%) or IVC medium (63.0%). Changes in the blastocysts' lipid profile occurred when supplementation was restricted to the IVM or IVC medium. However, the most prominent effects of the CLA on the embryonic PC and SM profiles were observed when the supplement was added to IVM + IVC media, which was an increase in the level of highly unsaturated PCs containing 36 or 38 carbons, which are likely to contain CLA residues. These results showed that the molecular mechanism resulting in the improved cryosurvival, observed with CLA supplementation during bovine embryonic in vitro production, was related to the composition of structural lipids of cellular membranes and is dependent on the treatment length. Monitoring the lipid profile of embryonic membranes may improve the CLA supplementation strategy and facilitate the development of new IVC systems to improve the cryopreservation of bovine embryos and those of other domestic species.

Isradipine dose-confirmation study in Filipino patients with mild to moderate hypertension.

The effective and well tolerated dose of isradipine was determined in 130 Filipino patients with mild to moderate essential hypertension in a multicentre study with a 2-week placebo pretreatment period followed by an 8-week active treatment period. 37 male and 93 female patients (mean age 51 years, mean weight 59.9kg) participated in the study. Average systolic/diastolic blood pressure on admission was 163.8/103.7mm Hg. Results showed isradipine normalised sitting diastolic blood pressures in 109 of 130 (83.8%) patients. 71 patients (54.6%) were receiving isradipine 1.25mg twice daily while 38 patients (29.2%) required a dose of 2.5mg twice daily. A drop of greater than or equal to 10mm Hg in sitting diastolic blood pressure was achieved in 71 patients (54.6%) administered isradipine 1.25mg twice daily and 44 patients (33.8%) on isradipine 2.5mg twice daily. Heart rate was not significantly changed with either dosage. Drug-related adverse effects were only transient in duration and mild to moderate in severity. No patient discontinued treatment because of these effects. This study provides confirmatory evidence of the clinical efficacy and tolerability of a daily dose of less than or equal to 5mg isradipine in Filipino patients with mild to moderate hypertension.

A new approach to artificial neural networks.

A novel approach to artificial neural networks is presented. The philosophy of this approach is based on two aspects: the design of task-specific networks, and a new neuron model with multiple synapses. The synapses' connective strengths are modified through selective and cumulative processes conducted by axo-axonic connections from a feedforward circuit. This new concept was applied to the position control of a planar two-link manipulator exhibiting excellent results on learning capability and generalization when compared with a conventional feedforward network. In the present paper, the example shows only a network developed from a neuronal reflexive circuit with some useful artifices, nevertheless without the intention of covering all possibilities devised.

EEG-based discrimination between imagination of left and right hand movements using Adaptive Gaussian Representation.

This article uses the Adaptive Gaussian Representation (AGR) for human electroencephalogram (EEG) feature extraction aiming the discrimination among mental tasks to be used in a brain computer interface (BCI). It does not focus on the AGR time-frequency representation, but rather on their projection coefficients. Ten volunteers were asked to imagine either right or left hand movement, according to a proper visual stimulus. The features of the resulting EEG signals were characterised by extracting AGR coefficients. Classification was carried out using a Multilayer perceptron (MLP) trained with the classical backpropagation algorithm. Overall results show that AGR coefficients representation is able to reveal a significant EEG discrimination between imagination of right and left hand movement with a mean classification performance of 91%+/-5.8% achieved for female subjects and 87%+/-5.0% achieved for male subjects.

Peripheral parenteral nutrition: an option for patients with an indication for short-term parenteral nutrition.

OBJECTIVE: The aim of this study was to examine and describe our experience with the use of peripheral parenteral nutrition (PPN). METHODS: Patients with an indication for parenteral nutrition for less than 15 days received it via a peripheral vein via a short, 20 or 22 gauge French polyurethane catheter. Parenteral nutrition had a final osmolality of 993 mOsm/l and was administered by infusion pump. The nutritional status of patients was assessed by the Subjective Global Assessment (SGA) technique. Patients were followed by a trained nutritional team and the access site was changed if problems developed. RESULTS: Fifty-three patients were followed with a mean age of 59.5 +/- 17.5 years. There were 36 males (69.2%). Nutritional requirements were reached in 67.6% of the patients within 2.9 +/- 0.7 days. The mean time on parenteral nutrition was 7.2 +/- 6.6 days. In 74.3% of the cases parenteral nutrition was offered until the end of the planned treatment. Pain at the venipuncture site occurred in 17.1% of the cases, pain and fever in 20% and pain, hyperthermia and edema in 2.8%. No patient developed an abscess. CONCLUSIONS: PPN can benefit a great number of patients without the risks linked to a venous central catheter. Complications associated with PPN are low especially when the care and follow-up are provided by a nutritional support team.

Assessment of the acute effects of different PEP levels on respiratory pattern and operational volumes in patients with Parkinson's disease.

The aim of the study was to determine the acute effects of positive expiratory pressure (PEP) on breathing pattern, operational volumes and shortening velocity of respiratory muscles on patients with Parkinson's disease. It was evaluated 15 patients and healthy controls, by optoelectronic plethysmography, using PEP in three different levels (10, 15 and 20cmH2O). Breathing pattern changed in both groups. Parkinson group increased tidal volume in all PEP levels (p<0.001), but with lower values compared to control. End-inspiratory chest wall volume increased in the Parkinson group at all PEP levels (p<0.001), end-expiratory chest wall volume show a slightly increase when we compared QB to all PEP levels in Parkinson's. There was an intergroup difference in the index of shortening velocity of abdominal, diaphragm and inspiratory muscles of the rib cage at all PEP levels (p<0.01). We conclude that Parkinson's disease promotes important alterations in different breathing pattern components and PEP has significant effects on these alterations.

In vitro and in vivo antitumor activity of crude extracts obtained from Brazilian Chromobacterium sp isolates.

Natural products produced by microorganisms have been an important source of new substances and lead compounds for the pharmaceutical industry. Chromobacterium violaceum is a Gram-negative ß-proteobacterium, abundant in water and soil in tropical and subtropical regions and it produces violacein, a pigment that has shown great pharmaceutical potential. Crude extracts of five Brazilian isolates of Chromobacterium sp (0.25, 2.5, 25, and 250 µg/mL) were evaluated in an in vitro antitumor activity assay with nine human tumor cells. Secondary metabolic profiles were analyzed by liquid chromatography and electrospray ionization mass spectrometry resulting in the identification of violacein in all extracts, whereas FK228 was detected only in EtCE 308 and EtCE 592 extracts. AcCE and EtCE 310 extracts showed selectivity for NCI/ADR-RES cells in the in vitro assay and were evaluated in vivo in the solid Ehrlich tumor model, resulting in 50.3 and 54.6% growth inhibition, respectively. The crude extracts of Chromobacterium sp isolates showed potential and selective antitumor activities for certain human tumor cells, making them a potential source of lead compounds. Furthermore, the results suggest that other compounds, in addition to violacein, deoxyviolacein and FK228, may be involved in the antitumor effect observed.

In vitro and in vivo antitumor activity of crude extracts obtained from Brazilian Chromobacterium sp isolates

Natural products produced by microorganisms have been an important source of new substances and lead compounds for the pharmaceutical industry. Chromobacterium violaceum is a Gram-negative β-proteobacterium, abundant in water and soil in tropical and subtropical regions and it produces violacein, a pigment that has shown great pharmaceutical potential. Crude extracts of five Brazilian isolates of Chromobacterium sp (0.25, 2.5, 25, and 250 µg/mL) were evaluated in an in vitro antitumor activity assay with nine human tumor cells. Secondary metabolic profiles were analyzed by liquid chromatography and electrospray ionization mass spectrometry resulting in the identification of violacein in all extracts, whereas FK228 was detected only in EtCE 308 and EtCE 592 extracts. AcCE and EtCE 310 extracts showed selectivity for NCI/ADR-RES cells in the in vitro assay and were evaluated in vivo in the solid Ehrlich tumor model, resulting in 50.3 and 54.6% growth inhibition, respectively. The crude extracts of Chromobacterium sp isolates showed potential and selective antitumor activities for certain human tumor cells, making them a potential source of lead compounds. Furthermore, the results suggest that other compounds, in addition to violacein, deoxyviolacein and FK228, may be involved in the antitumor effect observed.

No going back. Mexican women find opportunity and obstacles in a changing economy.

PIP: An overview was provided of some of the economic and social changes in Mexico that impact on women. At the Colegio de Postgraduados, an ongoing project will examine women's work roles in an agricultural setting. The Ford Foundation has funded research studies at Mexican universities. One such study will examine women workers in foreign-owned factories producing duty free export goods; another study involves interviews with street vendors in the informal sector. Jose Alonso is a specialist on the Mexican garment industry, teaches at the University of the Americas, and advises at the Autonomous Technological Institute of Mexico. He contends that the process of development can best be understood by examining the informal sector. There is no Mexican tradition of a business class. Scholars at the Colegio de Postgraduados' Center for Rural Development are exploring income generation schemes, and building a master's degree program specializing in gender and rural development. The program would train professionals with an understanding of the needs of rural women and appropriate strategies for improving women's social and economic conditions. Crises have precipitated major shifts in work patterns in Mexico. During the 1980s, inflation and unemployment rapidly increased and income declined to 1970s levels. Mass movement of women into the labor force occurred. For many women, the dual role in long paid work hours and family and domestic care has produced independence with a big price tag. Manufacturing jobs along the free trade border areas have provided work opportunities for women, who hold 70% of the jobs. These jobs have moved from low paid menial tasks to higher skilled and better paid positions with training, but only for some women. There are few unions, and the government Confederation of Mexican Workers does not include women. Notwithstanding working conditions, women confront other problems with housing and the lack of basic amenities such as electricity, tap water, trash collection, and paved roads and walkways. Border areas such as Juarez attract 200 unemployed daily. Unregulated growth will turn these border cities into densely populated areas. About 40% of the economically active population work in the informal sector. Much of the vendor merchandise is illegal contraband, and intricate handicrafts are sold next to electronic games, cosmetics, and silk-screened T shirts. Informal work is also available for women in cottage industries at home. The Agro-Industrial Women's Unit in Buenavista helps to secure agricultural land holdings for women.^ieng