Fatigue effects on the knee flexors neuromuscular parameters during repeated sprinting.

BACKGROUND: To identify at which point fatigue on neuromuscular parameters occurs in the knee flexors during a repeated sprint protocol. METHODS: Physical active males without previous hamstring strain injury were recruited. Neuromuscular parameters such as peak torque (PT) and rate of torque development (RTD) were assessed after every two sprints in a 5 × (2 x 30 m) repeated sprint protocol. RESULTS: Twenty physical active males participated in the study. A significant effect of sprint number was found (p < 0.001; η2p = 0.643) with a decreased sprint speed by 6.9% from fastest to slowest sprint. No significant differences were observed in the time between finishing the sprint and performing the first MVIC (46.3 ± 4.7s; p = 0.423), nor in the time between finishing a set and starting the next set (121.2 ± 7.6s; p = 0.503). Regarding neuromuscular parameters, the only significant difference found was in PT between before and after two sprints (117.95 ± 5.61 N⋅m vs. 110.64 ± 5.71 N⋅m; p = 0.048, d = 0.289) and on RTD 0-50ms before and after ten sprints (465.78 ± 223.76 N⋅m/s vs. 382.30 ± 189.56 N⋅m/s; p = 0.008; η2p = 0.149). CONCLUSIONS: A recovery time of 46s between sprints and testing neuromuscular parameters (due to experimental design) seems sufficient to restore the neuromuscular system. Therefore, it can be suggested that time recovery is the principal factor in detecting fatigue on neuromuscular parameters.

Comparison of basic and advanced behaviour management techniques between Colombian and Spanish parents during regular treatment and in emergency situations.

AIM: To evaluate the acceptance of behaviour management techniques by Spanish and Colombian parents used in paediatric dentistry and the influence of factors that determine their consent during regular treatment and in emergency situations. MATERIALS: An anonymous questionnaire was carried out in which 9 behaviour management techniques (BMTs) used in paediatric dentistry by Spanish and Colombian parents were evaluated in cases of regular dental treatment and in emergency situations (pain and/or dental trauma). The techniques evaluated were: tell-show-do (TSD), voice control, positive reinforcement, distraction, parental presence-absence, nitrous oxide, passive and active restraint, and general anaesthesia. The questionnaire also included information on the sociodemographic information about parents and their children, previous dental experience, and dental anxiety of the parents. The data were analysed using SPSSTM software, r. 26 of IBMTM. A value of p≤ 0.05 was considered as statically significant. RESULTS: A total sample of 124 questionnaire (62 from each country) was obtained. The basic BMT were the most accepted in both countries, especially by Spanish parents. In emergency situations, statistically significant differences were obtained in the acceptance of nitrous oxide and general anesthesia compared to their use in routine treatments (p<0.001). There were no significant differences in the preference of the techniques in relation to the age of the children or parental dental anxiety (p>0.05). An association was found between the socioeconomic status and the acceptance of nitrous oxide (p=0.005) and general anesthesia (p=0.004). CONCLUSION: The basic techniques were the most accepted by Spanish and Colombian parents. However, the Spanish parents had a better perception of both types of techniques compared to the Colombians. Their preference was influenced by factors such as annual income and need for urgent treatment of their children.

The MIGREX study: Prevalence and risk factors of sexual dysfunction among migraine patients.

BACKGROUND: Migraine attacks have a high impact on daily activities. There is limited research on the burden of migraine on sexual functioning. OBJECTIVE: To determine the prevalence of sexual dysfunction in patients with migraine and its relationship with migraine features and comorbidities. METHOD: This is a cross-sectional study. We included migraine patients between 18 and 60 years-old from 8 Headache Clinics in Spain. We recorded demographic data and migraine features. Patients fulfilled a survey including comorbidities, Arizona Sexual Experiences Scale, Hospital Anxiety and Depression Scale and a questionnaire about migraine impact on sexual activity. A K-nearest neighbor supervised learning algorithm was used to identify differences between migraine patients with and without sexual dysfunction. RESULTS: We included 306 patients (85.6% women, mean age 42.3±11.1 years). A 41.8% of participants had sexual dysfunction. Sexual dysfunction was associated with being female (OR [95% CI]: 2.42 [1.17-5.00]; p<0.001), being older than 46.5 years (4.04 [2.48-6.59]; p<0.001), having chronic migraine (2.31 [1.41-3.77]; p=0.001), using preventive medication (2.45 [1.35-4.45]; p=0.004), analgesic overusing (3.51 [2.03-6.07]; p<0.001), menopause (4.18 [2.43-7.17]; p<0.001) and anxiety (2.90 [1.80-4.67]; p<0.001) and depression (6.14 [3.18-11.83]; p<0.001). However, only female gender, age, menopause and depression were the statistically significant variables selected in the model to classify migraine patients with or without sexual dysfunction (Accuracy [95% CI]: 0.75 (0.62-0.85), Kappa: 0.48, p=0.005). CONCLUSIONS: Sexual dysfunction is frequent in migraine patients visited in a headache clinic. However, migraine characteristics or use of preventive medication are not directly associated with sexual dysfunction. Instead, risk factors for sexual dysfunction were female gender, higher age, menopause and depression.

The MIGREX study: Prevalence and risk factors of sexual dysfunction among migraine patients / Estudio MIGREX: Prevalencia y factores de riesgo de disfunción sexual en pacientes con migraña

Background: Migraine attacks have a high impact on daily activities. There is limited research on the burden of migraine on sexual functioning. Objective: To determine the prevalence of sexual dysfunction in patients with migraine and its relationship with migraine features and comorbidities. Method: This is a cross-sectional study. We included migraine patients between 18 and 60 years-old from 8 Headache Clinics in Spain. We recorded demographic data and migraine features. Patients fulfilled a survey including comorbidities, Arizona Sexual Experiences Scale, Hospital Anxiety and Depression Scale and a questionnaire about migraine impact on sexual activity. A K-nearest neighbor supervised learning algorithm was used to identify differences between migraine patients with and without sexual dysfunction. Results: We included 306 patients (85.6% women, mean age 42.3 ±11.1 years). A 41.8% of participants had sexual dysfunction. Sexual dysfunction was associated with being female (OR [95% CI]: 2.42 [1.17–5.00]; p < 0.001), being older than 46.5 years (4.04 [2.48–6.59]; p < 0.001), having chronic migraine (2.31 [1.41–3.77]; p = 0.001), using preventive medication (2.45 [1.35–4.45]; p = 0.004), analgesic overusing (3.51 [2.03–6.07]; p < 0.001), menopause (4.18 [2.43–7.17]; p < 0.001) and anxiety (2.90 [1.80–4.67]; p < 0.001) and depression (6.14 [3.18–11.83]; p < 0.001). However, only female gender, age, menopause and depression were the statistically significant variables selected in the model to classify migraine patients with or without sexual dysfunction (Accuracy [95% CI]: 0.75 (0.62–0.85), Kappa: 0.48, p = 0.005). Conclusions: Sexual dysfunction is frequent in migraine patients visited in a headache clinic. However, migraine characteristics or use of preventive medication are not directly associated with sexual dysfunction. Instead, risk factors for sexual dysfunction were female gender, higher age, menopause and depression.(AU)

Antecedentes: La migraña tiene un alto impacto en las actividades diarias, pero los datos sobre el impacto de la migraña en el funcionamiento sexual son limitados. Objetivo: Determinar la prevalencia de disfunción sexual en pacientes con migraña y su relación con las características y comorbilidades de la migraña. Métodos: Este es un estudio transversal. Se incluyeron pacientes con migraña de entre 18 y 60 años de ocho consultas de cefalea en España. Registramos datos demográficos y características de migraña. Los pacientes completaron una encuesta que incluía comorbilidades, la Escala de Experiencias Sexuales de Arizona, la Escala de Ansiedad y Depresión Hospitalaria y un cuestionario sobre el impacto de la migraña en la actividad sexual. Se usó un algoritmo de aprendizaje supervisado (k-nearest neighbors) para identificar diferencias entre pacientes con migraña, con y sin disfunción sexual. Resultados: Se incluyeron 306 pacientes (85,6% mujeres, edad media 42,3 ± 11,1 años). El 41,8% de los participantes tenía disfunción sexual. La disfunción sexual se asoció con ser mujer (OR [95%]: 2,42 [1,17-5,00]; p < 0,001), tener más de 46,5 años (4,04 [2,48-6,59]; p < 0,001), tener migraña crónica (2,31 [1,41-3,77]; p = 0,001), uso de medicación preventiva (2,45 [1,35-4.45]; p = 0,004), uso excesivo de analgésicos (3,51 [2,03-6,07]; p < 0,001), menopausia (4,18 [2,43-7,17]; p < 0,001), ansiedad (2,90 [1,80-4,67]; p < 0,001) y depresión (6,14 [3,18-11,83]; p < 0,001). Sin embargo, solo el sexo femenino, la edad, la menopausia y la depresión fueron las variables estadísticamente significativas seleccionadas en el modelo para clasificar a los pacientes con migraña, con o sin disfunción sexual (precisión [IC 95%]: 0,75 (0,62-0,85), kappa: 0,48, p = 0,005). Conclusiones: La disfunción sexual es frecuente en pacientes con migraña que son visitados en una consulta de cefalea.(AU)

Hamstrings mechanical properties profiling in football players of different competitive levels and positions after a repeated sprint protocol.

Purpose: This study compares the average speed, knee flexor peak torque and shear modulus of the hamstrings after a repeated sprint task, in football players of different competitive levels and playing positions. Methods: Fifty-four football field players without hamstring strain injury history participated, 15 being categorized as professional (2nd league) and 39 as semi-professional (17 in 3rd and 22 in 4th league). Muscle shear modulus was assessed using ultrasound-based shear wave elastography at rest and at 20% of maximal voluntary isometric effort before and immediately after the repeated sprint protocol. Results: No significant differences were seen in average sprint speed between competitive levels (p = 0.07; η2p = 0.28) and positions (p = 0.052; η2p = 0.29). Moreover, the sprint fatigue index showed no significant differences between competitive levels (p = 0.14; η2p = 0.08) and playing positions (p = 0.89; η2p = 0.05). No significant differences were observed in hamstring shear modulus changes between competitive levels (p = 0.94; η2p = 0.03) and positions (p = 0.92; η2p = 0.03). Peak torque changes also showed non-significant association with competitive levels (p = 0.46; η2p = 0.03) and positions (p = 0.60; η2p = 0.02). Conclusion: The results of this study suggest that the average sprint speed performance parameter and mechanical parameters are not able to distinguish football players of different competitive levels and positions.

Comparison of knowledge between Italian and Spanish parents about the oral health of their preschool children.

AIM: To evaluate and compare baseline knowledge between Italian and Spanish parents with regards to the oral and dental health of their preschool children. METHODS: Study design epidemiological descriptive observational cross-sectional study. The research data was collected through an anonymous bilingual survey, generated through Google Forms and distributed either in paper form or through several digital channels together with a QR code to drive the participants to the questionnaire. In order to assess the differences between Italy and Spain, t-Student (with confidence interval) or Mann-Whitney tests were used to compare the independent numerical variables, and the Chi-Square test was used to compare the independent categorical variables. CONCLUSION: Independently of the differences identified among the two countries, the results show that parents from both nationalities have limited knowledge about their preschool children's oral health and are not fully informed about child's oral hygiene practices.

Cefalea: embarazo y lactancia. Recomendaciones del Grupo de Estudio de Cefaleas de la Sociedad Española de Neurología (GECSEN) / Headache: pregnancy and breastfeeding Recommendations of the Spanish Society of Neurology's Headache Study Group

Introducción: La cefalea es uno de los motivos de consulta más comunes en neurología, siendo más frecuente durante la edad reproductiva. Por ello, es habitual encontrar en nuestras consultas pacientes embarazadas o en periodo de lactancia con dicha queja. Es importante conocer las opciones farmacológicas más seguras, cuáles no se deben emplear, así como cuándo sospechar cefaleas secundarias. Por este motivo, el Grupo de Estudio de Cefaleas de la Sociedad Española de Neurología ha elaborado una guía con las recomendaciones consensuadas acerca de los algoritmos diagnósticos y terapéuticos que se deben emplear durante el embarazo y la lactancia. Desarrollo: Esta guía ha sido redactada por un grupo de jóvenes neurólogos con especial interés y experiencia en cefaleas en colaboración con la Junta Directiva del Grupo de Estudio de Cefaleas de la Sociedad Española de Neurología. Las recomendaciones se centran en los fármacos aconsejados en las cefaleas primarias más frecuentes, tanto en su fase aguda como preventiva. En una segunda parte se aborda cuándo sospechar y qué pruebas realizar ante una posible cefalea secundaria durante el embarazo y la lactancia. Conclusiones: Esperamos que esta guía resulte de utilidad y permita su aplicación práctica en la consulta diaria. Asimismo, que sirva para actualizar y mejorar el conocimiento del manejo de las cefaleas durante estas etapas, para actuar con mayor confianza ante estas pacientes. (AU)

Introduction: Headache is one of the most common neurological complaints, and is most frequent during reproductive age. As a result, we are routinely faced with pregnant or breastfeeding women with this symptom in clinical practice. It is important to know which pharmacological choices are the safest, which should not be used, and when we should suspect secondary headache. To this end, the Spanish Society of Neurology's Headache Study Grouphas prepared a series of consensus recommendations on the diagnostic and therapeutic algorithms that should be followed during pregnancy and breastfeeding. Development: This guide was prepared by a group of young neurologists with special interest and experience in headache, in collaboration with the Group's Executive Committee. Recommendations focus on which drugs should be used for the most frequent primary headaches, both during the acute phase and for prevention. The second part addresses when secondary headache should be suspected and which diagnostic tests should be performed in the event of possible secondary headache during pregnancy and breastfeeding. Conclusions: We hope this guide will be practical and useful in daily clinical practice and that it will help update and improve understanding of headache management during pregnancy and breastfeeding, enabling physicians to more confidently treat these patients. (AU)

Headache: pregnancy and breastfeeding. Recommendations of the Spanish Society of Neurology's Headache Study Group.

INTRODUCTION: Headache is one of the most common neurological complaints, and is most frequent during reproductive age. As a result, we are routinely faced with pregnant or breastfeeding women with this symptom in clinical practice. It is important to know which pharmacological choices are the safest, which should not be used, and when we should suspect secondary headache. To this end, the Spanish Society of Neurology's Headache Study Group has prepared a series of consensus recommendations on the diagnostic and therapeutic algorithms that should be followed during pregnancy and breastfeeding. DEVELOPMENT: This guide was prepared by a group of young neurologists with special interest and experience in headache, in collaboration with the Group's Executive Committee. Recommendations focus on which drugs should be used for the most frequent primary headaches, both during the acute phase and for prevention. The second part addresses when secondary headache should be suspected and which diagnostic tests should be performed in the event of possible secondary headache during pregnancy and breastfeeding. CONCLUSIONS: We hope this guide will be practical and useful in daily clinical practice and that it will help update and improve understanding of headache management during pregnancy and breastfeeding, enabling physicians to more confidently treat these patients.

Polycystic ovary syndrome: clinical and laboratory variables related to new phenotypes using machine-learning models.

PURPOSE: Polycystic Ovary Syndrome (PCOS) is the most frequent endocrinopathy in women of reproductive age. Machine learning (ML) is the area of artificial intelligence with a focus on predictive computing algorithms. We aimed to define the most relevant clinical and laboratory variables related to PCOS diagnosis, and to stratify patients into different phenotypic groups (clusters) using ML algorithms. METHODS: Variables from a database comparing 72 patients with PCOS and 73 healthy women were included. The BorutaShap method, followed by the Random Forest algorithm, was applied to prediction and clustering of PCOS. RESULTS: Among the 58 variables investigated, the algorithm selected in decreasing order of importance: lipid accumulation product (LAP); abdominal circumference; thrombin activatable fibrinolysis inhibitor (TAFI) levels; body mass index (BMI); C-reactive protein (CRP), high-density lipoprotein cholesterol (HDL-c), follicle-stimulating hormone (FSH) and insulin levels; HOMA-IR value; age; prolactin, 17-OH progesterone and triglycerides levels; and family history of diabetes mellitus in first-degree relative as the variables associated to PCOS diagnosis. The combined use of these variables by the algorithm showed an accuracy of 86% and area under the ROC curve of 97%. Next, PCOS patients were gathered into two clusters in the first, the patients had higher BMI, abdominal circumference, LAP and HOMA-IR index, as well as CRP and insulin levels compared to the other cluster. CONCLUSION: The developed algorithm could be applied to select more important clinical and biochemical variables related to PCOS and to classify into phenotypically different clusters. These results could guide more personalized and effective approaches to the treatment of PCOS.

Safety of anti-CGRP monoclonal antibodies in patients with migraine during the COVID-19 pandemic: Present and future implications.

BACKGROUND AND OBJECTIVE: CGRP, a neuropeptide involved in migraine pathophysiology, is also known to play a role in the respiratory system and in immunological conditions such as sepsis. We analyzed the impact of the use of CGRP antagonists in patients with migraine during the COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus. METHODS: This is a multicentre cross-sectional study. From May to November 2020, through a national survey distributed by the Spanish Society of Neurology, we collected data about the presence of COVID-19 symptoms including headache and their characteristics and severity in patients with migraine treated with anti-CGRP monoclonal antibodies (mAb), and compared them with patients with migraine not receiving this treatment. We also conducted a subanalysis of patients with COVID-19 symptoms. RESULTS: We recruited 300 patients with migraine: 51.7% (155/300) were taking anti-CGRP mAbs; 87.3% were women (262/300). Mean age (standard deviation) was 47.1 years (11.6). Forty-one patients (13.7%) met diagnostic criteria for COVID-19, with no statistically significant difference between patients with and without anti-CGRP mAb treatment (16.1% vs 11.0%, respectively; P=.320). Of the patients with COVID-19, 48.8% (20/41) visited the emergency department and 12.2% (5/41) were hospitalised. Likewise, no clinical differences were found between the groups of patients with and without anti-CGRP mAb treatment. CONCLUSION: Anti-CGRP mAbs may be safe in clinical practice, presenting no association with increased risk of COVID-19.

Safety of anti-CGRP monoclonal antibodies in patients with migraine during the COVID-19 pandemic: Present and future implications / Seguridad de los anticuerpos monoclonales anti-CGRP en pacientes con migraña durante la pandemia de COVID-19: implicaciones actuales y futuras

Background and objective: CGRP, a neuropeptide involved in migraine pathophysiology, is also known to play a role in the respiratory system and in immunological conditions such as sepsis. We analyzed the impact of the use of CGRP antagonists in patients with migraine during the COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus.MethodsThis is a multicentre cross-sectional study. From May to November 2020, through a national survey distributed by the Spanish Society of Neurology, we collected data about the presence of COVID-19 symptoms including headache and their characteristics and severity in patients with migraine treated with anti-CGRP monoclonal antibodies (mAb), and compared them with patients with migraine not receiving this treatment. We also conducted a subanalysis of patients with COVID-19 symptoms.ResultsWe recruited 300 patients with migraine: 51.7% (155/300) were taking anti-CGRP mAbs; 87.3% were women (262/300). Mean age (standard deviation) was 47.1 years (11.6). Forty-one patients (13.7%) met diagnostic criteria for COVID-19, with no statistically significant difference between patients with and without anti-CGRP mAb treatment (16.1% vs 11.0%, respectively; P = .320). Of the patients with COVID-19, 48.8% (20/41) visited the emergency department and 12.2% (5/41) were hospitalised. Likewise, no clinical differences were found between the groups of patients with and without anti-CGRP mAb treatment.ConclusionAnti-CGRP mAbs may be safe in clinical practice, presenting no association with increased risk of COVID-19. (AU)

Antecedentes y objetivo: El péptido relacionado con el gen de la calcitonina (CGRP, por sus siglas en inglés), es un neuropéptido involucrado en la fisiopatología de la migraña, que también es conocido por participar en la regulación del sistema respiratorio y en algunas enfermedades inmunológicas como la sepsis. Hemos analizado el impacto del uso de los antagonistas de CGRP en pacientes con migraña durante la pandemia de COVID-19, causada por el coronavirus SARS-CoV-2.MétodosEstudio transversal multicéntrico desarrollado entre mayo y noviembre de 2020, en el que la Sociedad Española de Neurología distribuyó a nivel nacional una encuesta de la que recogimos datos sobre la presencia, las características y la gravedad de síntomas de COVID-19, entre los que se encontraba la cefalea, en pacientes con migraña tratados con anticuerpos monoclonales (AcM) anti-CGRP, y los comparamos con los de pacientes con migraña que no recibían dicho tratamiento. También realizamos un subanálisis de los pacientes con síntomas de COVID-19.ResultadosIdentificamos 300 pacientes con migraña: 51,7% (155/300) recibían AcM anti-CGRP; el 87,3% eran mujeres (262/300) y la edad media (desviación estándar) de la muestra fue de 47,1 (11,6) años. Un total de 41 pacientes (13,7%) cumplían los criterios diagnósticos de COVID-19, sin diferencias estadísticamente significativas entre los pacientes que recibían tratamiento con AcM anti-CGRP y los que no (16,1% y 11,0%, respectivamente; p = 0,320). De los pacientes con COVID-19, el 48,8% (20/41) acudieron a urgencias y el 12,2% (5/41) fueron hospitalizados. Igualmente, no se detectaron diferencias clínicas entre los pacientes que recibían dicho tratamiento y los que no.ConclusiónEl tratamiento con AcM anti-CGRP parece un recurso seguro en la práctica clínica, y no se asocia a un mayor riesgo de COVID-19. (AU)

Comparison of active versus passive audiovisual distraction tools on children's behaviour, anxiety and pain in paediatric dentistry: a randomised crossover clinical trial.

AIM: To determine the effect of active distraction when playing PlayStation® video games, compared to passive distraction when watching a cartoon with audiovisual eyeglasses, on parental perception of patients' anxiety, and children's anxiety, pain, behaviour and heart rate during restorative procedures in paediatric dentistry. MATERIALS AND METHODS: Study design: Randomised crossover clinical trial. There were 34 patients in the cartoon film group (passive distraction) and 34 in the Playstation® video game group (active distraction), aged 6-8 years, who required a minimum of 2 visits for restorative treatment. Rimax® iVision 5.0 eyeglasses were used in both groups. Parental perception of patients' anxiety (Modified Corah Dental Anxiety Scale), and children's anxiety (Venham Picture Test), pain (Wong-Baker Faces Scale), behaviour (Frankl Scale) and heart rate were evaluated at each of the treatment visits. Preference for and satisfaction with the audiovisual product were also assessed. RESULTS: There were significant differences in self-reported pain between control (P=0.016) and experimental (P=0.013) visits in both groups, with lower values in the Playstation® video game group. No significant differences were found (P>0.05) in the other variables evaluated with the use of active distraction. A significant increase in heart rate was recorded at each treatment visit (P=0.0001) when the anaesthetic was injected. All the patients wanted to continue watching or playing their chosen cartoon or Playstation® video game during subsequent visits. CONCLUSION: The use of PlayStation® video games for active audiovisual distraction, compared with passive distraction with a cartoon, improved self-reported pain but did not reduce parents' perception of patients' anxiety, pain, global behaviour, or heart rate. Both distraction methods were accepted by paediatric patients.

Defoliation heights for palisade grass cv. Marandu in silvopastoral system / [Alturas de desfolhação para capim-marandu em sistema silvipastoril]

The objective was to test the response of Urochloa brizantha cv. Marandu in monoculture and in silvopastoral system (SPS), at two distances from the trees, and define the best defoliation height for SPS. Four intermittent defoliation heights (25, 35, 45 and 55cm) and two distances from tree lines (2.5 and 5.0m) were evaluated in the SPS with a control defoliated with 25cm in full sun. The experiment was performed in a randomized block design with 3 replicates in a 4 × 2 + 1 split plot scheme. The control had higher forage accumulation (46.9kg/ha. day) than the SPS (31.1kg/ha. day). The bulk density was also higher in the control (0.89mg/cm³) than in SPS (0.48mg/cm³). The percentage of leaves (78.06%) and leaf/stem ratio (6.04) did not differ among the treatments. In the SPS, there was an increase of 31.07% in forage accumulation from 25 to 55cm. The forage accumulation and bulk density of Urochloa brizantha cv. Marandu in monoculture is greater than in the SPS regardless of the management goal and the distance from trees. The goal of 55cm in the SPS presented greater forage accumulation.(AU)

O objetivo foi testar a resposta de pastos de Urochloa brizantha cv. Marandu em monocultivo e em sistema silvipastoril (SSP), a diferentes distâncias das árvores, bem como definir qual altura de desfolhação é a mais indicada para manejo em SPS. Foram avaliadas quatro alturas de desfolhação intermitente (25, 35, 45 e 55cm) e duas distâncias das linhas de árvores (2,5 e 5,0m), no SPS, e uma testemunha desfolhada com 25cm, em pleno sol. O delineamento foi em blocos ao acaso, com três repetições, em esquema de parcelas subdivididas 4 × 2 + 1. O controle apresentou maior acúmulo de forragem (46,9kg/ha.dia) que a média do SSP (31,1kg/ha.dia). A densidade volumétrica da forragem do controle (0,89mg/cm³) foi maior que a do SSP (0,48mg/cm³). A porcentagem de folhas (78,06%) e a relação folha/colmo (6,04) não diferiram entre os tratamentos. O aumento das alturas de 25 para 55cm no SSP resultou em aumento de 31,07% no acúmulo de forragem. O acúmulo e a densidade volumétrica da forragem são maiores no monocultivo, independentemente da meta de manejo e da distância das árvores no sistema silvipastoril. A meta de 55cm no silvipastoril apresenta maior acúmulo de forragem.(AU)

Safety of anti-CGRP monoclonal antibodies in patients with migraine during the COVID-19 pandemic: Present and future implications.

BACKGROUND AND OBJECTIVE: CGRP, a neuropeptide involved in migraine pathophysiology, is also known to play a role in the respiratory system and in immunological conditions such as sepsis. We analyzed the impact of the use of CGRP antagonists in patients with migraine during the COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus. METHODS: This is a multicentre cross-sectional study. From May to November 2020, through a national survey distributed by the Spanish Society of Neurology, we collected data about the presence of COVID-19 symptoms including headache and their characteristics and severity in patients with migraine treated with anti-CGRP monoclonal antibodies (mAb), and compared them with patients with migraine not receiving this treatment. We also conducted a subanalysis of patients with COVID-19 symptoms. RESULTS: We recruited 300 patients with migraine: 51.7% (155/300) were taking anti-CGRP mAbs; 87.3% were women (262/300). Mean age (standard deviation) was 47.1 years (11.6). Forty-one patients (13.7%) met diagnostic criteria for COVID-19, with no statistically significant difference between patients with and without anti-CGRP mAb treatment (16.1% vs 11.0%, respectively; P=.320). Of the patients with COVID-19, 48.8% (20/41) visited the emergency department and 12.2% (5/41) were hospitalised. Likewise, no clinical differences were found between the groups of patients with and without anti-CGRP mAb treatment. CONCLUSION: Anti-CGRP mAbs may be safe in clinical practice, presenting no association with increased risk of COVID-19.

The MIGREX study: Prevalence and risk factors of sexual dysfunction among migraine patients.

BACKGROUND: Migraine attacks have a high impact on daily activities. There is limited research on the burden of migraine on sexual functioning. OBJECTIVE: To determine the prevalence of sexual dysfunction in patients with migraine and its relationship with migraine features and comorbidities. METHOD: This is a cross-sectional study. We included migraine patients between 18 and 60 years-old from 8 Headache Clinics in Spain. We recorded demographic data and migraine features. Patients fulfilled a survey including comorbidities, Arizona Sexual Experiences Scale, Hospital Anxiety and Depression Scale and a questionnaire about migraine impact on sexual activity. A K-nearest neighbor supervised learning algorithm was used to identify differences between migraine patients with and without sexual dysfunction. RESULTS: We included 306 patients (85.6% women, mean age 42.3±11.1 years). A 41.8% of participants had sexual dysfunction. Sexual dysfunction was associated with being female (OR [95% CI]: 2.42 [1.17-5.00]; p<0.001), being older than 46.5 years (4.04 [2.48-6.59]; p<0.001), having chronic migraine (2.31 [1.41-3.77]; p=0.001), using preventive medication (2.45 [1.35-4.45]; p=0.004), analgesic overusing (3.51 [2.03-6.07]; p<0.001), menopause (4.18 [2.43-7.17]; p<0.001) and anxiety (2.90 [1.80-4.67]; p<0.001) and depression (6.14 [3.18-11.83]; p<0.001). However, only female gender, age, menopause and depression were the statistically significant variables selected in the model to classify migraine patients with or without sexual dysfunction (Accuracy [95% CI]: 0.75 (0.62-0.85), Kappa: 0.48, p=0.005). CONCLUSIONS: Sexual dysfunction is frequent in migraine patients visited in a headache clinic. However, migraine characteristics or use of preventive medication are not directly associated with sexual dysfunction. Instead, risk factors for sexual dysfunction were female gender, higher age, menopause and depression.

Long-term evaluation of primary teeth molar pulpotomies with Biodentine and MTA: a CONSORT randomized clinical trial.

BACKGROUND: Calcium silicate-based materials have become widely used in recent years due to their positive effect on pulp cells, which stimulate tertiary dentin formation. AIM: The aim of the present study was to evaluate and compare clinically and radiographically the performance of MTA and Biodentine as pulp-dressing materials following pulpotomy in primary molars at 24-month follow-up. DESIGN: Molars from patients aged 4-9 years scheduled for pulpotomy were treated with either MTA or Biodentine followed by a stainless-steel crown. These molars were clinically and radiographically followed up at 6, 12, 18, and 24 months. Statistical analysis was performed to detect differences between the two groups. RESULTS: A total of 84 pulpotomies were performed obtaining a total success rate of 99.4 and 97.2% for Biodentine and MTA, respectively, at 24 months, showing no statistically significant differences between the two groups. CONCLUSION: 24-month follow-up showed that Biodentine and MTA have similar effectiveness.

PRL3 enhances T-cell acute lymphoblastic leukemia growth through suppressing T-cell signaling pathways and apoptosis.

T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive malignancy of thymocytes and is largely driven by the NOTCH/MYC pathway. Yet, additional oncogenic drivers are required for transformation. Here, we identify protein tyrosine phosphatase type 4 A3 (PRL3) as a collaborating oncogenic driver in T-ALL. PRL3 is expressed in a large fraction of primary human T-ALLs and is commonly co-amplified with MYC. PRL3 also synergized with MYC to initiate early-onset ALL in transgenic zebrafish and was required for human T-ALL growth and maintenance. Mass-spectrometry phosphoproteomic analysis and mechanistic studies uncovered that PRL3 suppresses downstream T-cell phosphorylation signaling pathways, including those modulated by VAV1, and subsequently suppresses apoptosis in leukemia cells. Taken together, our studies have identified new roles for PRL3 as a collaborating oncogenic driver in human T-ALL and suggest that therapeutic targeting of the PRL3 phosphatase will likely be a useful treatment strategy for T-ALL.

Headache: pregnancy and breastfeeding Recommendations of the Spanish Society of Neurology's Headache Study Group. / Cefalea: embarazo y lactancia. Recomendaciones del Grupo de Estudio de Cefaleas de la Sociedad Española de Neurología (GECSEN).

INTRODUCTION: Headache is one of the most common neurological complaints, and is most frequent during reproductive age. As a result, we are routinely faced with pregnant or breastfeeding women with this symptom in clinical practice. It is important to know which pharmacological choices are the safest, which should not be used, and when we should suspect secondary headache. To this end, the Spanish Society of Neurology's Headache Study Grouphas prepared a series of consensus recommendations on the diagnostic and therapeutic algorithms that should be followed during pregnancy and breastfeeding. DEVELOPMENT: This guide was prepared by a group of young neurologists with special interest and experience in headache, in collaboration with the Group's Executive Committee. Recommendations focus on which drugs should be used for the most frequent primary headaches, both during the acute phase and for prevention. The second part addresses when secondary headache should be suspected and which diagnostic tests should be performed in the event of possible secondary headache during pregnancy and breastfeeding. CONCLUSIONS: We hope this guide will be practical and useful in daily clinical practice and that it will help update and improve understanding of headache management during pregnancy and breastfeeding, enabling physicians to more confidently treat these patients.

Infiltración amigdalar de bupivacaína y adrenalina comparada con sueron fisiolótico en cirugía amigdalar pediátrica / Tonsil infiltration of bupivacaine and adrenaline compared with physiological serum in pediatric tonsil surgerys

INTRODUCCIÓN: La cirugía adenoamigdalar constituye una de las intervenciones quirúrgicas más frecuentes en la edad pediátrica. El dolor posoperatorio, junto con la hemorragia amigdalar, son complicaciones relativamente frecuentes que aumentan la morbilidad. El empleo de infiltración de anestésicos locales en el lecho quirúrgico ha sido ampliamente utilizado para reducir el dolor posoperatorio y las comorbilidades. OBJETIVO: El objetivo de este estudio es demostrar que la infiltración de anestésico local en combinación con adrenalina reduce tanto el dolor posoperatorio como el sangrado posquirúrgico en pacientes pediátricos sometidos a cirugía amigdalar. MATERIALES Y MÉTODOS: Estudio observacional prospectivo, doble ciego y aleatorizado con 90 pacientes entre 6 y 14 años, ASA I y II, divididos en dos grupos: 45 pacientes fueron sometidos a una infiltración periamigdalar con bupivacaína 0,25 % y adrenalina y otros 45 pacientes fueron sometidos a infiltración amigdalar son suero fisiológico. Se evaluó la eficacia analgésica, así como los efectos secundarios presentados durante las primeras 6 horas del posoperatorio inmediato. RESULTADOS Y ANÁLISIS: Durante su estancia en la unidad de recuperación posanestésica (URPA) el 80 % de los pacientes que recibieron infiltración de suero salino necesitaron analgesia suplementaria frente al 13,4 % de los que recibieron infiltración con bupivacaína, siendo esta diferencia estadísticamente significativa (p < 0,05). En nuestro estudio, tres pacientes presentaron sangrado posoperatorio, todos ellos procedentes del grupo que había recibido suero salino. Dentro de los 90 pacientes incluidos, de estos tres solo dos tuvieron que ser reintervenidos para controlar el sangrado. Así, la incidencia de sangrado en este estudio fue del 3,33 %, ligeramente inferior a los hallazgos de otros estudios de la literatura actual. CONCLUSIÓN: La infiltración periamigdalar de bupivacaína con vasoconstrictor es un método seguro y eficaz para el control analgésico posoperatorio en población pediátrica sometida a cirugía amigdalar en comparación con la terapia analgésica convencional. El impacto de esta medida en la reducción del sangrado arroja nuevos estudios para aclarar el papel de los vasoconstrictores en la reducción del sangrado posoperatorio

INTRODUCTION: The adenotonsillar surgery constitutes one of the most frequent surgical interventions in the pediatric age. Postoperative pain (1) together with tonsillar hemorrhage are two relatively frequent complications that increase morbidity. The use of local anesthetic infiltration in the surgical bed has been widely used to reduce postoperative pain and comorbidities. OBJECTIVE: The objective of this study is to demonstrate that infiltration of local anesthetic in combination with adrenaline reduces both postoperative pain and post-surgical bleeding in pediatric patients undergoing tonsillar surgery.Materials and methods: Prospective, double-blind, randomized observational study with 90 patients between 6 and 14 years old, ASA I and II, divided into two groups: 45 patients underwent periamigdalar infiltration with 0.25 % bupivacaine and adrenaline and 45 other patients underwent tonsillar infiltration with physiological saline.The analgesic efficacy was evaluated, as well as the side effects presented during the first 6 hours of the immediate postoperative period. RESULTS: During their stay in the post-anesthesia recovery unit (PACU), 80 % of patients who received saline infiltration needed supplemental analgesia com-pared to 13.4 % of those who received infiltration with bupivacaine, this difference being statistically significant (p < 0.05). In our study, 3 patients presented postoperative bleeding, all of them from the group that had received saline. Within the 90 patients included, of these 3 only 2 had to be reoperated to control bleeding. Thus, the incidence of bleeding in this study was 3.33%, slightly lower than the findings of other studies in the current literature (2,3). CONCLUSION: Periamigdalar infiltration of bupivacaine with vasocontrictor is a safe and effective method for postoperative analgesic control in pediatric popu-lation undergoing tonsillar surgery compared to conventional analgesic therapy. The impact of this measure on the reduction of bleeding yields no significant results, although it is true that there seems to be a lower incidence of bleeding in patients treated with adrenaline. New studies are needed to clarify the role of vasoconstrictors in the reduction of postoperative bleeding

Junctionless versus inversion-mode lateral semiconductor nanowire transistors.

This paper reports on gate-all-around silicon nanowire field-effect transistors (FETs) built in a lateral configuration, which represent the ultimate scaling limit of triple-gate finFET devices and allow a less disruptive CMOS scaling path in terms of processing and circuit layout design. We address several of their critical technological challenges, looking in particular at doping strategies. A comprehensive review of junctionless versus inversion-mode type of transistors is here presented, evaluating the impact on the devices' operation mode and on device properties such as: variability, reliability, noise, DC and analog/RF performance. We also discuss the potential for further manufacturable co-integration options.