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The influence exerted by temperature on the resistant capacity of structural steel is well known. A highly efficient and increasingly widely used protection system for steel consists of the application of intumescent paints, which in the case of fire retard its destructive action. Their effectiveness is based on the property that when they come into contact with flames they react by swelling to form an insulating layer, referred to as intumescence, which impedes the propagation of heat. Though in general these paints do not require continuous maintenance, their service behaviour depends on the exposure conditions to which they are exposed. This paper studies the behaviour of an acrylated rubber type intumescent system exposed to two outdoor atmospheres. The same system is also studied with the protection of a topcoat paint layer. The coating’s capacity to intumesce has been measured before and after its exposure to the corresponding atmospheres by means of fire resistance tests applied at laboratory scale. The evolution of the coating’s behaviour with exposure time has been studied by means of thermal analysis (TG/DTA) and infrared spectroscopy (FTIR).Es de sobra conocida la influencia que ejerce la temperatura en la capacidad resistente del acero estructural. Un sistema de protección del acero, altamente efectivo y de uso creciente, consiste en la utilización de pinturas intumescentes, las cuales en el caso eventual de un incendio, retardan la acción destructora del mismo. Su efectividad se basa en el hecho de que al entrar en contacto con la llama reaccionan hinchándose y formando una capa aislante que se denomina intumescencia y que impide la propagación del calor. Aunque en general estas pinturas no precisan de un mantenimiento continuo, su comportamiento en servicio depende de las condiciones de exposición. Este trabajo estudia el comportamiento de un sistema intumescente de tipo caucho acrilado expuesto en dos atmósferas de exterior. Al mismo tiempo se estudia también dicho sistema protegido mediante la aplicación de una capa de acabado posterior. La capacidad de intumescer del recubrimiento ha sido medida antes y después de la exposición a la atmósfera correspondiente, mediante ensayos de resistencia al fuego aplicados a escala de laboratorio. La evolución con el tiempo de exposición del comportamiento del recubrimiento ha sido estudiada mediante análisis térmico (TG/DTA) y espectroscopía infrarroja (FTIR).

Osteochondrosis (OC) is a developmental orthopaedic disease of significant concern in numerous sport horse breeds, with significant international relevance. Using digital radiographs, we assessed the occurrence of hock (tarsocrural joint) OC in 3 048 Pura Raza Española (PRE) horses which took part in a morpho-functional test, in three specific locations in the tarsus limbs: the Distal Intermediate Ridge of the Tibia (DIRT), the lateral trochlear ridges of the talus (LTT), and the medial trochlear ridges of the talus (MTT). An incidence rate of 13.3% was found for hock OC in the analysed sample, with the highest incidence rate observed in DIRT (10.0%) and the lowest in MTT (0.2%). Estimates of genetic predisposition to hock OC were carried out using three genetic approaches: 1a) a binomial threshold model based on the presence or absence of OC, 1b) a multinomial threshold model, on a scale from 0 (absence) to 3 (maximum), and 2) a linear model. The effects considered in the models included sex, genetic origin and stud class. All the analyses were based on the Bayesian inference methodology, using the THRGIBBS3F90 software. The binomial threshold model yielded the most suitable results, with an estimated heritability for Overall hock OC of 0.71 ± 0.055 on the underlying scale (0.53 on the observed scale), ranging in different locations from 0.48 ± 0.087 (LTT) to 0.66 ± 0.063 (DIRT) on the underlying scale (0.10 and 0.38 on the observed scale, respectively). The highest significative genetic correlation was observed between Overall and DIRT (0.97) for approach 1a, and the lowest significant genetic correlation was between Overall and LTT (0.49), for approach 2. This study contributes valuable insights into the genetic predisposition towards, as well as for the potential for selective breeding against, hock OC in PRE horses, and provides a basis for future research and breeding programmes aimed at minimising the occurrence of hock OC and promoting the overall health of this breed., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Heart failure (HF) is a major contributor to global health challenges, affecting mortality rates and healthcare expenditure. Glucagon-like peptide-1 receptor agonists (GLP-1RA) offer promise in HF management, though their precise impact is unclear. The main objective of this study was to evaluate the effect of semaglutide on HF-related outcomes., Methods: We conducted a meta-analysis of studies assessing the effects of semaglutide therapy on HF-related outcomes. This meta-analysis was performed according to PRISMA guidelines. Randomized clinical trials or observational cohorts studies with a follow-up duration ≥ 6 months were included. The random-effects model was performed., Results: Six randomised clinical trials (n = 28,762 patients) and two observational studies were identified and considered eligible for this systematic review. A total of 14,608 subjects were assigned to the semaglutide group and 14,716 individuals were assigned to control or placebo groups. Overall, this meta-analysis shows that semaglutide use was associated with an decreased risk of HF (OR: 0.74; 95 % CI: 0.58 to 0.94, I 2 45 %), compared to placebo or control groups. The analytical evaluation does not suggest publication bias, and the sensitivity analysis demonstrated that the result was robust., Conclusion: This meta-analysis demonstrates that the use of semaglutide is associated with a reduction in clinical events related to HF. As HF is a heterogeneous clinical condition, further studies will be necessary to analyze this association in different subgroups of patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Aims: Several particular characteristics of patients with congenital heart disease could affect lipid levels. The objectives of this study were: a) to analyze the prevalence of dyslipidemia in congenital heart disease patients; 2) to compare lipid levels between congenital heart disease patients and a control group., Data Synthesis: This systematic review and meta-analysis was performed according to PRISMA guidelines (PROSPERO CRD42023432041). A literature search was performed to detect studies that have reported lipid levels or the prevalence of dyslipidemia in congenital heart disease patients. We performed a qualitative analysis (studies that reported dyslipidemia prevalence) and quantitative analysis (studies that compared lipid values between congenital heart disease patients and controls). In total, 29 observational studies involving 22,914 patients with congenital heart disease and 641,086 controls were eligible for this review. The reported presence of "hyperlipidemia" or "dyslipidemia" ranged from 14.3% to 69.9%. When studies analyzed lipid variables dichotomously between congenital heart disease patients and controls, the results were conflicting. The quantitative analysis showed that patients with congenital heart disease have lower levels of total cholesterol (MD: -18.9 [95% CI: -22.2 to -15.7]; I 2  = 93%), LDL-C (MD: -10.7 [95% CI: -13.1 to -8.3]; I 2  = 90%) and HDL-C (MD: -6.3 [95% CI: -7.7 to -4.9]; I 2  = 95%) compared to controls., Conclusions: The qualitative analysis showed some concerns, but the quantitative analysis indicates that congenital heart disease patients showed lower levels of total cholesterol, LDL-C, and HDL-C compared to controls. New research should be developed to clarify this relevant topic., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Higher rates of type 2 diabetes mellitus (T2D) are found among racial and ethnic minorities in the United States. These groups also experience a higher rate of cardiovascular and renal complications. Despite the previously mentioned high risk, these minority groups are usually underrepresented in clinical trials. The purpose of this study was to report the effect of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) on major cardiovascular events (MACE) in subgroup analysis along different ethnic/racial and geographical groups in patients with T2D included in cardiovascular outcomes trials (CVOTs). A meta-analysis of randomized studies that evaluated the use of GLP-1 RAs in patients with T2D and reporting MACE across ethnic/race and geographical regions groups was performed after searching the PubMed/MEDLINE, Embase, Scielo, Google Scholar, and Cochrane Controlled Trials databases. This meta-analysis was performed according to PRISMA guidelines. Measures of the effect size were expressed as odds ratios (ORs). Fixed or random effects models were used. Seven trials, including 58,294 patients, were identified and considered eligible for the analyses. GLP-1 RAs were associated with a reduction in MACE incidence in Europe (OR 0.77, 95% CI: 0.65-0.91) and Asia/Pacific (OR 0.70, 95% CI: 0.55-0.90) regions with no significant reduction observed in North America (OR 0.95, 95% CI: 0.86-1.05) and Latin America (OR 0.87, 95%CI: 0.63-1.21) MACE reduction was observed in all ethnic/race groups evaluated with exception to black patients. In this meta-analysis, we observed ethnic/racial and geographic disparities in MACE reduction with GLP-1 RAs in CVOTs. Consequently, we believe it is essential to systematically include and assess ethnic/racial minorities in clinical studies., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Financial interests: Author WM, ML, LB, PC and JPN declare they have no financial interests. Authors ALC and EF have received speaker honoraria from NovoNordisk and Raffo., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Accumulation of epicardial adipose tissue (EAT) and Subclinical hypothyroidism (SH) are associated with increased cardio-metabolic risk. The objective of this study was to quantitatively compare EAT thickening between patients with SH and healthy controls. Therefore, after searching the PubMed/MEDLINE, Embase, Science Direct, Scopus, Google Scholar, and Cochrane databases; we analyzed a group of observational studies who compare the EAT changes between SH vs control groups. A total of 9 studies were included in the final analysis, for a total of 424 patients with SH and 330 controls. Random or fixed effects models were used. Pooled analysis revealed that HS increased EAT (MD: 1.0 mm [0.40; 1.50]; P < 0.01). This meta-analysis suggests that the amount of EAT is significantly increased in SH patients. EAT might be a marker of cardiovascular risk in patients with SH., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Unexpected variability across healthcare datasets may indicate data quality issues and thereby affect the credibility of these data for reutilization. No gold-standard reference dataset or methods for variability assessment are usually available for these datasets. In this study, we aim to describe the process of discovering data quality implications by applying a set of methods for assessing variability between sources and over time in a large hospital database., Methods: We described and applied a set of multisource and temporal variability assessment methods in a large Portuguese hospitalization database, in which variation in condition-specific hospitalization ratios derived from clinically coded data were assessed between hospitals (sources) and over time. We identified condition-specific admissions using the Clinical Classification Software (CCS), developed by the Agency of Health Care Research and Quality. A Statistical Process Control (SPC) approach based on funnel plots of condition-specific standardized hospitalization ratios (SHR) was used to assess multisource variability, whereas temporal heat maps and Information-Geometric Temporal (IGT) plots were used to assess temporal variability by displaying temporal abrupt changes in data distributions. Results were presented for the 15 most common inpatient conditions (CCS) in Portugal., Main Findings: Funnel plot assessment allowed the detection of several outlying hospitals whose SHRs were much lower or higher than expected. Adjusting SHR for hospital characteristics, beyond age and sex, considerably affected the degree of multisource variability for most diseases. Overall, probability distributions changed over time for most diseases, although heterogeneously. Abrupt temporal changes in data distributions for acute myocardial infarction and congestive heart failure coincided with the periods comprising the transition to the International Classification of Diseases, 10th revision, Clinical Modification, whereas changes in the Diagnosis-Related Groups software seem to have driven changes in data distributions for both acute myocardial infarction and liveborn admissions. The analysis of heat maps also allowed the detection of several discontinuities at hospital level over time, in some cases also coinciding with the aforementioned factors., Conclusions: This paper described the successful application of a set of reproducible, generalizable and systematic methods for variability assessment, including visualization tools that can be useful for detecting abnormal patterns in healthcare data, also addressing some limitations of common approaches. The presented method for multisource variability assessment is based on SPC, which is an advantage considering the lack of gold standard for such process. Properly controlling for hospital characteristics and differences in case-mix for estimating SHR is critical for isolating data quality-related variability among data sources. The use of IGT plots provides an advantage over common methods for temporal variability assessment due its suitability for multitype and multimodal data, which are common characteristics of healthcare data. The novelty of this work is the use of a set of methods to discover new data quality insights in healthcare data., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objectives: This study aimed to describe trends and patterns of cause-specific hospitalizations in mainland Portugal between 2000 and 2016., Study Design: This was a retrospective observational study based on hospital discharge data during the period 2000-2016 in mainland Portugal., Methods: All inpatient hospital discharges among mainland Portuguese public hospitals were considered to evaluate trends and patterns over the years through hospitalization proportions, number of hospitalizations, age-standardized hospitalization rates (direct standardization using the European standard population), and the number of in-hospital stay days (bed-days). Health Cost and Utilization Project Clinical Classifications Software was used to categorize and cluster inpatients' principal diagnosis., Results: Between 2000 and 2002 and between 2014 and 2016, age-standardized hospitalization rates decreased by 8.6%. Moreover, "liveborn," "diseases of the heart," and "respiratory infections" were the leading hospitalization causes in both periods with a variation of -8.8%, -8.3%, and 13.4% on age-standardized hospitalization rate, respectively. The age-standardized hospitalization rate due to "bacterial infection" increased by 108.7%. "Respiratory diseases" are the leading cause responsible for more in-hospital stay days in the period 2014-2016 (48.6% increase). All Portuguese regions presented decreasing overall trends in their age-standardized hospitalization rates in the study period, yet increasing trends were observed until 2004 except for the Lisbon region; in addition, the number of in-hospital stay days remained relatively stable through time., Conclusions: Hospitalizations in mainland Portugal decreased between 2000 and 2016 with heterogeneous patterns considering time, age group, and gender. "Aspiration pneumonitis; food/vomitus," "diseases of the white blood cells," "other nutritional, endocrine, and metabolic disorders," "bacterial infection," and "pathological fractures" revealed substantial increases, and further evaluations and monitoring are required., (Copyright © 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Aims: This study evaluates the prevention quality indicators (PQI) for Diabetes Mellitus (DM) in Portugal using contemporary data and explores their variability according to Primary Health Care (PHC) quality indicators., Methods: We conducted a retrospective observational analysis of secondary data comprising Portuguese PHC indicators by health centres group (ACES) and the National Hospital Morbidity Database. We calculated and analysed age-sex-adjusted rates for each PQI. Worse-performing ACES were identified using the 2017 median PQI values as an assessment cut-off. A multivariate logistic analysis was carried to find variables associated with the likelihood of being a worse-performing ACES for the biennium., Results: The median values of the indicator PQI93 - Prevention Quality Diabetes Composite were 79 and 65.2 hospitalizations per 100 000 pop, in 2016 and 2017 respectively. Diabetes long term complications (PQI 03) accounted for most of the hospitalizations. The quality indicator in PHC with greater influence on PQI93 was the proportion of DM patients with <65 years with test results for HbA1c < = 6.5%., Conclusions: This study shows that some PHC quality indicators are closely related to DM care, and so their monitoring is of high importance. Diabetes long term complications (PQI 03) demand greater attention from PHC professionals., (Copyright © 2021 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Aims: Clinical trials showed that statin therapy decreased cardiovascular events without significantly raising the level of transaminases. However, the information in subjects with altered liver test at baseline is more limited. The objectives of this meta-analysis were to analyze the liver safety and cardiovascular benefit when using a statin-based lipid-lowering treatment compared to a less intensive treatment or placebo, in subjects with abnormal liver tests at baseline., Data Synthesis: We performed a meta-analysis including randomized trials of statin-based lipid-lowering therapy versus less intensive lipid-lowering therapy or placebo, reporting worsening hepatic test (>3 ULN) and cardiovascular events in patients with abnormal liver tests at baseline. The random-effects model was performed. This meta-analysis was performed according to PRISMA guidelines. Five eligible trials, including 2548 patients were identified and considered eligible for the analyses. A more intensive statin-based lipid-lowering therapy were associated with a similar occurrence of serious alteration of liver tests (OR: 0.90, 95% confidence interval: 0.21-3.99; I 2 : 64%) compared to less intensive or placebo treatments. Likewise, more intensive lipid-lowering strategies were associated with a significant reduction in major cardiovascular events (OR: 0.34, 95% confidence interval: 0.17-0.70; I 2 : 66%)., Conclusions: In this study, a more intensive statin-based lipid-lowering treatment, compared with less intensive treatment or placebo, showed a similar incidence of worsening transaminases levels in patients with abnormal liver tests at baseline. Also, a reduction in cardiovascular events was observed when a more intensive lipid-lowering therapy was used., (Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Objective/background: Endograft limb occlusion is a potential complication of endovascular aneurysm repair (EVAR), being one of the major causes of secondary interventions and rehospitalisation. The aim of this review is to report on the impact of endograft kinking in endograft limb occlusion, as well as on risk factors, prevention, early diagnosis, and management., Methods: A systematic review and meta-analysis was conducted according to the recommendations of the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement., Results: After a MEDLINE and Scopus search, 55 articles (27,509 patients) were included in the qualitative analysis and eight in the quantitative analysis. In this meta-analysis, 179 at risk limbs were treated by pre-emptive stenting, which significantly reduced the risk of limb occlusion: not pre-emptively stenting limbs at risk had a negative impact on graft limb patency (odds ratio 4.30, 95% confidence interval 1.45-12.78). Post-operatively, a kink was identified in 422 patients (1.5%), contributing to 42.8% of all limb occlusions. Relevant data support that completion angiography is an inadequate means of diagnosing high risk limbs, proposing cone beam computed tomography and intravascular ultrasound as adjuncts. The post-operative limb occlusion rate ranged from 0% to 10.6%, affecting 984 patients. Several risk factors for limb occlusion have been identified. Regarding treatment, most patients were submitted to femorofemoral bypass (52.3%) or to deployment of a bare metal stent, either alone or associated with catheter directed thrombolysis or mechanical thrombectomy (26.4%). Complications and outcome after re-intervention for limb occlusion are described infrequently in the literature, but single studies have reported on re-occlusion, major amputation, and limb occlusion related mortality rates., Conclusion: Pre-EVAR planning should focus on identification of risk factors for kinking. Adjunctive stenting is an effective prophylaxis for selected high risk limbs, yet intra-operative identification remains problematic. Also, it is noteworthy that most limb occlusions occur in the first year after EVAR, emphasising the importance of careful early follow up of high risk patients., (Copyright © 2019 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.)

Background: Ruptured abdominal aortic aneurysm (rAAA) remains a critical life-threatening condition. We aimed to evaluate rAAA management in our center focusing on predictors of mortality at 48 hr of intensive care unit (ICU) and to develop a new mortality prediction score considering data at 48 hr postprocedure. External validation of the modified score with patient data from independent vascular surgery centers was subsequently pursued., Methods: Clinical data of all patients admitted in our center from January 2010 to December 2017 with the diagnosis of rAAA were retrospectively reviewed for the development of the mortality prediction score. Subsequently, clinical data from patients admitted at independent centers from January 2010 to December 2017 were reviewed for external validation of the score. Statistical analysis was performed with SPSS Version 25., Results: A total of 78 patients were included in the first part of the study: 21 endovascular aneurysm repairs (EVARs), 56 open repairs (ORs), and 1 case of conservative management. Intraoperative mortality in EVAR and OR groups was 0% vs. 24.6%, respectively (P = 0.012). Thirty-day mortality reached 50% and 33% in the OR and EVAR groups. For patients alive at 48 hr, 30-day mortality diminished to 27.6%. Several preoperative predictors of outcome were identified: smoking (P = 0.004), hemodynamic instability(P = 0.004), and elevated international normalized ratio (P < 0.0001). Dutch Aneurysm Score and Vascular Study Group of New England Score (VSGNE) were also significant predictors of outcome (area under the receiver operating characteristic curve [ROC AUC] 0.89 and 0.79, respectively; P < 0.0001). At 48 hr of ICU stay, high lactate level, high Sequential Organ Failure Assessment score, need for hemodyalitic technique, and hemodynamic instability were significant risk predictors for 30-day mortality (P < 0.05). VSGNE score was modified with the inclusion of 2 variables: hemodynamic instability and lactate level at 48 hr and a new score was attained-Postoperative Aneurysm Score (PAS). Comparing AUC for VSGNE and PAS for patients alive at 48 hr, the latter was significantly better (AUC 0.775 vs. 0.852, P = 0.039). The PAS was applied and validated in 3 independent vascular surgery centers (AUC VSGNE 0.782 vs. AUC PAS 0.820, P = 0.027)., Conclusions: Despite recent evidence on preoperative predictors of survival in an era when both EVAR and OR are available, emergent decision to withhold life-saving treatment will always be extremely difficult. Therefore, the policy in our department is to try surgical repair in all cases. It remains important, however, to identify whether late deaths can be predicted, so that unnecessary prolonged treatment can be avoided. A PAS was delineated predicting 30-day mortality significantly better in patients alive at 48 hr. The score was externally applied and validated in independent centers, corroborating the score's usefulness., (Copyright © 2019 Elsevier Inc. All rights reserved.)

In the last decade, several laboratory-scale experiments have shown the use of nanoscale zero-valent iron (nZVI) to be effective in reducing metal(loid) availability in polluted soils. The present study evaluates the capacity of nZVI for reducing the availability of As and Hg in brownfield soils at a pilot scale, and monitors the stability of the immobilization of these contaminants over a 32 month period. To the best of our knowledge, this is the first study to apply nZVI to metal(loid)-polluted soils under field conditions. Two sub-areas (A and B) that differed in pollution load were selected, and a 5 m 2 plot was treated with 2.5% nZVI (by weight) in each case (Nanofer 25S, NanoIron). In sub-area A, which had a greater degree of pollution, a second application was performed eight months after the first application. Overall, the treatment significantly reduced the availability of both As and Hg, after only 72 h, although the effectiveness of the treatment was highly dependent on the degree of initial contamination. Sub-area B (with a lower level of pollution) showed the best and most stable immobilization results, with As and Hg in toxicity characteristics leaching procedure (TCLP) extracts decreasing by 70% and 80%, respectively. In comparison, the concentrations of As and Hg in sub-area A decreased by 65% and 50%, respectively. Based on our findings, the use of nZVI at a dose of 2.5% appears to be an effective approach for the remediation of soils at this brownfield site, especially in sub-area B. For sub-area A, a higher dose of nZVI-or its use in combination with other remediation strategies-should be tested., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The present study was conducted to describe the major seminal plasma proteome of rabbits and potential associations between seminal proteins and semen criteria. Semen samples were collected from 18 New Zealand adult rabbits, and seminal plasma proteins were analyzed by 2-D SDS-PAGE and tandem mass spectrometry. Sperm motility, vigor, concentration, morphology and membrane sperm viability were evaluated. Rabbits ejaculated 364 ± 70 million sperm/ml, with 81 ± 6.1% motile cells, 3.8 ± 0.2 vigor and 66.7 ± 2.5% sperm with normal morphology. Based on the viability and acrosome integrity assay, there were 65.8 ± 2.5% live sperm with intact acrosome and most spermatozoa had both intact acrosome and functional membrane. On average, 2-D gels of rabbit seminal plasma had 232 ± 69.5 spots, as determined by PDQuest software (Bio Rad, USA). Mass spectrometry allowed the identification of 137 different proteins. The most abundant proteins in rabbit seminal plasma were hemoglobin subunit zeta-like, annexins, lipocalin, FAM115 protein and albumin. The intensity of the spots associated with these five proteins represented 71.5% of the intensity of all spots detected in the master gel. Multiple regression models were estimated using sperm traits as dependent variables and seminal plasma proteins as independent ones. Also, sperm motility had positive association with beta-nerve growth factor and cysteine-rich secretory protein 1-like and a negative one with galectin-1. The percentage of rabbit sperm with intact membrane was related to seminal plasma protein FAM115 complex and tropomyosin. Then, the population of morphologically normal sperm in rabbit semen was positively linked to carcinoembryonic antigen-related cell adhesion molecule 6-like and down regulated by seminal plasma isocitrate dehydrogenase. Based on another regression model, the variation in the percentage of live sperm with intact acrosome was partially explained by the amount of leukocyte elastase inhibitor and the peptidyl-prolyl cis-trans isomerase A in the rabbit seminal fluid. The current study reports the identification of 137 proteins of rabbit seminal plasma. Major proteins of seminal secretion relate primarily to prevention of damages caused by lipid peroxide radicals and oxidative stress, membrane functionality, transport of lipids to the sperm membrane and temperature regulation. Moreover, finding seminal plasma proteins as indicators of semen parameters will improve assisted reproductive technologies., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: Acute carotid stent thrombosis (ACST) occurring in the first hours after the procedure is an exceedingly rare complication of carotid artery stenting, but it is potentially devastating. This review aimed to evaluate current literature, identifying all reported cases during the last two decades, with the final purpose of reporting predictive factors and early management., Methods: A systematic review and meta-analysis was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement., Results: A total of 464 potentially relevant articles were selected. After review of records at title and abstract level, 29 articles with 60 patients were included. Twelve studies reported on ACST incidence rate in their cohorts, ranging from 0.36% to as high as 33%. In considering etiology, antiplatelet noncompliance or resistance is the most frequently reported risk factor. Emergency procedures seemed to be associated with greater risk for ACST, reaching 5.6% to 33% incidence. Dual-layer stents were also associated with greater risk (45% vs 3.7%; P = .0001; odds ratio, 21.3). Use of an overlapping stent as a bailout procedure because of dissection, malposition, or long lesions was correlated with increased risk (7.3% vs 0.002%), as were long stenotic lesions (22.9 ± 6.83 mm vs 14.2 ± 6.42 mm; P = .0034) and stent length (3.8 ± 0.4 cm vs 2.8 ± 0.86 cm; P = .0055). ACST was associated with neurologic status deterioration in 56.7% of cases. Time to symptoms or ACST diagnosis had a median of 1.5 hours, with 30% occurring intraprocedurally. In asymptomatic ACST, conservative management was unanimous. Endovascular treatment was the most common approach to intraprocedural ACST. Surgical options included carotid endarterectomy with stent explantation (n = 9), which was also a bailout after failed endovascular treatment in two cases., Conclusions: ACST incidence is higher in emergent, neurologically unstable patients. Antiplatelet noncompliance, antiplatelet resistance, long stenotic lesions, use of more than one stent, and dual-layer stents are also associated with increased risk. The decision as to the best approach depends on whether ACST occurs intraprocedurally or afterward, the development of neurologic status deterioration, and the center's experience. However, additional studies must be undertaken to better define optimal management., (Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Objectives: This study sought to describe the incidence, determinants, and prognostic impact of cardiogenic shock (CS) in takotsubo syndrome (TTS)., Background: TTS can be associated with severe hemodynamic instability. The prognostic implication of CS has not been well characterized in large studies of TTS., Methods: We analyzed patients with a definitive TTS diagnosis (modified Mayo criteria) who were recruited for the National RETAKO (Registry on Takotsubo Syndrome) trial from 2003 to 2016. Cox and competing risk regression models were used to identify factors associated with mortality and recurrences., Results: A total of 711 patients were included, 81 (11.4%) of whom developed CS. Male sex, QTc interval prolongation, lower left ventricular ejection fraction at admission, physical triggers, and presence of "a significant" left intraventricular pressure gradient, were associated with CS (C index = 0.85). In-hospital complication rates, including mortality, were significantly higher in patients with CS. Over a median follow-up of 284 days (interquartile range: 94 to 929 days), CS was the strongest independent predictor of long-term, all-cause mortality (hazard ratio [HR]: 5.38; 95% confidence interval [CI]: 2.60 to 8.38); cardiovascular (CV) death (sub-HR: 4.29; 95% CI: 2.40 to 21.2), and non-CV death (sub-HR: 3.34; 95% CI: 1.70 to 6.53), whereas no significant difference in the recurrence rate was observed between groups (sub-HR: 0.76; 95% CI: 0.10 to 5.95). Among patients with CS, those who received beta-blockers at hospital discharge experienced lower 1-year mortality compared with those who did not receive a beta-blocker (HR: 0.52; 95% CI: 0.44 to 0.79; p interaction  = 0.043)., Conclusions: CS is not uncommon and is associated with worse short- and long-term prognosis in TTS. CS complicating TTS may constitute a marker of underlying disease severity and could identify a masked heart failure phenotype with increased vulnerability to catecholamine-mediated myocardial stunning., (Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Background: Major pelvic ilio-iliac arteriovenous fistula (AVF) is an exceedingly rare diagnosis with only a few described cases in the literature, most of them related to congenital defects or trauma. In this case report, we aim to present a case of an ilio-iliac AVF with an atypical clinical presentation., Methods: Relevant medical data were collected from hospital database., Results: The patient is a 77-year-old woman, with a relevant medical history of a temporally remote hysterectomy. She developed an exuberant unilateral right leg edema and was diagnosed with a femoro-iliac deep vein thrombosis (DVT) and started on anticoagulation and daily use of elastic compression stockings. No improvement in leg edema was evident, and she reported painful complaints refractory to medication. She also progressively developed right foot numbness and foot drop. A computed tomography angiography (CTA) was performed to exclude any compressive or paraneoplastic syndrome, with no remarkable findings other than common iliac vein (CIV) occlusion. As the patient's symptoms continued to worsen, a new CTA was performed 5 months later, which revealed an ilio-iliac AVF that was confirmed by angiography. After 2 ineffective attempts to embolize AVF afferents, we chose to completely embolize the arterial component of the AVF with Helix EV3 coils and Onyx glue (Covidien, Irvine, CA, USA). CIV recanalization and deployment of a Venovo stent (Bard Inc, Tempe, AZ, USA) was also performed. The final angiograms showed exclusion of the AVF and rapid venous flow through the stent. There was progressive improvement of edema and pain but little improvement of foot drop., Conclusion: AVF etiology and mechanism of neurologic deficits are controversial, with multiple possible explanations. Endovascular treatment modalities are promising a safer and more efficient approach when compared with open surgery. Our experience in this case was encouraging, but long-term results are currently lacking., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Chlorpyrifos (CPF) is an organophosphate insecticide described to induce cognitive disorders, both after acute and repeated administration. However, the mechanisms through which it induces these effects are unknown. CPF has been reported to produce basal forebrain cholinergic neuronal cell death, involved on learning and memory regulation, which could be the cause of such cognitive disorders. Neuronal cell death was partially mediated by oxidative stress generation, P75 NTR and α 7 -nAChRs gene expression alteration triggered through acetylcholinesterase (AChE) variants disruption, suggesting other mechanisms are involved. In this regard, CPF induces Aβ and tau proteins production and activation of GSK3β enzyme and alters glutamatergic transmission, which have been related with basal forebrain cholinergic neuronal cell death and development of cognitive disorders. According to these data, we hypothesized that CPF induces basal forebrain cholinergic neuronal cell death through induction of Aβ and tau proteins production, activation of GSK-3β enzyme and disruption of glutamatergic transmission. We evaluated this hypothesis in septal SN56 basal forebrain cholinergic neurons, after 24 h and 14 days CPF exposure. This study shows that CPF increases glutamate levels, upregulates GSK-3β gene expression, and increases the production of Aβ and phosphorylated tau proteins and all these effects reduced cell viability. CPF increases glutaminase activity and upregulates the VGLUT1 gene expression, which could mediate the disruption of glutamatergic transmission. Our present results provide new understanding of the mechanisms contributing to the harmful effects of CPF, and its possible relevance in the pathogenesis of neurodegenerative diseases., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Cadmium, an environmental neurotoxic compound, produces cognitive disorders, although the mechanism remains unknown. Previously, we described that cadmium induces a more pronounced cell death on cholinergic neurons from basal forebrain (BF). This effect, partially mediated by M1 receptor blockade, triggering it through AChE splices variants alteration, may explain cadmium effects on learning and memory processes. Cadmium has been also reported to induce oxidative stress generation leading to M2 and M4 muscarinic receptors alteration, in hippocampus and frontal cortex, which are necessary to maintain cell viability and cognitive regulation, so their alteration in BF could also mediate this effect. Moreover, it has been reported that antioxidant treatment could reverse cognitive disorders, muscarinic receptor and AChE variants alterations induced by cadmium. Thus, we hypothesized that cadmium induced cell death of BF cholinergic neurons is mediated by oxidative stress generation and this mechanism could produce this effect, in part, through AChE variants altered by muscarinic receptors disruption. To prove this, we evaluated in BF SN56 cholinergic neurons, whether cadmium induces oxidative stress and alters muscarinic receptors, and their involvement in the induction of cell death through alteration of AChE variants. Our results show that cadmium induces oxidative stress, which mediates partially the alteration of AChE variants and M2 to M4 muscarinic receptors expression and blockage of M1 receptor. In addition, cadmium induced oxidative stress generation by M1 and M3 receptors alteration through AChE variants disruption, leading to cell death. These results provide new understanding of the mechanisms contributing to cadmium harmful effects on cholinergic neurons., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Understanding the metal behavior at the soil-root interface is of utmost significance for a successful implementation of phytoremediation. In this study, we investigated the differences in chromium (Cr) uptake, chemical changes in soil solution and the shifts in rhizosphere bacterial communities of two genotypes of Silene vulgaris (SV21, SV38) with different tolerance to Cr. A greenhouse experiment was performed in two soils that differed on pH and organic matter (OM) content. An industrial sludge with high content in Cr was used as pollution source. The soil solution in the rhizosphere was sample by Rhizon Soil Moisture Samplers. The total concentration of Cr reached the highest values in soil solution samplers from calcareous soils with poor contents in OM. Plants grown in this soil also increased the Cr uptake in roots of both genotypes, but the concentration was higher in genotype SV-38 than in SV21. The clustering analysis of denaturing gradient gel electrophoresis (DGGE) of 16S rRNA fragments revealed major differences in bacterial community structure related to Cr pollution, followed by soil type and finally, plant genotype. Diversity indices based on DGGE profiles were the highest in alkaline soil, and between genotypes, values were significantly greater in SV38. Canonical correspondence analysis (CCA) showed that changes in bacterial community structure of rhizosphere were highly correlated with total Cr concentration and soil solution pH. The isolation and identification of S. vulgaris bacterial rhizosphere revealed a different composition according to soil type and plant genotype. Results suggested the potential role of Pseudomonas fluorescens on Cr mobilization and therefore, on enhanced metal bioavailability and may provide a starting point for further studies aimed at the combined use of tolerant plants and selected metal mobilizing rhizobacteria, in the microbial-assisted phytoremediation of Cr-polluted soils., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Paraquat (PQ) is a widely used non-selective contact herbicide shown to produce memory and learning deficits after acute and repeated exposure similar to those induced in Alzheimer's disease (AD). However, the complete mechanisms through which it induces these effects are unknown. On the other hand, cholinergic and glutamatergic systems, mainly in the hippocampus, are involved on learning, memory and cell viability regulation. An alteration of hippocampal cholinergic or glutamatergic transmissions or neuronal cell loss may induce these effects. In this regard, it has been suggested that PQ may induce cell death and affect cholinergic and glutamatergic transmission, which alteration could produce neuronal loss. According to these data, we hypothesized that PQ could induce hippocampal neuronal loss through cholinergic and glutamatergic transmissions alteration. To prove this hypothesis, we evaluated in hippocampal primary cell culture, the PQ toxic effects after 24h and 14 consecutive days exposure on neuronal viability and the cholinergic and glutamatergic mechanisms related to it. This study shows that PQ impaired acetylcholine levels and induced AChE inhibition and increased CHT expression only after 14days exposure, which suggests that acetylcholine levels alteration could be mediated by these actions. PQ also disrupted glutamate levels through induction of glutaminase activity. In addition, PQ induced, after 24h and 14days exposure, cell death on hippocampal neurons that was partially mediated by AChE variants alteration and cholinergic and gultamatergic transmissions disruption. Our present results provide new view of the mechanisms contributing to PQ neurotoxicity and may explain cognitive dysfunctions observed after PQ exposure., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Nanoscale zero valent iron (nZVI) particles obtained by different methods differ in their structure, which lead to different reactivity, and therefore a likely difference in the remediation efficiency. The present study compares the effectiveness of three commercial ZVI nanoparticles to immobilize As and Hg in two soils (A and B) collected from a brownfield highly contaminated by mining and metallurgy activities. Scarce data are available on the effectiveness of nZVI for Hg immobilization in soil. Two commercial nZVI slurries from Toda (RNIP and RNIP-D) and one from Nano Iron (25S) were used at different doses (1, 5 and 10%). The metal(loid) availability and mobility was evaluated with the TCLP test and Tessier extraction procedure. The influence of nZVI application on As and Hg speciation was also evaluated as well as its impact on soil pH, electrical conductivity and soil phytotoxicity to vetch germination. The three commercial nZVI particles significantly reduced As and Hg availability in the two soils studied, which led to a decrease in soil phytotoxicity. At the dose of 5% of nZVI a decrease of exchangeable-As higher than 70% was observed for both soils, whereas in the case of Hg, a higher dose of nZVI (10%) was necessary to achieve reductions of exchangeable-Hg between 63 and 90% depending on the type of nZVI and soil. No impact on soil pH and electrical conductivity was observed. The effectiveness of metal(loid) immobilization depended on type of nZVI, soil properties and metal(loid) characteristics. Nanoparticles from Nano Iron showed better results for As immobilization whereas RNIP nanoparticles were more effective for Hg. Overall, 25S at the dose of 5% resulted more effective than RNIP nanoparticles for the reduction of exchangeable-As (in the range of 6-14%), whereas RNIP and RNIP-D were 10 and 13% more effective, respectively, for the reduction of exchangeable-Hg at the dose of 10% in soil B. Thus, nZVI can be used for the remediation of highly As and Hg polluted soils, although previous experiments at lab scale are necessary to determine the most viable type of nZVI and its dose., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The effectiveness of single- and multi-metal(loid) immobilization of As, Cd, Cr, Pb and Zn using different doses of nanoscale zero-valent iron (nZVI) was evaluated and compared in two different soils, a calcareous and an acidic one. The effectiveness of nZVI to immobilize metal(loid)s in soil strongly depended on the metal characteristics, soil properties, dose of nZVI and presence of other metal(loid)s. In the case of single contamination, this nanoremediation strategy was effective for all of the metal(loid)s studied except for Cd. When comparing the two soils, anionic metal(loid)s (As and Cr) were more easily retained in acidic soil, whereas cationic metal(loid)s (Cd, Pb and Zn), were immobilized more in calcareous soil. In multi-metal(loid) contaminated soils, the presence of several metal(loid)s affected their immobilization, which was probably due to the competitive phenomenon between metal(loid) ions, which can reduce their sorption or produce synergistic effects. At 10% of nZVI, As, Cr and Pb availability decreased more than 82%, for Zn it ranged between 31 and 75% and for Cd between 13 and 42%. Thus, the application of nZVI can be a useful strategy to immobilize As, Cr, Pb and Zn in calcareous or acidic soils in both single- or multi-metal(loid) contamination conditions., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Cadmium is a toxic compound reported to produce cognitive dysfunctions, though the mechanisms involved are unknown. In a previous work we described how cadmium blocks cholinergic transmission and induces greater cell death in primary cholinergic neurons from the basal forebrain. It also induces cell death in SN56 cholinergic neurons from the basal forebrain through M1R blockage, alterations in the expression of AChE variants and GSK-3β, and an increase in Aβ and total and phosphorylated Tau protein levels. It was observed that the silencing or blockage of M1R altered ChAT activity, GSK-3β, AChE splice variants gene expression, and Aβ and Tau protein formation. Furthermore, AChE-S variants were associated with the same actions modulated by M1R. Accordingly, we hypothesized that cholinergic transmission blockage and higher sensitivity to cadmium-induced cell death of primary basal forebrain cholinergic neurons is mediated by M1R blockage, which triggers this effect through alteration of the expression of AChE variants. To prove this hypothesis, we evaluated, in primary culture from the basal forebrain region, whether M1R silencing induces greater cell death in cholinergic neurons than cadmium does, and whether in SN56 cells M1R mediates the mechanisms described so as to play a part in the cadmium induction of cholinergic transmission blockage and cell death in this cell line through alteration of the expression of AChE variants. Our results prove that M1R silencing by cadmium partially mediates the greater cell death observed on basal forebrain cholinergic neurons. Moreover, all previously described mechanisms for blocking cholinergic transmission and inducing cell death on SN56 cells after cadmium exposure are partially mediated by M1R through the alteration of AChE expression. Thus, our results may explain cognitive dysfunctions observed in cadmium toxicity., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

In the present study, the residual toxicity and impact of aged nZVI after a leaching experiment on heavy metal (Pb, Zn) polluted soils was evaluated. No negative effects on physico-chemical soil properties were observed after aged nZVI exposure. The application of nZVI to soil produced a significant increase in Fe availability. The impact on soil biodiversity was assessed by fluorescence in situ hybridization (FISH). A significant effect of nZVI application on microbial structure has been recorded in the Pb-polluted soil nZVI-treated. Soil bacteria molecular response, evaluated by RT-qPCR using exposure biomarkers (pykA, katB) showed a decrease in the cellular activity (pykA) due to enhanced intracellular oxidative stress (katB). Moreover, ecotoxicological standardised test on Caenorhabditis elegans (C. elegans) showed a decrease in the growth endpoint in the Pb-polluted soil, and particularly in the nZVI-treated. A different pattern has been observed in Zn-polluted soils: no changes in soil biodiversity, an increase in biological activity and a significant decrease of Zn toxicity on C. elegans growth were observed after aged nZVI exposure. The results reported indicated that the pollutant and its nZVI interaction should be considered to design soil nanoremediation strategies to immobilise heavy metals., (Copyright © 2015 Elsevier B.V. All rights reserved.)

4-Aminopyridine (4-AP) is an orphan drug indicated for the treatment of neuromuscular disorders. There is a great controversy around the use of this drug because of its narrow safety index and because a large number of adverse effects have been reported. Moreover, it was shown to induce cell death in different cell lines, being reported mainly apoptosis and necrosis as the principal pathways of cell death mediated by blockage of K channels or the Na, K-ATPase, but until now it was not described in vivo cell death induced by 4-aminipyridine. To provide new subchronic toxicity data and specifically, evaluate if 4-AP is able to induce in vivo cell death process and the main pathways related to it, a repeated dose (28 days) oral toxicity study, at therapeutic range of doses, was conducted in rats. The anatomical pathology, the biochemical and hematological parameters were analyzed and a real-time PCR array analysis was developed with an Ingenuity Pathway Analysis (IPA). The leucocytes number, the lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) enzymatic activity were increased at all dose but the erythrocytes number, the hemoglobin concentration, the alkaline phosphatase (FAL) and alanine aminotransferase (ALT) enzymatic activity were increased only at highest dose studied. However, glucose levels decreased at all doses. The biochemical results are indicative of hepatic damage. The anatomy pathology studies showed cell death only on liver and kidney, and the real-time PCR array on liver tissue expressed a gene expression profile of necrotic and apoptotic induced cell death. The present work shows for the first time in vivo cell death on liver and kidney with features of apoptosis and necrosis induced by 4-AP and the gene expression profile shows that the cell death is mediated by necrotic and apoptotic pathways that support this finding., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

This study investigated the subcellular compartmentalization of focal adhesion kinase (FAK) fragments and their regulation during apoptosis of human umbilical vein endothelial cells. A 50 kDa NH(2)-terminal FAK fragment and a 120 kDa FAK variant were constitutively expressed and specifically found in the nuclear fraction of cells, while a 55 kDa COOH-terminal FAK fragment was only in the cytosolic fraction. FAK cleavage fragments generated during apoptosisremained in the cytosol, while p120FAK and p50 NH(2)-terminal FAK remained in the nuclear compartment. The caspase inhibitor, ZVAD-fmk, prevented the apoptosis-induced proteolysis of p125 and p120FAK, generation of the 80 kDa cleavage product, and increased expression of p50N-FAK. Western blot with phospho-specific FAK showed that nuclear p125(FAK) was phosphorylated at a significant level at Y861, while FAK phosphorylated at Y397 and Y407 was largely in the cytosol. These results indicate that FAK NH(2)- and COOH-terminal domain fragments are segregated between nuclear and cytosolic compartments in endothelial cells and suggest novel functions for the FAK NH(2)-terminal domain., (Copyright 2000 Academic Press.)

Background: Exhaled oral nitric oxide (NO), a reported marker of inflammation in the respiratory tract, can be elevated by "upper respiratory tract infections." However, the responsible viruses and the time course of this rise in NO are not clear., Objective: To determine the expired nasal and oral NO levels during experimentally induced influenza A infection in 14 healthy volunteers without a history of asthma, rhinitis, or sinusitis., Methods: After being housed in individual rooms, susceptible volunteers were inoculated with 10(6) 50% tissue culture infective dose of influenza A/Texas/36/91/(H1N1) virus on a single occasion by intranasal drops. Volunteers remained in the isolation unit for 8 days and returned for follow-up 21 days after inoculation. Symptom scores and nasal washing for viral culture were obtained daily. NO samples from the mouth and nose were obtained on days 0 through 4, 8, and 21 by having the patient perform a slow vital capacity maneuver through a plastic tube into a Mylar balloon., Results: All patients had influenza virus cultured from nasal washings (12 of 14 on day 1, 14 of 14 by day 5). Patient symptom scores peaked on day 3 (mean+/-SE; 15.4+/-3.2) and returned to baseline by day 8. Preinfection exhaled nasal NO (right, 28.4+/-3.7 parts per billion [ppb]; left, 27.7+/-4.6 ppb) was significantly higher than oral NO (5.8 ppb; p<0.001). Exhaled oral NO was significantly elevated on day 8 postinoculation (12.9+/-0.8 ppb; p<0.01 Bonferroni) and returned to baseline at follow-up. Nasal NO levels showed a slight decrease on days 2 to 4 but returned to baseline by day 8., Conclusion: Experimental influenza virus infection can increase oral but not nasal exhaled NO levels. The timing of exhaled NO changes suggests that NO does not contribute to illness manifestations directly.

A retrospective study has analyzed 562 sun-related burns out of 19,643 patients treated at our institution from 1 March 1988 to 28 February 1991. These patients were analysed according to sex, age, burn area, mode and length of treatment and outcome. Females, mainly adults, represented 60.8 per cent of all patients presenting burned due to sun bathing. There is a marked seasonal incidence, proportionally constant throughout these 3 years. The main causes of injury were sun only (36.7 per cent), sun plus fig leaf 'tea' tanning lotion (17.7 per cent) and lemon juice (17.7 per cent). Healing to normal skin appearance was achieved in 99.1 per cent, 0.7 per cent healed with scarring and one patient died due to massive sepsis. The effect of sunlight on skin and the process of 'sunburn' when using homemade plant-derived tanning lotions containing substances which can induce a photodermatitis reaction is also discussed.

This is a retrospective study analysing 12,423 patients treated at our institution from 1 July 1988 to 30 June 1990. Burn incidence and mode of treatment were classified according to age and sex, as well as causative agent, place of the accident, length of treatment and outcome. 96.6 per cent of the patients were surgically treated, about 41 per cent of the patients were under 14 years of age. The most frequent cause of injury was related to meal preparation, with more than two-thirds of the accidents occurring at home. Only large or complicated burns (1094-8.8 per cent) were admitted, with 49 deaths occurring during this period. We conclude that children and younger adults are at greater risk of being burned and preventative measures should be oriented towards the prevention of such accidents.