Pulmonary Asymmetry on Chest X-Ray

A ausência unilateral de uma artéria pulmonar é uma anomalia congénita rara. Os autores descrevem o caso de um rapaz de dois anos, sem antecedentes patológicos prévios e que é referenciado para avaliação após a detecção na telerradiografia de tórax de assimetria dos campos pulmonares com desvio do mediastino para a direita. A tomografia axial computorizada e a cintigrafia de perfusão pulmonar entretanto efectuadas, indicavam para a ausência da artéria pulmonar direita que foi comprovada no cateterismo cardíaco e em ressonância magnética. Esta é uma patologia relevante pois o seu diagnóstico precoce e a sua correcção atempada podem evitar morbilidades no futuro. Dada a idade e o facto de o doente estar de momento assintomático, optou-se por uma atitude conservadora e vigilância em ambulatório

Connective tissue disease-associated interstitial lung disease

BACKGROUND: Connective tissue diseases (CTD) are frequently associated with interstitial lung disease (ILD), significantly impacting their morbidity and mortality. AIM: Analyze the experience of an autoimmune specialized unit on treating CTD-ILD and characterize the population based on most frequent diseases, imaging patterns, lung function tests results, serology and treatment. Assess mortality and mortality predictors in these patients. METHODS: Retrospective, descriptive and statistical analysis of the CTD-ILD patients followed up at an autoimmune diseases unit during a 6-year period. RESULTS: Over the study period, 75 patients with CTD-ILD were treated with a mean follow-up of 49 ± 31 months. The most frequent CTD were systemic sclerosis and rheumatoid arthritis. ILD was diagnosed prior to CTD in 8% of patients and concomitantly in 35%. Nonspecific interstitial pneumonia was the CT pattern in 60% and 35% had an isolated diminished DLCO on lung function tests. Pulmonary hypertension was present in 12% and it was the single most important mortality predictor (OR 14.41, p = 0.006). Corticosteroids are the mainstay of treatment but biologics were prescribed in 39% of the patients (mostly tocilizumab and rituximab). Two scleroderma patients were recently treated with nintedanib. CONCLUSIONS: ILD is a potential complication of every CTD and can impose a dramatic burden on these patients. The clinical relevance of ILD together with their early expression in the course of the disease underlines the importance of the presence of chest physicians in these units.info:eu-repo/semantics/publishedVersio

Using a genetic algorithm to optimize a data-limited catch rule

Many data-limited fish stocks worldwide require management advice. Simple empirical management procedures have been used to manage data-limited fisheries but do not necessarily ensure compliance with maximum sustainable yield objectives and precautionary principles. Genetic algorithms are efficient optimization procedures for which the objectives are formalized as a fitness function. This optimization can be included when testing management procedures in a management strategy evaluation. This study explored the application of a genetic algorithm to an empirical catch rule and found that this approach could substantially improve the performance of the catch rule. The optimized parameterization and the magnitude of the improvement were dependent on the specific stock, stock status, and definition of the fitness function. The genetic algorithm proved to be an efficient and automated method for tuning the catch rule and removed the need for manual intervention during the optimization process. Therefore, we conclude that the approach could also be applied to other management procedures, case-specific tuning, and even data-rich stocks. Finally, we recommend the phasing out of the current generic ICES “2 over 3” advice rule in favour of case-specific catch rules of the form tested here, although we caution that neither works well for fast-growing stocks

The dynamics of apparent horizons in Robinson-Trautman spacetimes

We present an alternative scheme of finding apparent horizons based on spectral methods applied to Robinson-Trautman spacetimes. We have considered distinct initial data such as representing the spheroids of matter and the head-on collision of two non-rotating black holes. The evolution of the apparent horizon is presented. We have obtained in some cases a mass gap between the final Bondi and apparent horizon masses, whose implications were briefly commented in the light of the thermodynamics of black holes.Comment: 9 pages, 7 figure

SU(2)² -invariant G₂ -instantons

We initiate the systematic study of G₂-instantons with SU(2)² -symmetry. As well as developing foundational theory, we give existence, non-existence and classification results for these instantons. We particularly focus on R⁴ x S³ with its two explicitly known distinct holonomy G₂ metrics, which have different volume growths at infinity, exhibiting the different behaviour of instantons in these settings. We alsogive an explicit example of sequences of G₂-instantons where “bubbling” and “removable singularity” phenomena occur in the limit

Computational Complexity of interacting electrons and fundamental limitations of Density Functional Theory

One of the central problems in quantum mechanics is to determine the ground state properties of a system of electrons interacting via the Coulomb potential. Since its introduction by Hohenberg, Kohn, and Sham, Density Functional Theory (DFT) has become the most widely used and successful method for simulating systems of interacting electrons, making their original work one of the most cited in physics. In this letter, we show that the field of computational complexity imposes fundamental limitations on DFT, as an efficient description of the associated universal functional would allow to solve any problem in the class QMA (the quantum version of NP) and thus particularly any problem in NP in polynomial time. This follows from the fact that finding the ground state energy of the Hubbard model in an external magnetic field is a hard problem even for a quantum computer, while given the universal functional it can be computed efficiently using DFT. This provides a clear illustration how the field of quantum computing is useful even if quantum computers would never be built.Comment: 8 pages, 3 figures. v2: Version accepted at Nature Physics; differs significantly from v1 (including new title). Includes an extra appendix (not contained in the journal version) on the NP-completeness of Hartree-Fock, which is taken from v

In vitro and in vivo performance of methacrylated gellan gum hydrogel formulations for cartilage repair

Methacrylated gellan gum (GGMA) formulation is proposed as a second‐generation hydrogel for controlled delivery of cartilage‐forming cells into focal chondral lesions, allowing immediate in situ retention of cells and 3D filling of lesion volume, such approach deemed compatible with an arthroscopic procedure. Formulation optimization was carried out in vitro using chondrocytes and adipose mesenchymal stromal/stem cells (ASCs). A proof‐of‐concept in vivo study was conducted using a rabbit model with induced chondral lesions. Outcomes were compared with microfracture or non‐treated control. Three grading scores were used to evaluate tissue repair after 8 weeks by macroscopic, histological and immunohistochemical analysis. Intense collagen type II and low collagen type I gene and protein expression were achieved in vitro by the ASC + GGMA formulation, in light with development of healthy chondral tissue. In vivo, this formulation promoted significantly superior de novo cartilage formation compared with the non‐treated group. Maintenance of chondral height and integration with native tissue was further accomplished. The physicochemical properties of the proposed GGMA hydrogel exhibited highly favorable characteristics and biological performance both in vitro and in vivo, positioning itself as an attractive xeno‐free biomaterial to be used with chondrogenic cells for a cost‐effective treatment of focal chondral lesions

Major acute splenic sequestration crisis in an adult patient with sickle-cell disease

A crise de retenção esplénica é uma complicação, frequentemente, fatal da drepanocitose. É rara em adultos, pela elevada incidência de autoesplenectomia durante a infância. Heterozigóticos com traços de drepanocitose e de beta-talassémia têm fenótipos menos graves, podendo manter um baço funcional até à idade adulta. Descrevemos um caso de crise de retenção esplénica num homem de 19 anos, com concentração mínima de hemoglobina de 2,9g/dL, que resolveu após esplenectomia emergente. Os poucos casos descritos na literatura acarretam uma mortalidade elevada. Um diagnóstico rápido e actuação imediata são necessários para garantir a sobrevivência. É apresentada uma revisão da fisiopatologia e da abordagem terapêutica desta entidade