Prelacrimal window approach to the maxillary sinus: a systematic review and meta-analysis of the literature.

BACKGROUND: The prelacrimal window approach (PLWA) is a minimally invasive surgical technique that has been proposed as an alternative to the traditional approaches to access the maxillary sinus. METHODOLOGY: A systematic review with meta-analysis was performed following PRISMA guidelines and identified 368 articles for initial review of which 14 (610 participants) met the criteria for meta-analysis. Four databases, including PubMed, Google Scholar, Web of Science and Scopus, were searched to identify relevant articles. Two independent reviewers conducted the eligibility assessment for the included studies. Methodology quality and risk of bias were evaluated by New Castle Ottawa scale. The outcomes assessed were recurrence of the pathology, postoperative morbidity including epiphora, dry nose, facial, gingival numbness, epistaxis or local infection. RESULTS: The present data suggest a significant reduction in the recurrence rate of maxillary sinus pathology following PLWA when compared to conventional surgery (endoscopic medial maxillectomy, endoscopic sinus surgery and the Caldwell-Luc operation). The rates of epiphora, facial or gingival numbness, epistaxis or infection requiring intervention, were not significantly different between the procedures. CONCLUSIONS: Maxillary sinus pathology can be effectively treated using the PLWA technique, as it has been shown to result in a lower recurrence rate compared to conventional surgeries.

Cortico-cerebellar connectivity underlying motor control in chronic post-stroke individuals.

The robust, reciprocal anatomical connections between the cerebellum and contralateral sensorimotor cerebral hemisphere underscores the strong physiological interdependence between these two regions in relation to human behavior. Previous studies have shown that damage to sensorimotor cortex can result in a lasting reduction of cerebellar metabolism, the magnitude of which has been linked to poor rehabilitative outcomes. A better understanding of movement-related cerebellar physiology as well as cortico-cerebellar coherence (CCC) in the chronic, post-stroke state may be key to developing novel neuromodulatory techniques that promote upper limb motor rehabilitation. As a part of the first in-human phase-I trial investigating the effects of deep brain stimulation of the cerebellar dentate nucleus (DN) on chronic, post-stroke motor rehabilitation, we collected invasive recordings from DN and scalp EEG in subjects (both sexes) with middle cerebral artery stroke during a visuo-motor tracking task. We investigated the excitability of ipsilesional cortex, DN and the their interaction as a function of motor impairment and performance. Our results indicate that 1) event-related oscillations in the ipsilesional cortex and DN were significantly correlated at movement onset in the low-ß band, with moderately and severely impaired subjects showing desynchronization and synchronization, respectively. 2) Significant CCC was observed during isometric 'hold' period in the low-ß band, which was critical for maintaining task accuracy. Our findings support a strong coupling between ipsilesional cortex and DN in the low-ß band during motor control across all impairment levels which encourages the exploitation of the cerebello-thalamo-cortical pathway as a neuromodulation target to promote rehabilitation.Significance Statement:Cerebral infarct due to stroke can lead to lasting reduction in cerebellar metabolism resulting in poor rehabilitative outcomes. Thorough investigation of the cerebellar electrophysiology as well as cortico-cerebellar connectivity in humans that could provide key insights to facilitate development of novel neuromodulatory technologies, has been lacking. As a part of the first in-human phase-I trial investigating deep brain stimulation of the cerebellar dentate nucleus (DN) for chronic, post-stroke motor rehabilitation, we collected invasive recordings from DN and scalp EEG while stroke patients performed a motor task. Our data indicate strong coupling between ipsilesional sensorimotor cortex and DN in the low-ß band across all impairment levels encouraging the exploration of electrical stimulation of the DN.

What is the evidence for the effect of physical exercise on bone health in menopausal women? An umbrella systematic review.

This study aimed to analyze the effects of physical exercise (PE) on bone health in menopausal women through an umbrella review and to assess the quality of systematic reviews (SRs) and meta-analyses (MAs) included. The review was registered in PROSPERO (CRD42020208130) and the Rayyan application was used. The methodological quality of the included studies was evaluated by A MeaSurement Tool to Assess Systematic Reviews (AMSTAR), and Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to assess the level of evidence of the results. The results showed that low-intensity jumping exercises with longer sessions proved to be efficient in the hip segment. Swimming requires further investigation, as it showed high heterogeneity. Aerobic and resistance exercises showed inconsistent results, requiring further studies with these modalities of PE. Concurrent training showed improvements in the lumbar spine, femoral neck, Ward's triangle and trochanter. Finally, combined resistance exercises are effective in preserving bone mineral density (BMD) of the femoral neck and lumbar spine in postmenopausal women. In conclusion, jumping exercises were efficient in the hip, while aerobic and resistance exercises are still inconsistent. Concurrent training showed improvements in BMD of the lumbar spine, femoral neck, Ward's triangle and trochanter. Finally, combined resistance protocols are effective in preserving BMD of the femoral neck and lumbar spine in postmenopausal women.

Expression of enzymes involved in the urea cycle and muscle and mammary gland development of Holstein × Gyr heifers in a rotational grazing system supplemented with increasing protein levels.

Studies evaluating the crude protein (CP) supplementation strategies across the year for grazing cattle and its association with the enzymes involved in the urea cycle and muscle and mammary gland developments are scarce. Thus, we aimed to evaluate the effect of supplementation with different levels of CP on the expression of genes involved in the urea cycle and muscle and mammary gland development of Holstein × Gyr crossbreed heifers grazing intensively managed Brachiaria decumbens throughout the year. Thirty-eight heifers with average initial BW of 172.5 ± 11.15 kg (mean ± SE) and 8.2 ± 0.54 mo of age were randomly assigned to 1 of 4 treatments: 3 protein supplements (SUP) fed at 5g/kg of body weight, plus a control group (CON, non-supplemented animals). The supplement CP levels evaluated were: 12, 24, and 36%. The study was divided into 4 seasons: rainy, dry, rainy-dry transition (RDT), and dry-rainy transition (DRT). On the penultimate day of each season, ultrasound images of the carcass and mammary gland were taken. Five animals from each treatment were randomly chosen on the last day of each season, and liver and muscle tissue biopsies were performed. The target genes were the mammalian target of rapamycin (mTOR) and adenosine monophosphate-activated protein kinase (AMPK) in the muscle samples. Carbamoyl phosphate synthetase (CPS), ornithine transcarbamylase (OTC), argininosuccinate synthetase (ASS), arginosuccinate lyase (ASL), and arginase (ARG) were evaluated in the liver samples. Data were analyzed using PROC GLIMMIX of the SAS with repeated measures. We observed a greater rib eye area (cm2) and fat thickness (mm) in SUP animals than in non-supplemented animals. However, we did not observe differences among SUP levels for both variables. No effects of supplementation were detected on mammary gland development. Nevertheless, seasonal effects were observed, where the RDT and dry season had the most and least accumulated fat in the mammary gland. In muscle, we observed greater expression of AMPK in non-supplemented animals than SUP animals. On the other hand, no differences were observed in gene expression between SUP and non-supplemented animals and among SUP animals for mTOR. Season affected both AMPK and mTOR; heifers had a greater AMPK gene expression on rainy than RDT. For mTOR, we observed greater gene expression in RDT and DRT than in rainy. No differences were observed among RDT, dry, and DRT, and between dry and rainy seasons for mTOR. We observed greater CPS, ASL, and ARG gene expression in SUP animals than in non-supplemented animals. Among SUP animals, supplement CP linearly affected CPS. In conclusion, the supplementation strategy did not affect mammary gland development and mTOR expression in muscle tissue. However, we observed a seasonal effect on mammary gland development and AMPK and mTOR expression. The CP supplementation increased the rib eye area and fat thickness, directly affecting AMPK expression in the muscle. Moreover, the CP supplementation increased urea cycle enzyme expression, indicating greater urea production in the liver.

Assessment of the anterior superior alveolar nerve and its impact on surgery of the lateral nasal wall.

BACKGROUND: The anterior superior alveolar nerve (ASAN) plays a major role in innervation of the lateral nasal wall. Its damage during nasal surgery can cause dental paraesthesia and numbness around the upper lip. METHODOLOGY: Retrospective evaluation of the computed tomographic (CT) scans of 50 consecutive patients analysing 100 sides. We measured the mean distance from the shoulder of the inferior turbinate to the descending portion of the anterior superior alveolar nerve, to the anterior superior alveolar canal and the anterior-posterior distance between the 'shoulder' of the inferior turbinate and the pyriform aperture. RESULTS: The mean distance from the shoulder of the inferior turbinate to the descending portion of the anterior superior alveolar nerve was 6.4 ± 2.33 mm, with no difference between sides The mean relative height of the shoulder in relation to the anterior superior alveolar nerve canal was 4.78 ± 2.31mm with no significant difference between the two sides. The anterior-posterior distance between the 'shoulder' of inferior turbinate and the pyriform aperture was 6.96± 2.28mm, with no significant difference between the two sides. CONCLUSIONS: We found the anterior superior alveolar nerve to be a constant landmark in the lateral nasal wall. Therefore, the course of the ASAN should be assessed on a CT scan when a surgical approach through the pyriform aperture or anterior medial wall of the maxillary sinus is planned.

Novel PCR primers for improved detection of Mycobacterium leprae and diagnosis of leprosy.

AIMS: Diagnosis of leprosy, a chronic infection caused by Mycobacterium leprae, predominantly depends on clinical manifestations and histopathological analysis, hampering rapid and accurate diagnostics. Our aim was to increase accuracy of leprosy diagnosis by improving M. leprae's DNA detection based on polymerase chain reaction (PCR) technique using new specific primers for the RLEP repetitive sequence. METHODS AND RESULTS: The specific target region, RLEP, of M. leprae's genome was selected based on comparative genomics. After confirming the specificity of this region, using blastn analysis, primers were designed and tested for their in silico specificity. To evaluate the specificity and sensitivity of these primers in vitro, 184 blood samples from patients were used in qPCR. The new primer pair LYON1/LYON2 produced 91% positive samples, whereas the current primer pair LP1/LP2 produced 46%. Specificity and DNA detection limit test were carried out to compare the efficiency of the developed primer pair. The LYON1/LYON2 primer showed 100% specificity, whereas LP1/LP2 showed 64%. The DNA detection limit of LYON1/LYON2 was 10 copies of bacterial genomes per millilitre, whereas LP1/LP2 was 1000 copies of bacterial genomes per millilitre. CONCLUSIONS: In conclusion, the developed LYON1/LYON2 primer pair presented to be a specific and sensitive new molecular marker for the diagnosis of leprosy. SIGNIFICANCE AND IMPACT OF THE STUDY: The development of a specific primer pair for the detection of the M. leprae genome through qPCR technique contributes to a fast, sensitive and specific diagnosis, which is essential to prevent spreading and progression of this disease.

Performance of Iris pseudacorus and Typha domingensis for furosemide removal in a hydroponic system.

The potential of Iris pseudacorus and Typha domingensis to remove the pharmaceutical active compound (PhAC) Furosemide from a nutrient solution was assessed. Both plants were exposed to 2 mg L-1 of furosemide during 21 days and the removal of furosemide was monitored. Vessels without furosemide were also implemented as control systems for plants development. Likewise, unplanted vessels with furosemide were employed to assess abiotic removal mechanisms. All vessels were covered with aluminum foil to avoid photodegradation of the compound. Both plants showed potential to remove Furosemide, attaining, at the end of the experiment, a removal of 42.0-66.9% and 40.5-57.8%, for Typha and Iris, respectively. The plants do not presented a visible negative stress response to the exposure to furosemide, having a positive growth rate at the end of the experiment. Biodegradation seems to play an important role in furosemide removal, being enhanced by the presence of the plants. The two macrophytes presented different removal behaviors, particularly in the first 48 h of contact time. FUR removal by Iris follows a pseudo-first order while by Typha is divide in different phases. These results indicate that different plants species seem to have different mechanisms to remove pollutants from water.HighlightsPhACs removal potential of Iris pseudacorus and Typha domingensis was assessed.Plants were exposed to 2 mg L-1 of furosemide during 21 days.Both macrophytes showed good removal efficiencies.Biodegradation of furosemide seems to be the main removal mechanism.Plants demonstrated different removal behavior along the experiment.Removal mechanisms of plants seem to differ between species.

Microplastic effects on plants.

Microplastic effects in terrestrial ecosystems have recently moved into focus, after about a decade of research being limited to aquatic systems. While effects on soil physical properties and soil biota are starting to become apparent, there is not much information on the consequences for plant performance. We here propose and discuss mechanistic pathways through which microplastics could impact plant growth, either positively or negatively. These effects will vary as a function of plant species, and plastic type, and thus are likely to translate to changes in plant community composition and perhaps primary production. Our mechanistic framework serves to guide ongoing and future research on this important topic.

Evidence of a Nodal Line in the Superconducting Gap Symmetry of Noncentrosymmetric ThCoC_{2}.

The newly discovered noncentrosymmetric superconductor ThCoC_{2} exhibits numerous types of unconventional behavior in the field dependent heat capacity data. Here we present the first measurement of the gap symmetry of ThCoC_{2} by muon spin rotation and relaxation (µSR) measurements. The temperature dependence of the magnetic penetration depth measured using the transverse field µSR experiment reveals the evidence of a nodal pairing symmetry. To understand this finding, we carry out calculations of the superconducting pairing eigenvalue and eigenfunction (pairing symmetry) due to the spin-fluctuation mechanism by directly implementing the ab initio band structures. We find that the system possesses a single Fermi surface with considerable three dimensionality and a strong nesting along the k_{z} direction. Such nesting promotes a superconducting state with a cosk_{z}-like pairing symmetry with a prominent nodal line on the k_{z}=±π/2 plane. The result agrees well with the experimental data.

Homophily around specialized foraging underlies dolphin social preferences.

Individuals often associate socially with those who behave the same way. This principle, homophily, could structure populations into distinct social groups. We tested this hypothesis in a bottlenose dolphin population that appeared to be clustered around a specialized foraging tactic involving cooperation with net-casting fishermen, but in which other potential drivers of such social structure have never been assessed. We measured and controlled for the contribution of sex, age, genetic relatedness, home range and foraging tactics on social associations to test for homophily effects. Dolphins tended to group with others having similar home ranges and frequency of using the specialized foraging tactic, but not other traits. Such social preferences were particularly clear when dolphins were not foraging, showing that homophily extends beyond simply participating in a specific tactic. Combined, these findings highlight the need to account for multiple drivers of group formation across behavioural contexts to determine true social affiliations. We suggest that homophily around behavioural specialization can be a major driver of social patterns, with implications for other social processes. If homophily based on specialized tactics underlies animal social structures more widely, then it may be important in modulating opportunities for social learning, and therefore influence patterns of cultural transmission.

Effects of preparation with the Self-Adjusting File, TRUShape and XP-endo Shaper systems, and a supplementary step with XP-endo Finisher R on filling material removal during retreatment of mandibular molar canals.

AIM: To compare the effects of three instrumentation systems, and a supplementary approach with a finishing instrument, on filling material removal during retreatment of mandibular molar canals. METHODS: Sixty mesial canals from mandibular molars (Vertucci's type IV anatomy) were instrumented, filled and subjected to retreatment. After initial removal of the root canal filling material using the D-RaCe system, the canals were randomly distributed into three groups (n = 20) according to the instrument system used for preparation: the Self-Adjusting File (SAF), TRUShape or XP-endo Shaper. The filling material volume in the apical 5 mm of the canals was assessed by means of micro-computed tomography (micro-CT) before and after retreatment. All specimens with residual filling material were subjected to a supplementary approach with the XP-endo Finisher R instrument and another micro-CT scan was taken. Data on the volumes of filling material and incidence of total removal were compared between groups by the general linear model for paired data and the Fisher's exact test. The effects of the refinement step were evaluated by the Wilcoxon Signed Ranks test. RESULTS: The amount of removed material was 92.4%, 96.9% and 96.9% for the SAF, TRUShape and XP-endo Shaper, respectively. There were no significant differences between them (P > 0.05). Canals were completely cleaned of filling material in 70% of the specimens for XP-endo Shaper, 55% for SAF and 30% for TRUShape; the difference between XP-endo Shaper and TRUShape was significant (P = 0.03). The supplementary step with the XP-endo Finisher R instrument was associated with additional filling material removal of 38% (P < 0.001). Six more canals were rendered free of filling material after using this finishing instrument. CONCLUSIONS: The tested systems were equally effective in removing the mass of filling material from the apical 5 mm of molar canals. The supplementary step with the XP-endo Finisher R instrument enhanced filling material removal.

Clinical study on the efficacy of LED phototherapy for pain control in an orthodontic procedure.

Pain is an unpleasant and emotional subjective sensory experience that occurs during orthodontic procedures. Currently, LED phototherapy is an alternative to the use of laser light as analgesic agent due to similarity of response and lower cost. This case-control, quantitative, qualitative, and longitudinal study aimed to investigate the effect of IR LED phototherapy (λ846 ± 20 nm) in pain during the process of tooth separation during orthodontic treatment. After approval by the Institution Ethics Committee, 40 patients (30 female/10 male, 20-30 years old, average age 24.5 ± 2.6 years old) fulfilling the inclusion criteria entered the study and received a set of four visual analog scales (VAS) for scoring pain immediately, 48 h, 72 h, and 7 days after the insertion of the separating elastics. The patients were randomly distributed into two groups (experimental and control). The patients of experimental group received LED phototherapy (180 mW, 22 s, 4 J, 8 J/cm2, 0.36 W/cm2, spot of 0.5 cm2, spot diameter 0.8 cm) at the same times in which VAS was performed, and control patients were not irradiated. It was found that, in both groups, there was an increase in pain 48 h after insertion of the elastic tooth separator, decreasing 72 h after its installation and reached the lowest level of pain after 7 days. Comparison between groups showed that pain level in the LED group was always statistically significantly lower (p < 0.05), except for the time of installation (T1). The use of LED light was effective in significantly reducing the level of pain after insertion of the elastic tooth separators when compared to the control group.

Effects of rumen-undegradable protein on intake, performance, and mammary gland development in prepubertal and pubertal dairy heifers.

The objective of this study was to evaluate the influence of different amounts of rumen-undegradable protein (RUP) on intake, N balance, performance, mammary gland development, carcass traits, and hormonal status of Holstein heifers at different physiological stages (PS). Sixteen prepubertal (PRE) heifers (initial BW = 106 ± 7.6 kg; age = 4.3 ± 0.46 mo) and 16 pubertal (PUB) heifers (initial BW = 224 ± 7.9 kg; age = 12.6 ± 0.45 mo) were used in an experiment over a period of 84 d. Four diets with increasing RUP contents (38, 44, 51, and 57% of dietary crude protein) and heifers at 2 PS (PRE or PUB) were used in a 4 × 2 factorial arrangement of treatments in a completely randomized design. Throughout the experiment, 2 digestibility trials were performed over 5 consecutive days (starting at d 36 and 78) involving feed and ort sampling and spot collections of feces and urine. At d 0 and 83, body ultrasound images were obtained for real-time carcass trait evaluation. The mammary gland was ultrasonically scanned at d 0 and every 3 wk during the experiment. Blood samples were taken at d 0 and 84 to determine serum concentrations of progesterone, estrogen, insulin-like growth factor I (IGF-I), and insulin. No interaction between PS and the level of RUP was found for any trait. Apparent digestibility of dry matter, organic matter, and neutral detergent fiber corrected for ash and protein was not affected by RUP level but was lower for PRE compared with PUB heifers. Sorting against neutral detergent fiber corrected for ash and protein (tendency only) and for crude protein was greater for PUB than PRE heifers. Pubertal heifers had greater average daily gain (905 vs. 505 g/d) and N retention (25.9 vs. 12.5 g/d) than PRE heifers. In addition, average daily gain and N retention were greatest at 51% RUP of dietary protein. Mammary ultrasonography indicated no effects of RUP amounts on mammary gland composition, whereas PRE heifers had greater pixel values than PUB, indicating higher contents of fat rather than protein in the mammary glands of PRE heifers. Serum progesterone and IGF-I concentration was affected only by PS, and PRE heifers had greater values of progesterone and IGF-I concentrations than PUB heifers. Serum insulin concentration was unaffected by PS but tended to be higher at 51% of RUP. In conclusion, an RUP level of 51% increases body weight, average daily gain, feed efficiency, and N retention in heifers regardless of the PS. In addition, PRE heifers have a lower sorting ability and reduced intake, total-tract digestibility, and N retention. They also have higher amounts of fat in their mammary glands, even at moderate growth rates.

Chemical composition and morphology study of bovine enamel submitted to different sterilization methods.

OBJECTIVES: The morphology and chemical composition of enamel submitted to different sterilization methods was studied. METHODS: X-ray photoelectron spectroscopy (XPS), field emission gun scanning electron microscopy (FEG-SEM), and energy-dispersive X-ray spectroscopy (EDS) were performed to evaluate 50 bovine enamel specimens sterilized using four methods: microwaving (MI), gamma irradiation (GI), ethylene oxide (EO), and steam autoclave (SA). Non-sterilized specimens were used as control. RESULTS: XPS indicated that the concentration of P (phosphorus), CO3 (carbonate), and CO3/P was not changed in all groups. GI produced no significant change on elemental composition. SA produced the major decrease in calcium (Ca), Ca/P ratio, and increase in N (nitrogen). MI was found to decrease Ca, Ca/P ratio and O (oxygen), and increase in C (carbon) and N. EO produced decrease in Ca and O with increased C concentration. FEG-SEM revealed surface and in-depth morphological changes on SA specimens. Minor surface alterations were observed for EO and for MI groups, and no alteration was observed on GI group. EDS indicated no difference on elemental composition of enamel bulk among groups. CONCLUSIONS: SA produced mineral loss and morphological alterations on surface and in depth. MI and EO sterilization caused mineral loss showing only slight alteration on enamel surface. GI sterilization preserves the morphological characteristics of enamel. The sterilization methods could be classified from lower to high damage as GI < MI < EO < SA. CLINICAL RELEVANCE: This is a comprehensive comparative study where different methods for enamel sterilization were investigated in terms of chemical changes. The results presented here may help researchers to choose the most appropriate method for their research setting and purpose.

Front microrheology of the non-Newtonian behaviour of blood: scaling theory of erythrocyte aggregation by aging.

We introduce a new framework to study the non-Newtonian behaviour of fluids at the microscale based on the analysis of front advancement. We apply this methodology to study the non-linear rheology of blood in microchannels. We carry out experiments in which the non-linear viscosity of blood samples is quantified at different haematocrits and ages. Under these conditions, blood exhibits a power-law dependence on the shear rate. In order to analyse our experimental data, we put forward a scaling theory which allows us to define an adhesion scaling number. This theory yields a scaling behaviour of the viscosity expressed as a function of the adhesion capillary number. By applying this scaling theory to samples of different ages, we are able to quantify how the characteristic adhesion energy varies as time progresses. This connection between microscopic and mesoscopic properties allows us to estimate quantitatively the change in the cell-cell adhesion energies as the sample ages.

Beliefs and attitudes towards the influenza vaccine in high-risk individuals.

Societal and economic impact of influenza is mainly due to influenza infection of specific groups, who are at higher risk of health complications leading up to hospitalisation or death. In this study we applied the health belief model (HBM) to evaluate beliefs and attitudes towards influenza disease and vaccine in community-dwelling high-risk individuals (aged 65 or more or having a chronic disease). We conducted a mixed-method study using data collected through a telephone survey of a household unit sample. We used thematic analysis to map responses to HBM dimensions and Poisson regression to model vaccine non-uptake prevalence. The main self-reported reason not to take the vaccine referred to the susceptibility dimension: 'considering oneself to be a healthy person' (29·8%, (95% confidence interval (CI) 22·1-38·7)). Bad experiences after vaccination - barriers dimension - were also commonly reported (17·0%, (95% CI 10·8-23·8)). Vaccine non-uptake prevalence was 22% higher in those who did not consider themselves susceptible to contract flu (Prevalence Ratio (PR) = 1·22, (95% CI 1·0-1·5)) and 18% lower in those who did not consider that the vaccine causes flu symptoms (PR = 0·82, (95% CI 0·68-0·99)). Results suggest that high-risk individuals do not think of themselves susceptible to influenza infection and fear adverse events following immunisation.

Restless legs syndrome in Wilson's disease: frequency, characteristics, and mimics.

OBJECTIVE: To determine characteristics, clinical significance, frequency, and mimics of restless legs syndrome (RLS) in a cohort of Wilson's disease (WD, n = 42/f = 18), compared to healthy, matched controls. MATERIALS AND METHODS: Structured clinical interviews (patients and caregiving family members), repeated neurological examinations (afternoon and presleep), comprehensive laboratory tests, WD-, RLS-, and sleep-specific rating scales, and video-polysomnography. RESULTS: Thirteen patients with WD (13/42 = 31.0%) clearly fulfilled the five diagnostic criteria of RLS; in eight patients (19.1%), the burden of RLS was clinically significant. The RLS was of moderate severity, equally distributed among sexes, manifested mainly in the evening and before falling asleep, and had developed mostly after clinical manifestation of WD (time elapsed 10.2 ± 14.5 years), still at a young mean age (27.5 ± 11.5 years). The known RLS-associated features were absent (normal iron and kidney parameters) or rare (positive family history, polyneuropathy). Compared to WD patients without RLS, patients with RLS were significantly elder and had suffered longer from WD. WD-specific RLS mimics as well as RLS confounding motor comorbidities (dystonia, tremor, chorea) were frequent and a diagnostic challenge; in difficult cases, the differentiation was reached by clinical observation of the motor behavior in the evening or at nighttime. CONCLUSION: RLS was frequent in this cohort of WD and might be causally related to WD. RLS should be included in the diagnostic work-up of WD. In complex motor disorders, differential diagnosis of RLS might require evening/nighttime examination and video-polysomnography. In WD patients with a clinically significant RLS, treatment with dopaminergic substances may be considered.

Dosages of cold-water immersion post exercise on functional and clinical responses: a randomized controlled trial.

Cold-water immersion (CWI) is one of the recovery techniques commonly used by athletes for post-exercise recovery. Nevertheless, the effects of CWI using different temperatures and the dose-response relationship of this technique have not yet been investigated. The aims of this study were to compare the effects of two strategies of CWI, using different water temperatures with passive recovery post exercise in the management of some markers of muscle damage, and to observe whether any of the techniques used caused deleterious effects on performance. Sixty healthy male participants performed an eccentric protocol to induce muscle damage and were then randomized to one of three groups (CWI1: 15 min at 9 °C; CWI2: 15 min at 14 °C; CG: control group). Levels of creatine kinase, muscle soreness, pain threshold, perception of recovery, and maximal voluntary isometric contraction were monitored up to 96 h post exercise. A large effect for time for all outcomes was observed [P < 0.001; CK (ES = 0.516), muscle soreness (ES = 0.368); pain threshold (ES = 0.184); perception of recovery (ES = 0.565); MVIC (ES = 0.273)]. CWI groups presented an earlier recovery for muscle soreness with lower ratings immediately post recovery. For delayed effects, the application of CWI2 (15 min at 14 °C) presented earlier recovery compared with CWI1 and control condition for maximal voluntary isometric contraction (P < 0.05). There were no significant group and interaction (Group × Time) effects. CWI groups acted more efficiently for muscle soreness and performance considering the time of recovery was observed. No evidence was found to suggest dose-response relationship and deleterious effects.

The bone degenerative processes in senile fishes from Holocene Brazilian shell mounds.

Zooarchaeological collections from shell mounds in Rio de Janeiro (2,470-4,632 cal BP) contain a high prevalence of swollen fish bones belonging to the Atlantic spadefish (Chaetodipterus faber), crevalle jack (Caranx hippos) and fat snook (Centropomus parallelus). Given the lack of knowledge of the bone degenerative process in senile fishes, this study analysed hyperostotic bone in zooarchaeological and modern specimens to obtain high-resolution morphology and microstructure reconstruction. We used microCT as well as X-ray diffraction to characterize the crystallographic changes associated with fish senility. Our results showed that trabecular microstructures in hyperostotic bones were consistent with estimated values of the per cent bone volume-to-total volume ratio (BV/TV) and were greater than 60% in cortical bone. Hyperostotic bones indicated a high radiograph density, and X-ray diffractograms showed a decrease in hydroxyapatite [Ca10 (PO4 )6 (OH)2 ] and calcite (CaCO3 ) neocrystallization. These crystalline and density changes revealed an advanced stage of fish senile and indicate the vulnerability of ageing fish populations.

Technical note: Mammary gland ultrasonography to evaluate mammary parenchymal composition in prepubertal heifers.

Bovine mammary gland development studies are often terminal or involve invasive biopsy procedures. Therefore, noninvasive means of assessing mammary development should be considered as alternative methods in live animals. The objective was to test if mammary ultrasonography can be used as a noninvasive way to estimate mammary parenchyma (PAR) composition in prepubertal dairy heifers with different average daily body weight gains. In the 84 d preceding, the ultrasound exam heifers were maintained in 1 of 3 treatment groups. Individual heifers were fed a high gain (1 kg/d; n = 6), low gain (0.5 kg/d, n = 6), or maintenance (n = 6) treatment diet. To achieve desired body weight gains, heifers were fed differing amounts of the same silage-based diet. Mammary glands of 18 crossbred heifers Holstein:Gyr underwent a single mammary ultrasound exam immediately before heifer slaughter, which took place when heifers weighed 142.0 ± 8.0 kg and were 200 d old. The 4 mammary glands of each heifer were evaluated using a real-time B-mode ultrasound machine equipped with a 6.5-MHz micro-convex transducer. Digital images (8-bit) of glands were obtained and PAR was identified within gland. Average pixel values per unit of PAR area were determined for each gland and analyzed at the level of heifer. Pixel results were interpreted on the basis that lower average pixel values reflect PAR with relatively high amounts of protein as opposed to fat. To help validate that the pixel value within PAR is associated with composition of PAR, pixel findings were compared with histological [number of adipocytes in PAR (Nad) and epithelial area in PAR (Ep)] and biochemical [percent crude protein in PAR (%CP), percent ether extract in PAR (%EE), PAR weight (WPAR), and mammary fat pad weight (WFAT)] composition of PAR in these same heifers. Within PAR, %EE and WFAT were positively correlated with pixel values, whereas %CP, Ep, and Nad were negatively correlated. Parenchyma weight did not correlate with pixel values. Regression analyses (fixed effect log-pixel value; random effect treatment) were used to estimate Nad, Ep, %CP, %EE, WPAR, and WFAT. Sensitivity analysis of regression equations revealed that accuracy of tested equations ranged from 0.77 to 0.93 and precision ranged from 0.56 to 0.82. Concordance correlation coefficients of the equations ranged from 0.41 to 0.76. In conclusion, ultrasonography of PAR can accurately measure and predict PAR composition in prepubertal dairy heifers growing at various rates of gain.