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Context Summer ambient temperature and humidity are major factors negatively influencing the physiology and the productive and reproductive efficiency of dairy cows. Various management and breeding approaches may be useful for maintaining productivity in dairy cows during summer to minimise these effects. Aims The experiment was designed to test a natural phytochemical supplementation of capsaicin (CPS), followed by a specific oestrus synchronisation protocol as a means to maintain productivity and reproductive performance of Chinese Holstein cows during summer in Hubei province, China. Methods Lactating Chinese Holstein cows (n = 109) were randomly divided into four groups and supplemented with 0 (control, n = 27), 20 (CPS-20, n = 26), 40 (CPS-40, n = 28) and 60 (CPS-60, n = 28) mg of capsaicin (CPS) per kg of total mixed ration respectively for continuous 30 days initiated on 10 July 2018. Milk production and composition were measured over 45 days from the start of CPS supplementation. After CPS supplementation, all cows were synchronised through a modified Ovsynch oestrus synchronisation protocol, and reproductive variables were recorded. Metabolic parameters were measured on the days before CPS supplementation, artificial insemination (AI) and 50 days post-AI. Key results Highest (P < 0.05) milk production were found in the CPS-40 group, and highest total solids and milk fat in the CPS-20 and CPS-40 groups. Milk urea nitrogen and milk fat were generally increased in CPS supplemented cows compared with the control group. Significant increases (P < 0.05) in oestrus response, ovulatory follicle size, ovulation rate and pregnancy rates were observed in the CPS-40 group compared with other groups. Glucose, lipoprotein esterase and aspartate aminotransferase were increased (P < 0.05) in CPS-40 and CPS-60 supplemented groups at the time of AI and 50 days post-AI. Conclusions CPS supplementation has the capacity to maintain milk yield, milk composition and serum metabolites in Chinese Holstein dairy cows during summer. The synergistic effect of CPS and the modified oestrus synchronisation protocol also improved reproductive variables of the cows. Implications Adoption of CPS as a supplement along with oestrus synchronisation could be a useful and economical strategy for dairy herd keepers to improve herd performance during summer.

In the present study, we evaluated the sustaining effect of various glutathione (GSH) concentrations in extender on rabbit sperm attributes during storage at 5°C for 24 h. Semen was collected from regular donor rabbit bucks using an artificial vagina and initially evaluated for sperm quality. The qualifying ejaculates were diluted with one of the extenders having 0, 1, 2, 4 or 8 mM GSH, to achieve a final concentration of 1×108 sperm/mL. The extended samples were stored at 5°C for 24 h. Sperm motility, motion kinetics, acrosome integrity and viability were assessed after 3, 6, 12 and 24 h of storage. The results showed that total sperm motility and sperm motion kinetics (oscillation index of the sperm, straightness index and beat cross frequency) were influenced (PP

The study was conducted to evaluate the seasonal dynamics in the sperm acrosome reaction (AR), osmotic tolerance and serum testosterone concentration in rams. Blood and semen samples were collected from six mature rams during the winter, spring, summer and autumn seasons. The AR in sperm samples was induced by using lysophosphatidylcholine (LPC) and calcium ionophore (CI). The AR was monitored at various incubation times (15, 30, 60, 120 and 180 min) post-induction. To determine the osmotic tolerance through hypo-osmotic swelling test (HOST) the sperm were exposed to different osmotic conditions (50, 100, 290, 500 and 1000 mOsm/L). The serum testosterone concentration was assessed using a solid phase enzyme-linked immunosorbent assay (ELISA). The proportion of acrosome reacted sperm was greater (P 0.05) during the winter season in the LPC and control groups, whereas, it was greater (P 0.05) in two different seasons (winter and summer) at all incubation time points (15-180 min) in the CI group. The live HOST +ve, total HOST +ve and total live sperm were least (P 0.05) during the winter season. The greatest membrane integrity (P 0.05) was in the autumn season. The peak (P 0.05) serum testosterone concentration was during the summer season. In conclusion, the osmotic tolerance and sensitivity of ram sperm to undergo the AR in response to LPC and CI vary with season. The increased testosterone concentration in the summer season might be the reason for a greater membrane integrity during the subsequent autumn season in Kivircik ram sperm.

The present study was aimed to determine the carry-over effects of immunization against inhibin α-subunit (AIINHA) on fresh and post-thawed sperm quality during peak breeding (PBS) and low breeding seasons (LBS). Six Beetal bucks (n = 6) were either immunized against inhibin (AIINHA; n = 3) or kept untreated (CON; n = 3). Initially, the AIINHA group was treated with primary dose of inhibin α-subunit (0.50 mg) at Day 0 and followed by a booster dose 28 days later. The semen collection and cryopreservation were started five weeks post-AIINHA treatment and continued for eight consecutive weeks during LBS (n = 16 replicates; 8 in CON and 8 in AIINHA) and resumed in forthcoming eight weeks of PBS (n = 16 replicates; 8 in CON and 8 in AIINHA). Prior to cryopreservation, the fresh semen quality was assessed and afterwards, cryopreserved semen was evaluated for progressive motility, sperm kinetics, membrane, acrosomal and DNA integrities. The results indicated that AIINHA (P

The present study was conducted to investigate the antioxidant, histomorphometric, histochemical, immunohistochemical, biochemical, and cytological effects of coenzyme Q10 (CoQ10) against bisphenol-A (BPA)-induced testicular toxicity in rats. A total of 40 adult male Wistar rats were divided into five equal groups. The control group remained untreated. The vehicle control group was administered corn oil (2 ml/kg/day), the BPA group was given BPA (100 mg/kg/day), the CoQ10 group was supplemented with CoQ10 (10 mg/kg/day), and the rats in the CoQ10-BPA group received CoQ10 (10 mg/kg/day) followed by BPA (100 mg/kg/day) 1 h later. The treatments were administered by oral gavage for 14 days. Results showed that the seminiferous tubule diameters (STDs) and seminiferous epithelium heights (SEHs) at stages VII–VIII and XII–XIV, number of undifferentiated embryonic cell transcription factor-1 (UTF-1) positive cells per tubule, UTF-1 positive tubules (%), plasma glutathione (GSH), and serum superoxide dismutase activities, testicular GSH activity and sperm viability (%) decreased whereas the number of terminal dUTP nick end labeling (TUNEL) positive cells per tubule, TUNEL positive tubules (%), testicular and serum malondialdehyde (MDA) levels, and the rate of mid-piece sperm abnormality increased in the BPA administered group. However, while the STDs at stages VII–VIII and XII–XIV, SEHs at stages VII–VIII, plasma GSH, and serum SOD activities increased, serum MDA level decreased in the CoQ10-BPA group. In conclusion, these results suggest a protective effect of CoQ10 against BPA-induced testicular toxicity in rats.

The current study was carried out to determine the changes in serum electrolytes, liver enzymes, and hormones during breeding and non-breeding seasons in estrus-synchronized goats. Forty goats (n = 40) were synchronized by inserting the sponges intravaginally for 12 days; PMSG and PGF2α were injected on day of sponge removal. Blood samples were collected from the goats at the time of sponges insertion (day -12), estrus day (day 0), and at 15 day after sponge withdrawal (day 15). The blood samples were analyzed for glucose, cholesterol (CHO), aspartate aminotransferase (AST), alanine aminotransferase (ALT), thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) and progesterone (P4), calcium (Ca), phosphate (PO4), magnesium (Mg), sodium (Na), potassium (K), and chlorine (Cl) levels. Repeated measurements ANOVA of general linear model were used as statistical model. The results showed that seasons have an effect (p

WOS: 000472985900013, PubMed ID: 31158733, The objective of the present was to determine the effect of long-term release GnRH agonists "deslorelin" on suppression and restoration of testicular and accessory sex glands functions, and expression of HSP in testes of adult male rats. A group of twenty-eight male rats and fifty-six female rats were kept for eleven months. The male rats were subdivided into treatment (n = 18; deslorelin, an analogue of GnRH, 4.7 mg, S.C; six months) and control (n = 10; untreated), and the adult female rats were introduced with either treatment or control male rats at the 2nd, 6th and 11th months post implant insertion. At 6th month of deslorelin implants insertion, six male rats from treatment and five rats from control group were sacrificed. The remaining (twelve treatment and five control) male rats were sacrificed at 11 months. The testicular dimension were measured monthly in both treatment and control rats. The blood samples were collected for testosterone and HSP70 antibody, whereas, the testes and accessory glands were isolated for histological examination at each sacrificial time. The results showed that testicular dimension were significantly lesser in treatment group until 9 months post treatment. HSP70 protein expression was negligible at 6 months in treatment group but its intensity increased in spermatids 11 months of treatment similar to control group. Significantly lower testosterone concentrations with poor semen quality, and smaller litter size were observed in treatment group. The histological picture of accessory sex glands and seminiferous tubules shown a variable integrity in treatment group than control at 6 months implant insertion. In conclusion, the subcutaneous application of 4.7 mg of the GnRH-analogue deslorelin represents a practicable, like in the female rats, method to suppress testicular, accessory sex glands functions, testicular HSP expression and fertility in male rats. Moreover, the suppressive effects of deslorelin, continued until 11th months after removal of the implant. (C) 2019 Elsevier Inc. All rights reserved., Scientific Research Coordination Unit of Yuzuncu Yil University [2014-HIZ-VF063], This study was supported by Scientific Research Coordination Unit of Yuzuncu Yil University as a Project (2014-HIZ-VF063) and a part of this study was as a poster presented in 49th Annual Conference on Physiology & Pathology of Reproduction and also 41st Joint Conference of Veterinary and Human Reproductive Medicine, p.141, 10th-12th February, Leipzig, Germany, 2016.

Two experiments were conducted to evaluate the effect of royal jelly (RJ) on post-thaw sperm quality, in vitro and in vivo fertility rate of cryopreserved buffalo bull sperm. The semen was collected from three mature regular donor buffalo bulls, ejaculates were pooled and semen evaluated initially. In Experiment 1, the ejaculates were extended in tris-citric acid diluter supplemented with different RJ concentrations (0, 0.05, 0.1, 0.2, 0.3 or 0.4%). The diluted semen was cooled to 4°C, packaged into 0.5 mL straws and frozen using standard procedure. The straws were thawed and assessed for sperm progressive motility, viability, plasma membrane, acrosome, and chromatin integrity. The results indicated that sperm progressive motility was significantly greater (P0.05) in 0.05, 0.1, 0.2 and 0.3% RJ than 0.4% RJ supplemented and control groups. The sperm viability, plasma membrane and acrosome integrity were significantly improved (P0.05) in 0.1% RJ supplemented group the compared to other treatment groups. In Experiment 2, cryopreserved sperm with 0.1% RJ supplementation and control (without RJ supplementation) were used to observe the in vitro fertilizing potential and in vivo fertility. In vitro fertilization method was applied to assess the cleavage rate; whereas, AI was performed in buffalo during in vivo fertility trial. The buffaloes were inseminated 12h after standing estrus and pregnancy diagnosis was performed through ultrasonography. The results revealed that the cleavage rate was higher (P0.05) in 0.1% RJ as compared to control group. However, the pregnancy rate was similar (P0.05) between 0.1% RJ supplemented and control groups. It is concluded that supplementation of RJ in freezing extender can improve the cryosurvival rate and in vitro fertilizing capacity of buffalo bull sperm.

The aim of this work was to evaluate the efficacy of G6G and Ovsynch protocols on synchronization and pregnancy rate in Nili-Ravi buffalo. For this, a total of fifty buffalo were assigned into two treatment groups: (1) G6G (n=25) and (2) Ovsynch (n=25). The blood samples were collected from all the treated buffalo on day (D) 7 (PGF2α injection of Ovsynch) to measure the progesterone (P4). All the buffalo were fixed time inseminated (FTAI) following last GnRH of Ovsynch. Ultrasonography was performed for follicular, corpus luteum (CL) dynamics and pregnancy diagnosis. The results revealed that synchronization rate and response to final PGF2α were significantly (P

This study focused to determine beneficial impact of feeding quercetin supplemented diet on semen quality in summer heat imposed rabbits. Twelve heat stressed (HS) adult rabbits bucks were either fed with basal diet (HS; n = 06) or quercetin supplemented diet (QU-HS; n = 06) for a period of 56 days. Semen samples were collected and evaluated for volume, osmolality, morphology, concentration, motility, motion kinetics, viability, acrosome integrity, mitochondrial potential, and seminal plasma MDA level. Semen volume, concentration, motility and sperm kinetics parameters were affected by diet supplementation. Diet affected the sperm mitochondrial potential and day of treatment affected the viable sperm percentage. There was an effect of diet, day of treatment and diet by day interaction on acrosome reaction rate. Sperm head abnormalities were influenced by diet provision, sperm mid-piece abnormalities were affected by diet and day of treatment, whereas, the effect of diet and diet by day of treatment interaction were observed for total sperm abnormalities. There was an effect of diet and diet by day interaction for seminal plasma MDA level. In conclusions, quercetin reduces the damaging effects of HS and maintains the semen quality by lowering the oxidative stress in rabbits.

Three experiments were conducted to determine the protective effect of cholesterol-loaded cyclodextrin (CLC) against hydrogen peroxide (H2O2) or cryo-induced damage in ram sperm. In Experiment 1, the fresh ejaculates were either treated with CLC or remained untreated. Both CLC treated and untreated samples were then incubated with 0, 250 or 500 mu M H2O2 at 35 degrees C for 12 h. After incubation period of 12 h, the motility, viability and membrane integrity remained higher in CLC treated sperm even in the presence of 250 or 500 mu M H2O2. The H2O2 treatment affected all the sperm parameters adversely (P < 0.05). However, compared to CLC untreated counterpart, the motility, viability and membrane integrity remained higher (P < 0.05) in treated sperm, even in the presence of 250 or 500 mu M H2O2 during 12 h of incubation. In Experiment 2, semen was cryopreserved in the presence or absence of CLC. The post-thaw results revealed that CLC treated sperm has higher (P < 0.05) motility, viability and membrane integrity compared to the control. In Experiment 3, lipid peroxidation levels were assessed by determining malondialdehyde (MDA) concentrations during the H2O2-induced oxidative stress in CLC treated and untreated sperm. However, no difference (P > 0.05) in MDA level was observed among the groups at any stage of incubation. In conclusion, the CLC incorporation in ram sperm membrane may protects it against H2O2 or cryo-induced oxidative damage. The cryoprotective influence of CLC on ram sperm might be resulted from, at least partly, its antioxidative property. (C) 2015 Elsevier Inc. All rights reserved.

Following ejaculation, sperm appear morphologically mature, but functionally they are inactive. To attain functional capability or capacitation in vivo, sperm must reside in the female reproductive tract for a certain period of time before fertilization. In the female reproductive tract, cholesterol efflux from the sperm plasma membrane is considered vital for the initiation of capacitation. A number of in vitro studies have used biological and nonphysiological means to understand the phenomenon of cholesterol efflux and capacitation. In this review, we present a short overview of the role of cholesterol efflux in regulating sperm capacitation using various agents. This review provides insight to researchers designing new procedures for sperm preparation to be used in assisted reproductive technology.

An online survey was conducted with 72 Canadian occupational therapists to (1) explore if and how occupational therapists were aware of "arising moments" in clinical practice, which are moments that give rise to emotions, sensations, and thoughts, and (2) to examine therapists' responses to questions related to mindfulness. Participants described arising moments through an open-ended survey question. Framework analysis was used to develop key themes and subthemes. A modified Philadelphia Mindfulness Awareness (PHLMS) subscale with two additional survey questions "understanding of living in the moment and being present, and awareness of mindfulness" (sum = PAM) were used as indicators of mindfulness. There were significant differences in the means of PHLMS mindfulness among therapists working in diverse practice areas (F = 3.63, p = .009). Posthoc analysis revealed that therapists working in mental health had higher mean PHLMS-mindfulness scores than in all other groups. There were no significant differences in PAM mindfulness among the practice areas (ANOVA, F = 2.15, p = .08). However, posthoc tests showed that the participants in the mental health practice area had a significant difference with one group, general physical health. Findings have implications for practice in occupational therapy and education about mindfulness in occupational therapy.

The objective of this study was to compare oestrus expression and fertility rate in used and new controlled internal drug releasing (CIDR) device treated anoestrous buffaloes. Furthermore, to determine the timing of ovulation, and fertility rate in estradiol benzoate (EB) and GnRH-administered CIDR-treated anoestrous Nili-Ravi buffaloes. In experiment 1, buffaloes received either a used CIDR (UCIDR, n = 35) or a new CIDR (NCIDR, n = 36) for 7 day and PGF2α on day 6. Oestrous expression was similar (p > 0.05) between UCIDR (88.5%) and NCIDR (96.6%) buffaloes. The pregnancy rate did not differ (p > 0.05) because of treatment (37.1% in UCIDR vs 36.6% in NCIDR). In experiment 2, buffaloes (n = 55) received CIDR device for 7 days and PGF2α, on day 6 and randomly assigned into three treatment groups: (i) CIDR-EB (n = 17) received EB on day 8, (ii) CIDR-GnRH (n = 18) received GnRH on day 9 and (iii) control (n = 20) received no further treatment. Mean interval from CIDR removal to ovulation in CIDR-EB, CIDR-GnRH and CIDR group were 61.3 ± 0.8, 64.9 ± 1.8 and 65.1 ± 16.7 h, respectively. However, the buffaloes in the CIDR-EB and CIDR-GnRH group had lesser variability in the timing of ovulation compared to control. The pregnancy rate of both CIDR-EB group (58%) and CIDR-GnRH group (61%) were tended to be higher (p < 0.1) than control (30%). In conclusion, compared to NCIDR devices, previously UCIDR devices are equally effective to induce oestrus in anoestrous buffaloes resulting optimal pregnancy rate. Administration of EB and GnRH after CIDR removal results in tighter synchrony (less variability) and improved fertility in anoestrous buffaloes. CIDR based synchronization regimens have great potential in fertility improvement in anoestrous buffaloes.

The objective of the present study was to determine the relationship of age to body weight (BW), scrotal circumference (SC), number of pixels of testicular ultrasonograms (NP), and semen quality in Sahiwal bulls. The study was based on 128 Sahiwal bulls of different age groups (from 0 to100 months of age). Bulls were evaluated for SC, BW, and NP. Semen was evaluated once a week for five consecutive weeks from regularly collected donor bulls (n = 86) ranging in age from 25-30 to100 months. Ejaculate volume, sperm motility, sperm concentration, sperm morphology, percent live sperms, sperm plasma membrane integrity, and normal acrosome were compared among different age groups. Mean SC and BW increased (P 0.05) in a curvilinear manner from birth to100 months of age. Mean NP of testicular ultrasonograms increased (P 0.05) from 0 to 24 months and then plateaued until100 months of age. Body weight, SC, and NP were positively correlated with age from birth until100 months (r = 0.91, 0.87, and 0.40, respectively). Ejaculate volume (5.7 ± 0.2 vs. 4.6 ± 0.09 ml) and sperm concentration (1,281.6 ± 17.7 vs. 1,115.8 ± 55.9 × 10(6)/ml) increased (P 0.05) in mature bulls compared to younger ones. However, motility (68.6 ± 0.3%), plasma membrane integrity (50.8 ± 1.0%), and normal acrosome (74.8 ± 0.5%) remained insignificant due to age. In six of eight age groups studied, morphological abnormalities were well within the range (18.1 ± 0.3%). In conclusion, the BW, SC, and NP of testicular ultrasonograms, ejaculate volume, and concentration increased with age. Moreover, semen quality is fairly independent of age except volume and concentration in Sahiwal bulls.

While topical non-steroidal anti-inflammatory drugs are considered safe, their long-term efficacy for osteoarthritis has been suspect. We conducted a 12-week, double-blind, double-dummy, randomized controlled trial of topical diclofenac (TDiclo) in a vehicle solution containing dimethyl sulfoxide (DMSO) in 775 subjects with radiologically confirmed, symptomatic primary osteoarthritis of the knee. This 5-arm study compared TDiclo with a placebo solution, the DMSO vehicle, oral diclofenac (ODiclo) and the combination of TDiclo+ODiclo for relieving the signs and symptoms of knee osteoarthritis. Subjects applied study solution, 40 drops four times daily, and took one study tablet daily for 12 weeks. Co-primary efficacy variables were WOMAC pain and physical function and a patient overall health assessment. Secondary variables were WOMAC stiffness and patient global assessment (PGA) of the knee osteoarthritis. TDiclo was superior to placebo for pain (-6.0 vs. -4.7, P=0.015), physical function (-15.8 vs. -12.3, P=0.034), overall health (-0.95 vs. -0.37, P

Objective To determine the effect of equine chorionic gonadotropin (eCG) and controlled internal drug releasing (CIDR) on estrus response, ovulation and pregnancy rate in Nili–Ravi buffaloes under field condition. Methods Twenty anestrous buffaloes with more than 150 days postpartum were used in this study. To confirm anestrous condition, ovarian status and serum progesterone concentration were determined before the start of study. Buffaloes were randomly divided into eCG (n=10) and CIDR (n=10) groups. eCG group were treated with eCG (Chronogest 1000 I.U. i.m.), while CIDR group received CIDR devices for 7 days. All buffaloes in CIDR group were injected PGF2 α (0.25 ug/mL; 2 mL; i.m.) one day before CIDR removal. Buffaloes were observed for estrus visually and were inseminated with frozen-thawed semen at detected estrus. Ovulation was confirmed by presence of CL 12 day post AI. Pregnancy diagnosis was done 50 days post AI. Results Estrus response, ovulation rate and pregnancy rate were similar (P>0.05) among eCG and CIDR groups (90% vs. 80%; 78% vs. 75% and 50% vs. 60% respectively). Conclusion It is concluded that both CIDR and eCG protocols are effective and promising remedies for the anestrous buffaloes under commercial as well as under field conditions.

This study was aimed to investigate the influence of trehalose on osmotic tolerance and the ability of ram spermatozoon to undergo acrosome reaction induced by lysophosphatidylcholine (LPC). In experiment 1, the diluted ejaculates were exposed to anisosmotic fructose solutions (70, 500, 750 and 1000 mOsm l(-1) ) with or without 50 mm trehalose. The presence of trehalose in hyperosmotic conditions enhanced (P < 0.05) the percentage of live, live-intact and intact spermatozoa. Similarly, trehalose enhanced (P < 0.05) the live and live-intact spermatozoa during hypo-osmotic conditions. In experiment 2, the centrifuged ejaculates were diluted with TCG only or TCG containing either 50 or 100 mm trehalose. The acrosome reaction was induced by LPC. The percentage of acrosome-reacted spermatozoon was less (P < 0.05) in trehalose-supplemented groups compared to control. In experiment 3, the ejaculates were cryopreserved in an extender containing 0 mm (control), 50 mm or 100 mm trehalose. Supplementation of extender with trehalose, either 50 mm or 100 mm, enhanced the cryosurvival rate (P < 0.05) compared to the control. In conclusion, the presence of trehalose in anisosmotic conditions enhances the osmotic tolerance, cryosurvival rate of ram spermatozoon and suppresses their ability to undergo LPC and cryo-induced acrosome reaction.

In this study, two different semen cryopreservation protocols were compared to freeze goat semen. The ejaculates (n=12) were collected by using electro-ejaculator from six mature bucks (two ejaculates per each buck). Each ejaculate was divided into two groups as Protocol 1 (P1) and Protocol 2 (P2). In P1, semen was diluted directly in an extender containing 15% egg yolk, 300mM Tris, 28mM glucose, 95mM citric acid 5% glycerol to a concentration of 200×10(6)sperm/mL. In P2, after the removal of seminal plasma by centrifugation, the semen sample was diluted with the first portion of milk extender consist of 100mg/mL skimmed milk powder and 27.75mM glucose (without glycerol) to a concentration of 400×10(6)sperm/mL. The second portion of the milk extender containing 14% glycerol was added to semen gradually in order to achieve sperm concentration 200×10(6)sperm/mL and 7% glycerol level in the final volume. Extended semen was loaded in 0.25mL straws, held for 2h at 4°C, frozen in nitrogen vapor and stored in liquid nitrogen. Post-thaw motility and live sperm rate (mean±SEM) were significantly lower (P0.05) in P1 as compared to P2 (47.50±1.23% vs. 55.63±1.72%; 80.04±1.29% vs. 84.04±1.08%, respectively). However, live intact, total intact, abnormal, reacted acrosome and DNA damaged sperm rates were similar (P0.05) in both protocols. It was concluded that both protocols used in this study provided reasonable post-thaw parameters; however, P2 yielded better motility and live sperm rate compared to P1.

To assess the long-term safety of a topical solution of diclofenac sodium in a vehicle containing dimethyl sulfoxide (TDiclo), subjects with radiologically confirmed, symptomatic osteoarthritis of the knee(s) applied the clinical dose of TDiclo (40 drops, four times daily) to each painful knee for up to 52 weeks. Safety assessment included adverse events, skin irritation scores of the treated knee(s), ocular examinations, and routine laboratory tests. There were 793 subjects (mean age, 62.5 years) who applied TDiclo to one or both (72%) knees for an average of 204 days, including 463 subjects for 6 months and 144 for 1 year. The most frequent adverse events were at the application site with no increase in incidence with prolonged exposure: dry skin (25.3%), contact dermatitis without vesicles (13.0%) or with vesicles (9.5%). Skin irritation score was 0 (normal) in 61.0% of subjects, 0.5 (dryness or flaking) in 23.9%, 1 or 2 (erythema without or with induration) in 6.9%, and 3 or 4 (erythema with induration and vesicles/bullae) in 8.2%. Subject dropouts included 114 (14.4%) with an application site skin adverse event. Individual subject laboratory test shift to abnormal occurred for hemoglobin (3.2%), aspartate aminotransferase (6.4%), alanine aminotransferase (7.3%), and creatinine (4.2%), but few shifts (less than 0.3% per variable) were clinically significant. No increased risk of cardiovascular or cataract events was noted. This long-term study of TDiclo revealed a safety profile comparable to that shown in multiple, shorter, well-controlled, double-blind trials with the predominant adverse effect noted being an application site reaction.

Purpose. This paper reports on a study that was conducted to address the perceived occupational performance changes among school-aged children who received occupational therapy services for fine motor difficulties. It also addressed teacher awareness and the degree of implementation of occupational therapy recommendations by teachers. Methods. The study sample included 91 school-aged children referred for occupational therapy services for fine motor difficulties. The children were assessed, before and after intervention. Outcome measures used were the Canadian Occupational Performance Measure (COPM) and the Teacher Awareness Scale (TAS). Results. Significant change scores in both scales of the COPM were (Performance = 1.50, p < 0.001; Satisfaction = 1.92, p < 0.001). Regression analyses showed that lower teacher ratings of the students' performance and satisfaction of performance on the initial COPM resulted in significantly greater COPM change scores in the students' performance and satisfaction of performance at reassessment. The greater the degree of implementation of occupational therapy strategies by the teacher, the greater the COPM performance and satisfaction change scores. The greater the degree of teacher awareness of students' special needs resulted in greater COPM performance change scores. Practice Implications. Teachers may benefit from more education regarding fine motor difficulties in children and how the implementation of occupational therapy strategies are helpful to improve children's fine motor difficulties.