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Recognizing and classifying human actions in video clips is a powerful technology for surveillance applications. However, most of the state-of-the-art approaches for this task lack the possibility of being implemented in real-time applications without causing a critical delay. Thus, we propose a fast method to human action recognition for visual question answering, based on a novel feature extractor developed by us, 2D pose estimation, and machine learning techniques. Our extractor obtains features based on distances, angles, and positions of detected anatomical keypoints. We used the UCF101 dataset that corresponds to 13,320 videos with realistic human actions, collected from YouTube, for our work evaluation. The proposed feature extractor, combined with the Complement Naive Bayes classifier, reached a mean Average Precision ( m A P ) of 62.03 % and processed 5.26 frames per second, proving to be faster than most methods while achieving a decent m A P .

Rice is the basic food for over half the global population. Paddy cultivation is limited by environmental stressors, which tend to worsen with climate change. In addition, an increase in food demand is expected soon. Therefore, innovative agricultural technologies capable of increasing food production without increasing agricultural frontiers are needed. Some microorganisms can confer plant tolerance to environmental stresses; however, research with rhizospheric bacteria inducing cold tolerance in rice plants is scarce. In this work, we evaluated the prokaryotic community of cold-impacted rice paddies and the ability of selected rhizospheric bacteria towards increasing rice tolerance to cold temperatures without resulting in yield penalties. The most abundantly identified phyla (Proteobacteria, Acidobacteria, and Actinobacteria) are common soil bacteria, which harbor most plant growth-promoting bacteria (PGPB) and should be responsible for plant protection from abiotic stresses, such as low temperature. From these soils, nine PGPB were selected and inoculated in cold-stressed rice plants, and two (Kosakonia sp. CIR2 and Staphylococcus sp. CSR1T2) were able to confer cold tolerance to rice plants. These cold-stressed plants inoculated with CIR2 and CSR1T2 presented higher survival rates (69% and 85%, respectively) than non-inoculated plants (33%). In the greenhouse, cold-stressed inoculated plants reached the reproductive cycle approximately 25 days earlier than non-inoculated plants, besides presenting increased fertility (percentage of full seeds/full seeds per plant) and improvement in yield parameters (weight of 1,000 full seeds, grain length, seed weight per plant, and seed yield). These data can contribute to the improvement of inoculation practices in rice plants and to the maintenance of rice production in environments impacted by low-temperature stress in early developmental stages.

Background: Aortic dilation, stiffening, and dissection are common and potentially lethal complications of Marfan syndrome (MFS) and Loeys-Dietz syndrome (LDS), which involve abnormal transforming growth factor beta (TGF-β) signalling. The relation of aortic dimensions, stiffness, and biomarker levels is unknown. The objective of this study was to measure aortic dimensions, stiffness, TGF-β and matrix metalloproteinase (MMP) levels, and endothelial function in patients with MFS, and to compare TGF-β levels in patients with MFS receiving different therapeutic regimens. Methods: This was a cohort study of 40 MFS and 4 LDS patients and 87 control participants. Aortic dimension and stiffness indexes, including pulse wave velocity (PWV), were measured using echocardiography and Doppler. Total and free TGF-β and MMP blood levels were measured using Quantikine (R&D Systems, Inc, Minneapolis, MN) and Quanterix (Billerica, MA) kits. Endothelial function was measured using brachial artery flow-mediated dilation. Results: PWV was increased in patients with MFS. There were increased MMP-2 levels in those with MFS but no increase in free or total TGF-β or MMP-9 levels compared with control participants. There was no difference in TGF-β levels between MFS patients receiving no medications, angiotensin receptor blockers, and β-blockers. PWV correlated most strongly with age. Endothelial function showed premature gradual decline in patients with MFS. Conclusions: Despite the increased PWV, monitoring aortic stiffness or TGF-β levels would not be helpful in patients with MFS. TGF-β levels were not increased and the increased MMP-2 levels suggest consideration of a different therapeutic target. Résumé: Contexte: La dilatation, la rigidification et la dissection de l’aorte sont des complications fréquentes et parfois mortelles du syndrome de Marfan (SM) et du syndrome de Loeys-Dietz (SLD), qui sont tous deux dûs à une anomalie de la voie de signalisation du facteur de croissance transformant bêta (TGF-β). On ne connaît pas la relation entre les dimensions et la rigidité de l’aorte et la présence de biomarqueurs. Notre étude visait à mesurer les dimensions et la rigidité de l’aorte, les taux de TGF-β et de métalloprotéases matricielles (MMP) et la fonction endothéliale chez des patients atteints du SM, et à les comparer aux taux de TGF-β observés chez des patients également atteints de SM, mais recevant un autre traitement. Méthodologie: Il s’agissait d’une étude de cohorte menée auprès de 40 patients atteints du SM et de quatre patients atteints du SLD, ainsi que de 87 témoins. Les indices des dimensions et de la rigidité aortiques, y compris la vitesse d’onde de pouls (VOP), ont été mesurés par échocardiographie et par échographie Doppler. Les taux sanguins de TGF-β et de MMP totaux et libres ont été mesurés à l’aide de trousses Quantikine (R&D Systems, Inc, Minneapolis, MN) et Quanterix (Billerica, MA). La fonction endothéliale a été mesurée par dilatation liée au flux dans l’artère brachiale. Résultats: La VOP était plus élevée chez les patients atteints du SM. On a aussi observé une hausse des taux de MMP-2 chez les patients atteints de SM, mais aucune augmentation des taux de TGF-β ou de MMP-9 libres ou totaux comparativement aux témoins. Il n’y avait pas de différence entre les taux de TGF-β chez les patients atteints de SM ne recevant aucun traitement, ceux qui prenaient un antagoniste des récepteurs de l’angiotensine et ceux qui prenaient un bêtabloquant. La VOP été plus fortement corrélée avec l’âge. La fonction endothéliale a affiché un déclin progressif prématuré chez les patients atteints du SM. Conclusions: Malgré l’augmentation de la VOP, il ne semble pas utile de surveiller la rigidité aortique ni les taux de TGF-β en cas de SM. Les taux de TGF-β n’étaient pas plus élevés chez les patients atteints du SM, et la hausse des taux de MMP-2 indique qu’il conviendrait de choisir une autre cible thérapeutique.

Matrix metalloproteinases (MMPs) are enzymes that present a metallic element in their structure. These enzymes are ubiquitously distributed and function as extracellular matrix (ECM) remodelers. MMPs play a broad role in cardiovascular biology regulating processes such as cell adhesion and function, cellular communication and differentiation, integration of mechanical force and force transmission, tissue remodeling, modulation of damaged-tissue structural integrity, cellular survival or apoptosis and regulation of inflammation-related cytokines and growth factors. MMPs inhibition and downregulation are correlated with minimization of cardiac damage, i.e., Chinese herbal medicine has shown to stabilize abdominal aorta aneurysm due to its antiinflammatory, antioxidant and MMP-2 and 9 inhibitory properties. Thus phyto-derived products rise as promising sources for novel therapies focusing on MMPs inhibition and downregulation to treat or prevent cardiovascular disorders.

Implant malalignment during total knee arthroplasty (TKA) may lead to suboptimal postoperative outcomes. Accuracy studies are typically performed with experienced surgeons; however, it is important to study less experienced surgeons when considering teaching hospitals where younger surgeons operate. Therefore, this study assessed whether robotic-arm assisted TKA (RATKA) allowed for more accurate and precise implant position to plan when compared with manual techniques when the surgery is performed by in-training orthopaedic surgical fellows. Two surgeons, currently in their fellowship training and having minimal RATKA experience, performed a total of six manual TKA (MTKA) and six RATKAs on paired cadaver knees. Computed tomography scans were obtained for each knee pre- and postoperatively. These scans were analyzed using a custom autosegmentation and autoregistration process to compare postoperative implant position with the preoperative planned position. Mean system errors and standard deviations were compared between RATKA and MTKA for the femoral component for sagittal, coronal, and axial planes and for the tibial component in the sagittal and coronal planes. A 2-Variance testing was performed using an α = 0.05. Although not statistically significant, RATKA was found to have greater accuracy and precision to plan than MTKA for: femoral axial plane (1.1° ± 1.1° vs. 1.6° ± 1.3°), coronal plane (0.9° ± 0.7° vs. 2.2° ± 1.0°), femoral sagittal plane (1.5° ± 1.3° vs. 3.1° ± 2.1°), tibial coronal plane (0.9° ± 0.5° vs. 1.9° ± 1.3°), and tibial sagittal plane (1.7° ± 2.6° vs. 4.7° ± 4.1°). There were no statistical differences between surgical groups or between the two surgeons performing the cases. With limited RATKA experience, fellows showed increased accuracy and precision to plan for femoral and tibial implant positions. Furthermore, these results were comparable to what has been reported for an experienced surgeon performing RATKA.

In this study Aflatoxin B1 (AFB1), ochratoxin A (OTA) and zearalenone (ZEN) occurrence in fish feed, regarding its chemical composition, were investigated. Besides, AFB1 bioaccessibility to fish wa...

The SARS-CoV-2 Gamma variant spread rapidly across Brazil, causing substantial infection and death waves. We use individual-level patient records following hospitalisation with suspected or confirmed COVID-19 to document the extensive shocks in hospital fatality rates that followed Gamma’s spread across 14 state capitals, and in which more than half of hospitalised patients died over sustained time periods. We show that extensive fluctuations in COVID-19 in-hospital fatality rates also existed prior to Gamma’s detection, and were largely transient after Gamma’s detection, subsiding with hospital demand. Using a Bayesian fatality rate model, we find that the geographic and temporal fluctuations in Brazil’s COVID-19 in-hospital fatality rates are primarily associated with geographic inequities and shortages in healthcare capacity. We project that approximately half of Brazil’s COVID-19 deaths in hospitals could have been avoided without pre-pandemic geographic inequities and without pandemic healthcare pressure. Our results suggest that investments in healthcare resources, healthcare optimization, and pandemic preparedness are critical to minimize population wide mortality and morbidity caused by highly transmissible and deadly pathogens such as SARS-CoV-2, especially in low- and middle-income countries., One sentence summary COVID-19 in-hospital fatality rates fluctuate dramatically in Brazil, and these fluctuations are primarily associated with geographic inequities and shortages in healthcare capacity.

Severe caloric restriction (sCR) increases the risk for acute cardiovascular disease. Less understood are the long-term effects on cardiovascular disease risk after the sCR period has ended. We investigated the effects of sCR on heart structure and function months after refeeding (sCR-Refed). Female Fischer rats (3-months-old) were maintained on (CT) ad libitum or a 60% caloric restricted diet for 2 weeks. Thereafter, all rats received ad libitum chow for 3 months and they were analyzed by precision ultrasound to assess their heart function. After imaging, the animals were sacrificed and the hearts were subjected to ischemia-reperfusion (I/R) using a Langendorff preparation. After 2 weeks of sCR, rats lost 15% of their initial body weight (BW) [% (100*(Final-Initial/Initial)): CT, 1.5±0.8 vs sCR, -15.4±1.1; pdata not shown ) and remained doubled 3 months later [Arrhythmias (% of time): CT, 34±8 vs sCR-Refed, 68±9; p=0.02; n=8]. Ultrasound imaging showed no difference in stroke volume, coronary perfusion pressure and left ventricular mass. However, the thickness of the left ventricular posterior wall was significantly reduced in sCR-Refed rats [(mm): CT, 2.55 ±0.03 vs sCR-Refed, 2.10±0.04; p=0.002; n=4]. These findings indicate heart structure and function remained damaged months after the sCR period ended and BW was restored. These studies have adverse cardiovascular risk implications for who are subjected either voluntarily (crash diets) or involuntarily (very low food security) to periods of inadequate caloric intake.

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The signature benefits of continuous flow are largely a result of a reactor’s micro-sized features. However, as the technology gains industrial traction in the synthesis of active pharmaceutical ingredients (API), the reactors must be scaled to larger size to meet production demands. Often, the micro-features cannot be preserved, and thus the challenge is in transferring the benefits of micro to the pilot plant and beyond. This review presents solutions to typical problems encountered in plug flow reactors (PFR) related to heat transfer, mixing, handling biphasic reactions, and photochemistry. Lessons are taken from kilogram level syntheses developed in pharmaceutical process chemistry groups.

Laboratory analysis of soil texture is laborious and not environmentally friendly. After sampling, another 56 h are required for the final report and the laboratory procedure employs hydrogen peroxide and sodium hydroxide as chemical dispersion agents. Therefore a new analytical method to predict and classify soil texture is proposed using digital image processing of soil samples (image segmentation) and multivariate image analysis (MIA). Digital images of 63 soil samples, sieved to

INTRODUCTION Pediatric heart transplant (HTx) recipients have reduced exercise capacity typically two-thirds of predicted values, the mechanisms of which are not fully understood. We sought to assess the cardiorespiratory responses to progressive exercise in HTx relative to controls matched for age, sex, body size, and work rate. METHODS Fourteen HTx recipients and matched controls underwent exercise stress echocardiography on a semisupine cycle ergometer. Hemodynamics, left ventricular (LV) dimensions, and volumes were obtained and indexed to body surface area. Oxygen consumption (V˙O2) was measured, and arteriovenous oxygen difference was estimated using the Fick Principle. RESULTS At rest, LV mass index (P = 0.03) and volumes (P < 0.001) were significantly smaller in HTx, whereas wall thickness (P < 0.01) and LV mass-to-volume ratio (P = 0.01) were greater. Differences in LV dimensions and stroke volume persisted throughout exercise, but the pattern of response was similar between groups as HR increased. As exercise progressed, heart rate and cardiac index increased to a lesser extent in HTx. Despite this, V˙O2 was similar (P = 0.82) at equivalent work rates as HTx had a greater change in arteriovenous oxygen difference (P < 0.01). CONCLUSIONS When matched for work rate, HTx had similar metabolic responses to controls despite having smaller LV chambers and an attenuated increase in hemodynamic responses. These findings suggest that HTx may increase peripheral O2 extraction as a compensatory mechanism in response to reduced cardiovascular function.

The subject of sustainability reports, especially those related to GRI, has become an interesting topic to academics and practitioners. This paper seeks to propose an easy-to-use sustainability rep...

Biomass is a potential energy source for the diversification of the Brazilian energy matrix. In this context, the biogas produced from the anaerobic digestion of residues is a relevant renewable resource that plays a significant role in the mitigation of environmental problems and the local generation of electric energy. This review presents the scenario of the biogas production and electricity distributed generation within the Brazilian context. Firstly, it presents an overview of the electric energy generation from biogas and the Brazilian plants that compose this electric matrix. Secondly, the main technologies to produce biogas and the possibilities of its use, followed by the comparison of technologies for distributed generation of electric energy from biogas in the Brazilian market. To illustrate the application of biogas technology, this paper presents a case study of a biogas plant operation and its connectivity to the grid, the Colombari Farm. The information presented here aims to enhance and to foment the recovering of biomass residues to produce biogas via anaerobic digestion and its utilization to generate electricity. Although the case study considers a specific plant in Brazil, the information and results presented can be applied to others areas of the country or regions of the world, so contributing to promote the expansion of biogas plants to generate electricity. Finally, a future perspectives section describes the practical implications of the biogas production and electricity generation in rural and urban areas and its contribution to the implementation of Brazilian environmental and social policies. This review also is useful to support the research development of biogas for electricity production.

BACKGROUND Physical activity (PA) has been shown to have benefits, including improving health-related quality of life (HRQOL). However, there are few and conflicting studies assessing PA and its relationship with HRQOL in a pediatric solid-organ transplant (SOT) population. The aim of this study was to assess whether overall HRQOL was associated with PA and to determine whether that association was independent of other baseline and contemporaneous clinical and demographic indicators. METHODS A retrospective cross-sectional review was performed on 55 pediatric transplant patients (13 heart, 27 kidney, and 15 liver transplant). PA was measured by PAQ-C/PAQ-A, and HRQOL was measured using PedsQL. Demographics, baseline, and contemporaneous data were collected. RESULTS There were no significant differences in baseline and contemporaneous characteristics between heart, kidney, and liver transplant recipients. SOT recipients were 15.0 (11.0-18.0) years old at completion of surveys. Median PAQ score was 2.3 (1.6-3.2), PedsQL total score was 77 (65-91), and PedsQL physical functioning score was 88 (72-97). The PedsQL total score was not significantly associated with PAQ score. The PAQ score was significantly associated with physical functioning subscore of the PedsQL (r = 0.37, p

The recently emerged variants of concern (VOC) B.1.1.7 in UK, B.1.1.35 in South Africa and P.1 in Brazil have increased transmissibility and are rapidly spreading worldwide. These variants have several substitutions that allow them to bypass the immune responses and are up to 10 times more contagious than the previous circulating SARS-COV-2 lineages. While in some regions P.1 predominates (as several estates in Brazil), in other countries B.1.1.7 or B.1.1.35 are most prevalent. Therefore, real-time surveillance of VOC is the key for rapid public health responses. In this matter, RT-PCR protocols that are capable of detecting VOCs easily and rapidly are needed. We developed and validated a protocol that detect simultaneously the 3 most widespread VOC. Although this protocol does not discriminate among the VOCs, it can reliably detect mixed infection. Importantly, our protocol successfully identified a co-infection by two SARS-COV-2 lineages (P.1 and B.1), confirmed through complete genome sequencing.

Background: A new SARS-CoV-2 lineage, named P.1 (20J/501Y.V3), has recently been detected in Brazil. Mutations accrued by the P.1 lineage include amino acid changes in the receptor-binding domain of the spike protein that also are reported in variants of concern in the United Kingdom (B.1.1.7) and South Africa (B.1.325). Methods: We isolated two P.1-containing specimens from nasopharyngeal and bronchoalveolar lavage samples of patients of Manaus, Brazil. We measured neutralization of the P.1 virus after incubation with the plasma of 19 COVID-19 convalescent blood donors and recipients of the chemically-inactivated CoronaVac vaccine and compared these results to neutralization of a SARS-CoV-2 B-lineage previously circulating in Brazil. Findings: The immune plasma of COVID-19 convalescent blood donors had 6-fold less neutralizing capacity against the P.1 than against the B-lineage. Moreover, five months after booster immunization with CoronaVac, plasma from vaccinated individuals failed to efficiently neutralize P.1 lineage isolates. Interpretation: These data indicate that the P.1 lineage may escape from neutralizing antibodies generated in response to polyclonal stimulation against previously circulating variants of SARS-CoV-2. Funding: Sao Paulo Research Foundation, MCTI/FINEP, Medical Research Council, National Council for Scientific and Technological Development, National Institutes of Health. Conflict of Interest: M.S.D. is a consultant for Inbios, Vir Biotechnology, NGMBiopharmaceuticals, and Carnival Corporation, and on the Scientific Advisory Boards of Moderna and Immunome. The Diamond laboratory has received funding support in sponsored research agreements from Moderna, Vir Biotechnology, and Emergent BioSolutions. Ethical Approval: All procedures followed the ethical standards of the responsible committee on humanexperimentation and approved by the ethics committees from the University of Campinas, Brazil (Approval number CONEP 4.021.484 for plasma collection of blood donors, CAEE32078620.4.0000.5404 and 30227920.9.0000.5404 for the sampling of vaccinated and viral genome sequencing, respectively). All patient data were anonymized before study inclusion.Informed consent was obtained from all subjects for being included in the study.

PURPOSE Ionizing radiation therapy (RT) is the main option for head and neck cancer treatment, but it is associated with multiple side effects. This study aimed to evaluate the effect of RT associated with chewing simulation on the surface of human enamel and Yttria-partially stabilized zirconia (Y-TZP). METHODS Maxillary premolar cusps and Y-TZP slabs were divided in 7 experimental groups: CO: no RT (control); EZ groups had irradiation applied to both, enamel and zirconia samples (simulating restoration prior to RT); E groups had irradiation applied to enamel only (simulating restoration after RT). RT doses were either 30, 50 or 70 Gray (Gy). Enamel cusps were abraded against zirconia slabs in a chewing simulator (CS - one million cycles/ 80 N/ 60 mm/min, 2 mm horizontal path, artificial saliva, 37˚ C). Zirconia hardness was evaluated before CS; zirconia roughness and enamel volume (wear) were evaluated before and after CS. Hardness and wear data were analyzed by one-way Analysis of Variance and Tukey post hoc test. Roughness was analyzed by Repeated Measures test and Bonferroni test (p=0.05). RESULTS There was no significant effect of enamel or zirconia irradiation on enamel cusp wear (p=0.226), regardless of the irradiation dose used - up to 70 Gy. Irradiation also did not affect Y-TZP surface roughness (p=0.127) and hardness (p=0.964). CONCLUSIONS RT does not promote significant changes to the surface characteristics of zirconia. Irradiated enamel abraded against zirconia does not show higher wear volume when compared to non-irradiated enamel.

The acknowledgment of the hazards caused by using toxic chemicals and volatile organic solvents and components to both environment and human health drove governments and international organizations to consider some restrictions on the chemical industries. These actions forced both companies and the research community to pave a new path for science that proved to be challenging as well as much rewarding. Through this perspective of implementing sustainable routes to the industries, many renewable sources were started to be used both in research and development and industries. The materials synthesized using renewable resources and their properties turned out to be similar or even better than some petrochemical-based materials. Waterborne polyurethanes are one of the sustainable polymers which can be synthesized using renewable resources. These materials provide ease and green approaches by replacing volatile organic solvents with water in many procedures. Most importantly, a new set of materials with enhanced properties were developed for the usage in biomedical, coatings, adhesives, electromagnetic shielding, water purification, gas analysis, self-healing, and many more. This chapter discusses the green approaches and applications to get a clear and profound picture of the chemistry of cationic waterborne polyurethanes.

Introduction: Minimising spread of the COVID-19 infection through reducing face-to-face consults is essential. In doing so, alternative assessment and communication methods for management of patients with oral conditions should be considered. Material and methods: Patients on the waiting list for the joint oral medicine-paediatric dental clinic between March and June 2020 were prioritised based on a criteria including relevant medical history, diagnosis and clinical need and current management − monitoring, topical therapy or systemic therapy. A telephone consult method was chosen to assess and follow up patients and a parental satisfaction questionnaire was conducted following telephone consult. Results: Recurrent aphthous stomatitis (RAS) was the most common diagnosis of patients reviewed on the telephone clinic. Overall, the patient satisfaction questionnaire revealed that 100% of respondents would prefer a telephone consult during COVID-19 rather than face-to-face appointments. 74% opted for a video consult in preference to a telephone consult. Conclusion: This service evaluation has found telephone consults to be a valuable alternative to face-to-face consults in the management of patients with chronic oral mucosal diseases. Telephone consultations have high parental satisfaction and are an effective, convenient method to assess and follow up patients whilst maintaining their safety during the COVID-19 pandemic.

Made available in DSpace on 2022-04-28T19:44:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 The acquisition and treatment of strain data play an important role in various engineering applications, involving experimental stress analysis on a surface. Its operationalization, however, requires care and equipment that should ensure accuracy in data acquisition and ease of sampling. Deformation data acquisition systems are critical in these cases but still costly when it comes to applications in academic laboratories. This work shows he development of a portable data acquisition system for strain reading using electrical extensometry that can be used to acquire experimental strain data. The developed system has low cost and portability, being suitable to attend data acquisition in remote places. For its development an Arduino UNO R3 board was used in conjunction with an ADS1115 analog-to-digital converter. The converter is required to increase the analog/digital conversion accuracy of the Arduino board and to read electrical voltages in the μV range. In addition, an LCD display was added to the system to show the acquired data instantly. This way, the system does not require the use of a computer to function and can be easily transported. For its measurement, an experiment was carried out with strain gauges glued on the surface of an aluminum beam and connected in a Wheatstone bridge circuit. Also, a numerical model was developed using the LISA finite element program. After testing and comparing experimental, analytical and numerical results, it can be stated that the system was able to acquire data with great precision, reaching its objectives. Departament of Mechanical Engineering University of Taubaté, Rua Daniel Danelli, sn, Jardim Morumbi Department of Mechanical Engineering São Paulo State University (Unesp) Department of Mechanical Engineering São Paulo State University (Unesp)

Introduction: Underlying structural lesions in congenital heart disease (CHD) result in differences in anatomy and physiology that may affect peak aerobic capacity (VO 2peak ). The relationship between sports participation and VO 2peak is unclear in these patients. The aim of this study was to determine if children with CHD who participated in sports had a higher VO 2peak than those who did not. Methods: Two-year, single-centre, retrospective review (May 2016-November 2018). Fifty-eight CHD patients were included: 9 aortic valve disease; 13 coarctation; 6 Ross procedure for aortic stenosis; 20 tetralogy of Fallot, and 10 transposition of the great arteries. Sports participation was categorized into 3 groups: 0-1 days/week; 2-3 days/week; and ≥4 days/week. A validated institutional treadmill protocol (BCCH) was used. Criteria for a maximal test included: VO 2 plateau, respiratory exchange ratio>1.0, and/or a peak heart rate >200 bpm. VO 2peak z-scores, % VO 2 at ventilatory threshold, and O 2 Pulse were calculated. Medians and interquartile ranges are reported. P Results: Those who participated in sports ≥2-3 days/week had a significantly higher VO 2peak [39.9 (34.6, 48.1) vs 30.3 (27.8, 39.6) mL/min/kg; p2peak z-score [-0.84 (-1.28,-0.30) vs -1.89 (-2.37, -1.16); p=0.002], and O 2 Pulse [0.20 (0.19, 0.25) vs 0.16 (0.14, 0.21) mL/beat/kg; p=0.004] compared to those who participated 0-1 day/week, respectively. There were no differences between those who participated in sports 2-3 days/week and ≥4 days/week. VO 2peak was similar between CHD lesions (p=0.21). Conclusions: VO 2peak is higher in those who participate in sports compared to those who do not. It is unclear whether those who have a higher VO 2peak are more inclined to participate in sports or whether sports participation leads to a higher VO 2peak . The role of exercise rehabilitation in the 0-1 day/week group needs to be explored.

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is characterized by cardiac arrest during sudden exertion. However, standard exercise stress testing (EST) lacks sensitivity, leading to misdiagnosis and undertreatment. After a nondiagnostic standard gradual EST, we report 6 patients who underwent a novel burst exercise test characterized by sudden high workload at the outset of testing. In 5 of 6 patients, the burst EST induced new and more complex arrhythmias versus standard EST, which compelled medication initiation in 3 patients. We postulate that this simple EST modification better mimics a typical CPVT triggering event and could improve diagnostic sensitivity and therapeutic decision making.

AIMS/HYPOTHESIS: Melanocortin 4 receptor (MC4R) mutation is the most common cause of known monogenic obesity in humans. Unexpectedly, humans and rodents with MC4R deficiency do not develop hyperglycaemia despite chronic obesity and insulin resistance. To explain the underlying mechanisms for this phenotype, we determined the role of MC4R in glucose homeostasis in the presence and absence of obesity in mice. METHODS: We used global and hypothalamus-specific MC4R-deficient mice to investigate the brain regions that contribute to glucose homeostasis via MC4R. We performed oral, intraperitoneal and intravenous glucose tolerance tests in MC4R-deficient mice that were either obese or weight-matched to their littermate controls to define the role of MC4R in glucose regulation independently of changes in body weight. To identify the integrative pathways through which MC4R regulates glucose homeostasis, we measured renal and adrenal sympathetic nerve activity. We also evaluated glucose homeostasis in adrenaline (epinephrine)-deficient mice to investigate the role of adrenaline in mediating the effects of MC4R in glucose homeostasis. We employed a graded [(13)C(6)]glucose infusion procedure to quantify renal glucose reabsorption in MC4R-deficient mice. Finally, we measured the levels of renal glucose transporters in hypothalamus-specific MC4R-deficient mice and adrenaline-deficient mice using western blotting to ascertain the molecular mechanisms underlying MC4R control of glucose homeostasis. RESULTS: We found that obese and weight-matched MC4R-deficient mice exhibited improved glucose tolerance due to elevated glucosuria, not enhanced beta cell function. Moreover, MC4R deficiency selectively in the paraventricular nucleus of the hypothalamus (PVH) is responsible for reducing the renal threshold for glucose as measured by graded [(13)C(6)]glucose infusion technique. The MC4R deficiency suppressed renal sympathetic nerve activity by 50% in addition to decreasing circulating adrenaline and renal GLUT2 levels in mice, which contributed to the elevated glucosuria. We further report that adrenaline-deficient mice recapitulated the increased excretion of glucose in urine observed in the MC4R-deficient mice. Restoration of circulating adrenaline in both the MC4R- and adrenaline-deficient mice reversed their phenotype of improved glucose tolerance and elevated glucosuria, demonstrating the role of adrenaline in mediating the effects of MC4R on glucose reabsorption. CONCLUSIONS/INTERPRETATION: These findings define a previously unrecognised function of hypothalamic MC4R in glucose reabsorption mediated by adrenaline and renal GLUT2. Taken together, our findings indicate that elevated glucosuria due to low sympathetic tone explains why MC4R deficiency does not cause hyperglycaemia despite inducing obesity and insulin resistance.

PA has been shown to have benefits in SOT patients. Studies assessing physical activity levels and its correlates in a pediatric solid-organ transplant population are limited. The aim of this study was to assess PA levels and identify baseline and contemporaneous factors that contribute to PA in a pediatric SOT population. A retrospective cross-sectional review was performed on 58 pediatric transplant patients (16 heart, 29 kidney, and 13 liver transplant). PA was measured by PAQ-C or PAQ-A. Demographics, baseline, and contemporaneous factors were collected. There were no significant differences in baseline and contemporaneous characteristics between heart, kidney, and liver transplant recipients. SOT recipients were 15.2 [12.3-17.3] years old at time of completing the PAQ. Median PAQ score was 2.2 [1.7-2.9]. There were no significant differences in PAQ scores between organ transplant type or between genders. Lower PAQ score was associated with sensory disability (9 vs 49 without disability; P =

BACKGROUND Long QT syndrome (LQTS) is a dangerous arrhythmia disorder that often presents in childhood and adolescence. The exercise stress test (EST) and QT-stand test may unmask QT interval prolongation at key heart rate transition points in LQTS, but their utility in children is debated. OBJECTIVE To determine if the QT-stand test or EST can differentiate children with a low probability of LQTS from those with confirmed LQTS. METHODS This retrospective study compares the corrected QT intervals (QTc) of children (

Background Cancer trials often incorporate intensive imaging with Magnetic Resonance Imaging (MRI) and Positron Emission Tomography with Computerised Tomography (PET/CT), which can be physically and mentally exhausting for patients. This questionnaire study aimed to determine the aspects of imaging that affect a patient’s decision to participate in clinical trials in order to inform the design of future trials that utilise imaging. This should achieve greater patient compliance and improve the patient experience. Method A detailed questionnaire assessing patient expectation and acceptability of imaging within clinical trials was developed in collaboration with two patient representatives. The questionnaire addressed the influence of scan type, length, frequency, scheduling, invasiveness and staff support on acceptability of imaging. It was applied to three patient groups. Group 1 consisted of patients newly recruited to studies with imaging, Group 2 consisted of previous participants in studies with imaging and Group 3 consisted of patients having imaging for clinical care. Results One hundred ninety six patients completed the questionnaires (Group 1:47; Group 2: 50 and Group 3: 99). The use of ionising radiation and number of scans required were identified as negative influences on decision to participate by 25% of Group 3 but only by 6% of Groups 1 and 2. Scan duration >30mins was perceived as a negative factor for decision to participate by all Groups (12–22%). Good communication provided by researchers in terms of discussing the study before and after reading study materials was a key factor in influencing decision to participate (> 50% in Groups 1 and 2 and > 20% in Group 3). Conclusion Factors relating to imaging procedures within clinical trials that affect participation have been identified with communication around study materials as the key determinant. These data will be used to influence the development of future research protocols. Modification of imaging requirements within clinical trials will improve patient tolerance and acceptability and is likely to raise recruitment.

This paper presents a detailed review of the energy potential from residual biomass for distributed generation in Brazil, presenting the potential by macro-region of the different types of residues generated in the agricultural, forestry, livestock, industrial and urban sectors. The focus of this research is to map and point out, through bibliographic research, the great potential of biomass in the Brazilian market for the production of biogas and consequently the use for electric power generation in the country and especially in the state of Parana. Therefore, it should be emphasized that the methodology used is based on a bibliographic research from databases and recent research using a survey carried out by the ITAIPU Technological Park (PTI) in partnership with SENAI/PR, using the FIEP Observatories. As result, this research describes through data collection a favorable scenario for the technical feasibility of the use of biomass for the energetic use of biogas for power generation. The distributed generation of electricity from the use of biomass could help Brazil in the preservation of the environment as well as contribute to the diversification of the energy matrix, economic development and broadening access to energy in isolated communities.

© 2018 by Wroclaw Medical University and Polish Dental Society. Background. All-ceramic restorations have become popular and the trend is ongoing. However, the incidence of chipping within the veneering layer has been a commonly reported failure in clinical practice. Objectives. The aim of this in vitro study was to evaluate the effect of ceramic crown design (monolithic vs bi-layered) and material on the chipping resistance of molar crowns submitted to compressive cyclic loading. Material and methods. Fifty identical epoxy resin replicas of a mandibular first molar with crown preparation were divided into 5 groups (n = 10) as follows: the MLD group – monolithic CAD/CAM lithium-disilicate glass-ceramic (LDGC) crowns; 30 zirconia cores were veneered with either feldspathic porcelain by hand-lay-ering technique (ZHL) or by heat-pressing technique (ZVP), or with milled LDGC veneers and subsequently fused to the cores (ZLD); 10 porcelain-fused-to-metal (PFM) crowns acted as a control group. All crowns were cemented using Panavia® F2.0 resin cement (Kuraray Dental, Tokyo, Japan). After storage in water at 37°C for 1 week, the specimens were subjected to compressive cyclic loading at the mesiobuccal cusp which was tilted at 30°. A load cycle of 50–450 N was used and specimens were maintained in an aqueous environment throughout 500,000 cycles in a universal testing machine (Instron, Norwood, USA). The data was statistically analyzed at 5% significant level with Fisher’s exact test and Kaplan-Meier survival analysis. Results. Significant differences in survival rates of the specimens used in the groups (p < 0.001) were found. Specimens of the PFM, ZHL and ZVP groups underwent failures at different stages of the 500,000 fatigue cycles, while specimens of the MLD and ZLD groups survived the entire fatigue test. ZHL and ZVP crowns had the worst chipping-resistance, while PFM crowns performed slightly better. The Kaplan-Meier test revealed significantly higher survival rates for the MLD and ZLD specimens compared to the other 3 groups. Conclusions. The use of LDGC as a monolithic molar crown and as a veneer over a zirconia core resulted in superior resistance to cuspal chipping.

Silicon, aluminum, and iron oxides are very abundant in soil. Their quantification is important for soil classification, which is a relevant information for the sustainable use and management of soils. In soil laboratories the determination of these oxides, using standard methods, is destructive, costly, laborious, and time consuming. This article presents two analytical methods to quantify SiO2, Al2O3, and Fe2O3 in soil samples using computer vision (COMPVIS) and mid-infrared spectroscopy (MIR). These two methods were developed using 52 soil samples from four states of Brazil. Digital images and MIR spectra were correlated with oxides contents quantified by atomic absorption spectroscopy (AAS) after acid digestion using three multivariate calibration methods: PLS, SPA-MLR, and LS-SVM. This the first time that soil image data has been correlated to silicon and aluminum oxides and the proposed method found excellent correlation values ( r 2 ranging from 0.95 to 0.99). With the exception of SiO2, MIR resulted in similar predictions to the COMPVIS method’s. LS-SVM presented r 2 higher than 0.95 for all oxides estimates. The developed analyses are low cost, fast, and environmentally sustainables.

The comprehensive analysis of phenolic compounds from natural products comprises critical steps, including quantitative extraction, extract preparation, and chromatographic procedure. Performing these steps off-line requires a long time to obtain results, besides being laborious and more error-prone. This work discusses the concept and presents the details of assembling and validating a new system to comprehensively analyze phenolic compounds in natural products. The system is based on a bidimensional separation through the combination of pressurized liquid extraction with in-line solid-phase extraction coupled online with HPLC-PDA. The system proved to be able to perform a bidimensional separation to characterize the sample and ensure quantitative extraction of all detected components using the most appropriate extraction solvent gradient depending on the raw sample analyzed. The 1st dimension separation is achieved by PLE-SPE with a solvent gradient and differential interactions of extracted compounds with the adsorbent. The 2nd dimension presents the HPLC-PDA separation. The extraction/separation process can be monitored in real-time, and kinetic extraction curves for individual compounds can also be obtained to ensure quantitative extraction. Thus, the 2D PLE-SPE × HPLC-PDA may provide fast and precise comprehensive analyses of a large plethora of phenolic compounds, finding relevant applications in the chemical, food, pharmaceutical, and agricultural fields.

SUMMARY Objective This study evaluated in situ the potential of a glass ionomer and self-adhesive resin cements to inhibit enamel and dentin demineralization around indirect restorations exposed to cariogenic challenge. The cumulative fluoride release (CFR) of materials was measured in water and acid. Methods: Seventy blocks cut from human molars received two indirect composite restorations (one in enamel and another in dentin) luted with Ketac Cem EasyMix (GIC, positive control), SeT (SeT), Maxcem Elite (Max), Smart Cem2 (Smart), and RelyX Unicem 2 (Unicem2). Fourteen volunteers wore palatal appliances containing five blocks exposed to a cariogenic challenge (20% sucrose solution, eight times per day, seven days). Knoop microhardness (KH) at two distances from the margins and three depths from the outer surface determined enamel and dentin demineralization. Disc-shape specimens of materials were immersed in daily-replaced deionized water or lactic acid solutions. KH and CFR data were analyzed by analysis of variance, Games-Howell test, and Tukey test (α=0.05). Results: The overall KH ranking was GIC > SeT > Max > Smart = Unicem2 in both enamel and dentin (“>” means p SeT = Max > Smart = Unicem2. In acid, the rank was similar, except that Set was significantly superior to Max. Conclusion: SeT inhibited demineralization in enamel and dentin quite comparably to GIC. All resin cements released lower cumulative amounts of fluoride than the glass ionomer cement.

Ureterocele is a dilation of the final portion of the ureter, which results from an embryological failure of unknown cause. This article describes the case of a three-month-old female poodle with complaints of urinary incontinence. Imaging exams helped establish the diagnosis by disclosing an orthotopic cystic dilation. The surgical technique employed to treat the condition was resection of the ureterocele with marsupialization of the edges. Complete remission of clinical signs was achieved two months post-surgery; the dog remains continent two years after the procedure.

Radiotherapy plays a critical role in the management of cervix carcinoma, in the adjuvant setting for patients with high-risk pathologic features and in the definitive setting for locoregionally advanced disease. External beam radiotherapy fields encompass potential areas of microscopic disease spread in addition to known areas of gross disease. In the presence of gross disease, however, escalation of dose is required that is best accomplished using a brachytherapy boost to spare surrounding normal organs from toxicity. This article addresses indications for radiotherapy in the management of nonmetastatic cervix cancer and reviews various radiotherapy techniques, with a heavy focus on brachytherapy.

Aim:: This study aimed to report medicinal plants that are likely to be used in the control of salmonellosis. Materials and Methods:: A cross-sectional study was conducted in Southern Benin. Semi-structured questionnaires were administered to 150 farmers and 100 traditional therapists in seven high municipalities. This step helped to collect plants that are used in the treatment of animal salmonellosis and typhoid fever in human. Results:: The results revealed a low level of use of medicinal plants among breeders who prefer antibiotics such as oxytetracycline (53.55%), tylosine + sulfadimerazine (15.30%), and alphaceryl (19.13%). However, plants such as Moringa oleifera (leaves), Carica papaya (leaves and seeds), and Vernonia amygdalina (leaves) were mostly used by some farmers. From traditional therapists, 57 plant species of 32 families were identified as typhoid fever cures; among which Leguminosae, Asteraceae, and Euphorbiaceae were predominant. Persea americana (22.72%), V. amygdalina (7.57%), and Corchorus olitorius (7.57%) were the most cited by traditherapists for the treatment of typhoid fever in human. Conclusion:: This study provides a database for further studies on the in vitro and in vivo efficacy of Benin plant species on Salmonella spp. These evaluations will guarantee the availability of new therapeutic solutions for populations.

Background and Objective Periodontitis may promote harmful systemic effects such as changes in hepatic tissues. The purpose of this study was to investigate whether the steatosis and oxidative stress caused by experimental periodontitis are reversible in the liver. Material and Methods Twenty-four rats were divided into three groups: control, periodontitis and P20-20 (20 days with experimental periodontitis and 20 days without experimental periodontitis, to verify the reversibility of hepatic injuries). The following parameters were assessed: gingival bleeding index, probing pocket depth, myeloperoxidase activity, alveolar bone loss for periodontal tissues; liver weights, histopathological scores for steatosis, inflammation and necrosis in liver; glutathione, malondialdehyde, total cholesterol and triglyceride concentrations in hepatic tissues; and blood levels of aspartate aminotransferase, alanine aminotransferase, albumin, gamma-glutaryl transferase, total cholesterol and random glucose. Results Gingival bleeding index, probing pocket depth, myeloperoxidase and alveolar bone loss parameters demonstrated the development of periodontitis. There was a significant reduction in the steatosis score of animals from the P20-20 group when compared with the periodontitis group. P20-20 group presented significantly higher glutathione (11 times) and lower malondialdehyde (nearly 23%), total cholesterol (both in blood and hepatic tissue) and triglyceride concentrations compared with the periodontitis group. For levels of aspartate aminotransferase, alanine aminotransferase, albumin, gamma-glutaryl transferase and random glucose, a significant difference between the groups was not observed. Conclusion Our results demonstrate that the microvesicular steatosis caused by periodontitis in rats is reversible after removal of the ligature, which is associated with the increase in oxidative stress and lipid peroxidation in the liver.

Purpose To retrospectively compare clinical dosimetry of CT-based tandem–ring treatment plans using a model-based dose calculation algorithm (MBDCA) with the standard TG-43–based dose formalism. Methods and Materials A cohort of 10 cervical cancer cohorts treated using the tandem and ring high-dose-rate applicators were evaluated. The original treatment plans were created using the department CT-based volume optimization clinical standards. All plans originally calculated with TG-43 dose calculation formalism were recalculated using the MBDCA algorithm. The gross target volume and organs at risk (OARs) were contoured on each data set along with significant heterogeneities like air in cavity and high-density plastic tandem and ring components. The patient tissue was modeled as homogenous liquid water. D90, D95, and D100 for gross target volume, D0.1cm3, D1.0cm3, and D2.0cm3 for bladder, rectum, and sigmoid were extracted from dose–volume histograms for TG-43 and MBDCA calculated plans. Mean absolute difference ± 2σ in the above metrics was calculated for each plan. Results Using the manual applicator contouring method, MBDCA plans (n = 10) showed 2.1 ± 1.1% reduction in dose to Point A average, 2.6 ± 0.9% reduction in Target D90 dose, and 2.1 ± 0.3% dose reduction to OARs. Results from plans using vendor supplied solid applicator models (n = 5) showed 2.2 ± 1.10% reduction in dose to Point A average, 2.7 ± 0.2% reduction in Target D90 dose, and 2.7 ± 1.0% dose reduction on average to OARs. Conclusion For unshielded plastic gynecologic applicators, minimal dosimetric changes (

Background Dysautonomia of Adolescence (DAOA) results from a dysregulation of the autonomic nervous system during puberty and affects multiple organ systems in the body. Symptoms have a significant impact on quality of life (QoL) with many adolescents reporting a poorer QoL compared to other pediatric chronic illness populations. Furthermore, there is a paucity of research looking at underlying mental health conditions in patients with DAOA that might be contributing to poor QoL. Objectives The aim of this review was to characterize the underlying mental health status of patients with DAOA followed in a tertiary care DAOA Clinic. Design/Methods Single-centre retrospective chart review (January 2017-November 2019) of all current patients followed in a tertiary care DAOA Clinic. Mental health challenges were classified as significant symptoms reported and/or formal diagnosis of anxiety, depression, attention deficit hyperactivity disorder, obsessive compulsive disorder, eating disorders, somatization, mood disorders, suicidal ideation, and self-harm. Frequency tables were generated for all categorical variables. Results Seventy-three patients are currently being followed in the DAOA clinic. Fifty-five of 73 (75%) had some form of mental health challenge including 11 (15%) which had a history of suicidal ideation and/or self-harm, 12 (17%) had no mental health concerns, and 6 (8%) are unknown. Of the 55 patients with a mental health challenge, 27 (49%) were diagnosed with a mental health condition prior to formal DAOA diagnosis and 10 (18%) were diagnosed after DAOA diagnosis. Eighteen (14%) reported symptoms of a mental health challenge but no confirmed mental health diagnosis. A breakdown of mental health symptoms and diagnoses are shown in Table 1. Of the 73 current patients, 41 (56%) accessed psychology services either through the DAOA Clinic or in the community, 9 (12%) have been referred to other health care services, and 8 (11%) did not access services. Psychiatric services were required by 15 patients (21%). Conclusion Three-quarters of DAOA patients report some mental health challenges. This emphasizes the need for psychology to support patients with DAOA. It is unclear as to whether a mental health challenge exacerbates symptoms of DAOA or DAOA symptoms negatively impact their mental health.

BACKGROUND: The aim was to compare the diagnostic accuracy of 68Ga-PSMA PET/CT with conventional cross-sectional imaging and diffusion-weighted MRI (DW-MRI) for detecting lymph node metastasis (LNM) to stage prostate cancer patients. Twenty consecutive, newly- diagnosed prostate cancer patients were prospectively enrolled and underwent 68Ga-PSMA-11 PET/CT, anatomical MRI or contrast-enhanced CT, and DW-MRI prior to laparoscopic, template-based, extended lymph node dissection. Histopathological findings served as the reference test.RESULTS: Histopathology showed LNM in 13 of 20 patients (19 high-risk, 1 intermediate risk). Five patients had metastasis-suspected lymph nodes on 68Ga-PSMA PET/CT. Patient-based analysis showed that the sensitivity and specificity for detecting LNM were 39% and 100% with 68Ga-PSMA PET/CT, 8% and 100% with MRI/CT, and 36% and 83% with DW-MRI, respectively. The positive and negative predictive values were 100% and 49% with 68Ga-PSMA PET/C, 100% and 37% with MRI/CT, and 80% and 42% with DW-MRI. Of 573 dissected lymph nodes, 33 were LNM from 26 regions. True-positive LNM on 68Ga-PSMA PET/CT was 9-11 mm in diameter, whereas false-negative LNM had a median diameter of 4 mm, with only 3 of 30 lymph nodes being larger than 10 mm. LNM were positive for PSMA by immunostaining.CONCLUSIONS: The sensitivity of 68Ga-PSMA PET/CT was notably better than that of MRI/CT and comparable to that of DW-MRI. Some false positive findings with DW-MRI reduced its specificity and positive predictive value compared with those of 68Ga-PSMA PET/CT and MRI/CT.

Surveillance of overhead power line installations can be conveniently addressed using unmanned aerial vehicles (UAV). UAV are robotic platforms able to perform sophisticated tasks such as autonomous flight based on visual information. In this paper, we propose a novel solution to the problem of following a power line autonomously based on monocular vision. The method uses Deep Neural Networks (DNN) and the Hough transform to successfully discern power line images from environmental information, which is an essential result to accomplish fully autonomous vision-based navigation. A simulated navigation test demonstrates the efficiency of the proposed method, in the special condition of following right-angled changes of direction, which is a known restriction in many navigation methods reported in literature. The design of the proposed method is modular and can be incorporated in navigation strategies for automatic surveillance applications.

Implant malalignment during TKA may lead to suboptimal outcomes. Accuracy studies are typically performed with experienced surgeons; however, it is important to study less experienced surgeons when considering teaching hospitals where younger surgeons are operating. Therefore, the purpose of this study was to assess whether computer-assisted TKA (CATKA) allows for more accurate and precise implant position to plan when compared to manual TKA (MTKA) when the surgery is performed by less experienced surgeons.Two surgeons, currently in their fellowship training and having minimal CATKA experience, performed a total six MTKA and six CATKA on paired cadaveric knees. Computed tomography (CT) scans were obtained for each knee pre- and post- operatively. CT scans were analyzed to compare post-operative implant position to the pre-operative planned position. Mean system errors and standard deviations were compared between CATKA and MTKA for the femoral component sagittal, coronal, and axial planes and the tibial component in the sagittal and coronal planes. A 2-Variance testing was performed using an alpha=0.05.CATKA had greater accuracy and precision to plan than MTKA for: femoral axial plane (1.1o±1.1o vs. 1.6o±1.3o), coronal plane (0.9o±0.7o vs. 2.2±1.0o), femoral sagittal plane (1.5o±1.3o vs. 3.1o±2.1o), tibial coronal plane (0.9o±0.5o vs. 1.9o±1.3o) and tibial sagittal plane (1.7o±2.6o vs. 4.7o±4.1o). There was no statistical difference between surgical groups or between the two surgeons performing the cases.With limited CATKA experience, the fellows showed increased accuracy and precision to plan for femoral and tibial implant positions. Furthermore, these results are comparable to what has been reported for an experienced surgeon performing CATKA.

Introduction Lipid control is highly effective and improves clinical outcomes in coronary artery disease (CAD) patients, thus is one of the pillars of the cardiovascular secondary prevention. Purpose The aim of this preliminary analysis was to describe the lipid management in CAD patients in Brazil after one year of the clinical practice registry. Methods Patients with documented CAD were included by using electronic case report form based on the ACC PINNACLE Registry. The registry has been enrolling patients from general practitioners and specialists. Patients data were evaluated after 01 year of follow-up on regular clinical appointments and the differences on clinical practice were evaluated Results Currently, PINNACLE-Brazil enrolled individuals, with 2234 (29.4%) patients with CAD. Prescription of statin therapy was identified in 85.6% baseline and 78.3% follow-up. CAD patients with LDL-c 100 mg/dL with a documented plan to achieve LDL-c Conclusion The preliminary results of PINNACLE-Brazil show that, despite the relatively high prescription rate of statin therapy, LDL-c targeted level for CVD secondary prevention has not been achieved in the majority of patients after 01 year of follow-up. Nationwide knowledge translation initiatives are needed to improve the CVD burden in Brazil Acknowledgement/Funding ACC Foundation

Huntington’s disease (HD) is a neurodegenerative autosomal dominant disorder, characterized by symptoms of involuntary movement of the body, loss of cognitive function, psychiatric disorder, leading inevitably to death. It has been previously described that higher levels of brain expression of Cav1 channels are involved in major neurodegenerative disorders, such as Alzheimer’s disease and Parkinson’s disease. Our results demonstrate that a bacterial artificial chromosome (BAC)-mediated transgenic mouse model (BACHD mice) at the age of 3 and 12 months exhibits significantly increased Cav1.2 protein levels in the cortex, as compared with wild-type littermates. Importantly, electrophysiological analyses confirm a significant increase in L-type Ca2+ currents and total Ca2+ current density in cortical neurons from BACHD mice. By using an in vitro assay to measure neuronal cell death, we were able to observe neuronal protection against glutamate toxicity after treatment with Cav1 blockers, in wild-type and, more importantly, in BACHD neurons. According to our data, Cav1 blockers may offer an interesting strategy for the treatment of HD. Altogether, our results show that mutant huntingtin (mHtt) expression may cause a dysregulation of Cav1.2 channels and we hypothesize that this contributes to neurodegeneration during HD.

The hypothesis of decreased nitric oxide (NO) bioavailability in sickle cell disease (SCD) proposes that multiple factors leading to decreased NO production and increased consumption contributes to vaso-occlusion, pulmonary hypertension, and pain. The anion nitrite is central to NO physiology as it is an end product of NO metabolism and serves as a reservoir for NO formation. However, there is little data on nitrite levels in SCD patients and its relationship to pain phenotype. We measured nitrite in SCD subjects and examined its relationship to SCD pain. In SCD subjects, median whole blood, red blood cell and plasma nitrite levels were higher than in controls, and were not associated with pain burden. Similarly, Townes and BERK homozygous SCD mice had elevated blood nitrite. Additionally, in red blood cells and plasma from SCD subjects and in blood and kidney from Townes homozygous mice, levels of cyclic guanosine monophosphate (cGMP) were higher compared to controls. In vitro, hemoglobin concentration, rather than sickle hemoglobin, was responsible for nitrite metabolism rate. In vivo, inhibition of NO synthases and xanthine oxidoreductase decreased nitrite levels in homozygotes but not in control mice. Long-term nitrite treatment in SCD mice further elevated blood nitrite and cGMP, worsened anemia, decreased platelets, and did not change pain response. These data suggest that SCD in humans and animals is associated with increased nitrite/NO availability, which is unrelated to pain phenotype. These findings might explain why multiple clinical trials aimed at increasing NO availability in SCD patients failed to improve pain outcomes.