Blood lead levels in pregnant women of high and low socioeconomic status in Mexico City.

This study examined the determinants of blood lead (BPb) in 513 pregnant women in Mexico City: 311 from public hospital prenatal clinics, representing primarily women of low socioeconomic status (SES), and 202 from private hospitals, primarily women of high SES. Overall, BPb levels ranged from 1.38 to 29 micrograms/dl, with geometric means of 6.7 and 11.12 micrograms/dl for women from private and public hospitals, respectively. The crude geometric means difference obtained by t-test was 4.42 (p < 0.001). BPb was measured from January 1994 to August 1995 and showed higher levels during fall and winter and lower levels during spring and summer. The main BPb determinants were the use of lead-glazed ceramics in women from public hospitals and season of the year in women from private hospitals. Consumption of tortillas (corn bread rich in calcium) decreased BPb levels in the lower SES group, but the relationship was not statistically significant (p > 0.05). Consumption of milk products significantly (p < 0.05) reduced BPb levels in the higher SES group. In 112 women whose diets were deficient in calcium, taking calcium supplements lowered their blood lead levels about 7 micrograms/dl. A predictive model fitted to these data, using the strongest predictors plus gestational age, showed a difference of 14 micrograms/dl between the best and worst scenarios in women from public hospitals. Avoiding use of lead-glazed ceramics, consuming diets rich in calcium, and, if needed, taking calcium supplements, would be expected to result in substantial lowering of BPb, especially in pregnant women of low socioeconomic status

Spectral characteristics of side face excited microstructured fibers for photonic integrated circuits formations

We propose a new method for mass production of the photonic crystal devices on the basis of widely-known and well-developed technology such as microstructured optical fibers. In this paper, we investigate the optical properties of side-excited microstructured optical fiber and discuss the conditions for utilization such a structure as a planar photonic crystal device, namely, the high-quality resonance filter.Comment: 7 pages, 7 figure

Evaluación de la calidad y el impacto del ambiente acuático del río higueras en la provincia de Huánuco – 2014

Natural surface water is one of the most widespread, abundant substances on Earth. It is an integralpart of most living things and is present in allowable amount. The naturally pure drinking water isessential for life; the great civilizations have flourished near adequate supplies of the liquid of life.Riparian vegetation plays Higueras river habitat and ecosystem functions. Influences on hydrology,soil science, physicochemical, chemical and microbiological water, so it is relevant in productivity andperformance, regulates temperature, filtering, retaining nutrients and providing habitat for aquatic&nbsp;communities. The study made some approaches on quality and perceived negative impact on waterquality conditions by measuring various physical, chemical and microbiological parameters. Gradientas described sampling stations throughout the course of the channels. The results indicate highpollution and high negative impacts, with the highest incidence in sites close proximity to coastalsettlements channels. The variables which show excessively high values such sites are the accountof bacteria, coliforms and detergent concentrations, physico-chemical parameters. The temporarynature of the water increases the severity of concentration of some contaminants. It is also remarkablethe impact of the deterioration of the natural quality of the physical environment all the way fromsurface waters of the river, mainly due to agricultural activities, extraction of construction materialsand domestic wastewater discharges affecting the biota aquatic. The results indicate that since thewater stations up even still have low impact on quality, while at stations downstream (Season 4, 5, 6,7, 8, 9, 10) are at high risk for contamination, which is confirms strong electric conductivity, turbidity,eutrophication and disappearance of aquatic life becoming to be a dead river, organoleptic, physicalchemical parameters, microbiological very high concentrations and the presence of ammonia andmineral salts that characterize hard water inadmissible for loved alive and human consumption.Las aguas superficiales naturales es una de las sustancias más difundidas, abundantes en PlanetaTierra. Es parte integrante de la mayoría de los seres vivientes y está presente en cantidadpermisibles. El agua natural pura y potable es fundamental para la vida; las grandes civilizaciones hanflorecido cerca de abastecimientos adecuados de ese líquido de la vida. La vegetación ribereña delrío Higueras desempeña funciones de hábitat y ecosistemas. Influye sobre la hidrología, edafología,físico- químico, químico y microbiológico de las aguas, por lo que es relevante en productividad yfuncionamiento, regula la temperatura, filtrando, reteniendo nutrientes y otorgando hábitat a lascomunidades acuáticas. El estudio realizó unas aproximaciones sobre la calidad y su impacto negativopercibidas sobre condiciones de calidad del agua mediante la determinación de varios parámetrosfísico-químicos y microbiológicos. El gradiente de muestreos en estaciones ya descritos por todo elcurso de los cauces. Los resultados indican grado alto de contaminación e impactos negativos altos,con mayor incidencia en los sitios de asentamientos humanos muy próximos a los cauces ribereños.Las variables analizadas las que muestran valores excesivamente elevadas en dichos sitios, son lacuenta de bacterias, coliformes y las concentraciones de detergentes, parámetros físico- químicos. Elcarácter temporal de las aguas incrementa la gravedad de concentración de algunos contaminantes.Asimismo, es notable el impacto del deterioro de la calidad natural del medio físico en todo eltrayecto de las aguas superficiales del río debido, principalmente, a las actividades agropecuarias,extracción de materiales de construcción y vertidos de aguas servidas domesticas que afectan a labiota acuática. Los resultados indican que desde las estaciones aguas arriba aun todavía presentanbajo impacto en calidad, mientras en las estaciones aguas abajo (estación 4, 5, 6, 7, 8, 9, 10) sonde alto riesgo por la contaminación, lo cual se ratifica con fuerte conductividad eléctrica, turbidez,eutrofización y desaparición de seres vivos acuáticos tornándose a ser un río muerto, parámetrosorganolépticos, físico-químicos, microbiológicos muy altos y la presencia de concentraciones deamoníaco y sales minerales que caracterizan agua dura inadmisibles para los seres vivos y consumohumano

Chemical Abundances of M-Dwarfs from the Apogee Survey. I. The Exoplanet Hosting Stars Kepler-138 and Kepler-186

We report the first detailed chemical abundance analysis of the exoplanet-hosting M-dwarf stars Kepler-138 and Kepler-186 from the analysis of high-resolution (R ∼ 22,500) H-band spectra from the SDSS-IV–APOGEE survey. Chemical abundances of 13 elements—C, O, Na, Mg, Al, Si, K, Ca, Ti, V, Cr, Mn, and Fe—are extracted from the APOGEE spectra of these early M-dwarfs via spectrum syntheses computed with an improved line list that takes into account H2O and FeH lines. This paper demonstrates that APOGEE spectra can be analyzed to determine detailed chemical compositions of M-dwarfs. Both exoplanet-hosting M-dwarfs display modest subsolar metallicities: [Fe/H]Kepler-138 = −0.09 ± 0.09 dex and [Fe/H]Kepler-186 = −0.08 ± 0.10 dex. The measured metallicities resulting from this high-resolution analysis are found to be higher by ∼0.1–0.2 dex than previous estimates from lower-resolution spectra. The C/O ratios obtained for the two planet-hosting stars are near-solar, with values of 0.55 ± 0.10 for Kepler-138 and 0.52 ± 0.12 for Kepler-186. Kepler-186 exhibits a marginally enhanced [Si/Fe] ratio

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores &gt;2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores &gt;2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score &gt;2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores &gt;2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores &gt;2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk