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2. Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): study protocol for a randomized controlled trial
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Cavalcanti, AB, Berwanger, O, Suzumura, ÉA, Amato, MB, Tallo, FS, Rezende, AC, Telles, MM, Romano, E, Guimarães, HP, Regenga, MM, Takahashi, LN, Oliveira, RP, Carvalho, VO, Díaz Quijano, FA, Carvalho, CR, Kodama, AA, Ribeiro, GF, Abreu, MO, Oliveira, IM, Guyatt, G, Ferguson, N, Walter, S, Vasconcelos, MO, Segundo, VJ, Ferraz, ÍL, Silva, RS, de Oliveira Filho, W, Silva, NB, Heirel, C, Takatani, RR, Neto, JA, Neto, JC, Almeida, SD, Chamy, G, Neto, GJ, Dias, AP, Silva, RR, Tavares, RC, Souza, ML, Decio, JC, Lima, CM, Neto, FF, Oliveira, KR, Dias, PP, Brandão, AL, Ramos, JE Jr, Vasconcelos, PT, Flôres, DG, Filho, GR, Andrade, IG, Martinez, A, França, GG, Monteiro, LL, Correia, EI, Ribeiro, W, Pereira, AJ, Andrade, W, Leite, PA, Feto, JE, Holanda, MA, Amorim, FF, Margalho, SB, Domingues, SM Jr, Ferreira, CS, Ferreira, CM, Rabelo, LA, Duarte, JN, Lima, FB, Kawaguchi, IA, Maia, MO, Correa, FG, Ribeiro, RA, Caser, E, Moreira, CL, Marcilino, A, Falcão, JG, Jesus, KR, Tcherniakovisk, L, Dutra, VG, Thompson, MM, Piras, C, Giuberti, J. Jr, Silva, AS, Santos, JR, Potratz, JL, Paula, LN, Bozi, GG, Gomes, BC, Vassallo, PF, Rocha, E, Lima, MH, Ferreira, A. F, Gonçalves, F, Pereira, SA, Nobrega, MS, Caixeta, CR, Moraes, AP, Carvalho, AG, Alves, JD, Carvalho, FB, Moreira, FB, Starling, CM, Couto, WA, Bitencourt, WS, Silva, SG, Felizardo, LR, Nascimento, FJ, Santos, D, Zanta, CC, Martins, MF, Naves, SA, Silva, FD, Laube, G. Jr, Galvão, EL, Sousa, MF, Souza, MM, Carvalho, FL, Bergo, RR, Rezende, CM, Tamazato, EY, Sarat, SC Jr, Almeida, PS, Gorski, AG, Matsui, M, Neto, EE, Nomoto, SH, Lima, ZB, Inagaki, AS, Gil, FS, Araújo, MF, Oliveira, AE, Correa, TA, Mendonça, A, Reis, H, Carneiro, SR, Rego, LR, Cunha, AF, Barra, WF, Carneiro, M, Batista, RA, Zoghbi, KK, Machado, NJ, Ferreira, R, Apoena, P, Leão, RM, Martins, ER, Oliveira, ME, Odir, I, Kleber, W, Tavares, D, Araújo, ME, Brilhante, YN, Tavares, DC, Carvalho, WL, Winveler, GF, Filho, AC, Cavalcanti, RA, Grion, CM, Reis, AT, Festti, J, Gimenez, FM, Larangeira, AS, Cardoso, LT, Mezzaroba, TS, Kauss, IA, Duarte, PA, Tozo, TC, Peliser, P, Germano, A, Gurgel, SJ, Silva, SR, Kuroda, CM, Herek, A, Yamada, SS, Schiavetto, PM, Wysocki, N, Matsubara, RR, Sales, JA Jr, Laprovita, MP, Pena, FM, Sá, A, Vianna, A, Verdeal, JC, Martins, GA, Salgado, DR, Coelho, AM, Coelho, M, Morong, AS, Poquiriqui, RM, Ferreira, AP, Lucena, DN, Marino, NF, Moreira, MA, Uratani, CC, Severino, MA, Silva, PN, Medeiros, LG, Filho, FG, Guimarães, DM, Rezende, VM, Carbonell, RC, Trindade, RS, Pellegrini, JA, Boniatti, MM, Santos, MC, Boldo, R, Oliveira, VM, Corrêa, VM, Nedel, W, Teixeira, C, Schaich, F, Tagliari, L, Savi, A, Schulz, LF, Maccari, JG, Seeger, GM, Foernges, RB, Rieder, MM, Becker, DA, Broilo, FP, Schwarz, P, Alencastro, A, Berto, P, Backes, F, Dias, FS, Blattner, C, Martins, ET, Scaglia, NC, Vieira, SR, Prado, KF, Fialkow, L, Franke, C, Vieira, DF, Moraes, RB, Marques, LS, Hopf, JL, Wawrzeniak, IC, Rech, TH, Albuquerque, RB, Guerreiro, MO, Teixeira, LO, Macedo, PL, Bainy, MP, Ferreira, EV, Martins, MA, Andrade, LA, Machado, FO, Burigo, AC, Pincelli, M, Kretzer, L, Maia, IS, Cordeiro, RB, Westphal, G, Cramer, AS, Dadam, MM, Barbosa, PO, Caldeira, M, Brilenger, CO, Horner, MB, Oliveira, GL, Germiniani, BC, Duarte, R, Assef, MG, Rosso, D, Bigolin, R, Vanzuita, R, Prado, LF, Oliveira, V, Reis, DL, Morais, MO, Bastos, RS, Santana, HS, Silva, AO, Cacau, LA, Almeida, MS, Canavessi, HS, Nogueira, EE, Pavia, CL, Araujo, JF, Lira, JA, Nienstedt, EC, Smith, TC, Romano, M, Barros D, Costa, AF, Takahashi, L, Werneck, V, Farran, J, Henriques, LA, Miura, C, Lopes, RD, Vendrame, LS, Sandri, P, Galassi, MS, Amato, P, Toufen, C. Jr, Santiago, RR, Hirota, AS, Park, M, Azevedo, LC, Malbouison, LM, Costa, MC, Taniguchi, L, Pompílio, CE, Baruzzi, C, Andrade, AH, Taira, EE, Taino, B, Oliveira, CS, Silva, AC, Ísola, A, Rezende, E, Rodrigues, RG, Rangel, VP, Luzzi, S, Giacomassi, IW, Nassar, AP Jr, Souza, AR, Rahal, L, Nunes, AL, Giannini, F, Menescal, B, Morais, JE, Toledo, D, Morsch, RD, Merluzzi, T, Amorim, DS, Bastos, AC, Santos, PL, Silva, SF, Gallego, RC, Santos, GD, Tucci, M, Costa, RT, Santos, LS, Demarzo, SE, Schettino, GP, Suzuki, VC, Patrocinio, AC, Martins, ML, Passos, DB, Cappi, SB, Gonçalves, I. Jr, Borges, MC, Lovato, W, Tavares, MV, Morales, D, Machado, LA, Torres, FC, Gomes, TM, Cerantola, RB, Góis, A, Marraccini, T, Margarida, K, Cavalcante, E, Machado, FR, Mazza, BF, Santana, HB, Mendez, VM, Xavier, PA, Rabelo, MV, Schievano, FR, Pinto, WA, Francisco, RS, Ferreira, EM, Silva, DC, Arduini, RG, Aldrighi, JR, Amaro, AF, Conde, KA, Pereira, CA, Tarkieltaub, E, Oliver, WR, Guadalupe, EG, Acerbi, PS, Tomizuka, CI, Oliveira, TA, Geha, NN, Mecatti, GC, Piovesan, MZ, Salomão, MC, Moreno, MS, Orsatti, VN, Miranda, W, Ray, A, Guerra, A, Filho, ML, Ferreira, FH Jr, Filho, EV, Canzi, RA, Giuberti, AF, Garcez, MC, Sala, AD, Suguitani, EO, Kazue, P, Oliveira, LR, Infantini, RM, Carvalho, FR, Andrade, LC, Santos, TM, Carmona, CV, Figueiredo, LC, Falcão, A, Dragosavak, D, Filho, WN, Lunardi, MC, Lago, R, Gatti, C, Chiasso, TM, Santos, GO, Araujo, AC, Ornellas, IB, Vieira, VM, Hajjar, LA, Figueiredo, AC, Damasceno, B, Hinestrosa, A, Diaz Quijano, FA, CORTEGIANI, Andrea, RAINERI, Santi Maurizio, Cavalcanti, AB, Berwanger, O, Suzumura, ÉA, Amato, MB, Tallo, FS, Rezende, AC, Telles, MM, Romano, E, Guimarães, HP, Regenga, MM, Takahashi, LN, Oliveira, RP, Carvalho, VO, Díaz-Quijano, FA, Carvalho, CR, Kodama, AA, Ribeiro, GF, Abreu, MO, Oliveira, IM, Guyatt, G, Ferguson, N, Walter, S, Vasconcelos, MO, Segundo, VJ, Ferraz, ÍL, Silva, RS, de Oliveira Filho, W, Silva, NB, Heirel, C, Takatani, RR, Neto, JA, Neto, JC, Almeida, SD, Chamy, G, Neto, GJ, Dias, AP, Silva, RR, Tavares, RC, Souza, ML, Decio, JC, Lima, CM, Neto, FF, Oliveira, KR, Dias, PP, Brandão, AL, Ramos, JE Jr, Vasconcelos, PT, Flôres, DG, Filho, GR, Andrade, IG, Martinez, A, França, GG, Monteiro, LL, Correia, EI, Ribeiro, W, Pereira, AJ, Andrade, W, Leite, PA, Feto, JE, Holanda, MA, Amorim, FF, Margalho, SB, Domingues, SM Jr, Ferreira, CS, Ferreira, CM, Rabelo, LA, Duarte, JN, Lima, FB, Kawaguchi, IA, Maia, MO, Correa, FG, Ribeiro, RA, Caser, E, Moreira, CL, Marcilino, A, Falcão, JG, Jesus, KR, Tcherniakovisk, L, Dutra, VG, Thompson, MM, Piras, C, Giuberti, J Jr, Silva, AS, Santos, JR, Potratz, JL, Paula, LN, Bozi, GG, Gomes, BC, Vassallo, PF, Rocha, E, Lima, MH, Ferreira, A F, Gonçalves, F, Pereira, SA, Nobrega, MS, Caixeta, CR, Moraes, AP, Carvalho, AG, Alves, JD, Carvalho, FB, Moreira, FB, Starling, CM, Couto, WA, Bitencourt, WS, Silva, SG, Felizardo, LR, Nascimento, FJ, Santos, D, Zanta, CC, Martins, MF, Naves, SA, Silva, FD, Laube, G Jr, Galvão, EL, Sousa, MF, Souza, MM, Carvalho, FL, Bergo, RR, Rezende, CM, Tamazato, EY, Sarat, SC Jr, Almeida, PS, Gorski, AG, Matsui, M, Neto, EE, Nomoto, SH, Lima, ZB, Inagaki, AS, Gil, FS, Araújo, MF, Oliveira, AE, Correa, TA, Mendonça, A, Reis, H, Carneiro, SR, Rego, LR, Cunha, AF, Barra, WF, Carneiro, M, Batista, RA, Zoghbi, KK, Machado, NJ, Ferreira, R, Apoena, P, Leão, RM, Martins, ER, Oliveira, ME, Odir, I, Kleber, W, Tavares, D, Araújo, ME, Brilhante, YN, Tavares, DC, Carvalho, WL, Winveler, GF, Filho, AC, Cavalcanti, RA, Grion, CM, Reis, AT, Festti, J, Gimenez, FM, Larangeira, AS, Cardoso, LT, Mezzaroba, TS, Kauss, IA, Duarte, PA, Tozo, TC, Peliser, P, Germano, A, Gurgel, SJ, Silva, SR, Kuroda, CM, Herek, A, Yamada, SS, Schiavetto, PM, Wysocki, N, Matsubara, RR, Sales, JA Jr, Laprovita, MP, Pena, FM, Sá, A, Vianna, A, Verdeal, JC, Martins, GA, Salgado, DR, Coelho, AM, Coelho, M, Morong, AS, Poquiriqui, RM, Ferreira, AP, Lucena, DN, Marino, NF, Moreira, MA, Uratani, CC, Severino, MA, Silva, PN, Medeiros, LG, Filho, FG, Guimarães, DM, Rezende, VM, Carbonell, RC, Trindade, RS, Pellegrini, JA, Boniatti, MM, Santos, MC, Boldo, R, Oliveira, VM, Corrêa, VM, Nedel, W, Teixeira, C, Schaich, F, Tagliari, L, Savi, A, Schulz, LF, Maccari, JG, Seeger, GM, Foernges, RB, Rieder, MM, Becker, DA, Broilo, FP, Schwarz, P, Alencastro, A, Berto, P, Backes, F, Dias, FS, Blattner, C, Martins, ET, Scaglia, NC, Vieira, SR, Prado, KF, Fialkow, L, Franke, C, Vieira, DF, Moraes, RB, Marques, LS, Hopf, JL, Wawrzeniak, IC, Rech, TH, Albuquerque, RB, Guerreiro, MO, Teixeira, LO, Macedo, PL, Bainy, MP, Ferreira, EV, Martins, MA, Andrade, LA, Machado, FO, Burigo, AC, Pincelli, M, Kretzer, L, Maia, IS, Cordeiro, RB, Westphal, G, Cramer, AS, Dadam, MM, Barbosa, PO, Caldeira, M, Brilenger, CO, Horner, MB, Oliveira, GL, Germiniani, BC, Duarte, R, Assef, MG, Rosso, D, Bigolin, R, Vanzuita, R, Prado, LF, Oliveira, V, Reis, DL, Morais, MO, Bastos, RS, Santana, HS, Silva, AO, Cacau, LA, Almeida, MS, Canavessi, HS, Nogueira, EE, Pavia, CL, Araujo, JF, Lira, JA, Nienstedt, EC, Smith, TC, Romano, M, Barros D, Costa, AF, Takahashi, L, Werneck, V, Farran, J, Henriques, LA, Miura, C, Lopes, RD, Vendrame, LS, Sandri, P, Galassi, MS, Amato, P, Toufen, C Jr, Santiago, RR, Hirota, AS, Park, M, Azevedo, LC, Malbouison, LM, Costa, MC, Taniguchi, L, Pompílio, CE, Baruzzi, C, Andrade, AH, Taira, EE, Taino, B, Oliveira, CS, Silva, AC, Ísola, A, Rezende, E, Rodrigues, RG, Rangel, VP, Luzzi, S, Giacomassi, IW, Nassar, AP Jr, Souza, AR, Rahal, L, Nunes, AL, Giannini, F, Menescal, B, Morais, JE, Toledo, D, Morsch, RD, Merluzzi, T, Amorim, DS, Bastos, AC, Santos, PL, Silva, SF, Gallego, RC, Santos, GD, Tucci, M, Costa, RT, Santos, LS, Demarzo, SE, Schettino, GP, Suzuki, VC, Patrocinio, AC, Martins, ML, Passos, DB, Cappi, SB, Gonçalves, I Jr, Borges, MC, Lovato, W, Tavares, MV, Morales, D, Machado, LA, Torres, FC, Gomes, TM, Cerantola, RB, Góis, A, Marraccini, T, Margarida, K, Cavalcante, E, Machado, FR, Mazza, BF, Santana, HB, Mendez, VM, Xavier, PA, Rabelo, MV, Schievano, FR, Pinto, WA, Francisco, RS, Ferreira, EM, Silva, DC, Arduini, RG, Aldrighi, JR, Amaro, AF, Conde, KA, Pereira, CA, Tarkieltaub, E, Oliver, WR, Guadalupe, EG, Acerbi, PS, Tomizuka, CI, Oliveira, TA, Geha, NN, Mecatti, GC, Piovesan, MZ, Salomão, MC, Moreno, MS, Orsatti, VN, Miranda, W, Ray, A, Guerra, A, Filho, ML, Ferreira, FH Jr, Filho, EV, Canzi, RA, Giuberti, AF, Garcez, MC, Sala, AD, Suguitani, EO, Kazue, P, Oliveira, LR, Infantini, RM, Carvalho, FR, Andrade, LC, Santos, TM, Carmona, CV, Figueiredo, LC, Falcão, A, Dragosavak, D, Filho, WN, Lunardi, MC, Lago, R, Gatti, C, Chiasso, TM, Santos, GO, Araujo, AC, Ornellas, IB, Vieira, VM, Hajjar, LA, Figueiredo, AC, Damasceno, B, Hinestrosa, A, Diaz-Quijano, FA, Raineri, SM, and Cortegiani, A
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Research design ,ARDS ,medicine.medical_specialty ,Time Factors ,Ventilator-Induced Lung Injury ,Alveolar recruitment ,Treatment outcome ,Randomized ,Medicine (miscellaneous) ,Settore MED/41 - Anestesiologia ,Hospital mortality ,law.invention ,Positive-Pressure Respiration ,Study Protocol ,Mechanical ventilation ,Clinical trials ,Randomized controlled trial ,Clinical Protocols ,law ,Medicine ,Humans ,Pharmacology (medical) ,Hospital Mortality ,PEEP ,Protocol (science) ,Respiratory Distress Syndrome ,Acute respiratory distress syndrome ,business.industry ,respiratory system ,Length of Stay ,medicine.disease ,Clinical trial ,Pulmonary Alveoli ,Intensive Care Units ,Treatment Outcome ,Multicenter study ,Barotrauma ,Research Design ,Physical therapy ,business ,Brazil - Abstract
Background Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure ≤30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method. Trial registration ClinicalTrials.gov Identifier: NCT01374022
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- 2012
3. Distribution and Mineralization of 14C-Hexazinone in Soil-Plant Microcosm with the Riparian Forest Specie Cecropia Hololeuca
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Ferreira Em, Langenbach T, Marinho Da, and Bicalho St
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Rhizosphere ,Ecology ,fungi ,food and beverages ,Mineralization (soil science) ,complex mixtures ,Hexazinone ,Soil contamination ,chemistry.chemical_compound ,Bioremediation ,chemistry ,Agronomy ,Bioaccumulation ,Soil horizon ,Microcosm - Abstract
Although Brazil is one of the world’s largest consumers of the herbicide hexazinone there are few studies, in the country, on the fate of this compound in the environment. This work studied the distribution and mineralization of hexazinone in a microcosm, with and without plants. The herbicide 14C-hexazinone was applied to microcosms with soil and C. hololeuca seedlings and mineralization and volatilization was monitored over a two month period. After this incubation period, radioactivity was measured in different soil layers, the rhizosphere, as well as in parts of the plant: fine and thick roots, stems, and leaves. The results showed that evaporation promoted an upward movement of hexazinone to higher soil layers which was enhanced in the presence of plants, due to evapotranspiration. The mass balance showed an uptake of 12.2 % in plants, and the leaves had the highest bioaccumulation value (9.1%). Mineralization in the soil microcosm was low, about 0.6 % but with the presence of plants it increased to 1.15 % without increasing the CFU of hexazinone and lignin biodegrader fungi. Bioremediation of hexazinone by biodegradation and accumulation in plant biomass reduced its concentration in the soil slightly, showing that this molecule can have hazardous consequences for the environment.
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- 2011
4. Globalization and communication science: Suggested theoretical approaches and areas of research.
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Ferreira, Em
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GLOBALIZATION ,COMMUNICATION ,SCHOLARS ,SOCIAL consciousness ,RESEARCH - Abstract
Globalization is on inevitable phenomenon characterized by both integrating and disintegrating forces. This article argues that the outcome of Globalization will be determined by how the global community responds to, and engages in, the process. It suggests that communication scholars con play a role in influencing globalization towards a constructive outcome by directing their research endeavours and theoretical reflection towards finding ways to enhance human development and effective global integration. A conceptualization of globalization for communication science and o number of theoretical approaches which could be used to study the phenomenon from a communication perspective, are proposed. Lastly, suggestions ore offered for research contributions that could assist in steering the global system towards a more mature and stable state and the attainment of a higher order of societal consciousness. [ABSTRACT FROM AUTHOR]
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- 2004
5. PPAR gamma receptors as new targets to limit renal ischemia/reperfusion injury
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Pinheiro, Hs, Camara, Nos, Brum, Alg, Leite, Cca, Ferreira, Em, Vieira, Ev, Mota, Jqm, Amaro, Ta, Oliveira, Ms, Souza, Jl, Mesquita, Hl, Pacheco-Silva, A., and Bastos, Mg
6. Mapping high-risk areas for Mycobacterium tuberculosis complex bacteria transmission: Linking host space use and environmental contamination.
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Ferreira EM, Cunha MV, Duarte EL, Mira A, Pinto D, Mendes I, Pereira AC, Pinto T, Acevedo P, and Santos SM
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In many Mediterranean ecosystems, animal tuberculosis (TB), caused by Mycobacterium bovis, an ecovar of Mycobacterium tuberculosis complex (MTBC), is maintained by multi-host communities. It is hypothesised that interspecies transmission is mainly indirect via shared contaminated environments. Therefore, identifying spatial areas where MTBC bacteria occur and quantifying space use by susceptible hosts might help predict the spatial likelihood of transmission across the landscape. Here, we aimed to evaluate the transmission risk of MTBC in a multi-host system involving wildlife (ungulates and carnivores) and cattle (Bos taurus). We collected eighty-nine samples from natural substrates (water, soil, and mud) at 38 sampling sites in a TB endemic area within a Mediterranean agroforestry system in Portugal. These samples were analysed by real-time PCR to detect MTBC DNA. Additionally, host-specific space use intensity maps were obtained through camera-trapping covering the same sampling sites. Results evidenced that a significant proportion of samples were positive for MTBC DNA (49 %), suggesting that the contamination is widespread in the area. Moreover, they showed that the probability of MTBC occurrence in the environment was significantly influenced by topographic features (i.e., slope), although other non-significant predictor related with soil conditions (SMI: soil moisture index) incorporated the MTBC contamination model. The integration of host space use intensity maps with the spatial detection of MTBC showed that the red deer (Cervus elaphus) and wild boar (Sus scrofa) exhibited the highest percentages of high-risk areas for MTBC transmission. Furthermore, when considering the co-occurrence of multiple hosts, transmission risk analyses revealed that 26.5 % of the study area represented high-risk conditions for MTBC transmission, mainly in forest areas., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2024
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7. Effect of forage quality and narasin inclusion on ruminal fermentation, nutrient intake, and total tract digestibility of Nellore steers.
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de Paula MFFV, Marques RS, Pires AV, Soares LCB, Limede AC, Ferreira EM, and Polizel DM
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The study aimed to evaluate the effects of forage quality and narasin inclusion on intake, digestibility, and ruminal fermentation of Nellore steers. Twenty-eight rumen-cannulated Nellore steers (initial body weight [ BW ] = 350 ± 32.4 kg) were allocated to individual pens in a randomized complete block design, with 7 blocks, defined according to the fasting BW at the beginning of the experiment. The steers were randomly assigned within blocks to 1 of 4 experimental diets in 2 × 2 factorial arrangements, being the first-factor forage quality ( MEDIUM = 81 g of CP/kg of dry matter [ DM ], and HIGH = 153 g of CP/kg of DM), and the second factor was the inclusion ( N13 = diet plus 13 mg/kg of DM of narasin) or not ( N0 ) of narasin (Zimprova; Elanco Animal Health, São Paulo, Brazil). The experiment consisted of a 28-d period with 22 d for adaptation and the last 6 d for data collection. No haylage quality × narasin interaction ( P ≥ 0.68) was observed on DM and nutrient intake. Haylage quality affected ( P ≤ 0.01) DM intake, with greater values observed for steers fed HIGH compared with MEDIUM haylage. There was an increase ( P < 0.001) in OM, NDF, hemicellulose, and CP intake for steers consuming HIGH vs. MEDIUM haylage. Including N13 did not affect ( P > 0.39) DM and nutrient intake of steers. No haylage quality × narasin interactions were detected ( P ≥ 0.60) for total tract nutrient digestibility. However, steers fed with HIGH haylage showed an increase ( P > 0.001) in DM and digestibility of all nutrients compared with MEDIUM. Steers fed a MEDIUM haylage had a greater ( P < 0.01) proportion of acetate compared with steers fed HIGH during all evaluated hours. Steers fed HIGH haylage had a greater ( P < 0.01) proportion of propionate at 0 h compared with steers consuming MEDIUM, whereas at 12 h, steers consuming MEDIUM hay had a greater ( P < 0.01) proportion of propionate vs. HIGH haylage. A haylage quality × narasin and haylage quality × time of collection interactions were detected ( P ≤ 0.03) for rumen ammonia concentration, which was reduced ( P < 0.03) in N13 vs. N0 steers consuming HIGH haylage. Collectively, high-quality haylage allows increased consumption and digestibility, with more energy-efficient ruminal fermentation. In addition, narasin might be an important nutritional tool in forage-based diets to enhance the ruminal fermentation parameters of Bos indicus Nellore steers., Competing Interests: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Society of Animal Science.)
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- 2024
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8. Orange molasses as a new energy ingredient for feedlot lambs in Brazil.
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Dos Santos IJ, Junior PCGD, Vicente ACS, Alves AL, de Assis RG, Biava JS, Nogueira MVVA, Pires AV, and Ferreira EM
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- Sheep, Animals, Male, Brazil, Molasses, Diet veterinary, Zea mays, Minerals, Sheep, Domestic, Animal Feed analysis, Citrus sinensis
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The objectives of this experiment were to evaluate the effects of increasing levels of orange molasses in replacement of flint corn grain in high-concentrate diets on dry matter intake (DMI), average daily gain (ADG), and feed efficiency (FE) of feedlot lambs. Thirty male lambs without defined racial pattern (30.3 ± 5.3 kg of initial BW; mean ± SD) were used in a randomized complete block design with 10 blocks and 3 treatments. The treatments were defined by partial replacement of flint corn by orange molasses in the diet with 90% of concentrate and 10% of Cynodon spp. hay, as follows: 0OM-control diet without orange molasses; 20OM-20% of orange molasses replacing flint corn; and 40OM-40% of orange molasses replacing flint corn (DM basis). The experiment lasted 72 days divided into 3 subperiods, with 1 subperiod of 16 days and 2 subperiods of 28 days. Animals were weighed after a 16-h fast on days 1, 16, 44, and 72 of the experimental periods to determine the ADG and FE. The DMI, ADG, and FE showed an interaction between treatments and experimental periods. The DMI in the first period decreased linearly (P < 0.01); in the third period, there was no effect of treatments (P > 0.05) on DMI. The ADG decreased linearly (P < 0.01) in the first period as the orange molasses increased. Otherwise, in the third period, ADG increased linearly (P = 0.05) as flint corn was replacement by orange molasses. The FE showed an interaction between treatment and period (P = 0.09). The first period had a decreased linear effect; in the third period, there was a trend (P = 0.07) of increased linear effect. There was no difference between the diets regarding the final BW of the lambs. In conclusion, the orange molasses can replace up to 40% of flint corn in diets for feedlot lambs without affecting final BW. However, it is important to consider the adaptation time proved to be very important for better use of orange molasses as a source of energy in diets for lambs., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)
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- 2023
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9. Effect of sires' expected progeny difference for scrotal circumference and juvenile ADG on the puberty of crossbred beef heifers.
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Barroso JPR, de Castro Ferraz Junior MV, Oliveira GB, Miszura AA, Bertoloni AV, Martins AS, Baggio M, Polizel DM, Biava JS, Ferreira EM, and Pires AV
- Subjects
- Cattle, Animals, Female, Diet veterinary, Weaning, Sexual Maturation, Animal Feed analysis
- Abstract
The early attainment of puberty in heifers is essential for the profitability of the cow-calf farm. This study aimed to evaluate the impact of juvenile average daily gain (ADG) and sire's expected progeny difference (EPD) on puberty of crossbred beef heifers. Sixty Angus × Nellore heifers early weaned (age = 102 ± 4.3 d; initial BW = 103 ± 4.7 kg) were used in a 2 × 2 factorial arrangement. The factor 1 was the sire's EPD for scrotal circumference, in which heifers born from sires with positive EPD were considered precocious (P), and heifers born from sires with negative EPD were considered non-precocious (NP). The factor 2 was the high (HG; ADG = 0.9 kg; ad libitum) and medium ADG (MG; ADG = 0.7 kg) from 3
rd to 7th month of age (1st phase). After 1st phase until puberty, all heifers were fed ad libitum (2nd phase). Statistical analysis was performed by SAS. There was an interaction between factors for DMI in the 1st phase (P = 0.02), which PHG heifers had higher DMI than NPHG. There was no effect on puberty rate, BW, age and BCS at puberty comparing HG vs. MG. However, favorable sires' EPD for scrotal circumference induced a higher proportion of puberty (P 87% vs. NP 59%) at 15 months of age. Thus, the ADG in juvenile age did not affect puberty rate, but sires with positive EPD increased puberty rate of Angus × Nellore heifers in heifers fed a high gain diet., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)- Published
- 2023
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10. Effect of growth rates on hormonal and pubertal status in Nellore heifers early weaned.
- Author
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Ferraz MVC, Santos MH, Oliveira GB, Polizel DM, Barroso JPR, Nogueira GP, Gouvea VN, Carvalho PHV, Biava JS, Ferreira EM, and Pires AV
- Subjects
- Female, Cattle, Animals, Weaning, Diet veterinary, Insulin, Animal Feed analysis, Leptin, Sexual Maturation
- Abstract
This study aimed to determine the effect of growth rates on the hormonal status and puberty onset. Forty-eight Nellore heifers were weaned at 3.0 ± 0.1 (means ± standard error of the mean) months old were blocked according to body weight at weaning (84 ± 2 kg) and randomly assigned to treatments. The treatments were arranged in 2 × 2 factorial according to the feeding program. The first program was high (H; 0.79 kg/day) or control (C; 0.45 kg/day) average daily gain (ADG) from 3
rd to 7th month of age (growing phase I). The second program was also high (H; 0.70 kg/day) or control (C; 0.50 kg/day) ADG from the 7th month until puberty (growing phase II), resulting in four treatments: HH (n = 13), HC (n = 10), CH (n = 13), and CC (n = 12). To achieve desired gains, heifers in high ADG program were fed ad libitum dry matter intake (DMI), and the control group was offered around 50% of ad libitum DMI of high group. All heifers received a diet with similar composition. Puberty was assessed weekly by ultrasound examination, and the largest follicle diameter was evaluated every month. Blood samples were collected to quantify leptin, insulin growth factor-1 (IGF1) and luteinizing hormone (LH). At 7 months of age, heifers in high ADG were 35 kg heavier than the control. Heifers in the HH had greater DMI compared with CH in phase II. The puberty rate at 19 months old was greater in the HH treatment (84%) than in the CC (23%), but there was no difference between HC (60%) and CH (50%) treatments. Heifers from HH treatment had greater serum leptin concentration than others at 13 months old, and serum leptin was greater in HH compared with CH and CC at 18 months old. High heifers in phase I had greater serum IGF1 concentration than the control. In addition, HH heifers had a greater diameter of the largest follicle than CC. There was no interaction between phases and age in any variable relative to the LH profile. However, the heifers' age was the main factor that increased the frequency of LH pulse. In conclusion, increasing ADG was associated with greater ADG, serum leptin and IGF-1 concentration, and puberty onset; however, LH concentration was affected mainly by age of the animal. The increasing growth rate at younger age made heifers more efficient., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)- Published
- 2023
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11. Different combinations of monensin and narasin on growth performance, carcass traits, and ruminal fermentation characteristics of finishing beef cattle.
- Author
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Baggio M, Gouvêa VN, Barroso JPR, Miszura AA, Limede AC, Soares LCB, Ferraz MVC Jr, Vicente ACS, Ferreira EM, Marques RS, and Pires AV
- Abstract
The objective of this study was to evaluate the effects of different combinations of monensin and narasin on finishing cattle. In Exp. 1, 40 rumen-cannulated Nellore steers [initial body weight (BW) = 231 ± 3.64 kg] were blocked by initial BW and assigned to one of the five treatments as follows: Control (CON): no feed additive in the basal diet during the entire feeding period; Sodium monensin (MM) at 25 mg/kg dry matter (DM) during the entire feeding period [adaptation (days 1-21) and finishing (days 22-42) periods]; Narasin (NN) at 13 mg/kg DM during the entire feeding period (adaptation and finishing periods); Sodium monensin at 25 mg/kg DM during the adaptation period and narasin at 13 mg/kg DM during the finishing period (MN); and narasin at 13 mg/kg DM during the adaptation period and sodium monensin at 25 mg/kg DM during the finishing period (NM). Steers fed MM had lower dry matter intake (DMI) during the adaptation period compared to NM ( P = 0.02) but not compared to CON, MM, MN, or NN ( P ≥ 0.12). No differences in DMI were observed among the treatments during the finishing ( P = 0.45) or the total feeding period ( P = 0.15). Treatments did not affect the nutrient intake ( P ≥ 0.51) or the total apparent digestibility of nutrients ( P ≥ 0.22). In Exp. 2, 120 Nellore bulls (initial BW = 425 ± 5.4 kg) were used to evaluate the effects of the same treatments of Exp. 1 on growth performance and carcass characteristics of finishing feedlot cattle. Steers fed NM had greater DMI during the adaptation period compared to CON, MM, and MN ( P ≤ 0.03), but no differences were observed between NM and NN ( P = 0.66) or between CON, MM, and NN ( P ≥ 0.11). No other differences between treatments were observed ( P ≥ 12). Feeding narasin at 13 mg/kg DM during the adaptation period increases the DMI compared to monensin at 25 mg/kg DM, but the feed additives evaluated herein did not affect the total tract apparent digestibility of nutrients, growth performance, or carcass characteristics of finishing cattle., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Baggio, Gouvêa, Barroso, Miszura, Limede, Soares, Ferraz, Vicente, Ferreira, Marques and Pires.)
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- 2023
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12. The Analysis of Two Distinct Strategies toward the Enantioselective Formal Total Synthesis of (+)-Gelsenicine.
- Author
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Ji H, Knutson PC, Harrington CM, Ke YT, and Ferreira EM
- Abstract
A full account of a formal enantioselective total synthesis of (+)-gelsenicine is described. Separate strategies based on catalytic cycloisomerization as the central step are considered. One plan involves chirality transfer from enantioenriched substrates, while the other employs asymmetric catalysis. The chirality transfer strategy is less effective, while in the latter, phosphoramidite- and bisphosphine-gold complexes are tested and ultimately provide a key intermediate in high enantiopurity in our Gelsemium alkaloid syntheses., Competing Interests: Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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- 2023
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13. Processing methods of flint corn and protein supplement in forage-free diets for feedlot lambs.
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Sturion TU, Vicente ACS, de Paula Carlis MS, de Assis RG, de Souza TT, Polizel DM, Junior PCGD, Dos Santos IJ, Comelli JH, Biava JS, Pires AV, and Ferreira EM
- Subjects
- Animals, Sheep, Body Weight, Minerals, Phenotype, Zea mays, Diet
- Abstract
Diets without forage increase the productivity in less time and favor greater practicality and better quality carcass. The corn grain is mostly used associated with pellets but processing these ingredients can bring benefits. The present study evaluated the effect of diets without forage based on whole or coarse ground corn associated with pelleted or ground protein supplement on performance, eating behavior, carcass characteristics, and ruminal morphology of feedlot lambs. Thirty-five Dorper × Santa Inês lambs were used, with 23.85 ± 3.88 kg of initial body weight and 88 ± 9 days old. The experimental design was in a randomized complete block, defined by body weight and age. The experimental diets were control (CONT), containing 90% of concentrate and 10% of forage (coastcross hay), and 4 diets without forage: WC+P, 70% whole flint corn and 30% pelleted protein supplement; WC+G, 70% whole flint corn and 30% ground protein supplement; GC+P, 70% ground flint corn and 30% pelleted protein supplement; and GC+G, 70% ground flint corn and 30% ground protein supplement. There was an interaction between treatments and experimental periods for DMI in kg/day (P = 0.01) and g/kg of BW
0.75 (P < 0.01; Table 3). For the DMI in kg/day, no significant differences were observed between the treatments in any of the experimental periods. However, for DMI expressed in g/kg of BW0.75 , the animals fed WC+P had lower DMI than the animals on the CONT (P < 0.01) only in the first period. The ADG, FBW, and FE were not affected by the treatments. Compared to CONT, forage-free diets decreased ingestion time (min/day) and rumination and chewing (min/day and min/g of dry matter). There was no effect of treatments for any of the carcass traits evaluated. The diets did not cause lesions suggestive of ruminitis. Forage-free diets containing whole or ground corn associated with pelleted or ground protein supplement can be used successfully for feedlot lambs; they provide proper performance and carcass characteristics, without harming the animal's health., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)- Published
- 2023
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14. Effects of injectable and intravaginal progesterone on ewes' reproductive performance at breeding season beginning.
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da Silva TAS, Ferreira EM, de Souza TT, Barroso JPR, Biava JS, Pires AV, Carvalho PHV, and Ferraz Junior MVC
- Subjects
- Pregnancy, Male, Sheep, Female, Animals, Seasons, Reproduction, Estrus, Administration, Intravaginal, Progesterone, Estrus Synchronization
- Abstract
Progesterone (P4) is a steroid hormone that has a regulatory role in the female reproductive system. Studies on the effects of injectable progesterone on ewes are scarce, mainly related to their reproductive responses in the breeding season. This study aimed to compare reproductive performance and serum P4 concentration using injectable or intravaginal P4 in ewes. Two hundred and forty and eight Santa Inês x Dorper ewes (BW; 52.67 ± 11.76 kg; mean ± SE), body condition score (BCS; 2.5 ± 0.8; scale of 1-5), were distributed in four treatments: (i) Control: without administration of P4; (ii) CIDR: intravaginal implantation of 330 mg of P4 for 7 days; (iii) 1P4: 15 mg of P4 intramuscular (IM); and (iv) 2P4I: 30 mg of P4 IM. The first 18 days of breeding season were considered the synchronization period. Except for ewes in the control group, all other ewes received 263 μg IM of cloprostenol sodium for lysis of eventual CL at 24 h before the P4 treatment. After the synchronization period, all ewes were kept together with males for extra 28 days in the breeding season. At the beginning of breeding season, 90% of the ewes had serum P4 concentration less than 1 ng/mL. The estrus rate was greater (P < 0.01) in ewes on the CIDR treatment, with similar estrus rate among the other treatments. The P4 implant was able to keep blood P4 concentration greater than 1 ng/mL in ewes that received an implant of P4 during the 7 days. After implant removal, there was a great increase in the estrus manifestation on ewes in the CIDR treatment, leading to an increase in pregnancy rate at the beginning of breeding season. The current study demonstrated that ewes that received an intramuscular injection of 15 or 30 mg of P4 had similar reproductive performance than ewes that did not receive any P4 intramuscular injection. However, when ewes were implanted with P4 (CIDR), these animals had an increase in estrus manifestation, leading to greater pregnancy earlier during the breeding season., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)
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- 2023
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15. Effects of lasalocid, narasin, or virginiamycin supplementation on rumen parameters and performance of beef cattle fed forage-based diet.
- Author
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Miszura AA, Marques RS, Polizel DM, Cappellozza BI, Cruz VA, Ogg MA, Barroso JPR, Oliveira GB, Martins AS, Limede AC, Ferreira EM, Gouvêa VN, and Pires AV
- Subjects
- Cattle, Animals, Male, Propionates metabolism, Rumen metabolism, Animal Feed analysis, Digestion, Diet veterinary, Body Weight, Fermentation, Dietary Supplements, Lasalocid pharmacology
- Abstract
Two experiments were designed to evaluate the impacts of supplementing lasalocid (LAS), narasin (NAR), or virginiamycin (VRM) on rumen fermentation parameters, apparent nutrient digestibility, and blood parameters (Exp. 1), as well as feed intake and performance (Exp. 2) of Nellore cattle consuming a forage-based diet. In Exp. 1, 32 rumen-fistulated Nellore steers (initial shrunk body weight [BW] = 355 ± 4.4 kg) were assigned to a randomized complete block design. Within block, animals were randomly assigned to one of four treatments: 1) forage-based diet without feed additives (CON), 2) CON diet plus 13 mg/kg of dry matter (DM) of NAR, 3) CON diet plus 20 mg/kg of DM of sodium LAS, or 4) CON diet plus 20 mg/kg of DM of VRM. No treatment effects were detected (P ≥ 0.32) for intake and apparent digestibility of nutrients. Steers fed NAR had the lowest (P ≤ 0.01) molar proportion of acetate on day 28, 56, and 112 vs. CON, LAS, and VRM steers, whereas acetate did not differ (P ≥ 0.25) between LAS, VRM, and CON steers from day 28 to 84. On day 112, steers fed LAS had a lower (P < 0.02) molar proportion of acetate vs. VRM and CON, whereas it did not differ between CON and VRM (P > 0.33). Steers receiving NAR had a greater (P ≤ 0.04) ruminal propionate vs. CON, LAS, and VRM, whereas LAS steers had greater (P < 0.04) propionate vs. CON and VRM steers on day 28 and 112, and it did not differ (P > 0.22) between CON and VRM. In Exp. 2, 160 Nellore bulls were blocked by initial shrunk BW (212 ± 3.1 kg) in a 140-d feedlot trial. Diets contained the same treatments used in Exp. 1. Bulls fed NAR had greater (P < 0.02) average daily gain (ADG) vs. CON and VRM, and similar (P = 0.17) ADG between NAR and LAS, whereas ADG did not differ (P > 0.28) between LAS, VRM, and CON bulls. A treatment effect was detected (P = 0.03) for dry matter intake, being greater in NAR vs. CON, LAS, and VRM bulls, and similar (P > 0.48) between CON, LAS, and VRM bulls. A tendency was detected (P = 0.09) for feed efficiency, which was greater (P < 0.02) in NAR bulls vs. CON and VRM, and similar (P = 0.36) between NAR and LAS bulls. From day 112 to 140, bulls receiving NAR were heavier (P < 0.03) vs. CON, LAS, and VRM bulls, but no differences were observed (P > 0.51) between CON, LAS, and VRM bulls. Collectively, ruminal fermentation profile and intake were impacted by NAR supplementation, which partially contributed to the enhanced performance of Nellore bulls receiving a forage-based diet., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Society of Animal Science.)
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- 2023
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16. Determinants of death in critically ill COVID-19 patients during the first wave of COVID-19: a multicenter study in Brazil.
- Author
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Ramos FJDS, Atallah FC, Souza MA, Ferreira EM, Machado FR, and Freitas FGR
- Subjects
- Adult, Humans, Male, Middle Aged, Female, Brazil epidemiology, SARS-CoV-2, Critical Illness therapy, Multiple Organ Failure, Respiration, Artificial, Intensive Care Units, Retrospective Studies, COVID-19
- Abstract
Objective: To evaluate clinical outcomes and factors associated with mortality, focusing on secondary infections, in critically ill patients with COVID-19 in three Brazilian hospitals during the first pandemic wave., Methods: This was a retrospective observational study involving adult patients with COVID-19 admitted to one of the participating ICUs between March and August of 2020. We analyzed clinical features, comorbidities, source of SARS-CoV-2 infection, laboratory data, microbiology data, complications, and causes of death. We assessed factors associated with in-hospital mortality using logistic regression models., Results: We included 645 patients with a mean age of 61.4 years. Of those, 387 (60.0%) were male, 12.9% (83/643) had undergone solid organ transplant, and almost 10% (59/641) had nosocomial COVID-19 infection. During ICU stay, 359/644 patients (55.7%) required invasive mechanical ventilation, 225 (34.9%) needed renal replacement therapy, 337 (52.2%) received vasopressors, and 216 (33.5%) had hospital-acquired infections (HAIs), mainly caused by multidrug-resistant gram-negative bacteria. HAIs were independently associated with a higher risk of death. The major causes of death were refractory shock and multiple organ dysfunction syndrome but not ARDS, as previously reported in the literature., Conclusions: In this study, most of our cohort required invasive mechanical ventilation and almost one third had HAIs, which were independently associated with a higher risk of death. Other factors related to death were Charlson Comorbidity Index, SOFA score at admission, and clinical complications during ICU stay. Nosocomial COVID-19 infection was not associated with death. The main immediate causes of death were refractory shock and multiple organ dysfunction syndrome.
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- 2022
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17. Dearomative (3+2) Cycloadditions between Indoles and Vinyldiazo Species Enabled by a Red-Shifted Chromium Photocatalyst.
- Author
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Gall BK, Smith AK, and Ferreira EM
- Subjects
- Cycloaddition Reaction, Cations, Chromium, Indoles
- Abstract
A direct dearomative photocatalyzed (3+2) cycloaddition between indoles and vinyldiazo reagents is described. The transformation is enabled by the development of a novel oxidizing Cr
III photocatalyst, its specific reactivity attributed to increased absorptive properties over earlier Cr analogs and greater stability than Ru counterparts. A variety of fused indoline compounds are synthesized using this method, including densely functionalized ring systems that are feasible due to base-free conditions. Experimental insights corroborate a cycloaddition initiated by nucleophilic attack at C3 of the indole radical cation by the vinyldiazo species., (© 2022 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)- Published
- 2022
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18. Multigram Synthesis of a Combustion-Relevant δ-Ketohydroperoxide through Sulfonylhydrazine Substitution.
- Author
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Ke YT, Gall BK, Dewey NS, Rotavera B, and Ferreira EM
- Subjects
- Peroxides, Hydrogen Peroxide
- Abstract
A synthesis of a δ-ketohydroperoxide is described, addressing potential functional-group compatibilities in these elusive species relevant to combustion and atmospheric chemistries. The hydroperoxide is installed via sulfonylhydrazine substitution, which was found to be more effective than displacement of secondary halides. As part of this protocol, it was observed that 1,2-dimethoxyethane is an advantageous medium for the reaction, avoiding the formation of a tetrahydrofuran hydroperoxide side product. This discovery facilitated the multigram synthesis (6 steps, 41 % yield overall) and discrete characterization of the target δ-ketohydroperoxide., (© 2022 The Authors. Chemistry - A European Journal published by Wiley-VCH GmbH.)
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- 2022
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19. Performance, nutritional behavior, and carcass characteristics of feedlot lambs fed diets with non-forage fiber source or sodium bicarbonate.
- Author
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Vicente ACS, de Paula Carlis MS, Dos Santos IJ, da Silva ALA, Júnior PCGD, de Assis RG, Sturion TU, Biava JS, Pires AV, and Ferreira EM
- Subjects
- Animals, Body Weight, Diet veterinary, Dietary Fiber, Male, Sheep, Sheep, Domestic, Glycine max, Zea mays, Animal Feed analysis, Sodium Bicarbonate
- Abstract
The study was carried out to evaluate the effect of sodium bicarbonate (SB) supplementation in diets and compare its chemical effect with the fiber effect of soybean hulls on performance, nutritional behavior, and carcass characteristics of feedlot lambs. Twenty-eight ram lambs (Dorper × Santa Inês), with an initial body weight of 30.2 ± 4.5 kg and 94 ± 8.4 days old, were used. They were assigned to a randomized complete block design, defined by initial age and body weight. Experimental diets were positive control, diet containing soybean hulls in 400 g/kg dry matter (DM) (CONT), and three diets based on ground flint corn containing 10 (10SB), 20 (20SB), or 30 (30SB) g/kg DM of SB. Among the SB levels, the buffer supplementation quadratically increased dry matter intake, average daily gain, feed efficiency, as well as increased final and slaughter body weight, which led to higher hot and cold carcass weights, loin muscle area, leg compacity index, and weight of neck, shoulder, rib, and leg cuts, with higher values for the 20SB. Feeding SB linearly decreased the area and height of the papillae. None of the animals presented liver abscess; however, two animals from 30SB and one from CONT had F-rumen lesions. The use of SB provided a similar animal performance when compared to the treatment containing soybean hulls. This shows that the chemical effect of the buffer was efficient and provided greater safety for this type of diet without causing damages to the rumen health. Among the SB levels, the best results were observed in the 20 g/kg level (20SB), which shows that the buffer can be used as a strategy for diets with high inclusion of corn and no fiber source., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
- Published
- 2022
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20. The effect of progesterone length in timed AI in ewes.
- Author
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Sinimbu AP, Ferreira EM, Denadai R, Barroso JPR, Biava JS, Pires AV, and de Castro Ferraz Junior MV
- Subjects
- Animals, Dinoprost pharmacology, Estrus Detection, Estrus Synchronization, Female, Gonadotropin-Releasing Hormone pharmacology, Pregnancy, Pregnancy Rate, Sheep, Insemination, Artificial methods, Insemination, Artificial veterinary, Progesterone
- Abstract
This study aimed to evaluate the reproductive performance of ewes submitted to timed AI protocol with 7 (D7) or 9 (D9) days of progesterone. A total of 220 crossbred ewes (Doper × Santa Ines) were distributed in the treatments according to body weight (52.67 ± 11.76 kg), body condition score (2.5 ± 0.8; scale of 1-5), and the female category (multiparous, nulliparous and primiparous). Ewes received an intravaginal device of 0.3 g of progesterone (CIDR® Easy breed) on day 0, keeping in ewes for 7 or 9 days, which were the experimental treatments. At the time of P4 withdrawal, ewes received 300 IU of eCG (Novormon®) and 6.70 mg of dinoprost tromethamine (Lutalyse®). Insemination by laparoscopy was performed between 46 and 59 h after device removal, lasting from 1 to 5 min/ewe, which did not differ between protocols. The estrus detection rate was higher in the 9-day protocol compared to the 7-day protocol (82% and 65%, respectively, P = 0.0096). However, the 7-day protocol tended to increase pregnancy rate on the TAI compared to the 9-day protocol (45% and 33%, respectively, P = 0.09). The plasma concentration of progesterone at device removal was higher in the 7-day protocol than in the 9-day protocol (2.35 and 1.22 ng/mL, respectively, P = 0.04). We conclude that reducing the length of the estrus synchronization protocol to 7 days is recommended, which improved the reproductive response in ewes., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
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- 2022
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21. Chirality Transfer and Asymmetric Catalysis: Two Strategies toward the Enantioselective Formal Total Synthesis of (+)-Gelsenicine.
- Author
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Knutson PC, Ji H, Harrington CM, Ke YT, and Ferreira EM
- Subjects
- Catalysis, Molecular Structure, Stereoisomerism, Indole Alkaloids
- Abstract
Two strategies are described en route to an enantioselective total synthesis of gelsenicine. One approach centers on a chirality transfer cycloisomerization that ultimately fell short. Separately, an asymmetric catalysis route utilizing bisphosphine-gold-catalyzed cycloisomerization was pursued. A catalytic system was identified that provided a synthetic intermediate in our Gelsemium alkaloid syntheses in high enantiopurity and with absolute configuration determined by electronic circular dichroism, thus representing an enantioselective formal total synthesis of (+)-gelsenicine.
- Published
- 2022
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22. Persistence of Staphylococcus spp. in milk from cows undergoing homeopathy to control subclinical mastitis.
- Author
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Ferreira EM, Romero LC, Cunha MLRSD, Malagó Junior W, Camargo CH, Barioni Júnior W, and Zafalon LF
- Subjects
- Animals, Biofilms, Cattle, Female, Humans, Milk microbiology, Staphylococcus genetics, Staphylococcus aureus genetics, Cattle Diseases, Homeopathy veterinary, Mastitis, Bovine microbiology, Mastitis, Bovine therapy, Staphylococcal Infections microbiology, Staphylococcal Infections veterinary
- Abstract
Background: Mastitis is one of the major diseases in dairy cattle, as it causes great economic losses to producers due to the reduction of milk production and changes in the quality of the product. The disease is mainly caused by bacteria of the genus Staphylococcus spp., these microorganisms can express various virulence factors, such as biofilms for example. In herds with organic management, producers and technicians use unconventional ways to treat and control the disease, such as homeopathy. However, it is not known if this type of treatment is able to control pathogenic bacteria such as those of the genus Staphylococcus, of relevance to animal and human health. Thus, the objective of this study was to investigate the production of biofilm in vitro and its genes by Staphylococcus spp. isolated in the milk of cows treated with homeopathy, as well as the persistence of microorganisms in animals., Methods: Ninety-nine isolates of Staphylococcus spp. from cows treated and not treated with homeopathy were identified by internal transcribed space-polymerase chain reaction and investigated for the presence of the icaABCD, bap, aap, atlE, and bhp genes and in vitro biofilm production using the adhesion method on polystyrene plates. The enzyme restriction profile was determined by Pulsed-Field Gel Electrophoresis. Clusters of S. aureus and S. epidermidis with three or more isolates had an isolate selected for Multilocus Sequence Typing., Results: The frequency of S. aureus isolations was similar in treated and untreated cows, while 71.4% of the coagulase-negative identified were isolated in cows treated with homeopathy. The distribution of the operon ica genes was similar in animals with and without treatment, except for the icaD gene, more frequent in treated cows. Production of biofilm was associated with presence of one or more genes from the icaADBC operon. S. aureus revealed a greater diversity and greater dissemination in cows treated and not treated with homeopathy. Sequence Types ST1, ST5, and ST126 were identified in S. aureus., Conclusions: The presence of biofilm-associated genes and the in vitro production of biofilms, combined with the persistence of clonal profiles of Staphylococcus spp. demonstrate other forms of control for bovine mastitis should be researched for organic production herds., (© 2022. The Author(s).)
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- 2022
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23. The continuous decrease in Poliomyelitis vaccine coverage in Brazil.
- Author
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Fujita DM, Gomes da Cruz TC, Ferreira EM, and Henrique da Silva Nali L
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- Brazil, Humans, Infant, Poliomyelitis prevention & control, Vaccines
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- 2022
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24. Low frequency of SARS-CoV2 infection in daycare centers during the reopening of school activities in the Southeast's poor area of Brazil.
- Author
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Soares GDS, Morais LV, Silva KCN, Ferreira EM, Shio MT, Romano CM, Conde CR, Sabino EC, França CN, and Nali LH
- Subjects
- Brazil epidemiology, Child, Female, Humans, Male, RNA, Viral, Schools, COVID-19 epidemiology, COVID-19 prevention & control, SARS-CoV-2
- Abstract
SARS-Cov2 has already infected over 482 million people and caused more than 6.1 million deaths. The beginning of the pandemic has led the health authorities of several countries to adopt non-pharmacological preventive measures such as daycare closures. The reopening took place when the country had the highest rates of infection and mortality (mainly due to the gamma variant (P.1) outbreak) and the beginning of the vaccination program. Therefore, we aimed to investigate the prevalence of SARS-CoV2 in daycare after educational activities resumed. The study was conducted in seven childcare facilities. Swab samples from the nasopharynx were collected from children and staff members. The viral RNA was obtained through PureLink RNA extraction kit purification and SARS-CoV2 presence was detected using the All plex SARS-CoV2 kit. The study population included 201 participants, including daycare workers and children. The average age of the workers and children is 40 and 3 years old, respectively. Among the children, 47.5% are female and among the workers, 91.4%. One (0.5%) test came out positive for the presence of SARS-CoV-2, which was from a sample of an asymptomatic childcare worker, and no secondary infections were detected. Considering that the return to daycare activities occurred during a period with a high number of deaths and a lack of vaccines throughout the country, the small number of cases indicates the effectiveness of the several preventive measures used by daycare centers in preventing SARS-CoV2 transmission.
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- 2022
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25. The Impact of Controlled Ovarian Stimulation on Serum Oxidative Stress Markers in Infertile Women with Endometriosis Undergoing ICSI.
- Author
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Da Broi MG, Ferreira EM, Andrade AZ, Jordão AA, Ferriani RA, and Navarro PA
- Abstract
Endometriosis-related infertility is associated with oxidative stress (OS). The present study aims to compare serum OS markers of infertile women with endometriosis and controls during the follicular phase of the natural cycle (D1), after pituitary downregulation using a GnRH agonist (D2), after controlled ovarian stimulation (COS) on the day of human chorionic gonadotropin administration (D3), and on the day of oocyte retrieval (D4). One hundred and eight serum samples (58 controls and 35 early and 18 advanced endometriosis cases) were collected at these four timepoints. OS markers were compared among the groups and timepoints using a linear regression model with mixed effects and a post-test using orthogonal contrasts. The significance was set at 5%. We observed altered OS markers in the endometriosis patients during the D1, D2, D3, and D4 timepoints compared to the controls. The evidence of systemic OS in infertile patients with endometriosis during COS suggests the mobilization of potent antioxidants in an attempt to protect the oocyte from oxidative damage, especially on the day of oocyte retrieval.
- Published
- 2022
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26. Combining vanadyl sulfate with Newcastle disease virus potentiates rapid innate immune-mediated regression with curative potential in murine cancer models.
- Author
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McAusland TM, van Vloten JP, Santry LA, Guilleman MM, Rghei AD, Ferreira EM, Ingrao JC, Arulanandam R, Major PP, Susta L, Karimi K, Diallo JS, Bridle BW, and Wootton SK
- Abstract
The avian paramyxovirus, Newcastle disease virus (NDV), is a promising oncolytic agent that has been shown to be safe and effective in a variety of pre-clinical cancer models and human clinical trials. NDV preferentially replicates in tumor cells due to signaling defects in apoptotic and antiviral pathways acquired during the transformation process and is a potent immunostimulatory agent. However, when used as a monotherapy NDV lacks the ability to consistently generate durable remissions. Here we investigate the use of viral sensitizer-mediated combination therapy to enhance the anti-neoplastic efficacy of NDV. Intratumoral injection of vanadyl sulfate, a pan-inhibitor of protein tyrosine phosphatases, in combination with NDV significantly increased the number and activation status of natural killer (NK) cells in the tumor microenvironment, concomitant with increased expression of interferon-β, granulocyte-macrophage colony-stimulating factor, and monocyte chemoattractant protein-1, leading to rapid tumor regression and long-term cures in mice bearing syngeneic B16-F10 melanomas. The anti-tumor efficacy of this combination therapy was abrogated when NK cells were depleted and when interferon-β expression was transiently suppressed. Tumor-specific CD8
+ T cell responses were not detected, nor were mice whose tumors regressed protected from re-challenge. This suggested efficacy of the combination therapy predominantly relied on the innate immune system. Importantly, efficacy was not limited to melanoma; it was also demonstrated in a murine prostate cancer model. Taken together, these results suggest that combining NDV with vanadyl sulfate potentiates an innate immune response that can potentiate rapid clearance of tumors, with type I interferon signaling and NK cells being important mechanisms of action., Competing Interests: J.S.D. is an inventor on a patent describing the use of vanadium compounds as enhancers of oncolytic virotherapy. This patent (publication #20190231832) is licensed to Virica Biotech, where J.S.D. is co-founder and serves as an executive., (© 2021 The Author(s).)- Published
- 2021
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27. Implications of growth rates and compensatory growth on puberty attainment in Nellore heifers.
- Author
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Miszura AA, Ferraz MVC, Cardoso RC, Polizel DM, Oliveira GB, Barroso JPR, Gobato LGM, Nogueira GP, Biava JS, Ferreira EM, and Pires AV
- Subjects
- Aging, Animal Feed, Animal Nutritional Physiological Phenomena, Animals, Cattle genetics, Female, Gene Expression Regulation drug effects, Leptin metabolism, Weight Gain drug effects, Caloric Restriction, Cattle growth & development, Diet veterinary, Leptin blood, Sexual Maturation drug effects
- Abstract
This study investigated the effects of growth rates and compensatory growth on puberty attainment in Nellore heifers. Nellore heifers (n = 120), weaned at 8 ± 0.75 mo of age, were blocked by sire and BW (180 ± 8.6 kg) and assigned randomly to receive 1 of 4 treatments over a 10-mo period. Treatments included ad libitum feeding (high gain, HG), feed intake to gain 0.6 kg/d (medium gain, MG), restricted feeding (0.2 kg/d) for 4 mo followed by ad libitum feeding for 6 mo (compensatory gain, CG), and alternating periods of ad libitum and restricted feeding for 2 mo each throughout the trial (alternated CG, ACG). Puberty was assessed weekly by transrectal ultrasonography. Blood samples were collected at 8, 11, and 18 mo of age and at puberty to determine circulating concentrations of leptin. At 18 mo of age, nonpubertal heifers were treated with a puberty induction protocol using an intravaginal progestin device. There was no treatment effect (P = 0.17) on the percentage of heifers pubertal by 18 mo of age (HG: 66, MG: 40, CG: 58, and ACG: 52%), BW at puberty, and age at puberty. However, HG heifers had higher ADG (P < 0.01), dry matter intake (P < 0.01), and leptin concentrations (P = 0.03) than heifers from other groups. The response to the puberty induction protocol was similar (P = 0.90) among treatments. Regarding sire effects (genetic effects), there was an effect (P = 0.03) on the percentage of heifers pubertal by 18 mo of age and a tendency (P = 0.07) of sire effect in response to the puberty induction protocol. Compensatory growth appears to be an effective managerial approach to decrease feeding costs and stimulate puberty in Nellore heifers., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2021
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28. Fixation probabilities for the Moran process with three or more strategies: general and coupling results.
- Author
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Ferreira EM and Neves AGM
- Subjects
- Population Density, Population Dynamics, Probability, Selection, Genetic, Stochastic Processes, Biological Evolution, Game Theory, Models, Biological
- Abstract
We study fixation probabilities for the Moran stochastic process for the evolution of a population with three or more types of individuals and frequency-dependent fitnesses. Contrary to the case of populations with two types of individuals, in which fixation probabilities may be calculated by an exact formula, here we must solve a large system of linear equations. We first show that this system always has a unique solution. Other results are upper and lower bounds for the fixation probabilities obtained by coupling the Moran process with three strategies with birth-death processes with only two strategies. We also apply our bounds to the problem of evolution of cooperation in a population with three types of individuals already studied in a deterministic setting by Núñez Rodríguez and Neves (J Math Biol 73:1665-1690, 2016). We argue that cooperators will be fixated in the population with probability arbitrarily close to 1 for a large region of initial conditions and large enough population sizes.
- Published
- 2020
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29. Milk yield and composition from ewes fed diets containing narasin and their lambs' performance.
- Author
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Sardinha LA, Marques RS, Miszura AA, Barroso JPR, Oliveira GB, Martins AS, Limede AC, Ferraz MVC Jr, Ferreira EM, Pires AV, Eastridge ML, and Polizel DM
- Abstract
The changes promoted by feed additives in ruminal fermentation, especially increasing the availability of propionate, can improve the energy balance of an animal, which is of great importance in the lactation period. This trial aimed to evaluate the inclusion of narasin in the diet of lactating ewes on milk yield, composition, dry matter intake (DMI), and plasma metabolites of the ewes and growth rate of lambs. Thirty-two lactating ewes (59.0 ± 2.42 kg) were assigned to a randomized complete block design. The experimental diets contained 500 g/kg of dry matter (DM) of coast cross ( Cynodon dactylon (L.) Pers) hay and 500 g/kg DM of concentrate, and the treatments were: N0-no narasin inclusion; N13-inclusion of 13 mg of narasin/kg DM. Once a week, from week 2 to 10 of lactation, ewes were separated from their lambs, injected with oxytocin, and milked mechanically to empty the udder. After 3 h, the milk production was recorded, using the same procedure, and sampled to evaluate the composition. The blood samples were taken weekly, 4 h after feeding. The average daily gain (ADG) and starter DMI of the lambs were evaluated weekly from week 2 to 12 of age. The inclusion of narasin did not affect ( P = 0.93) DMI of ewes; however, it increased milk production ( P < 0.01) and feed efficiency ( P = 0.02; FE). Ewes fed N13 had a greater milk fat ( P < 0.01), protein ( P < 0.01), lactose ( P = 0.04), and total solids production ( P < 0.01). Narasin inclusion in ewe's diet increased plasma glucose concentration ( P = 0.05) at weeks 8, 9 and 10; however, there was no effect on plasma urea concentration ( P = 0.96). The lambs of N0 ewes had a greater starter DMI ( P < 0.01) at weeks 7, 8, 9, and 10; however, the ADG and body weight at weaning and after weaning were similar between treatments ( P > 0.05). The results showed that the inclusion of 13 mg of narasin/kg DM improved the milk production and FE of the ewes without altering the composition of the milk. The lower initial consumption of concentrate by N13 lambs before weaning was caused by the higher production of milk. The results obtained in the present study demonstrate the possible productive gain with the inclusion of narasin in diets for lactating ewes., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society of Animal Science.)
- Published
- 2020
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30. Uncovering the mechanisms of exertional dyspnoea in combined pulmonary fibrosis and emphysema.
- Author
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Costa CM, Neder JA, Verrastro CG, Paula-Ribeiro M, Ramos R, Ferreira EM, Nery LE, O'Donnell DE, Pereira CAC, and Ota-Arakaki J
- Subjects
- Dyspnea etiology, Exercise Test, Exercise Tolerance, Humans, Emphysema, Pulmonary Emphysema complications, Pulmonary Emphysema diagnostic imaging
- Abstract
The prevailing view is that exertional dyspnoea in patients with combined idiopathic pulmonary fibrosis (IPF) and emphysema (CPFE) can be largely explained by severe hypoxaemia. However, there is little evidence to support these assumptions.We prospectively contrasted the sensory and physiological responses to exercise in 42 CPFE and 16 IPF patients matched by the severity of exertional hypoxaemia. Emphysema and pulmonary fibrosis were quantified using computed tomography. Inspiratory constraints were assessed in a constant work rate test: capillary blood gases were obtained in a subset of patients.CPFE patients had lower exercise capacity despite less extensive fibrosis compared to IPF (p=0.004 and 0.02, respectively). Exertional dyspnoea was the key limiting symptom in 24 CPFE patients who showed significantly lower transfer factor, arterial carbon dioxide tension and ventilatory efficiency (higher minute ventilation ( V '
E )/carbon dioxide output ( V 'CO ) ratio) compared to those with less dyspnoea. However, there were no between-group differences in the likelihood of pulmonary hypertension by echocardiography (p=0.44). High dead space/tidal volume ratio, low capillary carbon dioxide tension emphysema severity (including admixed emphysema) and traction bronchiectasis were related to a high V '2 E / V 'CO ratio in the more dyspnoeic group. V '2 E / V 'CO nadir >50 (OR 9.43, 95% CI 5.28-13.6; p=0.0001) and total emphysema extent >15% (2.25, 1.28-3.54; p=0.01) predicted a high dyspnoea burden associated with severely reduced exercise capacity in CPFEContrary to current understanding, hypoxaemia per se is not the main determinant of exertional dyspnoea in CPFE. Poor ventilatory efficiency due to increased "wasted" ventilation in emphysematous areas and hyperventilation holds a key mechanistic role that deserves therapeutic attention., Competing Interests: Conflict of interest: C.M. Costa has nothing to disclose. Conflict of interest: J.A. Neder has nothing to disclose. Conflict of interest: C.G. Verrastro has nothing to disclose. Conflict of interest: M. Paula-Ribeiro has nothing to disclose. Conflict of interest: R. Ramos has nothing to disclose. Conflict of interest: E.M. Ferreira has nothing to disclose. Conflict of interest: L.E. Nery has nothing to disclose. Conflict of interest: D.E. O'Donnell has nothing to disclose. Conflict of interest: C.A.C. Pereira has nothing to disclose. Conflict of interest: J. Ota-Arakaki has nothing to disclose., (Copyright ©ERS 2020.)2 - Published
- 2020
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31. Implications of carbohydrate sources and rate of body weight gain on puberty in ewe lambs in tropical climate conditions.
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Ferreira EM, de Castro Ferraz MV Jr, Biava JS, de Assis RG, Barroso JPR, Polizel DM, de Araujo LC, and Pires AV
- Subjects
- Animals, Body Weight, Brazil, Citrus chemistry, Female, Poaceae chemistry, Random Allocation, Tropical Climate, Zea mays chemistry, Dietary Carbohydrates metabolism, Sexual Maturation drug effects, Sheep physiology, Weight Gain
- Abstract
The objectives were to evaluate the effects of two non-fibrous carbohydrate sources and the rate of body weight gain on puberty status in ewe lambs. Sixty ewe lambs (½ Dorper × ½ Santa Ines) with an initial body weight of 25.1 ± 4.1 kg and 102.8 ± 1.5 days old were distributed in a randomized complete block design with 10 blocks and 3 treatments. The trial lasted 119 days, in which performance was evaluated on days 28, 56, 84, and 119, and puberty status was every week evaluated by progesterone concentration. The treatments were characterized by the inclusion of different carbohydrate sources in the diets in order for ewe lambs to reach different rates of body weight gain: CORN, total diet containing 46% of corn (% DM); PCP, total diet containing 46% of pelleted citrus pulp (% DM); and HAY, total diet containing 80% of coastcross hay (% DM). The CORN- and PCP-based diets were formulated for an average daily gain (ADG) of 0.200 kg/day and a HAY-based diet for an ADG of 0.100 kg/day. There was an interaction between treatments and experimental periods for dry matter intake (DMI) (P < 0.01), in which lambs in the CORN treatment presented DMI similar to PCP in the first and second periods, but lambs from the PCP treatment presented lower DMI than the CORN treatment in subsequent periods. In all periods, the body weight, average daily gain, and feed efficiency of CORN lambs were similar to PCP lambs, but higher than HAY lambs. The age at puberty was not affected by treatments; however, lambs fed with non-fibrous carbohydrate sources reached puberty heavier (P < 0.0001) than lambs from the HAY treatment. Despite the high increase in body weight for lambs fed with non-fibrous carbohydrate sources, it did not affect the age of puberty.
- Published
- 2020
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32. Regioselectivity Influences in Platinum-Catalyzed Intramolecular Alkyne O-H and N-H Additions.
- Author
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Costello JP and Ferreira EM
- Subjects
- Catalysis, Ethers chemistry, Furans chemistry, Molecular Structure, Pyrans chemistry, Stereoisomerism, Alkynes chemistry, Ethers chemical synthesis, Furans chemical synthesis, Organometallic Compounds chemistry, Platinum chemistry, Pyrans chemical synthesis
- Abstract
The steric and electronic drivers of regioselectivity in platinum-catalyzed intramolecular hydroalkoxylation are elucidated. A branch point is found that divides the process between 5-exo and 6-endo selective processes, and enol ethers can be accessed in good yields for both oxygen heterocycles. The main influence arises from an electronic effect, where the alkyne substituent induces a polarization of the alkyne that leads to preferential heteroatom attack at the more electron-deficient carbon. The electronic effects are studied in other contexts, including hydroacyloxylation and hydroamination, and similar trends in directionality are predominant although not uniformly observed.
- Published
- 2019
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33. Systemic oxidative stress as a possible mechanism underlying the pathogenesis of mild endometriosis-related infertility.
- Author
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Ferreira EM, Giorgi VSI, Rodrigues JK, de Andrade AZ, Junior AAJ, and Navarro PA
- Subjects
- Birth Rate, Case-Control Studies, Female, Fertilization, Follicular Fluid metabolism, Humans, Menstrual Cycle, Oocytes cytology, Ovulation Induction, Pilot Projects, Pregnancy, Pregnancy Rate, Prospective Studies, ROC Curve, Sensitivity and Specificity, Sperm Injections, Intracytoplasmic, Superoxide Dismutase metabolism, Endometriosis complications, Infertility, Female etiology, Infertility, Female physiopathology, Oxidative Stress
- Abstract
Research Question: Does systemic oxidative stress occur during the early follicular phase of the menstrual cycle in infertile women with minimal (stage I) or mild (stage II) endometriosis? Are serum oxidative stress markers during the early follicular phase of the menstrual cycle good predictors of successful gestation in these women who undergo ovarian stimulation for intracytoplasmic sperm injection (ICSI)?, Materials and Methods: A pilot study (prospective case-control study) was conducted in a University Hospital. Serum samples were obtained during the early follicular phase of the natural cycle preceding ovarian stimulation for ICSI of infertile women (with and without stage I and II endometriosis, the latter having male factor infertility). Total hydroperoxides (FOX1), malondialdehyde, advanced oxidation protein products, reduced glutathione, superoxide dismutase, total antioxidant capacity (TAC), 8-hydroxy-2'-deoxyguanosine (8OHdG) and vitamin E were analysed in serum from 35 women with stage I or II endometriosis and 60 control women. The accuracy of oxidative stress markers for predicting clinical pregnancy and live births was determined by receiver operator characteristic curves., Results: Women with stage I and II endometriosis showed lower serum 8OHdG concentrations (16.02 ng/ml) compared with the control group (22.08 ng/ml). The best predictor for clinical pregnancy and live births was TAC, whereas FOX1 was the best predictor of clinical pregnancy in the control group., Conclusions: Infertile women with stage I and II endometriosis present systemic oxidative stress during the early follicular phase of the menstrual cycle. Some oxidative stress markers were good predictors of clinical pregnancy and live births after ICSI. Serum TAC was predictive of clinical pregnancy and live births after ICSI in women with stage I or II endometriosis., (Copyright © 2019 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2019
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34. The reused progesterone device has the same effect on short or long estrus synchronization protocols in tropical sheep.
- Author
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Biehl MV, de Ferraz Junior MVC, Barroso JPR, Susin I, Ferreira EM, Polizel DM, and Pires AV
- Subjects
- Administration, Intravaginal, Animals, Dinoprost administration & dosage, Dinoprost analogs & derivatives, Dinoprost pharmacology, Estrus, Estrus Synchronization drug effects, Female, Insemination, Artificial veterinary, Lactation, Pregnancy, Pregnancy Rate, Progesterone administration & dosage, Reproduction, Progesterone pharmacology, Sheep physiology
- Abstract
This study aimed to evaluate the effect of progesterone (P4) device reutilization in long and short protocols for transcervical timed artificial insemination (TAI) in Santa Inês ewes. A total of 275 multiparous lactating ewes were blocked according to body weight (BW, 49.1 ± 7.3 means ± SE), body condition score (BCS, 2.9 ± 0.4; scale of 1-5), and days postpartum (50 ± 8.2 days), and allocated to one of the treatments. The treatments were arranged in a factorial design, in which the factor 1 was the P4 device type (new or a device of 0.3 g of P4 previously used by 11 days), and the factor 2 was the short or long TAI protocol (P4 device remained by 7 or 11 days, respectively). At device removal, all ewes received 300 IU eCG and 6.70 mg of Dinoprost tromethamine. After TAI protocol, ewes remained with ram by 21 days. There was no interaction between factors in any variables. Ewes that received a new P4 device delayed (P = 0.05) to show estrus compared with ewes receiving a previously used P4 device, but it did not affect pregnancy rate. The long protocol tended to increase pregnancy rate compared with short protocol (33% vs. 24%, respectively; P = 0.07). However, the pregnancy rate at the end of reproductive period was similar in both groups (about 84%). Thus, the use of long protocols tended to improve reproductive performance, and the reused P4 device did not affect pregnancy rate.
- Published
- 2019
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35. Availability of resources to treat sepsis in Brazil: a random sample of Brazilian institutions.
- Author
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Taniguchi LU, Azevedo LCP, Bozza FA, Cavalcanti AB, Ferreira EM, Carrara FSA, Sousa JL, Salomão R, and Machado FR
- Subjects
- Brazil epidemiology, Cost of Illness, Hospital Bed Capacity statistics & numerical data, Humans, Prevalence, Sepsis epidemiology, Surveys and Questionnaires, Critical Care statistics & numerical data, Intensive Care Units statistics & numerical data, Sepsis therapy
- Abstract
Objective: To characterize resource availability from a nationally representative random sample of intensive care units in Brazil., Methods: A structured online survey of participating units in the Sepsis PREvalence Assessment Database (SPREAD) study, a nationwide 1-day point prevalence survey to assess the burden of sepsis in Brazil, was sent to the medical director of each unit., Results: A representative sample of 277 of the 317 invited units responded to the resources survey. Most of the hospitals had fewer than 500 beds (94.6%) with a median of 14 beds in the intensive care unit. Providing care for public-insured patients was the main source of income in two-thirds of the surveyed units. Own microbiology laboratory was not available for 26.8% of the surveyed intensive care units, and 10.5% did not always have access to blood cultures. Broad spectrum antibiotics were not always available in 10.5% of surveyed units, and 21.3% could not always measure lactate within three hours. Those institutions with a high resource availability (158 units, 57%) were usually larger and preferentially served patients from the private health system compared to institutions without high resource availability. Otherwise, those without high resource availability did not always have broad-spectrum antibiotics (24.4%), vasopressors (4.2%) or crystalloids (7.6%)., Conclusion: Our study indicates that a relevant number of units cannot perform basic monitoring and therapeutic interventions in septic patients. Our results highlight major opportunities for improvement to adhere to simple but effective interventions in Brazil.
- Published
- 2019
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36. Adaptable mesocosm facility to study oil spill impacts on corals.
- Author
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Silva DP, Duarte G, Villela HDM, Santos HF, Rosado PM, Rosado JG, Rosado AS, Ferreira EM, Soriano AU, and Peixoto RS
- Abstract
Although numerous studies have been carried out on the impacts of oil spills on coral physiology, most have relied on laboratory assays. This scarcity is partly explained by the difficulty of reproducing realistic conditions in a laboratory setting or of performing experiments with toxic compounds in the field. Mesocosm systems provide the opportunity to carry out such studies with safe handling of contaminants while reproducing natural conditions required by living organisms. The mesocosm design is crucial and can lead to the development of innovative technologies to mitigate environmental impacts. Therefore, this study aimed to develop a mesocosm system for studies simulating oil spills with several key advantages, including true replication and the use of gravity to control flow-through that reduces reliance on pumps that can clog thereby decreasing errors and costs. This adaptable system can be configured to (a) have continuous flow-through; (b) operate as an open or closed system; (c) be fed by gravity; (d) have separate mesocosm sections that can be used for individual and simultaneous experiments; and (e) simulate the migration of oil from ocean oil spills to the nearby reefs. The mesocosm performance was assessed with two experiments using the hydrocoral Millepora alcicornis and different configurations to simulate two magnitudes of oil spills. With few exceptions, physical and chemical parameters remained stable within replicates and within treatments throughout the experiments. Physical and chemical parameters that expressed change during the experiment were still within the range of natural conditions observed in Brazilian marine environments. The photosynthetic potential ( F
v /Fm ) of the algae associated with M. alcicornis decreased in response to an 1% crude-oil contamination, suggesting a successful delivery of the toxic contaminant to the targeted replicates. This mesocosm is customizable and adjustable for several types of experiments and proved to be effective for studies of oil spills., Competing Interests: The authors declare no competing financial interests.- Published
- 2019
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37. Molecular-decoration technique offers boost to medicinal chemists.
- Author
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Ferreira EM
- Subjects
- Chemistry, Pharmaceutical
- Published
- 2019
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38. Prevalence of colonisation by group B streptococcus in pregnant patients in Taguatinga, Federal District, Brazil: a cross-sectional study.
- Author
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Siqueira F, Ferreira EM, de Matos Calderon I, and Dias A
- Subjects
- Adult, Brazil, Cross-Sectional Studies, Female, Humans, Infant, Newborn, Pregnancy, Prevalence, Infectious Disease Transmission, Vertical statistics & numerical data, Pregnancy Complications, Infectious epidemiology, Streptococcal Infections epidemiology
- Abstract
Propose: Group B streptococcus is responsible for severe infections in neonates resulting from vertical transmission from pregnant women colonized in the anal, perineal or vaginal regions. The identification of colonized patients and use of intrapartum prophylaxis may reduce the risk of neonatal infection., Methods: A cross-sectional study of pregnant women of gestational age between 35 and 37 weeks was conducted. Material was collected from patients for laboratory identification of group B streptococcus. Epidemiological data, including weight, height, body mass index, antibiotic use during pregnancy, pathologies during pregnancy (diabetes, hypertensive diseases, and hypothyroidism), twinning, and others, were also collected from patients., Results: The sample consisted of 501 pregnant women, and the prevalence of group B streptococcus was 14%. The mean age was 29 years, and the mean BMI was 30.7. During pregnancy, 204 patients had some type of infection, and 201 used antibiotics. Ninety-five patients were diagnosed with gestational diabetes mellitus and 74 with some type of hypertensive disease., Conclusions: The prevalence of group B streptococcus observed did not differ from that observed in other studies. None of the factors studied can be considered as risk or protective factors for maternal colonization by group B streptococcus.
- Published
- 2019
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39. Fixation probabilities for the Moran process in evolutionary games with two strategies: graph shapes and large population asymptotics.
- Author
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de Souza EP, Ferreira EM, and Neves AGM
- Subjects
- Computational Biology, Genetic Fitness, Markov Chains, Mathematical Concepts, Models, Genetic, Population Density, Probability, Selection, Genetic, Stochastic Processes, Biological Evolution, Game Theory
- Abstract
This paper is based on the complete classification of evolutionary scenarios for the Moran process with two strategies given by Taylor et al. (Bull Math Biol 66(6):1621-1644, 2004. https://doi.org/10.1016/j.bulm.2004.03.004 ). Their classification is based on whether each strategy is a Nash equilibrium and whether the fixation probability for a single individual of each strategy is larger or smaller than its value for neutral evolution. We improve on this analysis by showing that each evolutionary scenario is characterized by a definite graph shape for the fixation probability function. A second class of results deals with the behavior of the fixation probability when the population size tends to infinity. We develop asymptotic formulae that approximate the fixation probability in this limit and conclude that some of the evolutionary scenarios cannot exist when the population size is large.
- Published
- 2019
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40. Re: New Brazilian law may put food production safety in check.
- Author
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Silva Ferreira EM, Moreira da Silva JF, Lima do Nascimento GN, and Pimenta RS
- Subjects
- Brazil, Humans, Food Safety, Legislation, Food
- Published
- 2019
- Full Text
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41. Active Life: a project for a safe hospital-community transition after arthroplasty.
- Author
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Ferreira EM, Lourenço OM, Costa PVD, Pinto SC, Gomes C, Oliveira AP, Ferreira Ó, and Baixinho CL
- Subjects
- Aged, Aged, 80 and over, Arthroplasty rehabilitation, Female, Humans, Male, Qualitative Research, Self Care, Transitional Care standards, Transitional Care trends, Activities of Daily Living psychology, Arthroplasty methods, Continuity of Patient Care standards
- Abstract
Objective: To define the criteria for the continuity of care to elderly people submitted to arthroplasty., Method: This is a qualitative study, inserted in the constructivist paradigm, whose methodological option fell on research-action. The participants were the health professionals of an orthopedic service and of the community care teams in the area of the hospital., Results: The different techniques allowed us to identify the difficulties in the safe transition from the hospital to the community. At this level, two categories of criteria for continuity of care emerged: criteria associated with the risk of ineffective management of the therapeutic regimen, and criteria associated with the knowledge and level of competence of the informal caregiver., Final Considerations: An elderly person undergoing arthroplasty (hip or knee) has functional alterations that affect their capacity for self-care and may lead to dependence, our findings allowed the design of an algorithm to facilitate clinical decision making and promote a safe hospital-community transition.
- Published
- 2019
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42. Synthesis of 1,3-Diynes via Cadiot-Chodkiewicz Coupling of Volatile, in Situ Generated Bromoalkynes.
- Author
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Knutson PC, Fredericks HE, and Ferreira EM
- Abstract
A convenient Cadiot-Chodkiewicz protocol that facilitates the use of low molecular weight alkyne coupling partners is described. The method entails an in situ elimination from a dibromoolefin precursor and immediate subjection to copper-catalyzed conditions, circumventing the hazards of volatile brominated alkynes. The scope of this method is described, and the internal 1,3-diyne products are preliminarily evaluated in ruthenium-catalyzed azide-alkyne cycloadditions.
- Published
- 2018
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43. Cyclopentene Annulations of Alkene Radical Cations with Vinyl Diazo Species Using Photocatalysis.
- Author
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Sarabia FJ, Li Q, and Ferreira EM
- Abstract
A direct (3+2) cycloaddition between alkenes and vinyl diazo reagents using either Cr or Ru photocatalysis is described. The intermediacy of a radical cation species enables a nucleophilic interception by vinyl diazo compounds, a departure from their traditional electrophilic behavior. A variety of cyclopentenes are synthesized using this method, and experimental insights implicate a direct cycloaddition instead of a cyclopropanation/rearrangement process., (© 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)
- Published
- 2018
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44. Epidemiology of Time-Loss Injuries in Senior and under-18 Portuguese Male Rugby Players.
- Author
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Cruz-Ferreira AM, Cruz-Ferreira EM, Ribeiro PB, Santiago LM, and Taborda-Barata L
- Abstract
Rugby union has one of the highest injury incidence rates in team sports, however, most of the available data focus on the epidemiology of injuries in countries where rugby is popular. We aimed to report the incidence rate and relevant epidemiological aspects of injuries occurred in a group of Portuguese male rugby players. A prospective cohort study was conducted with a group of 45 senior and 32 under-18 male players (total of 77 players). Outcome measures included injury incidence, position, type, location and severity of injuries. The match injury incidence for all players was 55.84 per 1000 player match-hours (66.66 for seniors, 42.85 for under-18), while mean time-loss for injury was 20.79 days. No statistical differences were found between groups. Lower limb injuries accounted for 60.5% of all injuries, while joint/ligament injuries were the most prevalent type. Contact events were responsible for 65.1% of injuries. Despite the limitations, the obtained data are consistent with the literature. Time-loss injuries seem highly prevalent in rugby union and the incidence rates found in this Portuguese-based study were lower than the reported for international and senior men's professional rugby union, but higher than those occurring in community rugby in tier-1 countries. The authors believe these data reinforce the need to develop and implement effective injury surveillance and prevention programs.
- Published
- 2018
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45. Epidemiology of injuries in Portuguese senior male rugby union sevens: a cohort prospective study.
- Author
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Cruz-Ferreira AM, Cruz-Ferreira EM, Silva JD, Ferreira RM, Santiago LM, and Taborda-Barata L
- Subjects
- Adolescent, Adult, Humans, Incidence, Joints injuries, Lower Extremity injuries, Male, Portugal, Prospective Studies, Seasons, Tendon Injuries epidemiology, Trauma Severity Indices, Young Adult, Athletic Injuries epidemiology, Football injuries, Musculoskeletal System injuries, Physical Education and Training, Soft Tissue Injuries epidemiology
- Abstract
Objectives: To assess the incidence, type and location of injuries sustained during the Portuguese rugby union sevens circuit. To investigate the influence of players' training loads on injury risk., Methods: A prospective cohort study recording time-loss injuries was conducted with all teams competing in the Portuguese national rugby sevens circuit (eight from the top-tier and seven from the second-tier). Main outcome measures included: incidence rate, anatomical location, type, injury incident and severity. Data were also collected regarding players' training loads. Fisher's exact test was used to estimate the relative risk of suffering an injury during the sevens season and training sevens during the fifteens season., Results: A total of 27 injuries were recorded corresponding to an incidence rate of 133.9 injuries per 1000 player match-hours. The average severity was 22.22 days. Contact events preceded 81.5% of injuries. Most injuries occurred in the lower limb (66.7%) and were joint/ligament or muscle/tendon injuries (85.1%). The association between injuries and lower volume of training during the sevens season was identified for the second-tier (p = 0.021). For the same level, an inverse relation between training hours and injury severity was also found (p = 0.008). Top-tier players training sevens and fifteens simultaneously during the year presented a significant increase of injury risk (relative risk = 3.2; p = 0.011)., Conclusions: Injury incidence in our study is similar to that reported for international sevens, although severity is lower. An association between training loads and the occurrence of injuries was found for both tiers, although with differential results, thus reinforcing the need to customize players' preparation. Further studies at non-elite competitions are needed to gather significant data to accurately formulate future injury prevention protocols or recommend modifications to game laws or competition formats, aiming at players' welfare.
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- 2018
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46. Establishment of Novel Biosynthetic Pathways for the Production of Salicyl Alcohol and Gentisyl Alcohol in Engineered Escherichia coli.
- Author
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Shen X, Wang J, Gall BK, Ferreira EM, Yuan Q, and Yan Y
- Subjects
- Biosynthetic Pathways, Gentisates metabolism, Microorganisms, Genetically-Modified, Mixed Function Oxygenases genetics, Mixed Function Oxygenases metabolism, Oxidoreductases genetics, Oxidoreductases metabolism, Plasmids, Recombinant Proteins genetics, Recombinant Proteins metabolism, Shikimic Acid metabolism, Benzyl Alcohols metabolism, Escherichia coli genetics, Escherichia coli metabolism, Metabolic Engineering methods
- Abstract
Salicyl alcohol and gentisyl alcohol are two important phenolic alcohols that possess significant biological activities and pharmaceutical properties. Here, we report establishment of novel biosynthetic pathways for microbial production of salicyl alcohol and gentisyl alcohol from renewable feedstocks. We first examined the promiscuity of the carboxylic acid reductase CAR toward salicylic acid and 2,5-DHBA, which enabled efficient synthesis of salicyl alcohol and gentisyl alcohol. Then, we employed a novel salicylic acid 5-hydroxylase to achieve 2,5-DHBA production from salicylic acid. After that, the de novo biosynthetic pathways were assembled and optimized by programming the carbon flux into the shikimate pathway. The final titers of salicyl alcohol and gentisyl alcohol reached to 594.4 mg/L and 30.1 mg/L, respectively. To our knowledge, this work achieved microbial production of salicyl alcohol and gentisyl alcohol for the first time. Our present study also demonstrated application of enzyme promiscuity to establish non-natural biosynthetic pathways for the production of high-value compounds.
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- 2018
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47. Effects of supplementation with vegetable oils, including castor oil, on milk production of ewes and on growth of their lambs.
- Author
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Parente MOM, Susin I, Nolli CP, Ferreira EM, Gentil RS, Polizel DM, Pires AV, Alves SP, and Bessa RJB
- Subjects
- Animal Nutritional Physiological Phenomena, Animals, Diet veterinary, Dietary Fats, Unsaturated pharmacology, Dietary Supplements, Fatty Acids pharmacology, Female, Maternal Nutritional Physiological Phenomena, Milk drug effects, Rumen drug effects, Animal Feed analysis, Castor Oil, Lactation drug effects, Plant Oils pharmacology, Sheep physiology
- Abstract
The objectives in this experiment were to compare the effects of castor oil, canola oil, or sunflower oil on lactation performance, milk composition, and milk fatty acid (FA) profile in Santa Inês ewes and on growth of lambs. Forty-four ewes (66.9 ± 4.7 kg of initial BW, mean ± SD) were penned individually with their lambs and used in a randomized complete block design with 11 blocks and four diets. The experimental diets were as follows: 1) basal diet without added oil (control), 2) 30 g FA/kg DM of canola oil (CAN), 3) 30 g FA/kg DM of sunflower oil (SUN), and 4) 30 g FA/kg DM of castor oil (CAS). The oils were added to a basal diet containing 50% of roughage. Once a week, from the 2nd to 8th wk of lactation, ewes were separated from their lambs, injected with oxytocin, and mechanically milked to empty the udder. After 3 h, using the same procedure, milk production was recorded, and milk was sampled for composition and FA profile determination. The growth of the lambs was monitored weekly. Ewes fed the control diet had greater (P < 0.05) dry matter intake (DMI) than those fed the oil-supplemented diets. No effect was observed on milk yield and on final BW of lambs. Milk fat and milk total solid concentrations were greater (P < 0.05) with the supply of CAS. Supplementation with CAN and SUN, but not with CAS, reduced (P < 0.05) the sum of FA with 14 or less carbon chains and increased (P < 0.05) the c9-18:1, 18:0 and most of the biohydrogenation intermediates, including the t10-18:1, t11-18:1, and c9,t11-18:2. All oil-supplemented diets reduced (P < 0.05) the content of 16:0 when compared with the control. Milk from ewes fed CAS presented only small proportion of 12-OH,c9-18:1 (0.31% of total FA) but much larger proportions of 12-OH-18:0 (1.58% of total FA) and particularly of 12-oxo-18:0 (2.95 % of total FA), which suggests that 12-OH,c9-18:1 was extensively metabolized in the rumen. Concluding, CAS increased milk fat and modified the milk FA composition by increasing the hydroxy- and oxo-FA. The potential health promoting proprieties and technological advantages of milk enriched with hydroxy- and oxo-FA are not know at present but deserve to be explored.
- Published
- 2018
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48. Engineering a bacterial platform for total biosynthesis of caffeic acid derived phenethyl esters and amides.
- Author
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Wang J, Mahajani M, Jackson SL, Yang Y, Chen M, Ferreira EM, Lin Y, and Yan Y
- Subjects
- Capsicum enzymology, Capsicum genetics, Plant Proteins genetics, Plant Proteins metabolism, Saccharomyces cerevisiae enzymology, Saccharomyces cerevisiae genetics, Saccharomyces cerevisiae Proteins genetics, Saccharomyces cerevisiae Proteins metabolism, Caffeic Acids metabolism, Escherichia coli genetics, Escherichia coli metabolism, Esters metabolism, Metabolic Engineering
- Abstract
Caffeic acid has been widely recognized as a versatile pharmacophore for synthesis of new chemical entities, among which caffeic acid derived phenethyl esters and amides are the most extensively-investigated bioactive compounds with potential therapeutical applications. However, the natural biosynthetic routes for caffeic acid derived phenethyl esters or amides remain enigmatic, limiting their bio-based production. Herein, product-directed design of biosynthetic schemes allowed the development of thermodynamically favorable pathways for these compounds via acyltransferase (ATF) mediated trans-esterification. Production based screening identified a microbial O-ATF from Saccharomyces cerevisiae and a plant N-ATF from Capsicum annuum capable of forming caffeic acid derived esters and amides, respectively. Subsequent combinatorial incorporation of caffeic acid with various aromatic alcohol or amine biosynthetic pathways permitted the de novo bacterial production of a panel of caffeic acid derived phenethyl esters or amides in Escherichia coli for the first time. Particularly, host strain engineering via systematic knocking out endogenous caffeoyl-CoA degrading thioesterase and pathway optimization via titrating co-substrates enabled production enhancement of five caffeic acid derived phenethyl esters and amides, with titers ranging from 9.2 to 369.1mg/L. This platform expanded the capabilities of bacterial production of high-value natural aromatic esters and amides from renewable carbon source via tailoring non-natural biosynthetic pathways., (Copyright © 2017 International Metabolic Engineering Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
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49. Promoting players' safety and welfare through the sharing of scientific knowledge with sports agents: the new reality of Portuguese rugby sevens.
- Author
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Cruz-Ferreira AM, Cruz-Ferreira EM, Taborda-Barata L, and Santiago LM
- Subjects
- Athletic Injuries, Humans, Athletic Performance, Football
- Published
- 2017
- Full Text
- View/download PDF
50. The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study.
- Author
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Machado FR, Cavalcanti AB, Bozza FA, Ferreira EM, Angotti Carrara FS, Sousa JL, Caixeta N, Salomao R, Angus DC, and Pontes Azevedo LC
- Subjects
- Brazil epidemiology, Humans, Incidence, Length of Stay, Prevalence, Random Allocation, Risk Factors, Sepsis mortality, Survival Analysis, Intensive Care Units, Sepsis epidemiology
- Abstract
Background: The sepsis burden on acute care services in middle-income countries is a cause for concern. We estimated incidence, prevalence, and mortality of sepsis in adult Brazilian intensive care units (ICUs) and association of ICU organisational factors with outcome., Methods: We did a 1-day point prevalence study with follow-up of patients in ICU with sepsis in a nationally representative pseudo-random sample. We produced a sampling frame initially stratified by geographical region. Each stratum was then stratified by hospitals' main source of income (serving general public vs privately insured individuals) and ICU size (ten or fewer beds vs more than ten beds), finally generating 40 strata. In each stratum we selected a random sample of ICUs so as to enrol the total required beds in 1690 Brazilian adult ICUs. We followed up patients until hospital discharge censored at 60 days, estimated incidence from prevalence and length of stay, and generated national estimates. We assessed mortality prognostic factors using random-effects logistic regression models., Findings: On Feb 27, 2014, 227 (72%) of 317 ICUs that were randomly selected provided data on 2632 patients, of whom 794 had sepsis (30·2 septic patients per 100 ICU beds, 95% CI 28·4-31·9). The ICU sepsis incidence was 36·3 per 1000 patient-days (95% CI 29·8-44·0) and mortality was observed in 439 (55·7%) of 788 patients (95% CI 52·2-59·2). Low availability of resources (odds ratio [OR] 1·67, 95% CI 1·02-2·75, p=0·045) and adequacy of treatment (OR 0·56, 0·37-0·84, p=0·006) were independently associated with mortality. The projected incidence rate is 290 per 100 000 population (95% CI 237·9-351·2) of adult cases of ICU-treated sepsis per year, which yields about 420 000 cases annually, of whom 230 000 die in hospital., Interpretation: The incidence, prevalence, and mortality of ICU-treated sepsis is high in Brazil. Outcome varies considerably, and is associated with access to adequate resources and treatment. Our results show the burden of sepsis in resource-limited settings, highlighting the need to establish programmes aiming for sepsis prevention, early diagnosis, and adequate treatment., Funding: Fundação de Apoio a Pesquisa do Estado de São Paulo (FAPESP)., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
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