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Obesity is a pandemic condition, absolutely out of control. Food assistance is among the main proposals for the management of the disease. Thus, the aim of this study was to evaluate the potential of aqueous pomegranate extract in a model of obesity, glucose intolerance and hepatic steatosis induced by high-fat diet. The pomegranate extract was obtained from the association of green extraction techniques. Through the crude extract containing punicalagin and ellagic acid (main compounds), extracts with isolated fractions of these compounds were obtained. For the experimental study, Swiss mice were subjected to the obesity induction period for eight weeks. After, were treated for another 30 days with crude extract of 250 mg/kg (group HF+[1]EXT); punicalagin extract isolated 8.35 mg/kg (HF+Punica group); isolated extract of ellagic acid 0.208 mg/kg (group HF+EA), via gavage. Both the crude extract and its subfractions reduced the body weight gain for the HF+Punica group (1.1 g); HF+EA (0.92 g) compared to HF, while the HF+EXT showed significant weight loss (P

The objective was to evaluate the supplementation of fat-soluble and water-soluble vitamins on the performance and plasma concentrations of vitamins in modern hybrids pigs. A total of 144 commercial hybrid castrated male, 43.531 ± 1.099kg, were used in a randomized block design with six treatments, eight replicates and three animals per pen. The experimental treatments were different vitamin supplementation levels - 0, 25, 50, 75, 100, and 125% of the recommended by Rostagno et al. (2011) for male pigs in growth I (40 to 50kg), growth II (50 to 70kg), and finishing I (70 to 90kg) phases. For growth phases I and II, a linear effect (P

Pressurized techniques are straightforward for high-scale applications and highly controllable, which seems an excellent strategy for recovering unstable natural compounds. In this work, the main advance was the development of a platform based on the pressurized liquid extraction coupled in-line with a solid-phase extraction step (PLE-SPE) combined with the use of eutectic mixtures as solvents to promote an efficient extraction and purification of natural pigments from food wastes. Eutectic mixtures, conventionally known as (deep) eutectic solvents – (D)ES, are combinations of two or more substances with a lower melting point than any of their components. (D)ES are often referred as “green solvents” because they can potentially be more environmentally friendly than other solvents, especially volatile organic solvents (VOSs). Overall, (D)ES have the potential to contribute to the achievement of several of the SDGs (especially 3, 13, and 14) through their positive impacts on health, environment, and sustainable production and consumption practices. Thus, in this work, (D)ES were used as solvents to valorize Brazilian berry waste (Plinia cauliflora). Anthocyanins are the biomass's main compounds of commercial interest, mainly for food and cosmetic applications. However, there are several technological issues regarding color control due to their high sensitivity to light, heat, oxygen, and pH variations. Thus, the data achieved in this work highlighted the high efficiency and low environmental footprint of the PLE-SPE-(D)ES platform developed. The success of the downstream process here developed was proved by the high extraction efficiency and the purity level of the anthocyanins obtained. Besides, thermal stability analysis was evaluated, demonstrating that (D)ES are not only solvents but also stabilizing agents, improving the shelf-life of the extracted colorants. published

A utilização da água da chuva para uso não-potável é uma das formas de evitar a redução da disponibilidade de água potável e seu reuso ou aproveitamento pode ser utilizado em diversos serviços rotineiros, como irrigações, lavagens de carros, varandas, dentre outros. Visando a preservação de recursos hídricos e economia no custo total das tarifas de água potável, o presente artigo, baseado em parâmetros técnicos e legais tem como objetivo apresentar o dimensionamento e detalhamento da implantação de um sistema para a captação e reuso de águas pluviais em uma residência unifamiliar, localizada em Guaçuí/ES que apresenta uma área de 150,36m² de cobertura e com jardins e circulação com 156,30m², que ocupa grande parte da área total do terreno, sendo a área de captação de água pluvial formada de telhas de cerâmica e fibrocimento. O reservatório foi dimensionado em 5000l de água, atendendo a demanda mensal e suprindo o tempo de estiagem. A implantação do sistema se torna economicamente viável, com retorno em 7,5 anos, podendo esse tempo ser reduzido de acordo com a sua utilização.

Citrus fruits (CF) are highly consumed worldwide, fresh, processed, or prepared as juices and pies. To illustrate the high economic importance of CF, the global production of these commodities in 2021 was around 98 million tons. CF's composition is considered an excellent source of phenolic compounds (PC) as they have a large amount and variety. Since ancient times, PC has been highlighted to promote several benefits related to oxidative stress disorders, such as chronic diseases and cancer. Recent studies suggest that consuming citrus fruits can prevent some of these diseases. However, due to the complexity of citrus matrices, extracting compounds of interest from these types of samples, and identifying and quantifying them effectively, is not a simple task. In this context, several extractive and analytical proposals have been used. This review discusses current research involving CF, focusing mainly on PC extraction and analysis methods, regarding advantages and disadvantages from the perspective of Green Chemistry.

Skin is usually the first and most affected organ involved in graft-versus-host disease (GvHD), and treatment is still a clinical challenge. Although the need for skin-directed treatments such as physical treatments and topical medications are generally agreed on, what the gold standard treatment strategy should be remains open to debate. The aim of this scoping review was to synthesize the current knowledge on the topical and physical treatments of cutaneous GvHD in haematopoietic stem cell transplantation patients and to highlight the best evidence available so as to reduce the gap between 'what is known' and 'what is done' in the clinical practice. Twenty-eight studies were included in this qualitative synthesis. Photo-biomodulation with psoralen was not included in this review. Phototherapy (ultraviolet A or B or narrowband B) was the physical treatment most described in the literature in both acute GvHD and chronic GvHD. Topical calcineurin inhibitors such as tacrolimus ointment and pimecrolimus cream as well as corticosteroid creams such as clobetasol and triamcinolone are mainly used in case of chronic GvHD. In all of the studies included in the review, topical treatments were always associated with systemic therapy. None of the topical interventions identified in our review provided strong evidence supporting its use, and the topical approaches seemed to have an adjuvant role in the treatment of cutaneous GvHD.

Evidence-Based Practice (EBP) is an approach that has emerged in medical practice. In 2000, Sackett et al. stated the most common definition of the EBP approach: "the integration of the best research evidence with clinical expertise and patient values". Over time, many elements have been added and discussed by various authors to this initial definition (cost and duration of the intervention, therapist skills, regional resources provided for health, cultural influences, …). With evolution of the EBP approach, and these successive additions, we wish to propose a new definition of the EBP in order to bring it a more contemporary and complete face. For that reason, the different objectives of this article are : - to explain why making such a proposal : a new extended definition - to propose a new extended definition - to explain our semantic choices - to propose (and explain) an updated graphic model for the extended definition

Se presentan en este artículo los hallazgos obtenidos mediante la aplicación de técnicas de clustering provistas por la minería de texto sobre un corpus de posteos de las cuentas que los diarios argentinos Clarín y La Nación poseen en Facebook: @clarincom y @lanacion. Se trata de un acercamiento que, a modo de ensayo, pone a prueba la riqueza de los métodos computacionales para acompañar combinadamente el estudio sociosemiótico de las publicaciones que los periódicos realizaron en sus respectivas fanpages entre los años 2010 y 2017. El análisis planteado se efectuó sobre un conjunto de posteos clasificados como «Otros» en la variable género periodístico, la cual discrimina si el contenido al que el posteo reenvía es una noticia, un reportaje, una nota de opinión, etc. Se pretende, así, identificar la existencia, al interior de dicho conjunto, de agrupamientos de publicaciones con características comunes —ya sean éstas derivadas de regularidades temáticas, retóricas, enunciativas o de otra índole— no detectadas, previamente, durante la observación convencional. Todo ello en el marco de una investigación mayor, de tipo interdisciplinaria, orientada a producir conocimiento sobre la manera en que los medios indagados enuncian en la plataforma de Facebook y el tipo peculiar de vínculo que le proponen, allí, a sus usuarios-lectores-seguidores. Los resultados así obtenidos no sólo han permitido avanzar en la caracterización de posibles nuevas clases de textos, propias de la performance del discurso de los medios en la plataforma estudiada —que, de ahora en más, podrían sumarse a los moldes de previsibilidad social ya reconocidos—, sino además, identificar una falla en el diseño de los instrumentos creados, a priori, para la pesquisa en cuestión. This paper presents the findings obtained through the application of clustering techniques provided by text mining on a corpus of posts from the accounts that the Argentine newspapers Clarín and La Nación have on Facebook: @clarincom and @lanacion. It is an approach that, by way of trial, test the wealth of computational methods to accompany in combination the socio-semiotic study of the publications that the newspapers made in their respective fanpages between 2010 and 2017. The proposed analysis was carried out on a set of posts classified as “Others” in the journalistic genre variable, which discriminates if the content to which the post forwards is news, a report, an opinion note, etc. Thus, it is intended to identify the existence, within said set, of groupings of publications with common characteristics —whether these are derived from thematic, rhetorical, enunciative or other regularities— not previously detected during conventional observation. All this within the framework of a larger, interdisciplinary investigation, aimed at producing knowledge about the way in which the investigated media enunciate on the Facebook platform and the peculiar type of link that they propose, there, to their users-readers-followers. The results thus obtained have not only made it possible to advance in the characterization of possible new classes of texts, typical of the performance of the media discourse in the studied platform —which, from now on, could be added to the already recognized social predictability molds— but also to identify a flaw in the design of the instruments created, a priori, for the research in question. Fil: Raimondo Anselmino, Natalia. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina. Universidad Abierta Interamericana; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina Fil: Rostagno, José Francisco. Universidad Tecnológica Nacional. Facultad Regional Rosario; Argentina Fil: Cardoso, Ana Laura. Universidad Tecnológica Nacional. Facultad Regional Rosario; Argentina

Propolis is a bee product with a complex chemical composition formed by several species from different geographical origins. The complex propolis composition requires an accurate and reproducible characterization of samples to standardize the quality of the material sold to consumers. This work developed an Ultra-high-performance liquid chromatography with a photodiode array detector method to analyze propolis phenolic compounds based on the two key propolis biomarkers, Artepillin C and p-Coumaric acid. This choice was made due to the complexity of the sample with the presence of several compounds. The optimized method was hyphenated with mass spectrometry detection allowing the detection of 23 different compounds. A step-by-step strategy was used to optimize temperature, flow rate, mobile phase composition, and re-equilibration time. Reverse-phase separation was achieved with a C18 fused-core column packed with the commercially available smallest particles (1.3 nm). Using a fused-core column with ultra-high-performance liquid chromatography allows highly efficient, sensitive, accurate, and reproducible determination of compounds extracted from propolis with an outstanding sample throughput and resolution. Optimized conditions permitted the separation of the compounds in 5.50 min with a total analysis time (sample-to-sample) of 6.50 min. This article is protected by copyright. All rights reserved.

INTRODUCCIÓN: el síndrome eutiroideo enfermo (SEE) es la principal anomalía endocrinológica enenfermos críticos. La presencia y gravedad del SEE se asocia a peor evolución clínica.OBJETIVO: conocer la prevalencia del SEE en niños críticamente enfermos y su correlación con lagravedad y resultado clínico de la enfermedad.MATERIALYMÉTODO: estudio prospectivo, observacional y analítico en niños críticamente enfermosinternados en terapia intensiva entre mayo de 2019 y mayo de 2020. Se definió al SEE como la alteracióntiroidea en enfermos críticos sin patología hipotálamo-hipófiso-tiroidea preexistente. Las variablesanalizadas fueron: edad, sexo, duración de internación, decesos, requerimiento de ventilación mecánica einotrópicos, diagnóstico al ingreso, PIM3. Para variables cualitativas se utilizó test de Chi cuadrado, paravariables cuantitativas, test de Wilcoxon.RESULTADOS: de 47 pacientes estudiados, 28 (60%) presentaron SEE. No hubo diferencias respecto asexo (p>0,999), decesos (p>0,999) ni uso de inotrópicos (p=0,1564). Hubo asociación significativa entreSEE y más días de internación (p= 0.0390) y mayor requerimiento de ventilación mecánica invasiva (p=0.0261) y entre valores bajos de hormonas tiroideas y mayor coeficiente y probabilidad de mortalidad delPIM3 (p

Purpose: This study analyzes changes in the epidemiology of fractures during the SARS-CoV-2 era. Its aim was to better understand the workload of the orthopedic department, as well as the management of healthcare professionals, in this situation, with a view to ensuring optimal resource allocation in the event of any future epidemic emergency. Methods: Admissions to the orthopedic emergency room for trauma care were analyzed with reference to the period January 2019 to April 2020. The rate of hospitalized patients (group A) and the rate of patients discharged pending delayed surgery (group B) were recorded. Furthermore, distribution of the various fracture types, and of different trauma dynamics, was also evaluated. Results: The data show a reduction in the number of total admissions (from an average of 70.92/day to 21.15/day during the COVID period). In the pre-COVID era, patients requiring hospitalization accounted for 7.01% of all admissions; this rate increased to 12.47% in March 2020 and 15.67% in April 2020. No increase was found in the rate of patients assigned to delayed surgery: 1.31% in the pre COVID-era, 1.11% in March 2020, and 0.70% in April 2020. The frequency of proximal femoral fractures remained stable (53.71/month in the pre-COVID era, 47.5/month in the COVID era), while high-energy fractures decreased during the outbreak. Conclusion: During epidemics such as the SARS-CoV-2 outbreak, trauma services must be guaranteed in order to treat fractures and orthopedic emergencies, while elective procedures should be discontinued to preserve resources and allow conversion of professionals in order to meet ICU needs. The epidemiology of fractures can change, but orthopedists must still ensure high quality of care and, at the same time, protect themselves and their patients from the risk of viral infection.

Three experiments were carried out to verify the effects of the enzyme phytase, alone or combined with an enzyme complex, in diets deficient in available phosphorus (AP), calcium (Ca), and metabolizable energy (ME) on broiler performance, ME, and dietary amino acid digestibility. A total of 1,538 male Cobb 500 broilers were allocated to the three experiments, each of which consisted of five treatments: positive control (PC; basal ration); negative control 1 (NC1; PC minus 0.15% of AP, 0.16% of Ca, and 68 kcal kg-1 ME); negative control 2 (NC2; PC minus 0.15% of AP, 0.16% of Ca, and 101 kcal kg-1 of ME); NC1 plus phytase; and NC2 plus phytase plus enzymatic complex. Body weight gain (WG) and feed intake were measured from 1-21 days and from 1-42 days, and the corrected feed conversion rate (FCR) for mortality was calculated. In the second and third experiments, the apparent ME corrected for nitrogen balance (AMEn) and standardized digestibility of amino acids, respectively, were determined, for the diets supplemented with phytase and the enzymatic complex. In the first experiment, enzyme supplementation increased (p < 0.05) WG at 21 days and 42 days relative to the negative controls. Phytase inclusion improved (p < 0.05) FCR at the initial phase compared to the NC1 diet. In the second experiment, enzyme supplementation did not affect (p > 0.05) AMEn. In the third experiment, both enzyme treatments improved (p < 0.05) the digestibility of amino acids in the supplemented diets compared to the deficient diets. Supplementation with phytase and carbohydrases preserves the performance of broilers fed diets deficient in AP, Ca, and ME and improves amino acid digestibility. Três experimentos foram conduzidos para determinar o efeito da enzima fitase, sozinha ou associada a um complexo enzimático, em dietas de milho-farelo de soja deficientes em fósforo disponível (Pd), cálcio (Ca) e energia metabolizável (EM) no desempenho de frangos de corte, valores de EM e digestibilidade de aminoácidos da dieta. Para ambos os experimentos, 1.538 frangos Cobb 500 machos foram alocados em 5 tratamentos: controle positivo (CP, ração basal), controle negativo 1 (CN1, CP menos 0,15% de Pd, 0,16% Ca e 68 kcal kg-1 EM), negativo controle 2 (CN2, CP menos 0,15% de Pd, 0,16% de Ca e 101 kcal kg-1 de ME em relação à dieta CP), CN1 mais fitase (CN1 + F) e CN2 mais fitase mais complexo multienzimático (CN2 + F + E). O ganho de peso corporal e o consumo de ração foram medidos de 1 a 21 dias e de 1 a 42 dias, e a taxa de conversão alimentar (CA) corrigida para mortalidade foi calculada. No segundo e terceiro experimentos, foram analisados os valores de energia metabolizável aparente corrigida para o balanço de nitrogênio (EMAn) e digestibilidade estandardizada de aminoácidos, respectivamente, em adição à fitase e ao complexo enzimático. No primeiro experimento, a suplementação enzimática aumentou (P < 0,05) o ganho de peso (GP) aos 21 dias e 42 dias em relação aos controles negativos. A inclusão de fitase melhorou (P < 0,05) a taxa de conversão alimentar na fase inicial, em comparação com a dieta CN1. No segundo experimento, a suplementação enzimática não afetou (P > 0,05) os valores de EMAn. No terceiro experimento, ambos os tratamentos enzimáticos melhoraram (P < 0,05) a digestibilidade dos aminoácidos nas dietas experimentais, em comparação com as dietas deficientes. A suplementação de fitase e carboidrases preserva o desempenho de frangos alimentados com dietas deficientes em Pd, Ca e EM e melhora a digestibilidade dos aminoácidos.

Background: Italy was one of the first European Countries to deal with the Coronavirus Disease 2019 (COVID-19) outbreak, since its appearance in China. The virus spread from northern regions to central and southern ones with different intensity. Drastic emergency restrictions were introduced including quarantine and self-isolation measures. Initially, these were limited to Northern Italy then extended nationwide. The Italian Health System is organized on a regional basis with different funding, resources, institutional pathways. Health Care Professionals (HCPs) working in clinically demanding areas such as Emergency Departments and Intensive Care Units are at high risk of developing physical/mental health outcomes related to Coronavirus pandemic, such as stress, anxiety, depression, sleep disorders and burn-out symptoms (Luo et al., 2020). Nurses in Hematopoietic Stem Cell Transplant (HSCT) Units are caring for "complex" immune-compromised patients, being hospitalized for long period without seeing relatives. However, it is not known if nurses working in HSCT settings experience similar problems during the pandemic. The aim of the study was to investigate physical and psychological issues among nurses working in Italian HSCT Units during COVID-19 spread. Methods: A cross-sectional study was conducted between June and August 2020 through an online questionnaire sent to nurses working in Italian HSCT centers registered with GITMO (Gruppo Italiano per il Trapianto Midollo Osseo). Data were collected immediately after the lockdown period (during phase 2, consisting of a progressive reduction of lockdown measures) in order to:-investigate the prevalence of sleep disorders and burnout symptoms with validated tools: Pittsburgh Sleep Quality Index (PSQI) and Maslach Burnout Inventory (MBI), respectively.-explore significant correlations with other variables such as geographical areas (Northern Italy-NIT vs Central Sothern Italy-CSIT) according with COVID-19 incidence, its spread. Statistical analysis was performed using the Matrix Laboratory (MATLAB) Statistical toolbox version 2008 (MathWorks, Natick, MA, USA). Results: Three hundred and eight nurses working in 61 Italian HSCT Units responded to the survey: 214 nurses from NIT and 94 nurses from CSIT. Nurses responding from CSIT were older (mean 47, p = 0.0001) and male (74.5%, p < 0.0001). More nurses from NIT did not have children compared to those from CIST (49.5% vs 30.9%, p = 0.0023). Symptoms like stress, anxiety and depression were more frequently reported by CSIT than NIT nurses (NIT 27.7% vs 12.6%, p = 0.0013). MBI results: NIT and CSIT nurses reported low level of emotional exhaustion (median score: 14.0 vs 12.0 respectively) and depersonalization (3.0 vs 4.0);medium level of personal accomplishment (36.0 vs 34.5) were reported without significant differences between groups. Worst sleep quality was detected on nurse working in CSIT centers than NIT (global PSQI score 7.6 vs 6.5;p = 0.008) with the main differences in sleep duration (p = 0.006), sleep disturbance (p = 0.03), need of medication (p < 0.001). Conclusions: Despite cited differences on disease incidence and spread of infection, COVID-19 pandemic did not appear to have an impact on nurses' sleep quality or symptoms of burnout. Greater sleep disorders of nurses working in CSIT centers suggests that other factors influencing this issue.

Converting the chemical and biologically resistant structure of cellulosic biomass into useful products is a technological and economic challenge. The use of sustainable and efficient conversion technology sustainably has been gaining prominence. This work aimed to evaluate the integration of subcritical water hydrolysis (SWH) and enzymatic hydrolysis of sugarcane straw to obtain fermentable products and second-generation ethanol. SWH was conducted under semi-continuous conditions at 200 °C, 5 mL/min, and a 19-min retention time. Enzymatic hydrolysis using an enzyme blend produced simple sugars that were evaluated for fermentation using two strategies: (i) Saccharomyces cerevisiae SA-1; and (ii) co-culture of S. cerevisiae SA-1 and Scheffersomyces stipitis NRRLY-7124. Integrating subcritical water and enzymatic hydrolysis resulted in greater fermentable sugar yield (2.40 ± 0.01 g/L of xylose and 8.9 ± 0.6 g/L of glucose) than subcritical pre-treatment on its own. The co-culture fermentation strategy was more efficient than fermentation by S. cerevisiae on its own, resulting in 2.8 ± 0.3 g/L of ethanol. Subcritical water hydrolysis pre-treatment disrupted the lignocellulosic matrix, leading to increased enzymatic accessibility of cellulose, with minimal formation of degradation compounds, and with minimal waste formation. Future work can optimize the hydrolysis process to increase the yield of simple sugars, increase fermentation efficiency by controlling oxygen concentration and removing acetic acid, and consequently increase the yields of second-generation ethanol.

Concentrated in the skins of red grapes are the anthocyanins, the primary colorants responsible for the fruits' reddish-purple color. These colorants are recognized for their significant antioxidant properties and potent nutraceutical and pharmaceutical ingredients. Nevertheless, their widespread use is compromised by the (i) need for more efficient yet sustainable downstream processes for their recovery and (ii) by the challenges imposed by their poor stability. In this work, these drawbacks were overcome by applying eutectic solvents and stabilizing agents. Besides, the anthocyanins were successfully loaded into a solid host material (approved in both food and pharmaceutical sectors) based on silicon dioxide (SiO2, loading capacity: 1extract:7silica m/m). Summing up, with the process developed, the extraction yield (21 mganthocyanins.gbiomass-1) and the stability (under 55, 75, and 95 °C) of the recovered anthocyanins were over three times better than with the conventional process. Finally, the raw materials and solvents were recycled, allowing an economical and environmentally friendly downstream process. published

A few years ago, the Ledesma sugar company (Argentina) started an investment process with the aim of increasing the milling capacity from 14,000 to 24,000 t/d (tonnes cane/day). The sugar plant began to install plate heat exchangers and plate evaporators as an alternative to the traditional tubular equipment. Information was collected on the installation, operation and maintenance parameters during more than 15 years, during both the harvesting and off-season. Some of the results obtained in comparison with tubular equipment and with data for plate equipment in the literature were: Heaters: heat transfer coefficients similar to those quoted in the literature for heating limed juice and 80% higher for clarified juice heating, shorter cleaning time (8–10 h reduced to 4 h), shorter maintenance times but higher costs in spare parts than expected; Evaporators: 15–30% higher heat transfer coefficients, 30–40% higher specific evaporation rates, shorter cleaning times (18–24 h reduced to 5 h), 20% less surface area per t/d, but higher cost of spare parts than expected.

Muscle mass is frequently reduced in older patients experiencing injurious falls and may further reduce during hospitalization for bone fracture. In these patients, renal function may be overestimated, because it is usually calculated using serum creatinine, which is strictly related to muscle mass. We evaluated if creatinine levels change during hospitalization in older patients with fracture. We also assessed the role of cystatin C as a more appropriate marker of renal function, comparing estimated glomerular filtration rate (eGFR) according to different formulas based on creatinine and/or cystatin C levels.Patients aged 65+ years, consecutively hospitalized for fracture, were enrolled in a prospective cohort study. Creatinine and cystatin C levels were measured at baseline and in the post-operative period; eGFR was calculated using six equations based on creatinine and/or cystatin C.425 patients were enrolled (mean age 84 years, mean creatinine 0.97 mg/dL, mean cystatin C 1.53 mg/L). Creatinine levels significantly decreased after surgery (p0.001), while cystatin C remained stable. According to creatinine-based formulas, eGFR was60 mL/min/1.73 mIn older fractured patients, creatinine levels decline during hospital stay and may possibly overestimate renal function, whereas cystatin C remains stable. Whether cystatin C is a more reliable marker of renal function in this specific population should be further investigated.

Acute cholecystitis in severely cardiopathic patients after major cardiac surgery represents a challenge for surgeons. Treatment with cholecystostomy, may offer a chance to these patients, however there is still a number of controversial issues on the topic: performance surgical techniques (transhepatic or transpapillary), optimal duration and timing of drain removal, the need for further tests before removal as well as the timing for definitive surgery. We therefore deemed it important to share our experience of a multidisciplinary approach for the definitive treatment of this patient with severe heart disease. A percutaneous cholecystostomy was the chosen strategy for a 58-year-old cardiopathic patient who had undergone surgery for hip replacement and had developed acute calculous cholecystitis a few days after surgery. Two weeks after discharge, a cholangiography through the cholecystostomy and an MRI cholangiopancreatography revealed the presence of stones in the cystic duct and in the ductus choledochus. The definitive treatment was decided after consulting with a multidisciplinary team. The choice was to perform an open cholecystectomy with simultaneous removal of the cholecystostomy, endoscopic removal of stones and sphincterotomy of the Oddi papilla. Currently, the patient is healthy and his heart function satisfactory. Although early cholecystectomy is the recommended choice for acute cholecystitis, a patient with severe co-morbidities may benefit from a bridging therapy before definitive surgery and a multidisciplinary approach can provide a safer solution.

Summary: Two experiments were carried out to determine the apparent metabolizable energy, nitrogen-corrected apparent metabolizable energy (AMEn), and the standardized ileal amino acid digestibility (SIAAD) and apparent ileal amino acid digestibility of corn distillers dried grains with solubles (corn-DDGS), without or with the singular supplementation of protease and phytase in broiler diets. One hundred sixty-eight male Cobb 500 broilers (experiment 1) were nutrient-properly fed to 13 D of age. At 14 D of age, broilers were fed one of four experimental diets (reference diet, reference diet + corn-DDGS, reference diet + corn-DDGS with 200 mg/kg of protease, or that with 100 mg/kg of phytase for 10 D). There was an effect (P 0.05) of the supplementation with protease and phytase on AMEn values. In experiment 2, one hundred sixty-eight male Cobb 500 broiler chickens were nutrient-adequately fed from 1 to 24 D of age. On D 24, broilers were allocated to 4 treatments (nitrogen-free diet [NFD], NFD + corn-DDGS, NFD with corn-DDGS with 200 mg/kg of protease, or that with 100 mg/kg of phytase for 5 D) in a completely randomized design. The SIAAD of all amino acids was increased (P

The objective of this study was to evaluate the effect of adding different xylanase and ?-glucanase enzyme blends to maize- and soybean meal-based diets on performance and energy metabolizability in broilers. Two experiments were carried out with broilers of the COBB 500 strain. In the first experiment, 1960 chicks were assigned to a completely randomized design with a 2 × 3 + 1 factorial arrangement, totaling seven treatments, namely, T1- Positive control (PC); T2 - Negative control 1 (NC1; PC minus 200 kcal kg-1 ME); T3 - NC1 + Blend A; T4 - NC1 + Blend B; T5 - Negative control 2 (NC2; PC minus 167 kcal kg-1 ME and 5% amino acids); T6 - NC2 + Blend A; and T7 - NC2 + Blend B. Fourteen replicates were used per treatment and 20 birds per experimental unit. The parameters evaluated at 21 and 42 days of age were weight gain (WG), feed intake (FI) and feed conversion (FC). At 42 days, production efficiency index (PEI), viability and the yields of cuts were also calculated. Birds that received diets with a reduced nutritional value showed a reduction in WG and PEI and worsened FC as compared those of PC treatment (p < 0.05). However, the birds that consumed the NC2 diet with Blend B exhibited a similar WG to those in PC group (p > 0.05) from 1 to 21 days of life. For the yield of thigh + drumstick, the factors were statistically similar (p > 0.05) to those observed in the PC birds. In the second experiment, 432 fourteen-day-old chicks were distributed in a completely randomized design with seven treatments, with eight replicates per treatment and six birds per experimental unit. The apparent metabolizable energy (AME) and nitrogen-corrected AME (AMEn) values were determined. Overall, the NC2 diet with Blend B provided the highest AME and AMEn values; however, NC1 with the same enzyme blend was the treatment which provided the lowest values. The addition of xylanase and ?-glucanase enzyme blends to maize- and soybean meal-based diets improves WG at 21 days as well as PEI in broilers; however, it does not influence the yield of cuts. Enzymes (Blend B) improve the energy metabolization of broiler diets with reduced energy and amino acid levels.

espanolEl objetivo del trabajo es evaluar la factibilidad tecnica y conveniencia economica de la instalacion de un biodigestor para la obtencion de biogas y biofertilizante como alternativa para el tratamiento de efluentes en un tambo de la cuenca lechera central santafesina, considerado como un caso de estudio. Se valora la contaminacion generada actualmente a partir de los efluentes, situacion sin proyecto, y se la compara con el beneficio proyectado a partir de las inversiones propuestas derivado del ahorro en compra de fertilizantes y de la generacion de biogas. El proyecto es tecnica, economica y financieramente factible para el caso analizado. El uso de biodigestores es una interesante alternativa para dar valor a los residuos organicos. EnglishThe objective of this paper is to evaluate the technical feasibility and economic convenience of a biodigester installation, to obtain biogas and biofertilizer as an alternative for the treatment of effl uents in a dairy farm in the central dairy basin of Santa Fe, considered as a case study. The pollution generated currently from the effl uents is assessed, a situation without a project, and comparedwith the projected benefi t from the proposed investments derived from the savings in the purchase of fertilizers and the generation of biogas. The project is technically, economically and fi nancially feasible for the case analysed. The use of biodigesters is an interesting alternative to give value to organic waste.

Background The prevalence of Takotsubo syndrome in hip fracture is not known. Methods Hip fracture patients were evaluated in a multidisciplinary unit. Patients with ECG abnormalities and increased troponin I values at the time of hospital admission were included in the study Follow-up was clinical at 30 days and by telephonic interview at one year. Results Between October 1st 2011 to September 30th 2016, 51 of 1506 patients had preoperative evidence of myocardial damage. Eight, all females, fulfilled the Mayo criteria for Takotsubo syndrome, six had no coronary lesions. Hip surgery was uneventful, and all eight were alive at thirty days, and seven of these were still alive after one year. Forty-three patients had myocardial infarction: mortality at thirty days and one year were 11% and 44% (p Conclusion At least 15% of patients with hip fracture and preoperative myocardial damage had Takotsubo syndrome. They were all elderly females. Contrary to myocardial infarction, Takotsubo syndrome has a favourable long term prognosis.

Aims The deposition of amyloid-β (Aβ) peptides in the form of extracellular plaques in the brain represents one of the classical hallmarks of Alzheimer's disease (AD). In addition to 'full-length' Aβ starting with aspartic acid (Asp-1), considerable amounts of various shorter, N-terminally truncated Aβ peptides have been identified by mass spectrometry in autopsy samples from individuals with AD. Methods Selectivity of several antibodies detecting full-length, total or N-terminally truncated Aβ species has been characterized with capillary isoelectric focusing assays using a set of synthetic Aβ peptides comprising different N-termini. We further assessed the N-terminal heterogeneity of extracellular and vascular Aβ peptide deposits in the human brain by performing immunohistochemical analyses using sporadic AD cases with antibodies targeting different N-terminal residues, including the biosimilar antibodies Bapineuzumab and Crenezumab. Results While antibodies selectively recognizing Aβ1- x showed a much weaker staining of extracellular plaques and tended to accentuate cerebrovascular amyloid deposits, antibodies detecting Aβ starting with phenylalanine at position 4 of the Aβ sequence showed abundant amyloid plaque immunoreactivity in the brain parenchyma. The biosimilar antibody Bapineuzumab recognized Aβ starting at Asp-1 and demonstrated abundant immunoreactivity in AD brains. Discussion In contrast to other studied Aβ1- x -specific antibodies, Bapineuzumab displayed stronger immunoreactivity on fixed tissue samples than with sodium dodecyl sulfate-denatured samples on Western blots. This suggests conformational preferences of this antibody. The diverse composition of plaques and vascular deposits stresses the importance of understanding the roles of various Aβ variants during disease development and progression in order to generate appropriate target-developed therapies.

Few information exist about incidence and prognostic significance of postoperative atrial fibrillation (POAF) in patients undergoing hip fracture surgery. In the period comprised between January 2012 and December 2016, we evaluated 3129 patients referred for hip fracture. At hospital admission 277 were in permanent atrial fibrillation and were excluded from the study. POAF was defined as symptomatic or asymptomatic AF of duration > 10 min occurring during hospitalization after hip surgery. In-hospital and 1-year outcomes of POAF patients were compared to that of an age- and sex-matched hip fracture control group. Survival rates were estimated by Kaplan–Meier curves and differences between groups compared by log-rank test. One hundred and four patients (mean age 83.7 years, men 27%) developed POAF (3.6%). Time of onset after surgery was on average 2 days after surgery. Eight POAF patients died during hospitalization. 81.7% were discharged in sinus rhythm. Patients with POAF had a longer time to surgery (3.8 ± 3.3 vs. 2.4 ± 1.6 days, p = 0.0007) and length of hospital stay (19.7 ± 10.4 vs. 14.4 ± 5.1 days p

Osteomyelitis is a relatively understudied disease with no standardized and evidence-based approach to treatment. We aimed to evaluate a cohort of patients with osteomyelitis, comparing the outcomes between intravenous (IV) and oral treatment.We performed an observational retrospective study on osteomyelitis cases in adult patients seen for care between 2017 and 2019. We collected information on patient characteristics, microbiological etiology, infection treatment, and outcome. In addition, we divided osteomyelitis cases by antibiotic regimens [oral (OTG) vs. intravenous±oral (ITG)] and therapy durations to evaluate outcomes differences.A total of 235 episodes of osteomyelitis were evaluated, with a higher prevalence in male gender. Staphylococci, especially S. aureus, were the most common strains. Out of the 235 evaluated episodes, we selected 142 cases. Of these, 75 were treated with OTG and 67 with ITG. Gram-positive bacteria were the most frequent aetiological agents, with 81 isolates (61.8%). Full recovery was observed in 79 (55.6%) cases; of these, 36 (53.7%) were in the ITG and 43 (57.3%) in the OTG (p = 0.666). At the logistic regression, a polymicrobial infection [OR 4.16 (95%CI 1.28-13.4), p = 0.017] and a less than six weeks treatment duration [OR 4.24 (95%CI 1.38-5.43) p = 0.004] were significantly associated with a higher risk of treatment failure.Our study suggests that oral treatment efficacy is comparable to ITG therapy for osteomyelitis, confirming the most recent evidence suggesting that oral therapy is non-inferior to intravenous therapy to treat osteomyelitis.

Proprioception is often impaired in poststroke individuals. This is a significant issue since altered proprioception is associated with poorer physical function outcomes poststroke. However, there is limited consensus on the best tools for assessing proprioception and support for their widespread use by clinicians. The objective is to appraise the psychometric properties of each test used to assess proprioception in poststroke individuals.A systematic search was performed according to PRISMA guidelines using the databases MEDLINE, Cochrane Library, PEDro, DiTa, and BioMedicalCentral for articles published up to January 2021.Sixteen studies of low methodological quality were included. Sixteen different proprioception assessment tests were extracted. The proprioception portion of the Fugl-Meyer Assessment Scale was found to be the most valid and reliable tool for screening patients in clinical settings. Although no real gold standard exists, the technological devices demonstrated better responsiveness and measurement accuracy than clinical tests. Technological devices might be more appropriate for assessing proprioception recovery or better suited for research purposes.This review revealed low-quality articles and a paucity of tests with good psychometric properties available to clinicians to properly screen and assess all subcomponents of proprioception. In perspective, technological devices, such as robotic orthoses or muscle vibration, may provide the best potential for assessing the different subcomponents of proprioception. Further studies should be conducted to develop and investigate such approaches.Video, Supplemental Digital Content 1, available at:http://links.lww.com/JNPT/A388.

Background The molecular heterogeneity of Alzheimer’s amyloid-β (Aβ) deposits extends well beyond the classic Aβ1-40/Aβ1-42 dichotomy, substantially expanded by multiple post-translational modifications that increase the proteome diversity. Numerous truncated fragments consistently populate the brain Aβ peptidome, and their homeostatic regulation and potential contribution to disease pathogenesis are largely unknown. Aβ4-x peptides have been reported as major components of plaque cores and the limited studies available indicate their relative abundance in Alzheimer’s disease (AD). Methods Immunohistochemistry was used to assess the topographic distribution of Aβ4-x species in well-characterized AD cases using custom-generated monoclonal antibody 18H6—specific for Aβ4-x species and blind for full-length Aβ1-40/Aβ1-42—in conjunction with thioflavin-S and antibodies recognizing Aβx-40 and Aβx-42 proteoforms. Circular dichroism, thioflavin-T binding, and electron microscopy evaluated the biophysical and aggregation/oligomerization properties of full-length and truncated synthetic homologues, whereas stereotaxic intracerebral injections of monomeric and oligomeric radiolabeled homologues in wild-type mice were used to evaluate their brain clearance characteristics. Results All types of amyloid deposits contained the probed Aβ epitopes, albeit expressed in different proportions. Aβ4-x species showed preferential localization within thioflavin-S-positive cerebral amyloid angiopathy and cored plaques, strongly suggesting poor clearance characteristics and consistent with the reduced solubility and enhanced oligomerization of their synthetic homologues. In vivo clearance studies demonstrated a fast brain efflux of N-terminally truncated and full-length monomeric forms whereas their oligomeric counterparts—particularly of Aβ4-40 and Aβ4-42—consistently exhibited enhanced brain retention. Conclusions The persistence of aggregation-prone Aβ4-x proteoforms likely contributes to the process of amyloid formation, self-perpetuating the amyloidogenic loop and exacerbating amyloid-mediated pathogenic pathways.

Affinity chromatography has, for many years, been at the research forefront as one of the simplest although highly versatile techniques capable of identifying biologically relevant protein-protein interactions. In the field of amyloid disorders, the use of ligands immobilized to a variety of affinity matrices was the method of choice to individualize proteins with affinity for soluble circulating forms of amyloid subunits. The methodology has also played an important role in the identification of proteins that interact with different amyloidogenic peptides and, as a result, are capable of modulating their physiological and pathological functions by altering solubility, aggregation propensity, and fibril formation proclivity. Along this line, classical studies conducted in the field of Alzheimer's disease (AD) identified clusterin as a major binding protein to both circulating soluble Aβ as well as to the brain deposited counterpart. The affinity chromatography-based approach employed herein, individualized clusterin as the major protein capable of binding the amyloid subunits associated with familial British and Danish dementias, two non-Aβ neurodegenerative conditions also exhibiting cerebral amyloid deposition and sharing striking similarities to AD. The data demonstrate that clusterin binding ability to amyloid molecules is not restricted to Aβ, suggesting a modulating effect on the aggregation/fibrillization propensity of the amyloidogenic peptides that is consistent with its known chaperone activity.

This study evaluated the subcritical water hydrolysis (SWH) of brewer's spent grains (BSG) to obtain sugars and amino acids. The experimental conditions investigated the hydrolysis of BSG in a single flow-through reactor and in two sequential reactors operated in semi-continuous mode. The hydrolysis experiments were carried out for 120 min at 15 MPa, 5 mL water min–1, at different temperatures (80 – 180 °C) and using an S/F of 20 and 10 g solvent g–1 BSG, for the single and two sequential reactors, respectively. The highest monosaccharide yields were obtained at 180 °C in a single reactor (47.76 mg g-1 carbohydrates). With these operational conditions, the hydrolysate presented xylose (0.477 mg mL-1) and arabinose (1.039 mg mL-1) as main sugars, while low contents of furfural (310.7 µg mL-1), 5-hydroxymethylfurfural (-1), and organic acids (0.343 mg mL-1) were obtained. The yield of proteins at 180 °C in a process with a single reactor was 43.62 mg amino acids g-1 proteins, where tryptophan (215.55 µg mL-1), aspartic acid (123.35 µg mL-1), valine (64.35 µg mL-1), lysine (16.55 µg mL-1), and glycine (16.1 µg mL-1) were the main amino acids recovered in the hydrolysate. In conclusion, SWH pretreatment is a promising technology to recover bio-based compounds from BSG; however, further studies are still needed to increase the yield of bioproducts from lignocellulosic biomass to explore two sequential reactors.

Resume L’echelle de qualite methodologique QUIPS sous forme d’une fiche synthetique est utile pour coter la validite interne d’etudes de facteurs pronostiques.

Car-cabin thermal systems, including heated seats, air-conditioning, and radiant panels, use a large proportion of the energy budget of electric vehicles and thus reduce their effective range. Optimising these systems and their controllers might be possible with computationally efficient simulation. Unfortunately, state-of-the-art simulators are either too slow or provide little resolution of the cabin’s thermal environment. In this work, we propose a novel approach to developing a fast simulation by machine learning (ML) from measurements within the car cabin over a number of trials within a climatic wind tunnel. A range of ML approaches are tried and compared. The best-performing ML approach is compared to more traditional 1D simulation in terms of accuracy and speed. The resulting simulation, based on Multivariate Linear Regression, is fast (5 microseconds per simulation second), and yields good accuracy (NRMSE 1.8%), which exceeds the performance of the traditional 1D simulator. Furthermore, the simulation is able to differentially simulate the thermal environment of the footwell versus the head and the driver position versus the front passenger seat, but unlike a traditional 1D model cannot support changes to the physical structure. This fast method for obtaining computationally efficient simulators of car cabins will accelerate adoption of techniques such as Deep Reinforcement Learning for climate control.

To date the optimal antiviral treatment against severe coronavirus disease 2019 (COVID-19) has not been proven; remdesivir is a promising drug with in vitro activity against several viruses, but in COVID-19 the clinical results are currently not definitive. In this retrospective observational study, we analyzed the clinical outcomes (survival analysis, efficacy, and safety) in a group of hospitalized patients with COVID-19 treated with remdesivir in comparison with a control group of patients treated with other antiviral or supportive therapies. We included 163 patients treated with remdesivir and 403 subjects in the control group; the baseline characteristics were similar in the two groups; the mortality rate was higher in the control group (24.8% vs. 2.4%, p 0.001), the risk of intensive care unit (ICU) admission was higher in the control group (17.8% vs. 9.8%, p = 0.008); hospitalization time was significantly lower in patients treated with remdesivir (9.5 vs. 12.5 days, p 0.001). The safety of remdesivir was good and no significant adverse events were reported. In multivariate analysis, the remdesivir treatment was independently associated with a 34% lower mortality rate (odds ratio = 0.669; p = 0.014). In this analysis, the treatment with remdesivir was associated with lower mortality, lower rate of ICU admission, and shorter time of hospitalization. No adverse events were observed. This promising antiviral treatment should also be confirmed by other studies.

This study aimed to extract anthocyanins from dried and semi-defatted açaí pulp using green technologies based on the coupling of pressurized liquid extraction (PLE) with in-line purification through solid-phase extraction (SPE) and on-line analysis by high-performance liquid chromatography (HPLC). Critical parameters that affect the extraction efficiency and purification were investigated and optimized by response surface methodology (RSM). PLE was performed with acidified water at different pH (2.0, 4.5, and 7.0) and temperatures (40, 80, and 120 °C) at 15 MPa, 2 mL/min, and solvent-to-feed mass ratio equal to 40. SPE was optimized in a column packed with the adsorbent PoraPak™ Rxn. Different ethanol concentrations (50, 75, and 100 %) and temperatures (30, 40, and 50 °C) were evaluated for the anthocyanin's elution. The optimal conditions of the two experimental designs were determined by the RSM, firstly for PLE: 71 °C and pH 2; then using this PLE condition, the optimization of the SPE was obtained: 30 °C and 50 % ethanol. The developed PLE method provided similar anthocyanin yield to other techniques, and the coupling with SPE in-line produced an extract 5-fold more concentrated than PLE alone. Therefore, the system (PLE-SPE × HPLC-PDA) proved to be a powerful tool for monitoring the extraction process in real-time.