Use of Saliva for Early Dengue Diagnosis

The importance of laboratory diagnosis of dengue cannot be undermined. In recent years, many dengue diagnostic tools have become available for various stages of the disease, but the one limitation is that they require blood as a specimen for testing. In many incidences, phlebotomy in needle-phobic febrile individuals, especially children, can be challenging, and the tendency to forgo a dengue blood test is high. To circumvent this, we decided to work toward a saliva-based assay (antigen-capture anti-DENV IgA ELISA, ACA-ELISA) that has the necessary sensitivity and specificity to detect dengue early. Overall sensitivity of the ACA-ELISA, when tested on saliva collected from dengue-confirmed patients (EDEN study) at three time points, was 70% in the first 3 days after fever onset and 93% between 4 to 8 days after fever onset. In patients with secondary dengue infections, salivary IgA was detected on the first day of fever onset in all the dengue confirmed patients. This demonstrates the utility of saliva in the ACA-ELISA for early dengue diagnostics. This technique is easy to perform, cost effective, and is especially useful in dengue endemic countries

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): study protocol for a randomized controlled trial

BACKGROUND: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). METHODS/DESIGN: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure 6430 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. DISCUSSION: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration metho

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Die Resistenz transgener Weizenlinien gegen Pilzkrankheiten im Feldversuch

Die Übertragung von zusätzlichen Resistenzgenen zwischen Pflanzen mit Hilfe der Transgenese erlaubt ein besseres Verständnis der Funktion dieser Gene und deren Zusammenspiel mit anderen Genen der Pflanze. In der vorliegenden Arbeit wird die Resistenz von verschiedenen transgenen Weizenlinien gegen die Krankheiten Echter Mehltau, Gelbrost und Ährenfusariose untersucht. Auf der einen Seite wurde das rassenspezifische Mehltauresistenzgen Pm3b aus der Weizenlandrasse Chul auf die Sorte Bobwhite übertragen. Der zweite Ansatz untersuchte eine verbesserte quantitative, unspezifische Resistenz durch die Gene Chitinase und Glukanase aus der Gerste in der Weizensorte Frisal. Die Versuche wurden mit hohem Infektionsdruck geführt um die Resistenz zwischen transgenen Linien und Ursprungssorte vergleichen zu können. Im Falle der Pm3b- Bobwhiteabkömmlinge konnte auch auf nicht-transgene Schwesterlinien zurückgegriffen werden. Die Schwesterlinien haben den gleichen Transformationsprozess durchschritten, jedoch ging das Transgen nach der Regeneration der Pflanzen bei der Segregation verloren. Die Ergebnisse zeigen, dass das zusätzliche Pm3b-Gen die Resistenz gegenüber Infektionen durch den Echten Mehltau auf dem Blatt und auf der Ähre deutlich verbessert. Überraschenderweise entwickelt eine der transgenen Bobwhitelinien ebenfalls eine verbesserte Resistenz gegen den Gelbrost. Die Resistenz gegen die Ährenfusariose wird hingegen kaum beeinflusst. Die zusätzlichen Chitinase und Glukanase Gene in der Sorte Frisal haben keinen Einfluss auf das Resistenzverhalten der transgene Pflanzen gezeigt. Die Erkenntnisse aus diesem Versuch sind unter anderem sehr wertvoll für die klassische Züchtung resistenter Sorten

Respiratory Condition of Family Farmers Exposed to Pesticides in the State of Rio de Janeiro, Brazil

Pesticide exposure is a growing public health concern. Although Brazil is the world’s largest consumer of pesticides, only a few studies have addressed the health effects among farmers. This study aimed to evaluate whether pesticide exposure is associated with respiratory outcomes among rural workers and relatives in Brazil during the crop and off-seasons. Family farmers (82) were interviewed about occupational history and respiratory symptoms, and cholinesterase tests were conducted in the crop-season. Spirometry was performed during the crop and off-season. Respiratory outcomes were compared between seasons and multiple regressions analysis were conducted to search for associations with exposure indicators. Participants were occupationally and environmentally exposed to multiple pesticides from an early age. During the crop and off-season, respectively, they presented a prevalence of 40% and 30.7% for cough, 30.7% and 24% for nasal allergies, and 24% and 17.3% for chest tightness. Significant associations between spirometry impairments and exposure indicators were found both during the crop and off-season. These findings provide complementary evidence about the association of pesticide exposure with adverse respiratory effects among family farmers in Brazil. This situation requires special attention as it may increase the risk of pulmonary dysfunctions, and the morbidity and mortality burden associated with these diseases

On the nonlinear behaviour of nematic single crystal elastomers under biaxial mechanic and electrical force fields

A slab of nematic-side-chain-liquid-single-crystal elastomer (NSCLSCE), with the director initially oriented in the z -direction, is subjected to a pair of equal mechanical loads and electrical force fields in the x , y directions. The electric fields tend to make easier the rotation of the director after the application of the mechanical force field. A nonlinear expression for the free energy density is used to obtain the interval of stretching for which the system becomes unstable. However, the elastic energy of the network is assumed to be linear. The stress-strain curves predicted by the model show an unstable zone between two linearly increasing segments. The possibility of bifurcation phenomena has been examined.Díaz Calleja, R.; Diaz Boils, P.; Llovera Segovia, P.; Quijano Lopez, A. (2014). On the nonlinear behaviour of nematic single crystal elastomers under biaxial mechanic and electrical force fields. European Physical Journal E. 37(66):1-13. doi:10.1140/epje/i2014-14066-5S1133766M. Warner, E. Terentjev, Liquid Crystal Elastomers (Oxford Science Publications, 2003).L. Golubovic, T.C. Lubensky, Phys. Rev. Lett. 63, 1082 (1989).A. Petelin, M. Copic, Phys. Rev. Lett. 103, 077801 (2009).I. Kundler, H. Finkelmann, Macromol. Chem. Rapid Commun. 16, 679 (1995).G.C. Verwey, M. Warner, Macromolecules 30, 4189 (1997).G.C. Verwey, M. Warner, Macromolecules 30, 4196 (1997).A. DeSimone, G. Dolzmann, Physica D 136, 175 (2000).S. Conti, A. DeSimone, G. Dolzmann, J. Mech. Phys. Solids 59, 1431 (2002).J.S. Biggins, E.M. Terentjev, M. Warner, Phys. Rev. E 78, 041704 (2008).S. Conti, A. DeSimone, G. Dolzmann, Phys. Rev. E 66, 061710 (2002).F. Yee, R. Mukhopadhyay, O. Stenull, T.C. Lubensky, Phys. Rev. Lett. 98, 147801 (2007).D. Rogez, G. Francius, H. Finkelmann, P. Martinoty, Eur. Phys. J. E 20, 369 (2006).H.R. Brand, H. Pleiner, P. Martinoty, Soft Matter 2, 182 (2006).O. Müller, H.R. Brand, Eur. Phys. J. E 17, 53 (2005).A.M. Menzel, H.R. Brand, Eur. Phys. J. E 26, 235 (2008).H.R. Brand, H. Pleiner, Physica A 208, 359 (1994).A. Menzel, H. Pleiner, H.R. Brand, J. Chem. Phys. 126, 234901 (2007).A. Menzel, H. Pleiner, H.R. Brand, J. Appl. Phys. 105, 013503 (2009).A. Menzel, H. Pleiner, H.R. Brand, Eur. Phys. J. E 30, 371 (2009).Y. Bitoh, N. Akuzawa, K. Urayama, T. Takigawa, J. Polym. Sci. Part B Polym. Phys. 48, 721 (2010).Y. Bitoh, N. Akuzawa, K. Urayama, T. Takigawa, M. Kidowaki, K. Ito, Macromolecules 44, 8661 (2011).T. Katashima, K. Urayama, U. Chung, T. Sakai, Soft Matter 8, 8217 (2012).A.N. Gent, Rubber Chem. Technol. 69, 59 (1996).H. Finkelmann, I. Kundler, E.M. Terentjev, M. Warner J. Phys. II 7, 1059 (1997).P.G. de Gennes, in Liquid Crystals of One- and Two-Dimensional Order, edited by W. Helfrich, G. Heppke (Springer, Berlin, 1980) p. 231.P. Martinoty, P. Stein, H. Finkelmann, H. Pleiner, H.R. Brand, Eur. Phys. J. E 14, 311 (2004).R. Diaz-Calleja, E. Riande, Eur. Phys. J. E 35, 2 (2012).R. Diaz-Calleja, P. Llovera-Segovia, E. Riande, A. Quijano-Lopez, Appl. Phys. Lett. 102, 052901 (2013).P.G. de Gennes, The Physics of Liquid Crystals (Clarendon Press, Oxford, 1975).E.H. Love, A Treatise on the Mathematical Theory of Elasticity (Dover, 1944) p. 160.A. DeSimone, G. Dolzmann, Stripe-domains in nematic elastomers: old and new, in Modeling of Soft Matter, edited by M.C. Calderer, E. Terentjev, IMA Volumes in Mathematics and its Applications, Vol. 141 (Springer, Berlin, 2005).R. Diaz-Calleja, M.J. Sanchis, E. Riande, J. Electrostatics 67, 158 (2009).R.W. Ogden, Non-Linear Elastic Deformations, Chapt. 7 (Dover, 1997).A. DeSimone, L. Teresi, Eur. Phys. J.E 29, 191 (2009).J. Weilepp, H.R. Brand, Europhys. Lett. 34, 495 (1996).G. Barbero, L.R. Evangelista, An Elementary Course on the Continuum Theory for Nematic Liquid Crystals (World Scientific, 2001) p. 148