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To develop a risk score for deep sternal wound infection (DSWI) after isolated coronary artery bypass grafting (CABG).
Multicenter, prospective study.
Tertiary-care referral hospitals.
The study included 7,352 patients from the European multicenter coronary artery bypass grafting (E-CABG) registry.
An additive risk score (the E-CABG DSWI score) was estimated from the derivation data set (66.7% of patients), and its performance was assessed in the validation data set (33.3% of patients).
DSWI occurred in 181 (2.5%) patients and increased 1-year mortality (adjusted hazard ratio, 4.275; 95% confidence interval [CI], 2.804–6.517). Female gender (odds ratio [OR], 1.804; 95% CI, 1.161–2.802), body mass index ≥30 kg/m2 (OR, 1.729; 95% CI, 1.166–2.562), glomerular filtration rate <45 mL/min/1.73 m2 (OR, 2.410; 95% CI, 1.413–4.111), diabetes (OR, 1.741; 95% CI, 1.178–2.573), pulmonary disease (OR, 1.935; 95% CI, 1.178–3.180), atrial fibrillation (OR, 1.854; 95% CI, 1.096–3.138), critical preoperative state (OR, 2.196; 95% CI, 1.209–3.891), and bilateral internal mammary artery grafting (OR, 2.088; 95% CI, 1.422–3.066) were predictors of DSWI (derivation data set). An additive risk score was calculated by assigning 1 point to each of these independent risk factors for DSWI. In the validation data set, the rate of DSWI increased along with the E-CABG DSWI scores (score of 0, 1.0%; score of 1, 1.8%; score of 2, 2.2%; score of 3, 6.9%; score ≥4: 12.1%; P < .0001). Net reclassification improvement, integrated discrimination improvement, and decision curve analysis showed that the E-CABG DSWI score performed better than other risk scores.
DSWI is associated with poor outcome after CABG, and its risk can be stratified using the E-CABG DSWI score.
In the Netherlands, the bulk of the Miocene to lowest Pliocene sedimentary succession is currently assigned to a single lithostratigraphical unit, the Breda Formation. Although the formation was introduced over 40 years ago, the definition of its lower and upper boundaries is still problematic. Well-log correlations show that the improved lecto-stratotype for the Breda Formation in well Groote Heide partly overlaps with the additional reference section of the older Veldhoven Formation in the nearby well Broekhuizenvorst. The distinction between the Breda and the overlying Oosterhout Formation, which was mainly based on quantitative differences in glauconite and molluscs, gives rise to ongoing discussion, in particular due to the varying concentrations of glauconitic content that occur within both formations. In addition, the Breda Formation lacks a regional-scale stratigraphic framework which relates its various regionally to locally defined shallow marine to continental members.
In order to resolve these issues, we performed renewed analyses of material from several archived cores. The results of archived and new dinocyst analyses were combined with lithological descriptions and wire-line log correlations of multiple wells, including the wells Groote Heide and Broekhuizenvorst. In this process, the updated dinocyst zonation of Munsterman & Brinkhuis (2004), recalibrated to the Geological Time Scale of Ogg et al. (2016), was used. To establish regionally consistent lithostratigraphic boundaries, additional data was used along a transect across the Roer Valley Graben running from its central part (well St-Michielsgestel-1) towards the southern rift shoulders (well Goirle-1). Along this transect, chronostratigraphic and lithostratigraphic analyses were integrated with well-log correlation and the analyses of seismic reflection data to constrain geometrical/structural relationships as well.
The results led to the differentiation of two distinct seismic sequences distinguished by three recognisable unconformities: the Early Miocene Unconformity (EMU), the Mid-Miocene Unconformity (MMU) and the Late Miocene Unconformity (LMU). The major regional hiatus, referred to as the Mid-Miocene Unconformity, occurs intercalated within the present Breda Formation and compels subdivision of this unit into two formations, viz. the here newly established Groote Heide and the younger Diessen formations. Pending further studies, the former Breda Formation will be temporally raised in rank to the newly established Hilvarenbeek subgroup, which comprises both the Groote Heide and Diessen formations. Whereas these two sequences were already locally defined, a third sequence overlying the LMU represents two newly defined lithostratigraphical units, named the Goirle and the Tilburg members, positioned in this study at the base of the Oosterhout Formation. Besides their unique lithological characteristics, in seismic reflection profiles the Goirle and the Tilburg members stand out because of their distinct seismic facies.
Use of an integrated, multidisciplinary and regional approach, an improved southern North Sea framework and more comprehensive lithostratigraphic subdivision of Neogene successions is proposed for the Netherlands, to make (cross-border) correlations more straightforward in the future.
The stable isotope ratios of carbon (δ13C) and nitrogen (δ15N) and total mercury concentrations (THg) of the three marine catfish species Aspistor luniscutis, Bagre bagre and Genidens genidens were evaluated to understand their trophic relationship in northern Rio de Janeiro state, south-eastern Brazil. The δ13C was similar among the three marine catfishes, whereas δ15N was similar in A. luniscutis and B. bagre and lower in G. genidens. THg was higher in G. genidens and lower in B. bagre. The greater assimilation of Sciaenidae fishes and squids by A. luniscutis and B. bagre resulted in smaller isotopic niche areas and trophic diversity but higher isotopic niche overlap, trophic redundancy and evenness. For G. genidens, the similar assimilation of all prey items resulted in the broadest isotopic niche among the marine catfishes. The higher mercury content in G. genidens is consistent with an increased important contribution of prey with a higher Hg burden. The bioaccumulation process was indicated by significant correlations of δ15N and THg with total length and total mass. Additionally, a significant correlation between THg and δ15N reflected the biomagnification process through the food web.
Progesterone (P4) plays a key role in pregnancy establishment and maintenance; during early pregnancy, P4 stimulates the production and release of uterine secretions necessary for conceptus growth prior to implantation; therefore, exogenous P4 supplementation may improve embryo development. This study evaluated the effects of supplementation during early pregnancy with long-acting injectable progesterone or altrenogest on embryonic characteristics of sows and gilts. Thus, a total of 32 sows and 16 gilts were used. On day 6 of pregnancy sows and gilts were allocated to one of the following groups: non-supplemented; supplemented with 20 mg of altrenogest, orally, from days 6 to 12 of pregnancy; supplemented with 2.15 mg/kg of long-acting injectable progesterone on day 6 of pregnancy. Animals were killed on day 28 of pregnancy, and ovulation rate, embryo survival, embryo weight, crown-to-rump length, uterine glandular epithelium and endometrial vascularization were assessed. Treatments had no effect on pregnancy rate, embryo survival or endometrial vascular density (P > 0.05). Non-supplemented gilts presented larger and heavier embryos compared to gilts from supplemented groups (P < 0.05). Sows in the altrenogest group presented larger and heavier embryos compared to non-supplemented sows and sows supplemented with long-acting injectable progesterone. In conclusion, supplementation of sows and gilts with progestagen from day 6 of pregnancy can be used as a means to improve embryo survival without deleterious effects.
Ecchordosis physaliphora is a congenital, benign lesion originating from notochordal remnants along the craniospinal axis, most frequently located at the level of the clivus and sacrum. Sometimes ecchordosis physaliphora is difficult to recognise and treat, with a total of twenty-six cases described in the literature.
This study reports on three cases of previously undiagnosed ecchordosis physaliphora presenting with cerebrospinal fluid rhinorrhoea and meningitis.
Endoscopic transclival or transsphenoid surgery including three-layer (fat, fascia and nasoseptal flap) reconstruction was used in all cases with complete resolution of the symptoms.
Current feed evaluation systems often assume that fermented starch (i.e. resistant starch (RS)) yields less energy than digested starch. However, growth rates of pigs fed low and high RS diets are often the same when feed is available ad libitum. This may be explained by its effect on digestive processes changing feeding behavior, and consequently energy utilization. This study aims to investigate the effect of RS on nutrient digestion and digesta passage rate in pigs, in combination with its effect on feeding behavior and growth performance under ad libitum conditions. In experiment 1, 20 male pigs (40 ± 2.82 kg) were fed diets containing either 50% waxy maize starch (low in RS (LRS)) or high-amylose maize starch (high in RS (HRS)), and soluble and insoluble indigestible markers. After 14 days of adaptation to the diets, pigs were fed hourly to reach steady state (6 h), dissected, and digesta were collected from eight segments. From the collected samples, nutrient digestion and passage rate of the solid and liquid digesta fraction were determined. In experiment 2, 288 pigs (80 ± 0.48 kg; sex ratio per pen 1 : 1; boar : gilt) were housed in groups of 6. Pigs were ad libitum-fed one of the experimental diets, and slaughtered at approximately 115 kg. Feed intake, growth and carcass parameters were measured. Ileal starch digestibility was greater for LRS-fed than for HRS-fed pigs (98.0% v. 74.0%; P < 0.001), where the additional undigested starch in HRS-fed pigs was fermented in the large intestine. No effects of RS on digesta passage rate of the solid or liquid digesta fraction and on feeding behavior were observed. Growth rate and feed intake did not differ between diets, whereas feed efficiency of HRS-fed pigs was 1%-unit higher than that of LRS-fed pigs (P = 0.041). The efficiency of feed used for carcass gain did not differ between diets indicating that the difference in feed efficiency was determined by the non-carcass fraction. Despite a 30% greater RS intake (of total starch) with HRS than with LRS, carcass gain and feed efficiency used for carcass gain were unaffected. RS did not affect digesta passage rate nor feeding behavior suggesting that the difference in energy intake between fermented and digested starch is compensated for post-absorptively. Our results indicate that the net energy value of fermented starch currently used in pig feed evaluation systems is underestimated and should be reconsidered.
Mental disorders are associated with lower subjective social status (SSS), but a more nuanced understanding of this relationship is needed. We examined the influence of disorder age of onset and recency on SSS and studied whether mental disorders are also associated with the discrepancy between actual and desired SSS.
Data are from the baseline and second wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). Mental disorders were assessed with the Composite International Diagnostic Interview (CIDI 3.0), while both actual and desired SSS were assessed with a ten-rung ladder. Linear regression was used to examine the association between mental disorders and SSS.
Of 5303 participants, 2237 had a lifetime mental disorder at baseline. These participants reported significantly lower actual SSS (6.28) at follow-up than healthy participants (6.66, B = −0.38 [95% CI −0.48 to −0.27], p < 0.001) and a significantly greater actual-desired SSS discrepancy (1.14 v. 1.05 after controlling for actual SSS, B = 0.09 [0.01–0.17], p = 0.024). Lower age of onset of the first mental disorder was marginally significantly associated with lower actual SSS (B = 0.006 [0.000–0.012], p = 0.046). More recent disorders were also associated with lower actual SSS (B = 0.015 [0.005–0.026], p = 0.005), such that participants whose disorder remitted ⩾6 years before baseline were statistically indistinguishable from healthy participants.
Lifetime mental disorders are associated with lower actual SSS and a slightly greater discrepancy between actual and desired SSS. However, people with mental disorders in (long-term) remission have a similar social status as healthy participants.
The Toarcian Oceanic Anoxic Event (T-OAE, c. 182 Ma) represents a major perturbation of the carbon cycle marked by widespread black shale deposition. Consequently, the onset of the T-OAE has been linked to the combined effects of global warming, high productivity, basin restriction and salinity stratification. However, the processes that led to termination of the event remain elusive. Here, we present palynological data from Arctic Siberia (Russia), the Viking Corridor (offshore Norway) and the Yorkshire Coast (UK), all spanning the upper Pliensbachian – upper Toarcian stages. Rather than a ‘dinoflagellate cyst black-out’, as recorded in T-OAE strata of NW Europe, both the Arctic and Viking Corridor records show high abundance and dinoflagellate diversity throughout the T-OAE interval as calibrated by C-isotope records. Significantly, in the Arctic Sea and Viking Corridor, numerous species of the Parvocysta and Phallocysta suites make their first appearance in the lower Toarcian Falciferum Zone much earlier than in Europe, where these key dinoflagellate species appeared suddenly during the Bifrons Zone. Our results indicate migrations of Arctic dinoflagellate species, driven by relative sea-level rise in the Viking Corridor and the establishment of a S-directed circulation from the Arctic Sea into the Tethys Ocean. The results support oceanographic models, but are at odds with some interpretations based on geochemical proxies. The migration of Arctic dinoflagellate species coincides with the end of the T-OAE and marks the arrival of oxygenated, low-salinity Arctic waters, triggering a regime change from persistent euxinia to more dynamic oxygen conditions.
There is no agreement regarding which solvent is more suitable to obtain sol–gel–derived titania (TiO2) samples with an enhanced photocatalytic behavior. Furthermore, the solvent effect on the preparation of TiO2-RGO (reduced graphene oxide) nanocomposites has not been published yet and could be an attractive experimental strategy to modulate structure and properties. On the basis of these observations, TiO2-RGO nanocomposites were fabricated in this study. It was evaluated for the influence of using either isopropyl (IsoprOH) or ethyl (EtOH) alcohol on the textural and photocatalytic properties of the prepared materials. The use of IsoprOH led to samples with smaller crystallite size, narrower apparent band gap, smaller isoelectric point, larger adsorption capacity, and higher photocatalytic activity. In addition, the incorporation of RGO into TiO2 greatly improved the adsorption capacity and photocatalytic activity of the latter. However, the optimal loading of RGO to prepare composites with enhanced photocatalytic activities was 1 wt%. This finding can be related to the stacking of RGO sheets when concentrations above 1 wt% are used, which could prevent UV light to reach the TiO2 particles and also decrease the photocatalytic capacity of the composites. Moreover, materials with RGO concentration above 1 wt% could exhibit a highly negatively charged surface, which may decrease the separation of the generated electron–hole pairs and lead to faster recombination rates of charge carriers.
Plants of Sumatran fleabane [Conyza sumatrensis (Retz.) E. Walker] were identified in a field with an unusual rapid leaf-injury herbicide symptoms after application of 2,4-D in mixture with glyphosate. The objectives of this study were to confirm the occurrence of resistance to 2,4-D herbicide and to characterize the occurrence of rapid necrosis as the mechanism associated with the herbicide resistance in C. sumatrensis. The studies performed were an initial screening, effect of 2,4-D alone and associated with glyphosate, cross- and multiple-resistance evaluation, effect of commercial formulation and analytical product, and rate of H2O2 evolution. The Marpr9-rn accession was identified with rapid necrosis symptoms and survival to 804 g ae ha−1 of 2,4-D. The resistance factor to the herbicide 2,4-D was 18.6 at 49 d after spraying. The analytical product 2,4-D and the commercial formulation resulted in similar symptoms of rapid necrosis. This symptom did not occur for the six other auxinic herbicides (dicamba, florpyrauxifen-benzyl, fluroxypyr, halauxifen-methyl, picloram, and triclopyr), indicating absence of cross-resistance. Multiple resistance to the herbicides paraquat, saflufenacil, and ammonium glufosinate was not identified in the Marpr9-rn population. However, survival following treatment with the herbicides glyphosate and chlorimuron-ethyl occurred. The evolution of H2O2 began at 15 min after application and was less pronounced in low light. These results indicate the first case of resistance to 2,4-D and occurrence of rapid necrosis in C. sumatrensis.
Contamination of raw milk by psychrotrophs can lead to the production of heat-resistant proteases and subsequent spoilage of UHT milk. Therefore, this research communication evaluated the effect of a pre-milking teat disinfectant (active components: L-(+)-lactic acid and salicylic acid) and a liner disinfectant (active components: peracetic acid and hydrogen peroxide) on the number of mesophilic and (proteolytic) psychrotrophic bacteria prior to milking. The teat orifices of 10 cows were sampled using a swabbing procedure before and after treatment with a pre-milking teat disinfectant on six subsequent days. On the teat orifices, there was a small but statistically significant decrease in the psychrotrophic bacterial counts between pre and post dipping. No differences were observed for the mesophilic bacterial counts and proteolytic active counts. Liners were also sampled using swabs pre and post disinfection. No statistically significant decrease in the bacterial counts was observed post liner disinfection, although there was a numerical decrease. Sixty-two percent of the proteolytic psychrotrophs were pseudomonads: 16.5% of which were P. fragi, 14.3% P. lundensis, 10.0% P. fluorescens and 2.9% P. putida. Trinitrobenzenesulfonic acid (TNBS) analysis revealed a wide variety in proteolytic activity (from 0 to 55 µmol glycine/ml milk) and the presence of high producers. It can be concluded that there was only a minor effect of teat and liner disinfection on the psychrotrophic bacterial counts indicating that the measures presented did not result in a reduction of the targeted bacteria on teat orifices and liners.
The accurate estimation of protein requirements for beef cattle is a key factor in increasing livestock profitability and decreasing the environmental impacts of excessive N excretion due to mismatching between assumed requirements and diet formulation. A meta-analysis was conducted to evaluate and validate a new equation to predict the net protein requirements for growth (NPg) of Zebu beef cattle. For the development of the new approach, a database of 552 observations comprised of bulls, steers, and heifers of different genetic groups (Zebu, beef crossbreed, and dairy crossbreed) was assembled. The new approach was evaluated and compared to current models devised by the international nutrient requirements system committees (Agricultural Research Council, 1980; Beef Cattle Nutrient Requirements Model, 2016; BR-CORTE, 2016) to predict NPg. The model evaluation was performed through the model evaluation system (version 3.1.16) using an independent data set (n = 177 observations). An equation was considered the best estimator of NPg if the following conditions were met: (1) the intercept and slope of the regression between ordinary residues and/or predicted NPg values must have been equal to zero and one, respectively; and (2) the greatest concordance correlation coefficient (CCC) and determination coefficient (R), and lowest mean squared error of prediction (MSEP) were attained. Based on the regression models of the observed v. predicted NPg of Zebu beef cattle, both the new approach and that of the ARC (1980) correctly estimated NPg, since the intercept and slope were not different (P > 0.05) from zero and one, respectively. Additionally, the new approach’s determination coefficient was the greatest and the closest to one. The fact that the new model achieved a higher CCC and lower MSEP than the existing models indicated its superior reproducibility and accuracy. The equations proposed by BR-CORTE (2016) and the BCNRM (2016) did not correctly estimate NPg in that the intercept and slope were different (P < 0.01) from zero and one, respectively. Thus, the equations proposed by the new approach and the ARC (1980) accurately and precisely estimated NPg and are recommended for Zebu cattle. Furthermore, the inclusion of equivalent empty BW (EQEBW) in the new approach improves the estimation of NPg. We suggest the use of the following equation to calculate NPg for Zebu beef cattle: NPg = 176.01 × EBG – 0.381 × EQEBW0.75 × EBG1.035 (R = 0.80 and CCC = 0.75); where NPg = net protein requirements for growth, EBG = empty body gain, and EQEBW = equivalent empty BW.
Neusticemys neuquina (Fernández and de la Fuente, 1988) is a turtle from the Upper Jurassic of the Neuquén Basin, Patagonia, Argentina. Here we describe in detail a new skull, lower jaw, and a vertebra, utilizing both traditional anatomical description and computed tomography (CT). New diagnostic cranial characters of Neusticemys neuquina are: a round depression on the ventral surface of the basisphenoid, a relatively larger oval foramen nervi trigemini, and reduced and steepened triturating surfaces on both the maxilla and dentary. The new morphological information presented in this study was included in a phylogenetic analysis, the primary result of which was recovery of Neusticemys neuquina within Thalassochelydia. Characters recognized as synapomorphies of this clade include: (1) anterolateral recess of the anterior surface of the quadrate positioned lateral to the processus trochlearis oticum, (2) presence of a fossa on the supraoccipital-opisthotic-exoccipital contact area, (3) foramina anterius caroticus cerebralis located close together but independently perforating the basisphenoid, and (4) the presence of the splenial in the mandible. Two contrasting dispersal scenarios could explain how this species of Thalassochelydia can be found outside of Europe. The presence of Neusticemys neuquina in the Neuquén Basin could be the consequence of an early dispersion event, for which we lack intermediate forms, or it could be the result of a later event once the clade was already established in Europe.
Consanguineous marriages potentially play an important role in the transmission of β-thalassaemia in many communities. This study aimed to determine the rate and socio-demographic associations of consanguineous marriages and to assess the influence on the prevalence of β-thalassaemia in Sri Lanka. Three marriage registrars from each district of Sri Lanka were randomly selected to prospectively collect data on all couples who registered their marriage during a 6-month period starting 1st July 2009. Separately, the parents of patients with β-thalassaemia were interviewed to identify consanguinity. A total of 5255 marriages were recorded from 22 districts. The average age at marriage was 27.3 (±6.1) years for males and 24.1 (±5.7) years for females. A majority (71%) of marriages were ‘love’ marriages, except in the Moor community where 84% were ‘arranged’ marriages. Overall, the national consanguinity rate was 7.4%. It was significantly higher among ethnic Tamils (22.4%) compared with Sinhalese (3.8%) and Moors (3.2%) (p < 0.001). Consanguinity rates were also higher in ‘arranged’ as opposed to ‘love’ marriages (11.7% vs 5.6%, p < 0.001). In patients with β-thalassaemia, the overall consanguinity rate was 14.5%; it was highest among Tamils (44%) and lowest among Sinhalese (12%). Parental consanguinity among patients with β-thalassaemia was double the national average. Although consanguinity is not the major factor in the transmission of the disease in the country, emphasis should be given to this significant practice when conducting β-thalassaemia prevention and awareness campaigns, especially in high-prevalence communities.
Bemisia tabaci (Gennadius) represents a relatively large cryptic species complex. Australia has at least two native populations of B. tabaci sensu lato and these were first found on different host plants in different parts of Australia. The species status of these populations has not been resolved, although their mitochondrial sequences differ by 3.82–4.20%. We addressed the question of whether these AUSI and AUSII B. tabaci populations are distinct species. We used reciprocal cross-mating tests to establish whether the insects from these different populations recognize one another as potential mating partners. The results show that the two native Australian populations of B. tabaci have a mating sequence with four phases, each of which is described. Not all pairs in the control crosses mated and the frequency of mating differed across them. Some pairs in the AUSI-M × AUSII-F did mate (15%) and did produce female progeny, but the frequency was extremely low relative to controls. Microsatellite genotyping of the female progeny produced in the crosses showed these matings were successful. None of the AUSII-M × AUSI-F crosses mated although some of the males did search for females. These results demonstrate the critical role of the mate recognition process and the need to assess this directly in cross-mating tests if the species status of different populations is to be tested realistically. In short, AUSI and AUSII B. tabaci populations are distinct species because the individual males and females do not recognize individuals of the alternative population as potential mating partners.
The bovine appeasing substance (BAS) is expected to have calming effects in cattle experiencing stressful situations. Therefore, this study investigated the impacts of BAS administration during two of the most stressful events within beef production systems: weaning and feedlot entry. In experiment 1, 186 Bos indicus-influenced calves (73 heifers, 113 bulls) were weaned at 211 ± 1 days of age (day 0). At weaning, calves were ranked by sex and BW, and assigned to receive BAS (Nutricorp, Araras, SP, Brazil; n = 94) or water (CON; n = 92). Treatments (5 ml) were topically applied to the nuchal skin area of each animal. Calf BW was recorded and samples of blood and tail-switch hair were collected on days 0, 15 and 45. Calves that received BAS had greater (P < 0.01) BW gain from day 0 to 15 compared with CON. Overall BW gain (days 0 to 45) and BW on days 15 and 45 were also greater (P ≤ 0.03) in BAS v. CON. Plasma haptoglobin concentration was less (P < 0.01) in BAS v. CON on day 15, whereas cortisol concentrations in plasma and tail-switch hair did not differ between treatments (P ≥ 0.13). In experiment 2, 140 B. indicus-influenced bulls (∼27 months of age) from 2 different pasture-based systems (70 bulls/origin) were transported to a commercial feedlot (≤ 200-km transport; day -1). On day 0, bulls were ranked by source and BW, and assigned to receive BAS (n = 70) or CON (n = 70) and the same sampling procedures as in experiment 1. Bulls receiving BAS had greater (P = 0.04) BW gain from day 0 to 15, but less (P < 0.01) BW gain from day 15 to 45 compared to CON. No other treatment effects were detected (P > 0.14). Therefore, BAS administration to beef calves alleviated the haptoglobin response associated with weaning, and improved calf growth during the subsequent 45 days. Administration of BAS to beef bulls at feedlot entry improved BW gain during the initial 15 days, but these benefits were not sustained throughout the 45-day experiment.
Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.
The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.
At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).
Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.
Hyperbaric oxygen therapy (HBOT) shows promising results in treating radionecrosis (RN) but there is limited evidence for its use in brain RN. The purpose of this study is to report the outcomes of using HBOT for symptomatic brain RN at a single institution.
This was a retrospective review of patients with symptomatic brain RN between 2008 and 2018 and was treated with HBOT. Demographic data, steroid use, clinical response, radiologic response and toxicities were collected. The index time for analysis was the first day of HBOT. The primary endpoint was clinical improvement of a presenting symptom, including steroid dose reduction.
Thirteen patients who received HBOT for symptomatic RN were included. The median time from last brain radiation therapy to presenting symptoms of brain RN was 6 months. Twelve patients (92%) had clinical improvement with median time to symptom improvement of 33 days (range 1–109 days). One patient had transient improvement after HBOT but had recurrent symptomatic RN at 12 months. Of the eight patients with evaluable follow-up MRI, four patients had radiological improvement while four had stable necrosis appearance. Two patients had subsequent deterioration in MRI appearances, one each in the background of initial radiologic improvement and stability. Median survival was 15 months with median follow-up of 10 months. Seven patients reported side effects attributable to HBOT (54%), four of which were otologic in origin.
HBOT is a safe and effective treatment for brain RN. HBOT showed clinical and radiologic improvement or stability in most patients. Prospective studies to further evaluate the effectiveness and side effects of HBOT are needed.
The constant search for the improvement of the performance of materials of industrial application, evaluated under aspects of weight reduction, greater resistance, greater resistance to wear and better thermal stability, among others, associated with the search for the development of ecologically viable products, that convert the context of environmental degradation in preservation and sustainability, reflects the need to conduct research that results in new materials. The objective of this work is to obtain composites of the AA6061 aluminum alloy reinforced with different contents of coke coal blast-furnace slag by powder metallurgy. The processing of these materials was done by sieving, mixing and compacting powders of reinforced aluminum alloy with 5, 10 and 15% of blast-furnace slag. The cold uniaxial compaction was realized at a pressure of 500MPa. The obtained materials were sintered at 580°C for 3h under inert atmosphere. Unreinforced aluminum alloy samples were also produced. The characterization of the materials was realized by density and hardness measurements and three-point bending tests. The analysis of its microstructure was realized by scanning electron microscopy. As results, the composites presented a homogeneous distribution of the reinforcing particles and also a progressive improvement of the hardness and the bending strength with the increase of the slag content, producing an increase of 79% in hardness and 128% in flexural strength, when compared to the material without reinforcement obtained by the same process. Such results give the coke coal blast-furnace slag a new possibility of exploitation in the metal-mechanical sector, besides contributing with the environmental issue.