538 research outputs found
Effects of terlipressin as early treatment for protection of brain in a model of haemorrhagic shock
Introduction:
We investigated whether treatment with terlipressin during recovery from hypotension due to haemorrhagic shock (HS) is effective in restoring cerebral perfusion pressure (CPP) and brain tissue markers of water balance, oxidative stress and apoptosis.
Methods:
In this randomised controlled study, animals undergoing HS (target mean arterial pressure (MAP) 40 mmHg for 30 minutes) were randomised to receive lactated Ringer’s solution (LR group; n =14; volume equal to three times the volume bled), terlipressin (TERLI group; n =14; 2-mg bolus), no treatment (HAEMO group; n =12) or sham (n =6). CPP, systemic haemodynamics (thermodilution technique) and blood gas analyses were registered at baseline, shock and 5, 30, 60 (T60), 90 and 120 minutes after treatment (T120). After the animals were killed, brain tissue samples were obtained to measure markers of water balance (aquaporin-4 (AQP4)), Na+-K+-2Cl− co-transporter (NKCC1)), oxidative stress (thiobarbituric acid reactive substances (TBARS) and manganese superoxide dismutase (MnSOD)) and apoptotic damage (Bcl-x and Bax).
Results:
Despite the HS-induced decrease in cardiac output (CO) and hyperlactataemia, resuscitation with terlipressin recovered MAP and resulted in restoration of CPP and in cerebral protection expressed by normalisation of AQP4, NKCC1, TBARS and MnSOD expression and Bcl-x/Bax ratio at T60 and T120 compared with sham animals. In the LR group, CO and blood lactate levels were recovered, but the CPP and MAP were significantly decreased and TBARS levels and AQP4, NKCC1 and MnSOD expression and Bcl-x/Bax ratio were significantly increased at T60 and T120 compared with the sham group.
Conclusions:
During recovery from HS-induced hypotension, terlipressin was effective in normalising CPP and cerebral markers of water balance, oxidative damage and apoptosis. The role of this pressor agent on brain perfusion in HS requires further investigation
Infectious causes of microcephaly: epidemiology, pathogenesis, diagnosis, and management
Microcephaly is an important sign of neurological malformation and a predictor of future disability. The 2015–16 outbreak of Zika virus and congenital Zika infection brought the world's attention to links between Zika infection and microcephaly. However, Zika virus is only one of the infectious causes of microcephaly and, although the contexts in which they occur vary greatly, all are of concern. In this Review, we summarise important aspects of major congenital infections that can cause microcephaly, and describe the epidemiology, transmission, clinical features, pathogenesis, management, and long-term consequences of these infections. We include infections that cause substantial impairment: cytomegalovirus, herpes simplex virus, rubella virus, Toxoplasma gondii, and Zika virus. We highlight potential issues with classification of microcephaly and show how some infants affected by congenital infection might be missed or incorrectly diagnosed. Although Zika virus has brought the attention of the world to the problem of microcephaly, prevention of all infectious causes of microcephaly and appropriately managing its consequences remain important global public health priorities
Bright ligand-activatable fluorescent protein for high-quality multicolor live-cell super-resolution microscopy
We introduce UnaG as a green-to-dark photoswitching fluorescent protein capable of high-quality super-resolution imaging with photon numbers equivalent to the brightest photoswitchable red protein. UnaG only fluoresces upon binding of a fluorogenic metabolite, bilirubin, enabling UV-free reversible photoswitching with easily controllable kinetics and low background under Epi illumination. The on- and off-switching rates are controlled by the concentration of the ligand and the excitation light intensity, respectively, where the dissolved oxygen also promotes the off-switching. The photo-oxidation reaction mechanism of bilirubin in UnaG suggests that the lack of ligand-protein covalent bond allows the oxidized ligand to detach from the protein, emptying the binding cavity for rebinding to a fresh ligand molecule. We demonstrate super-resolution single-molecule localization imaging of various subcellular structures genetically encoded with UnaG, which enables facile labeling and simultaneous multicolor imaging of live cells. UnaG has the promise of becoming a default protein for high-performance super-resolution imaging. Photoconvertible proteins occupy two color channels thereby limiting multicolour localisation microscopy applications. Here the authors present UnaG, a new green-to-dark photoswitching fluorescent protein for super-resolution imaging, whose activation is based on a noncovalent binding with bilirubin
Comments on black holes I: The possibility of complementarity
We comment on a recent paper of Almheiri, Marolf, Polchinski and Sully who
argue against black hole complementarity based on the claim that an infalling
observer 'burns' as he approaches the horizon. We show that in fact
measurements made by an infalling observer outside the horizon are
statistically identical for the cases of vacuum at the horizon and radiation
emerging from a stretched horizon. This forces us to follow the dynamics all
the way to the horizon, where we need to know the details of Planck scale
physics. We note that in string theory the fuzzball structure of microstates
does not give any place to 'continue through' this Planck regime. AMPS argue
that interactions near the horizon preclude traditional complementarity. But
the conjecture of 'fuzzball complementarity' works in the opposite way: the
infalling quantum is absorbed by the fuzzball surface, and it is the resulting
dynamics that is conjectured to admit a complementary description.Comment: 34 pages, 6 figures, v3: clarifications & references adde
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Evolução na utilização e nos gastos de uma operadora de saúde
Brazil’s aging population and the rising number of people reliant upon the country’s supplementary healthcare system have elicited the concern of public and private managers regarding the increase in healthcare costs. In this paper, the costs per gender, per type of medical expenses and per age group of a major Brazilian self-managed healthcare provider between 2007 and 2013 were analyzed. This healthcare provider is of interest because, besides portraying a single condition of revenue growth restricted to the existing contributors, it also replicates the demographic profile expected for Brazil in 2050, when approximately one-third of its population will be over 60 years of age. The analyses confirm the current literature as they show an increase in healthcare plan usage by the elderly and the difference between admission rates by gender. They also reveal an increase in average length of stay in hospital and the increase in medical costs far above inflation, especially for materials and medicines. It is hoped that this study will help scholars and others interested in comparisons of medical expense trends, especially by age and sex, and that it encourages further collaboration on the sustainability of health insurance providers in Brazil
Immunocytochemical study of the distribuition of endocrine cells in the pancreas of the Brazilian sparrow species Zonotrichia Capensis Subtorquata (Swaison, 1837)
Childhood socioeconomic position, adult socioeconomic position and social mobility in relation to markers of adiposity in early adulthood: evidence of differential effects by gender in the 1978/79 Ribeirao Preto cohort study
Background: Longitudinal studies drawn from high-income countries demonstrate long-term associations of early childhood socioeconomic deprivation with increased adiposity in adulthood. However, there are very few data from resource-poor countries where there are reasons to anticipate different gradients. Accordingly, we sought to characterise the nature of the socioeconomic status (SES)-adiposity association in Brazil. / Methods: We use data from the Ribeirao Preto Cohort Study in Brazil in which 9067 newborns were recruited via their mothers in 1978/79 and one-in-three followed up in 2002/04 (23–25years). SES, based on family income (salaries, interest on savings, pensions and so on), was assessed at birth and early adulthood, and three different adiposity measures (body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)) ascertained at follow-up. The association between childhood SES, adult SES and social mobility (defined as four permutations of SES in childhood and adulthood: low–low, low–high, high–low, high–high), and the adiposity measures was examined using linear regression. / Results: There was evidence that the association between SES and the three markers of adiposity was modified by gender in both adulthood (P<0.02 for all outcomes) and childhood SES (P<0.02 for WC and WHR). Thus, in an unadjusted model, linear regression analyses showed that higher childhood SES was associated with lower adiposity in women (coefficient (95% confidence intervals) BMI: −1.49 (−2.29,−0.69); WC: −3.85 (−5.73,−1.97); WHR: −0.03 (−0.04,−0.02)). However, in men, higher childhood SES was related to higher adiposity (BMI: 1.03 (0.28,−1.78); WC: 3.15 (1.20, 5.09); WHR: 0.009 (−0.001, 0.019)) although statistical significance was not seen in all analyses. There was a suggestion that adult SES (but not adult health behaviours or birthweight) accounted for these relationships in women only. Upward mobility was associated with protection against greater adiposity in women but not men. / Conclusion: In the present study, in men there was some evidence that both higher childhood and adulthood SES was related to a higher adiposity risk, while the reverse gradient was apparent in women
Secured Communication over Frequency-Selective Fading Channels: a practical Vandermonde precoding
In this paper, we study the frequency-selective broadcast channel with
confidential messages (BCC) in which the transmitter sends a confidential
message to receiver 1 and a common message to receivers 1 and 2. In the case of
a block transmission of N symbols followed by a guard interval of L symbols,
the frequency-selective channel can be modeled as a N * (N+L) Toeplitz matrix.
For this special type of multiple-input multiple-output (MIMO) channels, we
propose a practical Vandermonde precoding that consists of projecting the
confidential messages in the null space of the channel seen by receiver 2 while
superposing the common message. For this scheme, we provide the achievable rate
region, i.e. the rate-tuple of the common and confidential messages, and
characterize the optimal covariance inputs for some special cases of interest.
It is proved that the proposed scheme achieves the optimal degree of freedom
(d.o.f) region. More specifically, it enables to send l <= L confidential
messages and N-l common messages simultaneously over a block of N+L symbols.
Interestingly, the proposed scheme can be applied to secured multiuser
scenarios such as the K+1-user frequency-selective BCC with K confidential
messages and the two-user frequency-selective BCC with two confidential
messages. For each scenario, we provide the achievable secrecy degree of
freedom (s.d.o.f.) region of the corresponding frequency-selective BCC and
prove the optimality of the Vandermonde precoding. One of the appealing
features of the proposed scheme is that it does not require any specific
secrecy encoding technique but can be applied on top of any existing powerful
encoding schemes.Comment: To appear in EURASIP journal on Wireless Communications and
Networking, special issue on Wireless Physical Security, 200
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