Antimicrobial consumption and drug utilization patterns among COVID-19 and non-COVID-19 patients.

OBJECTIVES: To understand differences in antimicrobial use between COVID-19 and non-COVID-19 patients. To compare two metrics commonly used for antimicrobial use: Defined Daily Dose (DDD) and Days of Therapy (DOT). To analyse the order in which antimicrobials were prescribed to COVID-19 patients using process mining techniques. METHODS: We analysed data regarding all ICU admissions from 1 January 2018 to 14 September 2020, in 17 Brazilian hospitals. Our main outcome was the antimicrobial use estimated by the DDD and DOT (Days of Therapy). We compared clinical characteristics and antimicrobial consumption between COVID-19 and non-COVID-19 patients. We used process mining to evaluate the order in which the antimicrobial schemes were prescribed to each COVID-19 patient. RESULTS: We analysed 68 405 patients admitted before the pandemic, 12 319 non-COVID-19 patients and 3240 COVID-19 patients. Comparing those admitted during the pandemic, the COVID-19 patients required advanced respiratory support more often (42% versus 12%). They also had longer ICU length of stay (6 versus 3 days), higher ICU mortality (18% versus 5.4%) and greater use of antimicrobials (70% versus 39%). Most of the COVID-19 treatments started with penicillins with ß-lactamase inhibitors (30%), third-generation cephalosporins (22%), or macrolides in combination with penicillins (19%). CONCLUSIONS: Antimicrobial prescription increased in Brazilian ICUs during the COVID-19 pandemic, especially during the first months of the epidemic. We identified greater use of broad-spectrum antimicrobials by COVID-19 patients. Overall, the DDD metric overestimated antimicrobial use compared with the DOT metric.

Body Composition, Sarcopenia and Physical Performance After Bariatric Surgery: Differences Between Sleeve Gastrectomy and Roux-En-Y Gastric Bypass.

PURPOSE: Evaluate the differences between surgical techniques in the modifications of body composition and the interference in skeletal muscle health, risk of sarcopenia, and reduced physical performance. MATERIALS AND METHODS: This is a cross-sectional prospective study. A total of 71 patients, who underwent sleeve gastrectomy (SG) or underwent Roux-en-Y gastric bypass (RYGB). Both groups underwent anthropometric, laboratory analysis, body composition assessment, presence of sarcopenia, and physical performance tests. RESULTS: The study found a higher percentage of weight loss and lower BMI in RYGB compared to SG. The other assessments of sarcopenia and physical performance showed similarity between the surgical models. Baumgartner index (7.9 kg/m2 vs. 7.3 kg/m2), FNIH (9.0 vs. 3.0), handgrip strength (27.3 kg vs. 25.2 kg), and SPPB (9.5 vs. 9.3). Leptin in the general SG group was higher than in RYGB (14.2 ng/ml vs. 8.0 ng/ml). CONCLUSION: RYGB and SG have a similar presence of sarcopenia and physical performance. However, SG allows greater preservation of bone and muscle mass and is associated with higher values of leptin, which may represent protection from long-term postoperative complications.

Vaccine effectiveness of ChAdOx1 nCoV-19 against COVID-19 in a socially vulnerable community in Rio de Janeiro, Brazil: a test-negative design study.

OBJECTIVES: To estimate vaccine effectiveness after the first and second dose of ChAdOx1 nCoV-19 against symptomatic COVID-19 and infection in a socially vulnerable community in Brazil when Gamma and Delta were the predominant variants circulating. METHODS: We conducted a test-negative study in the community Complexo da Maré, the largest group of slums (n = 16) in Rio de Janeiro, Brazil, from January 17, 2021 to November 27, 2021. We selected RT-qPCR positive and negative tests from a broad community testing program. The primary outcome was symptomatic COVID-19 (positive RT-qPCR test with at least one symptom) and the secondary outcome was infection (any positive RT-qPCR test). Vaccine effectiveness was estimated as 1 - OR, which was obtained from adjusted logistic regression models. RESULTS: We included 10 077 RT-qPCR tests (6,394, 64% from symptomatic and 3,683, 36% from asymptomatic individuals). The mean age was 40 (SD: 14) years, and the median time between vaccination and RT-qPCR testing among vaccinated was 41 (25-75 percentile: 21-62) days for the first dose and 36 (25-75 percentile: 17-59) days for the second dose. Adjusted vaccine effectiveness against symptomatic COVID-19 was 31.6% (95% CI, 12.0-46.8) 21 days after the first dose and 65.1% (95% CI, 40.9-79.4) 14 days after the second dose. Adjusted vaccine effectiveness against COVID-19 infection was 31.0% (95% CI, 12.7-45.5) 21 days after the first dose and 59.0% (95% CI, 33.1-74.8) 14 days after the second dose. DISCUSSION: ChAdOx1 nCoV-19 was effective in reducing symptomatic COVID-19 in a socially vulnerable community in Brazil when Gamma and Delta were the predominant variants circulating.

Repercussions of intermittent fasting on the intestinal microbiota community and body composition: a systematic review.

CONTEXT: Several therapies have been tested for combating weight gain and obesity-related metabolic diseases, and among these therapies, intermittent fasting (IF) has gained a great deal of interest. OBJECTIVE: The aim of this study was to provide the reader with a current survey of IF protocols and an understanding of the outcomes found to date in terms of the profile of the intestinal microbiota (IM) in obese organisms. DATA SOURCES: Data were obtained from 4 databases: PubMed, SCOPUS, LILACs, and Web of Science. DATA EXTRACTION: Data from studies relating IF protocols to the microbiota and weight loss were extracted using a protocol in START program. DATA ANALYSIS: Of the 82 original articles identified from the databases, 35 were eliminated due to duplication, and 32 were excluded due to not meeting the inclusion criteria. Two additional articles found in a new search were added, yielding a total of 17 studies to be included in this review. Among the protocols, alternate-day fasting (ADF) and time-restricted feeding (TRF) were the most common, and they were shown to have different mechanisms of metabolic signaling. TRF influences weight control and biochemical parameters by regulating the circadian system, and improving satiety control systems by acting on leptin secretion. On the other hand, ADF leads to a reduction of ±75% of all energy consumption regardless of dietary composition in addition to promoting hormonal adjustments that promote weight control. Furthermore, both protocols showed the ability to remodel the IM by changing the Firmicutes/Bacteroidetes ratio and increasing the abundance of strains such as Lactobacillus spp. and Akkermansia m. that have a protective effect on metabolism against the effects of weight gain. CONCLUSION: In short, the ADF and TRF protocols have a positive effect on the remodeling of the IM and can possibly be used to control body adiposity, improve insulin sensitivity, and achieve other obesity-related metabolic changes.

Histomorphometry of mast cells in the convexity of human intracranial dura mater.

Mast cells, known as pro-inflammatory effector cells, are immunocytes present in the meninges and may be involved in the pathophysiology of migraine. This study aims to evaluate the histomorphometric parameters of mast cells located in the convexity of the human intracranial dura mater. For this, samples of intracranial dura mater from eight human fresh cadavers were collected between 8- and 24-h post-mortem. The whole samples were fixed and, subsequently, two fragments of 1.5 cm² each were cut from four different areas of the dura mater convexity, containing a segment of the middle meningeal artery, totaling 64 fragments. After histological processing, the fragments were submitted to microtomy (5 and 10 µm), stained with toluidine blue (0.1%), or immunohistochemically labeled for tryptase, and analyzed using optical microscopy. The following histomorphometric parameters were evaluated: distance from mast cells to vessels, the density of mast cells, and percentage of mast cells with degranulation. Histomorphometric analyzes showed a higher density of mast cells in the vicinity of blood vessels (arterial and venous), with distances around 0-150 µm. A greater number of mast cells was detected near venous vessels in the periosteal layer (17.0 ± 10.1 cells/mm²) than in the meningeal layer (14.1 ± 7.0 cells/mm²) (p < 0.05). Mast cells from the region close to the superior sagittal sinus were found in greater quantity close to the venous vessels (16.7 ± 10.1 cells/mm²) than to the arterial vessels (11.2 ± 7.5 cells/mm²) (p < 0.05). In short, in the convexity of the human intracranial dura mater, mast cells are located close to blood vessels, with a greater number of cells next to the venous vessels of the periosteal layer and in the proximal region of the superior sagittal sinus.

Caffeine slows heart rate autonomic recovery following strength exercise in healthy subjects.

INTRODUCTION AND OBJECTIVES: Studies assessing the effects of caffeine (CAF) on the cardiovascular system have demonstrated that CAF can delay cardiac recovery following exercise. This study intended to assess the impact of CAF intake before physical exercise on heart rate variability (HRV) and cardiovascular parameters. METHODS: This is a prospective, crossover, controlled clinical trial conducted at the University of Pernambuco, Petrolina, PE, Brazil. The experimental protocol was split into three stages with a minimum of 48 hours between them. Exercises intensity was standardized based on the one repetition maximum test (1RM), obtaining the load of each volunteer for the intensity of 75% of 1RM. In the second and third phases, the control protocols were applied and 300 mg caffeine was given 45 minutes before training. HRV indices were determined at the subsequent times: 0 to 5 minutes of rest (before) and during 30 minutes of recovery (Rec) (after exercise), divided into six intervals, each of 5 minutes. RESULTS: The final sample involved 30 volunteers. CAF delayed HRV recovery after resistance exercise. In general, CAF impaired recovery of HRV after resistance exercise. Significant changes were observed in the RMSSD, SDNN, TINN, SD1, low frequency and high frequency indices between the control and CAF group. CONCLUSION: CAF protocol delayed parasympathetic regulation of heart rhythm following exercise, slowing recovery of HR, blood pressure and HRV indices after exercise.

Does bariatric surgery improve cardiac autonomic modulation assessed by heart rate variability? A systematic review.

Our study aimed to explore the influence of bariatric surgery (BS) on heart rate (HR) variability (HRV) through a systematic review. Manuscripts were selected based on electronic searches of the MEDLINE, EMBASE, and CINAHL databases from the inception of each database up to year 2020, and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Searching of these studies was systematized using the Population Intervention Comparison Outcome Study Design strategy. We selected randomized and nonrandomized controlled trials and cohorts from prospective studies that reported the influence of BS on HRV. We assessed the quality rating using the Black and Downs questionnaire. Following the screening and eligibility stages, 14 studies were included in the review. All studies agreed that BS promotes an increase in parasympathetic HR control and HRV and a decrease in HR. Yet the literature does not provide evidence that these outcomes are directly caused by the surgical procedure. There is limited evidence to support that patients with type 2 diabetes have greater improvement in HRV as an interim measure, to individuals without. The decrease in insulin resistance was correlated with the increase in HRV in some studies, but, other studies are unsupportive of this outcome. Improvements in 2 metabolic parameters (e.g., leptin, N-terminal pro B-type natriuretic peptide) were connected with superior increases in HRV. This review demonstrated that BS promotes an increase in HRV, indicating improved autonomic control of HR.

Beetroot (Beta Vulgaris L.) Extract Acutely Improves Heart Rate Variability Recovery Following Strength Exercise: A Randomized, Double-Blind, Placebo-Controlled Crossover Trial-Pilot Study.

OBJECTIVE: We assessed the acute effect of beetroot extract intake on cardiovascular and autonomic recovery subsequent to strength exercise. METHODS: This is a crossover, randomized, double-blind and placebo-controlled trial. We assessed 16 subjects but only 12 healthy male adults completed the two protocols in two randomized days: Beetroot extract (600 mg in capsule) and placebo (600 mg starch in capsule). Beetroot extract or placebo was ingested, the subjects endured 120 minutes seated at rest, followed by a 75% 1RM strength exercise and then remained seated for 60 minutes at rest. Cardiorespiratory parameters, heart rate (HR) variability (HRV) (SDNN, rMSSD, pNN50, SD1, SD2 HF [ms2]) were estimated before, during exercise and during recovery from exercise. RESULTS: ingestion of beetroot extract before exercise: accelerates the recovery of SBP following physical effort; improves HR recovery to baseline resting levels (beetroot protocol: change in ∼62% vs. placebo protocol: change in ∼80%), and intensifies the return of vagal HR control during recovery after exercise. CONCLUSIONS: Beetroot extract acutely improved cardiovascular and autonomic recovery after exercise.

Physiological and socioeconomic characteristics predict COVID-19 mortality and resource utilization in Brazil.

BACKGROUND: Given the severity and scope of the current COVID-19 pandemic, it is critical to determine predictive features of COVID-19 mortality and medical resource usage to effectively inform health, risk-based physical distancing, and work accommodation policies. Non-clinical sociodemographic features are important explanatory variables of COVID-19 outcomes, revealing existing disparities in large health care systems. METHODS AND FINDINGS: We use nation-wide multicenter data of COVID-19 patients in Brazil to predict mortality and ventilator usage. The dataset contains hospitalized patients who tested positive for COVID-19 and had either recovered or were deceased between March 1 and June 30, 2020. A total of 113,214 patients with 50,387 deceased, were included. Both interpretable (sparse versions of Logistic Regression and Support Vector Machines) and state-of-the-art non-interpretable (Gradient Boosted Decision Trees and Random Forest) classification methods are employed. Death from COVID-19 was strongly associated with demographics, socioeconomic factors, and comorbidities. Variables highly predictive of mortality included geographic location of the hospital (OR = 2.2 for Northeast region, OR = 2.1 for North region); renal (OR = 2.0) and liver (OR = 1.7) chronic disease; immunosuppression (OR = 1.7); obesity (OR = 1.7); neurological (OR = 1.6), cardiovascular (OR = 1.5), and hematologic (OR = 1.2) disease; diabetes (OR = 1.4); chronic pneumopathy (OR = 1.4); immunosuppression (OR = 1.3); respiratory symptoms, ranging from respiratory discomfort (OR = 1.4) and dyspnea (OR = 1.3) to oxygen saturation less than 95% (OR = 1.7); hospitalization in a public hospital (OR = 1.2); and self-reported patient illiteracy (OR = 1.1). Validation accuracies (AUC) for predicting mortality and ventilation need reach 79% and 70%, respectively, when using only pre-admission variables. Models that use post-admission disease progression information reach accuracies (AUC) of 86% and 87% for predicting mortality and ventilation use, respectively. CONCLUSIONS: The results highlight the predictive power of socioeconomic information in assessing COVID-19 mortality and medical resource allocation, and shed light on existing disparities in the Brazilian health care system during the COVID-19 pandemic.

Evaluation of resistance to natural poisoning by Amorimia septentrionalis in goats which had received sodium monofluoroacetate degrading bacteria / Avaliação da resistência à intoxicação natural por Amorimia septentrionalis em caprinos que receberam bactérias degradadoras de monofluoroacetato de sódio

Amorimia septentrionalis is an important sodium monofluoroacetate (MFA) containing plant that causes sudden death in ruminants in northeastern Brazil. MFA degrading bacteria are being used in the prevention against poisoning by this plant. The aim of this study was to evaluate if goats which had per os received MFA degrading bacteria remained resistant when exposed to natural poisoning by A. septentrionalis. Eighteen goats were randomly distributed into three groups: the goats of Group 1 previously received, during 40 days, a solution containing the bacteria Ralstonia sp. and Burkholderia sp., those goats in the Group 2 received the bacteria Paenibacillus sp. and Cupriavidus sp. and goats from Group 3 did not receive any bacteria. After the administration period, during 60 days, the animals of all groups were released to graze on a one hectare paddock, with significant amount of A. septentrionalis. They were observed daily for the spontaneous consumption of A. septentrionalis leaves and the occurrence of clinical signs of poisoning or sudden death. Goats from all groups consumed significant amounts of A. septentrionalis during the experimental period. Goats that did not receive MFA-degrading bacteria (Group 3) became sick and died from the 25th to the 27th day of the experiment, whereas the goats of the groups that received MFA-degrading bacteria showed only clinical sings when A. septentrionalis regrowth after the 55th day of the experiment. The days elapsed from field observation to death of Group 3 goats (25.5±0.9 days) were significantly lower (p<0.05) than Group 1 (58.6±1.3 days) and Group 2 (57.8±1.5 days). Thus, it can be concluded that administration of MFA degrading bacteria increases the resistance to natural poisoning by A. septentrionalis.(AU)

Amorimia septentrionalis que contém monofluoroacetato de sódio (MFA) é responsável pela ocorrência de mortes súbitas em ruminantes no nordeste do Brasil. Bactérias degradadoras desse composto estão sendo utilizadas na prevenção contra a intoxicação por essa planta. O objetivo deste estudo foi avaliar se caprinos que receberam, via oral, bactérias degradadoras de MFA permaneciam resistentes quando expostos a intoxicação natural por A. septentrionalis. Dezoito caprinos foram divididos em três grupos, os caprinos do Grupo 1 receberam anteriormente, durante 40 dias, uma solução contendo as bactérias Ralstonia sp. e Burkholderia sp., os do Grupo 2 receberam, também por 40 dias as bactérias Paenibacillus sp. e Cupriavidus sp. e os do Grupo 3 não receberam nenhuma bactéria. Após o período de administração, durante 60 dias, os animais de todos os grupos foram soltos para pastar em um piquete de um hectare, que apresentava uma quantidade significativa da planta. Diariamente eles foram observados quanto ao consumo espontâneo das folhas de A. septentrionalis e quanto à presença de sinais clínicos de intoxicação ou morte. Os caprinos de todos os grupos consumiram quantidades significantes da planta durante o período experimental. Os caprinos que não receberam as bactérias degradantes de MFA (Grupo 3) adoeceram e morreram entre o 25º e o 27º dia de experimento, enquanto que os que receberam as bactérias degradantes de MFA (Grupo 1 e 2) só apresentaram sinais clínicos no 55º dia de experimento, o que coincidiu com a rebrota da planta. Os dias transcorridos desde a observação a campo até a morte dos caprinos do Grupo 3 (25,5±0,9 dias) foram significativamente menores (p<0,05) que os do Grupo 1 (58,6±1,3 dias) e do Grupo 2 (57,8±1,5 dias). Com isso pode-se concluir que a administração de bactérias degradadoras de MFA aumenta à resistência a intoxicação natural por A. septentrionalis.(AU)

Effects of MASP2 haplotypes and MASP-2 levels in hepatitis C-infected patients.

Mannan-binding lectin (MBL) and MBL-associated serine protease 2 (MASP-2) are components of the lectin pathway, which activate the complement system after binding to the HCV structural proteins E1 and E2. We haplotyped 11 MASP2 polymorphisms in 103 HCV patients and 205 controls and measured MASP-2 levels in 67 HCV patients and 77 controls to better understand the role of MASP-2 in hepatitis C susceptibility and disease severity according to viral genotype and fibrosis levels. The haplotype block MASP2*ARDP was associated with protection against HCV infection (OR = 0.49, p = .044) and lower MASP-2 levels in controls (p = .021), while haplotype block AGTDVRC was significantly increased in patients (OR = 7.58, p = .003). MASP-2 levels were lower in patients than in controls (p < .001) and in patients with viral genotype 1 or 4 (poor responders to treatment) than genotype 3 (p = .022) and correlated inversely with the levels of alkaline phosphatase, especially in individuals with fibrosis 3 or 4 (R = -.7, p = .005). MASP2 gene polymorphisms modulate basal gene expression, which may influence the quality of complement response against HCV. MASP-2 levels decrease during chronic disease, independently of MASP2 genotypes, most probably due to consumption and attenuation mechanisms of viral origin and by the reduced liver function, the site of MASP-2 production.

Tumor Stiffening, a Key Determinant of Tumor Progression, is Reversed by Nanomaterial-Induced Photothermal Therapy.

Tumor stiffening, stemming from aberrant production and organization of extracellular matrix (ECM), has been considered a predictive marker of tumor malignancy, non-invasively assessed by ultrasound shear wave elastography (SWE). Being more than a passive marker, tumor stiffening restricts the delivery of diagnostic and therapeutic agents to the tumor and per se could modulate cellular mechano-signaling, tissue inflammation and tumor progression. Current strategies to modify the tumor extracellular matrix are based on ECM-targeting chemical agents but also showed deleterious systemic effects. On-demand excitable nanomaterials have shown their ability to perturb the tumor microenvironment in a spatiotemporal-controlled manner and synergistically with chemotherapy. Here, we investigated the evolution of tumor stiffness as well as tumor integrity and progression, under the effect of mild hyperthermia and thermal ablation generated by light-exposed multi-walled carbon nanotubes (MWCNTs) in an epidermoid carcinoma mouse xenograft. SWE was used for real-time mapping of the tumor stiffness, both during the two near infrared irradiation sessions and over the days after the treatment. We observed a transient and reversible stiffening of the tumor tissue during laser irradiation, which was lowered at the second session of mild hyperthermia or photoablation. In contrast, over the days following photothermal treatment, the treated tumors exhibited a significant softening together with volume reduction, whereas non-treated growing tumors showed an increase of tumor rigidity. The organization of the collagen matrix and the distribution of CNTs revealed a spatio-temporal correlation between the presence of nanoheaters and the damages on collagen and cells. This study highlights nanohyperthermia as a promising adjuvant strategy to reverse tumor stiffening and normalize the mechanical tumor environment.

Perinatal undernutrition increases meal size and neuronal activation of the nucleus of the solitary tract in response to feeding stimulation in adult rats.

During the early periods of development, i.e., gestation and lactation, the influences of stimulus such as undernutrition can lead to several behavioural and morphofunctional damages to organs and systems in general, including pathways and structures that control energy balance and feeding behaviour. Although a large body of evidences have shown the effects of this stimulus on structures such as hypothalamus, only few studies have directed their attention to the long-term effects of undernutrition on the nucleus of the solitary tract (NTS). The aim of this study was to investigate the effects of early undernutrition on the NTS and control of food intake in adulthood. Male Wistar rats were divided into two groups according to the diet offered to the dams during gestation and lactation: control group (C, diet containing 17% casein) or isocaloric low-protein group (LP, diet containing 8% casein). On 35 or 180 days, we evaluated the rats' body weight, food intake, behavioural satiety sequence and c-Fos protein expression in the NTS in response to food stimulus. Based on these assessments, it was found that perinatal undernutrition promoted an increase in food intake and the number of activated cells in rostral and, mainly, medial NTS in response to food stimulation in adulthood. These results indicated that the NTS is a structure particularly vulnerable to the influences of nutritional manipulation in the early stages of development with effects on food control in adulthood.

Ingestive effects of NMDA and AMPA-kainate receptor antagonists microinjections into the lateral hypothalamus of the pigeon (Columba livia).

This study examined the ingestive and behavioral effects of NMDA- and AMPA/kainate glutamatergic receptor blockade in the lateral hypothalamic area (LHy) of free-feeding pigeons (Columba livia). Injections of MK-801 (NMDA receptor antagonist; 6 nmol) or CNQX (AMPA/kainate receptor antagonist; 25.8 nmol) into the LHy of free-feeding pigeons induced significant increases in food intake and in feeding duration, as well as reductions in the latency to start feeding. Duration, latency and volume of water intake, as well as duration of sleep-like behavior, alert immobility, locomotion and preening were not changed by these treatments in the LHy. These results indicate that glutamatergic inputs to cells containing NMDA and/or AMPA receptors located in the LHy could modify both the beginning of a feeding bout (or the end of a period of satiety) and its duration (satiation). Our data also suggest that these inhibitory glutamatergic influences on feeding behavior are tonically active in the LHy.

Feeding induced by microinjections of NMDA and AMPA-kainate receptor antagonists into ventral striatal and ventral pallidal areas of the pigeon.

The participation of glutamatergic circuits of the ventral basal ganglia in feeding-related regulatory mechanisms has been extensively indicated in primate and rodent species. In avian species, it has been shown that ICV injections of MK-801 or of CNQX increase food intake and reduce the latency of feeding initiation in free-feeding pigeons. In the present study, the effects of local injections of MK-801 (6 nmol), CNQX (160 nmol) or vehicle (0.2 microl) into a number of ventral striatopallidal nuclei on feeding, drinking and non-ingestive (sleep, preening) spontaneous behaviors were investigated in free-feeding pigeons (Columba livia). Intense feeding responses associated with an increased duration of feeding behavior were consistently recorded after injections of MK-801 or CNQX into the medial two-thirds of the tuberculum olfactorium (TO), the ventral aspect of lobus parolfactorium (LPOv), or the ventral pallidum (VP). In contrast, the latency of feeding initiation was unaffected by these treatments. No changes in drinking, preening or sleep responses were observed after drug injections into the TO/LPOv/VP area. These data indicate that glutamate-mediated circuits in the TO/LPOv/VP area can play an inhibitory role in feeding behavior in this species, contributing to the conclusion of a feeding bout, thus delaying satiation processes, and that these effects may be mediated by AMPA and NMDA receptors. Additionally, our data support the notion that a region functionally and anatomically comparable to the mammalian accumbens shell may be present in the TO/LPOv/VP region of the pigeon, and that the existence of a glutamatergic circuit in the ventral striatum controlling feeding-related phenomena may represent a highly conserved attribute throughout the amniote's evolution.