Septal Flash Assessment on CRT Candidates Based on Statistical Atlases of Motion

International audienceIn this paper, we propose a complete framework for the automatic detection and quantification of abnormal heart motion patterns using Statistical Atlases of Motion built from healthy populations. The method is illustrated on CRT patients with identified cardiac dyssyn-chrony and abnormal septal motion on 2D ultrasound (US) sequences. The use of the 2D US modality guarantees that the temporal resolution of the image sequences is high enough to work under a small displacements hypothesis. Under this assumption, the computed displacement fields can be directly considered as cardiac velocities. Comparison of subjects acquired with different spatiotemporal resolutions implies the reorientation and temporal normalization of velocity fields in a common space of coordinates. Statistics are then performed on the reoriented vector fields. Results show the ability of the method to correctly detect abnormal motion patterns and quantify their distance to normality. The use of local p-values for quantifying abnormal motion patterns is believed to be a promising strategy for computing new markers of cardiac dyssynchrony for better characterizing CRT candidates

The industrialization of ablation: a highly standardized and reproducible workflow for radiofrequency ablation of atrial fibrillation

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MOLECULAR CHARACTERIZATION OF INFLUENZA B VIRUS OUTBREAK ON A CRUISE SHIP IN BRAZIL 2012

In February 2012, an outbreak of respiratory illness occurred on the cruise ship MSC Armonia in Brazil. A 31-year-old female crew member was hospitalized with respiratory failure and subsequently died. To study the etiology of the respiratory illness, tissue taken at necropsy from the deceased woman and respiratory specimens from thirteen passengers and crew members with respiratory symptoms were analyzed. Influenza real-time RT-PCR assays were performed, and the full-length hemagglutinin (HA) gene of influenza-positive samples was sequenced. Influenza B virus was detected in samples from seven of the individuals, suggesting that it was the cause of this respiratory illness outbreak. The sequence analysis of the HA gene indicated that the virus was closely related to the B/Brisbane/60/2008-like virus, Victoria lineage, a virus contained in the 2011-12 influenza vaccine for the Southern Hemisphere. Since the recommended composition of the influenza vaccine for use during the 2013 season changed, an intensive surveillance of viruses circulating worldwide is crucial. Molecular analysis is an important tool to characterize the pathogen responsible for an outbreak such as this. In addition, laboratory disease surveillance contributes to the control measures for vaccine-preventable influenza.Em fevereiro de 2012, durante a temporada de verão no Brasil, um surto de doença respiratória ocorreu no navio de cruzeiro MSC Armonia. Mulher de 31 anos, membro da tripulação, foi internada com insuficiência respiratória e morreu. Com o objetivo de estudar a etiologia da doença foram investigadas necrópsia de tecido do caso fatal e secreções respiratórias de 13 passageiros e membros da tripulação com sintomas respiratórios. O teste de influenza por RT-PCR em tempo real foi realizado e o gene completo da hemaglutinina (HA) das amostras positivas foi sequenciado. O vírus influenza B foi detectado em sete indivíduos, sugerindo-o como a causa do surto de doença respiratória a bordo do navio. A análise da sequência do gene da HA indicou que os vírus estão fortemente relacionados com o vírus B/Brisbane/60/2008, linhagem Victoria, componente da vacina de influenza para 2011-2012 no hemisfério sul. Uma vez que a composição da vacina foi alterada para uso na temporada de 2012-2013, é essencial a vigilância ativa dos vírus circulantes em todo o mundo. A análise molecular é uma ferramenta importante para caracterização do patógeno responsável pelo surto. Além disso, a vigilância de doenças baseada em dados laboratoriais contribui para as medidas de controle da influenza, uma doença imunoprevinível

Temporal Diffeomorphic Free-Form Deformation for Strain Quantification in 3D-US Images

International audienceThis paper presents a new diffeomorphic temporal registration algorithm and its application to motion and strain quantification from a temporal sequence of 3D images. The displacement field is computed by forward eulerian integration of a non-stationary velocity field. The originality of our approach resides in enforcing time consistency by representing the velocity field as a sum of continuous spatiotemporal B-Spline kernels. The accuracy of the developed diffeomorphic technique was first compared to a simple pairwise strategy on synthetic US images with known ground truth motion and with several noise levels, being the proposed algorithm more robust to noise than the pairwise case. Our algorithm was then applied to a database of cardiac 3D+t Ultrasound (US) images of the left ventricle acquired from height healthy volunteers and three Cardiac Resynchronization Therapy (CRT) patients. On healthy cases, the measured regional strain curves provided uniform strain patterns over all myocardial segments in accordance with clinical literature. On CRT patients, the obtained normalization of the strain pattern after CRT agreed with clinical outcome for the three cases

Antiparasitic Activity of Natural and Semi-Synthetic Tirucallane Triterpenoids from Schinus terebinthifolius (Anacardiaceae): Structure/Activity Relationships

Leishmaniasis and Chagas are diseases caused by parasitic protozoans that affect the poorest population in the World, causing a high mortality and morbidity. As a result of highly toxic and long-term treatments, the discovery of novel, safe and more efficacious drugs is essential. in this work, the in vitro antiparasitic activity and mammalian cytotoxicity of three natural tirucallane triterpenoids, isolated from leaves of Schinus terebinthifolius (Anacardiaceae), and nine semi-synthetic derivatives were investigated against Leishmania (L.) infantum and Trypanosoma cruzi. Trypomastigotes of T. cruzi were the most susceptible parasites and seven compounds demonstrated a trypanocidal activity with IC50 values in the range between 15 and 58 mu g/mL. Four compounds demonstrated selectivity towards the intracellular amastigotes of Leishmania, with IC50 values in the range between 28 and 97 mu g/mL. the complete characterization of triterpenoids was afforded after thorough analysis of nuclear magnetic resonance (NMR) data as well as electrospray ionization mass spectrometry (ESI-MS). Additionally, structure-activity relationships were performed using Decision Trees.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)Universidade Federal de São Paulo, Inst Ciencias Ambientais Quim & Farmaceut, BR-09972270 Diadema, SP, BrazilAdolfo Lutz Inst, Ctr Parasitol, BR-01246902 São Paulo, BrazilUniv Fed Paraiba, Ctr Ciencias Aplicadas & Educ, BR-58297000 Rio Tinto, BrazilUniv Fed Uberlandia, Inst Quim, BR-38400902 Uberlandia, MG, BrazilUniversidade Federal de São Paulo, Inst Ciencias Ambientais Quim & Farmaceut, BR-09972270 Diadema, SP, BrazilCNPq: 300546/2012-2CNPq: 471458/2012-0FAPESP: 2011/51739-0FAPESP: 2012/18756-1FAPESP: 2013/16320-4Web of Scienc

Pediatric Patients With Steroid-Sensitive Nephrotic Syndrome Have Higher Expression of T Regulatory Lymphocytes in Comparison to Steroid-Resistant Disease

Background and Aim: Idiopathic nephrotic syndrome (INS) is classified according to the response to drug therapy in steroid-sensitive (SS), steroid-dependent (SD), and steroid-resistant (SR) categories. Previous studies showed changes in inflammatory activity of subpopulations of lymphocytes in INS. This study aimed to compare SS and SR patients in regard to subpopulations of leukocytes, profile of regulatory lymphocytes, and migratory activity of lymphocyte subpopulations. Results obtained in INS patients were also compared to age and sex-matched healthy controls.Methods: This is a cross-sectional study including SS patients (n = 30), SR patients (n = 14), and controls (n = 10). Peripheral blood samples were withdrawn for ex-vivo leukocyte flow cytometry analysis.Results: Percentage of B-lymphocytes and natural killer (NK) cells were significantly reduced in SR patients when compared to controls, while the percentage of NKT cells were decreased in SS patients in comparison to controls. Percentages of CD4+ expressing FoxP3 and CTLA4 were significantly higher in SS patients in comparison to SR patients and controls. The expression of integrin CD18 on the surface of T lymphocytes (CD3+) was reduced in SS patients if compared to controls.Conclusion: This study found that SS INS patients have higher levels of regulatory T-lymphocytes and lower expression of adhesion molecules than SR patients

Development, usability, formative assessment, and story immersion of Nutrigame, a mHealth nutrition education app

The replacement of unprocessed and minimally processed foods with processed and ultra-processed ones can be a contributor to the increased prevalence of obesity amongst adults and adolescents. Mobile health (mHealth) innovations, such as mobile applications (apps), especially games, can be used to improve health behaviors and increase adolescent knowledge. The aim of this qualitative research was to describe the development, assessment, and story immersion of a mHealth nutrition education app developed to improve the food knowledge of adolescents. This study employed the stepwise approach model to the mHealth app development, according to the person-based approach and evidence-based behavior change techniques. The mHealth app was based on the concepts of the NOVA system food classification, present in the Brazilian dietary guidelines. The developed app, Nutrigame – your food guide, is a story-based serious game set in the food routine of an adolescent who needs to choose what to eat, when, where, and with whom the meals are taken. The first version of the app was tested by a group of adolescents (convenience sample, n=6, mean age: 15.8 ± 0.9 years) for 30 days. To assess usability, feasibility, engagement (user testing), and formative evaluation from the user's perspective, five individual interviews. After the last interview, the participants were required to complete a 13-item immersion scale, adapted from the narrative transportation scale to assess story immersion game. The final version of the game was adapted to meet the suggestions presented by the adolescents. All steps used for the app development are described. The gamification elements chosen led to the comprehension of the main learning contents. The mean story immersion score (30.3 ± 1.9) demonstrates the participant's involvement with the game's narrative. This study can provide useful insights to public health researchers and nutrition educators who are planning to develop a mHealth nutrition education app from a practical perspective

A sensitive flow cytometric methodology for studying the binding of L. chagasi to canine peritoneal macrophages

BACKGROUND: The Leishmania promastigote-macrophage interaction occurs through the association of multiple receptors on the biological membrane surfaces. The success of the parasite infection is dramatically dependent on this early interaction in the vertebrate host, which permits or not the development of the disease. In this study we propose a novel methodology using flow cytometry to study this interaction, and compare it with a previously described "in vitro" binding assay. METHODS: To study parasite-macrophage interaction, peritoneal macrophages were obtained from 4 dogs and adjusted to 3 × 10(6 )cells/mL. Leishmania (Leishmania) chagasi parasites (stationary-phase) were adjusted to 5 × 10(7 )cells/mL. The interaction between CFSE-stained Leishmania chagasi and canine peritoneal macrophages was performed in polypropylene tubes to avoid macrophage adhesion. We carried out assays in the presence or absence of normal serum or in the presence of a final concentration of 5% of C5 deficient (serum from AKR/J mice) mouse serum. Then, the number of infected macrophages was counted in an optical microscope, as well as by flow citometry. Macrophages obtained were stained with anti-CR3 (CD11b/CD18) antibodies and analyzed by flow citometry. RESULTS: Our results have shown that the interaction between Leishmania and macrophages can be measured by flow cytometry using the fluorescent dye CFSE to identify the Leishmania, and measuring simultaneously the expression of an important integrin involved in this interaction: the CD11b/CD18 (CR3 or Mac-1) β2 integrin. CONCLUSION: Flow cytometry offers rapid, reliable and sensitive measurements of single cell interactions with Leishmania in unstained or phenotypically defined cell populations following staining with one or more fluorochromes

Saberes de um grupo de quiosqueiros de Capão da Canoa, RS : contribuições para a educação ambiental não-formal

Este estudo, desenvolvido no Programa de Pós-Graduação em Educação Ambiental: Mestrado, na Universidade Federal do Rio Grande - FURG, apoia-se na linha de pesquisa da Educação Ambiental Não Formal. Tem como objetivo investigar a realidade do grupo social denominado Quiosqueiros de Capão da Canoa, conhecer os saberes desse grupo, suas histórias de vida, e, assim, alcançar contribuições para ações de educação ambiental não formal naquela localidade. O trabalho aborda o diagnóstico socioambiental de Capão da Canoa e as questões sobre o impacto ambiental gerado na orla do município, decorrente das atividades comerciais exercidas nos quiosques, principalmente no período do veraneio. A discussão trata dos saberes populares vinculados com a educação popular e a construção da visão de mundo pela perspectiva da educação ambiental, articulando-os com a educação ambiental não formal, considerada como capaz de desenvolver uma práxis voltada para a mudança de atitudes e melhoria/solução das questões socioambientais. Em capítulo específico, é apresentado o contexto sociohistórico e ambiental de Capão da Canoa, que permite a leitura das ações da gestão e da educação ambiental do município, cm base nos aspectos da trajetória do balneário, possibilitando a compreensão do cenário local e a emergência dos conflitos socioambientais. Os dados que embasaram esta pesquisa foram coletados por meio de entrevistas e escuta das histórias de vida dos investigados. A análise dos dados foi ancorada na metodologia da análise textual discursiva (ATD) e o corpus da análise constituiu-se das entrevistas transcritas pelo investigador e validadas pelos participantes (18). Inicialmente ocorre a desconstrução dos textos "a unitarização", identificando as unidades de significados e seus respectivos códigos, com a emergência dos argumentos aglutinadores que embasam o processo seguinte ? a categorização. Nessa fase, operou-se com categorias a priori, que são identificadas como as etapas a serem trabalhadas pelos educadores em uma ação de educação ambiental ? sensibilização; conhecimento e habilidades; mobilização e projeção: ação ambiental, participação e multiplicação ? e com a categoria emergente no processo da análise, identificada como problematização, que representa a visão prévia dos investigados. O metatexto produzido a partir da análise efetuada articula os saberes com a proposição de uma ação de educação ambiental não formal. Essa proposta está alicerçada na perspectiva de problematizar, sensibilizar, redefinir, mobilizar, estimular conhecimentos e habilidades e participar da realidade dos Quiosqueiros a partir dos seus saberes, procurando contribuir para que aconteçam realizações individuais e coletivas e para que a visão do espaço da casa, do trabalho, da rua onde moram, do bairro e da cidade onde vivem seja ampliada. O trabalho é finalizado com a figura da "nuvem de saberes", que traz a representação dos saberes dos Quiosqueiros e das categorias discutidas para a formação de um processo de educação, proposta essa que entendemos ser capaz de preparar para as incertezas socioambientais e de provocar a capacidade de resposta dos atores diante do imprevisível, possibilitando que compreendam as inter-relações que constituem seus mundos de vida.This study, which was conducted at the Post-Graduation Program in Environmental Education: Master's degree, at the Federal University of Rio Grande - FURG, relies on the research line of Non-formal Environmental Education. It aims to investigate the reality of the social group denominated Quiosqueiros from Capão da Canoa, to identify the knowledge of this group, their life stories, and thus to achieve contributions for the actions in non-formal environmental education in that locality. The study addresses the socio-environmental diagnosis of Capão da Canoa and the issues about the environmental impact generated on the shoreline of the city, arising from commercial activities carried out on kiosks, especially during the summer. The discussion deals with popular knowledge linked with popular education and the construction of a world view from the perspective of the environmental education, articulating them with the non-formal environmental education, which is considered as capable of developing a praxis aimed at changing attitudes and improving/solving socio-environmental issues. In a particular chapter, the socio-historical and environmental context of Capão da Canoa is presented, which allows the reading of the management actions and environmental education in the city, based on the aspects of the history of the resort, enabling the understanding of the local scenery and the emergence of environmental conflicts. The data that supported this research were collected through interviews and audio recording from the life stories of those investigated. Data analysis was anchored in the methodology of discursive textual analysis (DTA) and the corpus of the analysis consisted of the transcribed interviews made by the researcher and validated by the participants (18). First there is the deconstruction of the texts ? the unitarization -, identifying units of meaning and their codes, with the emergence of binder arguments that support the following process - the categorization. At that stage, the research was operated with a priori categories, which are identified as the steps to be worked by the educators in an environmental educational action - awareness; knowledge and skills; mobilization and project: environmental action, participation and multiplication - and with the emerging category in the analysis processes identified as problematization, which represents the previous vision of those investigated. The metatext produced from the performed analysis articulated the knowledge with the proposition of a non-formal environmental education action. This proposal is based on the prospect of questioning, raising awareness, redefining, mobilizing, stimulating knowledge and skills, and participating in the reality of Quiosqueiros from their knowledge, seeking to contribute for the happening of individual and collective actions, and for the vision of the house space, work, the street, the neighborhood and the city where they live be enlarged. The study ends with the figure of the "cloud of knowledge", which brings the representation of the knowledge of Quiosqueiros and the categories discussed for the creation of an educational process, a proposal which is understood as capable to prepare for the socio-environmental uncertainties and provoke the ability of a response from the actors on the unpredictable, enabling them to understand the interrelationships that constitute their worlds