The applicability of the "surprise question" as a prognostic tool in patients with severe chronic comorbidities in a university teaching outpatient setting.

BACKGROUND: Life expectancy in recent decades has increased the prevalence of chronic diseases in the population, requiring an approach to new health topics, such as discussions on quality of life and expectations about death and dying. The concept of advance directives (ADs) gives individuals the opportunity to make known their decisions about the treatments they would like to receive at the end of life. Despite the recognition of relevance in clinical practice, the applicability of the concept presents challenges, including establishing the appropriate prognosis for each patient and the ideal time to approach the patient. Some prognostic tools were developed, such as the surprise question (SQ): "Would you be surprised if your patient died in 12 months?", which is used in some clinical settings to predict patient deaths and to make decisions regarding ADs. The main objective of the present study was to evaluate the behavior of second-year resident physicians (PGY-2) when the SQ was applied. METHOD: In our observational study, from July 1, 2016, to February 28, 2017, (PGY-2) in the Internal Medicine Residency Program (IMRP) applied SQ to all patients with multiple and varied chronic no communicable comorbidities, who were followed up at the general medicine outpatient clinic (GMOC) of a tertiary university hospital in São Paulo- Brazil. The frequency of the outcome (death or non-death within 12 months) was analyzed by correlating it with the clinical data (impact of the studied variables). RESULTS: Eight hundred forty patients entered the study. Fitfty-two of them (6.2%) died within one year. PGY-2 predicted that two hundred and fourteen patients (25.5% of total) would die within a year (answer No to SQ), of which, 32 (14.9%) did so. The correct residents' prognosis for the subgroup of 626 patients (answer "Yes" to SQ) was NPV = 96.8% (CI = 95.4%-98.2%) and PPV = 14.9% (CI 10.1%-19, 6%). Answering "Yes" to SQ correlated negatively to addressing AD while the outcomes death and the answer No to SQ were positively correlated, according to the number of comorbidities. CONCLUSION: The SQ, in addition to care, contributed to health education, communication and care planning shared by the doctor and patient.

Mandibular Dysmorphology and Clinical Presentation in Treacher Collins Syndrome.

INTRODUCTION: Treacher Collins syndrome is a rare congenital disease characterized by the multiple craniofacial malformations. Although the deformities affecting patients with Treacher Collins syndrome have been well characterized, the effects of these malformations to clinical severity of the syndrome are not well understood. OBJECTIVE: To determine the association of specific Treacher Collins mandibular malformations with clinical severity. DESIGN: A retrospective radiographic observational study. SETTING: Study conducted at a single institution, a quaternary craniofacial care center. PATIENTS: 54 patients with Treacher Collins syndrome. INTERVENTIONS: Computed tomography (CT), clinical photographs and medical history were included in this analysis. Mandibles were isolated from CT data and reconstructed in three dimensions using Mimics software. Cephalometric measurements were performed on CT data. Clinical severity was determined by Teber and Vincent scores. Association of craniofacial dysmorphology to clinical severity was determined by Spearman rank coefficient. MAIN OUTCOME MEASURES: The main results obtained were the measurements of the mandibles and the quantification of the malformations of the evaluated patients. RESULTS: Among the most frequent findings in the sample are hypoplasia of the zygomatic complex, descending palpebral cleft and mandibular hypoplasia. Patients with a lower ramus/corpus ratio had a higher (more severe) Teber and Vincent classification. CONCLUSION: Patients with the most compromised mandible are also the patients with the highest number of malformations, thus, the most severe patients.

Apoptosis induced by synthetic compounds containing a 3,4,5-trimethoxyphenyl fragment against lymphoid immature neoplasms.

T-cell acute lymphoblastic leukemia is an aggressive hematological malignancy originating from the malignant transformation of progenitor T cells at different stages of development. The treatment causes severe adverse effects and is associated with relapses and high morbidity and mortality rates. The present study aimed to evaluate the cytotoxic activity of 28 new compounds containing 3,4,5-trimethoxyphenyl analogues on hematological neoplastic cells lines. Cytotoxicity screening by the MTT method revealed that compound 1d was the most promising. Cell viability of neoplastic cells decreased in a concentration- and time-dependent manner, with compound 1d not causing hemolysis or reducing peripheral blood mononuclear cells viability, suggesting a selective cytotoxicity. We also suggested that compound 1d induced apoptotic-like cell death with mitochondrial involvement in Jurkat cells.

Prospective evaluation of the cardiac safety of HER2-targeted therapies in patients with HER2-positive breast cancer and compromised heart function: the SAFE-HEaRt study.

PURPOSE: HER2-targeted therapies have substantially improved the outcome of patients with breast cancer, however, they can be associated with cardiac toxicity. Guidelines recommend holding HER2-targeted therapies until resolution of cardiac dysfunction. SAFE-HEaRt is the first trial that prospectively tests whether these therapies can be safely administered without interruptions in patients with cardiac dysfunction. METHODS: Patients with stage I-IV HER2-positive breast cancer candidates for trastuzumab, pertuzumab or ado-trastuzumab emtansine (TDM-1), with left ventricular ejection fraction (LVEF) 40-49% and no symptoms of heart failure (HF) were enrolled. All patients underwent cardiology visits, serial echocardiograms and received beta blockers and ACE inhibitors unless contraindicated. The primary endpoint was completion of the planned HER2-targeted therapies without developing either a cardiac event (CE) defined as HF, myocardial infarction, arrhythmia or cardiac death or significant asymptomatic worsening of LVEF. The study was considered successful if planned oncology therapy completion rate was at least 30%. RESULTS: Of 31 enrolled patients, 30 were evaluable. Fifteen patients were treated with trastuzumab, 14 with trastuzumab and pertuzumab, and 2 with TDM-1. Mean LVEF was 45% at baseline and 46% at the end of treatment. Twenty-seven patients (90%) completed the planned HER2-targeted therapies. Two patients experienced a CE and 1 had an asymptomatic worsening of LVEF to ≤ 35%. CONCLUSION: This study provides safety data of HER2-targeted therapies in patients with breast cancer and reduced LVEF while receiving cardioprotective medications and close cardiac monitoring. Our results demonstrate the importance of collaboration between cardiology and oncology providers to allow for delivery of optimal oncologic care to this unique population.

Optical absorption in complexes of abasic DNA with noble-metal nanoclusters by first principles calculations.

Abasic sites (AP site) in a DNA duplex have been experimentally used to produce fluorescent Ag nanoclusters (NC) with a small number of atoms (n ≤ 6). These AP-DNA:NC complexes act as biological makers that help to locate genes associated with diseases related to single nucleotide polymorphisms (SNP), for example. Abasic sites are the most common SNP genetic variation, and their detection may help predict a host of genetically determined diseases. In this work, we report a theoretical study of the optical absorption spectra of AP-DNA:Ag4 and AP-DNA:Au4 complexes using a fully ab initio methodology. We consider several different base environments for the noble-metal nanocluster occupying the AP site, and compute the absorption spectra of sixteen AP-DNA:Ag4 and sixteen AP-DNA:Au4 complexes. We find that optical absorption in the AP-DNA:Ag4 complexes tends to concentrate in the green-to-violet range of frequencies (2.50 eV ≤ hω ≤ 3.2 eV) and that AP-DNA:Au4 complexes display absorption peaks in the violet-to-ultraviolet interval (hω ≥ 3.0 eV). An analysis of the optical absorption mechanisms in these complexes shows that they can be of local, charge-transfer, or hybrid nature, i.e., AP-DNA:NC complexes display the full variety of optical absorption processes in molecular systems. In particular, we identify both charge-transfer and hybrid processes involving several DNA bases surrounding the NC. Importantly, we find that even sequences where the Ag4 cluster is not in a guanine rich neighborhood display absorption peaks in the visible-light spectrum. Moreover, we obtain that the maximum intensities of the absorption peaks in complexes with pyrimidine vacancies are generally higher than those in complexes with purine vacancies. Regarding the selectivity of single-vacancy AP-DNA to specific noble-metal nanocluster sizes, our calculations show that the four-atom Ag4 (Au4) species fits naturally and binds into the AP-site in a single-vacancy AP-DNA.

Environmental and social valuation of shipping emissions on four ports of Portugal.

Maritime sector is expected to continue growing significantly in line with world trade, however its impacts on environmental, social and human health are not yet fully known. Thus, this study aimed to estimate the external costs of in-port shipping emissions (NOx, SO2, CO2, VOCs and PM2.5) and accomplish a comprehensive eco-efficiency evaluation of four ports in Portugal (Leixões, Setúbal, Sines and Viana do Castelo) during 2013. External costs were based on the external cost factors from BeTa, CAFE and NEEDS projects and from Song (2014). Eco-efficiency evaluation was based on environmental, social and economic criteria. Results showed higher externalities for Sines and Setúbal (2.0E+02 million €), followed by Leixões (1.8E+02 million €), and Viana do Castelo (6.3 million €). NOx, SO2, and PM2.5 were the pollutants with the highest externalities. Sines port showed the best overall eco-efficiency. Although Setúbal port showed higher performance than Viana do Castelo port based on the economic data, when social and environmental aspects were considered the results changed. This shows the importance of performing a more comprehensive analysis using social and environmental indicators. The combination of all these indicators is highly important to support the implementation of policies for the abatement of shipping in-port emissions.

X-ray powder diffraction at the XRD1 beamline at LNLS.

Various upgrades have been completed at the XRD1 beamline at the Brazilian synchrotron light source (LNLS). The upgrades are comprehensive, with changes to both hardware and software, now allowing users of the beamline to conduct X-ray powder diffraction experiments with faster data acquisition times and improved quality. The main beamline parameters and the results obtained for different standards are presented, showing the beamline ability of performing high-quality experiments in transmission geometry. XRD1 operates in the 5.5-14 keV range and has a photon flux of 7.8 × 109 photons s-1 (with 100 mA) at 12 keV, which is one of the typical working energies. At 8 keV (the other typical working energy) the photon flux at the sample position is 3.4 × 1010 photons s-1 and the energy resolution ΔE/E = 3 × 10-4.

Magnetic resonance correlation of iron content with neuromelanin in the substantia nigra of early-stage Parkinson's disease.

BACKGROUND AND PURPOSE: Magnetic resonance (MR) studies have demonstrated a significant reduction of neuromelanin in the substantia nigra (SN) of Parkinson's disease (PD) patients with high accuracy for differential diagnosis compared to non-PD controls and essential tremor. However, studies state that not knowing how paramagnetic effects of iron influence neuromelanin signal is a limitation. In this study a neuromelanin-sensitive MR sequence was combined with T2* relaxometry iron quantification analysis to study the SN of early-stage PD patients to investigate the correlation between these parameters. METHODS: The inclusion criteria were untreated de novo PD patients and a 2-5 year disease duration (early PD); in addition, age-matched controls were enrolled. These were studied at 3.0 T with a high-resolution T1-weighted MR sequence to visualize neuromelanin and a relaxometry sequence for iron quantification. The primary outcome was the correlation of the width of the neuromelanin high signal region and the T2* values in the lateral, central and medial segments of the SN. RESULTS: Very weak correlations of T2* values with neuromelanin width, positive for global and negative for the medial and lateral SN segments, were found in both PD groups and control subjects. The SN neuromelanin width was markedly reduced in the de novo and early PD groups compared with controls in all SN segments, but no significant difference in T2* values was found between the groups. CONCLUSIONS: The SN neuromelanin signal does not have a significant correlation with iron content in PD patients or controls. The neuromelanin MR signal reduction in PD does not seem to be significantly influenced by paramagnetic iron effects.

Substantia nigra neuromelanin magnetic resonance imaging in de novo Parkinson's disease patients.

BACKGROUND: Depigmentation of the substantia nigra (SN) and locus coeruleus (LC) is a conspicuous pathological feature of Parkinson's disease (PD) and is related to the loss of neuromelanin, whose paramagnetic properties result in high signal on specific T1-weighted magnetic resonance imaging (MRI). Recent studies have suggested that neuromelanin decrease in the SN and LC of PD patients may emerge as a possible diagnostic biomarker. The SN neuromelanin signal in de novo and early stage PD patients was studied to assess its diagnostic accuracy. This is the first study based on a semi-automated MRI analysis of the neuromelanin signal in de novo PD patients. METHODS: The inclusion criteria were untreated de novo PD and a 2-5 year disease duration; in addition, age matched healthy controls were enrolled. These were studied with a high-resolution T1-weighted MRI sequence at 3 T to visualize neuromelanin. The primary outcome was SN high signal area, length and neuromelanin/midbrain ratio obtained with semi-automated methods. RESULTS: A total of 12 de novo PD patients and 10 PD patients with a 2-5 year disease duration were evaluated. The area, length of the SN T1 high signal and the SN neuromelanin/midbrain ratio were markedly decreased in the PD groups compared with age-matched controls, with a substantial overlap between the two PD groups. CONCLUSIONS: Neuromelanin-sensitive MRI techniques can discriminate PD patients from healthy individuals with high sensitivity and specificity. Our findings are consistent with recent findings showing that PD neuromelanin changes remain stable during the course of the disease.

Children's exposure to indoor air in urban nurseries--Part II: Gaseous pollutants' assessment.

This study, Part II of the larger study "Children's exposure to indoor air in urban nurseries", aimed to: (i) evaluate nursery schools' indoor concentrations of several air pollutants in class and lunch rooms; and (ii) analyse them according to guidelines and references. Indoor continuous measurements were performed, and outdoor concentrations were obtained to determine indoor/outdoor ratios. The influence of outdoor air seemed to be determinant on carbon monoxide (CO), nitrogen dioxide (NO2) and ozone (O3) indoor concentrations. The peak concentrations of formaldehyde and volatile organic compounds (VOC) registered (highest concentrations of 204 and 2320 µg m(-3) respectively), indicated the presence of specific indoor sources of these pollutants, namely materials emitting formaldehyde and products emitting VOC associated to cleaning and children's specific activities (like paints and glues). For formaldehyde, baseline constant concentrations along the day were also found in some of the studied rooms, which enhances the importance of detailing the study of children's short and long-term exposure to this indoor air pollutant. While CO, NO2 and O3 never exceeded the national and international reference values for IAQ and health protection, exceedances were found for formaldehyde and VOC. For this reason, a health risk assessment approach could be interesting for future research to assess children's health risks of exposure to formaldehyde and to VOC concentrations in nursery schools. Changing cleaning schedules and materials emitting formaldehyde, and more efficient ventilation while using products emitting VOC, with the correct amount and distribution of fresh air, would decrease children's exposure.

Radon Levels in Nurseries and Primary Schools in Bragança District-Preliminary Assessment.

Lung cancer has been associated with radon concentration even at low levels such as those found in dwellings. This study aimed to (i) determine radon diurnal variations in three nurseries and one primary school in the Bragança district (north of Portugal) and (ii) compare radon concentrations with legislated standards and assess the legislated procedures. Radon was measured in three nurseries and a primary school in a rural area with nongranite soil. Measurements were performed continuously to examine differences between occupation and nonoccupation periods. Indoor temperature and relative humidity were also measured continuously. A great variability was found in radon concentrations between the microenvironments examined. Radon concentrations surpassed by severalfold the recommended guidelines and thresholds, and excessive levels of health concern were sporadically found (361.5-753.5 Bq m(-3)). Thus, it is of importance to perform a national campaign on radon measurements and to reduce exposure.

High prevalence of asymptomatic Leishmania spp. infection among liver transplant recipients and donors from an endemic area of Brazil.

Visceral leishmaniasis is an uncommon disease in transplant recipients; however, if left untreated, the mortality can be high. If an organ donor or recipient is known to be an asymptomatic Leishmania spp. carrier,monitoring is advised. This study proposes to assess the prevalence of asymptomatic Leishmania spp.infection in liver transplant donors and recipients from an endemic area. A total of 50 liver recipients and 17 liver donors were evaluated by direct parasite search, indirect fluorescent antibody test (IFAT), anti-Leishmania rK39 rapid test and Leishmania spp.DNA detection by polymerase chain reaction (PCR).Leishmania spp. amastigotes were not observed in liver or spleen tissues. Of the 67 serum samples, IFAT was reactive in 1.5% and indeterminate for 17.9%, and the anti-Leishmania rK39 rapid test was negative for all samples. The PCR test was positive for 7.5%, 8.9%, and 5.9% of blood, liver and spleen samples, respectively(accounting for 23.5% of the donors and 8% of the recipients). Leishmania infantum-specific PCR confirmed all positive samples. In conclusion, a high prevalence of asymptomatic L. infantum was observed in donors and recipients from an endemic area, and PCR was the most sensitive method for screening these individuals.

Meniscal transection rather than excision increases pain behavior and structural damage in experimental osteoarthritis in mice.

OBJECTIVE: To evaluate pain behavior and structural damage in mice subjected to either meniscal transection or removal. METHODS: Mice (10/group) were subjected to transection of the medial collateral and anterior cruciate ligaments (ACLT/MCLT) followed by either transection (meniscotomy) or removal (meniscectomy) of the medial meniscus. A control group was subjected only to transection of the ligaments. Pain was assessed using the electronic pressure-meter paw test. Cell influx, measured in joint exudates, and joint histopathology were assessed after 49 days. Four other groups subjected to meniscotomy received indomethacin, the inducible nitric oxide synthase (iNOS) inhibitor 1400W, morphine or the vehicles. RESULTS: Both meniscotomy and meniscectomy groups displayed persistent and significant increase in pain behavior as compared to controls, being significantly more severe in the former. Cell influx was more intense in the meniscotomy as compared to the meniscectomy group. Structural damage at the tibia, but not at the femur, was also more severe in the meniscotomy group. Indomethacin and 1400W partially but significantly reduced pain whereas morphine abrogated pain behavior in meniscotomized mice. CONCLUSION: Meniscal transection rather than resection promotes more severe pain and structural damage in mice. Administration of opioids, cyclooxygenase and nitric oxide (NO) synthase inhibitors provide analgesia in this model. Careful description of the structures damaged is crucial when reporting experimental osteoarthritis (OA).

Diffusion-weighted breast imaging at 3 T: preliminary experience.

AIM: To evaluate the performance of diffusion-weighted imaging (DWI) at 3 T for the detection and characterization of breast lesions. MATERIALS AND METHODS: Magnetic resonance imaging (MRI) of the breast, including DWI single-shot spin-echo echo planar images (SS-SE-EPI; eight b-values, 50-3000 s/mm(2)), were acquired in women with a clinical indication for breast MRI. The exclusion criteria were as follows: (1) previous breast surgery, radiotherapy and/or chemotherapy within the prior 48 months (14 women); (2) only cystic lesions (one woman); (3) no detectable enhancing lesion at dynamic contrast-enhanced (DCE)-MRI (15 women); and (4) breast implants (four women). MRI results were corroborated by histopathology or imaging follow-up. Apparent diffusion coefficients (ADCs) were estimated for lesions and normal glandular tissue. Differences in the ADC between tissue types were evaluated and the sensitivity and specificity of the method calculated by receiver operating characteristics (ROC) curves. RESULTS: The final cohort comprised 53 patients with 59 lesions. Histopathology was obtained for 58 lesions. One lesion was validated as benign on imaging follow-up. Mean ADCs of 1.99 ± 0.27 × 10(-3) mm(2)/s, 1.08 ± 0.25 × 10(-3) mm(2)/s, and 1.74 ± 0.35 × 10(-3) mm(2)/s were obtained for normal tissue, malignant, and benign lesions, respectively. Mean ADCs of malignancies were significantly lower than those of benign lesions (p < 0.001) and normal tissue (p < 0.0001). The sensitivity and specificity for stratifying lesions, considering an ADC threshold of 1.41 × 10(-3) mm(2)/s, were 94.3% and 87.5%, respectively; accuracy was 91.5%. CONCLUSION: DWI proved useful for the detection and characterization of breast lesions in the present sample. ADC values provide a high diagnostic performance for differentiation between benign and malignant lesions.

Growth promotion in wheat seedlings altered by conditions in the culture medium of Azospirillum brasilense.

Agricultural management using technologies that help farmers increase productivity and reduce production costs must be promoted to ensure agricultural sustainability. The objective of the study was to achieve the pH effect of growth solution, chemical treatment, use of osmoprotector additive and mineral nitrate presence, on the activity of growth promoting bacteria, Azospirillum brasilense, and its effects on the physiological quality of seeds and wheat seedling growth. The first experiment evaluated the physiological quality of seeds and the second experiment was divided into four, evaluating the growth of wheat seedling in a hydroponic system. The experiments were prolonged in a very randomized design, with four replications. The physiological quality of the seeds was evaluated by germination tests, first germination count, length of the shoot and root and dry mass of the shoot and root. Initial growth was evaluated by quantifying the dry mass of the leaf shoot and root and the root system intervals. The pH of the solution and the presence of nitrogen did not influence the effects of inoculation of the A. brasilense bacteria. With the use of chemical treatment and osmoprotective additive, A. brasilense had no effect on the growth of wheat seedlings.

HLA-B*58:01 is a risk factor for allopurinol-induced DRESS and Stevens-Johnson syndrome/toxic epidermal necrolysis in a Portuguese population.

BACKGROUND: HLA-B*58:01 is associated with allopurinol-induced severe cutaneous adverse drug reactions (sCADR) particularly in Han Chinese, but the risk in European populations has seldom been studied. OBJECTIVE: To study the association of HLA-B*58:01 with allopurinol-induced sCADR in a Portuguese population. METHODS: We studied 25 patients (11 male/14 female, mean age 67·4 years) with sCARD from allopurinol: 19 DRESS (drug reaction eosinophilia and systemic symptoms) and six Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). HLA was genotyped by reverse sequence-specific oligonucleotide-polymerase chain reaction and results compared statistically with a control group of 23 allopurinol-tolerant individuals and the control population. RESULTS: HLA-B*58:01 was present in 16 patients with sCADR (64%) [12 DRESS (63%), four SJS/TEN (67%)], one allopurinol-tolerant individual (4%) and 63 normal controls (1·96%), with a statistically significant difference between sCADR and the two control groups. When compared with the normal population, HLA-B*58:01 was associated with a higher risk of sCADR, both DRESS [odds ratio (OR) 85·36, 95% confidence interval (CI) 32·52-224·04] and SJS/TEN (OR 99·59, 95% CI 17·91-553·72). There was no statistically different risk between these two types of CADR. CONCLUSIONS: Portuguese patients with sCADR from allopurinol, both DRESS and SJS/TEN, have a high frequency of HLA-B*58:01, with an OR similar to European patients with SJS/TEN. This study also extends this association to DRESS in Europeans. The recommendation to genotype systematically before therapy is controversial, particularly when HLA-B*58:01 prevalence in the normal population is low, as in Europe. However it could be an option for patients with other risks factors.

Lubrication of Stone-Wales transformations in graphene by hydrogen and hydroxyl functional groups.

First-principles calculations were performed to address the role of functional groups (hydrogen atoms and hydroxyl molecules) in lubricating the fundamental transformation by which a Stone-Wales defect is formed in graphene. Energy barriers in the presence of a single H atom, as well as in the case of two, four, and six H atoms chemisorbed in graphene in several distinct site configurations are found to be smaller than in pristine graphene. Our study examines in detail the electronic mechanism behind the stabilization, by the functional groups, of the transition state of the defect-forming reaction relative to the reactants (functionalized graphene and Stone-Wales defect), due to partial strain relaxation and electronic saturation of the transition-state dangling bonds. We frame these findings in terms of the reactivity, to the functional groups, of the reactants and transition states. Our calculations point to a very favorable kinetic pathway with a strongly reduced activation barrier, in which two H atoms bind to next-nearest-neighbor C atoms, and saturate the two transition-state dangling bonds, resulting in a strong barrier reduction of 5.6 eV (from 9.3 eV without functional groups to 3.7 eV). In the case of two chemisorbed OH molecules, we find a further reduction of the Stone-Wales transformation barrier for one configuration considered, when compared to the similar one with two H atoms, providing additional confirmation of the reactivity-based mechanism.

Non-hexagonal-ring defects and structures induced by healing and strain in graphene and functionalized graphene.

We perform ab initio calculations for the strain-induced formation of non-hexagonal-ring defects in graphene, graphane (hydrogen-functionalized graphene) and graphenol (hydroxyl-functionalized graphene). We find that the simplest of such topological defects, the Stone-Wales defect, acts as a seed for strain-induced dissociation and multiplication of topological defects. Through the application of inhomogeneous deformations to graphene, graphane and graphenol with varying initial concentrations of pentagonal and heptagonal rings and small-sized voids, we obtain several novel stable structures that possess, at the same time, large concentrations of non-hexagonal rings (from fourfold to elevenfold) and small formation energies.

Correlated magnetic states in extended one-dimensional defects in graphene.

Ab initio calculations indicate that while the electronic states introduced by tilt grain boundaries in graphene are only partially confined to the defect core, a translational grain boundary introduces states near the Fermi level that are very strongly confined to the core of the defect, and display a ferromagnetic instability. The translational boundary lies along a graphene zigzag direction and its magnetic state is akin to that which has been theoretically predicted to occur on zigzag edges of graphene ribbons. Unlike ribbon edges, the translational grain boundary is fully immersed within the bulk of graphene, hence its magnetic state is protected from the contamination and reconstruction effects that have hampered experimental detection of the magnetic ribbon states. Moreover, our calculations suggest that charge transfer between grain boundaries and the bulk in graphene is short ranged, with charge redistribution confined to ~5 Å from the geometric center of the 1D defects.