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Multi-branched molecules have recently demonstrated interesting behaviour as charge-transporting materials within the fields of perovskite solar cells (PSCs). For this reason, extended triarylamine dendrons have been grafted onto a pillar[5]arene core to generate dendrimer-like compounds, which have been used as hole-transporting materials (HTMs) for PSCs. The performances of the solar cells containing these novel compounds have been extensively investigated. Interestingly, a positive dendritic effect has been evidenced as the hole transporting properties are improved when going from the first to the second-generation compound. The stability of the devices based on the best performing pillar[5]arene material has been also evaluated in a high-throughput ageing setup for 500 h at high temperature. When compared to reference devices prepared from spiro-OMeTAD, the behaviour is similar. An analysis of the economic advantages arising from the use of the pillar[5]arene-based material revealed however that our pillar[5]arene-based material is cheaper than the reference.

OBJECTIVE: Classification criteria for calcium pyrophosphate deposition disease (CPPD) will facilitate clinical research on this common crystalline arthritis. We report on the first two phases of a four-phase process for developing CPPD classification criteria. METHODS: CPPD classification criteria development is overseen by a 12-member Steering Committee. Item generation (Phase I) included a scoping literature review of five literature databases and contributions from a 35-member Combined Expert Committee and two Patient Research Partners. Item reduction and refinement (Phase II) involved a Combined Expert Committee meeting, discussions among Clinical, Imaging, and Laboratory Advisory Groups, and an item rating exercise to assess the influence of individual items toward classification. The Steering Committee reviewed the modal rating score for each item (range -3 [strongly pushes away from CPPD] to +3 [strongly pushes toward CPPD]) to determine items to retain for future phases of criteria development. RESULTS: Item generation yielded 420 items (312 from the literature, 108 from experts/patients). The Advisory Groups eliminated items they agreed were unlikely to distinguish between CPPD and other forms of arthritis, yielding 127 items for the item rating exercise. Fifty-six items, most of which had a modal rating of +/- 2 or 3, were retained for future phases. As numerous imaging items were rated +3, the Steering Committee recommended focusing on imaging of the knee, wrist, and one additional affected joint for calcification suggestive of CPP crystal deposition. CONCLUSION: A data- and expert-driven process is underway to develop CPPD classification criteria. Candidate items comprise clinical, imaging, and laboratory features.

A 33-year-old Hispanic male with a history of recent orchiectomy for suspected testicular cancer presented to the emergency department with worsening exertional chest pain and dyspnea in the setting of a 2-month history of diffuse myalgias and symmetric polyarthralgias.

Gout arthritis commonly affects joint regions by deposition of crystals, promoting functional damage mainly during periods of exacerbation. Cryotherapy is a commonly used resource to contain inflammatory processes, however, its use during a gout crisis is not yet well understood. Therefore, the objective was to evaluate the parameters of Wistar rats submitted to an experimental gout model and treated with dual cryotherapy protocol. Twenty-one male Wistar rats were used, separated into three groups: control group (CG), lesion group (LG), and lesion + cryotherapy group (LCG). Gout model induction was through intra-articular injection, with urate crystal solution, in the right knee and cryoimmersion treatment was performed for 20 minutes at a temperature of 5° ± 2°C. Seven evaluations and two treatment moments were performed, and the following parameters were analyzed: joint edema, grip strength, joint disability, motor function, and leukocyte migration through synovial lavage. In the statistical analysis we used SPSS 20.0 with Generalized Linear Models, with least significant difference posttest, always with 5% significance level. The treatment reduced edema, promoted strength recovery, and was effective in reducing total leukocytes in the synovial fluid. No difference was observed between the injured groups for joint disability and motor function. Cryotherapy promoted edema reduction and increased pelvic limb grip strength in Wistar rats during the acute period.

Rheumatoid arthritis (RA) is a debilitating autoimmune disease of unknown cause, characterized by infiltration and accumulation of activated immune cells in the synovial joints where cartilage and bone destructions occur. Myeloid-derived suppressor cells (MDSCs) are of myeloid origin and are able to suppress T cell responses. Src homology 2 domain-containing inositol polyphosphate 5-phosphatase 1 (SHIP1) was shown to be involved in the regulation of MDSC differentiation. The purpose of the present study was to investigate the effect of inhibition of SHIP1 on the expansion of MDSCs in RA using a collagen-induced inflammatory arthritis (CIA) mouse model. In DBA/1 mice, treatment with a small molecule-specific SHIP1 inhibitor 3α-aminocholestane (3AC) induced a marked expansion of MDSCs in vivo. Both pretreatment with 3AC of DBA/1 mice prior to CIA induction and intervention with 3AC during CIA progression significantly reduced disease incidence and severity. Adoptive transfer of MDSCs isolated from 3AC-treated mice, but not naïve MDSCs from normal mice, into CIA mice significantly reduced disease incidence and severity, indicating that the 3AC-induced MDSCs were the cellular mediators of the observed amelioration of the disease. In conclusion, inhibition of SHIP1 expands MDSCs in vivo and attenuates development of CIA in mice. Small molecule-specific inhibition of SHIP1 may therefore offer therapeutic benefit to patients with RA and other autoimmune diseases.

A área conhecida como Controladoria exerce um importante papel para assegurar a saúde econômico-financeira das entidades. Assim, analisar os fenômenos inerentes aos profissionais da área ajuda a compreender como eles podem auxiliar no desempenho das organizações. Nesse contexto, esta pesquisa buscou identificar o perfil comportamental dos controllers atuantes em empresas no Brasil. Para isso, foi realizado um levantamento, por meio de questionário, obtendo 104 respostas válidas de profissionais da Controladoria. O questionário foi aplicado entre agosto de 2019 a julho de 2020. A análise de dados contou com correlações e regressões lineares múltiplas. As evidências indicam que os atuantes da Controladoria de empresas brasileiras apresentam bons níveis de motivação, poder de tomada de decisão, conscienciosidade e capacidade de trabalhar em equipe. Em contrapartida, foi possível identificar a presença de comportamentos geradores de estresse e necessidades de melhorias nas características interpessoais desses profissionais. Como principais variáveis explicativas do perfil comportamental dos indivíduos da amostra, destacam-se a idade, o tempo de experiência e o estado civil. A pesquisa contribui para um melhor entendimento sobre as características presentes em controllers que atuam em empresas no país, auxiliando na evolução da literatura sobre a atuação dos profissionais da Controladoria. Adicionalmente, a investigação contribui para uma reflexão sobre a formação dos controllers no Brasil, levantando características e habilidades importantes para a atuação desses profissionais. O estudo permite, ainda, impulsionar incentivos para o desenvolvimento pessoal e profissional dos atuantes na Controladoria, os quais apresentam papel central no desempenho econômico-financeiro das empresas.

Studies around the world have revealed reduced levels of atmospheric particulate matter in periods of greatest human mobility restriction to contain the spread of SARS-CoV-2 during the COVID-19 pandemic. The present study aimed to carry out a health impact assessment in Recife, Brazil, hypothesizing a scenario in which the levels of PM10 and PM2.5 remained, throughout the year, as in the most restrictive period of human mobility. Particular material data (PM10 and PM2.5) were measured during the pandemic and population and health (mortality, hospital admissions for heart and respiratory problems) data from 2018 were used. We observed a reduction in the concentration of PM2.5 in up to 43.7% and PM10 up to 29.5% during the period of social isolation in the city of Recife. The reduction in PM2.5 would avoid 106 annual deaths from non-external causes and 58 annual deaths from cardiovascular diseases. In this scenario, $ 294.88 million would be saved ($ 114.88 million from heart problems and $ 180 million from non-external causes). When considering hospitalizations avoided by the decrease in PM10, we observed 57 fewer hospitalizations for respiratory diseases, 42 for heart diseases and a reduction of 37 deaths due to non-external causes. The reduction in spending on respiratory and cardiovascular hospitalizations would exceed $ 330,000. Therefore, the reduction of particulate matter could prevent hospital admissions, deaths and consequently there would be a reduction in disease burden in developing countries where economic resources are scarce. In this sense, governments should seek to reduce levels of pollution in order to improve the life quality and health of the population.

The aim of this work was to compare three techniques of local blockade, as part of a multimodal protocol in cats submitted to videoassisted ovariectomy (OVH). This study included 38 cats, assigned to four groups (control; incisional block, intraperitoneal block and block of the ovarian arteriovenous complex). Pain was assessed using Analogue Visual Scale, Pain Scale of the UNESP and Composite Multimodal Pains Scale-Feline, prior and after surgery. Anesthetic and analgesic protocols provided adequate post-surgical analgesia in most cats. It is concluded that the intraperitoneal administration of lidocaine may be a useful technique to reduce trans-surgical pain, while the use of incisional infiltration with this medication improves early postoperative pain in videosurgeries.

Introduction Enthesitis is a core outcome domain assessed in psoriatic arthritis (PsA) clinical trials. Limited evidence describes the impact of enthesitis on patient-reported outcomes (PROs) and physician satisfaction with current treatment options. The objective of this analysis is to characterize the impact of enthesitis on PROs and physician satisfaction with currently available treatment in clinical practice settings. Methods Cross-sectional survey of rheumatologists, dermatologists, and their consulting patients with PsA in Australia, Canada, European Union (EU5), and the USA conducted in 2018. Physicians assessed current presence and severity of enthesitis, overall disease severity, other symptoms experienced, and their satisfaction with the current treatment. PsA participant self-reported data included current pain level, EQ5D, Psoriatic Arthritis Impact of Disease (PsAID12), Health Assessment Questionnaire Disability Index (HAQ-DI), and Work Productivity and Activity Impairment Index (WPAI-SHP). Bivariate descriptive analyses were conducted to describe features and outcomes in participants with and without enthesitis. Results Rheumatologists (454) and dermatologists (238) provided information for 3157 participants with PsA. Mean participant age was 49.2 years, and 45.9% were female. Enthesitis was present currently in 6.5% (205) of participants with PsA. Those with enthesitis had worse overall disease severity compared to those without enthesitis (12.2% vs 2.2% severe) and had more extraarticular manifestations, including nail psoriasis, dactylitis, and sacroiliitis. Enthesitis was associated with more pain, worse quality of life (QoL), increased disability, and a negative impact on work. Participants with enthesitis had higher NSAIDs and opioid pain medication use but similar biologic use. Physicians were significantly less satisfied with current PsA treatment in participants with enthesitis versus without enthesitis. Conclusions Participants with psoriatic arthritis with enthesitis experienced significantly higher disease burden than those without enthesitis but were not more likely to receive advanced therapies. Physicians were significantly more dissatisfied with treatment in patients with enthesitis than in those without it. Electronic Supplementary Material The online version of this article (10.1007/s40744-020-00242-3) contains supplementary material, which is available to authorized users.

This report describes a horse presenting ileal impaction that went through a right flank laparotomy procedure while standing. The decision to use this technique was made under the influence of several factors: the patient exhibited a calm temperament and demonstrated responsiveness to the analgesic treatment for pain control; the abdominal lesion was amenable to correction by a standing right flank approach. Also, the owner reported financial problems. Ileal obstruction was relieved successfully, and the horse recovery was satisfactory. This case highlights that, in specific cases of colic syndrome, the use of surgical procedures in the standing position might be a viable option and promote fast recovery. RESUMO Este relato de caso descreve um equino com compactação de íleo corrigida por laparotomia em estação pelo flanco direito. A decisão dessa abordagem foi influenciada por vários fatores: o paciente exibiu um temperamento calmo e demonstrou responsividade ao tratamento analgésico para controle da dor; a afecção intestinal em questão foi passível de correção pela abordagem pelo flanco direito em estação; e o proprietário relatou limitações financeiras. A desobstrução ileal foi realizada com sucesso e o cavalo apresentou recuperação satisfatória. Este caso destaca que, em casos específicos da síndrome de cólica, o uso de um procedimento em estação pode ser uma abordagem viável e promover uma rápida recuperação.

Introduction: Intermittent 1-34 parathyroid hormone (iPTH) administration, a bone-forming treatment, is widely used as a therapy for severe osteoporosis. It can only be used for a maximum of 24 mo and must be followed by an antiresorptive drug to retain the new formed tissue. Mechanical load, in the form of low-intensity and high-frequency vibration, has received considerable attention due to its ability to prevent bone loss. Aim: To investigate the ability of whole body mechanical vibration (MV) to potentiate the anabolic effects of iPTH and to inhibit bone resorption following discontinuation of iPTH treatment in estrogen-deficient rats. Methodology: Fifty-four 6-month-old female Wistar rats were ovariectomized (OVX) or sham-operated. After 5 mo, they were divided into 7 groups: Sham – non-OVX; Control – OVX, vehicle for 60 d; MV – OVX, submitted to MV for 60 d; PTH60d – OVX, injected with iPTH for 60 d; PTH+MV – OVX, injected with iPTH combined with MV for 60 d; PTH30d – OVX, injected with iPTH for 30 d, and untreated for 30 d; PTH30d/MV30d – OVX, injected with iPTH for 30 d, followed by MV for 30 d. Bone mineral density (BMD) and body composition (lean mass and fat) were evaluated at OVX (T0), the beginning (T1), and at the end (T2) of treatments by dual X-ray absorptiometry (DXA). Femurs were processed for histomorphometry (bone volume - BV/TV and cortical thickness - Ct.Th) and tibias for biomechanical test. Results: Body composition and BMD were similar among the groups at T0. In T2, MV presented higher fat than other groups (except PTH60d) and PTH30d/MV30d showed greater lean mass than Control. At T1, Sham presented the highest BMD, but between T1 vs T2 there was an increase in all iPTH-treated groups. At T2, BMD was higher in PTH60d and PTH+MV than in the Control and MV groups. The highest BV/TV was observed in the PTH+MV group, followed by PTH60d. Cortical thickness was increased in PTH60d and PTH+MV compared to Sham. Vibration applied post-iPTH (PTH30d/MV30d) improved the force at failure in tibias when compared to Sham and Control groups. Conclusion: MV potentiated iPTH anabolic effects in cancellous bone; however, MV was unable to maintain bone mass after stopping iPTH in ovariectomized rats.

The Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network (PPACMAN) was established to optimize the clinical care of patients with psoriatic disease through multidisciplinary collaboration, education, and innovative research. This article is a report of the 2018 PPACMAN Annual Meeting held in New York City, on December 8, 2018. At this meeting, attendees discussed the benefits and challenges of combined dermatology/rheumatology clinics and PPACMAN ongoing project updates. In addition, collaborators participated in breakout sessions and plenary voting dedicated to achieving consensus on terminology for preclinical psoriatic arthritis studies, one of PPACMAN’s main areas of interest. The data obtained from this voting exercise were used to draft a formal Delphi survey that is currently underway.

In the last decades, obesity and nonalcoholic fatty liver disease (NAFLD) have become increasingly prevalent in wide world. Fatty liver can be detrimental to liver regeneration (LR) and offspring of obese dams (HFD-O) are susceptible to NAFLD development. Here we evaluated LR capacity in HFD-O after partial hepatectomy (PHx). HFD-O re-exposed or not to HFD in later life were evaluated for metabolic parameters, inflammation, proliferation, tissue repair markers and survival rate after PHx. Increasing adiposity and fatty liver were observed in HFD-O. Despite lower IL-6 levels, Ki67 labeling, cells in S phase and Ciclin D1/PCNA protein content, a lower impact on survival rate was found after PHx, even when re-exposed to HFD. However, no difference was observed between offspring of control dams (SC-O) and HFD-O after surgery. Although LR impairment is dependent of steatosis development, offspring of obese dams are programmed to be protected from the damage promoted by HFD.

This study examines the relationships between sustainability technologies, auditor transition, and circular economy models. Circular economy (CE) has been visited in recent studies as a matter of necessity to procure answers to pressing issues that befalls our society, aimed at the survival of the human species. While doing so, there has been little emphasis placed on sustainable technologies that will usher auditors into the new era. Data were constructed from a symposium organized by the Institute of Internal Auditors (IIA), where scholars and practitioners addressed the future of auditing technology, regarding, in particular, the International Social and Environmental Accreditation and Labeling (ISEAL) database official website and also interviews with experts dealing day to day with sustainability and circular economy. Discourse analysis assisted in working with these groups of data. Our findings identified 12 different relational types in our analysis, thus signaling upward trends in the preparedness of auditors in boosting sustainable technologies towards a circular economy environment. Additionally, our findings demonstrate the significant uptake of innovative tools implemented for new-generation technologies in order to enhance auditing. The findings of this study have implications for academia and practice which are aimed at technological preparedness for the transition of auditing towards CE. Finally, this paper contributes by summarizing the debate and speculations around the technologies that are driving auditing to CE.

Coexistence, as a concept and as a management goal and practice, has attracted increasing attention from researchers, managers and decision-makers dedicated to understanding and improving human-wildlife interactions. Although it still lacks a universally agreed definition, coexistence has increasingly been associated with a broad spectrum of human-wildlife interactions, including positive interactions, transcending a conservation focus on endangered wildlife, and involving explicitly considerations of power, equity and justice. In a growingly complex and interconnected human-dominated world, the key to turning human-wildlife interactions into large-scale coexistence is thorough planning. We present an approach for evidence-based, structured, and participatory decision-making in planning for human-wildlife coexistence. More specifically, we propose (i) a conceptual framework for describing the situation and setting the goals, (ii) a process for examining the causes of the situation and creating a theory of change, and (iii) a model for transdisciplinary research and collaboration integrating researchers, decision-makers and residents along with the interests of wildlife. To illustrate the approach, we report on the workshop considering the Jaguars of Iguaçu, a conservation project whose strategy includes the improvement of the relationship between ranchers and jaguars outside Iguaçu National Park, Brazil.

The Spanish version of the Educational Needs Assessment Tool (SpENAT), is a self-completed questionnaire that assesses the educational needs (ENs) in osteoarthritis (OA) patients, with the purpose of providing tailored and patient-centered information. This study established the sources of information that patients use and to evaluate the ENs of patients with knee osteoarthritis (KOA) using the SpENAT.

El Educational Needs Assessment Tool-versión española (SpENAT) es un cuestionario que evalúa las necesidades educativas (NE) de pacientes. Este estudio estableció las fuentes de información que los pacientes utilizan y evalúa las NE de pacientes con OA de rodilla utilizando el SpENAT.

Introdução: De acordo com o Instituto Nacional de Câncer (INCA) para cada ano, entre 2020 e 2022, são diagnosticados 10.810 novos casos de leucemias no Brasil. A leucemia mieloide aguda é um dos tipos mais comuns de leucemia em adultos, mas mesmo assim é bem rara. A leucemia mieloide aguda (LMA) é uma doença caracterizada pela expansão clonal, heterogênea e progressiva, com proliferação anormal de células progenitoras da linhagem mieloide, associada à perda da capacidade de diferenciação, ocasionando produção insuficiente de células sanguíneas maduras normais, com consequente substituição do tecido normal. Acomete frequentemente idosos acima de 60 anos de idade e é rara em menores de 45 anos, representando cerca de 15% a 20% das leucemias agudas na infância e 80% nos adultos. A doença também pode ser manifestar com formas extramedulares, onde células leucêmicas saem da medula e se infiltram em outros tecidos, como a pele, gânglios e sistema nervoso, levando a um aumento da gravidade. Relato de caso: Paciente, 14 anos, masculino, foi diagnosticado com LMA com acometimento extramedular. Iniciou quadro com mialgia intensa em MMII, progredindo com paraparesia, sensibilidade tátil, térmica e dolorosa preservadas, além de retenção urinária, conferindo uma mielite torácica. RM de coluna evidenciou lesões expansivas extramedulares e extradurais desde o nível T3 até o nível T9. Hemograma apresentava anemia (Hb 9,9g/dl), leucócitos totais 26.700, segmentados 500, linfócitos 3200, blastos 76% e plaquetas 120.000. Realizado estudo de medula óssea que diagnosticou a leucemia mieloide aguda. O cariótipo era 45, X, -Y, t (8:21) (q22;q22), 9qh+c [18], 9qh+c [2]. Paciente realizou radioterapia em região de coluna torácica e quimioterapia de indução “3+7”com remissão completa e DRM negativa. Sem doadores compatíveis na família, foi inscrito no REREME e seguiu com consolidação com ARA-C altas doses. Após o 4°ciclo de consolidação, paciente evoluiu com neutropenia febril secundária e pneumonia por COVID-19. Ficou internado por mais de 30 dias na UTI com piora do status performance e dificuldade de seguir tratamento da leucemia pela complicação clínica, apresentando recidiva da doença extra e intra-medular, evoluindo para óbito. Discussão: Neste caso o paciente abriu o quadro clínico com sintomas neurológicos sugestivos de mielite de causa desconhecida, após realização de RNM foi identificado lesão expansiva comprimido coluna torácica. Assim, feito o diagnóstico de LMA com acometimento extramedular pelo hemograma e estudo de medula óssea. LMA com sarcoma granulocítico é uma doença de pior prognóstico, com necessidade de tratamento intensivo e transplante de medula óssea alogênico. Nosso paciente acabou recidivando a doença antes do transplante devido complicação infecciosa por neutropenia febril secundária a pneumonia viral (COVID), evoluindo para óbito.

Brain metastasis is a serious consequence of breast cancer for women as these tumors are difficult to treat and are associated with poor clinical outcomes. Preclinical mouse models of breast cancer brain metastatic (BCBM) growth are useful but are expensive, and it is difficult to track live cells and tumor cell invasion within the brain parenchyma. Presented here is a protocol for ex vivo brain slice cultures from xenografted mice containing intracranially injected breast cancer brain-seeking clonal sublines. MDA-MB-231BR luciferase tagged cells were injected intracranially into the brains of Nu/Nu female mice, and following tumor formation, the brains were isolated, sliced, and cultured ex vivo. The tumor slices were imaged to identify tumor cells expressing luciferase and monitor their proliferation and invasion in the brain parenchyma for up to 10 days. Further, the protocol describes the use of time-lapse microscopy to image the growth and invasive behavior of the tumor cells following treatment with ionizing radiation or chemotherapy. The response of tumor cells to treatments can be visualized by live-imaging microscopy, measuring bioluminescence intensity, and performing histology on the brain slice containing BCBM cells. Thus, this ex vivo slice model may be a useful platform for rapid testing of novel therapeutic agents alone or in combination with radiation to identify drugs personalized to target an individual patient's breast cancer brain metastatic growth within the brain microenvironment.

Satellite imagery is used for many activities in different areas of the planet, including searching for alternative and sustainable sources to meet growing energy demand to reduce greenhouse gas (GHG) emissions. One way to minimize these effects and expand energy parks is to encourage local generation through the use of renewable sources, such as solar energy, which is free and affordable in many regions of the planet, but that in Brazil is not yet a reality. In order to make an assertive decision when installing a solar power system, one needs to use tools that involve remote sensing and geographic information systems (GIS), and compile information and variables that are relevant to the subject of solar power generation and take into account the inherent geographic space. In this context, the main objective of this work is to develop a GIS model to identify areas with solar potential on a regional scale using active remote sensor images and previously available solar models. To validate the model, this study used an area on the island part of the city of Florianopolis in Santa Catarina State—Brazil, which suffers from repeated climatic events which cause long power cuts, as its distribution occurs by air all over the island. Through the “solar analist” function of ArcGIS and the matrix bases derived from the Digital Model of the Space Shuttle Topography Mission (SRTM) with 30 m of spatial resolution and the supervised classification of panthromatic and multispectral images fused from LandSat 8 satellite, were generates indicative maps of the areas with solar potential. The results pointed to a high solar potential in the all year and that could be better explored by public managers and also by individual consumers.

The Drovers’ Paths are remnants of important land access roads from Rio Grande do Sul to Sao Paulo at the time of Colonial Brazil. They were built and used between the 18th and 20th centuries, particularly in the region of Coxilha Rica. The main objective of this research is to develop a method for decision-making applied to the territorial landscape management in the Coxilha Rica. The method consisted of generating criteria to map the visibility spot reached from the main selected points; define the human visual acuity, realize bibliographic research, use cartographic and historical documents, inter-views, as well as field surveys that enabled the identification, characterization and mapping of historical farms and drovers’ paths. After data processing, the information was entered into the cartographic database; the data were cross-checked and analysis was made of the visibility of the surrounding farms and stone-walled corridors. Quality assessments showed that, with the visibility polygons, and through the use of cartographic tools, we could cross-check between different levels of information and analyze landscape intervention alternatives in order to minimize environmental impacts. When applying the method in the Coxilha Rica it was possible mapping the visibility polygon, taking human visual acuity into consideration, based on historical farms and stone-walled corridors; and making spatial analyses to explore alternatives to intervention (installation of power transmission systems) in order to preserve the scenic environment of the region. In the end, the decision was by does not construct the system.

The present paper tries to assess to what extent corruption affects the different performance dimension of the Italian regional health care systems (RHSs). The Italian case is relevant because, in the European context, Italy presents the widest sub-national variation in both the levels of performance and corruption. The research focuses on petty corruption, measured using data from the European Quality of Government Index Survey. Italian RHSs' performance data are from the Meridiano Sanita, and are divided into three areas of analysis: a) population health status; b) equity and promptness to meet health needs; c) quality and responsiveness of the system. Taken together the results demonstrate that petty corruption is negatively associated to population health status and to the quality and responsiveness of the system. On the contrary, with reference to equity and promptness to meet health needs, a significant negative correlation was found only with reference to the Center-North regions.

Rheumatoid arthritis denotes hyperplasia and intense inflammatory process. Treatment involves exercise protocols and use of resources such as low-level laser therapy (LLLT) to modulate the inflammatory process and maintain physical capacity. The objective was to investigate whether treatment with LLLT and exercise modulates the inflammatory process and peripheral functionality. Sample is composed of 128 male rats, separated into three groups, control, treated and untreated, in the acute and chronic period of the disease with 64 animals in each group, divided into 8 subgroups with n = 8. The animals were immunized with injection at the base of the tail and 7 days after intra-articular injection with complete Freund adjuvant (CFA) for lesion groups, and saline solution for the controls. Joint disability was evaluated by PET (paw elevation time) and joint edema and treated with LLLT and/or resisted stair climbing exercise. Normality Shapiro-Wilk test, ANOVA mixed for the functional analyses, and ANOVA one-way for the variables of cellular differentiation, with Bonferroni post hoc, p = 5% were used. For the evaluations of joint disability and nociception, there was a significant difference between the evaluations, the groups, and the interaction groups-evaluations. The treated groups showed recovery of functionality; it is still verified that laser therapy increased the nociceptive threshold of the chronic inflammatory period, and the exercise reflected in significant functional improvement and modulation of the inflammatory process both in the acute and chronic periods. LLLT, resistance exercise, or a combination of treatments had a positive effect on the modulation of the inflammatory process, reducing the migration of leukocytes, in addition to helping the return of peripheral functionality by reducing joint disability in a model of rheumatoid arthritis induced by CFA in rats.

Cross-coupling reactions have played a key role in producing numerous types of π-conjugated small molecules having appealing properties for practical applications in organic electronics, especially in the field of photovoltaics. The main advantages of such synthetic methodology are the compatibility with many types of functional groups and the flexibility which allows an easy way to introduce diversity and tune the electronic and photophysical properties of the target molecules. As a result, many semiconducting and photoactive organic compounds have been synthesized using this powerful tool. In this paper we will highlight a number of selected syntheses and optimized C–C bond formation processes described in the years 2000–2018 and related to this specific field, choosing those examples which can demonstrate the enormous power of the cross-coupling processes, but also the room for improvements of these methodologies.

Introduction: Delayed graft function (DGF) is a frequent complication after deceased donor kidney transplantation with an impact on the prognosis of the transplant. Despite this, long-term impact of DGF on graft function after deceased donor kidney transplantation has not been properly evaluated. Objective: The main objective of this study was to evaluate risk factors for DGF and the impact of its occurrence and length on graft survival and function. Methods: A retrospective cohort study was performed in 517 kidney transplant recipients who received a deceased donor organ between January 2008 and December 2013. Results: The incidence of DGF was 69.3% and it was independently associated with donor's final serum creatinine and age, cold ischemia time, use of antibody induction therapy and recipient's diabetes mellitus. The occurrence of DGF was also associated with a higher incidence of Banff ≥ 1A grade acute rejection (P = 0.017), lower graft function up to six years after transplantation and lower death-censored graft survival at 1 and 5 years (P < 0.05). DGF period longer than 14 days was associated with higher incidence of death-censored graft loss (P = 0.038) and poorer graft function (P < 0.001). No differences were found in patient survival. Conclusions: The occurrence of DGF has a long-lasting detrimental impact on graft function and survival and this impact is even more pronounced when DGF lasts longer than two weeks. Resumo Introdução: A função tardia do enxerto (FTE) é uma complicação frequente após transplantes renais com doadores falecidos com repercussões sobre o prognóstico do transplante. Contudo, o impacto a longo prazo da FTE sobre a função do enxerto após transplante renal com doador falecido não foi avaliado adequadamente. Objetivo: O principal objetivo do presente estudo foi avaliar os fatores de risco para FTE e o impacto de sua ocorrência e duração na sobrevida e função do enxerto. Métodos: O presente estudo observacional retrospectivo incluiu 517 receptores de transplante renal que receberam órgãos de doadores falecidos entre janeiro de 2008 e dezembro de 2013. Resultados: A incidência de FTE foi de 69,3%. Foi identificada associação independente entre FTE e creatinina sérica final e idade do doador, tempo de isquemia fria, uso de terapia de indução com anticorpos e diabetes mellitus do receptor. A ocorrência de FTE também foi associada a incidência mais elevada de rejeição aguda com classificação de Banff ≥ 1 A (P = 0,017), função reduzida do enxerto até seis anos após o transplante e menor sobrevida do enxerto censurada para óbito em 1 e 5 anos (P

Background For horses requiring prolonged daily cephalic intravenous regional limb perfusion (IVRLP), the use of a totally implantable catheter (TIC) could be indicated to reduce complications associated with frequent venipuncture or external catheterization. This study aims to evaluate the implantation technique of the TIC in the cephalic vein of horses for IVRLP, describe the complications associated with the device’s placement and use, and assess its viability up to 60 days after implantation. Totally implantable catheters, cut to 15 cm (n = 5) and 46 cm (n = 5) in length, were implanted into one cephalic vein in ten adult horses (n = 10). Twenty-four hours following placement, IVRLP with contrast was performed via the TIC and evaluated with radiography. Physical examinations, lameness evaluation, hematologic assessment, and the catheter patency tests were performed at scheduled intervals for the duration of catheterization (7–60 days). Results Catheters were implanted without difficulty and allowed for IVRLP 24 h post implantation. Complications resulted in removal of the catheters, with four maintained for 7 days, three in place for 15 days, and three catheters maintained for 60 days. Complications included lameness, limb swelling, catheter kinking, and venous thrombosis. Conclusions The implantation technique of the TIC in the cephalic vein of horses is feasible and requires minimal technical effort. Although TIC allows venous access without the need for repeated venipuncture, its long-term use presents complications. For horses requiring prolonged daily cephalic IVRLP, the use of a TIC could be indicated. However, the high incidence of venous thrombosis may limit clinical application.

Several stink bugs in the subfamily Pentatominae are crop pests or have the potential to damage plants of economic importance. In the Brazilian state of Rio Grande do Sul, where agriculture plays a major role in the economy, the knowledge about pest stink bugs is fragmented and, in some instances, outdated. This work provides a summary of Pentatominae species recorded in Rio Grande do Sul feeding on the four most important grain crops for the state, i.e. soybean, rice, maize, and wheat, plus canola, an emerging crop. This survey is enhanced with new records from scientific collections, a short diagnosis for each species, distribution maps, an identification key, and carefully illustrated to allow for species recognition in the field. With this work, we aim to reunite the scattered knowledge of the group in one single revision, and provide a useful tool for identifying the pest stink bugs of Rio Grande do Sul.

Photocatalytic hydrogen production has recently emerged as a promising process for the long-term storage of solar energy. In this work, we studied the application to H2 generation of a series of heterogeneous photocatalysts obtained by sensitizing Pt/TiO2 nanoparticles with ten different D-pi-A organic dyes containing the benzo[c][1,2,5]thiadiazole (BTD) heterocyclic moiety. Starting from the known DSSC sensitizer RK-1, our approach involved the systematic and simultaneous alteration of several important structural features, such as steric bulk and hydrophobicity/hydrophilicity in different parts of the molecules, giving rise to a set of compounds with diverse physico-chemical properties. Visible light-driven H2 generation studies conducted with the dye-sensitized photocatalysts together with different sacrificial electron donors (SED) revealed that both their overall hydrogen production efficiency and their relative order of performances could be altered by the choice of SED and the corresponding reaction conditions. In particular, the best results were obtained with dyes having a strongly hydrophobic central core and a hydrophilic donor section in combination with ascorbic acid as the electron donor. In addition, the effect of changing the dye loading and extending the reaction time was examined, resulting in a stable three-component photocatalytic system displaying high activity up to 72 hours of experiment.

The Campus I of the University of Passo Fundo has historically been known for its diversified and lush green area, making it a leisure place for the community of Passo Fundo and region. This vegetation provides scenic spaces, allied to forest fragments with endangered species, representing a true living laboratory. Being used as didactic material by several courses and groups of the community, developing socio-cultural responsibility, valuing the natural environments and seeking for preservation toward sustainability. The objective of this work is to create a green trail project with the intention of instigate environmental education where the user can recognize the native, exotic and fruitful species found there. Carrying out the trail together with other sustainable approaches, in this case, the definition of a route for an internal bicycle lane on the campus and identification points of tree species, which have information boards and QR-codes for more information. Being the university an example of socio-cultural responsibility in the preservation and conservation of environments, providing the integration of experiences between teachers, students and the community, in teaching, research and extension. Encouraging the construction of sustainable paths, it improves the quality of life of users, as well as the design towards sustainable development.

Although pharmacokinetic studies of drugs administered by intravenous regional limb perfusion (IRLP) to treat equine orthopedic infections suggest efficient drug distribution in the limbs, it remains unclear whether drug perfusion is affected by the position of the horse during the procedure. This study compared the perfusion of a radiopaque contrast into tissues of the extremities of horses maintained in standing and recumbent positions during an IRLP. Radiopaque contrast was administered through IRLP into the cephalic vein of 10 healthy adult horses under general anesthesia and right lateral recumbency (RG) or under sedation and standing (SG). The same animals were used in both groups, respecting a two-week washout period. Sequential radiographic images were performed immediately at the beginning of contrast administration (T0) and after 10, 20, 30, 40, and 50 minutes. Tourniquets were removed after 30 minutes. The time required for the contrast to reach the hooves was compared between groups. Contrast reached the hooves faster in SG (114 ± 15 seconds) compared with RG (236 ± 29 seconds) (P0.5). SG showed more uniform perfusion of the limb vessels, whereas RG showed more deposition of the contrast in the lateral digital vein, with smaller amounts reaching the hooves. From T10 onward, soft tissue radiopacity increased, albeit more markedly in standing than in recumbent animals, remaining until T50. Contrast radiography evidenced that IRLP performed in standing position leads to a quicker and more uniform perfusion of the vasculature and a more noticeable diffusion to the tissues than in recumbent horses.

Organic fluorophores have found broad application as emitters in luminescent solar concentrators (LSCs) for silicon photovoltaics. In particular, the preparation of organic conjugated systems with intense light-harvesting ability, emissions in the deep-red and NIR regions, and large Stokes shift values represent a very challenging undertaking. Here, we report a simple and easy way to prepare three symmetrical donor–acceptor–donor (DAD) organic-emitting materials based on a thienopyrazine core. The central core in the three dyes was modified with the introduction of aromatic substituents, aiming to affect their optical properties. The fluorophores were characterized by spectroscopic studies. In all cases, visible-NIR emissions with large Stokes shifts were found, highlighting these molecules as promising materials for the application in LSCs.

The aim of the study is to determine the effects of a multidisciplinary lifestyle intervention (including a short period of physical exercise) on some health-related variables, particularly on blood pressure, in an overweight/obese adult group. The main outcome was blood pressure lowering. The study involved 378 subjects affected by obesity or type 2 diabetes. The intervention included exercise, nutrition and psychological aspects. Before and after the intervention, several anthropometrics, cardiovascular risk related measures (height, body weight, body mass index, waist circumference, body composition and WHTR index) and physical exercise measures (aerobic capacity, flexibility and dynamic muscle strength) were evaluated through fitness tests. We observed a significant reduction in: blood pressure values, body weight, BMI, waist circumference, WHTR, fat mass and an improvement of fat free mass and physical exercise measures. The C.U.R.I.A.Mo. multidisciplinary approach is effective for reducing blood pressure, after relatively few exercise sessions (three weeks), particularly in patients with hypertension. The intervention can ameliorate the health status and physical performance in the short term, in normotensive and hypertensive adult subjects with overweight/obesity.

Background: Wilson’s disease (DW) is a genetic disorder characterized by the accumulation of copper in the body. The copper accumulation is systemic and occurs in several tissues, with the central nervous system (CNS) being one of the most affected sites. The use of imaging tests is not necessary for the diagnosis. However, in the suspicion of neurological damage, Magnetic Resonance Imaging (MRI) plays an important role in the assessment of the metal deposit in the CNS and in the clinico-anatomical correlation in symptomatic patients. Objectives: to identify the characteristic findings of DW in neuroimaging exams. Methods: a narrative literature review. Results: in MRI, the most affected sites in the CNS are the basal ganglia (mainly the outermost portion of the putamen), followed by the midbrain, the pons, and the thalamus. Alterations are bilaterally and symmetrically. T2 sequence reveals hyperintensity in putamen, the most common abnormality, as well as in the rest of the basal ganglia. Eventually, it is possible to identify the “panda sign” in the axial section of the midbrain, due to the involvement of the tegmental region associated with the normal signal of the red nuclei and hypointensity of the superior colliculus, characteristic of DW. In the T1 sequence, patients with neurological symptoms present hypointense images. Conclusions: MRI has a diagnostic and prognostic role in DW. The putamen is the most affected structure, but abnormalities in the pons, midbrain, and thalamus are part of the neuroimaging spectrum of Wilson’s disease. The “panda sign” is the classic MRI finding.

Background Falls are the most frequent domestic accidents and their impact on subjects' quality of life, healthcare system and potentially serious complications, make their prevention fundamental. 80% of patients with Parkinson's disease fall in their homes, therefore the prevention of falls becomes a priority in caring for these patients. The aim of the study is to identify the evidence relating to home falls prevention interventions in patients with Parkinson's disease. Methods A literature review was performed considering articles published between 2000 and 2017 and indexed in PubMed, Cinhal and Cochrane Library. 655 articles were identified and 28 selected and considered for review. Results Four macro types of intervention have been identified: environmental and educational interventions, through the preparation of aids, lighting systems, room adaptation, adequate footwear and involvement of caregivers; physical and rehabilitative interventions, through programs of Qigong Baduanjin, Hi-Balance, Tai-Chi, Ai-Chi, vestibular rehabilitation and exercises marked by the metronome; pharmacological interventions, through a continuous infusion system of Rivastigmine or Levodopa; alternative therapies such as vitamin C and Macuna Pruriens. Conclusions The available literature points out the effectiveness of multiple interventions in reducing the risk of falling at home for Parkinson's disease patients. To ensure these interventions, a multidisciplinary team management is needed. This approach allows an improvement in the management of the Parkinsonian patient, promoting the maintenance of health and quality of life, preventing complications and optimizing subject's residual abilities and promoting caregivers' involvement. Key messages The literature points out the effectiveness of multiple interventions in reducing the risk of falling at home for Parkinson's disease patients. Four macro types of intervention have been identified: environmental and educational, physical and rehabilitative interventions, pharmacological and alternative therapies.

The objective of this paper is to analyze the determinants of the domestic banking credit in the South American countries, based on panel data, for the period 2000 to 2016. The results indicate that domestic deposits and liabilities to non-residents contribute positively to the growth of private credit, with domestic funding having a more representative impact than foreign funding. Economic growth leads to a greater demand for credit and an increase in credit, while higher domestic and US interest rates reduce credit growth. Rising inflation also negatively affect private sector credit. In addition, as regards credit composition, domestic deposits and economic growth are the main components of credit expansion, and, in turn, inflation and domestic interest rates contribute negatively.

Hydroelectric power plants cause impacts that are usually estimated by an indicator, the hydroelectric power generation per hectare of flooded area. And, although entrepreneurs use quality-declared cartographic bases to comply with the standards, at the project stages of a hydroelectric plant it is not a priori determined whether the altimetry tolerance of such bases is sufficient to ensure that the impacts will not increase, which in the project consolidation becomes a huge problem. This work aims to define the altimetry quality of SRTM Digital Elevation Models (DEM) and ASTER GDEM and whether they are a priori sufficient to simulate the flood level of hydroelectric power plants in different reliefs. To accomplish this objective, a morphological method of assessment of the DEM quality was developed, through Geographic Information Systems (GIS), so that the altimetry information generated by the models and field surveys, when compared, would show their actual differences also in relation to their areas. To this end, two study areas were used: one with a slightly undulated relief and the other with undulated relief. To validate the models, quality assessments were carried out: based on points, according to the Brazilian Map Accuracy Standard (MAS) and STANAG 2215; and based on surfaces, according to Article 500 of the Brazilian Civil Code and the morphological method. At the end, practical applications relating to the M&P indicator and hydroelectric power plants projects were also carried out. The results presented demonstrate that the quality of an SRTM DEM when used in undulating or gently undulating reliefs can be used up to 1:80,000 scale. Already for DEM ASTER under the same conditions, it is possible to use on the scale 1:100,000. In DEM SRTM and DEM ASTER, after removing the systematic error (−7.3 m) and (−6.2 m), respectively, the quality between 65% and 79% is verified for DEM SRTM and 53%, and 68% for DEM ASTER for common areas in flood level simulation.

In the Coal Minning Region of Santa Catarina is located the largest pole producing ceramic floors in Brazil. Considering the large volume of alkali feldspar rich waste that is generated during the porcelain polishing step. The ceramic industry is great generator of solid waste, usually deposited in landfills, being responsible for the pollution of extensive areas. There is a great availability of this alkaline material that can potentially be used as a neutralizing agent to prevent the generation of AMD in the coal minning. In this work the characterization of the potential of the generation of DAM through static and kinetic tests of a coal waste obtained in a beneficiation plant of the coal minning region, was characterized chemically the waste originated during the step of polishing in the production of porcelain tiles and determined the neutralization potential of the alkali feldspar waste. The results indicate that the coal mining waste presents a high potential of acidity (AP), the waste of the production of porcelanates presents as a major component of its composition silicon oxide and aluminum oxide, but also other oxides such as of potassium and has a moderate neutralization potential (NP). The results indicate a moderate potential of use as an alkaline additive in the prevention of AMD generation. However other uses are recommended, such as the production of soil-cement with this waste.

Assessment of heart rate variability (HRV) and cardiac ectopic beats is a clinically relevant topic. The present exploratory observational study aimed to inspect the relationships of lifestyle, dietary patterns, and anthropometrics with HRV, premature ventricular complexes (PVCs), and supraventricular premature complexes (SVPCs). A cross-sectional study enrolling subjects undergoing Holter monitoring was performed. Sociodemographic and clinical characteristics, body composition (full-body bio-impedentiometry), dietary patterns (validated food frequency questionnaire and 24 h dietary recall), and quality of life were assessed. Generalized additive models were estimated to evaluate the relationships between outcomes of interest and variables collected. The study enrolled 121 consecutive patients undergoing 24 h Holter monitoring. Upon univariable analysis, HRV was found to have an inverse association with mass of body fat (MBF) (p-value 0.015), while doing physical activity was associated with a significantly higher HRV (p-value 0.036). Upon multivariable analysis, fruit consumption in the 24 h dietary recall was found to be directly associated with HRV (p-value 0.044). The present findings might be useful for improving the management of patients attending cardiac rhythm labs, and to tailor ad hoc prevention strategies (modification of lifestyle and eating habits) based on Holter parameters.

The Global Strategy for Plant Conservation (GSPC) was established by the Conference of Parties in 2002 to decrease the loss of plant diversity, reduce poverty and contribute to sustainable development. To achieve this overarching goal, the GSPC has established a series of targets, one of which is to ensure that plant diversity is well understood, so that it can be effectively conserved and used in a sustainable manner. Brazil hosts more than 46,000 species of plants, algae and fungi, representing one of the most biodiverse countries on Earth, and playing a key role in the GSPC. To meet the GSPC goals of Target 1 and facilitate access to plant diversity, Brazil committed to preparing the List of Species of the Brazilian Flora (2008-2015) and the Brazilian Flora 2020 (2016-present). Managing all the information associated with such great biodiversity has proven to be an extremely challenging task. Here, we synthesize the history of these projects, focusing on the multidisciplinary and collaborative approach adopted to develop and manage the inclusion of all the knowledge generated though digital information systems. We further describe the methods used, challenges faced, and strategies adopted, as well as summarize advances to date and prospects for completing the Brazilian flora in 2020.

Ethnopharmacological relevance Morus nigra L. is a plant native to Asia, and well adapted to the Brazilian climate. It is popularly known as "amoreira preta”, and is part of the National List of Plants of Interest to the Brazilian Unified Health System. It is used in folk medicine mainly to soften the effects of menopause, as anti-inflammatory, antidiabetic and antihypertensive. However, information on safe doses and use is still precarious. Aim of the study To identify the chemical composition of the ethanolic extract of Morus nigra L. leaves (EEMN), as well as perform a toxicological study in male and female rats. Materials and methods The chemical composition of the extract was performed by HPLC/DAD. In the acute study, the dose administered was 2000 mg/kg, and signs of toxicity and mortality was observed. In the sub-acute study, the extract was administered at doses of 500, 750 and 1000 mg/kg for 28 days. Behavioral changes, object recognition test, renal and hepatic tissue assessments, biochemical and hematological parameters were determined. The extract was administered orally to male and female rats in both studies. Results Quercetin and caffeic acid showed as major compounds in the extract. In the acute treatment, the extract was classified as safe (category 5), according to the protocol. In the subacute study, there was a decrease in AST in males (750 and 1000 mg/kg) and females (1000 mg/kg), reduction of total cholesterol in females (750 and 1000 mg/kg), and increase in renal and hepatic change the LPO levels. Conclusion The present investigation showed that EEMN did not present significant toxic effects when administered orally. Moreover, presented a potentially protective action of organs and possesses hypocholesterolemic activity, thus, it is shown as a promising natural source to be used in pharmacology.

OBJECTIVE: To compare technical feasibility, surgical time, surgical complications, and postoperative pain in ovariectomy (OVE) by hybrid and total natural orifice transluminal endoscopic surgery (NOTES). STUDY DESIGN: Prospective randomized clinical trial. ANIMALS: Sixteen healthy and sexually intact bitches. METHODS: Dogs were randomly assigned to the hybrid NOTES group (HNG; n = 8) and the total NOTES group (TNG; n = 8) to compare surgical time, pain scores and complications. Pain was assessed by using the visual analog scale (VAS) and the Melbourne pain scale (MPS). RESULTS: Surgical time did not differ between the experimental groups (HNG = 46.3 ± 18.5 minutes, TNG = 54.6 ± 31.1 minutes). Exteriorization of the ovaries through the vaginal wound was the major difficulty. Complications were minor in both groups and occurred intraoperatively only in the HNG, and in both groups post operatively. No dogs required rescue analgesia in the intraoperative or postoperative period. There were no differences in VAS or MPS scores between the groups for any surgical times except for the VAS assessment at 72 hours after extubation (HNG = 1.1 ± 0.3, TNG = 0.7 ± 0.4, P = .0221). CONCLUSION: Both NOTES techniques were comparable for canine OVE, with no requirement for additional analgesia in the postoperative periods. It was not possible to determine whether there was a clear advantage of one technique rather than the other. CLINICAL SIGNIFICANCE: The minimally invasive techniques proposed for laparoscopic OVE are feasible for dogs with low pain scores and low rates of complications for both groups.

OBJECTIVE: The language currently used to describe gout lacks standardisation. The aim of this project was to develop a consensus statement on the labels and definitions used to describe the basic disease elements of gout. METHODS: Experts in gout (n=130) were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach consensus on the labelling and definitions for the basic disease elements of gout. Disease elements and labels in current use were derived from a content analysis of the contemporary medical literature, and the results of this analysis were used for item selection in the Delphi exercise and face-to-face consensus meeting. RESULTS: There were 51 respondents to the Delphi exercise and 30 attendees at the face-to-face meeting. Consensus agreement (≥80%) was achieved for the labels of eight disease elements through the Delphi exercise; the remaining three labels reached consensus agreement through the face-to-face consensus meeting. The agreed labels were: monosodium urate crystals, urate, hyperuric(a)emia, tophus, subcutaneous tophus, gout flare, intercritical gout, chronic gouty arthritis, imaging evidence of monosodium urate crystal deposition, gouty bone erosion and podagra. The face-to-face meeting achieved consensus agreement for the definitions of all 11 elements and a recommendation that the label 'chronic gout' should not be used. CONCLUSION: Consensus agreement was achieved for the labels and definitions of 11 elements representing the fundamental components of gout aetiology, pathophysiology and clinical presentation. The Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) recommends the use of these labels when describing the basic disease elements of gout. This article is protected by copyright. All rights reserved.

ObjectiveThere is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout.MethodsA content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions.ResultsThe content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: ‘asymptomatic hyperuricaemia’, ‘asymptomatic monosodium urate crystal deposition’, ‘asymptomatic hyperuricaemia with monosodium urate crystal deposition’, ‘gout’, ‘tophaceous gout’, ‘erosive gout’, ‘first gout flare’ and ‘recurrent gout flares’. There was consensus agreement that the label ‘gout’ should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus).ConclusionConsensus agreement has been established for the labels and definitions of eight gout disease states, including ‘gout’ itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.

Background: Non-alcoholic fatty liver disease (NAFLD) has an estimated prevalence of 20&ndash, 30% in the general population and even higher in individuals with metabolic risk factors. The aim of this study was to evaluate the effect of a lifestyle intervention program on surrogate markers of hepatic steatosis in obesity and/or type 2 diabetes patients, enrolled in the C.U.R.I.A.Mo. (Centro Universitario di Ricerca Interdipartimentale Attivit&agrave, Motoria) trial. Methods: 102 subjects (56 females and 46 males, aged between 23 and 78) with type 2 diabetes, obesity or a BMI of at least 25 kg/m2 with comorbidities, participated in the intensive phase of a multidisciplinary lifestyle intervention program at the Healthy Lifestyle Institute of the University of Perugia (C.U.R.I.A.Mo.). Six indices related to NAFLD (Visceral Adiposity Index, Fatty Liver index, Non-Alcoholic Fatty Liver Disease liver fat score and liver fat equation, hepatic steatosis index and TyG index) were calculated before and after a three-month multidisciplinary lifestyle intervention. Results: The intervention improved the anthropometric and clinical parameters in the total population, the obese and/or diabetics. Data showed a significant weight loss, a reduced waist circumference, triglycerides, and an improvement in Mediterranean diet adherence. Hepatic steatosis indices were significantly reduced in the total population and in different subgroups (males, females, obesity and diabetes).

The University of Passo Fundo, during its 50 years of implantation, has searched to insert itself into the urban landscape of the city, in urban or landscape terms. The methodology for elaboration of the Environmental Management Plan of the Flora in the Campus I attends the Environmental Management System guidelines of the UPF. Tree species were identified in botanic survey and defining the Permanent Preservation Areas, with individual components from the native vegetation in the region of the Mixed Ombrophilous Forest. From these surveys the formation of an ecological corridor with a strip of native vegetation was pointed as a mitigating measure, creating a green area for the interconnection of these arboreal fragments; it equally indicates the implementation of a vegetal replacement plan with native species. The importance of this area is highlighted by creating an environment where users (internal and external community) can perceive several examples of flora; besides contributing to the improvement of the microclimate with a dense green area interconnecting several buildings. The University does not only strengthen its formation role of students and teachers and external community that use Campus I as an urban park, but also enhances the sustainable performance in the local and regional area.