Double-Cut Tibial Plateau Leveling Osteotomy for the Management of Cranial Cruciate Ligament Insufficiency in Dogs with an Excessive Plateau Angle: Early Clinical Results in 16 Dogs.

OBJECTIVE: To describe a modification of the tibial plateau leveling osteotomy technique wherein a double cut is made in the same plane to level the tibial plateau (double-cut tibial plateau leveling osteotomy [DCTPLO]) for treating dogs with cranial cruciate ligament (CrCL) and excessive tibial plateau angle (eTPA) diseases. STUDY DESIGN: The DCTPLO technique was performed on 18 stifles in dogs with CrCL and an eTPA (>34°). This study evaluated the accuracy of preoperative planning, feasibility of the technique, postoperative clinical outcomes, radiographic examinations at the postoperative follow-up for the first 120 days, evolution of the tibial plateau angle (TPA), time of union of the osteotomy, apposition of the implants, and possible complications. RESULTS: The described technique proved to be feasible for clinical application, with reproducibility from preoperative planning. An effective reduction in the eTPA levels was observed. The mean preoperative and postoperative TPA values were 39.4° (36°-43.5°) and 6.3° (3°-13°), respectively. Radiographic healing time was 60 days in 17/18 of stifles. Minor complications (not requiring surgical review or clinical treatment) were observed in 4/18 of stifles. CONCLUSION: The DCTPLO technique was effective for treating CrCL disease with TPA of up to 43.5° in dogs.

Evaluating Nature-based Solutions as urban resilience and climate adaptation tools: A meta-analysis of their benefits on heatwaves and floods.

Extreme weather events driven by climate change threaten the resilience of urban structures and urban dwellers. Nature-based Solutions (NbS) are an effective tool to reduce urban vulnerability to climate risks and, at the same time, develop more liveable urban areas. Despite the acknowledged positive impacts of individual observed NbS, numerous questions persist unanswered. While existing research supports NbS' positive influence on urban climate adaptation, the extent of their impact remains insufficiently studied. Understanding the magnitude of NbS impact is crucial for justifying their preference over non-NbS alternatives and, consequently, for securing public investment. Via a meta-analysis, this paper aims to contribute to research and practice by providing a more systematic assessment of NbS effects, offering urban planners and decision-makers a robust justification for their incorporation in climate change adaptation, urban resilience, and enhanced liveability. The results of the meta-analytic model indicate that the effect of NbS is indeed positive. When assessing the impact on temperature and flood protection, there is a general positive effect across the studied NbS. However, when evaluating an average effect, the task appears to be more complex due to methodological issues and limitations. The need to increase the formalisation of how the impact of NbS is measured and reported also emerges as a result. Replicable protocols would positively impact the formalisation of the literature on the topic and positively affect the evidence-based support for the implementation of NbS by urban decision-makers.

Fermented Grapevine Leaves: Potential Preserving Agent in Yogurt.

In this study, we monitored the fermentative process of Vitis vinifera L. leaves (grapevine), spontaneously or promoted by Saccharomyces cerevisiae, in both solid and liquid media. We also aimed to evaluate the effect on the bioactivity and shelf life of yogurt incorporating fermented and non-fermented grapevine leaves compared to yogurt produced with the preservative potassium sorbate. The results revealed that fermented grapevine leaf extracts increased their bioactive compounds and antioxidant activity, particularly in fermentations in a solid medium. In yogurt samples with incorporation extract from solid spontaneous fermentation and extract from solid yeast fermentation, even in small quantities, they exhibited higher levels of total phenols (1.94 and 2.16 mg GAE/g of yogurt, respectively) and antioxidant activity (5.30 and 5.77 mg TroloxE/g of yogurt; and 1.33 and 1.34 mg Fe(II)E/g of yogurt, respectively) compared to control yogurt (1.44 mg GAE/g of yogurt, 4.00 mg TroloxE/g of yogurt, and 1.01 mg Fe(II)E/g of yogurt). Additionally, yogurts supplemented with fermented grapevine leaves demonstrated the potential to inhibit microbial growth without impairing the multiplication of lactic acid bacteria.

Anesthetic Management of a Patient With Subglottic Stenosis: The Crucial Role of Communication Between Teams.

Subglottic stenosis is characterized by the narrowing of the airway at the inferior edge of the cricoid cartilage level. It is either congenital or acquired, the latter being more commonly secondary to internal iatrogenic trauma. Airway management of these cases is challenging and requires multidisciplinary discussion. We present a case of a 17-year-old boy scheduled for tracheostomy in the context of subglottic stenosis probably caused by prolonged endotracheal intubation. On the day of surgery, it was decided to perform an asleep fiberoptic visualization of the lesion through a supraglottic device, which revealed a narrow circumferential fibrous membrane just below the vocal cords. Given the findings, a suspension laryngoscopy accompanied by supraglottic manual jet ventilation was performed. Balloon dilatation with the application of mitomycin C was the elected otorhinolaryngologic technique. At the end of the procedure, a fiberoptic exam was performed and only a minimal portion of the membrane remained. The patient was asymptomatic on follow-up visits. We aim to raise awareness of how the anesthetic management of patients with subglottic stenosis may prove challenging. Communication between anesthetic and surgical teams is essential for the achievement of the main goal, which is the acquisition of an adequate airway that allows normal patient activity associated with minimal postoperative morbidity.

Contribution to Characterizing the Meat Quality of Protected Designation of Origin Serrana and Preta de Montesinho Kids Using the Near-Infrared Reflectance Methodology.

The aims of this study were to describe and compare the meat quality characteristics of male and female kids from the "Serrana" and "Preta de Montesinho" breeds certified as "Cabrito Transmontano" and reinforce the performance of near-infrared reflectance (NIR) spectra in predicting these quality characteristics and discriminating among breeds. Samples of Longissimus thoracis (n = 32; sixteen per breed; eight males and eight females) were used. Breed significantly affected meat quality characteristics, with only color and fatty acid (FA) (C12:0) being influenced by sex. The meat of the "Serrana" breed proved to be more tender than that of the "Preta de Montesinho". However, the meat from the "Preta de Montesinho" breed showed higher intramuscular fat content and was lighter than that from the "Serrana" breed, which favors its quality of color and juiciness. The use of NIR with the linear support vector machine regression (SVMR) classification model demonstrated its capability to quantify meat quality characteristics such as pH, CIELab color, protein, moisture, ash, fat, texture, water-holding capacity, and lipid profile. Discriminant analysis was performed by dividing the sample spectra into calibration sets (75 percent) and prediction sets (25 percent) and applying the Kennard-Stone algorithm to the spectra. This resulted in 100% correct classifications with the training data and 96.7% accuracy with the test data. The test data showed acceptable estimation models with R2 > 0.99.

Microbiological and Physicochemical Evaluation of Hydroxypropyl Methylcellulose (HPMC) and Propolis Film Coatings for Cheese Preservation.

Dairy products are highly susceptible to contamination from microorganisms. This study aimed to evaluate the efficacy of hydroxypropyl methylcellulose (HPMC) and propolis film as protective coatings for cheese. For this, microbiological analyses were carried out over the cheese' ripening period, focusing on total mesophilic bacteria, yeasts and moulds, lactic acid bacteria, total coliforms, Escherichia coli, and Enterobacteriaceae. Physicochemical parameters (pH, water activity, colour, phenolic compounds content) were also evaluated. The statistical analysis (conducted using ANOVA and PERMANOVA) showed a significant interaction term between the HPMC film and propolis (factor 1) and storage days (factor 2) with regard to the dependent variables: microbiological and physicochemical parameters. A high level of microbial contamination was identified at the baseline. However, the propolis films were able to reduce the microbial count. Physicochemical parameters also varied with storage time, with no significant differences found for propolis-containing films. Overall, the addition of propolis to the film influenced the cheeses' colour and the quantification of phenolic compounds. Regarding phenolic compounds, their loss was verified during storage, and was more pronounced in films with a higher percentage of propolis. The study also showed that, of the three groups of phenolic compounds (hydroxybenzoic acids, hydroxycinnamic acids, and flavonoids), hydroxycinnamic acids showed the most significant losses. Overall, this study reveals the potential of using HPMC/propolis films as a coating for cheese in terms of microbiological control and the preservation of physicochemical properties.

Promoting advanced medical services in the framework of 3PM-a proof-of-concept by the "Centro" Region of Portugal.

Multidisciplinary team from three universities based in the "Centro" Region of Portugal developed diverse approaches as parts of a project dedicated to enhancing and expanding Predictive, Preventive, and Personalized Medicine (3PM) in the Region. In a sense, outcomes acted as a proof-of-concept, in that they demonstrated the feasibility, but also the relevance of the approaches. The accomplishments comprise defining a new regional strategy for implementing 3PM within the Region, training of human resources in genomic sequencing, and generating good practices handbooks dedicated to diagnostic testing via next-generation sequencing, to legal and ethical concerns, and to knowledge transfer and entrepreneurship, aimed at increasing literacy on 3PM approaches. Further approaches also included support for entrepreneurship development and start-ups, and diverse and relevant initiatives aimed at increasing literacy relevant to 3PM. Efforts to enhance literacy encompassed citizens across the board, from patients and high school students to health professionals and health students. This focus on empowerment through literacy involved a variety of initiatives, including the creation of an illustrated book on genomics and the production of two theater plays centered on genetics. Additionally, authors stressed that genomic tools are relevant, but they are not the only resources 3PM is based on. Thus, they defend that other initiatives intended to enable citizens to take 3PM should include multi-omics and, having in mind the socio-economic burden of chronic diseases, suboptimal health status approaches in the 3PM framework should also be considered, in order to anticipate medical intervention in the subclinical phase. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-024-00353-9.

Prospective Evaluation of the Efficacy of Isolated Balloon Eustachian Tuboplasty: Short- and Medium-term Follow-up Results Based on Tubomanometry, ETDQ-7, Tympanometry, and Valsalva Maneuver.

Introduction Balloon eustachian tuboplasty (BET) allows the treatment of the main etiology of eustachian tube disfunction (ETD). Objective To evaluate the efficacy of isolated BET, through objective and subjective results, in the short and medium term, in patients with chronic obstructive ETD. Methods Adult patients diagnosed with chronic obstructive ETD who underwent BET between January 2018 and December 2020 were enrolled in the study. We performed a prospective observational study of BET efficacy, by comparing subjective data, based on the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), and objective data, obtained by tympanometry, objective Valsalva maneuver and tubomanometry, prior to BET with these outcome tools on postprocedure follow-up. Results In total, 30 BETs were performed and analyzed. There were no complications with the procedure. Analysis of BET efficacy was performed in the short-term (average of 7.5 weeks) and in the medium-term (average of 8 months). There was a significant reduction ( p < 0.0001) in the total ETDQ-7 score from baseline to both follow-up periods. A normalization of the ETDQ-7 score was observed in 60 and 83.3% of the performed procedures, in the short- and medium-term, respectively. In tubomanometry, we verified a significant improvement ( p < 0.0001) at all pressures, with a normalization of tubomanometry values in 53.3% and 43.3% of cases in the short- and medium-term, respectively. Tympanogram normalization occurred in 71.4% of patients with abnormal preoperative assessments. Conclusion As an isolated procedure, BET results in significant improvements in symptomatology and objective metric results. This, associated with its safety profile, currently makes BET the most indicated therapeutic option in refractory obstructive ETD.

Blastic Plasmacytoid Dendritic Cell Neoplasm: A Rare Entity in Clinical Practice.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an exceedingly rare and aggressive hematologic malignancy. In the current World Health Organization classification, it is classified among histiocytic/dendritic cell neoplasms. This report describes the case of an 85-year-old female with a complex medical history, including rheumatoid arthritis, who presented with a one-month history of low-grade fever, anorexia, and unexplained weight loss. The diagnosis of BPDCN was confirmed following an immunophenotyping analysis of a bone marrow aspirate. With this report, the authors intend to shed some light on BPDCN's clinical presentation, diagnostic journey, therapeutic approaches, and patient outcomes, and denote the significance of early detection and interdisciplinary collaboration in enhancing patient care.

Sphenoid Meningoencephalocele Correction Through a Transpterygoid Approach.

Sphenoid meningoencephaloceles are rare, and their treatment is challenging. In this report, we describe two clinical cases of sphenoid meningoencephalocele, in which one patient presented with a cerebrospinal fluid leak after repeated head trauma, while in the other, sphenoid meningoencephalocele was detected during the study of memory impairment as the patient was otherwise asymptomatic. The CT scans showed bony dehiscence on the lateral wall of the sphenoid sinus filled with soft tissue that was confirmed by MRI as being herniated brain tissue. A transpterygoid endoscopic endonasal approach was performed with a multilayer reconstruction of the defect with success in both cases without perioperative complications. Imaging techniques are fundamental for diagnosis and surgical planning. Treatment using an endoscopic endonasal approach is efficient with very low morbidity.

Broken silence: 22,841 predicted deleterious synonymous variants identified in the human exome through computational analysis.

Synonymous single nucleotide variants (sSNVs) do not alter the primary structure of a protein, thus it was previously accepted that they were neutral. Recently, several studies demonstrated their significance to a range of diseases. Still, variant prioritization strategies lack focus on sSNVs. Here, we identified 22,841 deleterious synonymous variants in 125,748 human exomes using two in silico predictors (SilVA and CADD). While 98.2% of synonymous variants are classified as neutral, 1.8% are predicted to be deleterious, yielding an average of 9.82 neutral and 0.18 deleterious sSNVs per exome. Further investigation of prediction features via Heterogeneous Ensemble Feature Selection revealed that impact on amino acid sequence and conservation carry the most weight for a deleterious prediction. Thirty nine detrimental sSNVs are not rare and are located on disease associated genes. Ten distinct putatively non-deleterious sSNVs are likely to be under positive selection in the North-Western European and East Asian populations. Taken together our analysis gives voice to the so-called silent mutations as we propose a robust framework for evaluating the deleteriousness of sSNVs in variant prioritization studies.

AN ANATOMICAL STUDY OF THE THORACIC LIMB OF THE GIANT ANTEATER (MYRMECOPHAGA TRIDACTYLA) COMPARED WITH THE DOMESTIC DOG TO GUIDE SURGICAL APPROACHES TO THE HUMERUS AND RADIUS.

The giant anteater (Myrmecophaga tridactyla) is a neotropical mammal considered to be vulnerable to extinction. Recent increased interest in veterinary care in the giant anteater has prompted renewed interest in anatomical descriptions in this species. The terrestrial habits and slow movements of the giant anteater contribute to its susceptibility to vehicular trauma on highways, which is a significant cause of mortality in the species. This study describes the muscular anatomy of the thoracic limb and variations of the long bones with emphasis on the structures surrounding the humerus and radius. It also describes the possible surgical approaches for the management of fractures of humerus and radius, comparing these with the surgical approaches described in dogs (Canis lupus familiaris). Three giant anteater and three domestic dog cadavers, from deaths not related to this project, were used. The medial approach to the humeral diaphysis of the giant anteater resulted in the least tissue trauma, and provided access to the flattest surface for implant attachment. The lateral approach to the radius proved challenging, requiring total detachment of the extensor carpi radialis muscle and incision of the very robust abductor digitorum longus muscle to access the distal diaphysis. Although the giant anteater shares many similarities of the thoracic limb anatomy with the domestic dog, important differences exist. This comparative knowledge will allow veterinary practitioners to directly apply the principles of fracture repair in these species. Safe access to these bones for possible osteosynthesis is essential to allow implant placement and minimize postoperative complications in this species.

Multiple criteria decision analysis to support the design of safe and sustainable chemicals and materials.

The development of safe and sustainable chemicals and materials is essential to achieve the Zero-Pollution Ambition for a Toxic Free Environment stated in the EU Green Deal. For that, criteria need to be defined and considered since early stage of development. A Safe and Sustainable by Design (SSbD) framework is proposed in an EU Recommendation suggesting the assessment of multiple safety and sustainability aspects of chemicals and materials leaving open how the evaluation and selection of the preferable option should be done. This paper presents a proposal with different options for the use of multiattribute aggregation in an evaluation procedure for the SSbD assessment of chemicals and materials. This proposal is based on i) a review of the literature focusing on Multi-Criteria Decision Analysis (MCDA) application in the SSbD context (i.e. applications considering simultaneously safety and sustainability attributes) and ii) the definition of requisites for MCDA to be applied to the SSBD framework. In the latter, an absolute rather than a relative assessment is preferred as it should be possible for an organization developing a new chemical or material to assess if it is SSbD, without needing to obtain data on all of its possible competitors. Moreover, rank-reversals caused by the introduction of other options are avoided, i.e., assessments of one alternative that depends on other alternatives being assessed simultaneously are not the most adequate. Different options for the aggregation of attributes at different levels are discussed as well as for the consideration of data quality in the evaluation procedure. Regardless the approach selected, the use of multiattribute aggregation does not rule out a richer dashboard presenting not only the overall aggregate result, but also the results obtained in other levels of the hierarchy. Such complementary information is important to understand the strengths and weaknesses that an aggregate result might hide.

Prospective Evaluation of the Efficacy of Isolated Balloon Eustachian Tuboplasty: Short- and Medium-term Follow-up Results Based on Tubomanometry, ETDQ-7, Tympanometry, and Valsalva Maneuver

Abstract Introduction Balloon eustachian tuboplasty (BET) allows the treatment of the main etiology of eustachian tube disfunction (ETD). Objective To eval uate the ef ficacy of isolated BET, through objective and subjective results, in the short and medium term, in patients with chronic obstructive ETD. Methods Adult patients diagnosed with chronic obstructive ETD who underwent BET between January 2018 and December 2020 were enrolled in the study. We performeda prospective observational study of BET efficacy, by comparing subjective data, based on the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), and objective data, obtained by tympanometry, objective Valsalva maneuver and tubomanometry, prior to BET with these outcome tools on postprocedure follow-up. Results In total, 30 BETs were performed and analyzed. There were no complications with the procedure. Analysis of BET efficacy was performed in the short-term (average of 7.5 weeks) and in the medium-term (average of 8 months). There was a significant reduction (p < 0.0001) in the total ETDQ-7 score from baseline to both follow-up periods. A normalization of the ETDQ-7 score was observed in 60 and 83.3% of the performed procedures, in the short- and medium-term, respectively. In tubomanometry, we verified a significant improvement (p < 0.0001) at all pressures, with a normalization of tubomanometry values in 53.3% and 43.3% of cases in the short-and medium-term, respectively. Tympanogram normalization occurred in 71.4% of patients with abnormal preoperative assessments. Conclusion As an isolated procedure, BET results in significant improvements in symptomatology and objective metric results. This, associated with its safety profile, currently makes BET the most indicated therapeutic option in refractory obstructive ETD.

Melipona scutellaris Geopropolis: Chemical Composition and Bioactivity.

Geopropolis has been used in traditional medicine for centuries. In this study, the botanical origin, physicochemical profile, and biological activities of geopropolis from Melipona scutellaris harvested during rainy and dry seasons were investigated. Palynological analysis identified over 50 pollen types, with Schinus terebinthifolius and Cecropia being the predominant types. The analytical results were in line with those reported in the literature. Rainy-season geopropolis exhibited higher total phenol and flavonoid content (determined using High Performance Liquid Chromatography-25.13% and 3.92%, respectively) compared to the dry season (19.30% and 2.09%); the major peaks (naringin, gallic acid, and catechin) were similar among samples. Antioxidant capacity was assessed via DPPH, reducing power, and ß-carotene/linoleic acid discoloration assays. Rainy-season samples displayed superior antioxidant activity across methods. Antimicrobial effects were determined using microdilution, while the impact on the cholinesterase enzyme was quantified using 5-thio-2-nitrobenzoic acid accumulation. Anti-inflammatory and antimutagenic activities were assessed through hyaluronidase enzyme inhibition and by utilizing Saccharomyces cerevisiae ATCC-20113 cells. Both samples exhibited anti-inflammatory and antimutagenic properties. Moreover, a significant inhibition of acetylcholinesterase was observed, with IC50 values of 0.35 µg/mL during the rainy season and 0.28 µg/mL during the dry season. Additionally, the geopropolis displayed antimicrobial activity, particularly against Staphylococcus aureus. These findings suggest the therapeutic potential of M. scutellaris geopropolis in the context of inflammatory, oxidative, and infectious diseases.

Biomechanical evaluation of four surgical techniques for ventral stabilization of the atlantoaxial joint in dogs.

PURPOSE: This study compared, through biomechanical evaluation under ventral flexion load, four surgical techniques for ventral stabilization of the atlantoaxial joint in dogs. METHODS: In total, 28 identical atlantoaxial joint models were created by digital printing from computed tomography images of a dog, and the specimens were divided into four groups of seven. In each group, a different technique for ventral stabilization of the atlantoaxial joint was performed: transarticular lag screws, polyaxial screws, multiple screws and bone cement (polymethylmethacrylate-PMMA), and atlantoaxial plate. After the stabilization technique, biomechanical evaluation was performed under ventral flexion load, both with a predefined constant load and with a gradually increasing load until stabilization failure. RESULTS: All specimens, regardless of stabilization technique, were able to support the predefined load without failing. However, the PMMA method provided significant more rigidity (p ≤ 0.05) and also best resisted the gradual increase in load, supporting a significantly higher maximum force (p ≤ 0.05). There was no statistical difference in flexural strength between the transarticular lag screws and plate groups. The polyaxial screws method was significantly less resistant to loading (p ≤ 0.05) than the other groups. CONCLUSIONS: The PMMA technique had biomechanical advantages in ventral atlantoaxial stabilization over the other evaluated methods.

Assessing the climate change adaptability of sustainable land management practices regarding water availability and quality: A case study in the Sorraia catchment, Portugal.

In Mediterranean catchments, such as the Sorraia catchment in Portugal, it is expected that climate change will increase drought stress and the deterioration of water quality in reservoirs. Sustainable land management (SLM) practices are seen as an adaption measure for those problems, but the effectiveness on improving climate change impacted water availability and quality on catchment scale is still poorly understood. Therefore, this study aims to evaluate the effectiveness of SLM practices in adapting the impacts of climate change on water availability and quality of the Montargil and Maranhão reservoirs in the Sorraia catchment. A well-calibrated Soil Water Assessment Tool model is used to simulate four scenarios (2041-2071 and 2071-2100; representative climate pathways 4.5 and 8.5), to investigate the effects of climate change on total phosphorus load (TP) in streams, reservoir volume, irrigation use and water exploitation index (WEI). Results showed that WEI will not exceed any water stress level while reservoir water quality will worsen. In particular since the TP load in streams flowing into the reservoirs increases and the volume decreases, it is likely that the existing P limitation for eutrophication will be counteracted. Nevertheless, tested SLM practices were able to decrease the TP load in those streams and increase the reservoir volume under future climates. Overall, this study shows that the SLM practices are effective in adapting to the climate change effects regarding reservoir water quality, without worsening the water availability; thus, it is a promising tool that should be investigated further for application by e.g. local land-users and decision makers.