Concomitant pulmonary embolism and aortic dissection: approach to anticoagulation

Os autores descrevem um caso de uma doente admitida após episódio pré-sincopal associado a precordialgia e cujo ecocardiograma sumário feito no Servic¸o de Urgência demonstrou alterac¸ões compatíveis com tromboembolismo pulmonar, tendo a doente sido submetida a terapêutica fibrinolítica, após episódio de paragem cardiorrespiratória. Na angiotomografia de tórax feita posteriormente para confirmac¸ão diagnóstica demonstra-se a presenc¸a não só de trombos no nível da artéria pulmonar, mas também de dissec¸ão da aorta Stanford B, tendo-se optado pela manutenc¸ão de anticoagulac¸ão terapêutica e a doente evoluído de forma favorável.The authors describe a case of a patient admitted with a pre-syncopal episode and precordial discomfort, and whose cardiac ultrasound performed in the Emergency Room was suggestive of Pulmonary Embolism. The patient was submitted to fibrinolytic therapy after cardiac arrest. The computerized tomography done after this episode not only confirmed the presence of pulmonary embolism but had also shown a Stanford Type B Aortic Dissection. The option was to maintain the therapeutic anticoagulation, having the patient evolved favourably.info:eu-repo/semantics/publishedVersio

Towards the Opening of a Magnetic Observatory at Dome C (Antarctica)

The opening of a new magnetic observatory is one of the activities aimed at by the creation of a scientific base at DomeC, Antarctica (lat. 75° 06’S, long. 123° 21’E, elev. 3200m). There are many reasons supporting this objective: all Antarctic magnetic observatories providing absolute values are located along the shore and are therefore subject to coast effects and crustal field contamination. DomeC and Vostok will be so far the sole observatories free from these effects. On one hand, high latitude absolute observatories are very useful to global or regional modeling based upon satellite data, because, at high latitudes, only total field measurements can be used due to the strong influence of field aligned currents. On the other hand, the availability of magnetic data from the well distributed observatories of Terra Nova Bay (TNB), Scott Base (SBA), Dumont d’Urville (DRV), Casey (CSY) and Vostok (VOS) will provide strong support to auroral and polar cap ionosphere studies as well as asymmetry analyses between Northern and Southern hemispheres. This paper summarizes the results gathered during three summer campaigns, in 1999-2000, 2001 and 2003-2004

Influence of Nanoparticle Size and Shape on Oligomer Formation of an Amyloidogenic Peptide

Understanding the influence of macromolecular crowding and nanoparticles on the formation of in-register $\beta$-sheets, the primary structural component of amyloid fibrils, is a first step towards describing \emph{in vivo} protein aggregation and interactions between synthetic materials and proteins. Using all atom molecular simulations in implicit solvent we illustrate the effects of nanoparticle size, shape, and volume fraction on oligomer formation of an amyloidogenic peptide from the transthyretin protein. Surprisingly, we find that inert spherical crowding particles destabilize in-register $\beta$-sheets formed by dimers while stabilizing $\beta$-sheets comprised of trimers and tetramers. As the radius of the nanoparticle increases crowding effects decrease, implying smaller crowding particles have the largest influence on the earliest amyloid species. We explain these results using a theory based on the depletion effect. Finally, we show that spherocylindrical crowders destabilize the ordered $\beta$-sheet dimer to a greater extent than spherical crowders, which underscores the influence of nanoparticle shape on protein aggregation

Nonequilibrium Transport through a Kondo Dot in a Magnetic Field: Perturbation Theory

Using nonequilibrium perturbation theory, we investigate the nonlinear transport through a quantum dot in the Kondo regime in the presence of a magnetic field. We calculate the leading logarithmic corrections to the local magnetization and the differential conductance, which are characteristic of the Kondo effect out of equilibrium. By solving a quantum Boltzmann equation, we determine the nonequilibrium magnetization on the dot and show that the application of both a finite bias voltage and a magnetic field induces a novel structure of logarithmic corrections not present in equilibrium. These corrections lead to more pronounced features in the conductance, and their form calls for a modification of the perturbative renormalization group.Comment: 16 pages, 7 figure

The Impact of a SIG on Assessment Literacy

A major aim of professional associations is to provide opportunities for professionals to interact with others, share ideas and develop in their chosen profession. Professional associations exist to provide specialized networking and development opportunities to a specific profession, group of individuals or field of study. To promote and support specialized research and communication, smaller subgroups within an association are often chartered or developed. These subgroups are typically known as Special Interest Groups. According to Jacob et al. (2013), association members join SIGs because they want to go deeper into a specialized content area and they enjoy networking with others who ‘speak the same language.’ The TESOL Arabia Testing, Assessment and Evaluation SIG (TAE SIG) has focused their professional development activities on an important trend in the field, that of language assessment literacy (LAL). Language assessment literacy has been a critical topic in English language teaching since the late 1990s. Unfortunately, this is mainly due to the fact that so many English language teachers are not assessment literate. In other words, many English language teachers lack the knowledge and skills to write effective language tests, evaluate the effectiveness of their tests, and use their test results in meaningful ways. The purpose of this chapter is to critically examine the status of LAL in the Middle East and North Africa (MENA) region and report on activities that the TAE SIG has implemented to increase LAL

Beyond Hybridity to the Politics of Scale: International Intervention and 'Local' Politics

The evident failures of international peacebuilding and statebuilding interventions (PSBIs) have recently prompted a focus on the interaction between interventions and target societies and states. Especially popular has been the ‘hybridity’ approach, which understands forms of peace and governance emerging through the mixing of local and international agendas and institutions. This article argues that hybridity is a highly problematic optic. Despite contrary claims, hybridity scholarship falsely dichotomizes ‘local’ and ‘international’ ideal-typical assemblages, and incorrectly presents outcomes as stemming from conflict and accommodation between them. Scholarship in political geography and state theory provides better tools for explaining PSBIs’ outcomes as reflecting socio-political contestation over power and resources. We theorize PSBIs as involving a politics of scale, where different social forces promote and resist alternative scales and modes of governance, depending on their interests and agendas. Contestation between these forces, which may be located at different scales and involved in complex, tactical, multi-scalar alliances, explains the uneven outcomes of international intervention. We demonstrate this using a case study of East Timor, focusing on decentralization and land policy

Medicine and psychiatry in Western culture: Ancient Greek myths and modern prejudices

The origins of Western culture extensively relate to Ancient Greek culture. While many ancient cultures have contributed to our current knowledge about medicine and the origins of psychiatry, the Ancient Greeks were among the best observers of feelings and moods patients expressed towards medicine and toward what today is referred to as 'psychopathology'. Myths and religious references were used to explain what was otherwise impossible to understand or be easily communicated. Most ancient myths focus on ambiguous feelings patients may have had towards drugs, especially psychotropic ones. Interestingly, such prejudices are common even today

A search for trachoma in Timor-Leste: no evidence to justify undertaking population-based prevalence surveys

Purpose: We sought evidence to justify undertaking population-based trachoma surveys in Timor-Leste, believing that in the absence of such evidence, the country could be categorized as not needing interventions to eliminate trachoma.Methods: We undertook a systematic review of published literature on trachoma in Timor-Leste, with results updated to 28 April 2018. We also undertook a series of clinic- and field-based screening exercises, consisting of: (1) in October 2015, conjunctival examination of all children attending a school in Vila, Atauro Island; (2) from 1 November 2016 to 30 April 2017, examination for trichiasis, by specifically-trained frontline eye workers, of all individuals presenting to the ophthalmic clinics of six referral hospitals and five district eye clinics; and (3) house-to-house case searches in a total of 110 households, drawn from three communities that were reported by investigators from the 2016 Rapid Assessment of Avoidable Blindness (RAAB) to include residents with trachoma.Results: Three RAABs (2005, 2009–2010, 2016) and two relevant published papers were identified. The 2016 RAAB reported one female subject to have been diagnosed with trachomatous corneal opacity. Re-examination of that individual revealed that she had ankyloblepharon, without evidence of trichiasis or entropion. No children on Atauro Island, no clinic attendees, and no individuals examined in the targeted house-to-house searches had any sign of trachoma.Conclusion: Trachoma is very unlikely to be a public health problem in Timor-Leste. It would not be appropriate to incur the costs of conducting formal population-based trachoma prevalence surveys here

The effects of social determinants of health on acquired immune deficiency syndrome in a low-income population of Brazil: a retrospective cohort study of 28.3 million individuals.

BACKGROUND: Social determinants of health (SDH) include factors such as income, education, and race, that could significantly affect the human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS). Studies on the effects of SDH on HIV/AIDS are limited, and do not yet provide a systematic understanding of how the various SDH act on important indicators of HIV/AIDS progression. We aimed to evaluate the effects of SDH on AIDS morbidity and mortality. METHODS: A retrospective cohort of 28.3 million individuals was evaluated over a 9-year period (from 2007 to 2015). Multivariable Poisson regression, with a hierarchical approach, was used to estimate the effects of SDH-at the individual and familial level-on AIDS incidence, mortality, and case-fatality rates. FINDINGS: A total of 28,318,532 individuals, representing the low-income Brazilian population, were assessed, who had a mean age of 36.18 (SD: 16.96) years, 52.69% (14,920,049) were female, 57.52% (15,360,569) were pardos, 34.13% (9,113,222) were white/Asian, 7.77% (2,075,977) were black, and 0.58% (154,146) were indigenous. Specific socioeconomic, household, and geographic factors were significantly associated with AIDS-related outcomes. Less wealth was strongly associated with a higher AIDS incidence (rate ratios-RR: 1.55; 95% confidence interval-CI: 1.43-1.68) and mortality (RR: 1.99; 95% CI: 1.70-2.34). Lower educational attainment was also greatly associated with higher AIDS incidence (RR: 1.46; 95% CI: 1.26-1.68), mortality (RR: 2.76; 95% CI: 1.99-3.82) and case-fatality rates (RR: 2.30; 95% CI: 1.31-4.01). Being black was associated with a higher AIDS incidence (RR: 1.53; 95% CI: 1.45-1.61), mortality (RR: 1.69; 95% CI: 1.57-1.83) and case-fatality rates (RR: 1.16; 95% CI: 1.03-1.32). Overall, also considering the other SDH, individuals experiencing greater levels of socioeconomic deprivation were, by far, more likely to acquire AIDS, and to die from it. INTERPRETATION: In the population studied, SDH related to poverty and social vulnerability are strongly associated with a higher burden of HIV/AIDS, most notably less wealth, illiteracy, and being black. In the absence of relevant social protection policies, the current worldwide increase in poverty and inequalities-due to the consequences of the COVID-19 pandemic, and the effects of war in the Ukraine-could reverse progress made in the fight against HIV/AIDS in low- and middle-income countries (LMIC). FUNDING: National Institute of Allergy and Infectious Diseases (NAIDS), National Institutes of Health (NIH), US Grant Number: 1R01AI152938