Adaptive building envelopes can provide improvements in the building energy efficiency and economics, through their capability to change their behaviour in real time according to indoor-outdoor ...parameters, by means of materials, components and systems. Therefore, adaptive façades can make a significant and viable contribution to meeting the EU's 2020 targets. Several different types of adaptive façade concepts have already been developed, and an increase in emerging, innovative solutions is expected for the near future. The objective of this paper is to contribute to these developments by presenting the findings of an analysis of the existing concepts and case studies and by proposing a new approach for characterization of these elements.
•Aversive-based methods are correlated with indicators of compromised welfare in dogs.•The reviewed studies have a number of limitations.•Further studies are needed to draw strong conclusions on the ...topic.
The methods by which dogs are trained vary between methods involving mainly negative reinforcement and positive punishment (aversive-based methods) and methods based essentially in positive reinforcement and negative punishment (reward-based methods). However, the use of aversive-based methods is highly controversial. While some people defend their merits, others are concerned with their potential negative effect on dog welfare. To date, some studies have been performed aiming to assess the effects of aversive- and reward-based methods on the welfare and behaviour of dogs. In the present paper we perform a comprehensive review of those studies with the aim of characterizing the state of the art of scientific knowledge of the topic. Generally, the published studies suggest that the use of aversive-based methods is correlated with indicators of compromised welfare in dogs, namely stress‐related behaviours during training, elevated cortisol levels and problematic behaviours such as fear and aggression. However, there are a number of limitations that prevent any strong conclusion from being drawn. First, a considerable proportion of the studies relied upon surveys rather than on objective measures. Second, they focused on sub-populations of police and laboratory dogs and, thus, only represent a small portion of dogs undergoing training. Finally, the empirical studies have concentrated mainly on the effects of shock-collar training, which is only one of several tools used in aversive-based training, and, in some studies, the description of the training methodologies lacks details. Here we present a description of the published studies, discuss their limitations, debate other aspects that, in parallel with the nature of the training methods, may affect dog welfare, and point to future directions for research on the topic.
Human immunodeficiency virus type 1 (HIV-1) persistently infected cell lines are characterized by the continuous viral production without cytopathic effect. However, it is not completely clear if ...this production is contributed only by viral transcription or also by new cycles of viral replication. We studied an HIV-1 persistently infected cell line, designated H61-D, providing evidence of new replication cycles as sustained by: (i) a decrease in viral production, measured by p24 protein, after treatment of the culture with 3'-azydo-3'-deoxythymydine; (ii) detection of new integration events in the course of cell culture, and (iii) finding of two-long-terminal repeat circles in the cells. H61-D cells were not infected by cell-free virus, but infection was possible by co-culture with another productive-infected cell line. In conclusion, ongoing viral replication is taking place in H61-D persistent cells and new infections are mediated by a cell-to-cell spread mechanism.
HPV (human pappiloma virus) infection is an etiologic risk factor for esophageal carcinoma with several studies supporting its carcinogenic role. The main strains are HPV16 and 18 and the less ...frequent strains 11, 6, 31 and 36. We report the case of a 58 year old male, smoker, admitted to our hospital for progressive dysphagia. Previous endoscopies and biopsies were compatible with a hyperkeratotic esophagus, negative for dysplasia. Second endoscopy showed a hyperkeratotic, verrucous, esophagus with two circumferential stenosis which were dilated with TTS (Through the Scope) balloon. Biopsies revealed multiple squamous cell abnormalities, negative for dysplasia and positive for HPV 11. Symptoms recurred, and he was submitted to another upper gastrointestinal endoscopy with dilation of the stenosis and esophageal stent placement. Two months later, esophagectomy was performed, and the histopathological analysis revealed a squamous cell carcinoma of the esophagus (T2, N0, M0, G1). The patient died after surgery due to acute respiratory distress syndrome.
Spasticity is a complex problem in patients with neurological disorders and may distress their quality of life. Intrathecal baclofen infusion pumps reduce spasticity with low doses and minimal side ...effects but are not free from complications. We aimed to evaluate the efficacy and safety of intrathecal baclofen infusion pumps as well as patients' satisfaction.
Retrospective cohort study including all intrathecal baclofen infusion pumps placed up to December 2015. Demographic characteristics, clinical diagnoses, date of placement or withdrawal/replacement of intrathecal baclofen infusion pumps, baclofen dosage and complications of intrathecal baclofen infusion pumps were collected. Assessments from the Ashworth and Penn's scales, Katz index and patients' global satisfaction were analysed.
In 19 years we placed 251 intrathecal baclofen infusion pumps in 155 patients. The mean age was 41.1 ± 15.8 years. The most frequent conditions were: trauma (34%), cerebral palsy (14%), multiple sclerosis (12%) and stroke (12%). Eighty-five patients (55%) required a second pump, and eleven (7%) a third one. The lifetime of the first pump was 72 (36 - 89) and the total follow-up time was 96 (9 - 132) months. The causes of withdrawal/replacement were: battery failure (57%), catheter migration/kinking (24%), infection (14%) and pump displacement/exteriorization (7%). The complication rate was 0.21 events/month. There was a significant improvement in the Ashworth and Penn's scales after the placemen of intrathecal baclofen infusion pumps (p < 0.001 for all diagnoses) and the patients were satisfied with the treatment.
The incidence of complications was within range of other international studies despite our long follow-up time. Events per month, loss to follow-up, re-intervention rate, incidence of infection and mortality were similar to other studies.
Intrathecal baclofen infusion pumps are safe and effective in the treatment of spasticity. Infusion pumps provide a high level of satisfaction regarding treatment and quality of life.
Osteoarthritis (OA) is a complex joint disease and chronic pain source, affecting a patient's quality of life and posing a financial burden. As the dog is considered a nearly ideal species for ...translation research of human OA and the most used model for research, exploring spontaneous dog OA under the One Health/One Medicine concept can improve both humans and dogs' health and well-being.
In a clinical treatment experiment, forty (N=40) joints were selected and randomly assigned to a control group (CG), which received 0.9% NaCl or a treatment (HG), which received Hylan G-F 20. Evaluations were performed on treatment day (T0), 8, 15, 30, 90, and 180 days post-treatment. They consisted of four different Clinical Metrology Instruments (CMI), evaluation of weight distribution, joint range of motion, thigh girth, radiographic and digital thermography imaging, synovial fluid interleukin-1 (IL-1), and C-reactive protein concentrations. Results were compared with repeated measures ANOVA, with a Huynh-Feldt correction, Paired samples T-test, or Wilcoxon signed-ranks test, with p<0.05.
Patients had a mean age of 6.5±2.4 years and a bodyweight of 26.6±5.2kg, and joints graded as mild (n=28, 70%), moderate (n=6, 15%), and severe OA (n=6, 15%). No differences were found between groups at T0. Symmetry index and deviation showed significant improvements in HG from 30 days (p<0.01) up to 180 days (p=0.01). Several CMI scores, particularly pain scores, improved from 90 to 180 days. Radiographic signs progressed in both groups. In both groups, increasing body weight and age corresponded to worse clinical presentation. IA hyaluronan administration produced increased lameness in six cases, which resolved spontaneously.
This study characterizes the response to treatment with Hylan G-F 20, which can produce significant functional and pain level improvements in patients with OA, even those with factors related to worse response to treatment.
Atrial fibrillation (AF) is widely recognized as an adverse prognostic factor during acute myocardial infarction, although the impact of AF type – new-onset (nAF) or pre-existing (pAF) – is still ...controversial.
To identify the clinical differences and prognosis of nAF and pAF during acute coronary syndromes (ACS).
We performed a retrospective observational cohort study including 1373 consecutive patients (mean age 64 years, 77.3% male) admitted to a single center over a three-year period, with a six-month follow-up.
AF rhythm was identified in 14.5% patients, of whom 71.4% presented nAF and 28.6% pAF. When AF types were compared, patients with nAF more frequently presented with ST-elevation ACS (p=0.003). Patients with pAF, in turn, were older (p=0.032), had greater left atrial diameter (p=0.001) and were less likely to have significant coronary lesions (p=0.034). Regarding therapeutic strategy, nAF patients were more often treated by rhythm control during hospital stay (p<0.001) and were less often anticoagulated at discharge (p=0.001). Compared with the population without AF, nAF was a predictor of death during hospital stay in univariate (p<0.001) and multivariate analysis (OR 2.67, p=0.047), but pAF was not. During follow-up, pAF was associated with higher mortality (p=0.014), while nAF patients presented only a trend towards worse prognosis.
AF during the acute phase of ACS appears to have a negative prognostic impact only in patients with nAF and not in those with pAF.
A fibrilhação auricular (FA) é um reconhecido fator de mau prognóstico no enfarte agudo do miocárdio, no entanto, o impacto do tipo de FA, de novo (FAn) ou pré-existente (FAp), é ainda controverso.
Identificar as diferenças clínicas e o prognóstico da FAn e da FAp nas síndromes coronárias agudas (SCA).
Estudo retrospetivo observacional de coorte, incluindo 1373 doentes consecutivos (idade média 64 anos, 77,3% homens) com SCA, admitidos num hospital, ao longo de três anos, com follow-up de seis meses.
A FA foi identificada em 14,5% doentes, dos quais 71,4% tinham FAn e 28,6% FAp. Comparando os tipos de FA, verificou-se que os doentes com FAn apresentaram mais frequentemente SCA com elevação do segmento ST (p=0,003). Por sua vez, a FAp foi mais comum em doentes idosos (p=0,032), com diâmetro superior da aurícula esquerda (p=0,001) e ausência de doença coronária (p=0,034). Quanto à estratégia terapêutica, os doentes com FAn foram mais vezes submetidos a controlo de ritmo durante o internamento (p<0,001), mas menos hipocoagulados à alta (p=0,001). Quando comparada com a população sem FA, a FAn foi preditora de morte hospitalar na análise univariada (p<0,001) e multivariada (OR 2,67, p=0,047), enquanto a FAp não. Já no follow-up, a FAp associou-se a maior mortalidade (p=0,014), enquanto os doentes com FAn apresentaram apenas uma tendência para um pior prognóstico.
O impacto prognóstico negativo da FA na fase aguda das SCA parece ocorrer apenas nos doentes que apresentam FAn e não naqueles com FAp.
CT of the chest (figure 2) revealed a nodular lesion of parenchymatous density with well-defined edges, localised in the right middle lobe, measuring 45×23 mm. After intravenous administration of ...iodine contrast (figure 3), an arteriovenous malformation (AVM) was confirmed, with the afferent arterial vessel measuring 4 mm of diameter and a ectasic (7 mm) efferent vessel was identified originating from the AVM nidus and flowing into the upper right pulmonary vein. First-line treatment with bevacizumab and second line treatment both with tamoxifen and thalidomide was performed, but the patient remained with epistaxis, GI blood loss and anaemia requiring chronic ferric carboxymaltose therapy.2 HHT is a rare autosomal dominant inherited disorder which may give rise to arteriovenous malformations characterised by formation of abnormal vascular structures in telangiectasic shape in the microcircle of the derm, frequently involving the various mucosal surfaces, gastrointestinal tract and distal portion of the limbs.3 Vascular involvement of other organs occurs in an important percentage of patients, with cerebral vascular malformations (CVM) affecting 23% of diagnosed patients with HHT, and patients can present with stroke and brain abscess because of paradoxical emboli. Liver vascular malformations (LVM) are present in 32%–78% of patients but only a minority (8%) of those presenting with related symptoms, such as high-output heart failure, portal hypertension and biliary necrosis.1 The patient was submitted to transthoracic echocardiography (without contrast administration) and brain MRI with angiographic study, with no abnormal findings reported.
PDF
