Thrombotic risk assessment in antiphospholipid syndrome: do noncriteria antibodies contribute?

BACKGROUND/AIM: In this cross-sectional study, it was aimed to test the predictive value of noncriteria antiphospholipid antibodies (aPL) in addition to the global antiphospholipid syndrome score (GAPSS) in predicting vascular thrombosis (VT) in a cohort of patients with APS and aPL (+) systemic lupus erythematosus (SLE). MATERIAL AND METHODS: This study included 50 patients with primary APS, 68 with SLE/APS, and 52 with aPL (+) SLE who were classified according to VT as VT ± pregnancy morbidity (PM), PM only or aPL (+) SLE. Antiphospholipid serology consisting of lupus anticoagulant (LA), anticardiolipin (aCL) immunoglobulin G (IgG)/IgM/IgA, antibeta2 glycoprotein I (aβ2GPI) IgG/IgM/IgA, antiphosphatidylserine/prothrombin (aPS/PT) IgG/IgM and antidomain-I (aDI) IgG was determined for each patient. The GAPSS and adjusted GAPSS (aGAPSS) were calculated for each patient, as previously defined. Logistic regression analysis was carried out with thrombosis as the dependent variable and high GAPSS, aCL IgA, aβ2GPI IgA, and aDI IgG as independent variables. RESULTS: The mean GAPSS and aGAPSS of the study population were 11.6 ± 4.4 and 9.6 ± 3.8. Both the VT ± PM APS (n = 105) and PM only APS (n = 13) groups had significantly higher GAPSS and aGAPSS values compared to the aPL (+) SLE (n = 52) group. The patients with recurrent thrombosis had higher aGAPSS but not GAPSS than those with a single thrombotic event. The computed area under the receiver operating characteristic curve demonstrated that a GAPSS ≥13 and aGAPSS ≥10 had the best predictive values for thrombosis. Logistic regression analysis including a GAPSS ≥13, aCL IgA, aβ2GPI IgA, and aDI IgG showed that none of the factors other than a GAPSS ≥13 could predict thrombosis. CONCLUSION: Both the GAPSS and aGAPSS successfully predict the thrombotic risk in aPL (+) patients and aCL IgA, aβ2GPI IgA, and aDI IgG do not contribute to high a GAPSS or aGAPSS

Collision and symmetry-breaking in the transition to strange nonchaotic attractors

Strange nonchaotic attractors (SNAs) can be created due to the collision of an invariant curve with itself. This novel ``homoclinic'' transition to SNAs occurs in quasiperiodically driven maps which derive from the discrete Schr\"odinger equation for a particle in a quasiperiodic potential. In the classical dynamics, there is a transition from torus attractors to SNAs, which, in the quantum system is manifest as the localization transition. This equivalence provides new insights into a variety of properties of SNAs, including its fractal measure. Further, there is a {\it symmetry breaking} associated with the creation of SNAs which rigorously shows that the Lyapunov exponent is nonpositive. By considering other related driven iterative mappings, we show that these characteristics associated with the the appearance of SNA are robust and occur in a large class of systems.Comment: To be appear in Physical Review Letter

Intermittency transitions to strange nonchaotic attractors in a quasiperiodically driven Duffing oscillator

Different mechanisms for the creation of strange nonchaotic attractors (SNAs) are studied in a two-frequency parametrically driven Duffing oscillator. We focus on intermittency transitions in particular, and show that SNAs in this system are created through quasiperiodic saddle-node bifurcations (Type-I intermittency) as well as through a quasiperiodic subharmonic bifurcation (Type-III intermittency). The intermittent attractors are characterized via a number of Lyapunov measures including the behavior of the largest nontrivial Lyapunov exponent and its variance as well as through distributions of finite-time Lyapunov exponents. These attractors are ubiquitous in quasiperiodically driven systems; the regions of occurrence of various SNAs are identified in a phase diagram of the Duffing system.Comment: 24 pages, RevTeX 4, 12 EPS figure

Succinic semialdehyde dehydrogenase deficiency: Lessons from mice and men

Succinic semialdehyde dehydrogenase (SSADH) deficiency, a disorder of GABA degradation with subsequent elevations in brain GABA and GHB, is a neurometabolic disorder with intellectual disability, epilepsy, hypotonia, ataxia, sleep disorders, and psychiatric disturbances. Neuroimaging reveals increased T2-weighted MRI signal usually affecting the globus pallidus, cerebellar dentate nucleus, and subthalamic nucleus, and often cerebral and cerebellar atrophy. EEG abnormalities are usually generalized spike-wave, consistent with a predilection for generalized epilepsy. The murine phenotype is characterized by failure-to-thrive, progressive ataxia, and a transition from generalized absence to tonic-clonic to ultimately fatal convulsive status epilepticus. Binding and electrophysiological studies demonstrate use-dependent downregulation of GABA(A) and (B) receptors in the mutant mouse. Translational human studies similarly reveal downregulation of GABAergic activity in patients, utilizing flumazenil-PET and transcranial magnetic stimulation for GABA(A) and (B) activity, respectively. Sleep studies reveal decreased stage REM with prolonged REM latencies and diminished percentage of stage REM. An ad libitum ketogenic diet was reported as effective in the mouse model, with unclear applicability to the human condition. Acute application of SGS–742, a GABA(B) antagonist, leads to improvement in epileptiform activity on electrocorticography. Promising mouse data using compounds available for clinical use, including taurine and SGS–742, form the framework for human trials

Use of nanomaterials in the pretreatment of water samples for environmental analysis

The challenge of providing clean drinking water is of enormous relevance in today’s human civilization, being essential for human consumption, but also for agriculture, livestock and several industrial applications. In addition to remediation strategies, the accurate monitoring of pollutants in water sup-plies, which most of the times are present at low concentrations, is a critical challenge. The usual low concentration of target analytes, the presence of in-terferents and the incompatibility of the sample matrix with instrumental techniques and detectors are the main reasons that renders sample preparation a relevant part of environmental monitoring strategies. The discovery and ap-plication of new nanomaterials allowed improvements on the pretreatment of water samples, with benefits in terms of speed, reliability and sensitivity in analysis. In this chapter, the use of nanomaterials in solid-phase extraction (SPE) protocols for water samples pretreatment for environmental monitoring is addressed. The most used nanomaterials, including metallic nanoparticles, metal organic frameworks, molecularly imprinted polymers, carbon-based nanomaterials, silica-based nanoparticles and nanocomposites are described, and their applications and advantages overviewed. Main gaps are identified and new directions on the field are suggested.publishe

Turkish Arabesk music and the changing perceptions of melancholy in Turkish society

In this article, I look at the popular Turkish music genre known as Arabesk. Arabesk is a musical synthesis of Turkish Classical Music, folk music, Western popular music and Egyptian bellydance music (Stokes, 1994: 23), and articulates a collective mode of melancholy. This music was traditionally associated with working class Turks and often derided by middle class intellectual elites as representing an affront to the ideals of a modernised and westernised Kemalist Turkish Republic. Initially composed and/or performed by artists such as Orhan Gencebay and Müslüm Gürses, the most classic Arabesk songs encompass an ever-present feeling of melancholy, loss and displacement, of nostalgia for family, for the beloved, and a lack of any prospect for a better future. This paper focuses on more traditional examples of Arabesk produced during the 1970s, particularly Orhan Gencebay’s and Müslum Gürses’ music, rather than relatively new music forms exemplified by Ibrahim Tatlıses and Küçük Emrah in the 1980s and Mahsun Kırmızıgül and Özcan Deniz in the 1990s. The reason for this limitation is, first of all, that Arabesk music has evolved and assumed too numerous facets to handle within the scope of a single article. Secondly, as several critics have pointed out, in the 1990s Arabesk became closer to pop music, and lost, to some extent, the characteristics that made it melancholic. For the purposes of this article, first, I provide some brief definitions of melancholy from the Western tradition and compare these with recent definitions of collective melancholy in Turkish culture. I then describe Arabesk music’s relationship to melancholy and how this relationship was in conflict with the Kemalist ideology, which was shaped by progressivism, optimism and the ideal of Westernization. Finally, I briefly discuss how the reactions to Arabesk by the upper and middle class educated Turkish elite have changed through the decades from derision to ‘kitsch’ celebration and analyse some of the reasons behind it.10 page(s