Cancer-Associated Thrombosis in Cirrhotic Patients with Hepatocellular Carcinoma.

It is common knowledge that cancer patients are more prone to develop venous thromboembolic complications (VTE). It is therefore not surprising that patients with hepatocellular carcinoma (HCC) present with a significant risk of VTE, with the portal vein being the most frequent site (PVT). However, patients with HCC are peculiar as both cancer and liver cirrhosis are conditions that can perturb the hemostatic balance towards a prothrombotic state. Because HCC-related hypercoagulability is not clarified at all, the aim of the present review is to summarize the currently available knowledge on epidemiology and pathogenesis of non-malignant thrombotic complications in patients with liver cirrhosis and HCC. They are at increased risk to develop both PVT and non-splanchnic VTE, indicating that both local and systemic factors can foster the development of site-specific thrombosis. Recent studies have suggested multiple and often interrelated mechanisms through which HCC can tip the hemostatic balance of liver cirrhosis towards hypercoagulability. Described mechanisms include increased fibrinogen concentration/polymerization, thrombocytosis, and release of tissue factor-expressing extracellular vesicles. Currently, there are no specific guidelines on the use of thromboprophylaxis in this unique population. There is the urgent need of prospective studies assessing which patients have the highest prothrombotic profile and would therefore benefit from early thromboprophylaxis

A Flexible Implementation of a Matrix Laurent Series-Based 16-Point Fast Fourier and Hartley Transforms

This paper describes a flexible architecture for implementing a new fast computation of the discrete Fourier and Hartley transforms, which is based on a matrix Laurent series. The device calculates the transforms based on a single bit selection operator. The hardware structure and synthesis are presented, which handled a 16-point fast transform in 65 nsec, with a Xilinx SPARTAN 3E device.Comment: 4 pages, 4 figures. IEEE VI Southern Programmable Logic Conference 201

A bit deeper on hypercoagulability and cancer: focus on longitudinal trend of procoagulant microvesicles in gastro-intestinal malignancy

Introduction. It is fully recognized that cancer patients are at significant risk of developing thrombotic events (VTE). The prevention of such complications is of the utmost importance from a clinical point of view, seeing as they play a considerable part in the morbidity and mortality of these patients. The main issue is that the pathogenesis of the cancer-associated coagulopathy is complex and multifactorial. To assess the level of risk and identification of patients at high risk for thrombosis, the guidelines recommend including the detection of plasma thrombotic markers in “score systems” combining clinical and biological markers. However, current scores have been shown to perform poorly in predicting VTE in cancer patients. Thus, the identification of novel biomarkers associated with the grade of hypercoagulability in individual malignancies is required to drive the development of cancer type–specific scoring systems with improved predictive value. Aim of the study. We conducted a longitudinal cohort study to evaluate the trend of several coagulation parameters in patients with gastro-intestinal cancer with particular focus on circulating microvesicles (MVs) and MV-tissue factor (TF) activity. Our primary outcome was the description of coagulation fluctuations over a 6-month period following cancer diagnosis and the secondary outcome was the association between coagulation parameters and the occurrence of VTE complications. Material and Methods. Patients with a new diagnosis of gastro-intestinal cancer who underwent surgery were consecutively enrolled at the Padua University Hospital. Exclusion criteria were: cancer recurrence, severe liver or renal failure, Karnofsky Performance Status <60%, recent venous/arterial thromboembolism, pregnancy/puerperium, overt/recent sepsis. Longitudinal blood samples were collected at baseline, 7 days after surgery, 1 and 6 months after surgery. Each patient was followed for at least 6 months and for a maximum of 12 months. The primary outcome was the evaluation of coagulative parameters trend over a 6-month period following the diagnosis. Coagulation test performed included: factor (F)VIII and fibrinogen levels; D-Dimer and plasminogen activator inhibitor (PAI-1) antigen; hereditary thrombophilia; thromboelastometry; contact activation system (FXIIa-C1-inhibitor (C1INH), FXIa-C1INH and KAL-C1INH complexes); MV-TF activity; circulating MVs. Clinical outcomes recorded during the follow-up were: i) surgical radicality (i.e. complete or incomplete); ii) cancer severity (i.e. localized or advanced cancer); iii) any thrombotic event including superficial vein thrombosis, symptomatic or asymptomatic VTE or thrombosis in unusual sites. The secondary outcome was the association between the coagulative profile at the different time-points and the clinical outcomes. Results. Ninety-three patients (25 with pancreatic, 33 with colon and 35 with gastroesophageal cancer) were enrolled. The median clinical follow-up was 6 months [6-8.5] for pancreatic, 8 months [7-11] for colon, and 6.5 months for gastric cancer [6-9.25]. VTE incidence rate was 9.21 [95%CI 3.37-20.4] per 100 person-years for pancreatic cancer, 6.69 [95%CI 2.13-16.2] per 100 person-years for colon and 10.4 [95%CI 4.24-21.7] per 100 person-years for gastric cancer. The subgroup of pancreatic cancer at baseline showed increased levels of FVIII, D-Dimer, PAI-1 antigen, MV-TF activity and circulating MVs compared with the other cancer subtypes. In the overall cancer population, baseline contact system complexes were increased compared to levels measured in a reference healthy population, and pancreatic and gastric cancers showed the highest activation. Patients receiving chemotherapy at the 6-month time point showed significantly higher levels of FXIIa-C1INH and kallikrein-C1INH complexes compared to patients without chemotherapy. In a multivariate model, levels of MV-TF activity were independent predictors of incomplete surgical resection (OR 2.25 [1.25-7.0]) and cancer severity (OR 1.87 [1.20-3.8]). We observed that the majority of MVs detected were small (diameter 0.2-0.4 µm). Moreover, we confirmed that PS-negative MVs are the majority and thus PS is not the most suitable marker to detect the total number of MVs. MV-TF activity correlated with PS+MVs big and small, with endothelial MVs and big tumour MVs. Endothelial MVs, as well as MV-TF activity, showed a positive association with surgical radicality and cancer severity (OR 1.19 [1.04-1.36] and 1.30 [1.05-1.6], respectively). Levels of MV-TF activity ≥0.19 pg/mL conveyed a 2.38 [1.81-4.11] HR for VTE occurrence. Furthermore, baseline levels of FXIa >0.61 nM conveyed a 1.66 [1.02-2.9] HR to develop VTE over a median follow-up period of 6 months after diagnosis. This prediction model was adjusted for age, sex, BMI, cancer type, severity, and surgical radicality. Conclusions. Hypercoagulability in gastro-intestinal cancer is mainly mediated by high levels of FVIII, increased levels of complexes derived from the activation of the contact system, high MV-TF activity and increased levels of PS+MVs, endothelial and tumour MVs. Pancreatic cancer showed the most hypercoagulable profile. The prothrombotic factors remained altered up to 6 months after surgical resection of the neoplasm even in patients with surgical radicality, indicating that cancer-associated hypercoagulability persists months after tumour removal. Increased MV-TF activity and endothelial MVs are independent predictors of advanced disease and incomplete surgical resection. Finally, baseline increased levels of MV-TF activity and FXIa were independent predictors of VTE occurrence over the 6 months following cancer diagnosis. As TF is upregulated in cancer, it seems reasonable to hypothesize that concomitant activation of both the intrinsic and extrinsic pathways may act synergistically to produce a highly prothrombotic state in cancer

Access to liquidity and corporate investment in Europe during the financial crisis

We use a unique data set to show how firms in Europe used credit lines during the financial crisis. We find that firms with restricted access to credit (small, private, non-investment-grade, and unprofitable) draw more funds from their credit lines during the crisis than their large, public, investment-grade, profitable counterparts. Interest spreads increased (especially in "market-based economies"), but commitment fees remained unchanged. Our findings suggest that credit lines did not dry up during the crisis and provided the liquidity that firms used to cope with this exceptional contraction. In particular, credit lines provided the liquidity companies needed to invest during the crisis

Plantio de leguminosas arbóreas para produção de moirões vivos e construção de cercas ecológicas.

Os diferentes modelos de cercas utilizados nas propriedades rurais do Brasil. Justificativas para o uso de cercas de moirões vivos. Benefícios e vantagens do uso de leguminosas arbóreas na construção de cercas ecológicas. Custos de implantação mais baixos. Geração de produtos econômicos. Efeito estético, paisagístico e abrigo para os animais. Benefícios ecológicos. Fixação biológica de nitrogênio (FBN) associada às plantas. Aporte de biomassa e efeito sobre as forrageiras herbáceas. Uso como forragem. Durabilidade. Outros usos. Limitações para a adoção de leguminosas na construção de cercas ecológicas. Conhecendo a leguminosa arbórea Gliricidia sepium (Jacq.). Steud. Descrição botânica e características da espécie. Hsitórico e distribuição geográfica. Adaptação ambiental. Possibilidades para o Brasil. O uso da Gliricidia sepium como moirão vivo. Banco da multiplicação e produção de estacas de gliricidia. Construção das cercas ecológicas. Implantação da cerca. Fixação do arame. Manejo e tratos culturais. Composição química e descrição mineralógica da Gliricidia sepium. Produção de biomassa. Constituição química e influência na fertilidade do solo. Proteína bruta e digestibilidade in vitro. Outras espécies vegetais utilizadas na construção de cercas ecológicas. Leguminosas do gênero Erythrina. Utilização de outras espécies de leguminosas na cosntrução de cercas ecológicas. Espécies de outras famílias recomendadas para a implantação de cercas ecológicas. Análise sócio-econômica do uso de moirões vivos na construção de cercas ecológicas. Análise econômica da implantação e utilização dos diferentes modelos de cercas. Comercialização de estacas e moirões vivos. O ambiente de marketing do moirão vivo em relação à outros produtos utilizados na construção de cercas.bitstream/item/111693/1/CNPAB-SIST.-DE-PROD.-3-05.pd

Recuperação de voçorocas em áreas rurais.

Como recuperar uma voçoroca a baixo custo? Atividades necessárias antes da implantação das estratégias de controle de erosão. Implantação de estratégias físicas de controle da erosão. Determinação da declividade da área; Com nível retangular; Cálculo da distância entre os terraços; Demarcação e locação dos terraços; Com instrumentos alternativos; Com nível óptico; Determinação do escoamento superficial (Q); Dimensionamento das estruturas físicas; Terraços; Bacias de retenção; Paliçadas; Considerações sobre a forma da encosta ou morro; Revegetação de voçorocas com leguminosas arbóreas inoculadas com microrganismos; Por que utilizar espécies leguminosas? Quais espécies plantar? Preparo e plantio das mudas no campo; Custos de recuperação de uma voçoroca; Eficiência da metodologia de recuperação de voçorocas.bitstream/item/111696/1/CNPAB-Recuperacao-de-vocorocas-em-areas-rurais-SP.-06.pdfAutores: Roriz Luciano Machado, Alexander Silva de Resende, Eduardo Francia Carneiro Campello, Carlos Eduardo Gabriel Menezes, Caetano Marciano de Souza, Avílio Antônio Franco

Association between non-O blood group and spontaneous abortion in women with inherited thrombophilia

Abstract Background Spontaneous abortion is reported to be one of the most frequent pregnancy complications reaching a prevalence up to 15%. The association between congenital thrombophilia and pregnancy loss has been debated in several studies with conflicting results. We aimed to retrospectively evaluate the prevalence of inherited thrombophilia (i.e antithrombin, protein S and C deficiencies, factor V Leiden and prothrombin variant) in a group of women with a personal history of miscarriage. The prevalence non-O blood group, considered the most common thrombophilic condition, was concomitantly considered. Materials and methods A group of n. 566 women with a personal history of spontaneous abortion recruited among caregivers of patients admitted to the Medical Department of our University Hospital between December 2011 and December 2019 were enrolled. Women under 18 yrs, those with a personal history of venous and/or arterial thrombosis and with an acquired thrombophilic condition were excluded. An equally number of healthy women without a personal history of pregnancy loss acted as controls. The Odds Ratios (ORs) and 95% confidence intervals (CIs) were calculated as an estimate of pregnancy loss developing. Results Out of n. 566 enrolled women, n. 127 (22.4%) had an inherited thrombophilic condition. The prevalence of congenital thrombophilia was significantly higher in women with miscarriage than controls (OR 2.12; CI 95% 1.51–2.92). Non-O blood type was observed in n. 325 (57.4%) women. The prevalence of non-O blood group was significantly higher in women with pregnancy loss (p 0.01) and the association of thrombophilia and non-O blood type further increased the risk of pregnancy loss (OR 3.28; CI 95% 2.01–5.36). Conclusions Both inherited thrombophilia and non-O blood type should be considered risk factors for pregnancy loss. The knowledge of this information may help the clinician to better manage women with pregnancy loss. Further studies are required to confirm our findings. Funding Acknowledgement Type of funding sources: None

Revegetação de solos degradados.

Quebra de dormência das sementes; Inoculação das sementes; Obtenção do inoculante; Inoculação com fungos micorrízicos; Produção de mudas; Plantio no campo; Experiências de campo.bitstream/CNPAB-2010/27134/1/cot009.pd

Effect of size and location of simulated lytic lesions on the structural properties of human vertebral bodies, a micro-finite element study

Currently, the Spinal Instability Neoplastic Score system is used in clinics to evaluate the risk of fracture in patients with spinal metastases. This method, however, does not always provide a clear guideline due to the complexity in accounting for the effect of metastatic lesions on vertebral stability. The aim of this study was to use a validated micro Finite Element (microFE) modelling approach to analyse the effect of the size and location of lytic metastases on the mechanical properties of human vertebral bodies. Micro Computed Tomography based microFE models were generated with and without lytic lesions simulated as holes within a human vertebral body. Single and multiple lytic lesions were simulated with four different sizes and in five different locations. Bone was assumed homogenous, isotropic and linear elastic, and each vertebra was loaded in axial compression. It was observed that the size of lytic lesions was linearly related with the reduction in structural properties of the vertebral body (reduction of stiffness between 3% and 30% for lesion volume between 4% and 35%). The location of lytic lesions did not show a clear effect on predicted structural properties. Single or multiple lesions with the same volume provided similar results. Locally, there was a homogeneous distribution of axial principal strains among the models with and without lytic lesions. This study highlights the potential of microFE models to study the effect of lesions on the mechanical properties of the human vertebral body