Clinical and radiographic outcomes of a two-piece ceramic implant: one year results from a prospective clinical trial.

OBJECTIVE: To describe the clinical and radiographic performance and survival rate of a new two-piece ceramic implant system after at least 12 months of follow-up. MATERIALS AND METHODS: Sixty-five implants were placed and followed up for at least 12 months (12.3 ± 1.5), in 50 patients. The implants were installed both in fresh extraction sockets and in healed sites and received provisional restoration when the clinical insertion torque was greater than 35Ncm. The primary results describe the survival rate of these implants. Clinical performance was evaluated through the evaluation of the Pink Esthetic Score (PES) and the degree of satisfaction of the patients. Bone loss was measured through radiographic measurements of the marginal bone loss in the mesial (MBLM) and distal (MBLD) sites. RESULTS: The survival rate was 98.5%. The average MBLM was 0.24 mm (± 0.53) and the MBLD was 0.27 mm (± 0.57). A statistical difference was observed only when comparing immediate implants with delayed ones (MBLM - p = 0.046 and MBLD - p = 0.028) and when they received immediate provisionalization or not (MBLM - p = 0.009 and MBLD - p = 0.040). The PES before the intervention (T0) was 13.4 (± 0.8) and the PES at T2 (12-month follow-up) was 12.9 (± 1.5) (p = 1.14). CONCLUSION: The new two-piece ceramic implant used in the present study showed predictable and reliable results, similar to those found with titanium implants after one year of follow-up. CLINICAL RELEVANCE: These implants can be used as an alternative to titanium implants in terms of the marginal bone loss and the degree of patient satisfaction.

Izokibep for the treatment of moderate-to-severe plaque psoriasis: a phase II, randomized, placebo-controlled, double-blind, dose-finding multicentre study including long-term treatment.

BACKGROUND: Monoclonal antibodies to interleukin (IL)-17 have shown strong efficacy in patients with psoriasis. Izokibep is a unique IL-17A inhibitor with a small molecular size and favourable distribution to sites of inflammation. OBJECTIVES: To evaluate the dose response, efficacy and safety of izokibep in patients with plaque psoriasis. METHODS: In this double-blind, randomized, phase II dose-finding study (AFFIRM-35) in adults with moderate-to-severe plaque psoriasis and inadequate response to two or more standard therapies, patients were randomized (1:1:1:1:1) to placebo or izokibep 2, 20, 80 or 160 mg every 2 weeks for 12 weeks. During the remainder of the 52-week core study, patients given placebo were switched to izokibep 80 mg, and dosing intervals were adapted based on Psoriasis Area and Severity Index (PASI) scores for all patients. The core study was followed by two optional consecutive 1-year extension periods for a total duration of 3 years. The primary endpoint was a 90% reduction in PASI score (PASI 90) at week 12. Additional efficacy outcomes and adverse event (AE) rates were evaluated. RESULTS: In total, 109 patients were randomized [safety set, n = 108 (one exclusion criteria failure); full analysis set, n = 106]. At week 12, PASI 90 response rates were 0%, 5%, 19%, 71% and 59% for the placebo, 2-, 20-, 80- and 160-mg izokibep groups, respectively. Rapid dose-dependent improvements were also observed across other efficacy outcomes. During the placebo-controlled period, AEs in the izokibep groups were similar to placebo except for mild injection site reactions. AEs were generally mild to moderate and the drug was well tolerated. Izokibep maintained efficacy at the higher dosage groups for up to 3 years, with no new safety signals. CONCLUSIONS: Data from this phase II study indicate that izokibep is well tolerated and efficacious in the treatment of plaque psoriasis. Higher doses or more frequent dosing could be explored to further enhance response rates.

Lateral exposure of the proximal and distal peroneal artery without bone resection.

Surgical revascularization with distal bypass surgery is associated with good outcomes for chronic limb-threatening ischemia. The peroneal artery, the most-often preserved outflow vessel, is commonly reached through a lateral approach involving resection of the fibula. We present two different techniques for a lateral approach to the peroneal artery: the first by proximal exposure and the second by exposing the distal segment of the peroneal artery. Both techniques are performed without bone resection.

Implementation of risk stratification for the care of glaucoma patients during the resumption of in-person care during the COVID-19

Introduction: the COVID-19 pandemic sparked a serious health crisis in which non-essential medical services were suspended, with the management of serious diseases not related to the pandemic, including glaucoma, becoming secondary in importance. With the flexibilization of social isolation measures, resuming outpatient care was necessary, respecting the health equity provided by the Brazilian Unified Health System.Objective: to describe a risk classification of glaucoma progression based on clinical ophthalmology criteria during the COVID-19 pandemic.Methods: observational study of an administrative nature. A review was carried out of the medical records of patients who had scheduled appointments between March and September of 2020 in the glaucoma sector of the FMABC University Center's Department of Ophthalmology. A total of 489 medical records (881 eyes) were reviewed, and patients were divided into 4 groups according to the risk of glaucoma progression. Eyes were evaluated for visual acuity (VA), optic disc cup, pachymetry, intraocular pressure (IOP), mean number of eyes drop medications used, and global visual field indexes.Results: groups were homogeneous in terms of age (mean 67.04 ± 11.72 years) and sex (55.5% women and 44.5% men). Primary open-angle glaucoma was the most prevalent etiology, present in 45.2% of patients, followed by primary angle-closure glaucoma in 15.7%. The groups were compared with each other, and a statistical difference (p<0.005) was found in 04 of the 08 aspects analyzed: VA, optic disc cup, IOP and mean number of eyes drop medications used.Conclusion: the risk classification for progression proposed in this study was easily applied and aided managers in prioritizing the most serious care during the COVID-19 pandemic

Genomic prediction and genetic correlations estimated for milk production and fatty acid traits in Walloon Holstein cattle using random regression models.

The aims of this study were to: (1) estimate genetic correlation for milk production traits (milk, fat and protein yields and fat and protein contents) and fatty acids (FA: C16:0, C18:1 cis-9, LCFA, SFA, and UFA) over days in milk, (2) investigate the performance of genomic predictions using single-step GBLUP (ssGBLUP) based on random regression models (RRM), and (3) identify the optimal scaling and weighting factors to be used in the construction of the H matrix. A total of 302 684 test-day records of 63.875 first lactation Walloon Holstein cows were used. Positive genetic correlations were found between milk yield and fat and protein yield (rg from 0.46 to 0.85) and between fat yield and milk FA (rg from 0.17 to 0.47). On the other hand, negative correlations were estimated between fat and protein contents (rg from -0.22 to -0.59), between milk yield and milk FA (rg from -0.22 to -0.62), and between protein yield and milk FA (rg from -0.11 to -0.19). The selection for high fat content increases milk FA throughout lactation (rg from 0.61 to 0.98). The test-day ssGBLUP approach showed considerably higher prediction reliability than the parent average for all milk production and FA traits, even when no scaling and weighting factors were used in the H matrix. The highest validation reliabilities (r2 from 0.09 to 0.38) and less biased predictions (b1 from 0.76 to 0.92) were obtained using the optimal parameters (i.e., ω = 0.7 and α = 0.6) for the genomic evaluation of milk production traits. For milk FA, the optimal parameters were ω = 0.6 and α = 0.6. However, biased predictions were still observed (b1 from 0.32 to 0.81). The findings suggest that using ssGBLUP based on RRM is feasible for the genomic prediction of daily milk production and FA traits in Walloon Holstein dairy cattle.

Compositional dependence of the fragility in metallic glass forming liquids.

The viscosity and its temperature dependence, the fragility, are key properties of a liquid. A low fragility is believed to promote the formation of metallic glasses. Yet, the fragility remains poorly understood, since experimental data of its compositional dependence are scarce. Here, we introduce the film inflation method (FIM), which measures the fragility of metallic glass forming liquids across wide ranges of composition and glass-forming ability. We determine the fragility for 170 alloys ranging over 25 at.% in Mg-Cu-Y. Within this alloy system, large fragility variations are observed. Contrary to the general understanding, a low fragility does not correlate with high glass-forming ability here. We introduce crystallization complexity as an additional contribution, which can potentially become significant when modeling glass forming ability over many orders of magnitude.

Intraocular Peak Pressure in Patients Under Treatment With Fixed Combination of Bimatoprost/Timolol/Brimonidine Once Daily Versus Twice Daily.

PRCIS: We investigate the efficacy of triple-fixed-combination of bimatoprost/brimonidine/timolol once and twice a day, demonstrating higher intraocular pressure reduction with once-a-day use, and discuss possible implications based on previous literature. PURPOSE: The purpose of this study was to compare the efficacy of a fixed combination bimatoprost-timolol-brimonidine (Triplenex) instilled once-daily with twice-daily in primary open angle glaucoma. PATIENTS AND METHODS: A randomized clinical trial at a public eye care institution. Thirty patients with primary open angle glaucoma were followed up for 3 months. The right and left eyes of these patients were randomly assigned to once-daily (10:00 pm ) or twice-daily (10:00 am ; 10:00 pm ) regimens of fixed combination bimatoprost-timolol-brimonidine. Intraocular pressure peaks were obtained with the water drinking test before the introduction of this medication (basal WDT0), 1 month (WDT1), 2 months (WDT2), and 3 months (WDT3) after starting the use of the fixed combination of bimatoprost/timolol/brimonidine (Triplenex). Variation from peak intraocular pressure at WDT3 to peak at WDT0 was compared within groups of 2 versus once-daily regimen. RESULTS: Sixty eyes of 30 patients (age: 70.67±9.70 y) were included in this study. Baseline clinical characteristics were comparable between groups. The mean reduction in peak intraocular pressure from WDT0 to WDT3 was 6.1±6.1 mm Hg (30.5%) in the eyes receiving 1 drop per day and 4.3±5.7 mm Hg (21.5%) in the eyes receiving 2 drops per day ( P =0.023). Mean reduction in peak intraocular pressure considering all WDT was also higher in the group with once-a-day treatment (5.90±6.03 vs. 4.46±4.28 mm Hg, P =0.006). CONCLUSION: Fixed combination of bimatoprost 0.01%, brimonidine tartrate 0.15%, and timolol maleate 0.5% once-a-day is more effective in reducing peak intraocular pressure as measured by the WDT than twice-a-day dosing.

Random regression test-day models to describe milk production and fatty acid traits in first lactation Walloon Holstein cows.

We investigated the use of different Legendre polynomial orders to estimate genetic parameters for milk production and fatty acid (FA) traits in the first lactation Walloon Holstein cows. The data set comprised 302,684 test-day records of milk yield, fat and protein contents, and FAs generated by mid-infrared (MIR) spectroscopy, C16:0 (palmitic acid), C18:1 cis-9 (oleic acid), LCFAs (long-chain FAs), SFAs (saturated FAs) and UFAs (unsaturated FAs) were studied. The models included random regression coefficients for herd-year of calving (h), additive genetic (a) and permanent environment (p) effects. The selection of the best random regression model (RRM) was based on the deviance information criterion (DIC), and genetic parameters were estimated via a Bayesian approach. For all analysed random effects, DIC values decreased as the order of the Legendre polynomials increased. Best-fit models had fifth-order (degree 4) for the p effect and ranged from second- to fifth-order (degree 1-4) for the a and h effects (LEGhap: LEG555 for milk yield and protein content; LEG335 for fat content and SFA; LEG545 for C16:0 and UFA; and LEG535 for C18:1 cis-9 and LCFA). Based on the best-fit models, an effect of overcorrection was observed in early lactation (5-35 days in milk [DIM]). On the contrary, third-order (LEG333; degree 2) models showed flat residual trajectories throughout lactation. In general, the estimates of genetic variance tended to increase over DIM, for all traits. Heritabilities for milk production traits ranged from 0.11 to 0.58. Milk FA heritabilities ranged from low-to-high magnitude (0.03-0.56). High Spearman correlations (>0.90 for all bulls and >0.97 for top 100) were found among breeding values for 155 and 305 DIM between the best RRM and LEG333 model. Therefore, third-order Legendre polynomials seem to be most parsimonious and sufficient to describe milk production and FA traits in Walloon Holstein cows.

The End of Wire Wrapping: A Technique to Avoid Intertwining Preloaded Guidewires for Endovascular Aortic Arch Repair.

PURPOSE: The purpose of this study was to present a new technique for endovascular aortic arch repair for 1, 2, or 3 vessels using preloaded wires and precannulated target vessels without wire wrapping. TECHNIQUE: This technique uses a prototype catheter with 2 parallel lumens to position through-and-through guidewires in the supra-aortic branches and an extra-stiff guidewire in the ascending aorta with no wrapping. This allows the introduction and advancement of the device with the already precannulated target vessels. The endograft is advanced to the aortic arch without twisting or wrapping. Covered stents are deployed to align the graft and target vessels. CONCLUSION: To our knowledge, a technique that avoids wire wrapping has not been previously described. This technique allows safer and faster endovascular arch procedures and opens up new possibilities by enabling multi-vessel endovascular aortic arch repair with all precannulated target vessels.

Ângulo de fase para avaliar risco ou cicatrização de lesões: revisão sistemática / Phase angle for assessing lesion risk or healing: a systematic review / Ángulo de fase para evaluar el riesgo o la cicatrización de lesiones: revisión sistemática

OBJETIVO: Avaliar a efetividade do ângulo de fase medido por bioimpedância elétrica como preditor para avaliação de cicatrização em pacientes com lesões cutâneas ou risco de desenvolvê-las. MÉTODO: Revisão sistemática operacionalizada segundo metodologia Joanna Briggs Institute, recomendações checklist PRISMA. A amostra contemplou pacientes acima de 18 anos com lesões cutâneas variadas. RESULTADOS: Quatro estudos demonstraram o uso do ângulo de fase para o desfecho cicatrização e um estudo apontou uma possível relação do ângulo de fase com previsão de surgimento e risco de lesão por pressão. Foram obtidos pontos de cortes para determinadas lesões. Por não ter sido possível metanálise, se propõe a realização de estudos primários sobre o tema deste estudo. CONCLUSÃO: Apesar de serem poucos os trabalhos científicos com o tema proposto, foi possível demonstrar evidência moderada para o desfecho "cicatrização" e baixa para o desfecho "risco de lesão". Registro no PROSPERO com número CRD420201549.

OBJECTIVE: To assess the effectiveness of the phase angle measured by electrical bioimpedance as a predictor for healing evaluation in patients with skin lesions or risk of developing them. METHOD: A systematic review operationalized according to Joanna Briggs Institute methodology, PRISMA checklist recommendations. The sample included patients over 18 years old with varied skin lesions. RESULTS: Four studies demonstrated the use of phase angle for the healing outcome and one study indicated a possible relationship between phase angle and the prediction of the onset and risk of pressure ulcer. Cut-off points were obtained for certain lesions. As it was not possible to perform a meta-analysis, it is proposed to conduct primary studies on the theme of this study. CONCLUSION: Although there are few scientific papers with the theme proposed, it was possible to demonstrate moderate evidence for the "healing" outcome and low evidence for the "risk of lesion" outcome. Registration in PROSPERO with number CRD420201549.

OBJETIVO: Evaluar la efectividad del ángulo de fase medido por bioimpedancia eléctrica como predictor para la evaluación de la cicatrización en pacientes con lesiones cutáneas o riesgo de desarrollarlas. MÉTODO: Revisión sistemática realizada según la metodología del Joanna Briggs Institute, recomendaciones checklist PRISMA. La muestra incluyó a pacientes mayores de 18 años con diferentes lesiones cutáneas. RESULTADOS: Cuatro estudios demostraron el uso del ángulo de fase para el resultado cicatrización y un estudio señaló una posible relación entre el ángulo de fase y la previsión de la aparición y el riesgo de lesión por presión. Se obtuvieron puntos de corte para ciertas lesiones. Como no fue posible realizar un metaanálisis, se propone realizar estudios primarios sobre el tema de este estudio. CONCLUSIÓN: Aunque hay pocos estudios científicos sobre el tema propuesto, fue posible demostrar evidencia moderada para el resultado "cicatrización" y baja para el resultado "riesgo de lesión". Inscripción en PROSPERO con número CRD420201549.

Combinatorial measurement of critical cooling rates in aluminum-base metallic glass forming alloys.

Direct measurement of critical cooling rates has been challenging and only determined for a minute fraction of the reported metallic glass forming alloys. Here, we report a method that directly measures critical cooling rate of thin film metallic glass forming alloys in a combinatorial fashion. Based on a universal heating architecture using indirect laser heating and a microstructure analysis this method offers itself as a rapid screening technique to quantify glass forming ability. We use this method to identify glass forming alloys and study the composition effect on the critical cooling rate in the Al-Ni-Ge system where we identified Al51Ge35Ni14 as the best glass forming composition with a critical cooling rate of 104 K/s.

Recent genetic advances on boar taint reduction as an alternative to castration: a review.

Boar taint is an unpleasant odor in male pig meat, mainly caused by androstenone, skatole, and indole, which are deposited in the fat tissue. Piglet castration is the most common practice to prevent boar taint. However, castration is likely to be banished in a few years due to animal welfare concerns. Alternatives to castration, such as genetic selection, have been assessed. Androstenone and skatole have moderate to high heritability, which makes it feasible to select against these compounds. This review presents the latest results obtained on genetic selection against boar taint, on correlation with other traits, on differences in breeds, and on candidate genes related to boar taint. QTLs for androstenone and skatole have been reported mainly on chromosomes 6, 7, and 14. These chromosomes were reported to contain genes responsible for synthesis and degradation of androstenone and skatole. A myriad of work has been done to find markers or genes that can be used to select animals with lower boar taint. The selection against boar taint could decrease performance of some reproduction traits. However, a favorable response on production traits has been observed by selecting against boar taint. Selection results have shown that it is possible to reduce boar taint in few generations. In addition, modifications in diet and environment conditions could be associated with genetic selection to reduce boar taint. Nevertheless, costs to measure and select against boar taint should be rewarded with incentives from the market; otherwise, it would be difficult to implement genetic selection.

Linking first lactation survival to milk yield and components and lactation persistency in Tunisian Holstein cows.

Genetic parameters were estimated for first lactation survival defined as a binary trait (alive or dead to second calving) and the curve shape traits of milk yield, fat and protein percentages using information from 25 981 primiparous Tunisian Holsteins. For each trait, shape curves (i.e. peak lactation, persistency), level of production adjusted to 305 days in milk (DIMs) for total milk yield (TMY), and average fat (TF %) and protein (TP %) percentages were defined. Variance components were estimated with a linear random regression model under three bivariate animal models. Production traits were modelled by fixed herd  × â€¯test-day (TD) interaction effects, fixed classes of 25 DIMs  × â€¯age of calving  × â€¯season of calving interaction effects, fixed classes of pregnancy, random environment effects and random additive genetic effects. Survival was modelled by fixed herd  × â€¯year of calving interaction effects and age of calving  × â€¯season of calving interaction effects, random permanent environment effects, and random additive genetic effects. Heritability ( h 2 ) estimates were 0.03 ( ± 0.01 ) for survival and 0.23 ( ± 0.01 ), 0.31 ( ± 0.01 ) and 0.31 ( ± 0.01 ) for TMY, TF % and TP %, respectively. Genetic correlations between survival and TMY, TF % and TP % were 0.26 ( ± 0.08 ), - 0.24  ( ± 0.06 ) and - 0.13  ( ± 0.06 ), respectively. Genetic correlations between survival and persistency for fat and protein percentages were  - 0.35  ( ± 0.09 ) and  - 0.19  ( ± 0.09 ), respectively. Cows that had higher persistencies for fat and protein percentages were more likely not to survive.

Additional considerations to the use of single-step genomic predictions in a dominance setting.

Recent publications indicate that single-step models are suitable to estimate breeding values, dominance deviations and total genetic values with acceptable quality. Additive single-step methods implicitly extend known number of allele information from genotyped to non-genotyped animals. This theory is well derived in an additive setting. It was recently shown, at least empirically, that this basic strategy can be extended to dominance with reasonable prediction quality. Our study addressed two additional issues. It illustrated the theoretical basis for extension and validated genomic predictions to dominance based on single-step genomic best linear unbiased prediction theory. This development was then extended to include inbreeding into dominance relationships, which is a currently not yet solved issue. Different parametrizations of dominance relationship matrices were proposed. Five dominance single-step inverse matrices were tested and described as C1 , C2 , C3 , C4 and C5 . Genotypes were simulated for a real pig population (n = 11,943 animals). In order to avoid any confounding issues with additive effects, pseudo-records including only dominance deviations and residuals were simulated. SNP effects of heterozygous genotypes were summed up to generate true dominance deviations. We added random noise to those values and used them as phenotypes. Accuracy was defined as correlation between true and predicted dominance deviations. We conducted five replicates and estimated accuracies in three sets: between all (S1 ), non-genotyped (S2 ) and inbred non-genotyped (S3 ) animals. Potential bias was assessed by regressing true dominance deviations on predicted values. Matrices accounting for inbreeding (C3 , C4 and C5 ) best fit. Accuracies were on average 0.77, 0.40 and 0.46 in S1 , S2 and S3 , respectively. In addition, C3 , C4 and C5 scenarios have shown better accuracies than C1 and C2 , and dominance deviations were less biased. Better matrix compatibility (accuracy and bias) was observed by re-scaling diagonal elements to 1 minus the inbreeding coefficient (C5 ).

Multi-Trait analysis of growth traits: fitting reduced rank models using principal components for Simmental beef cattle / Efetividade da redução da dimensão da matriz de covariância do efeito genético direto na avaliação genética do crescimento em bovinos Simental

ABSTRACT: The aim of this research was to evaluate the dimensional reduction of additive direct genetic covariance matrices in genetic evaluations of growth traits (range 100-730 days) in Simmental cattle using principal components, as well as to estimate (co)variance components and genetic parameters. Principal component analyses were conducted for five different models-one full and four reduced-rank models. Models were compared using Akaike information (AIC) and Bayesian information (BIC) criteria. Variance components and genetic parameters were estimated by restricted maximum likelihood (REML). The AIC and BIC values were similar among models. This indicated that parsimonious models could be used in genetic evaluations in Simmental cattle. The first principal component explained more than 96% of total variance in both models. Heritability estimates were higher for advanced ages and varied from 0.05 (100 days) to 0.30 (730 days). Genetic correlation estimates were similar in both models regardless of magnitude and number of principal components. The first principal component was sufficient to explain almost all genetic variance. Furthermore, genetic parameter similarities and lower computational requirements allowed for parsimonious models in genetic evaluations of growth traits in Simmental cattle.

RESUMO: Objetivou-se estudar a efetividade da redução da dimensão da matriz de covariância do efeito genético direto na avaliação genética do crescimento (pesos dos 100 aos 730 dias de idade) de bovinos Simental, por meio da análise de componentes principais, e estimar componentes de (co)variância e parâmetros genéticos. A análise de componentes principais foi realizada ajsutando-se cinco diferentes modelos: um modelo multicaracterístico padrão, de posto completo, e quatro modelos de posto reduzido. Os modelos foram comparados via informação de Akaike (AIC) e informação Bayesiana de Schwarz (BIC). Os componentes de variância e parâmetros genéticos foram obtidos via REML. Os valores de AIC e BIC para os modelos testados foram similares, indicando a possibilidade da escolha de um modelo mais parcimonioso na avaliação genética da raça Simental. O primeiro componente principal explicou mais de 96% de toda variação genética aditiva direta em ambos os modelos. Os valores de herdabilidades foram maiores em idades mais avançadas e variaram de 0,05 (peso aos 100 dias) a 0,30 (peso aos 730 dias). As estimativas de correlações genéticas foram similares em todos os modelos e apresentaram mesma magnitude e comportamento independentemente do número de componentes principais adotado. Diante dos resultados, pode-se afirmar que apenas o primeiro componente principal foi suficiente para explicar quase que na totalidade a variação genética aditiva direta existente. Além disso, a similaridade dos parâmetros genéticos estimados e a menor demanda computacional são indicativos da possibilidade da utilização de modelos mais parcimoniosos na avaliação genética de bovinos Simental.

Genotype by environment interaction for tick resistance of Hereford and Braford beef cattle using reaction norm models.

BACKGROUND: The cattle tick is a parasite that adversely affects livestock performance in tropical areas. Although countries such as Australia and Brazil have developed genetic evaluations for tick resistance, these evaluations have not considered genotype by environment (G*E) interactions. Genetic gains could be adversely affected, since breedstock comparisons are environmentally dependent on the presence of G*E interactions, particularly if residual variability is also heterogeneous across environments. The objective of this study was to infer upon the existence of G*E interactions for tick resistance of cattle based on various models with different assumptions of genetic and residual variability. METHODS: Data were collected by the Delta G Connection Improvement program and included 10,673 records of tick counts on 4363 animals. Twelve models, including three traditional animal models (AM) and nine different hierarchical Bayesian reaction norm models (HBRNM), were investigated. One-step models that jointly estimate environmental covariates and reaction norms and two-step models based on previously estimated environmental covariates were used to infer upon G*E interactions. Model choice was based on the deviance criterion information. RESULTS: The best-fitting model specified heterogeneous residual variances across 10 subclasses that were bounded by every decile of the contemporary group (CG) estimates of tick count effects. One-step models generally had the highest estimated genetic variances. Heritability estimates were normally higher for HBRNM than for AM. One-step models based on heterogeneous residual variances also usually led to higher heritability estimates. Estimates of repeatability varied along the environmental gradient (ranging from 0.18 to 0.45), which implies that the relative importance of additive and permanent environmental effects for tick resistance is influenced by the environment. Estimated genetic correlations decreased as the tick infestation level increased, with negative correlations between extreme environmental levels, i.e., between more favorable (low infestation) and harsh environments (high infestation). CONCLUSIONS: HBRNM can be used to describe the presence of G*E interactions for tick resistance in Hereford and Braford beef cattle. The preferred model for the genetic evaluation of this population for tick counts in Brazilian climates was a one-step model that considered heteroscedastic residual variance. Reaction norm models are a powerful tool to identify and quantify G*E interactions and represent a promising alternative for genetic evaluation of tick resistance, since they are expected to lead to greater selection efficiency and genetic progress.

Avaliação da radiação espalhada e do impacto dos dispositivos locais de proteção em laboratório de cardiologia intervencionista / Evaluation of scattered radiation and impact of local protective devices in an interventional cardiology laboratory

Introdução: As aplicações médicas representam a maior fonte de exposição radiológica ionizante e, neste contexto, é de especial importância a questão do risco profissional. Embora existam diferentes sensibilidades à radiação dos distintos órgãos do corpo humano, avaliações específicas do impacto nas diversas regiões do corpo do operador, com diferentes dispositivos de radioproteção, são raras em nosso meio. Métodos: Teste de radiação espalhada foi realizado com câmara de ionização em estação de fluoroscopia, com jogo de acessórios de radioproteção padrão do equipamento (saia inferior e escudo móvel superior, em duas diferentes posições), a distâncias sequenciais em relação à fonte, utilizando fantoma de acrílico em simulação de tórax humano. Resultados: Foram identificadas diferenças na radiação em relação à distância e ao uso dos dispositivos de radioproteção. A redução mediana da radiação foi de 50,6% (intervalo interquartil − IQ de 39,42% a 51,05%) com uso do escudo saia inferior, 71,3% (IQ de 67,66% a 77,05%) com adição de escudo superior em posicionamento angulado e 84,7% (IQ de 83,75% a 85,87%) com adição de escudo superior em linha ao escudo inferior. Diferenças significativas foram encontradas ainda em relação à altura e à distância da fonte. Conclusões: O uso dos dispositivos locais de radioproteção avaliados se mostrou efetivo na redução global do impacto radiológico ao operador, havendo, no entanto, vias de escape de radiação, especialmente com posicionamento não ideal, demonstrando a importância do uso adicional dos dispositivos de proteção individuais

Background: Medical applications are the main source of ionizing radiation exposure, and in this context the issue of occupational risk is particularly important. Although the different organs of the human body present different radiation sensitivities, specific assessments of the impact on the different regions of the interventionist's body with diverse radioprotection devices are rare in Brazil. Methods: A scattered radiation test was performed using an ionization chamber in a fluoroscopy station, with standard radioprotection accessory kit of the equipment (lower skirt and upper movable shield, in two different positions), at sequential distances from the source, using acrylic phantoms as human chest simulation. Results: Differences in radiation were identified in relation to distance and use of radioprotection devices. The median radiation reduction was 50.6% (interquartile range ­ IQ from 39.42% to 51.05%) using the lower skirt shield, 71.3% (IQ from 67.66% to 77.05%) with the addition of an upper shield in angulated position, and 84.7% (IQ from 83.75% to 85.87%) with the addition of an upper shield aligned with the lower shield. Significant differences were also found regarding height and distance from the source Conclusions: The use of the assessed local radioprotection devices was effective in reducing the overall radiological impact to the interventionist. However, there were radiation escape routes, especially with non-ideal positioning, demonstrating the importance of the additional use of individual protection devices

Fraqueza muscular adquirida na UTI (ICU-AW): efeitos sistêmicos da eletroestimulação neuromuscular / Muscular weakness acquired in ICU (ICU-AW): effects of systemic neuromuscular electrical stimulation

Com os avanços tecnológicos alcançados atualmente na terapia intensiva e maior sobrevida dos pacientes, outros desafios têm surgido para os profissionais de saúde. Dentre alguns, destaca-se a fraqueza muscular adquirida na UTI (ICU-AW), caracterizada por paresia esquelética e respiratória dos músculos promovendo aumento nas taxas de mortalidade e comprometimento da qualidade de vida. Sua incidência varia de 30% a 60% e tem na síndrome da resposta inflamatória sistêmica (SIRS) e na disfunção de múltiplos órgãos (DMO) sua principal etiologia. Outros fatores de risco como a hiperglicemia, o uso de bloqueadores neuromusculares e sedativos, a imobilidade e a própria ventilação mecânica estão entre os mais comuns. Entre as medidas de combate à ICU-AW, está o conceito de mobilização precoce, bem como despertar diário e controle estreito da glicemia. Nesse contexto, a letroestimulação muscular apresenta-se como recurso de grande valia. Sua principal vantagem está no fato de poder ser empreendida independentemente da cooperação do paciente, e por ser capaz de gerar respostas musculares eficientes, bem como resultados satisfatórios na preservação da massa muscular, condicionamento físico e funcionalidade dos que usam essa ferramenta. Desfechos interessantes têm sido observados em diversos perfis de pacientes, como os de doença pulmonar obstrutiva crônica (DPOC) e traumatismo raquimedular (TRM). No paciente crítico, seu uso tem mostrado redução nos tempos de ventilação mecânica (VM), internação na UTI e maior funcionalidade dos pacientes. A relevância dos efeitos sistêmicos e metabólicos provenientes da eletroestimulação neuromuscular (ENM) tem sido a base para os estudos nos pacientes críticos. Portanto, a ICU-AW é uma realidade no cenário da terapia intensiva e sua prevenção tem dado margem à aparição de novas propostas e ferramentas na prevenção dessas complicações.

With technological advances currently achieved in intensive care and increased patient survival, other challenges have emerged to health professionals. Among some, there is acquired weakness in the ICU (ICU-AW), characterized by skeletal and respiratory muscle paresis promoting an increase in mortality and impaired quality of life. The range of occurrence is 30% to 60% of critically ill patients, and systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction (MOD) are is the main etiology. Other risk factors such as hyperglycemia, the use of neuromuscular blockers and sedatives, immobility and mechanical ventilation are among the most common. Preventing ICU-AW is the concept of early mobilization and daily awakening and tight control of blood glucose. In this context, muscle electrostimulation appears as a great resource. This can be used undertaken regardless of the cooperation of the patient, and be able to generate efficient muscle responses showing satisfactory results in the preservation of muscle mass, physical fitness and functionality of using this tool. Interesting outcomes have been observed in several profiles of patients, such as chronic obstructive pulmonary disease (COPD) and spinal cord injury (SCI). In critically ill patients, its use has shown reduction in mechanical ventilation (MV) days, ICU length and increased functionality of patients. The relevance of the systemic and metabolic effects from the electrostimulation neuromuscular (NMES) has been the basis for studies in critically ill patients. The refore, the ICU-AW is a reality in the setting of intensive care and prevention has given rise to appearance of new proposals and tools in preventing these complications.