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Made available in DSpace on 2022-04-29T08:46:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-10-01 The objective of this study was to verify the influence of the gravitational infusion method or syringe infusion pump on changes in hemolysis markers of irradiated and nonirradiated packed red blood cells (PRBCs) in vitro administered in a neonate peripheral intravenous catheter. An experimental study was conducted in a laboratory under controlled environmental conditions. Irradiated and nonirradiated PRBCs were administered in triplicate by the gravitational method and 10-mL/hour syringe infusion pump, in peripheral intravenous catheter, Vialon, 24-G caliber. Aliquots were collected directly from the PRBC bag, after manual filling of the infusion system and after infusion by the catheters. The following hemolytic markers were analyzed: degree of hemolysis (%), hematocrit (Ht, %), free hemoglobin (fHb, g/dL), potassium (K, mmol/L), and lactate dehydrogenase (LDH, U/L). Mann-Whitney and Student's t tests were used, P ≤ .05. The gravitational method significantly influenced increasing fHb (P = .007), Ht (P = .002), K (P = .002), and LDH (P = .003) values after PRBC irradiated infusion. The infusion of irradiated and non-irradiated PRBCs interferes with changes in hemolytic markers with the gravitational method. Syringe infusion pump proved to be a beneficial and safe alternative to irradiated and nonirradiated PRBC transfusion in newborns. Nursing School, Federal University of São Paulo, São Paulo, Brazil (Drs Orsi and Avelar and Mss Kita and de Souza); and Department of Biostatistics, Paulista State University Julio de Mesquita Filho, Botucatu, São Paulo, Brazil (Dr Tsunemi)

This study aimed to determine the prevalence and clinical features of Parkinson’s disease (PD)/PD dementia (PD/PDD) or dementia with Lewy bodies (DLB) in idiopathic normal pressure hydrocephalus (iNPH). Patients with iNPH who were admitted to the Department of Neurology, Juntendo University School of Medicine over the past 10 years have been retrospectively analyzed. The diagnosis of iNPH and concomitant PD/PDD or DLB was established using diagnostic criteria. Motor symptoms were assessed by the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III. 123I-ioflupane single-photon emission computed tomography (DaT-SPECT) and cerebrospinal fluid (CSF) real-time quaking-induced conversion (RT-QuIC)-based assay were performed for alpha synuclein aggregation. Overall, 79 patients met the criteria for iNPH, of which 34 developed iNPH without accompanying disorders (iNPHa; 43%), 23 developed iNPH with comorbid PD/PDD (iNPHc + PD/PDD; 29.1%), and 8 developed iNPH with comorbid DLB (iNPHc + DLB; 10.1%). Significant differences in facial expansion and upper-limb parkinsonism were observed with a comorbidity of either PD/PDD or DLB. The specific binding ratio (SBR) of DaTscan was reduced in iNPHa (p = 0.02), but it reduced further with comorbid PD/PDD (p

Background: Estimating the nutritional content of food is essential for self-management in people with type 2 diabetes mellitus, but it is a difficult skill to learn. The aim of this study was to investigate how diabetes management was impacted by the ability of patients to search for items they ate from a database of 26,300 different foods, and to visualize nutritional intake using the Japanese mobile application (app) "Calomeal." Methods: This was a single-arm, single-center, pilot study. Eighteen outpatients with type 2 diabetes mellitus used the "Calomeal" app for 3 months. The primary endpoint was change in hemoglobin A1c (HbA1c). Secondary endpoints were changes in body weight (BW), lipid parameters, and quality of life scores. Results: The baseline characteristics of the study subjects were as follows: age: 53.4 ± 7.8 years; male/female ratio: 11/7; HbA1c: 7.9 (7.58 - 8.23)%; and body mass index (BMI): 25.17 (21.63 - 28.59) kg/m 2 . Significant reductions in HbA1c and BMI were observed over 3 months (HbA1c: 7.9 (7.58 - 8.23)% to 7.6 (7.3 - 8.23)%, P = 0.0410; BMI: 25.17 (21.63 - 28.59) to 24.54 (21.57 - 27.81) kg/m 2 , P = 0.0057). Reductions in HbA1c and BMI both correlated with decreased carbohydrate intake estimated by the mobile app. Conclusions: Japanese patients who used their smartphones to visualize their nutritional intake using the "Calomeal" app demonstrated improved short-term glycemic control and BMI. Although the validity of the results should be tested in future randomized controlled trials, this approach may be a clinical option for improving self-management in Japanese patients with type 2 diabetes mellitus. J Clin Med Res. 2021;13(8):425-433 doi: https://doi.org/10.14740/jocmr4558

Advanced Parkinson's disease is inconsistently defined, and evidence is lacking in relation to device-aided therapies. To update existing reviews of intrajejunal infusion of levodopa/carbidopa (LCIG), we performed a literature search for relevant articles (to November 3, 2020) using PubMed supplemented by hand searching. Retrieved articles were categorized by relevance to identified research questions, including motor complications and symptoms; nonmotor symptoms; functioning, quality of life, and caregiver burden; optimal timing of treatment initiation and administration duration; discontinuation; and complications. Most eligible studies (n = 56) were open-label, observational studies including relatively small patient numbers. LCIG consistently reduces OFF time and increased ON time without troublesome dyskinesia with varying effects regarding ON time with troublesome dyskinesia and the possibility of diphasic dyskinesia. More recent evidence provides some increased support for the benefits of LCIG in relation to nonmotor symptoms, quality of life, activities of daily living, and reduced caregiver burden. Patient age does not appear to significantly impact the effectiveness of LCIG. Discontinuation rates with LCIG (~17%-26%) commonly relate to device-related issues, although the ability to easily discontinue LCIG may represent a potential benefit. LCIG may be a favorable option for patients with advanced Parkinson's disease who show predominant nonmotor symptoms and vulnerability to complications of other advanced therapy modalities. Larger, well-controlled studies, including precise investigation of cost effectiveness, would further assist treatment selection. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

We report a rare case of xanthomatized Sweet's syndrome with myelodysplastic syndrome (MDS) in a patient who presented with erythematous plaques on his chest that were elevated and became yellowish. A diagnosis of MDS with single lineage dysplasia was made during the development of the eruption. Bone marrow biopsy showed an increased number of megakaryoblasts. Histopathologically, there was neutrophil infiltration with leukocytoclasia and the infiltration of xanthomatous cells. Immunohistochemical analysis revealed that the xanthomatized cells were predominantly CD163 positive. We propose that our case of xanthomatized neutrophilic dermatosis is a rare clinicopathological variant of Sweet's syndrome associated with a hematologic disorder.

Late relapse of herpes simplex encephalitis (HSE) is defined as the recurrence of HSE more than 3 months after the initial exposure. The postoperative diagnosis of HSE following neurosurgery is complicated because the clinical presentation can mimic other common complications of neurosurgery. Cerebrospinal fluid polymerase chain reactions (CSF-PCR) is the gold standard for the diagnosis of HSE. We describe a case of late HSE relapse after epilepsy surgery in a patient who required a brain biopsy due to repeated negative CSF-PCR results. A 38-year-old woman had a history of HSE from the age of 3 years. She had intractable epilepsy from the age of 20 years and underwent right posterior quadrant disconnection (PQD) at the age of 38 years. Postoperatively, she had a right hemispheric intracerebral hemorrhage (ICH) and her consciousness was gradually worsening. Her consciousness improved after removal of the ICH. However, her consciousness gradually deteriorated again. Fluid-attenuated inversion recovery (FLAIR) revealed bilateral hyperintensity in the frontal lobes, including the white matter. CSF-PCR for herpes simplex virus (HSV) was performed twice, but yielded negative results. We performed a brain biopsy to target FLAIR hyperintensity in the right frontal lobe. PCR of the brain specimen was positive for HSV. Her consciousness improved with acyclovir, methylprednisolone, and cyclophosphamide. To our knowledge, this is a case of HSE induced by epilepsy surgery which had the longest duration until relapse after the initial HSE episode. A brain biopsy can be used to confirm the diagnosis of suspected HSE when CSF-PCR results are negative.

The goal of a treatment regimen for atopic dermatitis is to reach and maintain a state where the patient exhibits mild symptoms or an absence of symptoms, and the patient should not experience disturbance during daily activities. The basis of a treatment regimen for atopic dermatitis is topical therapy, and currently there exist topical corticosteroids, tacrolimus and delgocitinib. Using these, proactive therapy is performed as maintenance therapy after remission induction therapy. However, in cases of moderate to severe atopic dermatitis, topical drugs alone cannot induce remission and systemic therapies such as cyclosporin, ultraviolet therapy, and dupilumab should be used in combination. In particular, dupilumab has many advantages such as high efficacy, relatively few adverse reactions, and ease of use in elderly patients with severe atopic dermatitis. In this review, we present a treatment algorithm for atopic dermatitis that emphasizes the importance of maintaining remission after induction of remission, and summarizes the characteristics of current medication therapy for atopic dermatitis in Japan.

In this study we aim to show the application of ultrasound evaluation of the fetal heart in the ovine species, as well as its limitations in the field. Ten Dorper sheep, without any sedation, were evaluated starting from the second month of pregnancy through transabdominal ultrasound with an ultrasound device equipped with a convex transducer. Images of the fetal heart were obtained through maternal abdominal ultrasound by identifying the position of the fetus and conducting the following measurements: length and diameter of the heart, dimensions of the right and left ventricles and dimensions of the right and left atria. The measurements could only be conducted with acceptable precision starting from the third month of pregnancy. There was a significant difference only for left ventricle diameter, which was larger in the fifth month of pregnancy. The echocardiographic evaluation of the fetus enables monitoring the heart development identifying early fetal viability, assessing inadequate events that could put the pregnancy at risk, especially for production animals. For the experimental design of research employing production animals, it is important to consider, among other factors, the limitations of the evaluation on the field, such as restraining the animals, the stress caused by handling and environmental conditions, temperature, luminosity, facilities available and the qualifications of the team., Fetal ultrasound in sheep is an examination that can help identify fetal viability by analysing cardiac dimensions in sheep. There are limitations of the technique to the field. The method may contribute to the reduction in losses during pregnancy.

The "Guidelines for the management of dermatomycosis" of the Japanese Dermatological Association were first published in Japanese in 2009 and the Guidelines Committee of the Japanese Dermatological Association revised it in 2019. The first guidelines was prepared according to the opinions of the Guidelines Committee members and it was of educational value. The revised version is composed of introductory descriptions of the disease concepts, diagnosis, medical mycology and recent advances in treatment, along with clinical questions (CQ), which is intended to help in general practice for dermatologists. The CQ are limited to those involved in therapy but include some of the recently launched antifungal agents. The level of evidence and the degree of recommendation for each item were reviewed by the committee based on clinical studies published by 2018. For rare dermatomycoses, recommendations by the committee are described in the guidelines. In this field, there are still few good quality studies on treatment. Periodic revision in line with new evidence is necessary.

Aims/Introduction In Japan, an insulin pump with predictive low‐glucose management (PLGM) was launched in 2018. It automatically suspends insulin delivery when the sensor detects or predicts low glucose values. The aim of this study was to analyze the safety and efficacy of PLGM in patients treated in a Japanese center. Materials and Methods We carried out a retrospective observational analysis of 16 patients with type 1 diabetes mellitus and one patient after pancreatectomy. They switched from the MiniMed 620G device to the 640G device with PLGM. The primary outcome was the change in the percentage of time in hypoglycemia. The secondary outcome was the change in HbA1c (%) over a period of 3 months. We also explored the presence of “post‐suspend hyperglycemia” with the 640G device. Results After changing to the 640G device, the percentage of time in hypoglycemia (glucose 180 mg/dL) significantly increased from 25.53% (15.78–44.14%) to 32.9% (24.71–45.49%; P = 0.0373). HbA1c significantly increased from 7.6 ± 1.0% to 7.8 ± 1.1% (P = 0.0161). From 1.5 to 4.5 h after the resumption of insulin delivery, the percentage of time in hyperglycemia was 32.23% (24.2–53.75%), but it was significantly lower, 2.78% (0–21.6%), when patients manually restarted the pump within 30 min compared with automatic resumption 31.2% (20–61.66%; P = 0.0063). Conclusions Predictive low‐glucose management is an effective tool for reducing hypoglycemia, but possibly elicits “post‐suspend hyperglycemia.” This information is useful for achieving better blood glucose control in the patients treated with PLGM., An insulin pump with predictive low‐glucose management was launched in 2018 in Japan. It automatically suspends insulin delivery when the sensor detects or predicts low glucose values. Predictive low‐glucose management is an effective tool for reducing hypoglycemia, but possibly elicits “post‐suspend hyperglycemia.”

To assess the effectiveness of ultrasound (US)-guided laser ablation of benign thyroid nodules (TNs) under different amounts of applied energy.Thirty-four euthyroid patients with 5-18 ml TNs were enrolled: 21 (laser ablation) and 13 (clinical follow up) patients with a mean age of 56.2 ± 12.0 and 54.7 ± 14.7 years, respectively. The laser ablation protocol used a 1.064 mm wavelength diode laser source; 3.5 W output power; 1,100-1,500 J and 5-8 min/illumination; and one or two fibers/session. Clinical, laboratory, and US data were obtained immediately before treatment and at 6 and 12 months follow-up and were analyzed by Student's t test and Fisher's exact test. Low- and high-energy subgroups were subsequently defined, and the receiver operating characteristic (ROC) curves were calculated.Laser ablation follow-up showed an overall nodule volume reduction of more than 50%; improvement of symptoms and cosmetic complaints (P = 0.001); and stable laboratory data compared with the baseline and control groups. Minor complications were 9.5% ( n = 2). One or two fibers/session resulted in a similar nodule volume reduction among 10-18 ml nodules. Analysis of the applied energy suggested a 398.8 J/ml inferior cutoff (ROC curve: 0.889 sensitivity; 0.545 specificity) for the high-energy subgroup ( n = 14, mean 599.9 ± 136.5 J/ml) to reduce the nodule volume over time (-55.1% vs. -58.4%, P = 0.55). The low-energy subgroup ( n = 7, mean 240.2 ± 74.6 J/ml) did not show a persistent volume reduction ( P 0.05) from the 6- to 12-month follow-ups (-56.6% vs. -53.7%).Laser ablation of benign TNs achieved technique efficacy at 12 months posttreatment, with clinical improvement and few minor side effects. A single fiber in a single session with a high deployed energy (398.8 J/ml) may be associated with improved results, a finding to be confirmed with a larger series. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

BACKGROUND Baricitinib, an oral selective Janus kinase 1 and 2 inhibitor, effectively reduced atopic dermatitis (AD) severity in a phase II study with concomitant topical corticosteroids. OBJECTIVES To evaluate the efficacy and safety of baricitinib in patients with moderate-to-severe AD who had an inadequate response to topical therapies. METHODS In two independent, multicentre, double-blind, phase III monotherapy trials, BREEZE-AD1 and BREEZE-AD2, adults with moderate-to-severe AD were randomized 2 : 1 : 1 : 1 to once-daily placebo, baricitinib 1 mg, 2 mg, or 4 mg for 16 weeks. RESULTS At week 16, more patients achieved the primary end point of Validated Investigator's Global Assessment of AD (0, 1) on baricitinib 4 mg and 2 mg compared with placebo in BREEZE-AD1 [N = 624; baricitinib 4 mg 16·8% (P < 0·001), 2 mg 11·4% (P < 0·05), 1 mg 11·8% (P < 0·05), placebo 4·8%], and BREEZE-AD2 [N = 615; baricitinib 4 mg 13·8% (P = 0·001), 2 mg 10·6% (P < 0·05), 1 mg 8·8% (P = 0·085), placebo 4·5%]. Improvement in itch was achieved as early as week 1 for 4 mg and week 2 for 2 mg. Improvements in night-time awakenings, skin pain and quality-of-life measures were observed by week 1 for both 4 mg and 2 mg (P ≤ 0·05, all comparisons). The most common adverse events in patients treated with baricitinib were nasopharyngitis and headache. No cardiovascular events, venous thromboembolism, gastrointestinal perforation, significant haematological changes, or death were observed with any baricitinib dosage. CONCLUSIONS Baricitinib improved clinical signs and symptoms in patients with moderate-to-severe AD within 16 weeks of treatment and induced rapid reduction of itch. The safety profile remained consistent with prior findings from baricitinib clinical development in AD, with no new safety concerns.

Highlights • Emergent surgery for perforated appendicitis with abscess is should be carefully judged. • It may lead to insufficient anatomical recognition or postoperative complications. • The benefits of laparoscopic drainage for appendiceal abscess should be known. • It is very important to understand the correct management for perforated appendicitis with abscess., Introduction The management of appendiceal abscess or phlegmon is a clinical important issue. Immediate appendectomy in these cases may be technically demanding because of the distorted anatomy and difficult to close the appendiceal stump because of the inflammation. Presentation of case A 32-year-old female was referred to our hospital with abdominal pain. Enlarged appendix and abscess were recognized on CT scan. Preoperative diagnosis was perforated appendicitis with abscess and laparoscopic surgery was performed. The appendix was perforated and cut by stapler, but complete resection was impossible. Endoscopic transrectal drainage was performed for a pelvic abscess on the 10th POD and the patient’s condition improved. Thirty months after the surgery, however, the patient was again referred to our hospital for abdominal pain. CT scan revealed an enlarged remnant appendix. Preoperative diagnosis was stump appendicitis after the incomplete first appendectomy. Emergent second appendectomy and partial resection of the cecum were performed. The postoperative course was uneventful. Discussion In the first operation, we mistakenly thought that the base of the appendix was cut. It was not cut, however and it remained, which was lead to stump appendicitis. Furthermore, postoperative abdominal abscess was also occurred. Immediate appendectomy for perforated appendicitis with abscess is associated with a higher morbidity. Nonsurgical treatment with drainage and/or antibiotics should be selected. Laparoscopic drainage is the useful options when CT-guided drainage is impossible. Conclusion It is crucial to understand the correct management of perforated appendicitis with abscess to avoid serious complications.

In Japan, graduates who become independent professionals in society have the right to choose energy providers given the liberalization of the electricity market in the country. This issue renders student perceptions regarding various types of energy generation a critical factor for decision making. Accordingly, we explored the risk and benefit perceptions of undergraduates regarding Japan’s main energy resources, namely, liquid natural gas (LNG), coal, hydropower, solar and nuclear resources, and petroleum. We also assessed energy acceptance among the target population and its influencing factors, such as student age and gender, school department, hometown, knowledge and experience of main power sources in Japan, and trust in government and power plant operation. These objectives were accomplished through field surveys and empirical characterizations of energy acceptance determinants. Compared with risk perception, benefit perception regarding all kinds of power generation was significantly predicted by knowledge. Experience explained only the perception of benefit from coal power generation, and benefit perception more strongly predicted energy acceptance than did risk perception. The findings suggested the necessity of university energy education programs for increased student knowledge of energy sources. Energy companies should increase energy benefits from economic, environmental, and energy security and safety perspectives to enhance energy acceptance among students. On the basis of the results, we classified energy sources in Japan into obscure (LNG and petroleum), well-known (coal and nuclear), and exploratory (hydropower and solar) resources—a first in the energy field and contributory to energy education design.

Asteatosis is characterized by decreased stratum corneum water content, and the basic treatment is to keep the skin moisturized. Poor application of moisturizers by patients may reduce treatment efficiency, so it is important to continue application as instructed by dermatologists. Application instructions based on the finger-tip unit are useful for patients, but there is no clear evidence of its efficacy. We investigated the effects of the volume of the moisturizer (Hirudoid® Cream 0.3%) administrated with 1/3 finger-tip unit and 1 finger-tip unit equivalent doses per target lower leg of patients with asteatosis (twice daily, 28 days) on the overall dry skin scores, itch numerical rating scale scores, and skin physiological parameters (stratum corneum water content, transepidermal water loss, and skin pH). Sixty patients were randomized with a 1:1 allocation ratio into two groups: the 1/3 finger-tip unit and 1 finger-tip unit equivalent dose groups. The results showed that 43.3% of the patients in the 1 finger-tip unit equivalent dose group, compared with 13.3% in the 1/3 finger-tip unit equivalent dose group, presented zero overall dry skin scores 1 week later. As the overall dry skin scores improved, the stratum corneum water content also increased. In patients with moderate itching, the itch numerical rating scale scores of the 1 finger-tip unit equivalent dose group decreased significantly compared with those of the 1/3 finger-tip unit equivalent dose group. The results suggested that the application of 1 finger-tip unit equivalent dose of the moisturizer twice daily in clinical practice could induce remission more quickly. With the 1/3 finger-tip unit equivalent dose, prolonged treatment may be necessary to achieve the desired effect; therefore, application adherence is strictly required. In conclusion, the application of a 1 finger-tip unit equivalent dose would be quite reasonable in clinical practice.

Made available in DSpace on 2022-04-29T08:46:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-10-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) BACKGROUND AND PURPOSE: Youthful memory performance in older adults may reflect an underlying resilience to the conventional pathways of aging. Subjects having this unusual characteristic have been recently termed “superagers.” This study aimed to explore the significance of imaging biomarkers acquired by 1H-MRS to characterize superagers and to differentiate them from their normal-aging peers. MATERIALS AND METHODS: Fifty-five patients older than 80 years of age were screened using a detailed neuropsychological protocol, and 25 participants, comprising 12 superagers and 13 age-matched controls, were statistically analyzed. We used state-of-the-art 3T 1H-MR spectroscopy to quantify 18 neurochemicals in the posterior cingulate cortex of our subjects. All 1H-MR spectroscopy data were analyzed using LCModel. Results were further processed using 2 approaches to investigate the technique accuracy: 1) comparison of the average concentration of metabolites estimated with Cramer-Rao lower bounds,20%; and 2) calculation and comparison of the weighted means of metabolites' concentrations. RESULTS: The main finding observed was a higher total N-acetyl aspartate concentration in superagers than in age-matched controls using both approaches (P ¼.02 and P ¼.03 for the weighted means), reflecting a positive association of total N-acetyl aspartate with higher cognitive performance. CONCLUSIONS: 1H-MR spectroscopy emerges as a promising technique to unravel neurochemical mechanisms related to cognitive aging in vivo and providing a brain metabolic signature in superagers. This may contribute to monitoring future interventional therapies to avoid or postpone the pathologic processes of aging. The Department of Radiology and Oncology Universidade de Sao Paulo Department of Neurology Universidade de Sao Paulo Division and Laboratory of Nuclear Medicine Department of Radiology and Oncology Hospital das Clinicas da Faculdade Medicina Universidade de Sao Paulo The National Hospital of Neurology and Neurosurgery University College London Department of Biostatistics Institute of Biosciences Universidade Estadual Paulista, Sao Paulo Department of Biostatistics Institute of Biosciences Universidade Estadual Paulista, Sao Paulo

Introduction We conducted a retrospective study to investigate the progress of the operative outcome after laparoscopic splenectomy (LS), with a special reference to the administration of prophylactic antibiotics (PA). Methods The study included 123 patients who underwent elective LS. Operative outcomes before and after the operative procedure was standardized and the impact of treatment with PA on surgical-site infection were investigated. Results With regard to complications, wound infection developed in one (0.8%), portal trunk thrombosis in one (0.8%), pancreatic fistula in one (0.8%), postoperative bleeding in two (1.6%), pleural effusion in one (0.8%), and reoperation because of bowel injury in one (0.8%). Although morbidity did not differ between patients in the early (until the end of 2010) and late (after the beginning of 2011) periods, intraoperative blood loss was lower in patients in the late period. During the late period, no patients required conversion to open surgery. The proportion of patients with surgical-site infection did not differ between those who received PA 1 h before the start of surgery and every 3 h during surgery and those who received PA 1 h before the start of surgery, every 3 h during surgery, and twice a day for 24-72 h after surgery. Conclusion Operative outcomes after LS improved after the standardization of the operative procedure. The administration of PA 1 h before surgery and every 3 h during surgery seems to be sufficient to prevent surgical-site infection during LS.

The insufficiency of waste treatment capacity is a considerable challenge that must be solved by cultivating concern for waste problems. Correspondingly, this research investigated waste separation behavior (WSB) in rural Vietnam, specifically among 298 rural and semi-rural households, which were divided into livestock and non-livestock groups on the basis of livelihood. The study's objectives were to identify differences in WSB and waste separation performance between these groups using an independent samples t-test and to introduce new WSB-related constructs associated with the theory of planned behavior (TPB). The constructs, namely, awareness, perception, and socioeconomic factors (the ownership of a garden, the number of pigs and chickens raised, and the money saved from using waste), were incorporated into multiple regression models of the household groups. Results showed that the livestock group exhibits more positive attitudes toward waste separation, greater concern for subjective norms, a stronger awareness of the negative effects of waste, a more well-developed perception of the encouragement of waste separation, and higher waste separation performance than does the non-livestock group (p

Background: Olfactory dysfunction in eosinophilic chronic rhinosinusitis (ECRS) is poorly understood.Objective: To compare olfactory mucosal injury due to eosinophil infiltration in ECRS with posto...

Objective We employed a steroid-eluting, sinus-bioabsorbable device for local treatment after surgery for eosinophilic chronic rhinosinusitis (ECRS). One year later, we investigated its efficacy in suppressing recurrence and reducing the use of oral steroids. Methods At one year after ECRS surgery, both 18 cases treated with a postoperative steroid-eluting, sinus-bioabsorbable device (Post-ST group) and 25 cases receiving conventional postoperative therapy (Post-Con group) showed significant improvement in the nasal symptoms (nasal obstruction, nasal discharge and olfactory dysfunction), CT score and threshold test (discrimination test). Results The olfactory dysfunction, CT score and threshold test were significantly improved in the Post-ST group compared with the Post-Con group, but the polyp score was not. The mean total number of oral steroid tablets ingested during one year after surgery was 24.3 ± 2.8 tablets in the Post-ST group, which was significant lower than the 36.3 ± 3.7 tablets used in the Post-Con group. Conclusion The above results indicate that insertion of a steroid-eluting, sinus-bioabsorbable device after ECRS surgery can reduce the oral steroid intake while maintaining long-term suppression of disease recurrence.

Made available in DSpace on 2019-10-06T16:21:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-05-01 “Pheromonal therapy” has been promoted as a promising alternative therapy to improve the human-animal relationship and to reduce behavioral reactions to stressful stimuli. This placebo-controlled double blind study evaluated the use of a synthetic equine maternal pheromone (EMP) in animals undergoing hoof trimming for effects on behaviors and autonomous nervous system responses. Twenty foals (14 females and 6 males) with an average age of 24 months were divided into two experimental groups (A and B); one group receiving treatment with EMP and the other receiving placebo (excipient without the active ingredient). The parameters analyzed were heart rate (HR), respiratory rate, blood sugar levels, heart rate variability and behavioral reactions. There were no statistically significant differences in the HR, respiratory rate, and blood sugar levels when comparing the EMP and placebo groups. The heart rate variability indexes (minimum HR, average HR, maximum HR, NN, SDNN, RMSSD, and PNN50) also were not statistically significantly different when comparing the groups before, during, and after trimming. We also found no behavioral changes during the procedure of hoof trimming associated with the use of synthetic pheromonal analogues. This study provided no evidence for the effectiveness of synthetic pheromonal analogues to aid in the process of hoof trimming. Department of Veterinary Clinics São Paulo State University (Unesp) School of Veterinary Medicine and Animal Science Department of Animal Health School of Veterinary Medicine and Animal Science UNIMAR Department of Biostathistics São Paulo State University (UNESP) Institute of Biosciences Department of Veterinary Clinics São Paulo State University (Unesp) School of Veterinary Medicine and Animal Science Department of Biostathistics São Paulo State University (UNESP) Institute of Biosciences

Since textile industry has been claimed to endanger the environment and human health, the insight of textile firm behavior regarding chemical use and discharge is vital for designing environmental ...

Purpose The primary aim of this study was to compare patient reported versus clinician-observed nonulcerative foot conditions in patients attending a diabetic foot clinic and deemed at risk for diabetic foot ulcers. Design Retrospective review of medical records. Subjects and setting The medical records of 126 patients with diabetes mellitus and deemed at risk for developing diabetic foot ulcers were reviewed. All patients received care from a diabetic foot outpatient clinic in a university-based hospital in Tokyo, Japan, between November 2008 and October 2009. Methods We compared patients' self-identified foot complaints with clinically observable conditions affecting the feet of these individuals with diabetes mellitus. Patients' medical records were retrieved, and patient complaints and identified preulcerative signs of the foot were documented. All clinical observations were made by nurse specialists with knowledge of diabetic foot conditions. Nonulcerative diabetic foot conditions we observed included calluses, corns, abnormal nails, fissures, tinea pedis, and tinea unguium. Patient sensitivity to correctly identify these signs was calculated using the following formula: patient-reported foot signs divided by clinically identified preulcerative signs. Results Patient sensitivity for identifying nonulcerative signs varied based on the foot condition was 51.4% for calluses, 47.8% for pincer nails, 44.4% for corns, 33.3% for fissures, 19.4% for nail abnormalities, 3.9% for scales/maceration between the toes, 2.6% for interdigital tinea pedis, and 18.2% for tinea unguium. Conclusion These findings suggest that persons with diabetes vary in their awareness of conditions affecting their feet and enhancing their risk for the development of diabetic foot ulcers. We recommend additional education on foot-related self-care including how often to observe their feet and how to recognize symptoms that may elevate their risk for diabetic foot ulcers.

A 40-year-old Japanese man presented with child-onset hypertriglyceridemia recently complicated by diabetes mellitus. The patient's diabetes mellitus was maintained, but he had persistent insulin resistance. The patient also had persistent severe hypertriglyceridemia (1,224-4,104 mg/dL), despite the administration of bezafibrate and ezetimibe. Type V dyslipidemia was revealed by agarose gel electrophoresis and the refrigerator test, and a significantly reduced post-heparin lipoprotein lipase mass of 26 ng/mL was confirmed. Genetic testing confirmed two heterozygous LPL variants, p.Tyr88X and p.Gly215Glu in trans; thus, the patient was diagnosed with lipoprotein lipase deficiency. Lipoprotein lipase deficiency typically arises in type I dyslipidemia, but is latent in type V dyslipidemia.

A hipertensão arterial sistêmica (HAS) é uma doença crônica não transmissível, atualmente as relações entrereligiosidade, saúde física e mental vem sendo investigadas. O objetivo deste estudo foi verificar a associação doíndice de religiosidade por meio da escala de Durel com o melhor controle da pressão arterial (PAS ≤ 120 e PAD≤ 80) e qualidade de vida em pacientes hipertensos. Utilizou-se estudo prospectivo longitudinal com 56 pacienteshipertensos, que foram acompanhados por 120 dias submetidos à consulta de enfermagem com intervalos de 20 dias,na qual era desenvolvido um programa de orientação. Foi aplicado o instrumento de qualidade de vida, a escala deReligiosidade de Dure e realizada a Monitorizarão Ambulatorial da Pressão Arterial (MAPA) no início do estudo eao final. O estudo envolveu 30 mulheres (55,6%) e 26 homens (44,4%), com idade média de 53,9±10 anos, IMCmédio de 30,3±5 kg/m2, circunferência abdominal (CA)=99,7±5cm; PAS=153,6±28mmHg; PAD =91,6±17mmHge Frequência Cardíaca (FC)=69,±13bpm. Quanto ao controle da PA (PAS ≤ 120 e PAD ≤ 80), ao final de 120 diasobservou-se que apenas 4 (7,14%) pacientes controlaram a PA pela medida de consultório e 25 pacientes pela medidada MAPA sendo 7 (12,5%) no período da vigília e 18 (32,1%) no período do sono. Entretanto não se identificouassociação com o Índice de Religiosidade e qualidade de vida quando comparado com a variável controle da pressãoarterial. Diante dos dados verificou-se que o índice de religiosidade não se mostrou sensível para identificar pacientescom um melhor controle da PA após 120 dias de acompanhamento(AU), Systemic arterial hypertension (SAH) is a chronic non-communicable disease, and currently the relationships between religiosity, physical and mental health have been investigated. The objective of this study was to verify the association of the religiosity index through the DUREL scale with the best control of blood pressure (SBP ≤ 120 and DBP ≤ 80) and quality of life in hypertensive patients. A prospective longitudinal study was conducted with 56 hypertensive patients, who were followed up for 120 days and underwent a 20-day interval nursing visit, in which a counseling program was developed. The instrument for quality of life, the DUREL Religiosity Scale, was applied and Ambulatory Blood Pressure Monitor (ABPM) was performed at the beginning and end of the study. The study involved 30 women (55.6%) and 26 men (44.4%), mean age of 53.9 ± 10 years, mean BMI of 30.3±5 kg/m2, waist circumference (WC)=99.7±5cm; PAS=153.6±28mmHg; DBP=91.6±17mmHg and Heart Rate (HR)=69±13bpm. Regarding BP control (SBP ≤ 120 and DBP ≤ 80), at the end of 120 days, it was observed that only 4 (7.14%) patients controlled their BP by the clinic’s measurement and 25 patients by the measurement of the ABPM, those being 7 (12.5%) in the wake period and 18 (32.1%) in the sleep period. However, there was no association with the Index of Religiosity and quality of life when compared to the control variable of blood pressure. Given the data, it was determined that the religiosity index was not sensitive enough to identify patients with a better control of BP after 120 days of follow-up.

No methods to assess efficacy of levodopa-associated therapy by blood sampling in Parkinson’s disease (PD) have been established. In this study, we investigated levodopa associated metabolites to characterize their associations with medication and clinical symptoms in PD patients. Comprehensive metabolome analysis using plasma from PD and controls was performed in two independent cohorts (PD: 109, controls: 32; PD: 145, controls: 45). In another validation cohort [251 PD patients (16 de novo, 17 receiving only dopamine-receptor agonists, 218 receiving levodopa/benserazide or levodopa/carbidopa with/without other parkinsonian drugs) and 40 age-matched controls], serum levels of levodopa and its six metabolites were examined by liquid chromatography-mass spectrometry. The association of each metabolite with clinical parameters, medication, and enzymic genotypes was investigated. Significant increases in 3-methoxytyrosine and homovanillic acid were observed in PD patients administered levodopa/benserazide or levodopa/carbidopa. Serum levels of levodopa and five of its metabolites were significantly increased in PD patients administered levodopa and were related to the levodopa or entacapone dose but not to disease severity. Levodopa levels were more effectively preserved in PD patients given levodopa/benserazide than in those given levodopa/carbidopa, especially when taken with entacapone. Each dopamine or 3-methoxytyramine level was efficiently expressed with a numerical model using levodopa, entacapone, and selegiline doses as variables, indicative of its application for drug efficacy monitoring. Benserazide (25 mg) blocked AADC and preserved levodopa levels more effectively than carbidopa (10 mg), and entacapone provided a concomitant effect on levodopa level preservation. The drug efficacy of levodopa-associated medication could be monitored by dopamine or 3-methoxytyramine levels.

Background Cronobacter sakazakii (C. sakazakii) is a bacterium known to cause severe neonatal infections in premature infants with the consumption of contaminated powdered milk formula. Adult infections are rare, and there have been no reports of pyosalpinx due to C. sakazakii to date. Case presentation We report a case of left pyosalpinx due to C. sakazakii in a sexually inactive postmenopausal woman. A 70-year-old woman presented to our hospital with left lower abdominal pain and fever. Abdominal computed tomography disclosed a cystic mass continuous with the left edge of the uterus. Urgent laparotomy revealed a ruptured left pyosalpinx with pus-like content. Left salpingo-oophorectomy, resection of the right tube, and washing of the abdominal cavity with saline were performed. Pathological examination of the left adnexa showed tubal tissue with acute inflammation and inflammatory exudate, which were compatible with pyosalpinx, and pus culture yielded C. sakazakii. Conclusions This is the first case report of pyosalpinx due to C. sakazakii. Cronobacter sakazakii infections in adult women might occur in the elderly, whose immunity has weakened. Further accumulation of cases of C. sakazakii infection is needed to clarify the etiology and behavior of C. sakazakii in adults.

Background and study aims There has been little evidence assessing the prevalence of musculoskeletal disorders (MSDs) among endoscopists performing recent diagnostic and therapeutic endoscopic procedures requiring prolonged procedural times. We evaluated the prevalence and identified the risk factors for developing MSDs, focusing on procedural time. Methods An electronic survey of endoscopists (n = 213) employed at the Nagoya University Hospital and its affiliated hospitals was developed by a multidisciplinary group. Results Of the 110 endoscopists (51.6 %) who responded to the survey, eighty-seven endoscopists (79.1 %) had experienced endoscopy-related MSDs during the previous 1 year, and 49 endoscopists (44.5 %) had experienced these MSDs during the previous week. Nineteen endoscopists (17.3 %) reported absence from work due to severe MSDs. The most frequent sites of MSDs were neck, low back, and shoulders. Logistic regression analyses showed that longer upper endoscopic submucosal dissection ESD, (odds ratio: 5.7; 95 %CI: 1.3–25.0), lower ESD (odds ratio 4.9; 95 %CI: 1.1–22.0), and lower gastrointestinal treatment (odds ratio: 5.6; 95 %CI: 2.3–13.3) were significantly associated with the development of MSDs in the low back area. Moreover, longer lower ESD (odds ratio: 5.0; 95 % CI: 1.2–20.2) was a risk factor for symptoms in the left shoulder. Conclusion This study suggests a correlation between the volume of therapeutic endoscopic procedures including ESD and the risk of MSDs mainly low back area and left shoulder. Managing monthly total endoscopic time, in light of organizational ergonomics, could contribute to minimizing such risks of endoscopy-related MSDs.

Made available in DSpace on 2021-06-25T15:20:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-03-04 BACKGROUND AND PURPOSE: Primary posterior fossa tumors comprise a large group of neoplasias with variable aggressiveness and short and long-term outcomes. This study aimed to validate the clinical usefulness of a radiologic decision flow chart based on previously published neuroradiologic knowledge for the diagnosis of posterior fossa tumors in children. MATERIALS AND METHODS: A retrospective study was conducted (from January 2013 to October 2019) at 2 pediatric referral centers, Children?s Hospital of Philadelphia, United States, and Great Ormond Street Hospital, United Kingdom. Inclusion criteria were younger than 18 years of age and histologically and molecularly confirmed posterior fossa tumors. Subjects with no available preoperative MR imaging and tumors located primarily in the brain stem were excluded. Imaging characteristics of the tumors were evaluated following a predesigned, step-by-step flow chart. Agreement between readers was tested with the Cohen ?, and each diagnosis was analyzed for accuracy. RESULTS: A total of 148 cases were included, with a median age of 3.4?years (interquartile range, 2.1?6.1 years), and a male/female ratio of 1.24. The predesigned flow chart facilitated identification of pilocytic astrocytoma, ependymoma, and medulloblastoma sonic hedgehog tumors with high sensitivity and specificity. On the basis of the results, the flow chart was adjusted so that it would also be able to better discriminate atypical teratoid/rhabdoid tumors and medulloblastoma groups 3 or 4 (sensitivity = 75%?79%; specificity = 92%?99%). Moreover, our adjusted flow chart was useful in ruling out ependymoma, pilocytic astrocytomas, and medulloblastoma sonic hedgehog tumors. CONCLUSIONS: The modified flow chart offers a structured tool to aid in the adjunct diagnosis of pediatric posterior fossa tumors. Our results also establish a useful starting point for prospective clinical studies and for the development of automated algorithms, which may provide precise and adequate diagnostic tools for these tumors in clinical practice. Childrens Hosp Philadelphia, Div Neuroradiol, Dept Radiol, 3401 Civ Ctr Blvd, Philadelphia, PA 19104 USA UCL, Great Ormond St Hosp Children, Dept Radiol, London, England UCL, Great Ormond St Hosp Children, Dept Neurosurg, London, England Sao Paulo State Univ, Dept Biostat, Inst Biociencias, Sao Paulo, Brazil UCL, Great Ormond St Inst Child Hlth, Dev Biol & Canc Programme, London, England Hosp Clin Sao Paulo, Fac Med Sao Paulo, Dept Radiol, Sao Paulo, Brazil Sao Paulo State Univ, Dept Biostat, Inst Biociencias, Sao Paulo, Brazil

In 2009, diagnostic criteria for early chronic pancreatitis (DCECP2009) were proposed by the Japan Pancreas Society. This study aimed to evaluate the interobserver reliability (IOR) of endoscopic ultrasound (EUS) criteria for diagnosis of early chronic pancreatitis (ECP) between DCECP2009 and 2019 diagnostic criteria for ECP (DCECP2019) to assess the validity of the revision from the perspective of EUS findings. Among patients who underwent a detailed observation of the pancreas by EUS at our institution between January 2018 and March 2019, EUS images of 97 patients were extracted. Images were reviewed by 12 gastrointestinal endoscopy experts (eight pancreatologists, group A and four nonpancreatologists, group B). The overall kappa (K)-values for the IOR of the DCECP2009 EUS criteria were 0.424 and 0.563:0.231 for groups A:B, whereas the overall K-values for the DCECP2019 criteria were 0.618, and 0.733:0.442 for groups A:B. Regarding changes in the final diagnosis of ECP based on clinical features and EUS findings, 20 cases were definite ECP, 53 were probable ECP, and 24 were normal according to DCECP2009. In contrast, seven were definite ECP, 19 were probable ECP, and 71 were normal according to DECEP2019. IOR of DCECP2019 was higher than that of DCECP2009, which indicates an improvement in precision.

Made available in DSpace on 2021-06-25T10:52:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-02-01 This study evaluated the serum cortisol response to a single session of whole-body vibration (WBV) in healthy adult dogs. Ten healthy adult medium dogs, females and males, aged between 24 and 48 months and with body weight between 10.1 and 17.9 kg were used. A single WBV session at a frequency of 30 Hz for 5 min (3.10 mm peak displacement, 11.16 m/s2 peak acceleration, and 0.29 m/s velocity), then 50 Hz for 5 min (3.98 mm peak displacement, 39.75 m/s2 peak acceleration, and 0.62 m/s velocity), and finishing with 30 Hz for 5 min (3.10 mm peak displacement, 11.16 m/s2 peak acceleration, and 0.29 m/s velocity) was performed. Serum cortisol, heart and respiratory rate, and systolic blood pressure were evaluated at different time points: 1 min before WBV (1PRE) and 1 min (1POST), 60 min (60POST), and 360 min (360POST) after the WBV session. An increase (P = 0.0417) of the serum cortisol values was observed between 1PRE and 1POST and a decrease (P = 0.0417) between 1POST and 60POST and between 60POST and 360POST. However, the values remained within the reference range. The heart and respiratory rate and the systolic blood pressure remained unchanged. Our findings suggest that a single bout of WBV (5 min of 30 and 50 Hz) using a vibrating platform that delivered a vortex wave circulation does not modify the serum cortisol levels and clinical parameters of healthy adult dogs. School of Veterinary Medicine and Animal Science São Paulo State University (UNESP) Department of Veterinary Surgery and Animal Reproduction School of Veterinary Medicine and Animal Science São Paulo State University (UNESP) Department of Biostatistics Bioscience Institute São Paulo State University (UNESP) School of Veterinary Medicine and Animal Science São Paulo State University (UNESP) Department of Veterinary Surgery and Animal Reproduction School of Veterinary Medicine and Animal Science São Paulo State University (UNESP) Department of Biostatistics Bioscience Institute São Paulo State University (UNESP)

The incidence of cancers in atopic dermatitis (AD) is not increased, although the Th2-dominant environment is known to downregulate tumor immunity. To gain mechanistic insights regarding tumor immunity in AD, we utilized CCL17 transgenic (TG) mice overexpressing CCL17, which is a key chemokine in AD. Tumor formation and lung metastasis were accelerated in CCL17 TG mice when melanoma cells were injected subcutaneously or intravenously. Flow cytometric analysis showed increases in regulatory T cells (Tregs) in lymph nodes in CCL17 TG mice with high mRNA levels of IL-10 and Foxp3 in tumors, suggesting that Tregs attenuated tumor immunity. The frequency of myeloid-derived suppressor cells (MDSCs), however, was significantly decreased in tumors of CCL17 TG mice, suggesting that decreased MDSCs might promote tumor immunity. Expression of CXCL17, a chemoattractant of MDSCs, was decreased in tumors of CCL17 TG mice. Depletion of Tregs by the anti-CD25 antibody markedly reduced tumor volumes in CCL17 TG mice, suggesting that tumor immunity was accelerated by the decrease in MDSCs in the absence of Tregs. Thus, CCL17 attenuates tumor immunity by increasing Tregs and Th2 cells, while it decreases MDSCs through reductions in CXCL17, which may work as a “safety-net” to reduce the risk of malignant tumors in the Th2-dominant environment.

Behçet's disease (BD) is a chronic, relapsing, systemic inflammatory disease with clinical features showing mucocutaneous lesions involving the ocular, articular, and further miscellaneous organs. Mucocutaneous manifestations, one of the most characteristic signs of BD, have been most commonly observed upon onset or at any disease stage and are exceptionally important in its diagnosis. Given the lack of specific diagnostic laboratory tests for BD, diagnosis has been based on clinical findings. All diagnostic criteria published have thus far relied heavily on mucocutaneous manifestations, particularly oral ulcers (OU), genital ulcers (GU), cutaneous lesions, and pathergy test positivity. Worldwide, OU, GU, cutaneous lesions, and ocular and articular manifestations have been the most common symptoms, with erythema nodosum (EN)-like lesions and papulopustular lesions being the most prevalent cutaneous manifestations. While majority of the patients worldwide have reported OU as the most frequent symptom upon disease onset, GU, and EN-like lesions have also been identified upon onset. Considering that mucocutaneous symptoms precede severe organ involvement in most patients, familiarity with such symptoms is imperative for early diagnosis and prevention of potentially serious organ involvement through appropriate management.

This paper examines the willingness to pay for and participate in volunteer activities for the restoration of the Sosiani River in Eldoret, Kenya. The willingness to pay is examined through two scenarios which differ in the organizations conducting the proposed project. The study focuses on factory workers situated in textile industries and lay people living in the area, who are divided into two groups: respondents living downstream, who are situated mostly in town centers and at the mid/lower parts of the river and the respondents living upstream, mainly found at the upper parts of the River Sosiani. The study employs the double-hurdle model to identify the factors that influence the willingness to pay (WTP) for improved water quality in the area. An ordinal regression model is used to analyze the willingness to participate and its influencing factors. The results of the study show that an average of 74.4% of the 279 respondents studied were willing to pay for river restoration in the area. The mean willingness to pay for the government proposed scenario was KSh 182.51 (1.66$) per household/month and KSh 169.28 (1.54$) per household/month for a non-governmental proposed project. Within the groups upstream and downstream, inhabitants had higher mean scores for a non-government project as compared to a government project, while the reverse was observed in the factory group. The empirical results of this study show that risk perception, trust and socio-demographic variables were significant factors on the stated amount and the decision to participate of the respondents. The characteristics of respondents with zero WTP, who comprised a significant amount of the respondents (25.6%), are also analyzed in depth shaping the recommendations of this study. The empirical results show that the number of years lived in the community is a major determinant on willingness to participate and pay for environmental restoration projects in the area. The results of this study could influence decision makers in general and have potential implications that can be applied in other sectors not necessarily related to water issues.

This paper introduces a second-generation balloon-borne hard X-ray polarimetry mission, XL-Calibur. X-ray polarimetry promises to give qualitatively new information about high-energy astrophysical sources, such as pulsars and binary black hole systems. The XL-Calibur contains a grazing incidence X-ray telescope with a focal plane detector unit that is sensitive to linear polarization. The telescope is very similar in design to the ASTRO-H HXT telescopes that has the world’s largest effective area above ~10 keV. The detector unit combines a low atomic number Compton scatterer with a CdZnTe detector assembly to measure the polarization making use of the fact that polarized photons Compton scatter preferentially perpendicular to the electric field orientation. It also contains a CdZnTe imager at the bottom. The detector assembly is surrounded by the improved anti-coincidence shielding, giving a better sensitivity. The pointing system with arcsecond accuracy will be achieved.

Made available in DSpace on 2022-04-29T08:29:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: During pregnancy, cardiovascular adaptations occur in order to meet maternal demands and adequate support for fetal development, but they are still unclear in the equine species, especially in the American Miniature horse breed. The main hemodynamic changes that occur during pregnancy are increased heart rate, cardiac output, and blood volume. It is necessary to use the reference values for the miniature breeds, in addition to the age range and reproductive condition, so the objective of this study was to evaluate the effect of pregnancy on electrocardiographic (ECG) parameters in mares and also of age in newborns foals of American Miniature horse breed. Materials, Methods & Results: Ten American Miniature Horse mares, between 7 and 19 years old (12.14 ± 4.05 years), 116.85 ± 24.09 kg of body weight were used in the experiment. All these mares were pluriparous, with 5.9 ± 3.5 of births, minimum of 2, and maximum of 12 foaling times. They were maintained in common social group in an indoor house stable with straw bed, with access to an outdoor paddock for several h per day. Twice a day they were fed with hay. Mineral supplements and water were available ad libitum. The ECG were obtained in 10 pregnant mares and in 10 neonates. All females were examined at a representative time of each trimester of pregnancy, at 30, 210, 300 days before and 21 days after delivery. Neonates were examined on different times: first 24 h after delivery, weekly on the 7th, 14th, 21st, 28th and 35th days of age. The ECG parameters considered were the heart rate and rhythm, duration and intervals (P, PR, QRS, QT, T) and amplitude (P, R, S, T) of ECG waves. The mean of pregnancy duration was 319.4 ± 4.97 days. Heart Rate (HR) varied between 51 to 59 bpm during pregnancy and 56 bpm on the 21st day after delivery. Comparing the clinical parameters of pregnant mares, non-pregnant mares and foal a difference was found for HR, Respiration Rate (RR) and Temperature (P = 0.001). All ECG parameters of pregnant, non-pregnant and foal mares showed a significant difference (P = 0.0001), except for the amplitude of the P1, P2 and R waves, which was similar for the 3 groups. The mean values of HR and amplitude of the positive T wave were higher in foals when compared to pregnant and non-pregnant mares, which in turn did not differ from each other. The mean duration of the P wave, PR segment, QRS complex, QT segment and T wave were the same among mares and greater than in foals. Comparing pregnant and non-pregnant mares, there was a difference in only 3 parameters: duration of the QTc segment, amplitude of the S wave and negative T wave. The non-pregnant mares had a longer duration of the QTc segment and a greater amplitude of the negative T wave, while the foals had a greater amplitude of the S wave. Discussion: Although this study did not measure HR at delivery time, it is worth to consider the action of the parasympathetic autonomic nervous system close to delivery, which reduces the HR of mares. This is because at delivery, sympathetic-adrenal activation should be avoided since the increase in sympathetic tone can cause uterine atony via B2 receptors. For this reason, it has been shown that, during physiological birth, horses are under parasympathetic control, and stress response mechanisms are not activated. It was conclude that the morphometry of the waves, intervals and ECG complexes, during the evolution of the reproductive state, the electrocardiographic aspects were generally associated with heart rate (PR and QT intervals). As for neonates, there was a discrepancy among the most of ECG parameters when compared to the adult female, regardless of reproductive status, clarifying the importance of ECG patterns not only for the breed, but also for the age group. Department of Veterinary Clinic School of Veterinary Medicine and Animal Science (FMVZ) Department of Biostatistics Institute of Biosciences (IB) São Paulo State University (UNESP), SP Institute of Agricultural Sciences (ICA) Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), MG Department of Basic Sciences School of Animal Science and Food Engineering (FZEA) University of São Paulo (USP), SP Department of Veterinary Clinic - FMVZ - UNESP, Distrito de Rubião Jr. s/n. SP Department of Biostatistics Institute of Biosciences (IB) São Paulo State University (UNESP), SP Department of Veterinary Clinic - FMVZ - UNESP, Distrito de Rubião Jr. s/n. SP

Objectives: to compare the parameters of the activity/rest cycle of early postpartum breastfeeding women under a controlled and uncontrolled long wavelength ray light regimen. Methods: quasi-experimental study with breastfeeding women and their babies during postnatal rooming-in, São Paulo, Brazil. Participants were allocated to either an experimental (intervention) or a comparison group. The intervention involved exposure of the woman in a controlled room with artificial long wavelength ray light at night. Each woman’s level of 6-sulfatoxymelatonin at 24 hours and activity/rest times was analyzed. Results: the mean activity/rest times of women in the experimental and comparison groups were similar. The mean percentages of total load of 6-sulfatoxymelatonin during the day and night were similar (p=0.09). At 24 hours, the experimental group presented a significantly lower mean percentage of total load compared to the comparison group (p=0.04). Conclusions: women who stayed in the room with long-wavelength artificial light showed no difference in activity/rest and 6-sulfatoxymelatonin levels in the early postpartum period. RESUMO Objetivos: comparar os parâmetros do ciclo de atividade/descanso de puérperas lactantes no início do pós-parto sob regime de iluminação com raios de comprimento de onda longo controlado e descontrolado. Métodos: estudo quase-experimental com lactantes e seus bebês em alojamento conjunto, São Paulo, Brasil. Os participantes foram alocados para grupos experimental (intervenção) ou de comparação. A intervenção consistia na exposição em uma sala controlada com iluminação artificial de raios de comprimento de onda longo à noite. Foram analisados os horários de atividade/repouso (horas) e nível de 6-sulfatoximelatonina em 24 horas. Resultados: a atividade média e os tempos de repouso das mulheres nos grupos experimental e comparação foram semelhantes. Os percentuais médios de volume total de 6-sulfatoximelatonina durante o dia e a noite foram semelhantes (p=0,09). Em 24 horas, o grupo experimental apresentou percentual médio significantemente menor de volume total em relação ao grupo comparação (p=0,04). Conclusões: as mulheres que permaneceram no quarto com luz artificial de comprimento de onda longa não apresentaram diferenças nos níveis de atividade/repouso e 6-sulfatoximelatonina no início do período pós-parto. RESUMEN Objetivos: comparar parámetros del ciclo actividad/descanso en madres lactantes en posparto temprano bajo régimen lumínico de rayos de longitud de onda larga controlado y no controlado. Métodos: estudio cuasiexperimental con madres lactantes y sus bebés, São Paulo, Brasil. Las participantes fueron asignadas a grupos experimental (intervención) y comparación, consistente en exposición en habitación controlada con luz artificial de rayos de longitud de onda larga durante la noche. Se analizaron tiempos de actividad/descanso (horas) y nivel de 6-sulfatoximelatonina a las 24 horas. Resultados: actividad media y tiempos de descanso fueron similares en grupos comparación e intervención. Porcentajes promedio de volumen total de 6-sulfatoximelatonina durante día y noche resultaron similares (p=0,09). A las 24 horas, el grupo intervención presentó porcentaje promedio de volumen total significantemente menor comparado con grupo comparación (p=0,04). Conclusiones: las mujeres expuestas a luz artificial de longitud de onda larga no mostraron diferencias en niveles actividad/descanso y 6-sulfatoximelatonina durante el posparto temprano.

Background : Osteoarthritis is a degenerative joint disease that affects specially cartilage, meniscus, and tendons. Ligaments, muscles, subchondral bone and synovium. This pathology is a common condition limiting the quality of life of patients. Imaging modalities have also been used for evaluation the progression of the osteoarthritis, or degenerative processes induced by acute injury. In order to use more accessible imaging modalities for experimentation, this study aimed to compare radiographic, computed tomography, and ultrasound findings in the evaluation of osteoarthritis induced by the cranial cruciate ligament transection model in rabbits. Materials, Methods & Results : Twenty-four male Norfolk rabbits aged approximately 5 months old were used. All rabbits were submitted to cranial cruciate ligament transection of the left stifle and evaluated 45 days after the surgery. The radiographic findings were subchondral bone sclerosis (33.33%); joint space narrowing (66%); presence of osteophytes at medial femoral condyle (4.16%), lateral femoral condyle (4.16%), medial fabela (20.83%), lateral fabela (8.33%) and sesamoid of the popliteal muscle (4.16%). No osteophytes were seen at medial and lateral tibial condyles. The tomographic computed findings were joint space narrowing (62.5%); presence of osteophytes at medial femoral condyle (75%), lateral femoral condyle (54.16%), medial fabela (66.66%), lateral fabela (37.5%), medial tibial condyle (75%), lateral tibial condyle (20.83%) and sesamoid of the popliteal muscle (37.5%). The ultrasound findings were synovial hypertrophy (95.83%); effusion in the suprapatellar recess (75%), distal tibial recess (16.66%) and cranial joint space (75%); changes (hyperechogenic foci and heterogeneity) of the lateral meniscus (50%) and medial meniscus (25%); increased thickness of the medial condyle (54.16%) and lateral condyle (45.83%); irregularity of the medial condyle (66.66%) and lateral condyle (58.33%); alterations of the patellar tendon (12.5%) and extensor ligament (effusion and increased echogenicity) (20.83%). Discussion : Osteoarthritis is a degenerative joint disease and is common condition which limiting the quality of life of patients. Many studies performed in rabbits have evaluated the development of osteoarthritis through post-mortem macroscopic or microscopic assessments. Imaging modalities have also been used for evaluation the progression of the osteoarthritis, or degenerative processes induced by acute injury. High quality radiographs are accurate in identifying structural changes resulted from osteoarthritis, but computed tomography allows earlier identification in relation to conventional radiography. The three imaging modalities were helpful to identify the osteoarthritis, but the findings were different and compatible with each analysis method . The computed tomographic detected a higher number of osteophytes than plain radiographs. Also, osteophytes did not visualized by radiographic examination, such as medial tibial condyle and lateral tibial condyle, were identified by computed tomography. In turn, the ultrasound examination enabled identification of lesions did not seen on radiographic and computed tomography examinations. Synovial hypertrophy and joint effusion had the highest percentage. In human patients, ultrasound examination has been used to assess hypertrophy and inflammation of the synovium due to osteoarthritis. In conclusion, computerized tomography images provided more information than plain X-ray images and can be complemented by ultrasound examination to identify osteoarthritis induced by cranial cruciate ligament transection in rabbits. Comparison of Three Imaging Methods for the Evaluation of Osteoarthritis Induced by Cranial Cruciate Ligament Transection in Rabbits

Purpose To evaluate the effect of creatine supplementation in the diet of rats subjected to ischemia and reperfusion of hind limbs. Methods Eighteen male Wistar rats were randomized to receive dietary creatine supplementation (G1) or no supplementation (G2), before being subjected to 4 h of ischemia followed by 4 h of reperfusion. In addition, 10 rats (G3) underwent the same surgical procedure, without ischemia, but with supplementation. After reperfusion, kidney and musculature were evaluated for histological damage and serum levels of alanine aminotransferase, urea and creatinine were obtained. Results The urea dosage showed significant differences between the groups (averages G1 = 155.1; G2 = 211.27; G3 = 160.42). Histological analysis found significant differences between G1 and G2 (but not between G1 and G3) in renal myoglobin cylinders and vacuolar degeneration variables and in hypereosinophilia and karyopyknosis variables in muscle fibers. There were no significant differences in the other variables studied. Conclusions Creatine supplementation was related to fewer histological lesions, as well as lower levels of plasma urea, which may suggest a protective effect against lesions caused by ischemia and reperfusion of posterior paws muscles in Wistar rats.

XL-Calibur is a balloon-borne hard X-ray polarimetry mission, the first flight of which is currently foreseen for 2021. XL-Calibur carries an X-ray telescope consists of consists of 213 Wolter I grazing-incidence mirrors which are nested in a coaxial and cofocal configuration. The optics design is nearly identical to the Hard X-ray Telescope (HXT) on board the ASTRO-H satellite. The telescope was originally fabricated for the Formation Flying Astronomical Survey Telescope (FFAST) project. However, the telescope can be used for XL-Calibur, since the FFAST project was terminated before completion. The mirror surfaces are coated with Pt/C depth-graded multilayers to reflect hard X-rays above 10 keV by Bragg reflection. The effective area of the telescope is larger than 300 cm^2 at 30 keV. The mirrors are supported by alignment bars in the housing, and each of the bars has a series of 213 grooves to hold the mirrors. To obtain the best focus of the optics, the positions of the mirrors have to be adjusted by tuning the positions of the alignment bars. The tuning of the mirror positions is conducted using the X-ray beam at the synchrotron facility SPring-8 BL20B2, and this process is called optical tuning. First the positions of the second reflectors are tuned, and then those of the first reflectors are tuned. We did the first optical tuning in Jan 2020. The second tuning will be planned between April to July, 2020. This paper reports the current status of the hard X-ray telescope for XL-Calibur.

We intoduce our novel method of super high resolution astronomical X-ray imaging, Multi Image X-ray Interferometer Method, Modules, Missions (MIXIM). In series of experiments on the ground we not only verified the concept of MIXIM but also realized 2D imaging with angular resolution better than 0. ′′1. Employment of small pixel size CMOS sensor was the key to this achievement. Scalability is also an important feature of MIXIM., and various mission format is available. We show some examples from a very small satellite for sub arcsecond resolution to a formation flight with a millions km separation to gain µas resolution. MIXIM is different from X-ray mirrors in various points, for example, it does not have a collecting power. Considering the limitations and advantages of MIXIM, we should choose bright apparently point-like sources as targets. Nearby AGNs are primary ones, and the MIXIM scope just corresponds to spatial scales which have not yet resolved in X-rays.

We report current status of developing Soft X-ray Imager (SXI), the X-ray CCD camera onboard X-Ray Imaging and Spectroscopy Mission (XRISM). Four flight model (FM) CCDs have been selected considering several items including energy resolution at 5.9keV, CTI, dark current, etc. We have also completed calibration campaign for all the FM CCDs. Initial analyses show that the response function for monochromatic X-rays is basically the same as that of Hitomi CCDs. The focal plane including the single-stage Stirling cooler has been assembled. Production of key parts in SXI sensor body such as contamination blocking filter and onboard calibration source has been finished and they are waiting for assemble. The digitized signals of the CCD are corrected step by step before conversion to X-ray energy. We are preparing calibration database for the correction such as CTI, gain, and line redistribution function.

We have proposed a new style X-ray interferometer, Multi-Image X-ray Interferometer Module (MIXIM), to achieve high angular resolution. MIXIM is comprised of a grating and an X-ray detector, and its angular resolution is in inverse proportion to the distance between two components. Although we have already detected a 1D interference fringe which corresponds an angular resolution of about 1” in our past experiment, its amplitude is not so high partly because of the lack of the spatial resolution of the X-ray detector. Then we newly adopt a CMOS detector which has both high spatial resolution (< 2.5 μm) and high spectroscopic capability (FWHM∼ 170 eV @5.9 keV) and evaluate the performance of MIXIM at BL20B2 in SPring-8, the synchrotron radiation facility in Japan. 1D interference fringes in this experiment have much higher amplitudes than those in the past experiment, which demonstrates the improvement of the performance due to the new CMOS detector. We also introduce a 2D grating for the first time, and try to obtain the 2D profile of the X-ray beam of which the size is 0.28” (H) and 0.06” (V). Extending the distance between two components to 866.5 cm, 2D imaging by MIXIM succeeds in capturing the horizontally elongated beam structure. The angular resolution at this configuration is calculated to be 0.076”, which is the highest ever achieved for astronomical X-ray imagers.