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AbstractThe gut microbiota (GM) is essential for mammalian health. Although the association between infant GM and breast milk (BM) composition has been well established in humans, such a relationship has not been investigated in horses. Hence, this study was conducted to analyze the GM formation of foals during lactation and determine the presence of low-molecular-weight metabolites in mares’ BM and their role in shaping foals’ GM. The fecal and BM samples from six pairs of foals and mares were subjected to 16S ribosomal RNA metagenomic and metabolomic analyses, respectively. The composition of foal GM changed during lactation time; hierarchical cluster analysis divided the fetal GM into three groups corresponding to different time points in foal development. The level of most metabolites in milk decreased over time with increasing milk yield, while threonic acid and ascorbic acid increased. Further analyses revealed gut bacteria that correlated with changes in milk metabolites; for instance, there was a positive correlation between Bacteroidaceae in the foal’s gut microbiota and serine/glycine in the mother’s milk. These findings help improve the rearing environment of lactating horses and establish artificial feeding methods for foals.

Introdução: O crescimento da população idosa é um fenômeno mundial e traz como consequência o aumento de morbidades decorrentes do processo de envelhecimento, que podem levar o idoso à fragilidade. Assim, há necessidade de diversos serviços de saúde que atendam essa parcela da população, como o atendimento domiciliar. A avaliação dos idosos deve ser abrangente, por meio de instrumentos específicos, e é importante no contexto da assistência domiciliar. Objetivo: Caracterizar os idosos de um programa de atendimento domiciliar quanto à saúde e à funcionalidade. Método: Estudo quantitativo, descritivo e retrospectivo, realizado com dados coletados de prontuários dos idosos usuários do Programa de Atendimento Domiciliar ao Idoso, do período desde a admissão do idoso no programa até o final do ano de 2008. Utilizou-se um roteiro semiestruturado para análise documental. Analisaram-se os dados por frequência simples obtida. Resultados: Verificou-se que 75,4% dos idosos tinham 80 anos ou mais, 77% eram semidependentes para atividades de vida diária, 50,8% estavam acamados, 42% tinham déficit cognitivo, 90,2% eram incontinentes e 52,4% sofreram pelo menos uma queda. Conclusão: Os idosos do programa apresentam fragilidade e sua avaliação por equipe interdisciplinar permite intervenções que contribuem para a melhor assistência e qualidade do serviço.

Ai Goto,1 Sonoko Harada,1,2 Hitoshi Sasano,1 Yuuki Sandhu,1 Yuki Tanabe,1 Sumiko Abe,1 Shoko Ueda,1 Tomohito Takeshige,1 Kei Matsuno,1 Tetsutaro Nagaoka,1 Jun Ito,1 Ryo Atsuta,1 Kazuhisa Takahashi,1,3 Norihiro Harada1– 3 1Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan; 2Atopy (Allergy) Research Center, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan; 3Research Institute for Diseases of Old Ages, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, JapanCorrespondence: Norihiro Harada, Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 hongo, Bunkyo-ku, Tokyo, 113-8431, Japan, Tel +81-3-5802-1063, Fax +81-3-5802-1617, Email nor@juntendo.ac.jpPurpose: Omalizumab, the anti-IgE monoclonal antibody used to treat severe asthma, reduces asthma exacerbations, hospitalizations, and corticosteroid use. Although allergic asthma is a therapeutic target of omalizumab, omalizumab is not effective in all patients with severe allergic asthma and is not always available for long-term use. We retrospectively investigated factors related to long-term (≥ 2 years) use of omalizumab for severe asthma.Patients and Methods: Of the 116 patients treated with omalizumab for severe asthma at our hospital between 2009 and 2017, 82 were included in this retrospective analysis. Thirty-four were excluded because of adverse events, financial difficulties, or hospital transfers. The number of asthma exacerbations, unscheduled visits, corticosteroid doses, asthma control test scores, pulmonary function test results, and fractional exhaled nitric oxide levels were evaluated.Results: The median age of the study population was 58 years, with 66% female and 26% taking regular oral corticosteroids. After 2 years of treatment, 52 responders were identified using the global evaluation of treatment effectiveness (GETE) score. Improvements in asthma control test scores, airflow limitation, exacerbations, and oral corticosteroid use were observed in the responders. Multivariate analysis revealed that a peripheral blood eosinophil count of ≥ 200 or a perennial antigen-specific IgE antibody positivity of ≥ 2 predicted a response at the 2-year mark. However, Kaplan–Meier analysis demonstrated that neither high eosinophil counts nor perennial antigen-specific IgE positivity influenced the prolongation of treatment beyond 2 years, and responders at 2 years underwent omalizumab treatment for a significantly longer period than non-responders (HR = 9.89, p < 0.001), with GETE at 2 years being the only predictor of long-term omalizumab use.Conclusion: In this retrospective study the GETE after 2 years of omalizumab therapy emerged as the most meaningful predictor of the long-term effectiveness of omalizumab treatment in patients with severe asthma, highlighting the benefits of prolonged therapy in certain populations. These findings may guide future therapeutic strategies for severe asthma.Keywords: antigen-specific IgE antibody, GETE, predictive biomarker

Abstract Aims The adverse effects of low daily protein intake (DPI) on clinical outcomes in patients with heart failure (HF) are known; however, an optimal DPI to predict event adverse outcomes remains undetermined. Moreover, whether protein restriction therapy for chronic kidney disease is applicable in patients with HF and renal dysfunction remains unclear. Methods and results In this single‐centre, ambispective cohort study, we included 405 patients with HF aged ≥65 years (mean age, 78.6 ± 7.5 years; 50% women). DPI was estimated from consumption over three consecutive days before discharge and normalized relative to the ideal body weight [IBW, 22 kg/m2 × height (m)2]. The primary outcome was a composite of all‐cause mortality and HF‐related readmission within the 2 year post‐discharge period. Results During an average follow‐up period of 1.49 ± 0.74 years, 100 patients experienced composite events. Kaplan–Meier survival curves revealed a significantly lower composite event‐free rate in patients within the lowest quartile of DPI than in the upper quartiles (log‐rank test, P = 0.02). A multivariate Cox proportional hazards analysis after adjusting for established prognostic markers and non‐proteogenic energy intake revealed that patients in the lowest DPI quartile faced a two‐fold higher risk of composite events than those in the highest quartile [hazard ratio (HR), 2.03; 95% confidence interval (CI), 1.08–3.82; P = 0.03]. The composite event risk linearly increased as DPI decreased (P for nonlinearity = 0.90), with each standard deviation (0.26 g/kg IBW/day) decrease in DPI associated with a 32% increase in composite event risk (HR, 1.32; 95% CI, 1.10–1.71; P = 0.04). There was significant heterogeneity in the effect of DPI, with the possible disadvantage of lower DPI in patients with HF with cystatin C‐based estimated glomerular filtration rate 1.12 g/kg IBW/day in older patients with HF. Caution is warranted when protein restriction therapy is administered to older patients with HF and renal dysfunction.

Abstract Aims Elevated plasma branched‐chain amino acids (BCAAs) are tightly linked to incident diabetes and its complications, while lower BCAAs are associated with adverse outcomes in the elderly and heart failure (HF) patients. The interplay between body compositions and plasma BCAAs, especially under the influence of co‐morbid diabetes in HF patients, is not well understood. Here, we examined the impact of diabetes on the prognostic value of plasma BCAA and its association with body compositions in HF patients. Methods and results We retrospectively examined 301 HF patients (70 ± 15 years old; 59% male), among which 36% had diabetes. Blood samples for plasma BCAA measurements were collected in a fasting state after stabilization of HF and analysed using ultraperformance liquid chromatography. A dual‐energy X‐ray absorptiometry scan assessed regional body compositions, and muscle wasting was defined as appendicular skeletal muscle mass index (ASMI)

The bloomy rind sign, characterized by band-like abnormalities along the surface of the brainstem on magnetic resonance imaging without contrast enhancement, has been considered a specific imaging marker for leptomeningeal metastasis from lung adenocarcinoma. In this study, we describe the case of an 85-year-old male with a 3-week history of headache, fever, and progressive cognitive impairment. The patient was diagnosed with varicella-zoster virus brainstem meningoencephalitis and magnetic resonance imaging revealed hyperintensities along the brainstem surface on fluid-attenuated inversion recovery and diffusion-weighted imaging that mimicked a bloomy rind sign. However, the patient showed no signs of lung cancer or meningeal carcinomatosis. This case suggests that the bloomy rind sign is not exclusive to leptomeningeal metastasis but can also be observed in other conditions, such as central nervous system infections.

Agricultural cargo vehicles are responsible for applying severe soil pressures. However, the ground straw cover can attenuate the loads applied by wheels to the soil surface. This research evaluated the effect of three tires, p1—Radial Very Flex, p2—Radial Improved Flex, and a p3—Bias Ply tire, on three amounts of straw on the soil surface (0, 15, and 30 Mg ha−1). We adopted a completely randomized design (CRD) with a rigid surface for three replications for the total contact area and punctual area claws. The soil bin test verified the deformable surface, tread marks, and soil penetration resistance (SPR). The tire’s claw design determines its punctual contact area, and the construction model determines the total contact area. The contact area in the soil bin increased linearly due to a increase in straw covering, reducing sinkage; p2 to 30 Mg ha−1 straw shows the most significant contact area, p1 and p3 showed no difference. A straw increase from 0 to 30 Mg ha−1 increased the contact areas by 25.5, 38.0, and 20.0% for p1, p2, and p3, respectively. Compared to the rigid surface, the p1 and p3 contact areas in the soil bin increased 6.2, 6.8, and 7.8 times in bare soil, 15, and 30 Mg ha−1; for p2, this increase was up to 4.2, 4.5, and 5.9 times on the same surfaces. Keeping the straw on the soil improves its physical quality by reducing the SPR, so the straw has a buffer function in the wheel–soil relationship.