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The saturated LPC18:0 and unsaturated LPC18:1 lysophosphatidylcholines have important roles in inflammation and immunity and are interesting targets for immunotherapy. The synthetic cationic lipid DODAB has been successfully employed in delivery systems, and would be a suitable carrier for those lysophosphatidylcholines. Here, assemblies of DODAB and LPC18:0 or LPC18:1 were characterized by Differential Scanning Calorimetry (DSC) and Electron Paramagnetic Resonance (EPR) spectroscopy. LPC18:0 increased the DODAB gel-fluid transition enthalpy and rigidified both phases. In contrast, LPC18:1 caused a decrease in the DODAB gel-fluid transition temperature and cooperativity, associated with two populations with distinct rigidities in the gel phase. In the fluid phase, LPC18:1 increased the surface order but, differently from LPC18:0, did not affect viscosity at the membrane core. The impact of the different acyl chains of LPC18:0 and 18:1 on structure and thermotropic behavior should be considered when developing applications using mixed DODAB membranes., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Julio H K Rozenfeld reports equipment, drugs, or supplies was provided by Fapesp., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Urban parks have been studied for their effects on health and the environment. Accessing park data from reliable and comparable sources remains challenging, reinforcing the importance of standardized search tools, notably in Latin America. We designed a systematized methodology to identify processes of accessing, collecting, verifying, and harmonizing urban park spatial data in all Brazilian capitals included in the Urban Health in Latin America (SALURBAL) project. We developed a research protocol using official and non-official sources combining the results of Google Maps (GMaps) points and OpenStreetMap (OSM) polygons-GMaps-OSM. Descriptive analyses included the frequency of the distribution of parks before and after harmonization stratified by data source. We used the intraclass correlation coefficient (ICC) to assess agreement in the area between official and GMaps-OSM data. Official data were obtained for 16 cities; for the remaining 11 capitals, we used GMaps-OSM. After verification and harmonization, 302 urban parks were obtained from official data and 128 from GMaps-OSM. In a sub-study of the 16 cities with official data (n = 302 parks), we simulated a collection of non-official data using GMaps-OSM and OSM only. From GMaps-OSM, we obtained 142 parks, and from OSM, 230 parks. Statistical analysis showed a better agreement between official data and OSM. After completing verification and harmonization, the complete dataset (official and GMaps-OSM) included 430 urban parks with a total area of 145.14 km2. The mean number of parks across cities was 16, with a mean size area of 0.33 km2. The median number of parks was nine, with a median area of 0.07 km2. This study highlights the importance of creating mechanisms to access, collect, harmonize, and verify urban park data, which is essential for examining the impact of parks on health. It also stresses the importance of providing reliable urban park spatial data for city officials., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Slovic et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: Simultaneous pancreas-kidney transplantation (SPKT) remains the best treatment option in patients with type 1 diabetes and chronic kidney failure. There are only a few studies addressing the potential ischemic deterioration of peripheral arterial disease (PAD) due to blood diverting from the iliac artery to the kidney graft. We aimed to evaluate diabetic foot lesions and PAD evolution in SPKT recipients and investigate if they are more frequent in ipsilateral lower limb of kidney graft., Methods: We developed a retrospective cohort, including patients submitted to SPKT in our tertiary center, between 2000 and 2017. Diabetic foot lesions and PAD frequencies were compared in the period before and after transplantation., Results: Two hundred and eleven patients were included, 50.2% (n = 106) female, with a median age at transplantation of 35 years (IQR 9). After a median follow-up period of 10 years (IQR 7), patient, kidney, and pancreatic graft survival were 90.5% (n = 191), 83.4% (n = 176), and 74.9% (n = 158), respectively. Before transplant, 2.8% (n = 6) had PAD and 5.3% (n = 11) had history of foot lesions. In post-transplant period, 17.1% (n = 36) patients presented PAD and 25.6% (n = 54) developed diabetic foot ulcers, 47.6% (n = 35) of which in the ipsilateral and 53.3% (n = 40) in the contralateral lower limb of the kidney graft (p = 0.48). Nine patients (4.3%) underwent major lower limb amputation, 3 (30%) ipsilateral and 7 (70%) contralateral to the kidney graft (p = 0.29)., Conclusions: Diabetic foot lesions were not more frequent in the ipsilateral lower limb of the kidney graft, therefore downgrading the 'steal syndrome' role in these patients., (© 2023. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).)

Plasmepsins (Plms) are aspartic proteases involved in the degradation of human hemoglobin by P. falciparum and are essential for the survival and growth of the parasite. Therefore, Plm enzymes are reported as an important antimalarial drug target. Herein, we have applied molecular docking, molecular dynamics (MD) simulations, and binding free energy with the Linear Interaction Energy (LIE) approach to investigate the binding of peptidomimetic PlmIV inhibitors with a particular focus on understanding their selectivity against the human Asp protease cathepsin D (CatD). The residual decomposition analysis results suggest that amino acid differences in the subsite S3 of PlmIV and CatD are responsible for the higher selectivity of the 5a inhibitor. These findings yield excellent agreement with experimental binding data and provide new details regarding van der Waals and electrostatic interactions of subsite residues as well as structural properties of the PlmIV and CatD systems., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results., (This journal is © The Royal Society of Chemistry.)

Molecular docking, molecular dynamics (MD) simulations and the linear interaction energy (LIE) method were used here to predict binding modes and free energy for a set of 1,2,3-triazole-based KA analogs as potent inhibitors of Tyrosinase (TYR), a key metalloenzyme of the melanogenesis process. Initially, molecular docking calculations satisfactorily predicted the binding mode of evaluated KA analogs, where the KA part overlays the crystal conformation of the KA inhibitor into the catalytic site of TYR. The MD simulations were followed by the LIE method, which reproduced the experimental binding free energies for KA analogs with an r 2 equal to 0.97, suggesting the robustness of our theoretical model. Moreover, the van der Waals contributions performed by some residues such as Phe197, Pro201, Arg209, Met215 and Val218 are responsible for the binding recognition of 1,2,3-triazole-based KA analogs in TYR catalytic site. Finally, our calculations provide suitable validation of the combination of molecular docking, MD, and LIE approaches as a powerful tool in the structure-based drug design of new and potent TYR inhibitors.

Adherence to secondary prevention measures after acute coronary syndrome (ACS) is essential to prevent disease recurrence. In Brazil, the Brazilian Unified Health System (SUS, in Portuguese), and the private healthcare system (PHCS) coexist. We aimed to evaluate the adherence to secondary prevention in patients with ACS who were assisted by either SUS or PHCS. In this longitudinal prospective study, patients with ACS were admitted to the four cardiological reference hospitals of Sergipe, three of which assisted PHCS users, and one, SUS users. We analyzed the two patient care models with multiple logistic regression models for adherence to physical activity, pharmacotherapy, and smoking cessation. We enrolled 581 volunteers in this study: 44.1 % from SUS and 55.9 % from PHCS. PHCS users showed greater adherence to pharmacotherapy at both 30 and 180 (p = 0.001) days after ACS with better results in all classes of medications (p < 0.05) than SUS users did. They also showed better adherence to physical activity (p = 0.047). There was no distinction between the groups regarding smoking cessation. The secondary prevention measures after ACS were more effective in PHCS users than in SUS users due to better adherence, especially to pharmacotherapy and regular physical activity., Competing 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., (© 2022 Published by Elsevier Inc.)

(1) Background: Quality of life (QOL) is used as a health indicator to assess the effectiveness and impact of therapies in certain groups of patients. This study aimed to analyze the QOL of patients with acute coronary syndrome (ACS) who received medical treatment by a public or private health care system. (2) Methods: This observational, prospective, longitudinal study was carried out in four referral hospitals providing cardiology services in Sergipe, Brazil. QoL was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey. The volunteers were divided into two groups (public or private health care group) according to the type of health care provided. Multiple linear regression models were used to evaluate QoL at 180 days after ACS. (3) Results: A total of 581 patients were eligible, including 44.1% and 55.9% for public and private health care, respectively. At 180 days after ACS, the public health care group had lower QoL scores for all domains (functional capacity, physical aspects, pain, general health status, vitality, social condition, emotional profile, and health) (p < 0.05) than the private group. The highest QoL level was associated with male sex (p < 0.05) and adherence to physical activity (p ≤ 0.003) for all assessed domains. (4) Conclusions: This shows that social factors and health status disparities influence QoL after ACS in Sergipe.

Li-ion batteries are daily present in our electronic devices. These batteries are used in electric and hybrid vehicles supporting the current agreements to decrease greenhouse gas emissions. As a result, the electric vehicle demand has increased in the world. As Li-ion batteries are composed of critical metals in which there is a risk of interruption of supply in the medium term, recycling is the key to a sustainable future without internal combustion vehicles. Understanding the current scenario and future perspectives is important for strategies of new battery design, recycling routes and reverse logistics, as well as policies for sustainable development. This paper presents an overview of current and future vehicles used worldwide. An increase from 1.3 to 2 billion vehicles is expected worldwide until 2030; an outstanding demand will occur mainly in BRICS countries. The data demonstrated a correlation between the number of vehicles in use and GDP. Patents and processes designed for recycling Li-ion batteries and the new developments on pyro-, hydro-, and bio-metallurgical routes have been revised. The manuscript describes the importance and benefits of recycling as regards the supply of critical metals and future trends towards a circular economy., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The reuse of açaí seeds is an organic approach for valorizing biomass, encouraging the public policies of circular economy, which reduces the human impact on the production chain processes. This research proposes an alternative for açaí seed as a filler in castor oil-based polyurethane, obtaining eco-sorbent to evaluate the sorption capacity for another impactful food industry by-product: waste cooking oil (WCO). Eco-sorbents were obtained with castor oil based-polyol and isocyanate (MDI) by mass mixing equal to 1:1 (OH:NCO), reinforced with açaí seed residue (5-20 wt%). The samples were characterized by techniques scanning electron microscopy (SEM), optical microscopy (OM), apparent density, contact angle, infrared spectroscopy (FTIR), and thermogravimetric analysis (TGA). Sorption capacity and efficiency were evaluated as a function of the fiber content, with tests performed in times of 30-180 s in two systems: oil and oil/water. The results showed that the eco-sorbents had a hydrophobic nature (θ > 98.3°) and macroporous morphology (pore size from 152 to 119 μm), which allowed the adsorption of residual cooking oil by the porous structure. The kinetics study showed that the sample with greater fiber content (15% wt.) reached the equilibrium in a short time compared to the neat PU for the oil system, with a sorption capacity of 9.50 g g -1 in the first 30 s. For the oil/water system, an opposite behavior could be observed, with a sorption capacity of 9.98 g g -1 in the 150 s equilibrium time. The Langmuir isotherm model presented a maximum adsorption capacity of 10.42 g g -1 . However, the Freundlich isotherm model had a better fit to the experimental data with R 2 (0.97) and lower chi-square (0.159), showing favorable adsorption (n = 1.496). Thus, it was proved that the weak interactions (connection H) and the binding energy of the predominant physisorption for the oil/water system. Thus, developed eco-sorbents are an excellent option for the sorption of WCO., (Copyright © 2021. Published by Elsevier Ltd.)

Diltiazem (DIL) is a calcium channel blocker antihypertensive drug commonly used in the treatment of cardiovascular disorders. Due to the high solubility and prompt dissolution of the commercial form hydrochloride (DIL-HCl) that is closely related to short elimination drug half-life, this API is known for exhibiting an unfitted pharmacokinetic profile. In an attempt to understand how engineered multicomponent ionic crystals of DIL with dicarboxylic acids can minimize these undesirable biopharmaceutical attributes, herein, we have focused on the development of less soluble and slower dissolving salt/cocrystal forms. By the traditional solvent evaporation method, two hydrated salts of DIL with succinic and oxalic acids (DIL-SUC-H 2 O and DIL-OXA-H 2 O), and one salt-cocrystal with fumaric acid (DIL-FUM-H 2 FUM) were successfully prepared. An in-depth crystallographic description of these new solid forms was conducted through single and powder X-ray diffraction (SCXRD, PXRD), Hirshfeld surface (HS) analysis, energy framework (EF) calculations, Fourier Transform Infrared (FT-IR) spectroscopy, and thermal analysis (TG, DSC, and HSM). Structurally, the inclusion of dicarboxylic acids in the crystal structures provided the formation of 2D-sheet assemblies, where ionic pairs (DIL + /anion - ) are associated with each other via H-bonding. Consequently, a substantial lowering in both solubility (16.5-fold) and intrinsic dissolution rate (13.7-fold) of the API has been achieved compared to that of the hydrochloride salt. These findings demonstrate the enormous potential of these solid forms in preparing of novel modified-release pharmaceutical formulations of DIL., (Copyright © 2021 Elsevier B.V. All rights reserved.)

In this work, we prepared PU-composites with Australian palm residues (PR) in different contents (5, 10, 15, and 20 wt%) and granulometry (28 and 35 mesh) to improve the oil (crude oil and S500 Diesel) sorption capacity. The foams were characterized by life cycle assessment (LCA), scanning electron microscopy, oil sorption, desorption, and Langmuir, Freundlich, and Temkin sorption isotherms. LCA indicated that higher PR contents decreased the foam environmental impacts than the classical residue handling, indicating that 20 wt% PR is the better environmental option, independent of the residues granulometry. The PR incorporation into PU foams resulted in smaller pore sizes, with a higher number of homogeneous open-cells. The PU composites exhibited higher oil adsorption capacity than the pristine foam. The PU sample showed maximum absorption capability of 6.1 and 6.7 g g -1 for diesel S500 and crude oil, and the composites showed increased values of ∼18 g g -1 and ∼24 g g -1 . The Langmuir model presented the best fit and predicted a maximum adsorption capacity of 30.39 and 25.57 g g -1 for PU-20% PR 28 and 35 mesh, respectively. The composites presented excellent reusability with PU-20% PR (28 mesh) and PU-20% PR (35 mesh), showing removal efficiency after 16 and 9 cycles, respectively. The results classify the developed foams as excellent materials to sorb spilled crude oil in marine accidents., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

α-galactosylceramide (α-GalCer; KRN7000) strongly stimulates NKT cells. The structures of α-GalCer assemblies and of cationic DODAB bilayers containing α-GalCer were investigated by differential scanning calorimetry (DSC) and electron spin resonance (ESR) spectroscopy. Assemblies of α-GalCer have a very tightly packed gel phase, causing spin labels to cluster and display spin exchange interactions. An endothermic phase transition is observed by DSC, leading to a fluid phase. This phase transition peak disappears upon mixing with DODAB, showing that up to 9 mol% α-GalCer is miscible with the cationic lipid. ESR spectra show that α-GalCer decreases DODAB gel phase packing, resulting in a decrease of gel-fluid transition temperature and cooperativity in DSC thermograms of mixed bilayers. In contrast, α-GalCer increases the rigidity of the fluid phase. These effects are probably due to the conformation of the rigid amide bond that connects the phytosphingosine base of α-GalCer to its long and saturated acyl chain. Possibly, α-GalCer adopts a V-shaped conformation because of the perpendicular orientation of the amide bond towards the axes of the hydrocarbon chains. Apparently, the effect of the amide bond configuration is a key structural feature for the interaction between ceramide-based glycolipids and DODAB molecules, since we have previously reported a similar decrease of gel phase packing and increase in fluid phase rigidity for DODAB bilayers containing C24:1β-glucosylceramide. Since the structure of delivery systems is critical to the biological activity of α-GalCer, this work certainly contributes to the planning and development of novel immunotherapeutic tools., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Tyrosinase (TYR) is a metalloenzyme classified as a type-3 copper protein, which is involved in the synthesis of melanin through a catalytic process beginning with the conversion of the amino acid l-Tyrosine (l-Tyr) to l-3,4-dihydroxyphenylalanine (l-DOPA). It plays an important role in the mechanism of melanogenesis in various organisms including mammals, plants, and fungi. Herein, we used a combination of computational molecular modeling techniques including molecular dynamic (MD) simulations and the linear interaction energy (LIE) model to evaluate the binding free energy of a set of analogs of kojic acid (KA) in complex with TYR. For the MD simulations, we used a dummy model including the description of the Jahn-Teller effect for Cu 2+ ions in the active site of this enzyme. Our results show that the LIE model predicts the TYR binding affinities of the inhibitor in close agreement to experimental results. Overall, we demonstrate that the classical model provides a suitable description of the main interactions between analogs of KA and Cu 2+ ions in the active site of TYR.

Exogenous fibrolytic enzymes (EFE) improve the energy availability of grains for nonruminant animals by reducing encapsulation of the endosperm nutrients within grain cell walls; however, these benefits are unknown in the treatment of corn-based silage for cattle. The objective of the present study was to evaluate the effects of adding EFE at ensiling on the nutritive value of high-moisture corn (HMC) and snaplage (SNAP) for finishing Nellore bulls. The EFE dose was 100 g/Mg fresh matter in both HMC and SNAP. Diets were 1) a SNAP + HMC control (without enzyme addition); 2) SNAP + HMC EFE (with enzymes); 3) a whole-plant corn silage (WPCS) + HMC control (without enzyme addition); and 4) WPCS + HMC EFE (with enzymes). In addition to the silages, the diets were also composed of soybean hulls, soybean meal, and mineral-vitamin supplement. The statistical design was a randomized complete block with a factorial arrangement of treatments, and the experiment lasted 122 d. For in situ and in vitro analyses, 2 cannulated dry cows were used. There was no interaction between the diets and EFE application (ADG, P = 0.92; DMI, P = 0.77; G:F, P = 0.70), and there was no difference between the SNAP and WPCS diets regarding the DMI (P = 0.53), ADG (P = 0.35), and feed efficiency (ADG:DMI, P = 0.83). Adding EFE to the HMC and SNAP at ensiling did not affect ADG but decreased DMI (P = 0.01), resulting in greater feed efficiency by 5.91% (P = 0.04) than that observed in animals fed diets without the addition of EFE. Addition of EFE to HMC resulted in reduced NDF content and increased in vitro and in situ DM digestibility compared with untreated HMC. No effects were found for the addition of EFE to SNAP. Fecal starch decreased with EFE application (P = 0.05). Therefore, the diet energy content (TDN, NEm, and NEg) calculated from animal performance increased (P = 0.01) with the addition of EFE to HMC. In conclusion, exchanging the NDF from WPCS with that from SNAP did not affect the performance of finishing cattle, whereas the addition of EFE to HMC at ensiling improved animal performance by increasing the energy availability of the grain., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Superior patient and graft survival rates have been attributed to living donor kidney transplant (LDKT) when compared to deceased donor transplantation. The aim of this study was to assess graft survival in a population of LDKT in the last 14 years and the potential impact of some clinical features., Methods: A retrospective observational study was conducted, reviewing the records of all patients undergoing LDKT in one center from January 1, 2004, to December 31, 2017. Survival data were evaluated by Kaplan-Meier, log rank test, and Cox regression., Results: Two hundred seventy-seven LDKT were performed. The median follow-up time was 4 (0-13) years. Graft loss was observed in 9% of patients; 4 patients died. The overall survival was 97% at year 1, 94% at year 5, and 83% at years 10 and 13. We found a significantly worse graft survival in patients with early vascular complications that required surgical intervention (P = .00) ≥3 HLA MM (P = .01), ≥1 HLA-DR MM (P = .04) and female recipients (P = .01). The negative impact of ≥1 HLA-B MM on survival was borderline (P = .05). After excluding early graft losses secondary to vascular events, ≥1 HLA-A MM and rejection have also implicated a negative impact on survival (P = .04 and .01, respectively). In the multivariate analysis, these variables were still related to inferior survival., Conclusions: We observed a good overall graft survival (>80% after 13 years). Possible factors related to poor outcomes suggested by this study were early vascular complications; HLA mismatches; rejection; and, with less certainty, female recipients., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The effect of 5 mol%, 9 mol%, and 16 mol% of C24:1 β-glucosylceramide (βGlcCer) on the structure of cationic DODAB bilayers was investigated by means of differential scanning calorimetry (DSC), electron spin resonance (ESR) spectroscopy and fluorescence microscopy. βGlcCer is completely miscible with DODAB at all fractions tested, since no domains were observed in fluorescence microscopy or ESR spectra. The latter showed that βGlcCer destabilized the gel phase of DODAB bilayers by decreasing the gel phase packing. As a consequence, βGlcCer induced a decrease in the phase transition temperature and cooperativity of DODAB bilayers, as seen in DSC thermograms. ESR spectra also showed that βGlcCer induced an increase in DODAB fluid phase order and/or rigidity. Despite their different structures, a similar effect of loosening the gel phase packing and turning the fluid phase more rigid/organized has also been observed when low molar fractions of cholesterol were incorporated in DODAB bilayers. The structural characterization of mixed membranes made of cationic lipids and glucosylceramides may be important for developing novel immunotherapeutic tools such as vaccine adjuvants., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The objective of this study was to evaluate the effects of strategic supplementation in the dry period and dry/rainy transition period on the performance and nutritional, metabolic, and reproductive responses of Nellore heifers grazing Urochloa decumbens. Forty-eight Nellore heifers with age and body weight (BW) of eight months and 235 ± 3.3 kg, respectively, were used. The experimental design was a completely randomized design, with four treatments, all with 12 replications. The evaluated strategies were as follows: low supplementation (LOHI; 0.2% of BW/heifer/day) in the first 90 days and high supplementation (0.6% of BW/heifer/day) in the 90 days thereafter; average supplementation (AVER) with 0.4% of BW/heifer/day for 180 days; high supplementation (HILO; 0.6% of BW/heifer/day) in the first 90 days and low supplementation (0.2% of BW/heifer/day) in the 90 days thereafter; only mineral mix (MM) ad libitum during the 180 days. Data were evaluated using orthogonal contrasts. Supplementation improved the performance of the animals during of dry period (P < 0.05) and dry/rainy transition period (P < 0.05). Supplemented animals had higher longissimus muscle area (LMA) and subcutaneous fat thickness (SFT) at the end of the experiment (P < 0.05). Multiple supplementation increased intake of dry matter (DM), organic matter (OM), and crude protein (CP) in kg/day throughout the experiment. The supplementation increased the digestibility of DM, OM, CP, apNDF, and TDN (P < 0.05). Serum urea nitrogen (SUN), glucose (GLUC), insulin (INS), and progesterone (PROG) were higher in supplemented heifers (P < 0.05). Supplementation reduced the concentrations of non-esterified fatty acids (NEFA) (P < 0.05) and increased conception rate (P < 0.05). In summary, the supplementation strategies adopted in this study improve the performance, metabolic status, and carcass traits of heifers under grazing, allowing an improvement in the conception rate of 15-month-old Nellore heifers.

The objective of this study was to evaluate the effects of supplementation strategy on performance, nutritional and metabolic characteristics of Nellore suckling female calves, on grazing Urochloa decumbens during the rainy-dry transition period. Forty-four Nellore female calves, averaging 147.6 ± 1.34 kg (4 months), were used. A single supplement 20% of crude protein of dry matter was provided, consisting of daily supplement at 0.0, 0.2, 0.4, or 0.6% of body weight. A positive linear effect (P < 0.05) on final body weight and average weight gain of female calves was observed with increased supplementation. Supplementation increased consumption, in kilograms per day, of dry matter (DM), organic matter (OM), crude protein (CP), digested dry matter, and total digestible nutrients (TDN), all calculated as % of dry matter. There was no effect of supplementation on the consumption in kilograms per day of neutral detergent fiber corrected for ash and protein (apNDF) (P > 0.05). Supplementation increased, in a quadratic way, the total apparent digestibility coefficient of DM, OM, CP, apNDF, and TDN (P < 0.05). There was no effect of supplementation (P > 0.05) on non-esterified fatty acid concentrations. There was a positive linear effect (P < 0.05) of supplementation on insulin concentrations. In this study, it is concluded that linearly increasing the feeding level of a supplement with 20% crude protein (% of DM) in the range of 0.2-0.6% of body weight improves the performance, nutritional and metabolic characteristics of the animals, considering these pasture characteristics.

Beef cows' milk yield is typically determined by measuring milk yield once daily and then doubling this value to estimate daily production. However, it is not known whether this is accurate. Thus, we aimed to determine the association between morning and afternoon milk yield in grazing Nellore cows. Eighty Nellore cows were used, with initial weight of 516.0 ± 1.0 kg. The experiment was a completely randomized factorial scheme, with 20 replications and four treatments (i.e., + or - pre-partum supplementation in combination with + or - post-partum supplementation): PRMM-1 kg of supplement/cow/day for 90 days pre-partum; MMPS-1 kg of supplement/cow/day for 90 days post-partum; PRPS-1 kg of supplement/cow/day for 90 days pre-partum and 90 days post-partum; and MM-only mineral mix ad libitum during pre- and post-partum. Milk was sampled on days 45, 135, and 225 post-partum (early, middle, and late lactation, respectively). No effects were observed of pre- and post-partum supplementation on milk yield (P > 0.05). The afternoon/morning proportion of 0.45 in the early third of lactation was higher than other stages, which had a proportion of 0.41 (P < 0.05). Post-partum supplementation increased milk protein in the morning and afternoon milking (P < 0.05). There was also no effect of pre- and post-partum supplementation on afternoon-morning proportion other milk components (P > 0.05). We conclude that estimating daily milk production of grazing beef cattle by multiplying a once daily milking amount times two is not accurate. Under the conditions of this study, proportion of total daily production represented by the ratio of afternoon/morning milking was 0.45 in early lactation (first third) and 0.41 in mid- and late lactation.

The research aimed to evaluate the effect of replacing soybean meal with soybean grain on the nutritional parameters and productivity of heifers grazing on Urochloa decumbens in the rainy-dry transition period. Forty crossbred heifers with the initial age and weight of 18 months and 292 ± 6.1 kg, respectively, were used. The experimental design was a completely randomized design, with five treatments and eight replications. The evaluated treatments were as follows: SM 0.5 -supply of 0.5 kg/animal/day of soybean meal supplement; SG 0.5 -supply of 0.5 kg/animal/day of soybean grain supplement; SM 1.0 -supply of 1.0 kg/animal/day of soybean meal supplement; SG 1.0 -supply of 1.0 kg/animal/day of soybean grain supplement; MM-only mineral mix ad libitum. The supplement was isoprotein with 350 g of crude protein/kg of dry matter. Supplementation improved the performance of the heifers and this fact can be verified by the higher average daily gain (ADG) and final BW (fBW) of the supplemented animals (P < 0.10). The two supplemented treatments with 1 kg/day demonstrated similar performance (P > 0.10), the same happens for the two treatments receiving 0.5 kg/day (P > 0.10). However, animals receiving 1 kg/day of supplementation had an ADG and final BW higher than animals receiving 0.5 kg/day (P < 0.10). Supplementation (P < 0.10) affected the intake of dry matter (DM), organic matter, crude protein, ether extract, non-fiber carbohydrates, total digestible nutrients, and neutral detergent fiber corrected for ash and protein (apNDF). Supplementation improved DM digestibility and all constituents of the diet (P < 0.10), except for apNDF (P > 0.10). In summary, it is concluded that multiple supplementations improve the performance of grazing heifers in the rainy-dry transition period and the total replacement of soybean meal by soybean grain does not alter the performance of the animals.

Objectives: No consensus exists on the assessment of airway in CBCT scans. Two-dimensional measures remain the standard in the cephalometric analysis. This research aimed to evaluate linear and area measurements in two-dimensional views from specific airway regions of interest and compare these to the correspondent volume in CBCT exams., Materials and Methods: 250-selected CBCT scans were retrospectively analyzed. A trained and calibrated examiner performed the linear, area and volume measurements in specific sites for nasal cavity, nasopharynx and oropharynx compartments. Dolphin Software was used for the analysis. The correlations were performed using Pearson coefficient., Results: The highest positive correlations were observed in the nasopharynx and oropharynx sagittal areas and the most constricted area in the oropharynx. Nasopharynx linear measures and nasopharynx coronal area did not present correlation with whole volume. Two-dimensional measurements in the soft palate (width and sagittal area) showed very low positive correlations. Although nasal cavity presented highest volume means, changes in oropharynx contributed more to variations in total volume, compared with the other two sections., Conclusion: Airway sagittal areas, as well as the most constricted axial area in oropharynx remains a useful guide to correlate with airway volume in two-dimensional images.

The appropriate supply of nutrients in pregnant cows has been associated with the optimal development of foetal tissues, performance of their progeny and their meat quality. The aim of this study was to evaluate supplementation effects of grazing cows in different stages of gestation on skeletal muscle development and performance of the progeny. Thereby, 27 Nellore cows were divided into three groups (n=9 for each group) and their progeny as follows: UNS, unsupplemented during gestation; MID, supplemented from 30 to 180 days of gestation; LATE, supplemented from 181 to 281 days of gestation. The percentage composition of the supplement provided for the matrices was the following: ground corn (26.25%), wheat bran (26.25%) and soya bean meal (47.5%). The supplement was formulated to contain 30% CP. Supplemented matrices received 150 kg of supplement (1 and 1.5 kg/day for cows in the MID and LATE groups, respectively). After birth, a biopsy was performed to obtain samples of skeletal muscle tissue from calves to determine number and size of muscle fibres and for messenger RNA (mRNA) expression analysis. The percentage composition of the supplement provided for the progeny was the following: ground corn grain (30%), wheat bran (30%), soya bean meal (35%) and molasses (5%). The supplement was formulated to contain 25% CP and offered in an amount of 6 g/kg BW. Performance of the progeny was monitored throughout the suckling period. Means were submitted to ANOVA and regression, and UNS, MID and LATE periods of supplementation were compared. Differences were considered at P0.10). Similarly, no differences were observed between calves for nutrient intake (P>0.10). However, greater subcutaneous fat thickness (P=0.006) was observed in the calves of LATE group. The ribeye area (P=0.077) was greater in calves born from supplemented compared with UNS cows. The supplementation of pregnant cows did not affect the muscle fibre size of their progeny (P=0.208). On the other hand, calves born from dams supplemented at mid-gestation had greater muscle fibre number (P=0.093) compared with calves from UNS group. Greater mRNA expression of peroxysome proliferator-activated receptor α (P=0.073) and fibroblast growth factor 2 (P=0.003) was observed in the calves born from MID cows. Although strategic supplementation did not affect the BW of offspring, it did cause changes in carcass traits, number of myofibres, and mRNA expression of a muscle hypertrophy and lipid oxidation markers in skeletal muscle of the offspring.

The objective of the present study was to evaluate the effect of different schemes of calves' supplementation in a creep feeding system, on the behavior of Bos indicus calves and dams, and also the influence of the calves' supplementation on dams' performance. Forty-eight Nellore male calves (147 ± 7 kg body weight and 3 months of age) in the suckling phase and their dams (476 ± 9 kg and 6 years of age) were studied in a completely randomized design. The experiment was divided into two periods of 71 days. The treatments were 5- and 10-g supplement dry matter (DM)/kg BW day offered in periods 1 and 2, respectively (5S/10S); 10- and 5-g supplement DM/kg BW day offered in periods 1 and 2, respectively (10S/5S); 7.5-g supplement DM/kg BW day in both periods 1 and 2 (7.5S); and mineral mix ad libitum in both periods 1 and 2 (MM). No differences (P < 0.05) in body condition score (BCS), final body weight (FBW), and average daily gain (ADG) were found in dams' performance. Calves from MM treatment spent more time (P < 0.05) grazing than the supplemented calves from 5S/10S and 10S/5S treatments, in the first period. No difference in suckling time was found between the treatments (P > 0.05) in the first evaluated period. Calves from 10S/5S treatment spent more time suckling and less time eating supplements (P < 0.05) than 5S/10S treatment animals, in the second evaluated period. Dams of MM treatment's calves had more idle time and lower grazing time when compared with the mothers of calves from 5S/10S and 10S/5S treatments. It was concluded that different schedules of Nellore calves' supplementation on pasture do not affect their mothers' performance, and supplementation decreases the grazing time of calves in the suckling phase.

The role of de novo donor-specific anti-human leukocyte antigen (anti-HLA) antibodies (dnDSA) within the pathways leading to graft failure remains not fully understood. We investigated 56 patients who were transplanted between 2002 and 2014 with kidney graft failure (cases), for a possible association of development of dnDSA with graft failure. The 56 patients with failed transplants were matched with 56 patients with a functioning graft at present for the variables deceased or living donor, transplant number, transplant year, recipient age and gender, donor age and gender, dialysis vintage time, transplant induction therapy. All patients had at least one serum collected 1 year before failure (in cases) or end of follow-up (in controls). Cases and controls were very well-matched in several baseline characteristics. Post-transplant anti-HLA antibodies were found in 84% of cases and only 36% of controls (P < .001), with 54% of cases and 16% of controls (P < .001) having dnDSA at time of detection. Chronic active antibody-mediated rejection was significantly more common (P < .001) in patients with dnDSA (61% vs 12%), in 53 (47%) patients that had at least one graft biopsy performed during follow-up. dnDSA was a significant risk factor (odds ratio [OR] = 6.06; P = .003) for graft failure in a multivariable conditional logistic regression model. dnDSA as a time-dependent variable, was also an independent predictor [hazard ratio (HR) = 2.46; P = .002] of graft failure in a multivariable Cox regression analysis. In both statistical approaches, only dnDSA-II (OR = 11.90; P = .006) (HR = 2.30; P = .014) was significantly associated with graft failure. Post-transplant dnDSA was clearly associated with graft loss, particularly if against HLA class II antigens. dnDSA detection should be a tool for post-transplant monitoring of kidney graft recipients, allowing for the identification of those with a higher risk of graft failure., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

A grazing trial was carried out to evaluate the inclusion of three feed additives in supplements (crude protein, CP 230 g/kg dry matter, DM) on the performance, voluntary intake, and digestibility of beef heifers grazing Brachiaria decumbens (CP 81 and neutral detergent fiber, NDF 615 g/kg DM). Thirty-five Nellore heifers (21 months of age and 383 ± 6.29 kg of body weight, BW) were used in a completely randomized design. The treatments were as follows: no supplement (control); supplement fed at 1 kg/animal/day without additives (S); supplement with monensin (S + M); supplement with yeast culture (S + YC); and supplement with enzyme complex (S + EC). All of the supplemented heifers had greater (P < 0.1) average daily gain (∼0.186 kg/day) compared to the control treatment (0.014 kg/day). Average daily gain and final BW were similar (P > 0.1) among supplemented heifers. Monensin inclusion in the supplement decreased (P < 0.1) forage DM (expressed as g/kg BW) and NDF intake (expressed as kg/day and as g/kg BW). All of the feed additive inclusions decreased (P < 0.1) NDF digestibility. In conclusion, the heifers' performance was improved by concentrate supplementation. However, the inclusion of additives did not enhance this effect.

For the actinides, two segmented all-electron basis sets of valence double zeta quality plus polarization functions (DZP) are developed. One of them must be used along with the non-relativistic Hamiltonian, whereas the other with the Douglas-Kroll-Hess (DKH) one. Adding diffuse functions of s, p, d, f, and g symmetries to the non-relativistic and relativistic sets, augmented basis sets are developed. These functions are essential to describe correctly electrons far away from the nuclei. For some compounds, geometric parameters, atomic charges and valence orbital populations of the actinides, and bond dissociation energies are calculated using the Becke 3-parameter (exchange) and the Lee, Yang, and Parr (correlation) functional in conjunction with the DZP-DKH basis set. For Am and No, the static electric mean dipole polarizabilities are also reported. Comparison with benchmark theoretical and experimental values found in the literature is carried out. It is verified that the performances of the relativistic compact size basis sets generated in this work are regular, efficient, and reliable. They will be extremely helpful in molecular property calculations that need explicitly to consider the core electrons.

Malpighia emarginata is cultivated in almost all Brazil and is considered an important agricultural crop. The root-knot nematode Meloidogyne enterolobii has been described as a major threat to this crop, causing great production losses. Due to the scarcity of information about the severity of this parasite in M. emarginata plants in Brazil, this study investigated M. enterolobii resistance of ten M. emarginata genotypes from the active germplasm bank of Universidade Federal Rural de Pernambuco. The experiment was conducted adopting a completely randomized design in a factorial arrangement of 11 x 2 x 5, where M. emarginata cuttings were inoculated with 10,000 eggs in a greenhouse. After 150 days, plants were evaluated for the following parameters: gall index, egg mass index, number of eggs per root system, number of eggs per gram of root, and reproduction factor. The accessions showed different responses depending on host x pathogen interaction, from susceptibility to moderate tolerance. Accessions 027-CMF and 031-CMF were considered tolerant to the nematode and could be of great value in new breeding programs for resistance to M. enterolobii infection.

The impact of patient's biological differences in waiting time for kidney transplantation is well known and has been a subject of extensive debate and struggle in transplantation community. Our purpose was to evaluate patient's access to kidney transplantation in Portugal, regarding their degree of allosensitization and blood type. A retrospective cohort study including 1020 candidates for kidney transplantation between 01 January 2010 and 31 December 2011 in transplant unit Centro Hospitalar do Porto was performed. The deceased donor organ offer by blood type decreased with the calculated panel reactive antibody (cPRA) increase for A and B blood groups candidates, while in 0 blood group candidates, a significant reduction in organ offer was only observable in hypersensitized (HS) ones. As a consequence, the median waiting time was also significantly higher in 0 blood group patients, when compared to the remaining groups. However, waiting time increased extensively with cPRA regardless blood type, especially HS patients with increases of 368%, 632%, 486%, and 140% for blood groups A, B, AB, and 0, respectively, when compared to each blood group global median waiting time. Our study shows that important measures need to be undertaken in order to mitigate the huge disadvantage that HS and 0 blood type patients naturally have., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Immunosuppression has a pivotal role in kidney transplantation. The new prolonged-release formulation of tacrolimus was developed to provide a more convenient once-daily dosing to improve patient adherence., Methods: We selected 60 stable kidney transplant recipients who underwent tacrolimus conversion in our unit. Conversion was made on a 1 mg:1 mg basis in 66.7% of patients (n = 40) and on a 1 mg:1.1 mg basis in the remaining 33.3% (n = 20). Clinical and analytical data at conversion and postconversion was analyzed retrospectively to evaluate the efficacy and safety of conversion from tacrolimus twice-daily to once-daily formulation., Results: A significant reduction in tacrolimus blood levels requiring an increase in tacrolimus daily dose was observed postconversion. Postconversion tacrolimus blood level reduction >25% was significantly higher in the conversion group 1 mg:1 mg basis (P = .004). In patients converted 1 mg:1 mg, female sex and higher tacrolimus level at conversion were significant risk factors for a reduction >25% in tacrolimus blood levels after conversion. No significant change was detected between mean glomerular filtration rate at conversion (57 mL/min) and at 3, 6, and 9 months postconversion., Conclusions: Once-daily tacrolimus at similar doses to the twice-daily formulation is an efficient and safe treatment option. Conversion made on 1 mg:1.1 mg basis seems advantageous at least in some patients., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Phytoparasitic nematodes can infect a wide range of crop plants, and cause billions of dollars of agricultural losses each year. These parasites represent the largest source of biotic stress experienced by plants. The order Tylenchida comprises the most important parasitic nematodes, particularly the root-knot and cyst nematodes. These parasitic organisms obtain nutrients to support their development through complex interactions with their hosts. Plant-parasitic nematodes secrete a mixture of cell-wall degrading enzymes to facilitate migration through the plant root. Enzymes are secreted that degrade the principal cell-wall components, cellulose, hemi-cellulose, or pectin. Pectate lyases are important parasitism factors in plant-parasitic nematodes. These enzymes degrade polygalacturonic acid, which is a fundamental constituent of pectin of host cell walls. Thus, pectate lyases permit the penetration and colonization of plant host cells by parasites. Here, we analyzed 22 pectate lyase protein sequences from tylenchid nematode species. Our results revealed great variation in the isoelectric points of pectate lyases, and groups of acidic and alkaline proteins that may have distinct enzymatic activities were identified. Phylogenetic analysis also revealed the presence of two main groups of pectate lyases with distinct chemical properties. Seven conserved motifs were identified, but only five were present in all sequences. Results of the molecular docking analysis revealed differences in the predicted interaction sites in the pectate lyases from the two groups. These results may provide a theoretical basis for future studies of host plant resistance to nematode infection., Competing Interests: The authors declare no conflict of interest.

The aim of this study was to evaluate the effects of beef calves' supplementation in creep feeding systems on milk yield, body weight (BW), and body condition score (BCS) of their dams on tropical pastures using a meta-analytical approach. The database was obtained from 11 experiments conducted between 2009 and 2014 in Brazil, totaling 485 observations (cows). The database consisted of 273 Nellore and 212 crossbred (7/8 Nellore × 1/8 Holstein) cows. All experiments were carried out in the suckling phase (from 3 to 8 months of age of calves) during the transition phase between rainy and dry seasons from February to June of different years. The data were analyzed by a meta-analytical approach using mixed models and taking into account random variation among experiments. Calves' supplementation (P ≥ 0.59) and the calves' sex (P ≥ 0.48) did not affect milk yield of cows. The average fat-corrected milk (FCM) yield was 6.71 and 6.83 kg/day for cows that had their calves supplemented and not supplemented, respectively. Differences were observed (P < 0.0001) for milk yield due to the genetic group where crossbred cows presented greater FCM yield (7.37 kg/day) compared with Nellore cows (6.17 kg/day). There was no effect of the calves' supplementation on BW change (P ≥ 0.11) and BCS change (P ≥ 0.23) of the cows. Therefore, it is concluded that supplementation of beef calves using creep feeding systems in tropical pastures does not affect milk yield, body weight, or body condition of their dams.

The Neotropical Heliconia genus contains highly diversified plants and up to 220 species have been reported from the north of Mexico to the South of Brazil. Heliconia are cultivated as ornamental garden plants and as cut flowers. All species can be propagated by seeds or vegetatively, through rhizomes. Depending on the species, an individual plant can spread and form large clonal populations. H. bihai L., H. chartacea Lane ex Barreiros, and H. wagneriana Petersen are among the most cultivated Heliconia species. However, they still have undesirable characteristics that could be improved for the international market. This study aimed to characterize 15 half-sib families originating from commercial cultivations, by morphological and molecular markers. The genetic diversity (ĤE), considering all individuals of the three species was 0.103. For H. bihai half-sib families, the value of ĤE was 0.242, showing high genetic diversity. The ĤE value for H. chartacea was 0.068, indicating low genetic diversity. All individuals of H. wagneriana showed the same band patterns, suggesting that the two parental plants were propagated vegetatively from the same plant and may have undergone some endogamic crossings. These results showed that molecular characterization can differentiate individuals closely related as half-siblings for H. bihai and H. chartacea, despite the low variation observed with morphological descriptors. The high genetic diversity observed in H. bihai half-sibling genotypes can provide valuable resources for breeding programs.

Introduction: The cochlear implant device has the capacity to measure the electrically evoked compound action potential of the auditory nerve. The neural response telemetry is used in order to measure the electrically evoked compound action potential of the auditory nerve., Objective: To analyze the electrically evoked compound action potential, through the neural response telemetry, in children with bilateral cochlear implants., Methods: This is an analytical, prospective, longitudinal, historical cohort study. Six children, aged 1-4 years, with bilateral cochlear implant were assessed at five different intervals during their first year of cochlear implant use., Results: There were significant differences in follow-up time (p=0.0082) and electrode position (p=0.0019) in the T-NRT measure. There was a significant difference in the interaction between time of follow-up and electrode position (p=0.0143) when measuring the N1-P1 wave amplitude between the three electrodes at each time of follow-up., Conclusion: The electrically evoked compound action potential measurement using neural response telemetry in children with bilateral cochlear implants during the first year of follow-up was effective in demonstrating the synchronized bilateral development of the peripheral auditory pathways in the studied population., (Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.)

The symptoms of chronic renal disease-related mineral and bone disease improve significantly in patients after successful simultaneous pancreas-kidney transplantation (SPKT); however, bone pathology is still present even after many post-transplant years. The aim of this study was to analyze the bone densitometry in different periods after SPKT. Three-point densitometry was performed with the dual-energy X-ray absorptiometry (DXA) technique. Serum levels of alkaline phosphatase (ALP), total serum calcium, phosphate and parathyroid hormone were analyzed as markers of mineral metabolism. The study population consisted of 48 patients (28 females, 20 males) with a mean age of 35 ± 6 years and mean 24 ± 6 years of prior diabetes. Mean period of maintenance dialysis was 36 ± 26 months. The median time from SPKT and DXA measurement was 0.53, 26.2 and 41.9 months, respectively. Based on the DXA technique, 35.4 % of patients were categorized as having osteoporosis at the lumbar spine and 39.6 % at the femoral neck. Patients with diagnosed osteoporosis had significantly higher levels of ALP (OR = 1.5; 95 % CI = 1.1-2.2; p < 0.05 at the lumbar spine; OR = 1.4; 95 % CI = 1.0-1.9; p < 0.05 at the femoral neck). In addition, subjects with lumbar osteoporosis were characterized by a significantly lower body mass index (BMI) (OR = 0.5; 95 % CI = 0.3-0.9; p < 0.05). In the long-term follow-up, BMD increased significantly at the lumbar spine (T-score -1.86 ± 1.07 to -1.08 ± 0.89) and femoral neck (T-score -2.12 ± 0.78 to -1.63 ± 0.65). A multivariate linear model identified a BMI increase as a significant factor associated with improvement in BMD. Results of our study led us to conclude that, according to three-point densitometry, BMD among patients with functioning kidney and pancreas grafts improved. Increased serum levels of ALP were significantly associated with a decrease in BMD, suggesting a higher risk of osteoporosis. BMI gain was predictive of BMD improvement.

De novo donor-specific antibodies (dDSA) relevance in simultaneous pancreas-kidney (SPK) transplantation has been scarcely investigated. We analyzed dDSA relationship with grafts outcomes in a long-term follow-up SPK-transplanted cohort. In 150 patients that received SPK transplant between 2000 and 2013, post-transplant anti-human leukocyte antigen (HLA) antibodies were screened and identified using Luminex-based assays in sera collected at 3, 6, and 12 months, then yearly. dDSA were detected in 22 (14.7%) patients at a median 3.1 years after transplant. Pretransplant anti-HLA sensitization (OR = 4.64), full HLA-DR mismatch (OR = 4.38), and previous acute cellular rejection (OR = 9.45) were significant risk factors for dDSA. dDSA were significantly associated with kidney (in association with acute rejection) and pancreas graft failure. In dDSA+ patients, those with at least one graft failure presented more frequently dDSA against class II or I + II (P = 0.011) and locusDQ (P = 0.043) and had a higher median dDSA number (P = 0.014) and strength (P = 0.030). Median time between dDSA emergence and pancreas and kidney graft failure was 5 and 12 months, respectively. Emergence of dDSA increased the risk of grafts failure in SPK-transplanted patients. Full HLA-DR mismatch was associated with dDSA emergence. dDSA characteristics might help identify patients at a higher risk of graft failure., (© 2015 Steunstichting ESOT.)

Diabetes mellitus leads to increased Advanced Glycation End Products (AGE) production, which has been associated with secondary diabetic complications. Type 1 diabetic patients undergoing pancreas-kidney transplantation (SPKT) can restore normoglycemia and renal function, eventually decreasing AGE accumulation. We aimed to prospectively study AGE evolution after SPKT. Circulating AGE were assessed in 20 patients, at time 0 (T0), 3 months (T3), 6 months (T6), and 12 months (T12) after successful SPKT. Global AGE and carboxymethyllysine (CML) were analyzed, as well as advanced oxidation protein products (AOPP). Skin biopsies were obtained at T0 and T12. Immunohistochemistry with anti-AGE antibody evaluated skin AGE deposition. AGE mean values were 16.8 ± 6.4 μg/mL at T0; 17.1 ± 3.8 μg/mL at T3; 17.5 ± 5.6 μg/mL at T6; and 16.0 ± 5.2 μg/mL at T12. CML mean values were 0.94 ± 0.36 ng/mL at T0; 1.11 ± 0.48 ng/mL at T3; 0.99 ± 0.42 ng/mL at T6; and 0.78 ± 0.38 ng/mL at T12. AOPP mean values were 130.1 ± 76.8 μMol/L at T0; 137.3 ± 110.6 μMol/L at T3; 116.4 ± 51.2 μMol/L at T6; and 106.4 ± 57.9 μMol/L at T12. CML variation was significant (P = 0.022); AOPP variation was nearly significant (P = 0.076). Skin biopsies evolved mostly from a cytoplasmic diffuse to a peripheral interkeratinocytic immunoreaction pattern; in 7 cases, a reduction in AGE immunoreaction intensity was evident at T12. In conclusion, glycoxidation markers decrease, plasmatic and on tissues, may start early after SPKT. Studies with prolonged follow-up may confirm these data.

Mangabeira (Hancornia speciosa Gomes) is a fruit tree of the Apocynaceae family, which is native to Brazil and is a very important food resource for human populations in its areas of occurrence. Mangabeira fruit is collected as an extractive activity, and no domesticated varieties or breeding programs exist. Due to a reduction in the area of ecosystems where it occurs, mangabeira is threatened by genetic erosion in Brazil. The objective of this study was to characterize and evaluate the genetic diversity of 38 mangabeira individuals collected from natural populations in Pernambuco State using inter-simple sequence repeat (ISSR) molecular markers. The ISSR methodology generated a total of 93 loci; 10 were monomorphic and 83 were polymorphic. The average number of loci per primer was 15.5, ranging from 9 (#UBC 866) to 21 (#UBC 834). The results showed a high level of genetic diversity (0.30), and found that only around 30% of genetic variability is distributed among populations (GST = 0.29, ФST = 0.30), with the remainder (ФCT = 70%) found within each population, as expected for forest outcrossing species. Estimates for historic gene flow (1.18) indicate that there is some isolation of these populations, and some degree of genetic differentiation.

A novel combination of structurally simple, high-rate horizontal anaerobic reactors installed in series was used to treat swine wastewater. The reactors maintained stable pH, alkalinity, and volatile acid levels. Removed chemical oxygen demand (COD) represented 68% of the total, and the average specific methane production was 0.30L CH4 (g removed CODtot)(-1). In addition, next-generation sequencing and quantitative real-time PCR analyses were used to explore the methane-producing Archaea and microbial diversity. At least 94% of the sludge diversity belong to the Bacteria and Archaea, indicating a good balance of microorganisms. Among the Bacteria the Proteobacteria, Bacteroidetes and Firmicutes were the most prevalent phyla. Interestingly, up to 12% of the sludge diversity belongs to methane-producing orders, such as Methanosarcinales, Methanobacteriales and Methanomicrobiales. In summary, this system can efficiently produce methane and this is the first time that horizontal anaerobic reactors have been evaluated for the treatment of swine wastewater., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Introduction: Serum creatinine (SCr) alone does not allow for the early diagnosis of delayed graft function (DGF) following kidney transplantation (KTx)., Objective, Design and Methods: The diagnostic utility of urinary neutrophil gelatinase-associated lipocalin (uNGAL), serum leptin, malondialdehyde (MD.A), and cystatin C (CysC) for the early detection of DGF was previously evaluated by our group in a prospective cohort study of 40 consecutive adults undergoing KTx. Because no single biomarker achieved adequate sensitivity or specificity for practical purposes, this study was designed to evaluate the combined use of new markers with SCr. Urine and blood samples were collected 8-to-12h after KTx (day-1). Logistic regression was used to combine the biomarkers, and receiver operating characteristic curves and areas under the curve (AUC-ROC) were generated., Results: Eighteen recipients developed DGF (dialysis requirement during the first post-transplant week). On day-1, the AUC for SCr to predict DGF was 0.73, 0.88 for uNGAL, 0.90 for MDA, 0.76 for leptin, and 0.91 for CysC. Adding new biomarkers to SCr enhanced the performance of DGF prediction, and the best combination was achieved with SCr, MDA, and CysC (AUC=0.96, sensitivity=100%; specificity=86%)., Conclusion: A combination of graft damage biomarkers outperformed SCr in the early diagnosis of DGF, and the best performance was achieved by a triple-marker approach, using SCr, MDA, and CysC., (Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)

It remains controversial whether dialysis modality prior to SPKT (simultaneous pancreas-kidney transplantation) affects the outcome. We analyzed outcomes in type 1 diabetic patients undergoing SPKT, comparing peritoneal dialysis (PD) and hemodialysis (HD) groups: 119 had been on HD; 39 on PD. They were comparable except regarding dialysis time, higher in HD patients (30 ± 23 vs. 21 ± 15 months, P = 0.003). Thrombosis-driven relaparotomy was more frequent in PD patients (12.8% vs. 1.7%, P = 0.014). Pancreas loss due to infection was higher in PD patients (12.8% vs. 3.4%, P = 0.042). Thrombosis-related kidney loss was more frequent in PD patients (5.1%, vs. 0% in HD patients, P = 0.058). Thirteen deaths occurred, more within the PD group (17.9% vs. 5%; P = 0.011), being infection the leading cause (13.5%, vs. 1.7% in HD patients, P = 0.010). Patient survival was inferior in PD patients. Besides PD, cardiovascular disease and graft failure were independent predictors of patient death. In conclusion, PD patients more frequently complicated with intra-abominal infection leading to pancreatic loss and with renal thrombosis, with adverse impact on survival. As a PD first strategy in end-stage renal disease patients is generally associated with good outcomes, these gloomier results after SPKT urge for careful adjustment of infection and thrombosis prophylactic protocols in PD patients., (© 2015 Steunstichting ESOT.)

Kidney transplantation is the treatment of choice for end-stage renal disease. The evaluation of graft function is mandatory in the management of renal transplant recipients. Glomerular filtration rate (GFR), is generally considered the best index of graft function and also a predictor of graft and patient survival. However GFR measurement using inulin clearance, the gold standard for its measurement and exogenous markers such as radiolabeled isotopes ((51)Cr EDTA, (99m)Tc DTPA or (125)I Iothalamate) and non-radioactive contrast agents (Iothalamate or Iohexol), is laborious as well as expensive, being rarely used in clinical practice. Therefore, endogenous markers, such as serum creatinine or cystatin C, are used to estimate kidney function, and equations using these markers adjusted to other variables, mainly demographic, are an attempt to improve accuracy in estimation of GFR (eGFR). Nevertheless, there is some concern about the inability of the available eGFR equations to accurately identify changes in GFR, in kidney transplant recipients. This article will review and discuss the performance and limitations of these endogenous markers and their equations as estimators of GFR in the kidney transplant recipients, and their ability in predicting significant clinical outcomes.

Objectives: To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach., Methods: Between January 2011 and March 2012, 49 patients (50 hips) underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips) fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS), the Non-Arthritic Hip score (NAHS) and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip., Results: Out of the 41 hips treated, 31 (75.6%) presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4̊ for the internal rotation of the hip (p < 0.001). Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9̊ and mean increase of 0.10, respectively (p < 0.001)., Conclusion: Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

Background: Histiocytic sarcoma (HS) is a rare hematologic neoplasm with a few hundred cases having been described to date., Case Presentation: We report the case of a 56-year-old woman with a history of hepatitis C infection and chronic kidney disease (CKD), submitted to a kidney transplant in 1984, under maintenance immunosuppression with prednisone and azathioprine. Patient presented with a relentlessly growing mass on her right front thorax. It was painless, smooth, and adherent to the deep muscle. Laboratory studies were unremarkable. Ultrasonography and computerized tomography (CT) scan revealed a highly vascularized heterogeneous mass (8×9 cm), with a necrotic centre. Positron emission tomography (PET) scan demonstrated multiple thoracic, abdominal, and pelvic nodules. Histology revealed a highly undifferentiated HS (vimentin, CD68, CD99, and CD4 positive). In spite of having started treatment with etoposide and thalidomide, no clinical response was achieved and the patient died three months later., Conclusions: To the authors' knowledge, this is the first described case of HS in a solid organ transplant patient.

Objective: In kidney transplantation, the impact of delayed graft function (DGF) on long-term graft and patient survival is controversial. We examined the impact of DGF on graft and recipient survival by accounting for the possibility that death with graft function may act as a competing risk for allograft failure., Study Design and Setting: We used data from 1281 adult primary deceased-donor kidney recipients whose allografts functioned at least 1 year., Results: The probability of graft loss occurrence is overestimated using the complement of Kaplan-Meier estimates (1-KM). Both the cause-specific Cox proportional hazard regression model (standard Cox) and the subdistribution hazard regression model proposed by Fine and Gray showed that DGF was associated with shorter time to graft failure (csHR = 2.0, P = 0.002; sHR = 1.57, P = 0.009), independent of acute rejection (AR) and after adjusting for traditional factors associated with graft failure. Regarding patient survival, DGF was a predictor of patient death using the cause-specific Cox model (csHR = 1.57, P = 0.029) but not using the subdistribution model., Conclusions: The probability of graft loss from competing end points should not be reported with the 1-KM. Application of a regression model for subdistribution hazard showed that, independent of AR, DGF has a detrimental effect on long-term graft survival, but not on patient survival., (© 2015 Steunstichting ESOT.)

Introduction: Allograft nephrectomy (AN) is associated with a high number of surgical complications. Some authors advocate that early nephrectomy (<1 year) is associated with fewer complications. Intracapsular (ICAN) and extracapsular AN (ECAN) might have a different impact on allosensitization and surgical outcomes. Our goal was to compare surgical outcomes between early and late AN in our institution and to compare ICAN and ECAN in terms of surgical outcomes and panel reactive antibodies (PRA) variation., Materials and Methods: Between January 2000 and October 2012, we performed 104 AN at our institution (32 early and 72 late). Comparisons between early and late AN, and, within the latter, between the 2 different techniques were sought. Statistical analysis was performed for sample description, group comparison and %PRA variation., Results: Among the 104 patients with a mean age of 47.9 ± 14.2 years, 54 were men. Age, gender, body mass index, and number of previous transplants were similar between early and late AN and between ICAN and ECAN patients. Late AN was associated with less blood loss (293.4 ± 229.0 vs 414.3 ± 349.5 mL; P = .03), shorter hospital stay (12.8 ± 14.5 vs 26.8 ± 26.5; P < .05), and fewer complications (22.2% vs 59.3%; P < .05). The chance of being relisted for transplantation was similar (50.0% in early vs 59.7% in late AN; P = .7). When comparing ICAN and ECAN, there was no difference in surgical outcomes. The %PRA variation between the 2 techniques was comparable (-1.2 ± 10.6 ICAN vs -0.5 ± 15.9 ECAN; P = .8), as was the chance of being relisted for transplantation (60.5% ICAN vs 58.6% ECAN; P = .8)., Conclusions: Early AN was associated with a greater number of surgical complications. Nevertheless, the number of AN patients returning to the active waiting list was similar between early and late AN groups. ICAN and ECAN had similar surgical and postoperative outcomes, although a bias may be present because some conversions from ECAN to ICAN occurred owing to technical issues. As in other studies, ICAN did not seem to affect allosensitization or jeopardize the chance of being relisted for transplant when compared with ECAN., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: Donated kidney volume influences post-transplant outcomes and graft survival. We evaluated the relationship between living-donor kidney volume and recipient graft function at 12 months post-transplantation, exploring a volume threshold for a suboptimal graft function, and compared two different formulas of volume estimation., Methods: A retrospective analysis of 82 pairs of living-donor kidney transplants was conducted. Donor renal volumes were estimated from computerized tomography scans using the ellipsoid formula and the voxel counting technique. Linear and restricted cubic regression spline was used to analyze the association of volume with graft function. Additionally, we determined the correlation between the two volume estimation formulas and established a correction factor for the ellipsoid formula., Results: Renal volume (adjusted to recipient BSA) had the strongest independent effect (B = 1.65 per 10 ml/m(2) increase, p value <0.001) on graft function at 12 months. The eGFR at 12 months was 52.5, 63.6 and 67.6 ml/min/1.73 m(2) for the low, medium and high volume ratio terciles, respectively (p value <0.001). The odds of a GFR <50 ml/min became significantly reduced with volumes above 145 cc/1.73 m(2). A strong positive correlation between the two formulas was identified (R(2) = 0.705), but the optimal correction factor for our cohort was 0.566., Conclusions: In a Caucasian population, higher donor kidney volumes estimated from preoperative CT scans are associated with higher recipient eGFRs at 12 months after live-donor transplantation. Using this criterion, transplant teams can potentially improve selection of living donors if multiple donors are available. However, the need for precise estimation of donor kidney volumes should not be overlooked.

Pancreas-kidney transplantation (PKT) may significantly improve quality of life (HRQOL) in patients with type 1 diabetes. We have assessed the changes felt by PKT patients, using the Gastrointestinal Quality of Life Index (GIQLI) and EuroQol-5D questionnaires. Patients were asked to compare how their HRQOL had changed from pre-transplantation to the last visit. The 60 men and 66 women enrolled had a mean follow-up of five yr; 84.1% with both grafts, 15.9% with one graft functioning. In all domains of EuroQol-5D scores improved after PKT, as well as the visual analogue scale health state (from 38% to 84%, p < 0.001; effect size 3.34). In GIQLI, physical function was felt better after PKT than before (14.83 ± 3.86 vs. 7.86 ± 4.43, p < 0.001; effect size 1.68); the same was observed for psychological status, social function, and GI complaints. Concerning the burden of medical treatment, the score significantly improved (from 1.31 to 3.63, p < 0.001, effect size 2.02). The rate of unemployed patients decreased after PKT (from 50.8% to 36.5%, p < 0.001). Multivariate analysis showed that having only one functioning graft was associated with worse HRQOL scores (B = -5.157, p = 0.015). In conclusion, for all assessed domains, patients reported a significant improvement in HRQOL after PKT. Maintenance of the two grafts functioning predicted higher improvement of HRQOL scores., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The relevance of preformed donor specific antibodies (DSA) detected by Luminex assays, with a negative complement-dependent cytotoxicity (CDC) crossmatch, remains unsettled in kidney transplantation (KT). We aimed to analyze the impact of preformed DSA characteristics on kidney graft outcomes., Methods: In 462 patients that received a kidney graft in our unit, between 2007 and 2012, pre-transplant sera were analyzed by Luminex screening assay to determine the presence of anti-human leukocyte antigen (HLA) antibodies and single-antigen bead assay [positive if mean fluorescence intensity (MFI) ≥ 1000] to assign anti-HLA specificities., Results: Anti-HLA antibodies were present in 95 patients (20.6%), but only 40 (8.7%) had DSA. Antibody-mediated rejection (AMR) at 1-year was higher in patients with DSA (35.0%) than in those without them (0.9%) (P < 0.001). Only DSA with a MFI of >3000 were significantly associated with AMR occurrence. Receiver operator curves revealed that a MFI of >4900 in the highest DSA bead had a high sensitivity (85.7%) and that the sum of all DSA beads MFI > 11,000 had a high specificity (92.3%) for AMR prediction. Anti-thymocyte globulin versus basiliximab induction was more frequent in DSA+ AMR- (65.4%) versus DSA+ AMR+ (34.6%) patients (P = 0.072). Five-year censored graft survival was lower in DSA+ than in DSA- patients (respectively, 84.8% versus 94.9%, P = 0.006), although survival was only reduced in DSA+ AMR+ (68.8%) versus DSA+ AMR- (96.0%) patients (P = 0.038)., Conclusions: Preformed DSA is associated with kidney graft loss, in relation with AMR occurrence. DSA strength may be used to improve immunological risk stratification of sensitized patients and their clinical management., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Context and Objective: Based on evidence that leptin and adiponectin are removed from circulation primarily by the kidney, we designed a study to examine the longitudinal changes of these adipokines during the first week after kidney transplantation (KTx) and to test the hypothesis that higher levels of leptin and/or adiponectin could be early biomarkers of delayed graft function (DGF=dialysis requirement during the first post-transplant week) and acute rejection., Study Design: Repeated-measures prospective study., Material and Methods: Forty consecutive adult patients with end-stage renal disease who were undergoing KTx. Leptin and adiponectin were measured in blood samples that were collected before (day-0) and after KTx (days-1, 2, 4 and 7). Linear mixed-models, receiver operating characteristic and area under curve (AUC-ROC) were used., Results: At post-transplant day-1, leptinemia and adiponectinemia declined 43% and 47%, respectively. At all times studied after KTx, the median leptin levels were significantly higher in patients developing DGF (n=18), but not adiponectin levels. Shortly after KTx (day-1), leptin values were significantly higher in DGF recipients in contrast to patients with promptly functioning kidneys, approximately two times higher when controlling for gender and BMI. The leptin reduction rate between pre-tranplant and one-day after KTx moderately predicted DGF (AUC=0.73). On day-1, serum leptin predicted DGF (AUC-ROC=0.76) with a performance slightly better than serum creatinine (AUC-ROC=0.72), even after correcting for BMI (AUC-ROC=0.73). Separating this analysis by gender showed that the performance of leptin in predicting DGF for male gender (AUC-ROC=0.86) improved., Conclusions: Kidney graft function is an independent determinant of leptin levels, but not of adiponectin. Leptin levels at day-1 slightly outperformed serum creatinine in predicting the occurrence of DGF, and more accurately in male gender. No significant association was detected with acute rejection., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Objective: To correlate the annoyance of tinnitus assessed by the Tinnitus Handicap Inventory and on a visual analogue scale with the evoked otoacoustic emission test result in tinnitus patients with normal hearing., Study Design: Case-control study., Setting: Public tertiary hospital., Subjects and Methods: The sample was initially based on a population of 80 subjects with tinnitus; 20 of them had normal hearing and normal evoked otoacoustic emission test results and comprised the study group. For the purpose of comparison, a control group was formed, which consisted of 17 subjects with no hearing complaints and normal hearing. The participants were submitted to hearing tests, immittance testing and tests for the evaluation of acoustic reflexes, distortion product otoacoustic emissions, transient evoked otoacoustic emissions (TEOAEs), and suppression of TEOAEs. The tests were performed in a sound-treated booth using a linear contralateral noise of 60 dB. The presence of suppression effects was defined when the response amplitude was 0.5 dB or higher., Results: Abnormal evoked otoacoustic emission suppression test results were observed in 52.9% of tinnitus patients and in 32.4% of control subjects (p = 0.086). Suppression effects of TEOAEs were absent in 38.5% of subjects with minimal or mild discomfort and in 61.9% of subjects with moderate or severe discomfort (p = 0.183)., Conclusion: It was not possible to associate the annoyance caused by tinnitus with the TEOAE suppression test results, although suppression effects were found to decrease with increasing annoyance.