Atmospheric CO2 and d13C-CO2 reconstruction of the little ice age from antarctic ice cores

The decrease of atmospheric CO2 concentration recorded in Antarctic ice around 1600 AD is one of the most significant atmospheric changes to have occurred during the last millennia, before the onset of the industrial period.Together with the temperature decrease, the CO2 drop has been used to derive the sensitivity of carbon stores to climate. However, the cause of it is still under debate because models are not yet able to reproduce either its magnitude, or its timing. Here we present new measurements of the CO2 concentration decrease recorded in an ice core from a medium accumulation rate site in Antarctica (DML). We show that the new record is compatible(differences <2 ppm) with the CO2 record from the high accumulation rate DSS site on Law Dome (East Antarctica), when the different age distributions are taken into account. We have also measured the d13C-CO2 change in DML ice, filling a gap around 1600 AD in the DSS d13C record. We use a double deconvolution of the CO2 and d13C records together to provide quantitative evidence that the CO2 decrease was caused by a change in the net flux to the terrestrial biosphere. Finally, we provide a new interpretation of a published record showing increasing atmospheric carbonyl sulphide during the CO2 decrease, suggesting that cooler LIA climate affected terrestrial biospheric fluxes. Altogether our findings support the hypothesis that reduced soil heterotrophic respiration is likely to have given the most significant contribution to the LIA CO2 decrease implying a positive CO2-climate feedback. © 2015, Authors

Acolhimento na Atenção Básica: Navegações e Mergulhos nos Discursos e Práticas Produzidos no Cotidiano de uma Unidade de Saúde da Família.

RESUMO HOFFMANN, Catharina. Acolhimento na Atenção Básica: navegações e mergulhos nos discursos e práticas produzidos no cotidiano de uma Unidade de Saúde da Família. Orientadora: Profa. Dra. Maristela Dalbello Araújo. Vitória/ES: PPGPSI/UFES, 2009. 167f. Dissertação de Mestrado. Esta pesquisa abrange os processos de produção de saúde, tendo como objeto de estudo os discursos e práticas de saúde relacionados ao acolhimento. O contexto de análise é a Atenção Básica do município de Vitória/ES e o campo de pesquisa, o cotidiano da Unidade de Saúde da Família da Ilha do Príncipe. O estudo utilizou como referência os aportes teóricos da Análise Institucional e da Saúde Coletiva. Buscou-se analisar o modo como os trabalhadores fazem acolhimento no cotidiano do serviço, além de escutar as concepções e os discursos produzidos a respeito, na relação com suas práticas cotidianas, o que inclui os processos de trabalho e as interações com os usuários. Para isso, utilizou-se a Cartografia como estratégia metodológica. Os dados foram produzidos no período de fevereiro a setembro de 2008, por meio de observação, diário de campo e entrevistas realizadas com usuários e trabalhadores da USF. Os resultados produzidos expressam que o processo de trabalho e sua gestão são fragmentados e burocratizantes. Há intenção dos trabalhadores de rever os processos de trabalho, entretanto, isto encontra obstáculos na prática. No tocante ao acolhimento, a exigência que os trabalhadores sofrem para que atendam a uma certa produtividade é um aspecto que compromete a qualidade da relação entre as equipes e destas com o usuário, afetando o atendimento às necessidades destes e a própria oferta de ações de saúde. As necessidades que os trabalhadores esperam acolher estão circunscritas à doença ou sintoma manifesto fisicamente. Demonstrou-se que ir ao serviço para conversar constitui-se em uma demanda valorizada pelos usuários, sendo acolhida por alguns trabalhadores. Evidenciou-se que a comunicação nas equipes é restrita às discussões de questões administrativas e procedimentos. A hierarquização entre os níveis de formação contribui para entender o acolhimento como uma atividade ou procedimento que é atribuição de uma categoria específica (auxiliares de enfermagem), a qual supõe-se, tem capacidade técnica para fazê-lo no ato de recepção do usuário. Constatou-se que as ações de saúde não são pactuadas com os usuários, de modo que o PSF não garante o acolhimento. Porém, os tensionamentos nas relações cotidianas entre trabalhador e usuário favorecem a problematização do acolhimento como ação que pode ultrapassar a recepção. Fica evidente a necessidade de reorganização dos processos de trabalho e de se engendrar subjetividades por uma humanização que valorize os processos de singularização, de modo a se promover uma real democracia no acesso à saúde, na qualidade da assistência e na garantia dos princípios do SUS. Palavras-chave: acolhimento; processos de trabalho em saúde; produção de subjetividade; relação trabalhador-usuário

Multiple uncontrolled conditions and blood pressure medication intensification: an observational study

Abstract Background Multiple uncontrolled medical conditions may act as competing demands for clinical decision making. We hypothesized that multiple uncontrolled cardiovascular risk factors would decrease blood pressure (BP) medication intensification among uncontrolled hypertensive patients. Methods We observed 946 encounters at two VA primary care clinics from May through August 2006. After each encounter, clinicians recorded BP medication intensification (BP medication was added or titrated). Demographic, clinical, and laboratory information were collected from the medical record. We examined BP medication intensification by presence and control of diabetes and/or hyperlipidemia. 'Uncontrolled' was defined as hemoglobin A1c &#8805; for diabetes, BP &#8805; 140/90 mmHg (&#8805; 130/80 mmHg if diabetes present) for hypertension, and low density lipoprotein cholesterol (LDL-c) &#8805; 130 mg/dl (&#8805; 100 mg/dl if diabetes present) for hyperlipidemia. Hierarchical regression models accounted for patient clustering and adjusted medication intensification for age, systolic BP, and number of medications. Results Among 387 patients with uncontrolled hypertension, 51.4% had diabetes (25.3% were uncontrolled) and 73.4% had hyperlipidemia (22.7% were uncontrolled). The BP medication intensification rate was 34.9% overall, but higher in individuals with uncontrolled diabetes and uncontrolled hyperlipidemia: 52.8% overall and 70.6% if systolic BP &#8805; 10 mmHg above goal. Intensification rates were lowest if diabetes or hyperlipidemia were controlled, lower than if diabetes or hyperlipidemia were not present. Multivariable adjustment yielded similar results. Conclusions The presence of uncontrolled diabetes and hyperlipidemia was associated with more guideline-concordant hypertension care, particularly if BP was far from goal. Efforts to understand and improve BP medication intensification in patients with controlled diabetes and/or hyperlipidemia are warranted.http://deepblue.lib.umich.edu/bitstream/2027.42/78266/1/1748-5908-5-55.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78266/2/1748-5908-5-55.pdfPeer Reviewe

Age-related delay in information accrual for faces: Evidence from a parametric, single-trial EEG approach

Background: In this study, we quantified age-related changes in the time-course of face processing by means of an innovative single-trial ERP approach. Unlike analyses used in previous studies, our approach does not rely on peak measurements and can provide a more sensitive measure of processing delays. Young and old adults (mean ages 22 and 70 years) performed a non-speeded discrimination task between two faces. The phase spectrum of these faces was manipulated parametrically to create pictures that ranged between pure noise (0% phase information) and the undistorted signal (100% phase information), with five intermediate steps. Results: Behavioural 75% correct thresholds were on average lower, and maximum accuracy was higher, in younger than older observers. ERPs from each subject were entered into a single-trial general linear regression model to identify variations in neural activity statistically associated with changes in image structure. The earliest age-related ERP differences occurred in the time window of the N170. Older observers had a significantly stronger N170 in response to noise, but this age difference decreased with increasing phase information. Overall, manipulating image phase information had a greater effect on ERPs from younger observers, which was quantified using a hierarchical modelling approach. Importantly, visual activity was modulated by the same stimulus parameters in younger and older subjects. The fit of the model, indexed by R2, was computed at multiple post-stimulus time points. The time-course of the R2 function showed a significantly slower processing in older observers starting around 120 ms after stimulus onset. This age-related delay increased over time to reach a maximum around 190 ms, at which latency younger observers had around 50 ms time lead over older observers. Conclusion: Using a component-free ERP analysis that provides a precise timing of the visual system sensitivity to image structure, the current study demonstrates that older observers accumulate face information more slowly than younger subjects. Additionally, the N170 appears to be less face-sensitive in older observers

Statistical analysis plan for the Dex-CSDH trial: a randomised, double-blind, placebo-controlled trial of a 2-week course of dexamethasone for adult patients with a symptomatic chronic subdural haematoma

Abstract Background The incidence of chronic subdural haematoma (CSDH) is increasing. Although surgery remains the mainstay of management for symptomatic patients, uncertainty remains regarding the role of steroids. Hence, the Dex-CSDH trial was launched in the UK in 2015 aiming to determine whether, compared to placebo, dexamethasone can improve the 6-month functional outcome of patients with symptomatic CSDH by reducing the rate of surgical intervention and recurrence rate. Methods and design Dex-CSDH is a multi-centre, pragmatic, parallel group, double-blind, randomised trial assessing the clinical utility of a 2-week course of dexamethasone following a CSDH. Seven hundred fifty patients were randomised to either dexamethasone or placebo. The primary outcome is the modified Rankin Scale at 6 months which is dichotomised to favourable (a score of 0–3) versus unfavourable (a score of 4–6). Conclusions This paper and the accompanying additional material describe the statistical analysis plan for the trial. Trial registration ISRCTN, ISRCTN80782810. Registered on 7 November 2014. http://www.isrctn.com/ISRCTN80782810. EudraCT, 2014-004948-35. Registered on 20 March 2015. </jats:sec

Solution structure of a repeated unit of the ABA-1 nematode polyprotein allergen of ascaris reveals a novel fold and two discrete lipid-binding sites

Parasitic nematode worms cause serious health problems in humans and other animals. They can induce allergic-type immune responses, which can be harmful but may at the same time protect against the infections. Allergens are proteins that trigger allergic reactions and these parasites produce a type that is confined to nematodes, the nematode polyprotein allergens (NPAs). These are synthesized as large precursor proteins comprising repeating units of similar amino acid sequence that are subsequently cleaved into multiple copies of the allergen protein. NPAs bind small lipids such as fatty acids and retinol (Vitamin A) and probably transport these sensitive and insoluble compounds between the tissues of the worms. Nematodes cannot synthesize these lipids, so NPAs may also be crucial for extracting nutrients from their hosts. They may also be involved in altering immune responses by controlling the lipids by which the immune and inflammatory cells communicate. We describe the molecular structure of one unit of an NPA, the well-known ABA-1 allergen of Ascaris and find its structure to be of a type not previously found for lipid-binding proteins, and we describe the unusual sites where lipids bind within this structur

Measurement of the hadronic photon structure function F_{2}^{γ} at LEP2

The hadronic structure function of the photon F_{2}^{γ} (x, Q²) is measured as a function of Bjorken x and of the photon virtuality Q² using deep-inelastic scattering data taken by the OPAL detector at LEP at e⁺e⁻ centre-of-mass energies from 183 to 209 GeV. Previous OPAL measurements of the x dependence of F_{2}^{γ} are extended to an average Q² of 〈Q²〉=780 GeV² using data in the kinematic range 0.15<x<0.98. The Q² evolution of F_{2}^{γ} is studied for 12.1<〈Q²〉<780 GeV² using three ranges of x. As predicted by QCD, the data show positive scaling violations in F_{2}^{γ} with F_{2}^{γ} (Q²)/α = (0.08±0.02⁺⁰·⁰⁵_₀.₀₃) + (0.13±0.01⁺⁰·⁰¹_₀.₀₁) lnQ², where Q² is in GeV², for the central x region 0.10–0.60. Several parameterisations of F_{2}^{γ} are in qualitative agreement with the measurements whereas the quark-parton model prediction fails to describe the data

Liver injury and fibrosis induced by dietary challenge in the ossabaw miniature Swine

BACKGROUND: Ossabaw miniature swine when fed a diet high in fructose, saturated fat and cholesterol (NASH diet) develop metabolic syndrome and nonalcoholic steatohepatitis (NASH) characterized by liver injury and fibrosis. This study was conducted to further characterize the development of NASH in this large animal model. METHODS: Ossabaw swine were fed standard chow (control group; n = 6) or NASH diet (n = 6) for 24 weeks. Blood and liver tissue were collected and liver histology were characterized at 0, 8, 16 and 24 weeks of dietary intervention. Hepatic apoptosis and lipid levels were assessed at week 24. RESULTS: The NASH diet group developed metabolic syndrome and progressive histologic features of NASH including: (a) hepatocyte ballooning at 8 weeks which progressed to extensive ballooning (>90% hepatocytes), (b) hepatic fibrosis at week 16, which progressed to moderate fibrosis, and (c) Kupffer cell accumulation with vacuolization at 8 weeks which progressed through week 24. The NASH diet group showed increased hepatocyte apoptosis that correlated with hepatic total and free cholesterol and free fatty acids, but not esterified cholesterol or triglycerides. CONCLUSIONS: This report further characterizes the progression of diet-induced NASH in the Ossabaw swine model. In Ossabaw swine fed the NASH diet: (a) hepatocyte injury and fibrosis can occur without macrovesicular steatosis or excess triglyceride accumulation; (b) hepatocyte ballooning generally precedes the development of fibrosis; (c) there is increased hepatocyte apoptosis, and it is correlated more significantly with hepatic free cholesterol than hepatic free fatty acids and had no correlation with hepatic triglycerides