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For vascular trauma purposes the abdomen is divided into four retroperitoneal anatomical areas:
Zone 1: The midline retroperitoneum from the aortic hiatus to the sacral promontory is broken into supramesocolic and inframesocolic areas. The supramesocolic area contains the suprarenal aorta and its major branches (celiac artery, superior mesenteric artery, and renal arteries), the supramesocolic segment of the inferior vena cava with its major branches, and the superior mesenteric vein. The inframesocolic area contains the infrarenal aorta and infrarenal inferior vena cava.
Zone 2 (left and right): This is the paired right and left region lateral of Zone 1 containing the kidneys and renal vessels.
Zone 3: The pelvic retroperitoneum, which contains the iliac vessels.
The abdominal aorta originates between the two crura of the diaphragm at the level of T12–L1 and bifurcates into the common iliac arteries at the level of L4–5. The umbilicus is an approximate external landmark for the aortic bifurcation. The first large branch is the celiac trunk, followed by the superior mesenteric artery 1–2 cm inferiorly, and both course anteriorly and inferiorly. The renal arteries originate 1–2 cm below the origin of the superior mesenteric artery at the level of L2 and course laterally. Finally, the inferior mesenteric artery originates 2–5 cm above the aortic bifurcation on the left anterior aspect of the aorta.
Celiac artery: The main trunk originates on the anterior surface of the aorta at the level of T12–L1. It is 1–2 cm long and divides into three branches at the upper border of the pancreas—the common hepatic, left gastric, and splenic arteries. The celiac is encased in extensive fibrous, ganglionic, and lymphatic tissues, which makes surgical dissection of the celiac artery difficult. In 10–20% of patients, the left gastric artery gives off a replaced left hepatic artery that courses through the gastrohepatic omentum and can be injured while mobilizing the left lobe of the liver or lesser curve of the stomach.
Superior mesenteric artery (SMA): The SMA originates from the anterior surface of the aorta at the level of L1, 1–2 cm below the celiac artery. It courses posterior to the neck of the pancreas and anterior to the third part of the duodenum, beyond which it enters the root of the mesentery. SMA branches include the inferior pancreaticoduodenal artery, the middle colic artery, an arterial arcade with 12–18 intestinal branches, the right colic artery, and the ileocolic artery. In 10–20% of patients, the SMA gives off a replaced right hepatic artery, which courses posterior to the head of the pancreas and runs posteriorly and to the right of the portal vein.
Renal arteries: The right renal artery emerges at a slightly higher level and is longer than the left and courses posteriorly to the inferior vena cava. Approximately 30% of patients have more than one renal artery, usually an accessory artery supplying the lower pole of the kidney. Both renal veins lie anteriorly of their accompanying renal arteries. The left renal vein is significantly longer than the right and courses anteriorly to the aorta. The left renal vein drains the left gonadal vein inferiorly, the left adrenal vein superiorly, and the renolumbar vein posteriorly. The right gonadal vein drains directly into the IVC.
Inferior mesenteric artery (IMA): The IMA provides blood supply to the left colon, sigmoid, and the rectum. It communicates with the SMA through the marginal artery of Drummond and arc of Riolan.
Cognitive tests of inhibitory control show variable results for the differential diagnosis between behavioural variant of Frontotemporal Dementia (bvFTD) and Alzheimer’s disease (AD). We compared the diagnostic accuracies of tests of inhibitory control and of a behavioural questionnaire, to distinguish bvFTD from AD.
Three groups of participants were enrolled: 27 bvFTD patients, 25 AD patients, and 24 healthy controls. Groups were matched for gender, education, and socio-economic level. Participants underwent a comprehensive neuropsychological assessment of inhibitory control, including Hayling Test, Stroop, the Five Digits Test (FDT) and the Delay Discounting Task (DDT). Caregivers completed the Barratt Impulsiveness Scale 11th version (BIS-11).
bvFTD and AD groups showed no difference in the tasks of inhibitory control, while the caregiver questionnaire revealed that bvFTD patients were significantly more impulsive (BIS-11: bvFTD 76.1+9.5, AD 62.9+13, p < .001).
Neuropsychological tests of inhibitory control failed to distinguish bvFTD from AD. On the contrary, impulsivity caregiver-completed questionnaire provided good distinction between bvFTD and AD. These results highlight the current limits of cognitive measures of inhibitory control for the differential diagnosis between bvFTD and AD, whereas questionnaire information appears more reliable and in line with clinical diagnostics.
This study reports the effects of a high-fat (HF) diet on the iron (Fe) status of growing rats over 8 weeks. Tissue Fe levels were analysed by atomic absorption spectrophotometry, and whole-body adiposity was measured by dual-energy X-ray absorptiometry. Histopathology and morphometry of adipose tissue were performed. Liver homogenates were used for measuring ferroportin (Fpn)-1 protein levels by immunoblotting, and transcript levels were used for Fe genes measured by real-time PCR. Tissue Fe pools were fit to a compartmental biokinetic model in which Fe was assessed using 14 compartments and 27 transfer constants (kj,i from tissue “i” to tissue “j”) adapted from the International Commission on Radiological Protection (ICRP) 69. Ten kj,i were calculated from the experimental data using nonlinear regression, and 17 were estimated by allometry according to the formula kj,i = a · Mb. Validation of the model was carried out by comparing predicted and analysed Fe pool sizes in red blood cells (RBCs), the liver and the spleen. Body adiposity was negatively associated with serum Fe levels and positively associated with liver Fe stores. An inferred increase in Fe transfer from bone marrow to the liver paralleled higher hepatic Fe concentrations and ferritin heavy-chain mRNA levels in the HF diet-fed animals, suggesting that liver Fe accumulation occurred at least in part due to a favoured liver RBC uptake. If this feeding condition were to be prolonged, impaired Fe decompartmentalization may occur, ultimately resulting in dysmetabolic Fe overload.
In the present study, TiO2NT coatings grown on simulated body fluid-based electrolyte were investigated as drug delivery devices. Nanotubes (NTs) were grown over commercially pure Ti and Ti6Al4V alloy. Morphology analysis showed that NTs in alloy samples present an inner diameter of 10 nm smaller in average than NTs grown over pure Ti. The surface wettability in water decreased with the anodizing time for both substrates. The application of coatings as drug delivery devices has been studied through the incorporation of ciprofloxacin. To control the drug release, collagen was used as the diffusional barrier. It was observed the drug release follows a Fick’s kinetics. Bioactivity assays showed the absence of hemolytic activity. The concentration of the drug during the release interval remained below the toxic concentration limit, presenting a bacteriostatic activity. All coatings prepared presented a high antibacterial activity, being the area of inhibition of bacterial growth above 13 times the area of the implant.
Around 60–80% of oocytes maturated in vivo reached competence, while the proportion of maturation in vitro is rarely higher than 40%. In this sense, butafosfan has been used in vivo to improve metabolic condition of postpartum cows, and can represent an alternative to increase reproductive efficiency in cows. The aim of this study was to evaluate the addition of increasing doses of butafosfan during oocyte maturation in vitro on the initial embryo development in cattle. In total, 1400 cumulus–oocyte complexes (COCs) were distributed in four groups and maturated according to supplementation with increasing concentrations of butafosfan (0 mg/ml, 0.05 mg/ml, 0.1 mg/ml and 0.2 mg/ml). Then, 20 oocytes per group were collected to evaluate nuclear maturation and gene expression on cumulus cells and oocytes and the remaining oocytes were inseminated and cultured until day 7, when blastocysts were collected for gene expression analysis. A dose-dependent effect of butafosfan was observed, with decrease of cleavage rate and embryo development with higher doses. No difference between groups was observed in maturation rate and expression of genes related to oocyte quality. Our results suggest that butafosfan is prejudicial for oocytes, compromising cleavage and embryo development.
With respect to De Dreu and Gross's article, we comment on the psychological functions for attack and defense, focusing on associations between individual differences in psychopathic personality traits and the behavioral patterns observed in attack-defense conflicts. We highlight the dimensional nature of psychopathy and formulate hypothetical associations between distinct traits, their different behavioral outcomes, and associated brain mechanisms.
Many school-based interventions for obesity prevention have been proposed with positive changes in behavior, but unsatisfactory results on weight change. The objective was to verify the effectiveness of a combined school and home-based obesity prevention program on excessive weight gain in adolescents. Teachers delivered the school-based primary prevention program to fifth and sixth graders (9 schools, 48 control classes, 49 intervention classes), which included encouraging healthy eating habits and physical activity. A subgroup of overweight or obese adolescents also received a home-based secondary prevention program delivered by community health professionals. Schools were randomized to intervention or control group. Intent-to-treat analysis used mixed models for repeated continuous measures and considered the cluster effect. The main outcomes were changes in body mass index (BMI) and percent body fat (%body fat) after one school-year of intervention and follow-up. Against our hypothesis, BMI increased more in the intervention group than in the control group (Δ=0.3kg/m2; p=0.05) with a greater decrease in %body fat among boys (Δ=-0.6%; p=0.03) in the control group. The intervention group increased physical activity by 12.5 minutes per week compared with the control group. Female adolescents in the intervention group ate healthier items more frequently than in the control group. The subgroup who received both the school and home interventions had an increase in %body fat than in the control group (Δ=0.89%; p=0.01). In this study, a behavioral change led to a small increased in physical activity and healthy eating habits but also to an overall increase in food intake.
This study aimed to determine the cutoff and the specificity and sensitivity of the Emotion Thermometers (ET) in a Portuguese sample of cancer patients.
A total of 147 patients (mean age = 49.2; SD = 12.6) completed the ET, the Brief Symptom Inventory (BSI), and the Subjective Experiences of Illness Suffering Inventory. Data were collected in a cancer support institution and in a major hospital in the North of Portugal.
The optimal cutoff for the Anxiety Thermometer was 5v6 (until 5 and 6 or more), which identified 74% of the BSI-anxiety cases and 70% of noncases. The Depression Thermometer cutoff was 4v5 (until 4 and 5 or more), which identified 85% of BSI-depression cases and 82% of noncases. Cutoff for the Anger Thermometer was 4v5 (until 4 and 5 or more), which identified 83% of BSI-hostility cases and 73% of noncases; for the Distress Thermometer, the optimal cutoff was 4v5 (until 4 and 5 or more), which identified 84% of the suffering cases and 73% of noncases. Finally, for the Help Thermometer, it was 3v4 (until 3 and 4 or more), which helped to identify 93% of the suffering cases and 64% of noncases.
Significance of results
Results supported the Portuguese version of the ET as an important screening tool for identifying the emotional distress in cancer patients.
This paper proposes a framework to assess the influence of Offshore Wind Farms (OWFs) on maritime traffic flow based on raw Automatic Identification System (AIS) data collected before and after the installation of the offshore wind turbines. The framework includes modules for data acquisition, data filtering and statistical analysis. The statistical analysis characterises the influence of an OWF on maritime traffic in terms of minimum passing distances and lateral distribution of the ship trajectories near the OWF. The framework is applied to a specific route for which AIS data is available before and after an OWF installation. The impacts of the OWF on marine traffic are diverse and depend on the ship type categories. This paper quantitatively characterises an OWF's influence on a specific route that is probabilistically modelled, which is important for further studies on OWF site selection and maritime traffic risk assessment and management.
Correction of tetralogy of Fallot during infancy usually eliminates the risks associated with general anaesthesia. In rare cases of uncorrected defects persisting into adulthood, anaesthetic management during non-cardiac surgery may therefore be challenging. We describe the use of continuous spinal anaesthesia to successfully circumvent the operative risk of major abdominal surgery in an adult patient with uncorrected tetralogy of Fallot.
The investigation of the glycan repertoire of several organisms has revealed a wide variation in terms of structures and abundance of glycan moieties. Among the parasites, it is possible to observe different sets of glycoconjugates across taxa and developmental stages within a species. The presence of distinct glycoconjugates throughout the life cycle of a parasite could relate to the ability of that organism to adapt and survive in different hosts and environments. Carbohydrates on the surface, and in excretory-secretory products of parasites, play essential roles in host–parasite interactions. Carbohydrate portions of complex molecules of parasites stimulate and modulate host immune responses, mainly through interactions with specific receptors on the surface of dendritic cells, leading to the generation of a pattern of response that may benefit parasite survival. Available data reviewed here also show the frequent aspect of parasite immunomodulation of mammalian responses through specific glycan interactions, which ultimately makes these molecules promising in the fields of diagnostics and vaccinology.
In Portugal, specific legal rules allowing surrogacy were introduced very recently. Law no. 25/2016, dated 22 August 2016, which introduced amendments to Law no. 32/2006, dated 26 July 2006 (‘the Medically-Assisted Procreation Law’), created a legal framework for surrogacy in Portugal in 2016. A specific Regulatory Decree was enacted in 2017 (Regulatory Decree no. 6/2017, dated 31 July 2017) to supplement Law no. 25/2016, governing surrogacy.
In 1997, a change to the Constitution of the Portuguese Republic mandated the Portuguese State to regulate access to medically assisted procreation techniques ‘in such a way as to safeguard the dignity of the human person’, as is stated in its Art. 67 no. 2(e). But it took almost 10 years before the constitutional mandate was finally fulfilled: the law governing Medically-Assisted Procreation Law no. 32/2006, dated 26 July 2006 was enacted in 2006. According to its first version, although the use of medically assisted techniques to procreate was authorised (as long as certain requirements were met) surrogacy was not permitted in any circumstances. Another 10-year period elapsed before surrogacy was accepted by the Portuguese legal system: this happened with the enactment of Law no. 25/2016, dated 22 August 2016, which created many particular safeguards and envisaged the use of surrogacy as exceptional, and only possible when certain strict conditions were fulfilled.
Article 3 of this law expressly referred to the need for regulation of surrogacy, stating that the government had to approve the corresponding Regulatory Decree of the abovementioned Law no. 25/2016 within 120 days after the date of its publication in the Portuguese Official Journal which was 22 August 2016. The deadline was not met as Regulatory Decree no. 6/2017 was published almost one year later, on 31 July 2017. As a consequence, the legal regime governing surrogacy only entered into force on 1 August 2017.
Less than nine months later, on 24 April 2018, the Portuguese Constitutional Court has declared that rules of the statutory framework regarding surrogacy, as they were enacted in 2016, violated provisions of the Constitution of Portuguese Republic.
The dynamics of electron-plasma waves is described at arbitrary collisionality by considering the full Coulomb collision operator. The description is based on a Hermite–Laguerre decomposition of the velocity dependence of the electron distribution function. The damping rate, frequency and eigenmode spectrum of electron-plasma waves are found as functions of the collision frequency and wavelength. A comparison is made between the collisionless Landau damping limit, the Lenard–Bernstein and Dougherty collision operators and the electron–ion collision operator, finding large deviations in the damping rates and eigenmode spectra. A purely damped entropy mode, characteristic of a plasma where pitch-angle scattering effects are dominant with respect to collisionless effects, is shown to emerge numerically, and its dispersion relation is analytically derived. It is shown that such a mode is absent when simplified collision operators are used, and that like-particle collisions strongly influence the damping rate of the entropy mode.
Understanding the properties of time averaging (age mixing) in a stratigraphic layer is essential for properly interpreting the paleofauna preserved in the geologic record. This work assesses the age and quantifies the scale and structure of time averaging of land snail-rich colluvial sediments from the Madeira Archipelago (Portugal) by dating individual shells using amino acid racemization calibrated with graphite-target and carbonate-target accelerator mass spectrometry radiocarbon methods. Gastropod shells of Actinella nitidiuscula were collected from seven sites on the volcanic islands of Bugio and Deserta Grande (Desertas Islands), where snail shells are abundant and well preserved in Quaternary colluvial deposits. Results show that the shells ranged in age from modern to ~48 cal ka BP (calibrated radiocarbon age), covering the last glacial and present interglacial periods. Snail shells retrieved from two of the colluvial sites exhibit multimillennial age mixing (>6 ka), which significantly exceeds the analytical error from dating methods and calibration. The observed multimillennial mixing of these assemblages should be taking into consideration in upcoming paleoenvironmental and paleoecological studies in the region. The extent of age mixing may also inform about the time span of colluvial deposition, which can be useful in future geomorphological studies. In addition, this study presents the first carbonate-target radiocarbon results for land snail shells and suggests that this novel, rapid, and more affordable dating method offers reliable age estimates for small land snail shells younger than ~20 cal ka BP.
Although accumulating evidence supports the hypothesis that immune/inflammatory mechanisms are associated with the pathophysiology of bipolar disorder (BD), data about the profile of chemokines (chemotactic cytokines) and chemokine receptors are still scarce. The current study was designed to evaluate the expression of chemokine receptors on lymphocytes of patients with BD in comparison with controls.
Thirty-three patients with type I BD (N = 21 in euthymia; N = 6 in mania/hypomania; N = 6 in depression) and 22 age- and sex-matched controls were subjected to clinical evaluation and peripheral blood draw. The expression of chemokine receptors CCR3, CCR5, CXCR4, and CXCR3 on CD4+ and CD8+ lymphocytes was assessed by flow cytometry.
Patients with BD had decreased percentage of CD4+CXCR3+ (p = 0.024), CD4+CCR3+ (p = 0.042), and CD4+CCR5+ (0.013) lymphocytes in comparison with controls. The percentage of both CD4+ and CD8+ lymphocytes expressing the chemokine receptor CXCR4 was similar in patients with BD and controls. Likewise, the percentages of CD8+CXCR3+, CD8+CCR3+, and CD8+CCR5+ lymphocytes were similar in patients with BD and controls.
Our findings reinforce the hypothesis that immune pathways, especially involving CD4+ lymphocytes, are involved in the physiopathology of BD.
To assess iodine status and its effects on maternal thyroid function throughout pregnancy.
In the present prospective cohort study, three urinary samples were requested for urinary iodine concentration (UIC) determinations in both the first and third gestational trimesters. Serum thyrotropin (TSH) and free thyroxine (FT4) were analysed in both trimesters and thyroid antibodies were assessed once.
Rio de Janeiro, Brazil.
First-trimester pregnant women (n 243), of whom 100 were re-evaluated during the third trimester.
Iodine sufficiency was found in the studied population (median UIC=216·7 µg/l). The first- and third-trimester median UIC was 221·0 and 208·0 µg/l, respectively. TSH levels (mean (sd)) were higher in the third trimester (1·08 (0·67) v. 1·67 (0·86) mIU/l; P<0·001), while FT4 levels decreased significantly (1·18 (0·16) v. 0·88 (0·12) ng/dl; P<0·001), regardless the presence of iodine deficiency (UIC<150 µg/l) or circulating thyroid antibodies. UIC correlated (β; 95% CI) independently and negatively with age (–0·43; –0·71, –0·17) and positively with multiparity (0·15; 0·02, 0·28) and BMI (0·25; 0·00, 0·50). Furthermore, median UIC per pregnant woman tended to correlate positively with TSH (0·07; –0·01, 0·14). Women with median UIC≥250 µg/l and at least one sample ≥500 µg/l throughout pregnancy had a higher risk of subclinical hypothyroidism (OR=6·6; 95% CI 1·2, 37·4).
In this cohort with adequate iodine status during pregnancy, excessive UIC was associated with an increased risk of subclinical hypothyroidism.
This paper presents a modified genetic algorithm (GA) using a new crossover operator (ADX) and a novel statistic correlation mutation algorithm (CAM). Both ADX and CAM work with population information to improve existing individuals of the GA and increase the exploration potential via the correlation mutation. Solution-based methods offer better local improvement of already known solutions while lacking at exploring the whole search space; in contrast, evolutionary algorithms provide better global search in exchange of exploitation power. Hybrid methods are widely used for constrained optimization problems due to increased global and local search capabilities. The modified GA improves results of constrained problems by balancing the exploitation and exploration potential of the algorithm. The conducted tests present average performance for various CEC’2015 benchmark problems, while offering better reliability and superior results on path planning problem for redundant manipulator and most of the constrained engineering design problems tested compared with current works in the literature and classic optimization algorithms.
It can be hypothesized that the body composition characteristics of different sheep breeds affect their nutritional requirements. However, no study has yet been carried out to determine the nutritional requirements for maintenance of Texel purebred lambs, despite their growing importance in sheep meat production globally. Our objective was therefore to determine the energy and protein requirements for maintenance of Texel lambs. Thirty-four Texel lambs were used, all intact males that were weaned at 50 days old, and confined in individual pens. Two experiments were conducted, as follows. In Experiment 1, a digestibility assay was performed to determine the dietary energy value, in a 3×3 double Latin square design, in which lambs were submitted to three levels of feed restriction (0%, 55% and 70% of ad libitum feed intake). In Experiment 2, the energy and protein requirements for maintenance of Texel lambs from 21 to 40 kg BW were determined using a randomized block design, in which lambs were also submitted to three levels of feed restriction (0%, 55% and 70% of ad libitum feed intake). The requirements for net energy for maintenance (NEm), metabolizable energy for maintenance (MEm), net protein for maintenance (NPm) and metabolizable protein for maintenance (MPm) were determined. The digestibility of dry matter, energy, protein and metabolizability were similar between food restriction levels, averaging 74.4%, 75.5%, 80.3% and 0.636, respectively. The NEm determined for growing Texel lambs was 263 kJ/kg of the metabolic fasting BW (FBW), the MEm was 417 kJ/kg0.75 FBW and the efficiency of use of MEm was 0.63. In addition, the NPm was 1.24 g/day per kg0.75 FBW and the MPm was 2.98 g/day per kg0.75 FBW. The energy requirements of Texel lambs are different from those reported in the literature, possibly due to differences between breeds, diets and environmental effects, whereas the protein requirements are different from literature mainly due to methodological differences; further studies are need to address these aspects that affects the nutritional requirements for raising sheep from different breeds in different environments.