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Low frequency rTMS of the prefrontal cortex have been shown to have a statistically and clinically significant antidepressant effect. The present pilot study was carried out to investigate if right prefrontal low frequency rTMS as an add-on to ECT accelerates the antidepressant effect and reduces cognitive side effects.
In this randomized, controlled, double blind study thirty-five patients with major depression were allocated to ECT+placebo or ECT+ low frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the Major Depression Inventory. Furthermore, neuropsychological assessment of cognitive function was carried out.
The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short lived and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.
The addition of low frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low frequency rTMS could inhibit the antidepressant effect of ECT.
The genera Ophiophragmus and Amphiodia are amphiurids that are considered taxonomically difficult due to their great resemblance, few diagnostic characters and synonymy problems. Our aim is to redescribe the species using scanning electron microscopy and morphometry of diagnostic structures, and to provide new information for the identification of these Ophiuroidea. Five Amphiodia spp. and six Ophiophragmus spp. recorded in Brazil were rigorously redescribed. The descriptions include new diagnostic characters derived from external morphology, arm microstructures and morphometry. We also provided comparative analyses of species with shared characters such as Amphiodia riisei and Amphiodia trychna. The geographic and bathymetric distributions of the studied species were updated, and new records are provided. All the information presented may be used in taxonomic, ecological and phylogenetic studies, helping to fill gaps in the knowledge of the biodiversity, ecology and evolution of these Ophiuroidea. Conclusively, all the tools applied here assisted in the identification of genera and species and could be useful in other taxonomic studies of Echinodermata.
The aim of this study was to evaluate the differences in the metabolic profile and body composition of monozygotic (MZ) twins concordant and discordant for the practice of physical exercise. The sample consisted of 92 MZ twins (72.5% female and 27.5% male, mean age 25.4 ± 5.69 years), registered with the Brazilian Registry of Twins, residing in Natal, Brazil. Data collection was carried out between the years 2016 and 2018. On day 1, subjects underwent a whole-body fitness evaluation, including measures of weight, height, body composition by Dual-Energy X-ray Absorptiometry and the Cardiorespiratory Exercise Test. On day 2, 10 ml blood samples were collected (overnight fasting) to determine the lipid profile and fasting glucose. The sample was separated into three groups: Active Concordant twins (Concordant A, n = 44 subjects), Inactive Concordant twins (Concordant I, n = 22 subjects) and Discordant pairs for Physical Exercise (Discordant PE, n = 26 subjects). The results demonstrated a difference between the discordant twins for exercise and also between the active versus sedentary groups, indicating a causal effect of exercise on the fat percentage, maximum oxygen consumption (VO2max) and second ventilatory threshold variables. Between groups, a difference was also observed between the groups in ventilatory threshold, very low-density lipoprotein and triglycerides. We concluded that, regardless of genetics, the practice of physical exercise was sufficient to generate alterations in body composition and VO2max in MZ twins, but not in the lipid profile or fasting glucose.
Owing to its contribution to the maintenance of carbon stocks, soil nitrogen and nutrient cycling for subsequent crops, the integrated systems become increasingly important for agricultural conservation. Thus, the objective of this study was to evaluate the biomass production of and total nutrient in Brachiaria spp. and Panicum maximum forage grasses used as mulch and soybean yields in an integrated crop–livestock system and second-crop maize succession system. The treatments consisted of the following cropping systems: Xaraes palisadegrass intercropped with soybean, Congo grass intercropped with soybean, Mombaça guinea grass intercropped with soybean, Tamani guinea grass intercropped with soybean and a soybean/maize succession system. The forage grasses were established during the soybean R6–R7 stage. Compared with Congo grass, Xaraes palisadegrass, Mombaça guinea grass and Tamani guinea grass produced more biomass and equivalent amounts of fertilizer returned to the soil and resulted in greater nutrient cycling, indicating the benefits of these grasses for use as mulch in integrated production systems. Maize had a greater C/N ratio, but the forage grasses also exhibited high potential by protecting the soil until the end of the soybean development cycle. The use of an integrated crop–livestock system combined with a forage cropping system provided greater soil nutrient cycling than the maize cropping system did, which resulted in increased soybean yields, thus contributing to the sustainability of agricultural systems.
Oral nutritional supplements are widely recommended to head and neck cancer patients undergoing anticancer treatment, however, their effect on outcomes of most importance to patients is unclear. This study aimed to systematically review the evidence of the effect of oral nutritional supplements on mortality, treatment tolerance, quality of life, functional status, body weight, and adverse effects. We searched PubMed, Embase, CENTRAL, LILACS, Web of Science, CINAHL, two trials registry platforms, three sources of grey literature, and reference lists of included studies. We assessed risk of bias using the revised Cochrane risk of bias tool (RoB 2) and certainty of evidence using the GRADE approach. We used random-effects models with Hartung-Knapp correction for the meta-analyses. We included 15 trials, of which 5 were ongoing or unpublished, providing evidence in four comparisons. We found very low to low certainty evidence for the effect of oral nutritional supplements on mortality, treatment tolerance, quality of life, functional status, and adverse effects. When compared to nutritional counselling alone, nutritional counselling plus oral nutritional supplements probably increases body weight slightly. We also found adverse events related to the supplements such as nausea and vomiting, and feeling of fullness. Possible increases in mortality, in treatment tolerance, and in quality of life, besides a possible decrease in functional status, are worth of further investigation. Future research could attempt to address the clinical importance of the probable increase in body weight. Possible adverse effects of the use of oral nutritional supplements should not be overlooked.
Differences in how individuals cope with stressful conditions (e.g. novel/unfamiliar environment, social isolation and increases in human contact) can explain the variability in data collection from nutrient digestibility trials. We used the collared peccary (Pecari tajacu), which is under process of domestication and shows high individual behavioral distinctiveness in reactions toward humans, to test the hypothesis that behavioral differences play a role in nutrient digestibility. We assessed the individual behavioral traits of 24 adult male collared peccaries using both the ‘behavioral coding’ and the ‘subjective ratings’ approaches. For the behavioral coding assessment, we recorded the hourly frequency of behaviors potentially indicative of stress during the 30-day habituation period to the experimental housing conditions. The subjective ratings were performed based on the individuals’ reactions to three short-term challenge tests (novel environment, novel object and threat from a capture net) over a period of 56 days. During the last 26 days, the collared peccaries were fed diets either high (n = 12) or low (n = 12) in dietary fiber levels, and we determined the total tract apparent digestibility of nutrients. The individual subjective ratings showed consistency in the correlated measures of ‘relaxedness’, ‘quietness’ and ‘satisfaction’ across the three challenge tests, which were combined to produce z score ratings of one derived variable (‘calmness’). Individual frequency of BPIS/h and calmness scores were negatively correlated and both predicted the total tract digestibility of acid detergent fiber (ADF), which ranged from 0.41 to 0.79. The greater the calmness z scores (i.e. calmer individuals), the greater the total tract digestibility of ADF. In contrast, the higher the frequency of BPIS/h, the lower the total tract digestibility of ADF. Therefore, our results provide evidence that by selecting calmer collared peccaries, there will be an increase in their capacity to digest dietary fiber.
Hip joint arthroplasty is considered to be a safe, successful and cost-effective procedure to restore hip joint functionality. However, a successful hip joint arthroplasty affects different stakeholders e.g. patient and surgeon and depends on various influencing factors within the product life cycle as well as the applied technological opportunities. Due to the complex dependencies between influencing factors, technological opportunities and stakeholders, this contribution introduces an IPD-based approach to improve the quality of total hip arthroplasties.
The DesignOBS project was created to collect, map and interpret data about the Portuguese Design Ecosystem, providing supportive information for decision making. This study takes advantage of a participative Design perspective to define and test an observation process via a case based on Design doctorates undertaken in Portugal. It emphasises the need for additional participatory analysis and curation by experts to evaluate and develop more reliable information about the discipline. Moreover, it develops recommendations that can enhance the communicability of Design doctorates.
With design methodologies, as Integrated Product Development, industry is continuously looking to improve their product development processes. Staying ahead concurrence forces them to deliver new and more complex products in shorter time. When it comes to fast delivery and requirement changes, product development can be inspired by agile methods. Although the application is difficult, the idea to implement these methods for development of products other than software comes out. To ease its implementation, this paper proposes to use IPD as a framework for agile product development.
Telenomus podisi Ashmead (Hymenoptera: Scelionidae) is the most important egg parasitoid of Euschistus heros (Fabricius) (Hemiptera: Pentatomidae), and its successful parasitism is related to their searching ability to find suitable hosts under a complex chemical environment using host-reliable cues. Thus, the objective of this study was to elucidate chemical substances on the external layer of E. heros eggs and report its potential kairomonal activity on T. podisi. We tested female wasps in olfactometer system to synthetic compounds obtained from a chemical identification of E. heros egg masses. The synthetic blend was also evaluated in parasitism tests under laboratory and semi-field conditions. We identified 31 substances from egg surface extracts, including monoterpenes, aldehydes and alkanes. Among those compounds, a synthetic solution including camphene, β-pinene, limonene and benzaldehyde-induced chemotaxic behaviour on the wasps and increased the parasitism on E. heros eggs, either in laboratory or semi-field test, suggesting its potential use to T. podisi manipulation and parasitism improvement.
Chapter 2 outlines the issue of teacher cognition, particularly teachers’ beliefs, in their classroom practice. The authors argue that good language teachers are cognizant of their beliefs and align their teaching with these beliefs, and they also report on two cases of experienced teachers’ reflection on their beliefs.
Alterations in the maternal environment may impact on the fetal development. The objective of this study was to investigate the gastrointestinal consequences of maternal hypothyroidism for the male offspring from Wistar rats. The pregnant rats were divided into three groups: control (C – received water), experimental 1 [E1 – received methimazole (MMI) solution] during gestation and lactation, and experimental 2 (E2 – received MMI solution) during gestation. Maternal parameters evaluated: free T3 and T4, bodyweight variation, and water/food intake. Offspring parameters evaluated: litter size, number of male/female, free T3 and T4, stomach area, gastric ulcer susceptibility, small intestine length and weight, small intestine and distal colon motility, the stomach and intestinal weight–body weight ratio (SW/BW–IW/BW), and the accumulation of intestinal fluid. Maternal T3 and T4 from E1 were decreased when compared to the other groups. There were no differences for maternal water/food intake and weight gain, litter size, and number of males and females. Regarding to offspring, free T3, SW/BW, IW/BW, and intestinal fluid accumulation were not different between the groups, but T4 was decreased in E1. However, 30-day-old pups from E1 and E2 were smaller with lower stomach and small intestine. Even more, E1 presented a lower ulcer index when compared to the C, while E2 had a higher distal colon transit. It can be concluded that maternal hypothyroidism impaired the total body development, as well as gastric and intestinal development, besides interfering with the susceptibility to the ulcer and intestinal transit of male offspring from Wistar rats.
Cognitive–behavioural therapy (CBT) is an effective treatment for Hypochondriacal Disorder, but the long-term effect has not been examined extensively.
To investigate the long-term effect of CBT on Hypochondriacal Disorder using several mental health measures. Follow-up time was at least 10 years.
A total of 50 patients with a long history of Hypochondriacal Disorder, diagnosed according to ICD-10, received 16 sessions of individual CBT and were followed up with an uncontrolled design. All participants were assessed before and after the intervention period, and 10 years later. Intention-to-treat mixed-model repeated-measures analysis were conducted. The study has been registered at clinicaltrials.gov: NCT00959452.
Patients displayed significant improvements across all outcomes, including level of health anxiety, somatisation, symptoms of anxiety and depression, quality of life, somatisation at treatment completion. Treatment gains were well maintained 10 years later.
This uncontrolled treatment study suggests that patients treated with CBT for Hypochondriacal Disorder have significantly reduced health anxiety 1 year after treatment completion and the results are maintained 10 years later. The results indicate that CBT has a lasting effect, but the lack of a control group and use of only one therapist, means that care should be taken when generalising the findings.
Since 2012, when Ophiothela was first described in the Atlantic, there has been no consensus regarding its identification. It has been described as O. mirabilis, O. cf. mirabilis, O. danae, or only Ophiothela sp. In order to fill these gaps, our aim was to test if specimens from Brazil are Ophiothela mirabilis and/or Ophiothela danae. Syntypes from the Museum of Comparative Zoology and United States National Museum, Smithsonian Institution, were used. We examined species boundaries of the small six-rayed brittle star Ophiothela using independent character sets utilizing morphology (external morphology and morphometry) and molecular data (16S and COI). Concordance was found between the analyses indicating that Ophiothela sp. from Brazil (BR), Ophiothela mirabilis and Ophiothela danae are closely related. We suggest that O. danae should be considered as a junior synonym of O. mirabilis. A detailed description of O. mirabilis BR is presented using external morphology and microstructural ossicles (arm plates, vertebra, dental and oral plates). This description includes new diagnostic features, particularly regarding its microstructures: (i) transspondylous articulation (first record in Ophiotrichidae); (ii) eight smooth knobs on the dorsal surface of the vertebrae (to date only in Ophiothela); (iii) vertebrae with distal keel divided into two separate end processes matching the two large dorsal grooves proximally (first time in the literature); and (iv) an opening on both sides of the oral plate (as seen in other fissiparous species Ophiactis savignyi and Ophiocomella ophiactoides).
Major depression is one of the most prevalent diagnoses in the elderly and represents an important cause of morbidity and mortality in this group. There exists evidence that electroconvulsive therapy (ECT) is particularly efficient and safe in the elderly patient.
Bibliographic review on Pubmed, Medline and Textbooks of Psychiatry
The use of ECT in the psychogeriatric patient has indication in episodes of major depression, mania, schizophrenia and other psychotic disorders, and also when there exists concomitant neurological (affective disorders in dementia, Parkinson´s disease, and post stroke depression). or other mental syndromes (catatonia or delirium secondary to various medical conditions).
Because the geriatric population suffers multiple organic comorbidities, the following risk factors require evaluation: history of head trauma, focal or general neurological complaints (recent stroke, intracranial tumour, hypertension or aneurysm), angina, congestive heart failure, bone fractures, osteoporosis, spinal disease and oesophageal reflux.
The following adverse effects have been described: cardiac ischemia, arrhythmia (tachycardia and bradycardia), hypertension, pneumonia secondary to aspiration of gastric contents, musculoskeletal and dental injury, increase of intraocular pressure, post ictal confusion and disorientation, impaired retrograde and anterograde memory.
The indication, risks factors and possible adverse effects of ECT should be carefully evaluated in the elderly patient.
Recent studies involved the pathways of kinases regulated by extracellular signal (ERK - extracellular signal regulated kinases), a broad range of key cellular processes, in the mechanisms of depression and consequently in the action of antidepressants. It is also known that the use of specific inhibitors of phosphorylation of ERKs1 / 2 showed to have antidepressant effect in animal models. Fluoxetina (SSRI) was recently discovered to be a potente inhibitor of phosphorylation of ERKs. The ERKs1 / 2 and recently the 3, are present in neurons and glia, these also engaged in biological mechanisms of depression.
The authors propose to do, based on the current literature, the characterization of the type (s) of cell (s) where changes in activation of ERKs1 / 2, occur during depression, and during the administration of antidepressants, in order to understand, to what extent these kinases may be considered as biological markers of depression. Possibly also to examine the feasibility of using these markers in clinical use.