Association Between Hypertensive Disorders of Pregnancy and Neurodevelopmental Outcomes Among Offspring

Importance: Hypertensive disorders of pregnancy (HDP) have been associated with poorer neurodevelopmental outcomes in offspring, but the role of familial confounding in these associations is unclear. Objective: To investigate associations of maternal HDP with risks in offspring of autism spectrum disorders (ASDs), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability (ID), as well as variation in overall cognitive performance in offspring. Design, Setting, and Participants: This Swedish register-based study used data from a birth cohort divided into 1 085 024 individuals born between 1987 and 1996 and followed up until December 31, 2014, and 285 901 men born between 1982 and 1992 who attended assessments for military conscription, including a cognitive function test. Statistical analysis was performed from April 1, 2019, to June 1, 2020. Exposures: Diagnoses of HDP, which were provided by the Medical Birth Register. Main Outcomes and Measures: Diagnoses of ASDs, ADHD, and ID were extracted from the National Patient Register. Cognitive function was assessed using written tests and summarized as a single 9-point score. Whole-cohort and within-sibship analyses were performed; the latter accounted for unmeasured familial confounding factors shared by siblings. Results: The study included 1 085 024 individuals (556 912 male participants [51.3%]) born between 1987 and 1996 and 285 901 men born between 1982 and 1992 who attended assessments for military conscription. The prevalence of maternal HDP was 4.0% in the 1987-1996 birth cohort (n = 42 980) and 5.1% in the military conscription cohort (n = 14 515). A total of 15 858 participants received a diagnosis of ASD, 36 852 received a diagnosis of ADHD, and 8454 received a diagnosis of ID. The mean (SD) cognitive score among the men in the conscription cohort was 5.1 (1.9). In whole-cohort analyses with multivariable adjustment, HDP were associated with offspring ASDs (hazard ratio [HR], 1.22; 95% CI, 1.13-1.31), ADHD (HR, 1.10; 95% CI, 1.05-1.16), and ID (HR, 1.39; 95% CI, 1.27-1.53). Analyses comparing siblings discordant for HDP were less statistically powered but indicated estimates of similar magnitude for ASDs (HR, 1.19; 95% CI, 1.00-1.42) and possibly ADHD (HR, 1.09; 95% CI, 0.95-1.24), but not for ID (HR, 1.04; 95% CI, 0.83-1.29). Hypertensive disorders of pregnancy were associated with somewhat lower cognitive scores in whole-cohort analysis (mean difference comparing offspring exposed with those unexposed, -0.10; 95% CI, -0.13 to -0.07), but in within-sibship analysis, the association was null (mean difference, 0.00; 95% CI, -0.09 to 0.08). Conclusions and Relevance: The study results suggest that HDP are associated with small increased risks of ASDs and possibly ADHD in offspring, whereas associations with ID and cognitive performance are likely confounded by shared familial (environmental or genetic) factors

Variation in the chemical composition, physical characteristics and energy values of cereal grains produced in the Western Cape area of South Africa

Grain samples were produced at 10 different locations in the Western Cape region of South Africa, on 2.1 m x 6 m experimental plots, over a period of three years. Twenty different cereal grain cultivars were used in the study. A randomised square experimental design with four replicates per sample was used. An area of 1.35 m x 5 m from each plot was harvested during 1994, 1995 and 1996 and the yield was determined. Thousand seed mass (TSM) and hectolitre mass (HLM) were also determined. Samples were analysed for dry matter (DM), ash, crude protein (CP), ether extract (EE), neutral detergent fibre (NDF), acid detergent fibre (ADF) and in vitro organic matter digestibility (IVOMD). Digestible energy values (DE) for pigs were determined with a mobile nylon bag technique, while non-structural carbohydrate values (NSC) were calculated. In the first analysis, cultivars were compared by a one-way analysis of variance, followed by pooling of grain type data. Naked oats had the highest DE value, and the respective values (DM basis) for naked oats, wheat, triticale, 2-row brewer's barley, 6-row feed barley and oats were 18.0, 16.0, 15.8, 14.9, 14.4, and 12.6 MJ/kg DM. The high EE value of naked oats (97 g/kg) might be partly responsible for the high DE value. The 6-row and 2-row naked barley cultivars had the highest IVOMD (946 g/kg and 944 g/kg), followed by wheat (910 g/kg), triticale (905 g/kg), naked oats (899 g/kg), 2-row brewer's barley (882 g/kg), 6-row feed barley (844 g/kg) and oats (671 g/kg). Considerable variation was found between samples within a cultivar for DE and IVOMD. Two-row naked barley had the highest mean CP value (159 g/kg) followed by naked oats (159 g/kg), 6-row naked barley (154 g/kg), wheat (148 g/kg), triticale (146 g/kg), oats (143 g/kg), 2-row brewer's barley (136 g/kg) and 6-row feed barley (135 g/kg) on DM basis. Triticale had the highest yield, with naked oats and barley cultivars having the lowest yield. Keywords: Cereal grains, Chemical composition, Energy value South African Journal of Animal Science Vol.33(2) 2003: 117-12

Variação da massa específica básica da madeira de Pinus taeda em função das diferentes idades e posições longitudinais no tronco.

EVINCI. Resumo

Fabry in the older patient: Clinical consequences and possibilities for treatment.

Baseline demographic and phenotypic characteristics of patients aged ≥50years in the Fabry Outcome Survey (Shire; data extracted June 2014) were compared with younger adults to investigate potential factors influencing treatment decisions in later life. Age groups were defined using age at treatment initiation or at FOS entry for untreated patients: 18-49 (n=1344; 49.5% male; 64.6% received agalsidase alfa enzyme replacement therapy [ERT]); 50-64 (n=537; 35.4% male; 74.3% treated); 65-74 (n=137; 32.1% male; 68.6% treated); and ≥75years (n=26; 26.9% male; 50.0% treated). Successive age groups showed higher median age at first symptom and diagnosis. Median alpha-galactosidase A activity, measured as percentage activity of the midpoint of the normal range, was much greater in females than males of all groups except ≥75years (33.4% in females; 27.8% in males). Patients aged ≥75years showed greater values than patients aged 18-49years for median left ventricular mass indexed to height (62.7 vs 42.4g/m(2.7)), mean ventricular wall thickness (15.0 vs 10.0mm) and prevalence of hypertension (57.7% vs 21.8%), and lower median estimated glomerular filtration rate (Modification of Diet in Renal Disease: 65.6 vs 98.5mL/min/1.73m(2)). Larger proportions in the groups aged ≥50 exhibited cardiac and/or cerebrovascular manifestations compared with patients aged 18-49years. The smaller proportion of patients receiving ERT aged ≥75years compared with the younger groups might reflect relatively milder disease burden or physician/patient reluctance to initiate/continue ERT at this age. Further studies are needed to increase knowledge of Fabry disease and ERT in later life

SISTEMAS DE INFORMA??O INTEGRADOS: UMA AN?LISE SOBRE O PROCESSO DE DESENVOLVIMENTO E IMPLANTA??O DE BUSINESS INTELLIGENCE EM UMA DISTRIBUIDORA DE MEDICAMENTOS

Este estudo busca objetivamente a an?lise sobre o processo de desenvolvimento e implanta??o de um sistema de Business Intelligence (BI). Sobre o tema, foi realizado um estudo de caso na empresa Elfa Medicamentos Ltda., levantando informa??es sobre o processo desde a decis?o da empresa em investir na solu??o de BI at? a vis?o do usu?rio sobre todo o processo de implanta??o. No levantamento de dados, realizou-se entrevistas com com o especialista de BI que comandou o projeto, com os analistas de sistema e o analista de neg?cio envolvidos exclusivamente nessa implanta??o e com usu?rios do setor de contas a pagar na ?rea financeira. Desta maneira, foi poss?vel analisar o planejamento do projeto de forma geral e principalmente identificar os impactos da metodologia adotada na empresa para execu??o do desenvolvimento e implanta??o do sistema

In situ neutron diffraction for analysing complex coarse-grained functional materials

Complex functional materials play a crucial role in a broad range of energy-related applications and in general for materials science. Revealing the structural mechanisms is challenging due to highly correlated coexisting phases and microstructures, especially for in situ or operando investigations. Since the grain sizes influence the properties, these microstructural features further complicate investigations at synchrotrons due to the limitations of illuminated sample volumes. In this study, it is demonstrated that such complex functional materials with highly correlated coexisting phases can be investigated under in situ conditions with neutron diffraction. For large grain sizes, these experiments are valuable methods to reveal the structural mechanisms. For an example of in situ experiments on barium titanate with an applied electric field, details of the electric-field-induced phase transformation depending on grain size and frequency are revealed. The results uncover the strain mechanisms in barium titanate and elucidate the complex interplay of stresses in relation to grain sizes as well as domain-wall densities and mobilities

A Educação a Distância como Estratégia de Ensino: o caso do Curso de Administração na modalidade a Distância de uma IFES vinculada ao Projeto da Universidade Aberta do Brasil

A educação a distância vem crescendo impulsionada pela demanda de pessoas com formação superior, bem como pela possibilidade de utilização de tecnologias de informação, que se desenvolveram intensamente nos últimos anos. Nesse sentido, este artigo tem como intuito apresentar um Curso de Graduação em Administração na modalidade a Distância vinculada ao Projeto da Universidade Aberta do Brasil. Quanto à metodologia classifica-se como: qualitativa, descritiva, estudo de caso, documental e bibliográfica. Para a obtenção de bons resultados num projeto como este, o planejamento e a organização da estrutura física são processos essenciais. Foi projetado no curso analisado uma estrutura para o acompanhamento dos estudantes em 15 pólos de ensino nos estados de Roraima, Bahia, Paraná e Rio Grande do Sul. O curso utiliza uma combinação de materiais didáticos: impressos, vídeo-aulas, videoconferências, ambiente virtual de ensino-aprendizagem e, principalmente, um sistema de acompanhamento ao estudante à distância, com apoio de tutores presenciais e a distância

Diagnosing lysosomal storage diseases in a Brazilian non-newborn population by tandem mass spectrometry

OBJECTIVES: High-throughput mass spectrometry methods have been developed to screen newborns for lysosomal storage disorders, allowing the implementation of newborn screening pilot studies in North America and Europe. It is currently feasible to diagnose Pompe, Fabry, Gaucher, Krabbe, and Niemann-Pick A/B diseases, as well as mucopolysaccharidosis I, by tandem mass spectrometry in dried blood spots, which offers considerable technical advantages compared with standard methodologies. We aimed to investigate whether the mass spectrometry methodology for lysosomal storage disease screening, originally developed for newborns, can also discriminate between affected patients and controls of various ages. METHODS: A total of 205 control individuals were grouped according to age and subjected to mass spectrometry quantification of lysosomal α-glucosidase, β-glucocerebrosidase, α-galactosidase, acid sphingomyelinase, galactocerebrosidase, and α−L-iduronidase activities. Additionally, 13 affected patients were analyzed. RESULTS: The median activities for each enzyme and each age group were determined. Enzyme activities were significantly lower in individuals aged older than 18 years compared with those in newborns. Affected patients presented enzymatic activities corresponding to less than 20% of the age-matched controls. CONCLUSIONS: Our data indicate that the mass spectrometry methodology can be used for the screening of lysosomal storage diseases in non-newborn patients. However, for some diseases, such as Fabry and mucopolysaccharidosis I, a combination of biochemical and clinical data may be necessary to achieve accurate diagnoses