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Reproductiveperformance is crucialforprofitabilityofdual-purpose cow-calfproduction in the Ecuadorian Amazon. To evaluate three different fixed-time artificial insemination (FTAI) protocols in suckled, dual-purpose cows in the Ecuadorian Amazon. Lactating, Brown Swiss cows (n=301) received 2 mg estradiol benzoate (EB) and an intravaginal device containing 0.5 g of progesterone (P4) on Day 0. They were allocated randomly into the following three treatment groups: Cows in the EB group received 500 μg cloprostenol (PGF2α), and P4 devices were removed on Day 7, and 1 mg EB was administered on Day 8. Cows in the ECP group were treated as those in the EB group, except that they received 0.5 mg estradiol cypionate (ECP) at the time of P4 device removal on Day 7 instead of EB on Day 8. Cows in the J-Synch group had the P4 device removed and PGF2α administered on Day 6. All cows were FTAI on Day 9; cows in the J-Synch group also received 100 µg gonadorelin at that time. Although the diameter of the dominant follicle and the resulting CL were greater (P<0.05) in cows in the J-Synch group, pregnancies per AI did not differ (P>0.2) among groups (EB: 51.0%, ECP: 53.0% and J-Synch: 59.4%). The three protocols tested were applied successfully in suckled, dual-purpose cows with no differences in pregnancies per AI. [ABSTRACT FROM AUTHOR]

The effect of gas-entrapping polydimethylsiloxane (PDMS) microstructures on the dynamics of cavitation bubbles laser-induced next to the PDMS surface is investigated and compared against the cavitation dynamics next to a flat smooth boundary. Local pressure gradients produced by a cavitation bubble cause the air pockets entrapped in the PDMS microstructures to expand and oscillate, leading to a repulsion of the cavitation bubble. The microstructures were fabricated as boxed crevices via a simple and scalable laser ablation technique on cast acrylic, allowing for testing of variable structure sizes and reusable molds. The bubble dynamics were observed using high speed photography and the surrounding flows were visualized and quantified using particle tracking velocimetry. Smaller entrapped air pockets showed an enhanced ability to withstand deactivation at three stand-off distances and over 50 subsequent cavitation events. This investigation provides insight into the potential to direct the collapse of a cavitation bubble away from a surface to mitigate erosion or to enhance microfluidic mixing in low Reynolds number flows. [ABSTRACT FROM AUTHOR]

By using digital video microscopy, we study the three-dimensional displacement of fluorescent colloidal particles that are located close to a water-air interface. Our technique takes advantage of the diffraction pattern generated by fluorescent spheres that are found below the focal plane of the microscope objective. By means of image analysis software, we are able to determine the spatial location of a few beads in a sequence of digital images, which allows us to reconstruct their trajectories. From their corresponding mean square displacements, we get the diffusion coefficients in the directions parallel and perpendicular to the interface. We find a qualitatively different kind of diffusion between the two directions, in agreement with theoretical predictions that are obtained from established models as well as our own proposals. Quite interesting, we observe the enhanced Brownian motion in the parallel direction. [ABSTRACT FROM AUTHOR]

Hierarchical structures were fabricated on brass surfaces by means of a straightforward 2-step laser-scribing process. We tested the ability of these surface structures to withstand cavitation erosion and compared their performance to untreated brass samples. We found that hierarchical surface structures reduced the eroded volume by a factor between 7.2 and 22.7 times when compared to untreated samples after 800,000 cavitation events. Additionally, the hierarchical surface structures reduced the erosion by a factor between 1.1 and 1.5 times when compared to samples patterned with only microchannel surface structures, for the same amount of cavitation events. Up to 800,000 laser-induced cavitation bubbles were generated at a fixed standoff distance of 0.5 to test the mitigation effect of the scribed surface structures on the eroded volume. The eroded volume was computed by means of confocal microscopy. The results show that additional roughness imposed by the hierarchical surface structure acts as an energy dissipator as observed by comparing the sizes of the higher order rebound cavitation bubbles. These findings provide a promising solution for protecting equipment from cavitation erosion. • Facile femtosecond laser hierarchical surface structuring. • Hierarchical surface structuring enhances mitigation of erosion caused by cavitation. • Structurally driven energy dissipation plays a key role in erosion mitigation. • Gaining insight for the design against erosion in dynamic cavitation systems. [ABSTRACT FROM AUTHOR]

Background: The increase in body temperature in febrile states caused by diseases, prolonged trapping or stress affects the seminal quality. The objective was to evaluate how the spermogram of individuals affected by a systemic bacterial infection and its recovery after antibiotic therapy was modified. Methods: The case was presented in two Blackbelly sheep, belonging to the flock of the Center for Research, Postgraduate and Conservation of Amazonian Biodiversity. Semen is extracted weekly using the artificial vagina technique. In March 2018 it was observed that the two males presented different pathologies. On the same day that the symptoms were detected in the two rams, the treatment was implemented, without performing the etiological identification of the pathogens. After the treatment was started, serial semen extractions were performed for two months, once a week, two jumps in the morning between 9:00 and 11:00 am, with a difference of 10 to 15 minutes each. A total of 16 samples of each ro-ro were obtained. Results: The pH of the ejaculates of both rams ranged from 7.3 before treatment and in their recovery, to 6.1 at the most critical time of infection. In the volume of the ejaculates, it was observed that there were differences 1.15 ± 0.19 ml and 1.00 ± 0.15 ml respectively (p=0.001). The concentration of the ejaculate was 3000 (500-6000) x106 / ml and 2200 (800-6000) x106 / ml. Both rams showed the same behavior with respect to color, mass motility, individual and progressive, which were affected from the second extraction until the tenth, from which they slowly began to recover their normal values. Conclusions: In the two clinical cases presented, the greatest impact on seminal quality was observed in the first 7 to 8 samples, all the analyzed parameters being affected, coinciding with the duration of the spermatogenesis cycle. [ABSTRACT FROM AUTHOR]

Fixed- time artificial insemination (IATF, in Spanish) in beef cattle has provided the use of genetically superior bulls in order to maximize the quality of calves. However, implementing this reproductive technique has proved to be difficult to apply in heifers nursing calves for several months of lactancy. An immediate solution to fertility decline of cattle includes the use of hormones. Some hormonal treatments have been developed which are able to control the moment of the first artificial insemination (IA) and the following inseminations in non- pregnant heifers as well as for the treatment of anestrus. The objective of this work was to evaluate two protocols with prolonged proestrus performing artificial insemination at fixed time at 60 or 72 hours in dual purpose cattle from the Ecuadorian Amazon. The study was held from October 2015 to October 2016. A total of 226 multiparious Brows Swiss cattle with nursing calves were inseminated at 60 (T1, n=115) and at 72 (T2, n=111) hours after removing the progesterone device., The conception rate for T1 was 61% (70/115) and for T2: 47% of pregnancy (52/111), showing significant differences (p≤0.05). The estrus was expressed on average by 70.8%, with no significant difference between the protocols (P = 3.15, p≥0.082), for T1 it was 76% (87/115) and for T2 of 65%. The follicular growth at the withdrawal of the progesterone device (T1: 9.53 ± 0.11 mm, T2: 9.87 ± 0.12 mm), the IATF (T1: 12.3 ± 0.12 mm; T2: 11.9 ± 0.12 mm), and the corpus luteum size (T1: 23.1 0.14±mm; T2:22.8 0.15 ±mm) did not show significant differences p≥0.5 between both protocols. It was concluded that both protocols did not show significant differences regarding follicular development at the time of withdrawal of the IATF device and the size of the corpus luteum size measured at day seven after withdrawal. However, the pregnancy rate was higher for the 60-hour protocol. [ABSTRACT FROM AUTHOR]

The article discusses the study regarding the effect of religious diversity on social cooperation between Christians and Muslims in Ghana. Topics discussed include the adoption of sustainable development goals (SDGs) by the international community, the different measures of altruism and trustworthiness among members of different religious affiliations, and the impact of priming on altruism, trustworthiness, and trust.

In this paper we study the effects of the κ-deformed sum, defined as x...y = x√1 + κ²y² + y√1 + κ²x², on the Euclidean distance function d(P, F1) + d(P, F2) = 2a, where P is an arbitrary point in R² ; F1 and F2 are the focus of the curve named Ellipse. The points satisfying the resulting equality d(P, F1)... d(P, F2) = 2a, describe a curve named κ-deformed ellipse for which the resulting analityc expression is analogue to the standard one. We make a deep study of the vertex, local extrema, asymptotes, the latus rectum and the graph of the resulting κ-deformed conic sections: Ellipse, hyperbola, circumference and parábola in the κ-deformed setting. We also make a study of the area of the regions limited by the κ-deformed ellipse and hyperbola for an arbitrary value of κ. [ABSTRACT FROM AUTHOR]

The main purpose of this article is to share the results from a research just finished. Such research aimed, through a comparative analysis of regional technological coefficient matrices (regional and nation-wide), to evaluate advantages and identify those productive branches with potential to become development drivers. The comparative analysis of technological structures was done by using input-output tables (20 x 20 sectors) for 2003. Starting from the inverse matrix of the Bío-Bío Region, multiplier and indexes are calculated, under the approach of supply and demand. Initially, production multiplier, uniform demand expansion and, finally, to create indexes on dispersion power and dispersion sensibility; both concepts allow to quantify the nature of sector linkages in both senses, forward and backward. Later on, activities are characterised as key, strategic, driver and island sectors. The output is shown as a set of tables that are aimed to give a vision of inter-sector linkages of main activities in regional economy. [ABSTRACT FROM AUTHOR]

Background: While immediate benefits of levodopa–carbidopa intestinal gel (LCIG) are evident in patients with Parkinson's disease (PD), long-term LCIG effects require further study. Objectives: We explored long-term LCIG on motor symptoms, nonmotor symptoms (NMS), and LCIG treatment settings in patients with advanced PD (APD). Methods: Data were obtained (medical records and patient visit) from COSMOS, a multinational, retrospective, cross-sectional post-marketing observational study in patients with APD. Patients were stratified into 5 groups based on LCIG treatment duration at the patient visit, from 1–2 to > 5 years LCIG. Between-group differences were assessed for changes from baseline in LCIG settings, motor symptoms, NMS, add-on medications, and safety. Results: Out of 387 patients, the number of patients per LCIG group was: > 1– ≤ 2 years LCIG (n = 156); > 2– ≤ 3 years LCIG (n = 80); > 3– ≤ 4 years LCIG (n = 61); > 4– ≤ 5 years LCIG (n = 30); > 5 years LCIG (n = 60). Baseline values were similar; data reported are changes from the baseline. There were reductions in "off" time, dyskinesia duration, and severity across LCIG groups. Prevalence, severity, and frequency of many individual motor symptoms and some NMS were reduced amongst all LCIG groups, with few differences between groups. Doses for LCIG, LEDD and LEDD for add-on medications were similar across groups both at LCIG initiation and patient visit. Adverse events were similar across all LCIG groups and consistent with the established safety profile of LCIG. Conclusions: LCIG may provide sustained, long-term symptom control, while potentially avoiding increases in add-on medication dosages. Trial registration: ClinicalTrials.gov Identifier: NCT03362879. Number and date: P16-831, November 30, 2017. [ABSTRACT FROM AUTHOR]

Background: Caring for a partner or family member with Parkinson's disease (PD) negatively affects the caregiver's own physical and emotional well-being, especially those caring for people with advanced PD (APD). This study was designed to examine the impact of APD on caregiver perceived burden, quality of life (QoL), and health status. Methods: Dyads of people with PD and their primary caregivers were identified from the Adelphi Parkinson's Disease Specific Program (DSP™) using real-world data from the United States, Japan and five European countries. Questionnaires were used to capture measures of clinical burden (people with PD) and caregiver burden (caregivers). Results: Data from 721 patient-caregiver dyads in seven countries were captured. Caregivers had a mean age 62.6 years, 71.6% were female, and 70.4% were a spouse. Caregivers for people with APD had a greater perceived burden, were more likely to take medication and had lower caregiver treatment satisfaction than those caring for people with early or intermediate PD; similar findings were observed for caregivers of people with intermediate versus early PD. Caregivers for people with intermediate PD were also less likely to be employed than those with early PD (25.3% vs 42.4%) and spent more time caring (6.6 vs 3.2 h/day). Conclusions: This real-world study demonstrates that caregivers of people with APD experience a greater burden than those caring for people with early PD. This highlights the importance of including caregiver-centric measures in future studies, and emphasizes the need for implementing treatments that reduce caregiver burden in APD. Trial registration: N/A. [ABSTRACT FROM AUTHOR]

Background: In advanced Parkinson's disease (PD), dyskinesias and non-motor symptoms such as sleep dysfunction can significantly impair quality of life, and high-quality management is an unmet need. Objective: To analyze changes in dyskinesia and non-motor symptoms (including sleep) among studies with levodopa-carbidopa intestinal gel (LCIG) in patients with advanced PD. Methods: A comprehensive literature review identified relevant studies examining LCIG efficacy. Outcomes of interest were dyskinesia (UDysRS, UPDRS IV item 32), overall non-motor symptoms (NMSS), mentation/behavior/mood (UPDRS I), and sleep/daytime sleepiness (PDSS-2, ESS). The pooled mean (95% confidence interval) change from baseline per outcome was estimated for each 3-month interval with sufficient data (i.e., reported by≥3 studies) up to 24 months using a random-effects model. Results: Seventeen open-label studies evaluating 1243 patients with advanced PD were included. All outcomes of interest with sufficient data for meta-analysis showed statistically significant improvement within 6 months of starting LCIG. There were statistically significant improvements in dyskinesia duration as measured by UPDRS IV item 32 at 6 months (–1.10 [–1.69, –0.51] h/day) and 12 months (–1.35 [–2.07, –0.62] h/day). There were statistically and clinically significant improvements in non-motor symptoms as measured by NMSS scores at 3 months (–28.71 [–40.26, –17.15] points). Significant reduction of NMSS burden was maintained through 24 months (–17.61 [–21.52, –13.70] points). UPDRS I scores significantly improved at 3 months (–0.39 [–0.55, –0.22] points). Clinically significant improvements in PDSS-2 and ESS scores were observed at 6 and 12 months in individual studies. Conclusion: Patients with advanced PD receiving LCIG showed significant sustained improvements in the burden of dyskinesia and non-motor symptoms up to 24 months after initiation. [ABSTRACT FROM AUTHOR]

Introduction: Research comparing levodopa/carbidopa intestinal gel (LCIG), deep brain stimulation (DBS), and continuous subcutaneous apomorphine infusion (CSAI) for advanced Parkinson's disease (PD) is lacking. This network meta-analysis (NMA) assessed the comparative effectiveness of LCIG, DBS, CSAI and best medical therapy (BMT) in reducing off-time and improving quality of life (QoL) in patients with advanced PD.Methods: A systematic literature review was conducted for randomized controlled trials (RCTs), observational and interventional studies from January 2003 to September 2019. Data extracted at baseline and 6 months were off-time, as reported by diary or Unified Parkinson's Disease Rating Scale Part IV item 39, and QoL, as reported by Parkinson's Disease Questionnaire (PDQ-39/PDQ-8). Bayesian NMA was performed to estimate pooled treatment effect sizes and to rank treatments in order of effectiveness.Results: A total of 22 studies fulfilled the inclusion criteria (n = 2063 patients): four RCTs, and 16 single-armed, one 2-armed and one 3-armed prospective studies. Baseline mean age was between 55.5-70.9 years, duration of PD was 9.1-15.3 years, off-time ranged from 5.4 to 8.7 h/day in 9 studies, and PDQ scores ranged from 28.8 to 67.0 in 19 studies. Levodopa/carbidopa intestinal gel and DBS demonstrated significantly greater improvement in off-time and QoL at 6 months compared with CSAI and BMT (p < 0.05). There was no significant difference in the effects of LCIG and DBS, but DBS was ranked first for reduction in off-time, and LCIG was ranked first for improvement in QoL.Conclusions: This NMA found that LCIG and DBS were associated with superior improvement in off-time and PD-related QoL compared with CSAI and BMT at 6 months after treatment initiation. This comparative effectiveness research may assist providers, patients, and caregivers in the selection of the optimal device-aided therapy. [ABSTRACT FROM AUTHOR]

Introduction: Patients with advanced Parkinson's disease (APD) commonly experience motor and nonmotor symptoms (NMS) associated with functional limitations and decreased quality of life. We compared motor and nonmotor outcomes in patients with APD receiving 24- versus 16-h levodopa-carbidopa intestinal gel (LCIG).Methods: Data from COSMOS, a large, real-world, retrospective and cross-sectional, observational study on LCIG and comedication in APD were obtained from medical records and a single patient visit for patients receiving 24- and 16-h LCIG infusion. Changes from baseline were evaluated for motor symptoms, NMS, and clinical characteristics. Safety was also assessed.Results: Data for 401 patients were included in this subanalysis. At the patient visit there were 35 patients on 24-h LCIG and 366 on 16-h LCIG. "Off" time and dyskinesia (duration and severity) were reduced in both groups. In both LCIG treatment groups, prevalence of most symptoms was reduced. There were significant differences in the change from baseline in severity and frequency of freezing of gait with 24-h LCIG versus 16-h LCIG (p = 0.011 and p = 0.038), severity of urinary symptoms (p = 0.006), and frequency of cognitive impairment (p = 0.014) with 24-h LCIG versus 16-h LCIG. Adverse events were similar for both treatment groups and considered tolerable.Conclusions: LCIG 24-h infusion may be a useful treatment option, when clinically justified, for select patients with APD.Clinical Trial Number: NCT03362879. [ABSTRACT FROM AUTHOR]

Objectives: In the absence of widely accepted criteria, determining when a patient with Parkinson's disease (PD) may benefit from more advanced treatments such as device‐aided therapy (DAT) so far remains a matter of physician judgment. This analysis investigates how classification of PD varies across countries relative to measures of disease severity. Materials and Methods: The OBSERVational, cross‐sEctional PD (OBSERVE‐PD) study included consecutive patients with PD at centers that offer DATs in 18 countries. In this subgroup analysis, we explore intercountry differences in identification of advanced versus non‐advanced PD based on physician's clinical judgment, symptoms assessed using Delphi consensus criteria, use of DAT, motor and non‐motor symptoms, and caregiver support. Demographic and clinical characteristics were obtained through review of medical records. Results: Overall, 1342 of 2615 patients (51.3%) were assessed by physicians as having advanced PD. The proportion of patients in different countries identified as having advanced PD (24.4–82.2%) varied. In 15 of 18 countries, a greater proportion of patients with advanced PD, according to select Delphi criteria, were identified by physicians as having advanced PD than with non‐advanced PD. There was a wide variability across countries in the proportion of patients with no dyskinesia, disabling dyskinesia, dyskinesia pain, and non‐motor symptoms who were identified by physicians as having advanced versus non‐advanced PD. Conclusions: The proportion of patients identified with advanced PD symptoms varies widely across countries, despite differences on the patients' profiles, indicating a need for objective diagnostic criteria to help identify patients who may benefit from DAT. [ABSTRACT FROM AUTHOR]

Introduction: Standardized and validated criteria to define advanced Parkinson's disease (PD) or identify patient eligibility for device-aided therapy are needed. This study assessed the psychometric properties of clinical indicators of advanced PD and eligibility for device-aided therapy in a large population. Methods: This retrospective analysis of the Adelphi Parkinson's Disease Specific Programme collected data from device-aided therapy-naïve people with PD in G7 countries. We assessed the presence of 15 clinical indicators of advancing PD and seven indicators of eligibility for device-aided therapy in patients classified with advanced PD or as eligible for device-aided therapy by the treating physician. Accuracy was assessed using area under the curve (AUC) and multivariable logistic regression models. Construct validity was examined via known-group comparisons of disease severity and burden among patients with and without each clinical indicator. Results: Of 4714 PD patients, 14.9% were classified with advanced PD and 17.5% as eligible for device-aided therapy by physician judgment. The presence of each clinical indicator was 1.9- to 7.3-fold more likely in patients classified with advanced PD. Similarly, the presence of device-aided therapy eligibility indicators was 1.8- to 5.5-fold more likely in patients considered eligible for device-aided therapy. All indicators demonstrated high clinical screening accuracy for identifying advanced PD (AUC range 0.84–0.89) and patients eligible for device-aided therapy (AUC range 0.73–0.80). The Unified Parkinson's Disease Rating Scale (UPDRS) score, cognitive function, quality of life, and caregiver burden were significantly worse in indicator-positive patients. Conclusion: Specific clinical indicators of advanced PD and eligibility for device-aided therapy demonstrated excellent psychometric properties in a large sample, and thus may provide an objective and reliable approach for patient identification and treatment optimization. Plain Language Summary: Advanced Parkinson's disease (PD) refers to the stage of disease when motor complications are difficult to manage with standard therapy. Patients reaching this stage of the disease may benefit from a treatment change from pills to the so-called device-aided therapies. However, there is currently no unanimous definition of advanced PD, which makes it challenging to identify suitable candidates for device-aided therapies. There is urgent need to define specific features (or 'clinical indicators') to support healthcare professionals and patients in the identification of advanced PD as well as to define suitability for device-aided therapy. This study aimed to assess the accuracy of 15 clinical indicators and seven device-aided therapy eligibility criteria using information from a large database of 4714 patients in G7 countries. Physicians classified 14.9% of patients as having advanced PD and 17.5% were judged to be eligible for device-aided therapy. Each clinical indicator or device-aided therapy eligibility indicator was detected more frequently in patients classified as having advanced PD and in patients considered eligible for device-aided therapy, respectively. All indicators had high accuracy for identifying advanced PD and device-aided therapy-eligibility. These previously identified clinical indicators of advanced PD and device-aided therapy eligibility may provide an objective and reliable approach for patient screening and treatment optimization. [ABSTRACT FROM AUTHOR]

Introduction: Making Informed Decisions to Aid Timely Management of Parkinson's Disease (MANAGE-PD) is a clinician-reported tool designed to facilitate timely identification and management of patients with advancing Parkinson's disease (PD) with suboptimal symptom control while on standard therapy. The objective of this study was to evaluate the validity and clinical value of the tool.Methods: Driven by structured inputs from a steering committee and panel of PD experts, the tool was developed to classify patients into 3 categories. Validity and clinical value were elucidated using a two-pronged approach: (i) hypothetical patient vignettes (n = 10) developed based on the MANAGE-PD tool and rated by 17 PD specialists and 400 general neurologists (GN) and (ii) patients with PD (n = 2546) managed in real-world clinical settings. Vignette validity was based on concordance between PD experts' clinical judgement and MANAGE-PD vignette categorization. Patient-level data was used for known-group comparisons (validity) and discordant pair analysis (clinical value).Results: The tool demonstrated strong validity and clinical value among PD specialists (intraclass coefficient [ICC] 0.843; Fleiss weighted kappa [ƙweighted] 0.79) and GN (ICC 0.690; ƙweighted 0.65) using patient vignettes. MANAGE-PD also demonstrated real-world validity and clinical value based on ability to identify patients with incrementally higher clinical, economic, and humanistic PD burden across categories of the tool (p < 0.01).Conclusions: MANAGE-PD demonstrated robust validity and clinical value in identifying patients with suboptimal PD symptom control. Clinical use of MANAGE-PD may complement treatment decision-making and facilitate timely and comprehensive management of patients with advancing PD. [ABSTRACT FROM AUTHOR]

In this paper, mechanical behavior of TiAlV/TiAlVN bilayers was studied by means of nanoindentation experiment simulated using ANSYS software. In the simulations, a Vickers type diamond tip, a steel substrate and TiAlV/TiAlVN bilayers distributed in a constant thickness of 2 µm by an axisymmetric geometry were considered. The parameters used in the simulation as Young's modulus E, Poisson ratio ? and yield stress σe for TiAlV and TiAlVN were 113.6 GPa and 350 GPa, 0.342 and 0.2, and 830 MPa and 870 MPa respectively. Results showed the radial stress distribution seems to be tooth -like and the maximum shear stress decreased as the number of bilayers increased. [ABSTRACT FROM AUTHOR]

Background: Levodopa‐carbidopa intestinal gel (LCIG) is administered directly to the small intestine of patients with advanced Parkinson's disease (APD) to help maintain stable plasma levodopa levels. Objective: The objective of this study was to investigate the effect of LCIG in reducing polypharmacy for the treatment of APD. Methods: The COmedication Study assessing Mono‐ and cOmbination therapy with levodopa‐carbidopa inteStinal gel (COSMOS) is a large, real‐world, multinational observational study investigating comedication use with LCIG. All enrolled patients had used LCIG for ≥12 months and data were collected cross‐sectionally (study visit) and retrospectively. The primary endpoint was the percentage of patients using LCIG as monotherapy (without add‐on PD medications) at initiation and at 3, 6, 9, and 12 months thereafter. Results: Overall, 409 patients were enrolled from 14 countries and were treated with LCIG for a mean of 35.8 ± 23.2 months. A total of 15.2% of patients initiated LCIG as monotherapy and 31.7% were receiving monotherapy at 12 months after initiation. The mean duration of LCIG monotherapy was 39.3 ± 25.6 months. Use of add‐on medications decreased over time with all LCIG regimens. From LCIG initiation to the patient visit, mean off time decreased by 3.8, 4.6, and 3.9 hours/day for LCIG monotherapy, LCIG daytime monotherapy, and LCIG polytherapy groups, respectively, while duration of dyskinesia decreased by 1.7, 2.0, and 1.9 hours/day, respectively. Adverse events likely related to study treatment occurred in 112 patients (27.4%) during LCIG treatment. Conclusions: LCIG is an effective long‐term monotherapy option with a positive risk–benefit profile and contributes to reduced polypharmacy for patients with APD. © 2021 The AbbVie Inc. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society [ABSTRACT FROM AUTHOR]

Device-aided therapy may improve the quality of life (QoL) for people with advanced Parkinson's disease (PD) and poorly controlled symptoms with oral therapy. MANAGE-PD is a validated tool classifying patients based on symptom control and advanced treatment eligibility. This study focused on patient/caregiver reported outcomes and healthcare resource utilization among patients grouped by MANAGE-PD categories. Device-aided therapy-naïve patients receiving oral treatments were identified from the Adelphi Parkinson's Disease Programme. Patients were categorized (category 1 to 3) using MANAGE-PD. PD-specific QoL (PDQ-39), care partner burden (ZBI), satisfaction with current treatment, healthcare resource utilization, associated healthcare costs, and future treatment discussion with providers were measured. Categories were compared using ANOVA, t -test, chi square and adjusted regression analyses. Of the analytical sample (n = 2709), 18.9% were inadequately controlled on current therapy and potentially eligible for device-aided therapies (category 3). As expected, they had worse patient/caregiver reported outcomes versus patients in categories 1 or 2. However, the degree of difference in healthcare resource utilization, including: greater number of hospitalizations, emergency room (ER) visits and consultations, higher likelihood of being recipients of respite care, and greater PD treatment burden, was unexpected. Importantly, of patients in category 3 and their care partners, >40% did not report discussions with providers about device-aided therapies. MANAGE-PD category 3 patients had significantly higher burden on healthcare resources versus patients well-controlled with oral treatment or requiring only oral medication adjustments; yet almost half had no discussion on device-aided therapies with providers. Device-aided therapies may be considered in these patients. • Device-aided therapy can improve symptom control and QoL in patients with advanced PD. • The MANAGE-PD tool can help identify eligibility for device-aided therapy. • Healthcare resource utilization is high in patients eligible for device-aided therapy. • Many providers do not discuss device-aided therapy with eligible patients/caregivers. [ABSTRACT FROM AUTHOR]

To review binocular and accommodative disorders documented after corneal or intraocular refractive surgery, in normal healthy prepresbyopic patients. A bibliographic revision was performed; it included works published before 1st July 2017 where accommodation and/or binocularity was assessed following any type of refractive surgical procedure. The search in Pubmed yielded 1273 papers, 95 of which fulfilled the inclusion criteria. Few publications reporting binocular vision and/or accommodative changes after refractive surgery in normal subjects were found. The reduction in fusional vergence is the most frequently reported alteration. Anisometropia is an important risk factor for postoperative binocular vision‐related complaints. Most diplopia‐related visual complaints, irrespective of the surgical procedure, were in fact misdiagnosed preoperative disorders. The preoperative evaluation of patients seeking spectacle/contact lens independence should include a complete binocular and accommodation assessment where parameters such as the phoric posture, accommodative amplitude and facility, near point of convergence, fusional reserves and accommodative convergence/accommodation coefficient are measured. This would allow the identification of risk factors that could compromise the success of the refractive surgery and cause clinical symptoms. [ABSTRACT FROM AUTHOR]

Background: Levodopa-carbidopa intestinal gel (LCIG) is effective in the treatment of advanced Parkinson's disease (PD). However, the patients' profile that might benefit from treatment with LCIG has not been characterized. Objective: This retrospective study explored the influence of disease duration (DD) on the effectiveness of LCIG and identified factors associated with treatment discontinuation in a cohort of advanced PD patients. Methods: Patients initiating LCIG therapy between Jan-2006 and Dec-2011 in 18 Spanish centers were included. Effectiveness in treating motor symptoms (MSs), non-motor symptoms (NMSs), and adverse events (AEs) occurrence was compared in DD≥10 or <10 years and LCIG continuation/discontinuation groups. Factors associated with LCIG discontinuation were evaluated using univariate and multivariate analyses. Results: Overall, 177 PD patients were included (52.5% male; mean age 70.6±8.4 years; mean LCIG duration 35.6±18.6 months). Patients with DD≥10 years (n = 125) experienced less reduction in "off" time (–29%) than those with DD <10 years (–38%; n = 51; p = 0.021), and reported more severe AEs (32.8% vs. 17.6%; p = 0.043). DD did not significantly influence changes in NMSs or discontinuation rates. Fifty-four patients discontinued LCIG therapy, factors associated with discontinuation were higher percentages of waking day in the "off" state (OR, 1.028; 95% CI, 1.002–1.055; p = 0.0360) and in the "on" state with troublesome dyskinesia (OR, 1.032; 95% CI, 1.002–1.064; p = 0.0376) at baseline. Conclusions: Advanced PD patients with DD <10 years might benefit more from treatment with LCIG than patients with a longer DD. Although MSs severity at baseline was statistically associated with LCIG discontinuation, the probability was very low with little clinical significance. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this paper was to examine the distribution of macular, retinal nerve fiber layer (RNFL) thickness and optic disc parameters of myopic and hyperopic eyes in comparison with emmetropic control eyes and to investigate their variation according to axial length (AL) and spherical equivalent (SE) in healthy children. Methods: This study included 293 pairs of eyes of 293 children (145 boys and 148 girls), ranging in age from 6 to 17 years. Subjects were divided according to SE in control (emmetropia, 99 children), myopia (100 children) and hyperopia (94 children) groups and according to axial AL in 68 short (22.00mm, 68), medium (from 22.00mm to 25.00mm, 189) and long eyes (25.00mm, 36). Macular parameters, RNFL thickness and optic disc morphology were assessed by the CirrusTM HD-OCT. AL was measured using the IOL-Master system. Littmann's formula was used for calculating the corrected AL-related ocular magnification. Results: Mean age (SD) was 10.843.05 years; mean (SD) SE was 0.140.51 D (range from 8.75 to 8.25 D) and mean AL (SD) was 23.121.49. Average RNFL thickness, average macular thickness and macular volume decreased as AL and myopia increased. No correlations between AL/SE and optic disc parameters were found after correcting for magnification effect. Conclusions: AL and refractive error affect measurements of macular and RNFL thickness in healthy children. To make a correct interpretation of OCT measurements, ocular magnification effect should be taken into account by clinicians or OCT manufacturers. [ABSTRACT FROM AUTHOR]

The aim of the COmedication Study assessing Mono- and cOmbination therapy with levodopa-carbidopa inteStinal gel (COSMOS) was to assess the use of levodopa/carbidopa intestinal gel (LCIG) as monotherapy in patients with advanced Parkinson's disease (APD) in routine clinical practice. COSMOS was an international observational study with one cross-sectional visit and retrospective data collection. In Romania, 95 adult patients with APD on LCIG treatment for at least 12 months were enrolled and stratified according to their LCIG therapy after 12 months: monotherapy (without any add-on PD medication), monotherapy with night PD medication and LCIG + add-on medication. Compared to the moment of LCIG initiation, the percentage of patients on monotherapy increased at three months after LCIG initiation and remained constant up to 12 months, when 30.5% of the patients were on LCIG monotherapy and 11.6% were on monotherapy with night medication. "Off" time and "On" time with dyskinesia decreased from LCIG initiation to patient visit in all groups. LCIG monotherapy with or without night medication may provide a simplified treatment option for selected APD patients, with long-term efficacy similar to that of LCIG plus add-on medication. [ABSTRACT FROM AUTHOR]

Background: To assess age-related differences in cardiovascular risk factors, clinical course and management of patients with acute myocardial infarction (AMI) in intensive care (ICU) or coronary care units (CCU). Methods: A retrospective cohort study was conducted of all AMI patients listed in the ARIAM register (Analysis of Delay in AMI), a multi-centre register in which 119 Spanish hospitals participated. The study period was from January 1995 to January 2001. A univariate analysis was carried out to evaluate differences between different age groups. Multivariate analysis was used to assess whether age difference was an independent predisposing factor for mortality and for differences in patient management. Results: 17,761 patients were admitted to the ICUs/CCUs with a diagnosis of AMI. The distribution by ages was: <55 years, 3954 patients (22.3%); 55–64 years, 3593 (22.2%); 65–74 years, 5924 (33.4%); 75–84 years, 3686 (20.8%); and >84 years, 604 (3.4%) (P<0.0001); 24.6% of the patients were female, and the relative proportion of females increased with age. There were clear differences in risk factors between the different age groups, with a predominance of tobacco, cholesterol and family history of heart disease in the younger patients. The incidence of complications, including haemorrhagic complications, increased significantly with age. The older age groups had a lower rate of thrombolysis and less use of revascularisation techniques. The mortality of the above groups was 2.6, 5.4, 10.7, 17.7 and 25.8%, respectively. Age difference was an independent predictive variable for mortality and the administration of thrombolysis. Conclusions: The distinct age groups differed in cardiovascular risk factors, management and mortality. Age is a significant independent predictive variable for mortality and for the administration of thrombolysis. [Copyright &y& Elsevier]

• Positive correlations between Ψ MD with NDVI (R2 = 0.61) and WI (R2 = 0.61) were found. • Stomatal conductance was positively related to NDVI (R2 = 0.58) and WI (R2 = 0.69). • NDVI and WI were significantly sensitive to water stressed plants. • Mild water deficit maintained or improved blueberry yield and quality. Remote sensing based on visible and near infrared (VIS/NIR) reflectance is being recognized as a promising option to estimate water status in crops. In this research, we explored the relationship between the midday leaf water potential (Ψ MD) and stomatal conductance (g s) with the normalized difference vegetation index (NDVI) and the water index (WI) in leaves of blueberry shrubs subjected to two irrigation treatments based on crop evapotranspiration (ETc): mild water deficit (60% of ETc) and full-irrigation (100% of ETc). Moreover, the impact of the irrigation doses on photosynthesis as well as on fruit yield and quality was assessed. Noteworthy, we detected positive correlations between Ψ MD with NDVI (R2 = 0.61**; P < 0.01) and WI (R2 = 0.60**, P < 0.01). Besides, g s was positively related to NDVI (R2 = 0.58**, P < 0.01) and WI (R2 = 0.69**, P < 0.01). Nonetheless, both indices appear to be more sensitive to water stressed plants. Despite mild water deficit decreased photosynthetic performance, fruit yield and quality were maintained or improved. Our results revealed that the spectral indices studied here could be used as non-destructive predictors of plant water stress in blueberry orchards. Further studies are needed to confirm our outcomes. [ABSTRACT FROM AUTHOR]

Background: There are currently no standard diagnostic criteria for characterizing advanced Parkinson's disease (APD) in clinical practice, a critical component in determining ongoing clinical care and therapeutic strategies, including transitioning to device-aided treatment. The goal of this analysis was to determine the proportion of APD vs. non-advanced PD (non-APD) patients attending specialist PD clinics and to demonstrate the clinical burden of APD.Methods: OBSERVE-PD, a cross-sectional, international, observational study, was conducted with 2615 PD patients at 128 movement disorder centers in 18 countries. Motor and non-motor symptoms, activities of daily living, and quality-of-life end points were assessed. The correlation between physician's global assessment of advanced PD and the advanced PD criteria from a consensus of an international group of experts (Delphi criteria for APD) were evaluated.Results: According to physician's judgment, 51% of patients were considered to have APD. There was a moderate correlation between physician's judgment and Delphi criteria for APD (K = 0.430; 95% CI 0.406-0.473). Activities of daily living, motor symptom severity, dyskinesia duration/disability, "Off" time duration, non-motor symptoms, and quality-of-life scores were worse among APD vs. non-APD patients (p < 0.0001 for all). APD patients (assessed by physicians) had higher disease burden by motor and non-motor symptoms compared with non-APD patients and a negative impact on activities of daily living and quality of life.Conclusions: These findings aid in identifying standard APD classification parameters for use in practicing physicians. Improvements in identification of APD patients may be particularly relevant for optimizing treatment strategies including transitioning to device-aided treatment. [ABSTRACT FROM AUTHOR]