669 research outputs found

    Cardiac surgery and percutaneous intervention in pregnant women with heart disease

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    In pregnant women with heart disease, complications can arise due to the haemodynamic burden of pregnancy and to hypercoagulation. Most problems can be managed medically, but sometimes cardiac surgery or percutaneous intervention is unavoidable. Cardiac surgery has similar maternal mortality to that outside pregnancy, but foetal mortality and morbidity are considerable. Measures to reduce the risk by adaptation of the management of cardiopulmonary bypass are described. When gestational age is > 28 weeks, pre-surgery delivery of the foetus should be considered. Percutaneous intervention exposes the foetus to radiation. The radiation dose for common cardiac procedures, however, does not result in detectable harmful foetal effects

    Mechanistic interplay between ceramide and insulin resistance

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    Recent research adds to a growing body of literature on the essential role of ceramides in glucose homeostasis and insulin signaling, while the mechanistic interplay between various components of ceramide metabolism remains to be quantified. We present an extended model of C16:0 ceramide production through both the de novo synthesis and the salvage pathways. We verify our model with a combination of published models and independent experimental data. In silico experiments of the behavior of ceramide and related bioactive lipids in accordance with the observed transcriptomic changes in obese/diabetic murine macrophages at 5 and 16 weeks support the observation of insulin resistance only at the later phase. Our analysis suggests the pivotal role of ceramide synthase, serine palmitoyltransferase and dihydroceramide desaturase involved in the de novo synthesis and the salvage pathways in influencing insulin resistance versus its regulation

    Steps toward Determination of the Size and Structure of the Broad-Line Region in Active Galactic Nuclei. XII. Ground-Based Monitoring of 3C 390.3

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    Results of a ground-based optical monitoring campaign on 3C 390.3 in 1994-95 are presented. The broad-band fluxes (B, V, R, and I), the spectrophotometric optical continuum flux F(5177) and the integrated emission-line fluxes of Ha, Hb, Hg, HeI, and HeII all show a nearly monotonic increase with episodes of milder short-term variations superposed. The amplitude of the continuum variations increases with decreasing wavelength (4400-9000 A). The optical continuum variations follow the variations in the ultraviolet and X-ray with time delays, measured from the centroids of the cross- correlation functions, typically around 5 days, but with uncertainties also typically around 5 days; zero time delay between the high-energy and low-energy continuum variations cannot be ruled out. The strong optical emission lines Ha, Hb, Hg, and HeI respond to the high-energy continuum variations with time delays typically about 20 days, with uncertainties of about 8 days. There is some evidence that HeII responds somewhat more rapidly, with a time delay of around 10 days, but again, the uncertainties are quite large (~8 days). The mean and rms spectra of the Ha and Hb line profiles provide indications for the existence of at least three distinct components located at +-4000 and 0 km/s relative to the line peak. The emission-line profile variations are largest near line center.Comment: 42 pages (Latex), 13 figures, 14 table

    Supermassive black holes do not correlate with galaxy disks or pseudobulges

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    The masses of supermassive black holes are known to correlate with the properties of the bulge components of their host galaxies. In contrast, they appear not to correlate with galaxy disks. Disk-grown pseudobulges are intermediate in properties between bulges and disks. It has been unclear whether they do or do not correlate with black holes in the same way that bulges do, because too few pseudobulges were classified to provide a clear result. At stake are conclusions about which parts of galaxies coevolve with black holes, possibly by being regulated by energy feedback from black holes. Here we report pseudobulge classifications for galaxies with dynamically detected black holes and combine them with recent measurements of velocity dispersions in the biggest bulgeless galaxies. These data confirm that black holes do not correlate with disks and show that they correlate little or not at all with pseudobulges. We suggest that there are two different modes of black hole feeding. Black holes in bulges grow rapidly to high masses when mergers drive gas infall that feeds quasar-like events. In contrast, small black holes in bulgeless galaxies and galaxies with pseudobulges grow as low-level Seyferts. Growth of the former is driven by global processes, so the biggest black holes coevolve with bulges, but growth of the latter is driven locally and stochastically, and they do not coevolve with disks and pseudobulges.Comment: 6 pages, 3 Postscript figures, 1 table; to appear in Nature (20 January 2011

    HIV Drug Resistance (HIVDR) in Antiretroviral Therapy-NaĂŻve Patients in Tanzania Not Eligible for WHO Threshold HIVDR Survey Is Dramatically High

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    The World Health Organization (WHO) has recommended guidelines for a HIV drug resistance (HIVDR) survey for resource-limited countries. Eligibility criteria for patients include age below 25 years in order to focus on the prevalence of transmitted HIVDR (tHIVDR) in newly-infected individuals. Most of the participating sites across Africa have so far reported tHIVDR prevalences of below 5%. In this study we investigated whether the rate of HIVDR in patients <25 years is representative for HIVDR in the rest of the therapy-naïve population. HIVDR was determined in 88 sequentially enrolled ART-naïve patients from Mwanza, Tanzania (mean age 35.4 years). Twenty patients were aged <25 years and 68 patients were aged 25-63 years. The frequency of HIVDR in the study population was 14.8% (95%; CI 0.072-0.223) and independent of NVP-resistance induced by prevention of mother-to-child transmission programs. Patients >25 years had a significantly higher HIVDR frequency than younger patients (19.1%; 95% CI 0.095-0.28) versus 0%, P = 0.0344). In 2 out of the 16 patients with HIVDR we found traces of antiretrovirals (ARVs) in plasma. ART-naïve patients aged over 25 years exhibited significantly higher HIVDR than younger patients. Detection of traces of ARVs in individuals with HIVDR suggests that besides transmission, undisclosed misuse of ARVs may constitute a significant factor in the generation of the observed high HIVDR rate. The current WHO tHIVDR survey that is solely focused on the transmission of HIVDR and that excludes patients over 25 years of age may therefore result in substantial underestimation of the prevalence of HIVDR in the therapy-naïve population. Similar studies should be performed also in other areas to test whether the so far reported optimistic picture of low HIVDR prevalence in young individuals is really representative for the rest of the ART-naïve HIV-infected population

    Business model innovation and transition to a sustainable food system: A case study in the Lisbon metropolitan area

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    The food systems’ transition towards a sustainable involves structural changes, namely the emphasis on local production, short supply chains, and the preference for organic products. The shift in the agri-food system is taking place through the creation of entirely new businesses and individual farms moving towards organic production. In both cases, the enterprises use a combination of well-established agricultural knowledge and techniques, new scientific knowledge on productive methods and new technological platforms for commercialization. These mixed sources permit the creation of innovative business models (BMs). They exemplify how traditional industries can absorb/generate innovation at technological and organizational levels, and become part of the new knowledge-based era. The study has three objectives: to analyse the emerging agri-food businesses in the Lisbon Metropolitan Area (LMA); to characterize innovative sustainable BMs within the transition dynamics; to reflect on the challenges that the characteristics of the food system pose for the emergence of these BMs. The study is part of an interdisciplinary project on Spatial Planning for Change (SPLACH). The analysis addresses the food system transition in a specific territory, namely the LMA. The paper presents results of the research conducted, focusing on the case of an organic food initiative, Quinta do Oeste.info:eu-repo/semantics/acceptedVersio

    Intensive disc-reverberation mapping of Fairall 9: 1st year of Swift & LCO monitoring

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    We present results of time-series analysis of the first year of the Fairall 9 intensive disc-reverberation campaign. We used Swift and the Las Cumbres Observatory global telescope network to continuously monitor Fairall 9 from X-rays to near-infrared at a daily to sub-daily cadence. The cross-correlation function between bands provides evidence for a lag spectrum consistent with the τ∝λ4/3\tau\propto\lambda^{4/3} scaling expected for an optically thick, geometrically thin blackbody accretion disc. Decomposing the flux into constant and variable components, the variable component's spectral energy distribution is slightly steeper than the standard accretion disc prediction. We find evidence at the Balmer edge in both the lag and flux spectra for an additional bound-free continuum contribution that may arise from reprocessing in the broad-line region. The inferred driving light curve suggests two distinct components, a rapidly variable (100100 days) component with an opposite lag to the reverberation signal

    f(R) theories

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    Over the past decade, f(R) theories have been extensively studied as one of the simplest modifications to General Relativity. In this article we review various applications of f(R) theories to cosmology and gravity - such as inflation, dark energy, local gravity constraints, cosmological perturbations, and spherically symmetric solutions in weak and strong gravitational backgrounds. We present a number of ways to distinguish those theories from General Relativity observationally and experimentally. We also discuss the extension to other modified gravity theories such as Brans-Dicke theory and Gauss-Bonnet gravity, and address models that can satisfy both cosmological and local gravity constraints.Comment: 156 pages, 14 figures, Invited review article in Living Reviews in Relativity, Published version, Comments are welcom
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