Improved stability and specificity of baits for oral administration of substances to wild boar.

Oral vaccination is one of the most effective interventions for disease control in wildlife. As a result of the recent global reemergence of African swine fever and ongoing classical swine fever and animal tuberculosis, oral vaccination of Eurasian wild boar (Sus scrofa) receives increased interest. Several baits for wild boar and feral pigs have been described, but developing more stable and personalized formulations is important. This paper proposes a new bait formulation primarily composed of corn flour, piglet feed, sugar, and honey as a binder to obtain improved elasticity. The bait consists of a matrix with no protective coats, has a hemispherical shape (ø 3.4 ×1.6 cm), and displays an anise aroma and blue color. The color and aroma did not affect bait choice by wild boar, while bait coloring contributed to avoid consumption by non-target species (corvids). Baits with the new formulation were significantly more resistant to humidity and high temperatures than previous versions. Simulations suggest that baits with the new formulation are elastic enough to resist impacts from a maximum altitude of 750 m. Thus, the new bait prototype solves several problems of previous bait formulations while keeping a format that can be selectively consumed by piglets and adult wild boar.

Influence of different midsole foam in advanced footwear technology use on running economy and biomechanics in trained runners.

BACKGROUND: Ethylene and vinyl acetate (EVA) and polyether block amide (PEBA) are recently the most widely used materials for advanced footwear technology (AFT) that has been shown to improve running economy (RE). This study investigated the effects of these midsole materials on RE and biomechanics, in both fresh and worn state (after 450 km). METHODS: Twenty-two male trained runners participated in this study. Subjects ran four 4-min trials at 13 km‧h-1 with both fresh EVA and PEBA AFT and with the same models with 450 km of wear using a randomized crossover experimental design. We measured energy cost of running (W/kg), spatiotemporal, and neuromuscular parameters. RESULTS: There were significant differences in RE between conditions (p = 0.01; n2 = 0.17). There was a significant increase in energy cost in the worn PEBA condition compared with new (15.21 ± 1.01 and 14.87 ± 0.99 W/kg; p < 0.05; ES = 0.54), without differences between worn EVA (15.13 ± 1.14 W/kg; p > 0.05), and new EVA (15.15 ± 1.13 w/kg; ES = 0.02). The increase in energy cost between new and worn was significantly higher for the PEBA shoes (0.32 ± 0.38 W/kg) but without significant increase for the EVA shoes (0.06 ± 0.58 W/kg) (p < 0.01; ES = 0.51) with changes in step frequency and step length. The new PEBA shoes had lower energy cost than the new EVA shoes (p < 0.05; ES = 0.27) with significant differences between conditions in contact time. CONCLUSION: There is a clear RE advantage of incorporating PEBA versus EVA in an AFT when the models are new. However, after 450 km of use, the PEBA and EVA shoes had similar RE.

Advances in Cruciform Biaxial Testing of Fibre-Reinforced Polymers.

The heterogeneity and anisotropy of fibre-reinforced polymer matrix composites results in a highly complex mechanical response and failure under multiaxial loading states. Among the different biaxial testing techniques, tests with cruciform specimens have been a preferred option, although nowadays, they continue to raise a lack of consensus. It is therefore necessary to review the state of the art of this testing methodology applied to fibre-reinforced polymers. In this context, aspects such as the specific constituents, the geometric design of the specimen or the application of different tensile/compressive load ratios must be analysed in detail before being able to establish a suitable testing procedure. In addition, the most significant results obtained in terms of the analytical, numerical and experimental analyses of the biaxial tests with cruciform specimens are collected. Finally, significant modifications proposed in literature are detailed, which can lead to variants or adaptations of the tests with cruciform specimens, increasing their scope.

Design of Triaxial Tests with Polymer Matrix Composites.

Multiaxial testing in composites may generate failure modes which are more representative of what occurs in a real structure submitted to complex loading conditions. However, some of its main handicaps include the need for special facilities, the correct design of the experiments, and the challenging interpretation of the results. The framework of this research is based on a triaxial testing machine with six actuators which is able to apply simultaneous and synchronized axial loads in the three space directions. Then, the aim was to design from a numerical point of view a triaxial experiment adapted to this equipment. The methodology proposed could allow for an adequate characterization of the triaxial response of a polymer-based composite with apparent isotropic behaviour in the testing directions. The finite element method (FEM) is applied in order to define the geometry of the triaxial specimen. The design pursues to achieve homogeneous stress and strain states in the triaxially loaded region, which should be accessible for direct measurement of the strains. Moreover, a fixing system is proposed for experimentally reproducing the desired boundary conditions imposed on the numerical simulations. The procedure to determine the full strain tensor in the triaxially loaded region is described analytically and with the help of FEM virtual testing. The hydrostatic component and the deviatoric part of the strain tensor are proposed for estimating the susceptibility of the polymer-based composite to fail due to the triaxial strain state imposed. Then, the loading scenarios that cause higher values of the deviatoric components in the triaxially loaded region are considered to be more prone to damage the region of interest. Nevertheless, the experimental failure is expected to be produced in the arms of the specimen which are uniaxially loaded, since in all of the loading cases the simulations show higher levels of stress concentration out of the triaxially loaded region. Thus, although the triaxial strength could not be accurately determined by the proposed tests, they can be utilized for observing the triaxial response before failure.

¿Ha cambiado el paradigma de la prevención del ictus en los pacientes con diabetes? / Has the paradigm of stroke prevention changed in patients with diabetes?

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CA125-Guided Diuretic Treatment Versus Usual Care in Patients With Acute Heart Failure and Renal Dysfunction.

BACKGROUND: The optimal diuretic treatment strategy for patients with acute heart failure and renal dysfunction remains unclear. Plasma carbohydrate antigen 125 (CA125) is a surrogate of fluid overload and a potentially valuable tool for guiding decongestion therapy. The aim of this study was to determine if a CA125-guided diuretic strategy is superior to usual care in terms of short-term renal function in patients with acute heart failure and renal dysfunction at presentation. METHODS: This multicenter, open-label study randomized 160 patients with acute heart failure and renal dysfunction into 2 groups (1:1). Loop diuretics doses were established according to CA125 levels in the CA125-guided group (n = 79) and in clinical evaluation in the usual-care group (n = 81). Changes in estimated glomerular filtration rate (eGFR) at 72 and 24 hours were the co-primary endpoints, respectively. RESULTS: The mean age was 78 ± 8 years, the median amino-terminal pro-brain natriuretic peptide was 7765 pg/mL, and the mean eGFR was 33.7 ± 11.3 mL/min/1.73m2. Over 72 hours, the CA125-guided group received higher furosemide equivalent dose compared to usual care (P = 0.011), which translated into higher urine volume (P = 0.042). Moreover, patients in the active arm with CA125 >35 U/mL received the highest furosemide equivalent dose (P <0.001) and had higher diuresis (P = 0.013). At 72 hours, eGFR (mL/min/1.73m2) significantly improved in the CA125-guided group (37.5 vs 34.8, P = 0.036), with no significant changes at 24 hours (35.8 vs 39.5, P = 0.391). CONCLUSION: A CA125-guided diuretic strategy significantly improved eGFR and other renal function parameters at 72 hours in patients with acute heart failure and renal dysfunction.

Pharmacological management of post-stroke depression.

Introduction: Post-stroke depression (PSD) is a common clinical problem affecting approximately one-third of stroke survivors. PSD is associated with poor functional outcome and higher morbidity and mortality rates. Currently, uncertainty remains regarding optimal pharmacological strategies for its prevention and treatment.Areas covered: This article reviews the state of the current literature on pharmacologic intervention strategies for PSD, providing a summary of the most recent evidence to support pharmacological treatment in PSD.Expert opinion: Experimental and clinical research have increased our knowledge on PSD, although unanswered questions still remain regarding the best time to begin treatment, the effect of the antidepressants in areas other than emotion, or their capability to reduce mortality in stroke patients, among others.Currently, though numerous trials and meta-analyses suggest that antidepressants are effective in treating PSD and guidelines recommend their use for PSD, in the daily clinical practice, only a minority of patients are properly assessed and treated. Therefore, though further evidence is needed to clarify the real role of antidepressants in patients with stroke, physicians and other healthcare professionals must be familiar with the pharmacological treatment of PSD, in order to improve the outcome and increase the quality of life of this vulnerable group of patients.

Factores asociados al abandono de la lactancia materna exclusiva en una ciudad de Perú / Factors Associated with Excusive Breastfeeding Abandonment in a Peruvian City

Introducción: El abandono de la lactancia materna exclusiva representa un problema de salud pública que afecta el desarrollo del niño durante los seis primeros meses de vida. Objetivo: Identificar los factores asociados al abandono de la lactancia materna exclusiva en una ciudad de Perú. Métodos: Estudio descriptivo transversal, que estuvo constituido por 177 mujeres que acudieron al consultorio de crecimiento y desarrollo de los hospitales "Víctor Ramos Guardia y "EsSalud II" de la ciudad de Huaraz (Perú) durante los meses de julio a diciembre del 2018. Se utilizó la entrevista personal para recolectar los factores socioeconómicos, culturales y biológicos relacionados al abandono de la lactancia materna exclusiva. El programa Statistical Package for the Social Sciences versión 25 se utilizó para el análisis de datos. La prueba Chi Cuadrado se usó para evaluar la estadística inferencial. Resultados: De los factores evaluados, solo el biológico se relacionó significativamente al abandono de la lactancia materna exclusiva. El 61,36 por ciento fueron hombres; 55,45 por ciento recibieron lactancia en la primera hora de vida; 38,64 por ciento no tuvieron leche materna; 52,27 por ciento tuvieron buena experiencia con la lactancia materna; 65,91 por ciento consideraron conveniente brindar fórmula láctea; 84,09 por ciento y 97,73 por ciento de niños menores de seis meses estuvieron recibiendo solo lactancia materna y comenzaron a brindar formula láctea; y 52,27 por ciento consideró como motivo de abandono cuando el bebé tenía hambre. Conclusiones: Los factores socioeconómico y cultural no se relacionaron al abandono de la lactancia materna exclusiva, mientras que el factor biológico sí se relaciona significativamente(AU)

Introduction: Exclusive breastfeeding abandonment represents a public health concern that affects child development during the first six months of life. Objective: To identify the factors associated with exclusive breastfeeding abandonment in a Peruvian city. Methods: Cross-sectional and descriptive study including 177 women who attended the growth and development clinic of Víctor Ramos Guardia and EsSalud II hospitals in Huaraz City (Peru) during the months from July to December 2018. We used the personal interview to collect the socioeconomic, cultural and biological factors associated with exclusive breastfeeding abandonment. The Statistical Package for the Social Sciences (version 25) was used for the data analysis. The Chi-square test was used to evaluate the inferential statistics. Results: Of the evaluated factors, only the biological one was significantly related to exclusive breastfeeding abandonment. 61.36 percent were men. 55.45 percent were breast-fed in the first hour of life. 38.64 percent had no breast milk. 52.27 percent had a good experience with breastfeeding. 65.91 percent considered it convenient to provide milk formula. 84.09 percent and 97.73 percent of children younger than six months were only breastfed and began to be offered milk formula. 52.27 percent considered that the baby was hungry as reason for abandonment. Conclusions: The socioeconomic and cultural factors were not related to exclusive breastfeeding abandonment, while the biological factor was significantly related to it(AU)

Evaluación del riesgo hemorrágico de la terapia antitrombótica en pacientes con ictus / Bleeding risk assessment for stroke patients on antithrombotic therapy

Introducción: Tras un evento cerebrovascular isquémico el riesgo de recurrencias es elevado, por lo que se hace necesario el uso de terapia antitrombótica para disminuir nuevos eventos. Desarrollo: A pesar de su beneficio, estas terapias aumentan el riesgo de sangrado. Por tanto, determinar qué pacientes presentan mayor riesgo de hemorragia es fundamental. Existen diferentes modelos predictores de hemorragia y, en particular, de hemorragia intracraneal, asociados al uso de antiagregantes en pacientes con ictus isquémico o AIT, como las escalas CCSC, Intracranial-B2LEED3S score o la S2TOP-BLEED. No obstante, mientras que las principales guías internacionales recomiendan el uso de escalas, como HAS-BLED, para evaluar el riesgo de sangrado en pacientes anticoagulados, no existe una recomendación específica en el caso del uso de antiagregantes. Conclusiones: En esta revisión se presentan los principales modelos disponibles en la actualidad para la predicción de sangrado de la terapia antitrombótica en pacientes con ictus o AIT

Introduction: After an ischemic cerebrovascular event the risk of new ischemic events is high, therefore antithrombotic therapy are indicated to prevent stroke recurrence. Discussion: Despite its clear benefit, these therapies increase the risk of bleeding. Therefore, it is essential to identify high hemorrhagic risk patients. There are different predictive models of hemorrhage, in particular of intracranial hemorrhage, associated with the use of antiaggregants in patients who have presented an ischemic stroke or TIA, such as the CCSC, intracranial scales -B2LEED3S score or S2TOP-BLEED. However, though main international guidelines recommend the use of scales, in particular, the HAS-BLED score, to assess the risk of bleeding in anticoagulated patients, there is no specific recommendation in the case of the use of antiplatelet drugs. Conclusions: In this review we present the main models currently available for the prediction of bleeding of antithrombotic therapy in patients who have had a stroke or TIA

Statins in Ischemic Stroke Prevention: What Have We Learned in the Post-SPARCL (The Stroke Prevention by Aggressive Reduction in Cholesterol Levels) Decade?

PURPOSE OF REVIEW: We describe the current status of lipid-lowering therapies for ischemic stroke prevention. The SPARCL trial published in 2006 has been a landmark study in vascular neurology. The trial demonstrated that high-dose atorvastatin prevents recurrent stroke, and led the AHA/ASA to recommend statin therapy for patients with stroke or TIA of atherosclerotic origin. RECENT FINDINGS: Recently, the J-STARS study demonstrated that therapy with low-dose pravastatin reduced atherothrombotic infarction incidence among patients with prior ischemic stroke. Besides, several trials have shown improved stroke outcomes with non-statin lipid-lowering medications: IMPROVE-IT with ezetimibe on top of simvastatin and PCSK9 inhibitors-FOURIER with evocolumab and ODYSSEY-OUTCOMES with alirocumab-on top of statin therapy. LDL-cholesterol remains the primary lipid treatment target for reduction of stroke risk. Randomized trials have shown that each reduction of 40 mg/dL in the level of LDL-cholesterol reduces the stroke risk by approximately one quarter, and further, reductions in LDL-cholesterol levels have shown to produce additional reductions in stroke risk. Currently, we have evidence of benefit for adding non-statin lipid-modifying therapies to statins to reduce stroke risk. Surely, these novel strategies to reduce residual lipidic risk will provide future benefits on stroke prevention.

Bleeding risk assessment for stroke patients on antithrombotic therapy. / Evaluación del riesgo hemorrágico de la terapia antitrombótica en pacientes con ictus.

INTRODUCTION: After an ischemic cerebrovascular event the risk of new ischemic events is high, therefore antithrombotic therapy are indicated to prevent stroke recurrence. DISCUSSION: Despite its clear benefit, these therapies increase the risk of bleeding. Therefore, it is essential to identify high hemorrhagic risk patients. There are different predictive models of hemorrhage, in particular of intracranial hemorrhage, associated with the use of antiaggregants in patients who have presented an ischemic stroke or TIA, such as the CCSC, intracranial scales -B2LEED3S score or S2TOP-BLEED. However, though main international guidelines recommend the use of scales, in particular, the HAS-BLED score, to assess the risk of bleeding in anticoagulated patients, there is no specific recommendation in the case of the use of antiplatelet drugs. CONCLUSIONS: In this review we present the main models currently available for the prediction of bleeding of antithrombotic therapy in patients who have had a stroke or TIA.

Experimental, Numerical, and Analytical Study on The Effect of Graphene Oxide in The Mechanical Properties of a Solvent-Free Reinforced Epoxy Resin.

This paper presents a methodology for manufacturing nanocomposites from an epoxy resin reinforced with graphene oxide (GO) nanoparticles. A scalable and sustainable fabrication process, based on a solvent-free method, is proposed with the objective of achieving a high level of GO dispersion, while maintaining matrix performance. The results of three-point bending tests are examined by means of an analytical technique which allows determining the mechanical response of the material under tension and compression from flexural data. As result, an increase of 39% in the compressive elastic modulus of the nanocomposite is found with the addition of 0.3 wt % GO. In parallel, we described how the strain distribution and the failure modes vary with the amount of reinforcement based on digital image correlation (DIC) techniques and scanning electron microscopy (SEM). A novel analytical model, capable of predicting the influence of GO content on the elastic properties of the material, is obtained. Numerical simulations considering the experimental conditions are carried out. the full strain field given by the DIC system is successfully reproduced by means of the finite element method (FEM). While, the experimental failure is explained by the crack growth simulations using the eXtended finite element method (XFEM).

Antidiabetic drugs and stroke risk. Current evidence.

Cardiovascular disease (CVD) is the major cause of morbidity and mortality for individuals with type 2 diabetes (T2D). In particular, the risk for stroke is twice that of patients without diabetes, and diabetes may be responsible for >8% of first ischemic strokes. Therefore, the way to prevent stroke in these patients has become an important issue. Traditionally, glucose-lowering drugs had not been shown to protect against stroke. Moreover, several antidiabetic drugs (i.e., sulfonylureas, rosiglitazone) have been reported to be associated with increased risks of CVD and stroke. On the contrary, data on the CV risks and benefits associated with new antidiabetic treatment in patients with T2D are emerging - and look promising. Therefore, it could be of great value to find out if any type of these new antidiabetic agents has protective effect against stroke. We review the available evidence regarding the risk of stroke in individuals taking non-insulin antidiabetic agents. To date, several antidiabetic agents have shown to have a positive effect on stroke prevention. The accumulated evidence suggests that metformin, pioglitazone and semaglutide reduce stroke risk. These agents do not represent only a way of controlling blood glucose and but also offer the opportunity to reduce stroke risk. Surely, new data from ongoing and future studies will provide additional information to select the best treatment for decreasing stroke risk in T2D patients.

Estrategias diuréticas en insuficiencia cardiaca aguda con disfunción renal: terapia convencional frente a guiada por el antígeno carbohidrato 125. Diseño de ensayo clínico / Diuretic strategies in acute heart failure and renal dysfunction: conventional vs carbohydrate antigen 125-guided strategy. Clinical trial design

Introducción y objetivos: El tratamiento óptimo de pacientes con insuficiencia cardiaca aguda (ICA) y síndrome cardiorrenal tipo 1 (SCR-1) no está bien definido. La hipoperfusión arterial y la congestión venosa tienen un papel fundamental en la fisiopatología del SCR-1. El antígeno carbohidrato 125 (CA125) ha emergido como marcador indirecto de sobrecarga de volumen en la ICA. El objetivo de este estudio es evaluar la utilidad del CA125 para el ajuste del tratamiento diurético de pacientes con SCR-1. Métodos: Ensayo clínico multicéntrico, abierto y paralelo, que incluye a pacientes con ICA y creatinina ≥ 1,4 mg/dl al ingreso, aleatorizados a: a) estrategia convencional: titulación basada en la evaluación clínica y bioquímica habitual, o b) estrategia basada en CA125: dosis altas de diuréticos si CA125 > 35 U/ml y bajas en caso contrario. El objetivo principal es el cambio en la función renal a las 24 y las 72 h tras el comienzo del tratamiento. Como objetivos secundarios: a) cambios clínicos y bioquímicos a las 24 y las 72 h, y b) cambios en la función renal y eventos clínicos mayores a 30 días. Resultados: Los resultados de este estudio aportarán datos relevantes sobre la utilidad del CA125 para guiar el tratamiento diurético en el SCR-1. Además, permitirá ampliar el conocimiento de la fisiopatología de esta compleja entidad clínica. Conclusiones: La hipótesis del presente estudio es que las concentraciones de CA125 aumentadas pueden identificar a una población de pacientes con SCR-1 para quienes una estrategia diurética más intensa puede ser beneficiosa. Por el contrario, las concentraciones bajas de esta glucoproteína seleccionarían a los pacientes para los que serían perjudiciales las dosis altas de diuréticos (AU)

Introduction and objectives: The optimal treatment of patients with acute heart failure (AHF) and cardiorenal syndrome type 1 (CRS-1) is far from being well-defined. Arterial hypoperfusion in concert with venous congestion plays a crucial role in the pathophysiology of CRS-I. Plasma carbohydrate antigen 125 (CA125) has emerged as a surrogate of fluid overload in AHF. The aim of this study was to evaluate the clinical usefulness of CA125 for tailoring the intensity of diuretic therapy in patients with CRS-1. Methods: Multicenter, open-label, parallel clinical trial, in which patients with AHF and serum creatinine ≥ 1.4 mg/dL on admission will be randomized to: a) standard diuretic strategy: titration-based on conventional clinical and biochemical evaluation, or b) diuretic strategy based on CA125: high dose if CA125 > 35 U/mL, and low doses otherwise. The main endpoint will be renal function changes at 24 and 72 hours after therapy initiation. Secondary endpoints will include: a) clinical and biochemical changes at 24 and 72 hours, and b) renal function changes and major clinical events at 30 days. Results: The results of this study will add important knowledge on the usefulness of CA125 for guiding diuretic treatment in CRS-1. In addition, it will pave the way toward a better knowledge of the pathophysiology of this challenging situation. Conclusions: We hypothesize that higher levels of CA125 will identify a patient population with CRS-1 who could benefit from the use of a more intense diuretic strategy. Conversely, low levels of this glycoprotein could select those patients who would be harmed by high diuretic doses (AU)