Metabolic and behavioural risk factors for cardiovascular diseases in Southern Latin America: analysis of the Global Burden of Disease 1990-2019.

OBJECTIVES: Cardiovascular diseases (CVDs) are the leading causes of global mortality. Modifiable behavioural and metabolic risk factors significantly contribute to the burden of CVD. Given the vast socio-demographic and health outcome heterogeneity in Latin America, similar southern Latin American countries (Argentina, Chile, and Uruguay) were analysed as a distinct group to describe the CVD death rates related to metabolic and behavioural risk factors. STUDY DESIGN: An ecological study was performed using data from the Global Burden of Disease Study 2019. METHODS: Metabolic and behavioural risk factors-related CVD death were examined by analysing age-standardised rates per 100,000 individuals in the three countries between 1990 and 2019. RESULTS: While exposure to behavioural risk is decreasing, an upwards trend was observed in metabolic risks. Among the assessed risk factors, metabolic factors emerged as the primary contributors to deaths. High fasting plasma glucose exhibited a remarkable increase in relative importance across most studied contexts. Dietary risks stood out among behavioural factors due to their complexity and substantial changes observed. Although mortality rates have declined for overall CVD, peripheral artery disease mortality is rising. CONCLUSION: Modifiable behavioural and metabolic risk factors significantly influence CVD mortality in Southern Latin America. Despite the increasing exposure to metabolic risks, advancements in prevention and treatment are evidenced in the decline of mortality rates for most CVD. These findings emphasise the need for targeted interventions and comprehensive strategies to address their impact on cardiovascular health, advocating for healthy lifestyle behaviours to mitigate the progression and CVD development.

Evaluating the potential of biodiversity offsets to achieve net gain.

Evaluating the outcomes and tracking the trajectory of biodiversity offsets is essential to demonstrating their effectiveness as a mechanism to conciliate development and conservation. We reviewed the literature to determine the principles that should underpin biodiversity offset planning and the criteria for offset evaluation at the project level. According to the literature, the core principles of equivalence, additionality, and permanence are used as criteria to evaluate conservation outcomes of offsets. We applied the criteria to evaluate offsets of a large iron ore mining project in the Atlantic Forest in Brazil. We examined equivalence in terms of the amount of area per biodiversity value affected and fauna and flora similarity, additionality in terms of landscape connectivity, and permanence in terms of guarantees to ensure protection and restoration offsets lasting outcomes. We found an offset ratio (amount of affected area:offset area) of 1:1.8 for forests and 1:2 for grasslands. Ecological equivalence (i.e., similarity between affected and offset areas) was found for forested areas, but not for ferruginous rupestrian grasslands or for fauna. Landscape metrics showed that connectivity improved relative to the preproject situation as a result of locating restoration offsets in the largest and best-connected forest patch. Permanence of offsets was addressed by establishing covenants and management measures, but financial guarantees to cover maintenance costs after mine closure were lacking. Offsets should be equivalent in type and size, provide conservation outcomes that would not be obtained without them (additionality), and be lasting (permanence). To monitor and evaluate offsets, it is necessary to determine how well these 3 principles are applied in the planning, implementation, and maintenance of offsets. Achieving measurable conservation outcomes from offsets is a long-term endeavor that requires sustained management support, and is information intensive. Thus, offsets require ongoing monitoring and evaluation as well as adaptive management.

Evaluación del potencial de las compensaciones por biodiversidad para obtener ganancias netas Resumen La evaluación de resultados y el rastreo de la trayectoria de las compensaciones por biodiversidad son esenciales para demostrar su efectividad como mecanismo de conciliación entre el desarrollo y la conservación. Revisamos la literatura para determinar los principios que deberían sustentar los planes de compensación y los criterios para evaluarla a nivel de proyecto. Según la literatura, se usan los principios nucleares de equivalencia, adicionalidad y permanencia como criterio para evaluar los resultados de conservación de las compensaciones. Aplicamos este criterio para evaluar las compensaciones de un gran proyecto minero de mineral de hierro en el Bosque Atlántico de Brasil. Analizamos la equivalencia en términos de cantidad de área por valor de biodiversidad afectado y similitudes entre la flora y fauna; la adicionalidad en términos de conectividad de paisaje; y la permanencia en términos de las garantías que aseguran que las compensaciones tengan resultados longevos de restauración y protección. Descubrimos una proporción en las compensaciones (cantidad del área afectada:área de compensación) de 1:1.8 para los bosques y de 1:2 en los campos naturales. Encontramos equivalencias ecológicas (es decir, la similitud entre las áreas afectadas y las de compensación) para las áreas boscosas, pero no para los campos rupestres ferruginosos ni para la fauna. Las medidas del paisaje mostraron que la conectividad mejoró en relación a la situación previa al proyecto gracias a la ubicación de las compensaciones por restauración en los fragmentos de bosque más grandes y mejor conectados. Establecimos Contractos y medidas de manejo fueron establecidos la permanencia de las compensaciones, pero las garantías económicas para cubrir los costos de mantenimiento después del cierre de la mina no están suficientemente garantizadas. Las compensaciones deberían ser iguales en tipo y tamaño (equivalencia), proporcionar resultados de conservación que no se obtendrían en su ausencia (adicionalidad) y ser duraderas (permanencia). Se necesita determinar cómo se aplican estos tres principios en la planeación, implementación y mantenimiento de las compensaciones para poder monitorearlas. Si se quieren lograr resultados medibles de conservación, se necesita que el manejo cuente con un apoyo mantenido y a largo plazo que contenga con información intensiva. Por lo tanto, las compensaciones requieren un monitoreo y evaluación continua además del manejo adaptativo.

Association between physical activity and sickness absenteeism in university workers.

BACKGROUND: Sedentary occupations have increased by more than 10% in Western countries over the last two decades, and the yearly global cost of physical inactivity has been estimated to be $53.8 billion. As workers tend to move less in the workplace, they are more likely to develop a sedentarism-related chronic condition and to be absent from work due to illness, although research evidence on the issue remains unclear. AIMS: To investigate associations between physical activity (PA) and sickness absenteeism in the workplace among Spanish university workers. METHODS: We conducted cross-sectional research with data from 1025 workers aged 18-65 years (43% women) from a Spanish university. Physical Activity Vital Sign (PAVS) and International Physical Activity Questionnaire (IPAQ) short versions were used to evaluate levels of PA. Workplace absenteeism was self-reported by participants. Written questionnaires distributed during medical checks included PAVS, IPAQ and the question about absenteeism among other information. The association between PA and sickness absenteeism was examined using adjusted multiple linear regression. RESULTS: After adjusting for age, sex, job function, chronic conditions, sedentarism and smoking, each weekly hour of PA reduced sickness absence by -1.20 (95% confidence interval: -2.40-0.00) days per year. CONCLUSIONS: The implementation of PA promotion strategies aimed at university employees may lead to a reduction of days off work due to illness.

A retrospective comparison of neoadjuvant chemoradiotherapy regimens for locally advanced esophageal cancer.

Preoperative chemoradiotherapy (CRT) with carboplatin/paclitaxel has been shown to increase survival in patients with esophageal cancer, including gastroesophageal junction (GE) junction cancer, over surgery alone; however, there have been no studies comparing the different neoadjuvant CRT regimens. We retrospectively evaluated the long-term results of trimodality therapy for patients with locally advanced esophageal cancer treated on several chemotherapy regimens. Between 1999 and 2014, 215 patients with locally advanced esophageal cancer underwent neoadjuvant CRT followed by surgical resection. The median age was 62 years (range 21-84), 80.5% were men and 86% had adenocarcinoma. The following chemotherapy regimens were administered: cisplatin/5FU (14.9%), cisplatin/irinotecan (35.8%), carboplatin/paclitaxel (35.8%), and other (9.7%). The majority of patients (92.1%) received a radiation dose of 50.4 Gy. Predictors of toxicities and surgical complications were assessed using logistic regression. Overall survival (OS) and recurrence-free survival (RFS) were estimated using the Kaplan-Meier method and proportional hazards regression was used to model time-to-event outcomes. The median follow-up among surviving patients was 4.1 years (range 0.4,13). The median OS was 3.0 years from time of diagnosis and OS was 36.8% at 5 years. RFS was 34.9% at 5 years. After neoadjuvant CRT, 34.7% of patients achieved a pathologic complete response including 60.7% of squamous cell carcinoma patients and 18.4% of adenocarcinoma patients (P < 0.001) and 66% were downstaged. Of the variables examined, pathologic stage, preoperative baseline cardiac comorbidity, postoperative cardiac or pulmonary complications, and chemotherapy regimen were associated with OS. Using cisplatin and 5FU as the reference regimen, patients treated with carboplatin/paclitaxel had significantly improved OS (HR = 0.47, P = 0.017 after adjusting for surgery type, radiation modality, baseline cardiac comorbidity, and preoperative stage) with 5-year OS rate of 66%. The most common surgical complications were cardiac in 61 patients (28.5%) and pulmonary in 52 patients (24.3%). Cardiac complications were associated with age (OR 1.05, P = 0.007) and cardiac comorbidity (OR 2.6, P = 0.02) and pulmonary complications with female gender (OR 3.98, P < 0.001). Forty-four patients (20.5%) required readmission within 30 days of discharge, and readmission was associated with cardiac comorbidity (OR 2.7, P = 0.017). Three patients died within 30 days of surgery. We observed an association between neoadjuvant carboplatin/paclitaxel and improved overall survival that requires confirmation in a prospective randomized trial.

Transplantation of amniotic membrane-derived multipotent cells ameliorates and delays the progression of chronic kidney disease in cats.

Chronic kidney disease (CKD) is a common clinical condition in domestic cats, characterized by tubulointerstitial, vascular and glomerular inflammation and severe fibrosis. Studies in rodent model of induced CKD have shown a decrease and stabilization of the clinical condition. In this study was evaluated the safety and effect of intrarenal and intravenous infusion of allogeneic mesenchymal stem cells (AMSCs) derived from feline amniotic membrane in cats with naturally occurring CKD. Cat AMSCs were harvested after mechanical and enzymatic digestion of amnion. A healthy cat received intrarenal injection of AMSCs guided by ultrasound in both kidneys (5 × 105  cells/kidney). Nine cats with CDK received repeated intravenous infusions of AMSCs (2 × 106 cells × 2 treatments). The clinical parameters of healthy cat did not change, but sedation and general anaesthesia was required. The number of interventions stressed the animal, and he developed transient haematuria after AMSC injection. Cats with CDK registered a significant improvement of renal function (decrease in serum creatinine and urine protein concentrations and increase in urine specific gravity). The kidney architecture and morphology did not change following the treatment. The feline AMSCs have a renoprotective effect and improve renal function in cats with naturally occurring CKD, stabilizing the clinical condition and disease progression. Thus, intravenous injection of AMSCs may be an important tool to provide welfare in cats with chronic kidney disease.

Downregulation of ATM Gene and Protein Expression in Canine Mammary Tumors.

The ataxia telangiectasia mutated (ATM) gene encodes a protein associated with DNA damage repair and maintenance of genomic integrity. In women, ATM transcript and protein downregulation have been reported in sporadic breast carcinomas, and the absence of ATM protein expression has been associated with poor prognosis. The aim of this study was to evaluate ATM gene and protein expression in canine mammary tumors and their association with clinical outcome. ATM gene and protein expression was evaluated by reverse transcription-quantitative polymerase chain reaction and immunohistochemistry, respectively, in normal mammary gland samples (n = 10), benign mammary tumors (n = 11), nonmetastatic mammary carcinomas (n = 19), and metastatic mammary carcinomas (n = 11). Lower ATM transcript levels were detected in benign mammary tumors and carcinomas compared with normal mammary glands (P = .011). Similarly, lower ATM protein expression was observed in benign tumors (P = .0003), nonmetastatic mammary carcinomas (P < .0001), and the primary sites of metastatic carcinomas (P < .0001) compared with normal mammary glands. No significant differences in ATM gene or protein levels were detected among benign tumors and nonmetastatic and metastatic mammary carcinomas (P > .05). The levels of ATM gene or protein expression were not significantly associated with clinical and pathological features or with survival. Similar to human breast cancer, the data in this study suggest that ATM gene and protein downregulation is involved in canine mammary gland tumorigenesis.

Phytochemical Composition and Antitumor Activities of New Salad Greens: Rucola (Diplotaxis tenuifolia) and Corn Salad (Valerianella locusta).

D. tenuifolia and V. locusta, two greens, were analyzed for active compounds and antitumor actions on colorectal cancer cells. Phenolics were determined by UHPLC-Orbitrap-MS; carotenoids and glucosinolates by HPLC-MS; and sterols and fatty acids by gas-liquid chromatography (GLC). For antitumor effects, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and lactate dehydrogenase (LDH) tests were run on HT-29 colorectal cancer cells, and in CCD-18 untransformed enterocyte cells. Six main carotenoids were identified in both vegetables, while total carotenoids accounted for 3520 and 2970 µg · g(-1) dry weight in D. tenuifolia and V. locusta, respectively. Six phenolics were detected in D. tenuifolia (68,600 µg · g(-1) dry weight) and five in V. locusta (139,000 µg · g(-1) dry weight). Three glucosinolates (GSL) were found in D. tenuifolia (1960 µg · g(-1) dry wt. total). Low-polarity extracts from V. locusta and D. tenuifolia showed IC50 ~ 150 and ~200 µg · mL(-1) on HT-29 cells, while both plants lacked actions on CCD-18 cells. V. locusta inhibited HT-29 cancer cells viability more efficiently than D. tenuiofolia, but induced less cytotoxicity. This work highlights the importance of functional foods for colorectal cancer prevention.

Adsorption and Coupling of 4-aminophenol on Pt(111) surfaces.

We have deposited 4-aminophenol on Pt(111) surfaces in ultra-high vacuum and studied the strength of its adsorption through a combination of STM, LEED, XPS and ab initio calculations. Although an ordered (2√3×2√3)R30° phase appears, we have observed that molecule-substrate interaction dominates the adsorption geometry and properties of the system. At RT the high catalytic activity of Pt induces aminophenol to lose the H atom from the hydroxyl group, and a proportion of the molecules lose the complete hydroxyl group. After annealing above 420K, all deposited aminophenol molecules have lost the OH moiety and some hydrogen atoms from the amino groups. At this temperature, short single-molecule oligomer chains can be observed. These chains are the product of a new reaction that proceeds via the coupling of radical species that is favoured by surface diffusion.

ATM down-regulation is associated with poor prognosis in sporadic breast carcinomas.

BACKGROUND: Ataxia telangiectasia-mutated (ATM) gene downexpression has been reported in sporadic breast carcinomas (BC); however, the prognostic value and mechanisms of ATM deregulation remain unclear. PATIENTS AND METHODS: ATM and miRNAs (miR-26a, miR-26b, miR-203, miR-421, miR-664, miR-576-5p and miR-18a) expression levels were evaluated by quantitative real-time PCR (RT-qPCR) in 52 BC and 3 normal breast samples. ATM protein expression was assessed by immunohistochemistry in 968 BC and 35 adjacent normal breast tissues. ATM copy number alteration was detected by array comparative genomic hybridization (aCGH) in 42 tumours. RESULTS: Low ATM levels were associated with tumour grade. Absence of ATM protein expression was associated with distant metastasis (P < 0.001), reduced disease-free survival (DFS, P < 0.001) and cancer-specific survival (CSS, P < 0.001). Multivariate analysis indicated ATM protein expression as an independent prognostic marker for DFS (P = 0.001, HR = 0.579) and CSS (P = 0.001, HR = 0.554). ATM copy number loss was detected in 12% of tumours and associated with lower mRNA levels. miR-421 over-expression was detected in 36.5% of cases which exhibit lower ATM transcript levels (P = 0.075, r = -0.249). CONCLUSIONS: The data suggest that ATM protein expression is an independent prognostic marker in sporadic BC. Gene copy number loss and miR-421 over-expression may be involved in ATM deregulation in BC.

New Zealand juvenile oyster mortality associated with ostreid herpesvirus 1-an opportunistic longitudinal study.

During the 2010-11 summer outbreak of ostreid herpesvirus 1 (OsHV-1) in New Zealand, an opportunistic longitudinal field study was conducted. OsHV-1 PCR-negative oyster spat (Crassostrea gigas) were relocated to an OsHV-1 PCR-positive area of the North Island of New Zealand that was experiencing juvenile oyster mortalities. Over a period of 13 d, spat were monitored for mortality, sampled for histopathology, and tested for the presence of OsHV-1 using real time PCR and Vibrio culture. Histopathology showed some evidence of tissue pathology; however, no consistent progressive pathology was apparent. Field mortalities were evident from Day 6 on. After 5 and 7 d of exposure, 83 and 100% of spat, respectively, tested positive for the virus by real time PCR. Vibrio species recovered during the longitudinal study included V. splendidus and V. aestuarianus. This study offers insight into the rapidity of onset and virulence of the virus in naïve oyster spat in New Zealand waters.

An evaluation of the periapical status of teeth with necrotic pulps using periapical radiography and cone-beam computed tomography.

AIM: To evaluate the presence or absence of periapical (PA) radiolucencies on individual roots of teeth with necrotic pulps, as assessed with digital PA radiographs and cone-beam computed tomography (CBCT). METHODOLOGY: Digital PA radiographs and CBCT scans were taken from 161 endodontically untreated teeth (from 155 patients) diagnosed with non-vital pulps (pulp necrosis with normal PA tissue, symptomatic apical periodontitis, asymptomatic apical periodontitis, acute apical abscess and chronic apical abscess). Images were assessed by two calibrated endodontists to analyse the radiographic PA status of the teeth. A consensus was reached in the event of any disagreement. The data were analysed using a McNemar's test, and significance was set at P ≤ 0.05. RESULTS: Three hundred and forty paired images of roots were assessed with both digital PA radiographs and CBCT images. Fifteen additional roots were identified with CBCT. PA radiolucencies were present in 132 (38.8%) roots when assessed with PA radiographs, and in 196 (57.6%) roots when assessed with CBCT. This difference was statistically significant (P < 0.05). In teeth diagnosed with pulp necrosis, symptomatic apical periodontitis or acute apical abscess, CBCT images revealed a statistically larger number of PA radiolucencies than did PA radiographs (P < 0.05). No statistical differences were observed between PA radiographs and CBCT in teeth classified with asymptomatic apical periodontitis (P = 0.31) or chronic apical abscess (P = 1). CONCLUSIONS: Unlike PA radiographs, CBCT revealed a higher prevalence of PA radiolucencies when endodontically untreated teeth with non-vital pulps were examined.

Innovative approaches to controlling Salmonella in the meat industry.

Salmonella, a Gram-negative, rod-shaped bacterium from the Enterobacteriaceae family, is a significant cause of illnesses in humans and animals. It resides in the digestive tracts of livestock, poultry, and other warm-blooded animals and can contaminate various environments and foods through fecal matter. Salmonella enterica, the main species that affects humans, is widespread in cattle, pigs, and poultry. Despite efforts to control pathogens in meat systems, over 1.4 million human salmonellosis cases occur annually in the U.S., with serotypes S. enteritidis and S. typhimurium being predominant. Advances in meat processing have targeted pathogen reduction at multiple stages, but more innovative approaches are needed for substantial public health impact. This paper discusses current and future strategies to minimize Salmonella in the food supply. It emphasizes pre- and post-harvest Salmonella prevalence by biomapping it through the whole processing chain, focusing on beef and pork interventions such as probiotics. These interventions have shown promise in reducing pathogen loads in cattle manure and lymph nodes. Techniques such as microbiome, whole genome sequencing (WGS), and electron microscopy (EM) provide detailed insights into Salmonella's genetic and bacterial structural-morphological characteristics, aiding in the development of targeted interventions. Integrating rapid detection, biomapping, and enviromapping enhances pathogen tracking in meat production, reducing Salmonella prevalence and improving risk assessment and food safety. The advanced, current, and innovative techniques allow for timely identification, detailed spatial and quantitative data, and more effective interventions. This leads to safer food products and reduces foodborne illnesses.

The effects of six electronic apex locators on pacemaker function: an in vitro study.

AIM: To assess the effects of six electronic apex locators (EALs) on pacemaker function in vitro. METHODOLOGY: Six EALs (Mini Apex Locator®, Dentaport ZX®, Novapex®, Raypex5®, Root ZX mini®, and Justy II®) were tested for electromagnetic interference (EMI) with one pacemaker (Saint Jude Medical). The pacemaker, with a single electrode, was immersed in a saline solution bath adjusted to 400-800 hms to simulate the electrical resistance of the human body and to register the activity by the system. The pacemaker was tested with each of the EALs to analyse the presence of EMI with the EAL switched on, the EAL switched off and during EAL operation. Each series of tests began with a 15-second baseline recording (R0) and continued until all the recording conditions had been covered. The conditions were as follows: R1: recording with the lead of the EAL <2 cm from the tip of the electrode; R2: recording with the lead of the EAL <2 cm from the generator; R3: recording with the lead of the EAL <2 cm from the sensing arc; and R4: recording with the lead of the EAL 15 cm from the sensing arc. If any of the EALs produced interference, its characteristics were categorized. RESULTS: When the lead of the EAL was <2 cm from the tip of the electrode, the majority of the EALs tested produced only background noise. Only one (the Mini Apex Locator) resulted in EMI that was detected as false heart activity. When the EAL was <2 cm from the generator, just one EAL detected background noise (the Mini Apex Locator). When the EAL was <2 cm from the sensing arc or 15 cm from the sensing arc, the recordings were not affected by any of the EALs. There were no significant differences amongst the EALs analysed with respect to the production of EMI. CONCLUSIONS: EMI occurred when the EALs were placed close to the tip of the electrode and occasionally when close to the pacemaker; however, no EMI was detected when the EALs were placed near to or 15 cm from the sensing arc in this laboratory experimental model.

Trichogramma pretiosum parasitism and dispersal capacity: a basis for developing biological control programs for soybean caterpillars.

In order to succeed in biological control programs, not only is it crucial to understand the number of natural enemies to be released but also on how many sites per area this releasing must be performed. These variables might differ deeply among egg parasitoid species and crops worked. Therefore, these trials were carried out to evaluate the parasitism (%) in eggs of Anticarsia gemmatalis and Pseudoplusia includens after the release of different densities of the egg parasitoid Trichogramma pretiosum. Field dispersal was also studied, in order to determine appropriate recommendations for the release of this parasitoid in soybean fields. The regression analysis between parasitism (%) and densities of the parasitoid indicated a quadratic effect for both A. gemmatalis and P. includens. The maximum parasitism within 24 h after the release was reached with densities of 25.6 and 51.2 parasitoids per host egg, respectively, for the two pests. Parasitism of T. pretiosum in eggs of P. includens decreased linearly as the distance of the pest eggs from the parasitoid release sites increased. For P. includens, the mean radius of T. pretiosum action and the area of parasitoid dispersal in the soybean crop were 8.01 m and 85.18 m2, respectively. We conclude that for a successful biological control program of lepidopteran pests using T. pretiosum in soybean fields, a density of 25.6 parasitoids per host egg, divided into 117 sites per hectare, should be used.

Biological characteristics of Anticarsia gemmatalis (Lepidoptera: Noctuidae) for three consecutive generations under different temperatures: understanding the possible impact of global warming on a soybean pest.

Climate changes can affect the distribution and intensity of insect infestations through direct effects on their life cycles. Experiments were carried out during three consecutive generations to evaluate the effect of different temperatures (25°C, 28°C, 31°C, 34°C and 37±1°C) on biological traits of the velvetbean caterpillar Anticarsia gemmatalis Hübner, 1818 (Lepidoptera: Noctuidae). The insects were fed on artificial diet and reared in environmental chambers set at 14 h photophase. The developmental cycle slowed with the increase in the temperature, within the 25°C to 34°C range. Male and female longevities were reduced with an increase in temperature from 25°C to 28°C. Egg viability was highest at 25°C, and the sex ratio was not influenced by temperature, in the three generations. There was no interactive effect between development time and temperature on pupal weight. The results suggested that the increase in the temperature negatively impacted A. gemmatalis development inside the studied temperature range, indicating a possible future reduction of its occurrence on soybean crops, as a consequence of global warming, mainly considering its impact on tropical countries where this plant is cropped. A. gemmatalis was not able to adapt to higher temperatures in a three-generation interval for the studied temperature range. However, a gradual increase and a longer adaptation period may favor insect selection and consequently adaptation, and must be considered in future studies in this area. Moreover, it is important to consider that global warming might turn cold areas more suitable to A. gemmatalis outbreaks. Therefore, more than a future reduction of A. gemmatalis occurrence due to global warming, we might expect changes regarding its area of occurrence on a global perspective.

Handgrip strength and respiratory disease mortality: Longitudinal analyses from SHARE.

BACKGROUND: While the association between handgrip strength and all-cause mortality is more deeply explored, no previous studies have been specifically focused on handgrip strength and respiratory disease mortality. The purpose of the study was to investigate the association between handgrip strength and respiratory disease mortality in a large representative sample. METHODS: Individuals aged 50 or over from 27 European countries and Israel participated in this longitudinal study. Data on handgrip strength and all-cause and respiratory disease mortality were retrieved from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6 and 7. We estimated the sub hazard ratios (SHRs) for respiratory disease mortality using a Fine-Gray sub-distribution method with both time-varying exposure and covariates and mortality due to other causes as competing risk. Furthermore, we assessed dose-response associations of handgrip strength (modelled as a continuous exposure) with respiratory disease mortality using restricted cubic splines and estimated hazard ratios (HRs). RESULTS: We included 60,883 men and 74,904 women with a mean age of 63.6 (SD 9.7) years at study entry. During a median (interquartile range) of 7.4 years of follow-up 565 (0.4%) participants died due to respiratory diseases. The increase of 1 single kg of handgrip strength showed a 6% incidence reduction on respiratory disease mortality (SHR, 0.94; 95%CI, 0.92-0.96) after adjusting for potential confounders. Furthermore, each kg increase of handgrip strength reduced respiratory disease mortality risk in a dose-response fashion and a significant threshold for values of 41 kg (HR, 0.49; 95%CI, 0.26-0.92) and higher was identified. CONCLUSIONS: Higher handgrip strength is associated with lower mortality due to respiratory disease. Intervention studies are needed to determine whether strength training in respiratory disease patients can prevent premature mortality.

Does the presence of proximal humerus growth plate changes in young baseball pitchers happen only in symptomatic athletes? An x ray evaluation of 21 young baseball pitchers.

OBJECTIVE: To evaluate the presence of x ray changes in the proximal humerus growth plate of 21 young pitchers. DESIGN: Case series. SETTING: This study was conducted at the Orthopaedic and Traumatology Department of the ABC College of Medicine, Santo André, São Paulo, Brazil, tertiary institution. PATIENTS: 21 male adolescent baseball pitchers, with a mean age of 14.5 years and selected from the Brazilian National Team, were studied. INTERVENTIONS: The patients underwent x ray examinations of the shoulders. MAIN OUTCOME MEASUREMENTS: The x rays of the pitchers' shoulders were studied to determine any changes in the proximal humeral growth plate and correlate them with clinical findings. RESULTS: Fourteen athletes (66%) had radiographic changes in the humerus growth plate but only 5 (36%) had pain complaints. Nine of these 14 cases (64%) whom the observers found radiographic changes did not complain of pain. It was also observed that there was a correlation in only 11 cases between clinical and radiographic evaluations. CONCLUSION: Radiographic changes in the proximal humerus growth plate were found in 66% of the cases, but 64% were asymptomatic. These changes indicate possible evolution, in the future, to a greater degree of retroversion in pitchers' dominant shoulders.

Efficacy of three different rotary files to remove gutta-percha and Resilon from root canals.

AIM: To evaluate the efficacy of ProTaper Retreatment files, Mtwo Retreatment files and Twisted Files for removal of gutta-percha and Resilon in straight root canals. METHODOLOGY: Ninety single root canals were instrumented and randomly allocated into 6 groups of 15 specimens each with regards to the filling material and instruments used. Group 1: gutta-percha/ProTaper; Group 2: Resilon/ProTaper; Group 3: gutta-percha/Mtwo; Group 4: Resilon/Mtwo; Group 5: gutta-percha/Twisted Files; Group 6: Resilon/Twisted Files. For all roots, the following data were recorded: procedural errors, duration of retreatment, canal wall cleanliness through optical microscope and cone beam computed tomography (CBCT). Data were statistically analysed, and the level of significance was set at P=0.05. RESULTS: No system completely removed the root filling material from root canal walls. No significant differences were observed between the rotary systems in terms of the area of filling material left within the canals (P>0.05). There were statistically significant differences between the filling materials: Resilon/Real Seal had less residual material than gutta-percha/AH plus (CBCT: P=0.01; microscope: P=0.018). Mtwo Retreatment files were more rapid when removing filling material than ProTaper Retreatment files (P=0.19) and Twisted Files (P=0.04). CONCLUSIONS: No system removed the root filling materials entirely. Mtwo Retreatment files required less time to remove root filling material than the other instruments. Resilon was removed significantly better from the canal walls than gutta-percha, irrespective of the rotary instruments used.

Reliability of point-of-care coagulometer measurements in patients with acute ischaemic stroke receiving intravenous fibrinolysis. / Fiabilidad del coagulómetro portátil en pacientes con ictus isquémico agudo tratados con fibrinólisis intravenosa.

BACKGROUND: Speed of administration conditions the effectiveness of intravenous fibrinolysis in treating acute ischaemic stroke. To reduce the risk of haemorrhagic complications, the intervention is contraindicated in certain cases, such as where the International Normalised Ratio (INR) is ≥ 1.7. This study aimed to determine the reliability of point-of-care INR readings (POC-INR) taken using the CoaguChek® XS portable coagulometer compared to laboratory results (L-INR). METHODS: We conducted a retrospective observational study of consecutive patients admitted to our centre with acute ischaemic stroke and who were treated with intravenous fibrinolysis, over a period of 4 years. Patients' INR was measured with a portable coagulometer and in the laboratory. Results were compared using the paired-sample t test; using L-INR results as a reference value, ROC analysis was performed to determine POC-INR with greater predictive value. RESULTS: The study included 210 patients with a mean age of 74.3±11.5 years old; 18 (8.6%) were taking vitamin K antagonist oral anticoagulants (OAC). There were no significant differences between the 2 INR measurements in the population as a whole (POC-INR-L-INR difference: 0.001±0.085; P=.82). In subgroup analysis, the results coincided for patients taking OACs (0.001±0.081; P=.42) and those with L-INR ≤ 1.2 (0.008±0.081; P=.16). For L-INR>1.2, however, the portable coagulometer underestimated INR (0.058±0.095; P=.01). Through ROC analysis, POC-INR < 1.6 was found to be the cut-off point with greatest sensitivity (100%) and specificity (98.97%) for identifying patients eligible for intravenous fibrinolysis (L-INR < 1.7). CONCLUSIONS: POC-INR shows a good correlation with L-INR. Our results suggest that the best threshold to predict an L-INR < 1.7 is POC-INR < 1.6. Internal validation studies for POC-INR should be considered in all treatment centres.

Non-additive genetic effects on weights and performance of a Brazilian Bos taurus x Bos indicus beef composite.

The aim of the present study was to evaluate the heterosis effects on weaning weight at 205 days (WW, n = 146,464), yearling weight at 390 days (YW, n = 69,315) and weight gain from weaning to yearling (WG, n = 59,307) in composite beef cattle. The fixed models were: RM, which included contemporary groups, class of age of dam, outcrossing percentages for direct and maternal effects, and additive direct and maternal (AM) breed effects; R, RM model, minus AM breed effects, and H, RM model, minus additive breed effects. The estimates for W205 were in general positive (P < 0.01). The R and H models resulted in similar estimates, but they were very different from the ones estimated by the RM model. For W390, the R and H models resulted in general positive estimates (P < 0.05). For WG, the RM model resulted in general significant heterosis effects (P < 0.05). It can be concluded that the RM model seems to supply estimates of better quality (P < 0.01).