Are sarcopenia, frailty and malnutrition prognostic markers of liver disease decompensation in the ambulatory setting? - A prospective cohort study

BACKGROUND

sarcopenia, frailty and malnutrition are associated with adverse outcomes in liver cirrhosis. Studies assessing the prognostic value of these conditions in ambulatory patients with cirrhosis are scarce.

METHODS

a prospective cohort study was performed, with consecutive inclusion of all patients with cirrhosis observed in the Hepatology outpatient clinic of a Portuguese tertiary center. At study enrolment, evaluation of muscle mass (ultrasound quadriceps femoris thickness), muscle strength (handgrip dynamometry) and nutritional status (Patient-Generated Subjective Global Assessment Short Form) were performed. Follow-up ended upon the occurrence of a composite endpoint, comprising of liver decompensation events and liver-related death, or last medical appointment/non-liver related death before the end of the study. The prognostic value of anthropometrical parameters and nutritional status in the composite endpoint was assessed using a multivariate Cox regression analysis, adjusted for several confounders.

RESULTS

ninety patients were enrolled (80 % male), with a mean age of 63.5 ± 10.5 years. The median follow-up was 30 (interquartile range 38) weeks, during which, 12 patients reached the composite endpoint. These patients presented a lower mean handgrip strength (23.1 ± 6.41 vs 30.3 ± 10.4 kg, p = 0.04) compared to patients who did not reach the composite endpoint. However, Cox regression multivariate analysis did not find any independent predictors of the composite endpoint, apart from previous decompensation episodes.

CONCLUSION

in this study, muscle strength was lower in the group of patients with cirrhosis who presented a liver-related event. Handgrip strength might be a promising tool in the ambulatory setting to identify patients at risk of liver decompensation and liver-related death in the short term.

Peritoneal Protein Loss With Time in Peritoneal Dialysis

Longitudinal evolution of peritoneal protein loss (PPL), a reflection of hydrostatic pressure-driven leak of plasma proteins through the large-pore pathway, is not clear. Time on PD causes loss of mesothelial cells, vasculopathy, and increased thickness of the submesothelial fibrous layer. Are these structural changes associated with progressive increase of PPL, in a parallel with the rise in the D/P creatinine? The aim of the present study was to identify longitudinal changes of PPL over time. This single-center, longitudinal study included 52 peritoneal dialysis (PD) patients with a median follow-up of 26.5 months, evaluated at two different time points with a minimum interval of 6 months. Repeated measures analysis was performed using paired sample t-test or the nonparametric Wilcoxon signed-rank test, depending on the distribution. After a median interval of 15.5 months, lower levels of residual renal function and urine volume, lower Kt/V, and creatinine clearance were found. D/P creatinine and PPL were stable, but a decrease in ultrafiltration was present. Systemic inflammation, nutrition, and volume overload showed no significant change with time on PD. Analysis of a subpopulation with over 48 months between initial and subsequential assessment (n = 11) showed again no difference in inflammation, nutritional and hydration parameters from baseline, but importantly PPL decreased after more than 4 years on PD (mean difference 1.2 g/24, p = 0.033). D/P creatinine and dip of sodium remained unchanged. The absence of deleterious effects of time on PD is reassuring, pointing to the benefit of updated PD prescription, including the standard use of more biocompatible solutions towards membrane preservation and adjusted prescription avoiding overhydration and inflammation while maintaining nutritional status. After controlling for confounders, PPL may act as a biomarker of acquired venous vasculopathy, even if small pore fluid transport rates and free water transport are preserved.

Enrichment of medium-quality colostrum by adding colostrum replacer, combined or not with transition milk in the feeding of dairy calves

Fifty Holstein calves were allocated in randomized blocks and distributed in a 2 × 2 factorial arrangement; (A) two sources of Ig: (1) Control: bovine colostrum (25% Brix); (2) Enriched colostrum: mid-quality bovine colostrum (20% Brix) enriched with colostrum replacer to 25% Brix; and (B) two transition feeding diets: (1) Whole milk (WM): supply of 4 L/day of whole milk for 3 days after the colostrum feeding; and (2) Formulated transition milk (FTM): supply 4 L/day of whole milk enriched with 70 g/L of colostrum replacer for 3 days after the colostrum feeding. Blood samples were collected at 0, 24, 48, and 72 h of age to determine total serum protein (TSP), glucose, non-esterified fatty acids (NEFA), erythrocyte and leukocyte concentrations. IgG was measured at 48 h. During the preweaning period, calves received 6 L/day of whole milk. Blood samples were collected weekly to determine TSP, glucose, and lactate. The colostrum protocols were equally efficient for transfer of passive immunity with IgG concentration at 48 h ≥ 49.6 g/L. Colostrum or transition feeding program did not influence the erythrocyte and leukocyte concentrations. The TSP concentration measured until 72 h was higher for calves fed maternal colostrum. Calves fed milk in the transition period had higher glucose concentrations. Calves receiving bovine colostrum and FTM had higher glucose concentrations in the preweaning period, while the enriched colostrum decreased plasma lactate concentrations. In summary, enrichment of mid-quality colostrum is an alternative in situations of a shortage of high-quality colostrum; however, feeding 4 L/day of FTM only for 3 days after colostrum feeding does not show additional benefits.

Dichotomous effect of methylphenidate on microglia and astrocytes: Insights from in vitro and animal studies

Methylphenidate (MPH) has been used for decades to treat attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. Moreover, several studies have shown that it is subject to misuse, particularly among college students and adolescents, for cognitive enhancement or as a recreational drug. This phenomenon causes concern, and it is critical to clarify better how MPH impacts brain cells. In fact, data has suggested that MPH could result in neuroinflammation and neurodegeneration across several brain regions; however, little is known about the effect of MPH on glial cells. To address this, we used microglia N9 cell line and primary cultures of cortical astrocytes that were exposed to MPH (0.01 - 2 mM), as well as Wistar Kyoto rats (WKY) chronically administered with MPH (1.5 mg/kg/day). Several parameters were analyzed, and we concluded that MPH has no significant direct effect on microglial cells, apart from cell migration impairment. On the contrary, MPH promotes astrogliosis, oxidative/nitrosative stress, and increases proinflammatory cytokine TNF levels by astrocytes, which was concordant with the results obtained in the hippocampus of WKY rats. Overall, the present results suggest that brain cells respond differently to MPH, with a more prominent direct effect on astrocytes when compared to microglia.

Whole-plant flint corn silage inclusion in total mixed rations for pre- and postweaning dairy calves

Assuming that acetic acid plays a minor role in the development of ruminal epithelium of preweaning dairy calves, the fiber supply for growing calves has been neglected. More research has been done on including starch and nonfibrous carbohydrates in solid feed for preweaning calves. Accordingly, the fiber requirement of these calves is not well known, as diet recommendations vary greatly. Hence, elucidating the effects of including fiber from long particle sizes in the diet may be essential for helping calves overcome the transition challenge during weaning. Forty-five Holstein calves were used in a randomized block design, considering sex, birth date, and weight at 28 d of age, when the supply of the total mixed ration (TMR) with the inclusion of corn silage started. Three TMR with increasing whole-plant flint corn silage content (0, 10, or 20% on a dry matter basis) were compared: 0CS, 10CS, or 20CS, respectively. During the first 28 d of life, the calves were managed homogeneously and were fed 6 L/d of whole milk, a commercial calf starter pelleted, and water ad libitum. Next, the solid diet was changed to the respective solid feed treatment. Calves were gradually weaned from 52 to 56 d of age but were evaluated for an additional 14 d postweaning. Feed intake was measured daily, while body weight and metabolic indicators of intermediate metabolism were evaluated weekly. Ruminal fluid was collected at 6, 8, and 10 wk of age. Behavioral analysis was conducted on wk 7 (preweaning) and 10 (postweaning). There was a quadratic effect for dry matter intake from wk 7 to 10, with higher intake for the 10CS diet than the 0CS and 20CS diets. Consequently, the 10CS diet also promoted greater average daily gain at wk 8 and 9 compared with the 0CS and 20CS diets. However, the final body weight was not affected by the different solid diets. Silage inclusion in calves' diet positively affected time spent ruminating and chewing pre- and postweaning. Including 10% of whole-plant flint corn silage in the diets of young dairy calves is a strategy to increase total solid intake and decrease acidosis risk by increasing pH and ruminating activity around weaning.

A Transgender Chatbot (Amanda Selfie) to Create Pre-exposure Prophylaxis Demand Among Adolescents in Brazil: Assessment of Acceptability, Functionality, Usability, and Results

BACKGROUND

HIV incidence rates have increased in adolescent men who have sex with men (AMSM) and adolescent transgender women (ATGW). Thus, it is essential to promote access to HIV prevention, including pre-exposure prophylaxis (PrEP), among these groups. Moreover, using artificial intelligence and online social platforms to create demand and access to health care services are essential tools for adolescents and youth.

OBJECTIVE

This study aims to describe the participative process of developing a chatbot using artificial intelligence to create demand for PrEP use among AMSM and ATGW in Brazil. Furthermore, it analyzes the chatbot's acceptability, functionality, and usability and its results on the demand creation for PrEP.

METHODS

The chatbot Amanda Selfie integrates the demand creation strategies based on social networks (DCSSNs) of the PrEP1519 study. She was conceived as a Black transgender woman and to function as a virtual peer educator. The development process occurred in 3 phases (conception, trial, and final version) and lasted 21 months. A mixed methodology was used for the evaluations. Qualitative approaches, such as in-depth adolescent interviews, were used to analyze acceptability and usability, while quantitative methods were used to analyze the functionality and result of the demand creation for PrEP based on interactions with Amanda and information from health care services about using PrEP. To evaluate Amanda's result on the demand creation for PrEP, we analyzed sociodemographic profiles of adolescents who interacted at least once with her and developed a cascade model containing the number of people at various stages between the first interaction and initiation of PrEP (PrEP uptake). These indicators were compared with other DCSs developed in the PrEP1519 study using chi-square tests and residual analysis (P=.05).

RESULTS

Amanda Selfie was well accepted as a peer educator, clearly and objectively communicating on topics such as gender identity, sexual experiences, HIV, and PrEP. The chatbot proved appropriate for answering questions in an agile and confidential manner, using the language used by AMSM and ATGW and with a greater sense of security and less judgment. The interactions with Amanda Selfie combined with a health professional were well evaluated and improved the appointment scheduling. The chatbot interacted with most people (757/1239, 61.1%) reached by the DCSSNs. However, when compared with the other DCSSNs, Amanda was not efficient in identifying AMSM/ATGW (359/482, 74.5% vs 130/757, 17.2% of total interactions, respectively) and in PrEP uptake (90/359, 25.1% vs 19/130, 14.6%). The following profiles were associated (P<.001) with Amanda Selfie's demand creation, when compared with other DCS: ATGW and adolescents with higher levels of schooling and White skin color.

CONCLUSIONS

Using a chatbot to create PrEP demand among AMSM and ATGW was well accepted, especially for ATGW with higher levels of schooling. A complimentary dialog with a health professional increased PrEP uptake, although it remained lower than the results of the other DCSSNs.

Attention-Deficit/Hyperactivity Disorder Animal Model Presents Retinal Alterations and Methylphenidate Has a Differential Effect in ADHD versus Control Conditions

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders. Interestingly, children with ADHD seem to experience more ophthalmologic abnormalities, and the impact of methylphenidate (MPH) use on retinal physiology remains unclear. Thus, we aimed to unravel the retina's structural, functional, and cellular alterations and the impact of MPH in ADHD versus the control conditions. For that, spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY) were used as animal models of ADHD and the controls, respectively. Animals were divided into four experimental groups as follows: WKY vehicle (Veh; tap water), WKY MPH (1.5 mg/kg/day), SHR Veh, SHR MPH. Individual administration was performed by gavage between P28-P55. Retinal physiology and structure were evaluated at P56 followed by tissue collection and analysis. The ADHD animal model presents the retinal structural, functional, and neuronal deficits, as well as the microglial reactivity, astrogliosis, blood-retinal barrier (BRB) hyperpermeability and a pro-inflammatory status. In this model, MPH had a beneficial effect on reducing microgliosis, BRB dysfunction, and inflammatory response, but did not correct the neuronal and functional alterations in the retina. Curiously, in the control animals, MPH showed an opposite effect since it impaired the retinal function, neuronal cells, and BRB integrity, and also promoted both microglia reactivity and upregulation of pro-inflammatory mediators. This study unveils the retinal alterations in ADHD and the opposite effects induced by MPH in the retina of ADHD and the control animal models.

Distance Learning of Financial Accounting: Mature Undergraduate Students’ Perceptions

This research sought to explore self-reported satisfaction levels of mature students enrolled in the virtual financial accounting course of the first online-only bachelor’s degree in Portugal. While doing so, it attempted to generate understanding of which factors may affect undergraduate mature students’ engagement—herein measured in terms of overall satisfaction—with online learning, particularly, of financial accounting. Thereby, this research addresses several research gaps. First, unlike most recent empirical research, it provides evidence from a post-pandemic period, in 2022. Second, responding to calls for further education research in different contexts, Portugal poses a highly relevant, unexplored research setting since it was only in 2019 that the Portuguese government approved a legal regime to frame distance education at Higher Education Institutions (HEIs). Third, this research focuses on the overlooked, and yet growing, population of adult mature students. The research evidence emerges from 32 valid responses to a structured electronic questionnaire circulated to students at the end of a financial accounting module (in July 2022). Satisfaction rates from students’ own perspectives were derived in terms of (i) overall satisfaction, (ii) learning outcomes, (iii) e-learning process, and (iv) pedagogical practices adopted. The assessment of satisfaction levels was determined through Likert-type items with responses ranging from a minimum score of 1 to the highest score of 5. Data gathered were subject to quantitative analysis: descriptive statistics, Pearson correlations, statistical tests, principal component analysis, and linear regression. High levels of satisfaction with distance education were uncovered. We found that pedagogical practices constitute the dimension that contributed the least (though, still importantly) to overall satisfaction as compared with learning outcomes and e-learning process. The results of this research offer the potential to contribute to the implementation of training offerings of online courses at other Portuguese HEIs as well as abroad.

ApoE Mimetic Peptides to Improve the Vicious Cycle of Malnutrition and Enteric Infections by Targeting the Intestinal and Blood-Brain Barriers

Apolipoprotein E (apoE) mimetic peptides are engineered fragments of the native apoE protein’s LDL-receptor binding site that improve the outcomes following a brain injury and intestinal inflammation in a variety of models. The vicious cycle of enteric infections and malnutrition is closely related to environmental-driven enteric dysfunction early in life, and such chronic inflammatory conditions may blunt the developmental trajectories of children with worrisome and often irreversible physical and cognitive faltering. This window of time for microbiota maturation and brain plasticity is key to protecting cognitive domains, brain health, and achieving optimal/full developmental potential. This review summarizes the potential role of promising apoE mimetic peptides to improve the function of the gut-brain axis, including targeting the blood-brain barrier in children afflicted with malnutrition and enteric infections.

Orchard Net Covers Improve Resistance to Cherry Cracking Disorder

Orchard net cover improves plant physiology, yield and fruit quality, pest and disease control, and anticipates fruit ripening. Moreover, this crop technology has been used to reduce natural cherry cracking (NCC). This is a serious physiological disorder that cracks the epidermis, the hypodermis, and the storage parenchyma layers of the fruit due to rainfall events near the harvest and it is related to low fruit osmotic potential and/or high fruit water permeability. This work aims to study the effect of orchard net cover on sweet cherry trees, cv. Early Bigi, in two harvesting years (2019 and 2021). The NCC, the induced cracking index (CI), and the cracking type incidence were determined. In addition, epicuticular and intra-cuticular wax content, biometric and physicochemical parameters were also evaluated. Net cover reduced the natural cracking index by 40%. High fruit weight values were observed in covered trees comparing to the control ones, with increases of 45% and 13%, in 2019 and 2021, respectively. A positive correlation was observed between CI and total soluble solids and a negative correlation between CI and wax content. Therefore, with forecasts of worsening heavy precipitation events near harvest, protecting cherry trees with nets will increase resistance to fruit cracking.

Prevalence of syphilis and sexual behavior and practices among adolescents MSM and TrTGW in a Brazilian multi-center cohort for daily use of PrEP

Syphilis has reemerged as a serious public health problem in Brazil and worldwide, disproportionately affecting men who have sex with men (MSM) and travestis and transgender women (TrTGW). Studies on sexually transmitted infections (STI) in adolescents from these key populations are relatively scarce. This is a Brazilian multi-center, cross study with prevalence analysis, using as baseline the PrEP1519 cohort of sexually active MSM and TrTGW adolescents, recruited from April 2019 to December 2020. Analyses were made using the dimensions of vulnerability to STI/HIV and logistic regression models were conducted to estimate the odds ratios of the association between the predictor variables and positive treponemal test for syphilis at the moment of entry in the study. In total, 677 participants were analyzed; participants' median age was 18.9 years (IQR: 18.1-19.5); 70.5% (477) self-declared as black; 70.5% (474), as homosexuals/gays; and 48 (7.1%), as trans women or travestis. The baseline prevalence of syphilis was 21.3%. In the final logistic regression model, higher chance of syphilis was associated with: self-reported episode of STI in the last 12 months (OR = 5.92; 95%CI: 3.74-9.37), sex worker (OR = 3.39; 95%CI: 1.32-8.78), and < 11 years of schooling (OR = 1.76; 95%CI: 1.13-2.74). The prevalence of syphilis among MSM/TrTGW adolescents aged from 15 to 19 years was alarming, much higher than the described for the general population within this age range and associated with vulnerability factors. This reinforces the urgent need to strengthen public health programs to debate about race, gender, sexuality, and prevention.

When prevention is the best remedy: HIV pre-exposure prophylaxis (PrEP) among adolescents gays and transgender women in Belo Horizonte, Minas Gerais State, Brazil

Based on the incorporation of pre-exposure prophylaxis (PrEP) as an HIV prevention strategy and considering the need to comprehend the use of medication among young people, this article analyzes narratives of gay men and transgender women from Belo Horizonte, Minas Gerais State, Brazil, participating in the PrEP1519 study. This is a qualitative research, based on the interpretative anthropology, developed by 10 in-depth interviews with PrEP users followed-up for at least three months between October and November 2019. The results showed that the drug was seen as the main motivation for participating in the study and as a strategy combined with the use of condoms, whether as additional prevention, or assuming the leading role. The medication revealed signs built by the gender performances and their relation to other medications, especially the experience of trans girls in hormonal therapy. Regarding the socialization of the use of PrEP, the narratives showed that there was no secret between the couples, which did not meant that stigmas on the association with HIV did not exist, mainly in the virtual context. In the family environment, they reported questions about the preventive function of the medication and the voluntary nature of the participation in the study. The youth’s narratives revealed plural meanings of the medication and its social use, composing both the boys’ and girls’ performances. The signs attributed to the medication indicated that in addition to maintenance of health, the medication improves life and sexual freedom.

Exogenous Application of Glycine Betaine on Sweet Cherry Tree (Prunus avium L.): Effects on Tree Physiology and Leaf Properties

Biostimulants, such as glycine betaine (GB), are a sustainable way to boost productivity and quality in fruit crops, even in adverse environment conditions. Sweet cherry (Prunus avium L.) is an important crop, which is very sensitive to abiotic stress. Known primarily for its fruits, its leaves are also rich in bioactive substances, which, however, still have no commercial value. There are no studies about the effects of GB exogenous application on biochemical parameters of sweet cherry leaves and few studies about effects in sweet cherry tree physiology. This study was conducted in a Portuguese sweet cherry commercial orchard. Lapins sweet cherry trees were treated with a commercial product based on GB, at two different concentrations (0.25% and 0.40%). The applications were performed at three different phenological stages, according to the BBCH (Biologische Bundesanstalt, Bundessortenamt und Chemische Industrie) scale: 77, 81 and 86 BBCH. Both GB treatments improved leaf water status, photosynthetic pigments, soluble solids content, total phenolic contents, and antioxidant activity, resulting in better leaf water status regulation, greater photosynthetic capacity, and higher antioxidant activity. These results shows that GB can benefit sweet cherry tree physiology and provide new opportunities for sweet cherry leaves valorisation.

Litter inputs and standing stocks in riparian zones and streams under secondary forest and managed and abandoned cocoa agroforestry systems

Background

Cocoa is an important tropical tree crop that is mainly cultivated in agroforestry systems (AFS). This system, known as cabruca in northeastern Brazil, holds promise to reconcile biodiversity conservation and economic development. However, since cocoa AFS alters forest structure composition, it can affect litter dynamics in riparian zones and streams. Thus, our objective was to determine litter inputs and standing stocks in riparian zones and streams under three types of forest: managed cocoa AFS, abandoned cocoa AFS, and secondary forest.

Methods

We determined terrestrial litter fall (TI), vertical (VI) and lateral (LI) litter inputs to streams, and litter standing stocks on streambeds (BS) in the Atlantic Forest of northeastern Brazil. Litter was collected every 30 days from August 2018 to July 2019 using custom-made traps. The litter was dried, separated into four fractions (leaves, branches, reproductive organs, and miscellaneous material) and weighed.

Results

Terrestrial litter fall was similar in all forests, ranging from 89 g m^-2 month^-1 in secondary forest (SF) to 96 g m^-2 month^-1 in abandoned cocoa AFS (AC). Vertical input were higher in AC (82 g m^-2 month^-1) and MC (69 g m^-2 month^-1) than in SF (40 g m^-2 month^-1), whereas lateral input were higher in MC (43 g m^-2 month^-1) than in AC (15 g m^-2 month^-1) and SF (24 g m^-2 month^-1). Standing stocks followed the order SF > AC > MC, corresponding to 425, 299 and 152 g m^-2. Leaves contributed most to all litter fractions in all forests. Reproductive plant parts accounted for a larger proportion in managed AFS. Branches and miscellaneous litter were also similar in all forests, except for higher benthic standing stocks of miscellaneous litter in the SF. Despite differences in the amounts of litter inputs and standing stocks among the forests, seasonal patterns in the abandoned AFS (AC) were more similar to those of the secondary forest (SF) than the managed AFS, suggesting potential of abandoned AFS to restore litter dynamics resembling those of secondary forests.

Tip Lesion Variant of Focal and Segmental Glomerulosclerosis in a COVID-19 Patient

Acute kidney injury is a common complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Several pathologic findings are continually being reported, showing a probably multifactorial etiology. The authors present a case of a patient diagnosed with a tip lesion variant of focal segmental glomerulosclerosis (FSGS) in the setting of COVID-19. A 43-year-old African American female with no known renal disease presented to the emergency department with a 6-day history of fatigue, headache, hypoageusia, myalgia, cough, nausea, and vomiting. Laboratory tests confirmed SARS-CoV-2 infection. During hospitalization, there was a progressive decline in kidney function and evidence of nephrotic-range proteinuria without nephrotic syndrome. Biopsy specimen showed a tip lesion variant of FSGS. Genetic test revealed a homozygous variant of uncertain clinical significance (c.397G>A [p.V133M]) in the epithelial membrane protein 2 (EMP2) gene. To our knowledge, this is the first case report of a tip lesion in a COVID-19 patient with no renal history. More studies are warranted to define susceptible groups and identify the detailed mechanisms of COVID-19-related kidney disease that would allow for specific management of this complication.

Preliminary Evaluation of the Application of Algae-Based Biostimulants on Almond

To improve almond performance under water limitations, the use of algae-based biostimulants may become a useful tool to reduce drought stress. However, besides possible effects on plant behavior, changes in fruit characteristics must also be considered. In this work, a preliminary study on the effect of two levels of an Ascophyllum nodosum-based biostimulant in the chemical characteristics of fruits from rain-fed cv. Marinada almond trees was carried out. The use of the recommended manufacturer's dosage resulted in a decreased content of soluble sugars and proteins when compared to the use of half the recommended dosage and the control assays (water only). Similarly, and although no significant differences were recorded, the content of bioactive compounds (ortho-diphenols, total phenolics, and flavonoids) tended to increase in non-treated trees. Finally, sensory analysis of treated and non-treated fruits did not record any changes in the perceived attributes, showing that no negative effects on consumers' acceptance will be caused by the application of this product. Long-term studies are needed to further confirm these results, also aimed at the monitoring of leaf gas exchange and water status parameters of trees.

The Effects of the Cultivar and Environment on the Phenolic Contents of Hazelnut Kernels

Different climatic conditions are known to affect the synthesis of primary and secondary metabolites. Therefore, the phenolic contents in new growing areas could affect the quality and flavor of hazelnuts. The aim of this study was to determine the variability of the phenolic contents of the kernels in different commercial hazelnut cultivars depending on their growing area. Five cultivars ('Tonda Gentile delle Langhe', 'Merveille de Bollwiller', 'Pauetet', 'Tonda di Giffoni', and 'Barcelona' (syn. 'Fertile de Coutard')) grown in different European collection orchards were included in the study. High-performance liquid chromatography coupled with mass spectrometry was used to identify and quantify the phenolic compounds. Thirteen phenols were identified in the hazelnut kernels, including 7 flavanols, 2 hydroxybenzoic acids, 3 flavonols, and one dihydrochalcone. Catechin and procyanidin dimers were the main phenolic compounds found in the hazelnut kernels. The highest contents of catechin and total flavanols were determined in cultivars cultivated in Spain and northern Italy, and the lowest in Slovenia and France. Flavanols were the major phenolic groups independent of the place of cultivation, as they accounted for more than 50% of all phenolic compounds identified. The flavanols were followed by hydroxybenzoic acids, flavonols, and dihydrochalcones. Higher contents of flavanols and flavonols were found in kernels from areas characterized by higher natural irradiation, which stimulates their accumulation. The contents of hydroxybenzoic acids correlated with altitude, which stimulated phenolic acid synthesis. A negative correlation was observed between the dihydrochalcone content and annual rainfall, probably due to hydric stress.

The Usefulness of Calcium/Magnesium Ratio in the Risk Stratification of Early Onset of Renal Replacement Therapy

Background: A growing number of studies have reported a close relationship between high serum calcium (Ca)/low serum magnesium (Mg) and vascular calcification. Endothelial dysfunction and vascular inflammation seem plausible risk factors for the enhanced progression of kidney disease. The aim of this study was to evaluate the role of the Ca/Mg ratio as a predictor of the early onset of renal replacement therapy (RRT). Methods: This was a prospective study conducted in an outpatient low-clearance nephrology clinic, enrolling 693 patients with stages 4−5 of CKD. Patients were divided into two groups according to the start of renal replacement therapy (RRT). Results: The kidney’s survival at 120 months was 60% for a Ca−Mg ratio < 6 and 40% for a Ca−Mg ratio ≥ 6 (p = 0.000). Patients who started RRT had lower levels of Hb, Ca, Mg, albumin, and cholesterol and higher values of phosphorus, the Ca/Mg ratio, and PTH. High values of phosphorus and the Ca/Mg ratio and low levels of Mg and GFR were independent predictors of entry into RRT. A high Ca/Mg ratio, high phosphorus levels, and low levels of GFR were associated with a cumulative risk for initiation of RRT. Conclusions: In our population, the Ca/Mg ratio is an independent predictive factor for the initiation of a depurative technique.

Protein Loss in Peritoneal Effluent: Different Meaning for 24-h versus PET Samples

INTRODUCTION

Quantification of peritoneal protein loss (PPL) may be expressed according to a timely collection (24-h measurement or 4-h PET assessment) and as a concentration. The aim of this study was to compare the quantification methods of 24-h and 4-h collections.

METHODS

This study included 81 prevalent peritoneal dialysis patients. Demographics and clinical and bioelectrical impedance features were registered. PPL was measured (4-h PET and 24-h results) and peritoneal protein clearance was calculated. A linear regression model was performed.

RESULTS

Age and continuous ambulatory peritoneal dialysis (compared to cycler) were positively associated with greater PPL on 24-h collections. Neither cardiovascular disease, hypertension, diabetes nor the comorbidity Charlson Index was significantly associated with PPL. There was a consistent univariable relationship with D/P creatinine, whichever sampling method was used. Only 24-h measurements of PPL correlated with body composition variables. In multiple linear regression analysis, D/P creatinine association with PPL stands out. On the other hand, 24-h determinations (in grams or clearance) were associated with overhydration. PET protein quantification was associated with peritoneal creatinine clearance.

DISCUSSION/CONCLUSION

Different methods sign different pathophysiological pathways. PET protein loss quantification should be regarded as a marker of peritoneal membrane intrinsic permeability. Measurements of a 24-h sample might be closer to patients' clinical status and prognosis, signalizing opportunities for therapy intervention.

Take a closer look at TINU syndrome; analysis of a case

Tubulointerstitial nephritis and uveitis syndrome (TINU) combines tubulointerstitial nephritis and uveitis and is a known cause of kidney failure in children and adults. This is a challenging diagnosis since renal and ocular manifestations may not occur simultaneously and may be present in several alternative diagnosis. The authors report the case of a 28-year-old patient with acute kidney injury (AKI) and biopsy-proven acute tubulointerstitial nephritis. Bilateral symptomatic uveitis presented six months after the initial presentation. Physicians in charge of patients with kidney disease attributed to acute tubulointerstitial nephritis must bear in mind the need for ophthalmologic surveillance for at least one year post-diagnosis. Although a diagnosis of exclusion, its incidence may be higher than described. Kidney disease is believed to be self-limited and prognosis still, most patients will require systemic therapy and relapses are common.

Peritoneal Protein Loss, Inflammation, and Nutrition: Refuting Myths

Peritoneal protein loss (PPL) has been correlated with mortality, malnutrition and inflammation. More recently overhydration was brought to the equation. This study aims to review classic and recent factors associated with PPL. Prevalent and incident peritoneal dialysis (PD) patients were included. Dialysate and serum IL-6 was obtained during PET. Hydration and nutritional status were assessed by bio-impedance. Linear regression and Cox regression were performed. The 78 included patients presented median values of PPL 4.8 g/24 h, serum IL-6: 5.1 pg/mL, and IL-6 appearance rate 153.5 pg/min. Mean extracellular water excess (EWexc) was 0.88 ± 0.94 L, and lean body mass index (LBMI) 17.3 ± 2.4 kg/m2. After mean follow-up of 33.9 ± 29.3 months, 12 patients died. Linear univariable analysis showed positive associations between PPL and small solute transport, body composition (LBMI and EWexc), comorbidities and performing CAPD (vs. cycler). PPL correlated positively with dialysate appearance rate of IL-6, but not with serum IL-6. Linear multivariable analysis confirmed positive association between PPL and EWexc (p = 0.012; 95%CI: 4.162–31.854), LBMI (p = 0.008; 95%CI: 1.720–11.219) and performing CAPD (p = 0.023; 95%CI: 4.375–54.190). In survival analysis, no relationship was found between mortality and PPL. Multivariable Cox regression showed Charlson Comorbidity Index (HR: 1.896, 95%CI: 1.235–2.913), overhydration (HR: 10.034, 95%CI: 1.426–70.587) and lower PPL (HR: 0.576, 95%CI: 0.339–0.978) were predictors for mortality. Overhydration, was a strong predictor of PPL, overpowering variables previously reported as determinants of PPL, namely clinical correlates of endothelial dysfunction or local inflammation. PPL were not associated with malnutrition or higher mortality, emphasizing the importance of volume overload control in PD patients.

Peritoneal Protein Loss, Inflammation, and Nutrition: Refuting Myths

Peritoneal protein loss (PPL) has been correlated with mortality, malnutrition and inflammation. More recently overhydration was brought to the equation. This study aims to review classic and recent factors associated with PPL. Prevalent and incident peritoneal dialysis (PD) patients were included. Dialysate and serum IL-6 was obtained during PET. Hydration and nutritional status were assessed by bio-impedance. Linear regression and Cox regression were performed. The 78 included patients presented median values of PPL 4.8 g/24 h, serum IL-6: 5.1 pg/mL, and IL-6 appearance rate 153.5 pg/min. Mean extracellular water excess (EWexc) was 0.88 ± 0.94 L, and lean body mass index (LBMI) 17.3 ± 2.4 kg/m2. After mean follow-up of 33.9 ± 29.3 months, 12 patients died. Linear univariable analysis showed positive associations between PPL and small solute transport, body composition (LBMI and EWexc), comorbidities and performing CAPD (vs. cycler). PPL correlated positively with dialysate appearance rate of IL-6, but not with serum IL-6. Linear multivariable analysis confirmed positive association between PPL and EWexc (p = 0.012; 95%CI: 4.162-31.854), LBMI (p = 0.008; 95%CI: 1.720-11.219) and performing CAPD (p = 0.023; 95%CI: 4.375-54.190). In survival analysis, no relationship was found between mortality and PPL. Multivariable Cox regression showed Charlson Comorbidity Index (HR: 1.896, 95%CI: 1.235-2.913), overhydration (HR: 10.034, 95%CI: 1.426-70.587) and lower PPL (HR: 0.576, 95%CI: 0.339-0.978) were predictors for mortality. Overhydration, was a strong predictor of PPL, overpowering variables previously reported as determinants of PPL, namely clinical correlates of endothelial dysfunction or local inflammation. PPL were not associated with malnutrition or higher mortality, emphasizing the importance of volume overload control in PD patients.

MO451: The Usefulness of Calcium/Magnesium Ratio in the Risk Stratification of Early Onset of Renal Replacement Therapy

BACKGROUND AND AIMS

Recently, a growing number of studies have reported a close relationship between high serum calcium and low serum magnesium with vascular calcification. Endothelial dysfunction and vascular inflammation seem plausible risk factors for enhanced progression of kidney disease nevertheless, the knowledge remains scarce. The aim of this study is to evaluate the role of the calcium/magnesium ratio as a risk factor in CKD progression.

METHOD

Observational, prospective study involving 693 patients (f = 371, m = 322) with stage 4 and 5 CKD. Patients were divided into two groups, according to the development of end-stage renal disease (ESRD): G1 (n = 541), who did not undergo renal replacement therapy and G2 (n = 152), who had started renal replacement therapy (RRT). Several laboratory parameters were measured: haemoglobin, eGFR (MDRD), albumin, cholesterol, magnesium and mineral metabolism markers (PTH, calcium and phosphorus). Baseline characteristics were analysed and compared using Student%u2019s T-test for continuous variables and chi-squared test for categorical variables. Multivariate Cox regression analysis was used to identify independent factors associated with RRT initiation. A modified Poisson regression with robust error variance was used to estimate the cumulative relative risk for RRT initiation.

RESULTS

The mean age and estimated glomerular filtration rate (eGFR) of the study population was 70.09 ± 12.51 years and 19.91 ± 8.11 mL/min, respectively. Comparing the two groups, G2 had a significantly lower serum levels of Hb (11.75 versus 10.95 g/dL, P = 0.000), calcium (9.34 versus 8.95 mg/dL, P = 0.000), magnesium (1.92 versus 1.40 mg/dL, P = 0.0001), albumin (4.00 versus 3.88 g/dL, P = 0.03) and cholesterol (183.17 versus 172.39 mg/dL, P = 0.01) and a higher serum levels of phosphorus (3.88 versus 4.69 mg/dL, P = 0.0001), calcium/magnesium ratio (5.73 versus 7.56, P = 0.0001) and PTH (209.71 versus 338.84 pg/mL, P = 0.0001). In univariate Cox regression analysis, age, haemoglobin, eGFR, calcium, magnesium, phosphorus, calcium-magnesium ratio and PTH correlate with onset of RRT, which were further tested using a multivariate COX regression model. The results showed a clear relationship between high levels of phosphorus (HRa = 1.638, P = 0.001) and calcium-magnesium ratio (HRa = 1.292; P = 0.002), and low levels of magnesium (HRa = 0.761, P = 0.005) and eGFR (HRa = 0.934; P = 0.0001) were independent risk factors to start depurative techniques. Additionally, Poisson regression analysis showed that high calcium-magnesium ratios (aPR = 1.986; 95% CI 1.026–3.051; P = 0.002), high phosphorus levels (aPR = 1.607; 95% CI 1.324–1.950; P &lt; 0.0001) and low levels eGFR (aPR = 0.927; 95% CI 0.891–0.964; P &lt; 0.0001) were associated with a cumulative risk for initiation of RRT.

CONCLUSION

Our results suggest that the calcium/magnesium ratio is an independent predictive factor for the initiation of renal replacement therapy. Further studies are required to validate the use of this novel marker as a predictor of CKD progression.

The effect of parthenolide on methamphetamine-induced blood-brain barrier and astrocyte alterations

BACKGROUND

Methamphetamine abuse is a worldwide concern with long-term health complications. Its impact on neurons has been extensively investigated, and it is currently known that glial cells, including astrocytes, are involved in drug-induced outcomes. Importantly, METH also causes blood-brain barrier (BBB) disruption and astrocytes are critical for BBB (dys)function. Therefore, we aimed to clarify the involvement of neuroinflammation mediated by astrocytes in BBB permeability and brain oedema induced by METH. Further, we aimed to identify a new approach to counteract METH effects.

METHODS

Mice were administered with a METH binge regimen (4 × 10 mg/kg) alone or in combination with parthenolide (PTL; 4 × 1 mg/kg), and hippocampi were analysed. For in vitro studies, mouse primary cultures of astrocytes were exposed to 250 µM METH, alone or co-treated with 10 µM PTL.

RESULTS

We observed a neuroinflammatory response characterized by astrocytic morphological changes and increased TNF-α, iNOS and ICAM-1 protein levels (213.62%, 205.76% and 191.47% of control, respectively). Additionally, brain oedema and BBB disruption were identified by increased water content (81.30% of tissue weight) and albumin (224.40% of control) in the hippocampal tissue, as well as a significant decrease in vessel coverage by astrocytes after METH exposure. Regarding astrocyte cultures, we further identified TNF-α as a key player in METH-induced cell swelling. Importantly, PTL (present in feverfew plant) prevented both animal and in vitro effects induced by METH.

CONCLUSIONS

We provided important insights on brain dysfunction induced by METH, and we also suggest a new approach to counteract such negative effects.

Overhydration May Be the Missing Link between Peritoneal Protein Clearance and Mortality

INTRODUCTION

Peritoneal protein loss (PPL) has been associated with mortality. Inflammation was assumed a putative cause with malnutrition as a consequence. Hydrostatic convection is a major drive for microvascular protein transport, but most studies in peritoneal dialysis (PD) patients overlooked this mechanism. An association between peritoneal protein clearance (PPCl) and venous congestion has been reported recently. The aim of this study was to explore the importance of fluid overload in PPCl in PD.

METHODS

Sixty-seven prevalent PD patients were assessed with peritoneal equilibration test and multifrequency bioelectrical impedance assessment (BIA). PPL and PPCl were calculated from simultaneously obtained 24-h peritoneal effluent.

RESULTS

PPL averaged 5.2 g/24 h. It was higher in patients on continuous treatment than in those without a long dwell. Significant associations between PPCl and BIA parameters of overhydration were found in both univariable and multivariable analyses. Lean mass index, partly dependent on hydration status, was associated with PPCl in univariable but not in multivariable analysis. A multiple linear model identified extracellular water excess and higher D/P creatinine as predictors of higher PPCl, independent of PD duration, type of PD, age, gender, albumin, cardiovascular disease, C-reactive protein, or lean mass index.

CONCLUSIONS

The uni- and multivariable strong associations between fluid overload and PPCl support the importance of hydrostatic pressure-induced convection for PPCl. Also, peritoneal small solute transport was associated with PPCl. Both are amenable by adjusted dialysis prescription, especially focused on fluid status and avoidance of overhydration. The assumption of an association with inflammation and malnutrition was not confirmed.

Microglia Dysfunction Caused by the Loss of Rhoa Disrupts Neuronal Physiology and Leads to Neurodegeneration

Nervous tissue homeostasis requires the regulation of microglia activity. Using conditional gene targeting in mice, we demonstrate that genetic ablation of the small GTPase Rhoa in adult microglia is sufficient to trigger spontaneous microglia activation, producing a neurological phenotype (including synapse and neuron loss, impairment of long-term potentiation [LTP], formation of β-amyloid plaques, and memory deficits). Mechanistically, loss of Rhoa in microglia triggers Src activation and Src-mediated tumor necrosis factor (TNF) production, leading to excitotoxic glutamate secretion. Inhibiting Src in microglia Rhoa-deficient mice attenuates microglia dysregulation and the ensuing neurological phenotype. We also find that the Rhoa/Src signaling pathway is disrupted in microglia of the APP/PS1 mouse model of Alzheimer disease and that low doses of Aβ oligomers trigger microglia neurotoxic polarization through the disruption of Rhoa-to-Src signaling. Overall, our results indicate that disturbing Rho GTPase signaling in microglia can directly cause neurodegeneration.

Preliminary Insights in Sensory Profile of Sweet Cherries

Sweet cherry (Prunus avium L.) is a fruit appreciated by consumers for its well-known physical and sensory characteristics and its health benefits. Being an extremely perishable fruit, it is important to know the unique attributes of the cultivars to develop cultivation or postharvest strategies that can enhance their quality. This study aimed to understand the influence of physicochemical characteristics of two sweet cherry cultivars, Burlat and Van, on the food quality perception. Several parameters (weight, dimensions, soluble solids content (SSC), pH, titratable acidity (TA), colour, and texture) were measured and correlated with sensory data. Results showed that cv. Van presented heavier and firmer fruits with high sugar content. In turn, cv. Burlat showed higher pH, lower TA, and presented redder and brightest fruits. The principal component analysis revealed an evident separation between cultivars. Van cherries stood out for their sensory parameters and were classified as more acidic, bitter, and astringent, and presented a firmer texture. Contrarily, Burlat cherries were distinguished as being more flavourful, succulent, sweeter, and more uniform in terms of visual and colour parameters. The results of the sensory analysis suggested that perceived quality does not always depend on and/or recognize the quality parameters inherent to the physicochemical characteristics of each cultivar.

Kaolin, Ascophyllum nodosum and salicylic acid mitigate effects of summer stress improving hazelnut quality

BACKGROUND

Various strategies are needed to mitigate the negative impact on or to increase fruit quality. The effect of spraying kaolin (K), Ascophyllum nodosum (An) and salicylic acid (SA), in trees with and without irrigation, on quality and sensorial attributes of hazelnut (Grada de Viseu cultivar) was investigated during two consecutive years (2016 and 2017) in a commercial orchard located in Moimenta da Beira, Portugal.

RESULTS

The treatments affected positively the biometric parameters nut and kernel weight, length, width, thickness and volume as well as the vitamin E level, antioxidant activity and content of some individual phenolics, such as protocatechuic acid, gallocatechin, catechin and epicatechin. The levels of amino acids in hazelnut kernels decreased in all the assayed treatments, while the kernel colour and sensorial attributes were not affected by the treatments. Hazelnut physical properties (nut and kernels), chemical and phytochemical composition and antioxidant activities were positively related.

CONCLUSIONS

The application of K, An and SA improved the hazelnut tree response to climate change, without compromising the hazelnut chemical and sensorial quality. Furthermore, due to the similar observations for the same treatments with and without irrigation, it can be stated that K, An and SA can be efficient and cost-effective tools to mitigate summer stress in rain-fed orchards. © 2020 Society of Chemical Industry.

Utilização de exergames e seus efeitos sobre a saúde física de pacientes com diagnóstico de câncer: uma revisão integrativa

RESUMO Este estudo teve como objetivo a busca de registros com diferenças significativas a respeito da saúde física de pacientes com câncer ao praticarem exergames. Utilizou-se como método a Revisão Integrativa de Literatura com as palavras chaves “Fisioterapia”, “Realidade Virtual”, “Wii”, “Exergames” e “Câncer”, em português e inglês, nas bases de dados PubMed, Science Direct, Medline, Scopus, Lilacs, SciELO, PEDro, Cochrane e Periódicos Capes. Os critérios de inclusão foram: estudos que utilizassem exergames em tratamentos clínicos e que apresentassem diferenças sobre a saúde física de pacientes com diagnóstico de câncer, de ambos os sexos, de todas as idades e tipos de câncer, publicados nos últimos 10 anos, em qualquer idioma. Dos 3172 artigos encontrados, apenas nove foram incluídos, sendo que esses avaliaram: desempenho físico, sedentarismo, funcionalidade de membros superiores, força muscular de membros inferiores e fadiga. Concluiu-se que os exergames demostraram ser ferramenta promissora para a saúde física de pacientes com diagnóstico de câncer.

PSII-18 Effect of two different milk-feeding methods on performance and plasma glucose of dairy calves

The objective of this study was to evaluate two different methods of milk feeding calves and the effects on performance and plasma glucose. Thirty newborn Holsteins calves were individually housed with free access to water and starter concentrate and fed 6 L/d of whole milk divided in two meals (7h and 17h). A randomized blocks experimental design was used, with weight and day of birth as blocking effect, and calves were distributed in two methods of milk-feeding: (1) open bucket; (2) bucket with an artificial teat. Milk-feeding period started with 3 d of age, after colostrum feeding by bottle. The starter intake was monitored daily. Speed of milk intake, body weight and measures, and blood samples were taken weekly. Data were analyzed using the proc mixed of SAS for repeated measures, and the means were compared using the F test (P ≤ 0.05). Feeding milk using a bucket with an artificial teat decreased average daily starter intake (P &lt; 0.03), probably because calves were more satisfied by the act of suckling. However, there were no effects on body weight gain, weight at weaning and average body measures. The bucket with artificial teat had a positive influence on blood glucose concentration, measure 2h after milk feeding (P &lt; 0.01), as a response of lower speed for milk intake (P &lt; 0.01). These results suggest that the speed for milk intake may interfere on blood glucose concentrations peak, however because the behavioral need of suckling is attended, it may decrease starter intake, but without decrease performance.

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PSIX-6 Gastrointestinal microbiome of calves fed solid diets containing different levels and sources of NDF

Different levels and sources of NDF can modify the gastrointestinal microbiome. This study evaluated 18 Holstein calves housed in not-bedded suspended individual cages and fed one of three treatments: 22NDF - conventional starter containing 22% NDF (n = 7); 31NDF - starter with 31% NDF, replacing part of the corn by soybean hull (n = 6); and 22NDF+H - conventional starter with 22% NDF plus coast-cross hay ad libitum (n = 5). All animals received 4 L of milk replacer daily (24% CP; 18.5% fat; diluted to 12.5% solids), divided into two meals, being weaned at 8th week of age. After weaning, animals were housed in tropical shelters, fed with the respective solid diet and coast-cross hay ad libitum for all treatments. To evaluate the microbiome, ruminal fluid samples were collected using a modified Geishauser oral probe at weeks 2, 4, 6, 8 and 10, two hours after the morning feeding, and fecal samples were collected at birth (0) and at weeks 1, 2, 4, 8 and 10. The microbial community was determined by sequencing V3 and V4 region amplicons of the 16S rRNA gene that was amplified by PCR and sequenced by the Illumina MiSeq platform. Ruminal microbiome had no differences in diversity for the effects of weeks, treatments or interaction of both factors (Table 1). In feces, the diversity indices and evenness were higher for 22NDF+H when compared to 22NDF, with no difference for 31NDF. All indices were significantly affected by calves age. At birth, calves had the greatest diversity and richness. Week 1 and 2 had less evenness and diversity. Bacteroidota, Firmicutes_A and Firmicutes_C were the most abundant phylum in rumen and feces. The supply of hay was only effective in modifying the fecal microbiome of dairy calves, suggesting a resilience in the ruminal microbiome.

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PSIX-1 Fecal microbiome of dairy calves fed with fresh or frozen maternal colostrum or colostrum powder

Besides the importance for passive immune transfer, the supply of colostrum accelerates the bacterial colonization of the calf small intestine by providing nutrients, that will function as bacteria growth substrate, as well being a microorganism inoculum source. However, it is not known whether the effect is maintained when the calves are fed with frozen colostrum or colostrum powder. The present work evaluated 15 Holstein calves housed in tropical shelters, fed one of the colostrum sources: I – fresh colostrum from the dam (n = 5), II – frozen colostrum and III – colostrum powder, a dose of 150g of IgG (n = 5). Animals fed with fresh or frozen colostrum received a corresponding volume 10% of its birth weight of high-quality colostrum (IgG &gt; 50g / L). All animals were fed within 4h after birth. From the second meal, calves received 6 L of liquid diet, divided into two meals, being weaned at the 8th week of age. After weaning, calves were grouped housed, and fed with starter and coast-cross hay ad libitum. To evaluate the microbiome, fecal samples were collected at birth and at weeks 1, 2, 4, 8 and 10. The microbial community was determined by sequencing V3 and V4 region amplicons of the 16S rRNA gene that was amplified by PCR and sequenced by the Illumina MiSeq platform. There was no treatment effect for the diversity indices, evenness and richness. Simpson’s diversity and evenness had no effect for weeks. Weeks 1 and 2 had less Shannon’ diversity. Richness was higher for week 0. Analyzing the relative abundance, 31 phyla were identified in the fecal samples, the most abundant being Bacteriodota, Firmicutes_A, Proteobacterias, Fusobacteriota and Firmicutes. Different sources of colostrum can be used to feed dairy calves, without affecting the diversity in the colonization of the intestinal tract.

PSXII-20 Whole flint corn grain or tropical grass hay free choice in the diet of milk-fed dairy calves

The objective of this study was to evaluate the effect of whole flint corn grain or tropical grass hay free choice, as a fiber source in the diet, on the performance, ruminal and intestinal development of Holstein dairy calves. Forty-two Holstein calves were used in a randomized block design, considering sex, birth date and weight at 21 days of age (48.7 ± 0.82 kg), when the study started. Three solid diets were compared: 1) SC: starter concentrate only (24% CP, 14% NDF, 47% NFC); 2) SCH: starter concentrate, with free access to chopped Tifton-85 hay; and 3) SCW: starter concentrate with free access to whole flint corn grain. Animals were fed with 6 L/d until d 21, and then 4L/d of whole milk until gradual weaning at d 56. At weaning, 12 animals were randomly selected to be slaughtered to evaluate the weight of forestomach compartments and rumen and intestine morphometrics. Data were analyzed using the GLM or MIXED (repeated measures) procedure of SAS, and the means were compared using Tukey test (P ≤ 0.05). The SCH diet increased the total DMI (P = 0.01) and ADG (P = 0.01). Calves fed with SCH diet presented higher total proximal digestive tract weight (kg; P &lt; 0.01). The empty reticulum-rumen weight was higher in calves fed the SCH diet (P = 0.03). The papillae area was higher in calves fed with SCH diet (P = 0.05). The depth of the crypts and the number of goblet cells from the duodenum and cecum were not affected by diets; however, the duodenum villus height was higher for animals that received SCH (P = 0.02). The tropical grass hay supplementation in the diet improved performance, ruminal and intestinal development. The whole flint corn grain do not play a fiber role for dairy calves.

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Antioxidant and antibacterial compounds from feijoa leaf extracts obtained by pressurized liquid extraction and supercritical fluid extraction

This work investigated the efficiency of pressurized liquid extraction (PLE) and supercritical fluid extraction with cosolvent (SFE) in obtaining feijoa leaf extracts with high antioxidant and antibacterial activities. PLE was performed in customized equipment with environmentally friendly solvents, at 40/80 °C, in dynamic and static mode, and SFE was carried out for 210 min at 30 MPa, 55 °C and 15% ethanol-water as cosolvent. PLE extract (80 °C/ethanol-water/dynamic) provided the highest yield, total phenolic content, and antioxidant activities, but it was not effective as antibacterial agent. In contrast, SFE extract exhibited effectiveness against S. aureus, E. coli, and S. typhimurium, with minimum inhibitory concentration values from 14,211 to 3,553 µg.mL^-1. Finally, gallic acid, catechin and isoquercetin were the major phenolics identified by liquid chromatography. Our findings revealed that feijoa leaf extracts by PLE and SFE have remarkable bioactivity, presenting a great potential to be used as natural food additives.

Cracking in Sweet Cherry Cultivars Early Bigi and Lapins: Correlation with Quality Attributes

Fruit cracking is one of the main concerns in sweet cherry production and is caused by a heavy rainfall before and during the harvest. This physiological disorder leads to severe economic losses, which can be more or less effective depending on the cracked region of the fruit: in the cheeks (side cracks), in the stylar scar region, or in the stem cavity region. Sweet cherry cracking can be affected by several factors such as cultivar, growing conditions, rootstock, fruit size, flesh osmotic potential, cuticular characteristics of the skin, and stage of fruit development. In this sense, the objective of this work was to evaluate the cracking incidence in two sweet cherry cultivars (Early Bigi and Lapins grafted on "Saint Lucie 64" rootstock) and correlate the cracking index with other quality parameters. Fruits were harvested on 2 May (cv. Early Bigi) and on 27 May (cv. Lapins) 2019 at their commercial ripening stage. In the field, the total yield and the trunk cross-sectional area were determined for each tree in order to calculate the yield efficiency. In the laboratory, the cracking index was determined in 150 fruits without visual defects. In addition, fruit size and weight, wax content, flesh firmness, epidermis rupture force, total soluble solids, pH, titratable acidity, and maturity index of 30 fruits were also evaluated. In general, all the analyzed quality parameters were influenced by the cultivar, being that cv. Lapins presented larger, heavier, firmer, and sweeter fruits, with more acidity and higher maturation index. However, cv. Lapins also presented higher cracking index, which was positively correlated with all the parameters above-mentioned and negatively correlated with the wax content. In fact, cv. Early Bigi presented a high wax content and simultaneously a low cracking index. The stylar scar region cracks were the most prevalent in both cultivars. These results allowed us to conclude that, in the North Portugal region, the Lapins cherries presented better quality attributes than the Early Bigi cherries. However, the latter are still very valuable to the region due to its early ripening. Additionally, it was also possible to conclude that bigger, firmer, more mature, and with lower wax content cherries were more sensitive to cracking than the smaller fruits, soft-fleshed, less mature, and with higher wax content.

Protective effect of neuropeptide Y2 receptor activation against methamphetamine-induced brain endothelial cell alterations

Methamphetamine (METH) consumption is a health problem that leads to neurological and psychiatric disturbances. The cellular alterations behind these conditions have been extensively investigated and it is now well-established that METH causes cerebrovascular alterations being a key feature in drug-induced neuropathology. Although promising advances in understanding the blood-brain barrier (BBB) alterations induced by METH, there is still no available approach to counteract or diminish such effects. Interestingly, several studies show that neuropeptide Y (NPY) has an important protective role against METH-induced neuronal and glial toxicity, as well as behavioral deficits. Despite these beneficial effects of the NPY system, nothing is known about its role in brain endothelial cells under conditions of METH exposure. Thus, our aim was to unravel the effect of NPY and its receptors against METH-induced endothelial cell dysfunction. For that, we used a human brain microvascular endothelial cell line (hCMEC/D3) and our results demonstrate that endothelial cells express both NPY Y1 (Y1R) and Y2 (Y2R) receptors, but only Y2R is upregulated after METH exposure. Moreover, this drug of abuse induced endothelial cell death and elicited the production of reactive oxygen species (ROS) by these cells, which were prevented by the activation of Y2R. Additional, cell death and oxidative stress triggered by METH were dependent on the concentration of the drug. In sum, with the present study we identified for the first time the NPY system, and particularly the Y2R subtype, as a promising target to protect against METH-induced neurovascular dysfunction.

Climate-induced variability in South Atlantic wave direction over the past three millennia

Through alteration of wave-generating atmospheric systems, global climate changes play a fundamental role in regional wave climate. However, long-term wave-climate cycles and their associated forcing mechanisms remain poorly constrained, in part due to a relative dearth of highly resolved archives. Here we use the morphology of former shorelines preserved in beach-foredune ridges (BFR) within a protected embayment to reconstruct changes in predominant wave directions in the Subtropical South Atlantic during the last ~ 3000 years. These analyses reveal multi-centennial cycles of oscillation in predominant wave direction in accordance with stronger (weaker) South Atlantic mid- to high-latitudes mean sea-level pressure gradient and zonal westerly winds, favouring wave generation zones in higher (lower) latitudes and consequent southerly (easterly) wave components. We identify the Southern Annular Mode as the primary climate driver responsible for these changes. Long-term variations in interhemispheric surface temperature anomalies coexist with oscillations in wave direction, which indicates the influence of temperature-driven atmospheric teleconnections on wave-generation cycles. These results provide a novel geomorphic proxy for paleoenvironmental reconstructions and present new insights into the role of global multi-decadal to multi-centennial climate variability in controlling coastal-ocean wave climate.

Endoscopic and histologic activity assessment considering disease extent and prediction of treatment failure in ulcerative colitis

BACKGROUND AND AIMS

DUBLIN score allows evaluation of disease activity and extent in ulcerative colitis (UC). This study aimed to evaluate DUBLIN score as a predictor of therapeutic failure as well as to associate endoscopic and histological activity scores to assess their joint performance.

METHODS

Retrospective cohort study, with consecutive inclusion of patients undergoing total colonoscopy with serial biopsies between 2016 and 2019. DUBLIN score (0-9) was calculated as the product of Mayo endoscopic score (MSe 0-3) by disease extent (E1-E3). Histological activity was evaluated through Nancy score (0-4). Activity scores were correlated with biomarkers, treatment failure (therapeutic escalation, hospitalization and/or colectomy) and clinical remission at 6 months (Mayo partial score ≤ 1).

RESULTS

One-hundred and seven patients were included. In 38.3% (n = 41) there was evidence of endoscopic activity (MSe ≥ 2) and in 50.5% (n = 54) histological activity (Nancy ≥ 2). MSe and DUBLIN scores showed good correlation (r = 0.943; p < .001) and both were significantly higher in patients with histological activity (p < .001). Therapeutic failure occurred in 25.2% (n = 27). MSe, DUBLIN, and Nancy scores were significantly associated with therapeutic failure (p < .001). The areas under the (AUC) ROC curve were 0.74 (MSe; p < .001), 0.78 (DUBLIN; p < .001) and 0.84 (Nancy; p < .001). Joint evaluation of endoscopic and histological activity by combining DUBLIN and Nancy scores was associated with therapeutic failure with a significantly higher AUC of 0.84 (p < .001) compared to the Dublin score alone (p = .003).

CONCLUSION

Mayo and DUBLIN endoscopic scores correlated with each other and with histological activity. The joint evaluation of endoscopic and histological activity allowed to predict with greater accuracy treatment failure.

Quality preservation of sweet cherry cv. 'staccato' by using glycine-betaine or Ascophyllum nodosum

Pre-harvest application of exogenous compounds has been employed in many crops, as a cultural practice, to promote their adaptation to a new climate-changing environment. Effect of foliar pre-harvest application of salicylic acid, glycine-betaine complex and seaweed extract (Ascophyllum nodosum) on the cherry quality from 'Staccato' cultivar was studied. Treatments significantly affected (p < 0.01) the fruit size, soluble solids content, pH, colour, polyphenols, vitamin C and antioxidant activity. Glycine-betaine and A. nodosum treated cherries presented higher dimensions, soluble solids content and pH and lower acidity. In addition, these cherries had a higher content of polyphenols and vitamin C and antioxidant capacity, but lower values of L*, C*ab and hue angle, meaning that both treatments can rise the fruit ripening process. Therefore, the pre-harvest application of glycine-betaine and A. nodosum can be a good alternative to promote the adaptation of sweet cherry tree to stressful environmental conditions, without compromising the fruit quality.

Metaplastic contribution of neuropeptide Y receptors to spatial memory acquisition

Neuropeptide Y (NPY) is highly abundant in the brain and is released as a co-transmitter with plasticity-related neurotransmitters such as glutamate, GABA and noradrenaline. Functionally, its release is associated with appetite, anxiety, and stress regulation. NPY acting on Y2 receptors (Y₂R), facilitates fear extinction, suggesting a role in associative memory. Here, we explored to what extent NPY action at Y₂R contributes to hippocampus-dependent spatial memory and found that dorsal intrahippocampal receptor antagonism improved spatial reference memory acquired in a water maze in rats, without affecting anxiety levels, or spontaneous motor activity. Water maze training resulted in an increase of Y₂R, but not Y₁R expression in the hippocampus. By contrast, in the prefrontal cortex there was a decrease in Y₂R, and an increase of Y₁R expression. Our results indicate that neuropeptide Y₂R are significantly involved in hippocampus-dependent spatial memory and that receptor expression is dynamically regulated by this learning experience. Effects are consistent with a metaplastic contribution of NPY receptors to cumulative spatial learning.

Prevalence and risk factors of fatty liver in Portuguese adults

BACKGROUND

Prevalence of fatty liver (FL) and nonalcoholic fatty liver disease (NAFLD) depends mainly on obesity, diabetes and genetic factors. FL and NAFLD prevalence was evaluated in Portuguese adult population and correlated with several risk factors and related mortality data, within the same period.

MATERIALS AND METHODS

A cross-sectional, population-based multicenter study, voluntary and randomly selected in 834 Portuguese adults (18-79 years). Participants were evaluated after 12-hour fasting. Anthropometric data, past history including alcohol consumption, and associated diseases were registered. Blood samples were collected for biochemical testing. Dietary intake was evaluated using a semi-quantitative food frequency questionnaire. Presence of FL was evaluated using ultrasound, and NAFLD was diagnosed after exclusion of other causes for liver disease.

RESULTS

Adjusted prevalence of FL and NAFLD was 37.8% and 17.0%, respectively. FL individuals were older, more frequently males, with increased probability of having obesity, diabetes or harmful alcohol consumption (HAC). NAFLD individuals were also older, but had a similar sex distribution and an increased probability of obesity and diabetes. In both groups, no differences were found regarding dietary pattern or physical activity. During the same time period, nonalcoholic steatohepatitis (NASH) liver-related deaths in Portugal were 0.105/100 000, while alcohol-related liver disease mortality was 6.790/100 000.

CONCLUSION

The large spectrum of FL was present in more than one third of the population, although only less than half could be classified as NAFLD. Other significant risk factors, such as HAC, are probably implicated in FL, explaining the low NASH-related mortality compared with the high alcohol-related mortality during the same time period.

Effects of exogenous compound sprays on cherry cracking: skin properties and gene expression

BACKGROUND

Cherry fruit cracking is a costly problem for cherry growers. The effect of repeated sprayings (gibberellic acid - GA₃ ; abscisic acid - ABA; salicylic acid - SA; glycine betaine - GB, and Ascophyllum nodosum - AN) combined with CaCl₂ , on 'Sweetheart' cherry fruit-cracking characteristics was investigated. Cracking was quantified in terms of cracking incidence, crack morphology, confocal scanning laser microscopy, cuticular wax content, cell-wall modification, and cuticular wax gene expression.

RESULTS

All spray treatments reduced cracking compared with an untreated control (H₂ O), with fewer cheek cracks. The least cracking incidence was observed for ABA + CaCl₂ - and GB + CaCl₂ -treated fruits, indicating an added benefit compared to spraying with CaCl₂ alone. In addition, GB + CaCl₂ -treated fruits showed higher fruit diameter. ABA + CaCl₂ and GB + CaCl₂ sprays showed higher wax content and higher cuticle and epidermal thickness compared with the control, including increased expression of wax synthase (ABA + CaCl₂ ) and expansin 1 (GB + CaCl₂ ).

CONCLUSION

In general, factors that improve the cuticle thickness appear to be important at the fruit-coloring stage. At the fruit-ripening stage, larger cell sizes of the epidermis, hypodermis, and parenchyma cells lower cracking incidence, indicating the importance of flexibility and elasticity of the epidermis. © 2020 Society of Chemical Industry.

Computerized cognitive training using virtual reality on everyday life activities for patients recovering from stroke

Purpose: Recent studies argue that the use of virtual reality tasks depicting activities daily living may be effective means for cognitive rehabilitation. The aim of this study was to test an ecologically oriented approach in virtual reality resembling the demands of everyday life activities for cognitive rehabilitation following stroke. Materials and Methods: The sample comprised 30 sub-acute stroke patients recovering from stroke in a rehabilitation hospital. They were assessed in a single-arm pre-post intervention study on global cognition, executive functions, memory and attention abilities. The intervention consisted of virtual reality in a multidomain cognitive training approach depicting everyday life tasks (preparing food, choosing clothes, shopping, etc.). Results: Improvements were found in the assessed cognitive domains at 6 to 10 post-treatment sessions. In-depth analysis through reliable change scores has suggested larger treatment effects on global cognition. Conclusions: Overall results suggest that the use of virtual reality-based exercises on everyday life activities may be a useful cognitive rehabilitation approach to provide short-term gains in cognition following stroke.Implications for rehabilitationVirtual reality-based cognitive rehabilitation resembling everyday life activities may provide short-term gains in cognition of stroke patients;Consistent improvements in executive functions may require higher treatment dosage than for improvements in global cognition.

Prediction of adenoma recurrence after piecemeal endoscopic mucosal resection: interobserver agreement and utilization of the Sydney EMR recurrence tool

Background and aims: Piecemeal endoscopic mucosal resection (pEMR) allows resection of larger non-invasive colorectal lesions. Adenoma recurrence is an important limitation and occurs in ≤20%. The present study aimed to validate the Sydney EMR recurrence tool (SERT) score as a predictor of both endoscopic and histologic recurrence and evaluate interobserver agreement in adenoma recurrence based on endoscopic scar assessment, among nonexperts in EMR.Methods: Retrospective cohort and cross-sectional study, in which all patients submitted to pEMR in a tertiary care center in Portugal, between 2012 and 2018 were included. SERT-score was calculated for all lesions and compared with the SMSA (size, morphology, site, access) score already validated as a predictor of adenoma recurrence. Image based offline analysis was performed to evaluate adenoma recurrence prediction and assess the interobserver agreement within a heterogeneous group of participants, mostly composed by nonexperts in EMR.Results: There was a moderate positive correlation between the SERT and SMSA scores (p <.001; r = 0.61). SERT-score was significantly associated with endoscopic recurrence (p =.005) and histologic recurrence (p = .015). Endoscopic prediction of recurrence had high coefficient of agreement (k-0.806; p < .001).Conclusion: Histologic recurrence after pEMR can be predicted by SERT score and optical diagnosis of recurrent adenoma has high interobserver agreement between nonexperts in EMR.