The association between glycated haemoglobin levels and P100 visual evoked potentials in diabetes mellitus

Diabetes mellitus (DM) is a metabolic disorder which is characterised by hyperglycaemia resulting from defects in insulin secretion, insulin action or both. The long-term specific effects of DM include the development of retinopathy, nephropathy and neuropathy. Cardiac disease, peripheral arterial and cerebrovascular disease are also known to be linked with DM. Type 1 diabetes mellitus (T1DM) accounts for approximately 10% of all individuals with DM, and insulin therapy is the only available treatment. Type 2 diabetes mellitus (T2DM) accounts for 90% of all individuals with DM. Diet, exercise, oral hypoglycaemic agents and occasionally exogenous insulin are used to manage T2DM. The diagnosis of DM is made where the glycated haemoglobin (HbA1c) percentage is greater than 6.5%. Pattern-reversal visual evoked potential (PVEP) testing is an objective means of evaluating impulse conduction along the central nervous pathways. Increased peak time of the visual P100 waveform is an expression of structural damage at the level of myelinated optic nerve fibres. This was an observational cross sectional study. The participants were grouped into two phases. Phase 1, the control group, consisted of 30 healthy non-diabetic participants. Phase 2 comprised of 104 diabetic participants of whom 52 had an HbA1c greater than 10% (poorly controlled DM) and 52 whose HbA1c was 10% and less (moderately controlled DM). The aim of this study was to firstly observe the possible association between glycated haemoglobin levels and P100 peak time of pattern-reversal visual evoked potentials (PVEPs) in DM. Secondly, to assess whether the central nervous system (CNS) and in particular visual function is affected by type and/or duration of DM. The cut-off values to define P100 peak time delay was calculated as the mean P100 peak time plus 2.5 X standard deviations as measured for the non-diabetic control group, and were 110.64 ms for the right eye. The proportion of delayed P100 peak time amounted to 38.5% for both diabetic groups, thus the poorly controlled group (HbA1c > 10%) did not pose an increased risk for delayed P100 peak time, relative to the moderately controlled group (HbA1c ≤ 10%). The P100 PVEP results for this study, do however, reflect significant delay (p < 0.001) of the DM group as compared to the non-diabetic group; thus, subclincal neuropathy of the CNS occurs in 38.5% of cases. The duration of DM and type of DM had no influence on the P100 peak time measurements.

Silagem do bagaço de sorgo sacarino

Brazilian sweet sorghum is used to generate ethanol and the bagasse is burned in industrial boilers or deposited on soil polluting the environment. This study evaluated the performance of sorghum plants and its bagasse silage nutritional value aiming to use it in the ruminant nutrition. Experiments were set up on the UTFPR campus at Dois Vizinhos-PR. The first trial was established on October 2nd, 2012 using the genotypes ADV 2010, Hunnigreen, Sugargraze, Volumax, BR 505, 503, 501 and the second trial at 2013 on November 27th assessing the materials ADV 2010, Sugargraze, Hunnigreen, EX 5110, BR 506, 508, 509 and 511. Experimental was laid out as a randomized block design with three replications. Results were analyzed through ANOVA comparing the averages by Duncan test at 5% error probability. As field variables were evaluated: plant height (Pl hei), green mass production (GM Prod), percentage of leaves, stems and panicles in relation to the plant, stems production without straw (Prod stems with straw), whole stems production (Who stems Prod), stem diameter (Stem diam), juice production (Juice prod) and Brix degree (oBrix). After juice plant extraction, forage bagasse was crushed and packed in silos for 60 days and green matter yield was estimated (GM). In bagasse silage gauged to buffer capacity (BC), dry matter (DM), mineral matter (MM), crude protein (CP), ether extract (EE), total carbohydrates (TC), non-fibrous carbohydrates (NFCH), neutral detergent fiber (NDF), acid detergent fiber (ADF), lignin (LIG ) and digestibility "in vitro" (DIGIV). There was no significant difference (P> 0.05) between genotypes regarding to green matter production and on average, the second crop yield was lower and reflected in the reduction of bagasse production. Bagasse silage DM was of 32.3% and 33.1%; NDF 73% and 65.8%, crude protein 3.8% and 5.9; pH 3.7 and 3.7; TC and 9.8 and 10.7. mg MS-1; the amount of NFCH was 11.1 and 13.5%; DIG of DM 36.9 and 62.4% for the respectively to the bagasse produced from materials grown in the 2012/2013 and 2013/2014 seasons. Hybrid genotypes had a better agronomic performance while the varieties were more efficient in bromatological indexes. And despite the high percentage of NDF and the low protein level, it is possible to feed ruminants with this coproduct.

Altura do pasto e adubação nitrogenada sobre a produção de forragem e eficiência no uso de nutrientes em sistema de integração lavoura-pecuária

The proper use of management strategies, such as grazing intensity and nitrogen fertilization are primordial to the success of integrated crop-livestock system. Several studies have demonstrated the influence of grazing intensity and nitrogen fertilization on dynamics of forage production and nutrient cycling. However, most this researches studying these strategies in isolation and little is known about the interaction of these factors in the management of an integrated crop-livestock system. In this context, the aim of this study is to determine the best management strategy involving sward height and nitrogen fertilization, permitting greater forage production and improved efficiency in the use of nitrogen soil by a black oat ‘BRS 139’ plus ryegrass ‘Barjumbo’ pasture in integrated crop-livestock system. The experiment was realized in Abelardo Luz – SC, in an area of 14 ha, where has been conducted an experiment in long term with integrated crop-livestock system under no-tillage since 2012. The experimental design is a randomized block design with three replications in a factorial design (2x2), the first factor was the grazing intensity (high and low), characterized by two sward height management (10 and 25 cm), and the second included the time factor application of N in the system: N applied on pasture (N-pasture) and N applied on the culture of grain (N-grain), at dose of 200 kg N ha stocking and variable stocking rate. The previous crop to pasture was corn. The nitrogen fertilization of pasture increased tiller density, forage density, participation of ryegrass ‘Barjumbo’ and percentage of ryegrass leaves in forage mass. Forage mass was less at low sward height on average, however the percentage of ryegrass ‘Barjumbo’ and rye leaves was greater and dead material was lower in this treatment. With nitrogen fertilization of pasture it was possible to double the amount of forage accumulated in periods with further development of ryegrass, furthermore, the total production of DM was increased in 38.4% and the shoot N concentration in 28.6%. When the nitrogen fertilization is applied in pasture, it is possible to keep black oat ‘BRS 139’ plus ryegrass ‘Barjumbo’ pasture with an average sward height of 11 cm. The residual effect of N applied at corn was not sufficient to meet the nutritional needs of pasture and the forage production was affected by periods with N deficiency, while a single application of 200 kg N ha was sufficient to meet the N requirements throughout the forage accumulation period. The black oat ‘BRS 139’ plus ryegrass ‘Barjumbo’ pasture is efficient in use and recovery of the nitrogen applied in both treatments of sward height.

Desempenho e eficiência biológica de bubalinos de três grupos genéticos terminados em confinamento e abatidos em diferentes estádios de maturidade

Neste trabalho objetivou-se estudar o desempenho e a eficiência biológica de 48 bubalinos (16 Murrah - MUR, 16 Jafarabadi - JAF e 16 Mediterrâneo - MED) com média de 18 meses de idade e de peso vivo inicial de 330 kg terminados em confinamento. Quatro animais de cada grupo genético foram designados por sorteio para o abate inicial e serviram de referência para o estudo dos pesos iniciais de corpo vazio e de carcaça. Os 12 animais restantes de cada grupo genético foram divididos aleatoriamente em três subgrupos de quatro animais e submetidos aos seguintes tratamentos: Maturidade 1 (400 kg PV ao abate); Maturidade 2 (450 kg PV ao abate); Maturidade 3 (500 kg PV ao abate). Foi fornecida uma ração única, ad libitum, para todos os animais, composta por 50% de feno de coastcross na MS e 50% de concentrado à base de fubá de milho, uréia e farelo de soja, devidamente suplementado com minerais. Após os abates pré-fixados, determinou-se o peso corporal vazio (PCVZ) dos animais, por meio do somatório das partes integrantes do corpo. Os consumos médios diários de MS e MO não diferiram entre grupos genéticos, embora animais JAF tenham apresentado os maiores valores numéricos. Animais MUR, JAF e MED não diferiram quanto aos ganhos de peso corporal vazio e de carcaça. Não houve diferenças quanto à eficiência biológica (ganho de peso corporal vazio e ganho de carcaça por unidade de energia metabolizável ingerida) entre os grupos genéticos, embora animais Murrah tenham apresentado os maiores valores. Bubalinos abatidos aos 400 e 450 kg apresentaram melhor eficiência de ganho de peso corporal vazio e ganho de carcaça que os abatidos aos 500 kg.

Awareness and practices on eye effects among people with diabetes in rural Tamil Nadu, India.

Background: Recently eye effects of Diabetes Mellitus (DM) are an important concern due to increase in its trend especially in developing countries. Objectives: To assess the awareness related to eye effects of DM and its prevention practices among people with diabetes. Methods: This cross sectional study was conducted from January 2013 to April 2013 in Villupuram district of Tamil Nadu, India. All 105 people with diabetes from the service area of two sub-centres were included. Data on socio demographic details, history of DM, awareness on systemic complications of DM, effects of DM on eyes, practice on regular blood check-up, eye examination and source of information were collected by interview technique using a structured questionnaire. Univariate and multiple logistic regression analysis were done to assess the association of awareness of eye examination with socio-demographic variables. Results: Mean age of the study population was 56.7 years. About 93 people with diabetes (88.6%) tested their blood sugar at least once in every 3 months. About 80 people with diabetes (76.2%) were aware of at least one systemic complication of DM. Although 78 (74.3%) people with diabetes were aware that DM could affect the eyes, majority of this group (68, 87.2%) did not know the specific effects of DM on eyes. In this group, about 28(35.9%) people with diabetes were not aware of the reasons for eye effects, while others mentioned that persistent high blood sugar level (n=26, 33.3%), longer duration of DM (n=14, 17.9%) and lifestyle (n=10, 12.8%) were the reasons for the eye effects of DM. Only 31 (29.5%) of them knew that their eyes must be regularly examined. People with diabetes who had post-secondary and above (>10th standard) level of education had significantly higher awareness on examination of eye (Adjusted OR=19.63). Conclusion: Although awareness of people with diabetes on systemic effects of DM was more, their awareness on specific eye effects and need for regular screening was low. Systematic efforts are required to increase awareness on eye effects and importance of regular screening in this population.

Diabetes mellitus among tuberculosis patients: a cross sectional study from Pakistan

Background: The co-occurrence of diabetes mellitus (DM) and tuberculosis (TB) is largely associated with high frequency of morbidity. Objective: To determine the prevalence of DM among TB patients and describe the socio-demographic and behavioral factors associated with TB-DM co-occurrence . Methods: We enrolled 500 TB patients from September, 2014 to August 2015 at four major public sector hospitals of Lahore, Pakistan. A questionnaire was used to collect information regarding associated socio-demographic and behavioral factors of the patients. We monitored the fasting blood sugar of each patient by using a semi automated clinical chemistry analyzer followed by an HbA1c level check of all hyperglycemic patients. Results: The prevalence of TB-DM co-occurrence was 14.8%. The prevalence of TB-DM was higher (62.2%) among males. The >57 year age group had the highest proportion of patients (35.1%), with co-existent TB-DM. Most were illiterate (73.0%) and unemployed (48%). Moreover, among the 74 patients positive for TB-DM had a history of smoking. Age and education level were significantly associated with DM-TB while gender, occupation and smoking were not associated. Conclusion: The study revealed a 14.8% prevalence of DM among TB patients. This was associated with several socio-demographic factors, including age, unemployment, literacy and polluted environment. Thus, poor and unhealthy lifestyles were the factors associated with DM among immunologically compromised individuals due to TB.

Aditivos químicos e biológicos na ensilagem de cana-de-açúcar: 1. composição química das silagens, ingestão, digestibilidade e comportamento ingestivo

Avaliou-se o efeito da inclusão de aditivos na ensilagem de cana-de-açúcar (Saccharum officinarum L.) sobre a composição químico-bromatológica das silagens, o comportamento ingestivo, o consumo voluntário e a digestibilidade em bovinos de corte. Utilizaram-se cinco novilhos da raça Nelore providos de cânula ruminal, alocados em delineamento quadrado latino 5 ´ 5 e alimentados com dietas com 65% de volumoso na MS. Foram avaliadas cinco silagens (base úmida): controle - cana-de-açúcar sem aditivos; uréia - cana-de-açúcar + 0,5% uréia; benzoato - cana-de-açúcar + 0,1% de benzoato de sódio; LP - cana-de-açúcar inoculada com Lactobacillus plantarum (1 ´ 10(6) ufc/g MV); LB - cana-de-açúcar inoculada com L. buchneri (3,6 ´ 10(5) ufc/g forragem). A forragem foi armazenada em silos do tipo poço por 90 dias antes do fornecimento aos animais. A composição químico-bromatológica da cana-de-açúcar foi alterada após a ensilagem, em relação à cana-de-açúcar original, com redução no teor de carboidratos solúveis e na digestibilidade in vitro e elevação relativa nos teores de FDN e FDA. Os teores de etanol (0,30% da MS) e ácidos orgânicos (0,99% de ácido lático e 2,31% de acético) foram baixos e semelhantes entre as silagens. Os aditivos aplicados na ensilagem não promoveram alterações no consumo e na digestibilidade aparente da MS (7,2 kg/dia e 63,6%, respectivamente). O comportamento ingestivo dos animais também não foi alterado, com tempos médios de 230,6; 519,6 e 672,8 minutos/dia despendidos com ingestão de ração, ruminação e ócio, respectivamente. Os aditivos acrescidos à cana-de-açúcar promoveram pequenas alterações na maioria das variáveis avaliadas.

Aditivos químicos ou biológicos na ensilagem de cana-de-açúcar: 2. parâmetros ruminais e degradabilidade da matéria seca e das frações fibrosas

Objetivou-se avaliar o efeito da inclusão de aditivos na ensilagem de cana-de-açúcar (Saccharum officinarum L.) sobre a degradação de MS e de componentes da parede celular e sobre os parâmetros de fermentação ruminal em bovinos alimentados com dietas contendo essas silagens. Utilizaram-se cinco novilhos da raça Nelore providos de cânula ruminal, alocados em delineamento quadrado latino 5 ´ 5 e alimentados com dietas com 65% de volumoso (%) MS. Foram avaliadas cinco silagens (base úmida): controle - cana-de-açúcar, sem aditivos; uréia - cana-de-açúcar + 0,5% ureia; benzoato - cana-de-açúcar + 0,1% de benzoato de sódio; LP - cana-de-açúcar inoculada com Lactobacillus plantarum (1 ´ 10(6) ufc/g MV); LB - cana-de-açúcar inoculada com L. buchneri (3,6 ´ 10(5) ufc/g forragem). A forragem foi armazenada em silos do tipo poço por 90 dias antes do fornecimento aos animais. Os parâmetros ruminais foram afetados de forma moderada pelas silagens e tiveram forte efeito do horário de coleta de amostras. As concentrações molares médias dos ácidos acético, propiônico e butírico foram de 60,9; 19,3 e 10,2 mM, respectivamente. O ambiente ruminal proporcionado por dietas formuladas com silagens de cana-de-açúcar foi satisfatório e similar ao tradicionalmente observado em dietas contendo cana. O uso de aditivos na ensilagem influenciou, de forma não-significativa, a degradabilidade ruminal da MS e da MO, mas não alterou a degradabilidade ruminal da fração fibrosa. Os aditivos aplicados à cana-de-açúcar resultaram em pequenas alterações na maior parte das variáveis avaliadas. Apesar de a degradabilidade ruminal das silagens ter sido pouco afetada pelo uso de aditivos, os valores observados foram próximos aos observados para a cana-de-açúcar in natura.

Transient hyperglycemia in patients with tuberculosis in Tanzania: implications for diabetes screening algorithms.

BACKGROUND: Diabetes mellitus (DM) increases tuberculosis risk while tuberculosis, as an infectious disease, leads to hyperglycemia. We compared hyperglycemia screening strategies in controls and patients with tuberculosis in Dar es Salaam, Tanzania. METHODS: Consecutive adults with tuberculosis and sex- and age-matched volunteers were included in a case-control study between July 2012 and June 2014. All underwent DM screening tests (fasting capillary glucose [FCG] level, 2-hour CG [2-hCG] level, and glycated hemoglobin A1c [HbA1c] level) at enrollment, and cases were tested again after receipt of tuberculosis treatment. Association of tuberculosis and its outcome with hyperglycemia was assessed using logistic regression analysis adjusted for sex, age, body mass index, human immunodeficiency virus infection status, and socioeconomic status. Patients with tuberculosis and newly diagnosed DM were not treated for hyperglycemia. RESULTS: At enrollment, DM prevalence was significantly higher among patients with tuberculosis (n = 539; FCG level > 7 mmol/L, 4.5% of patients, 2-hCG level > 11 mmol/L, 6.8%; and HbA1c level > 6.5%, 9.3%), compared with controls (n = 496; 1.2%, 3.1%, and 2.2%, respectively). The association between hyperglycemia and tuberculosis disappeared after tuberculosis treatment (adjusted odds ratio [aOR] for the FCG level: 9.6 [95% confidence interval {CI}, 3.7-24.7] at enrollment vs 2.4 [95% CI, .7-8.7] at follow-up; aOR for the 2-hCG level: 6.6 [95% CI, 4.0-11.1] vs 1.6 [95% CI, .8-2.9]; and aOR for the HbA1c level, 4.2 [95% CI, 2.9-6.0] vs 1.4 [95% CI, .9-2.0]). Hyperglycemia, based on the FCG level, at enrollment was associated with tuberculosis treatment failure or death (aOR, 3.3; 95% CI, 1.2-9.3). CONCLUSIONS: Transient hyperglycemia is frequent during tuberculosis, and DM needs confirmation after tuberculosis treatment. Performance of DM screening at tuberculosis diagnosis gives the opportunity to detect patients at risk of adverse outcome.

Avaliação da produção e da qualidade do capim Panicum maximum cv. Massai

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Agronomia e Medicina Veterinária, 2016.

Medication adherence and direct treatment cost among diabetes patients attending a tertiary healthcare facility in Ogbomosho, Nigeria

Background Diabetes mellitus (DM) is now prevalent in many countries in sub- Saharan Africa, with associated health and socioeconomic consequences. Adherence to antidiabetic medications has been shown to improve glycaemic control, which subsequently improves both the short- and longterm prognosis of the disease. The main objective of this study was to assess the level of adherence to antidiabetic drugs among outpatients in a teaching hospital in southwestern Nigeria. Methods A cross-sectional study was carried out using the eight-item Morisky Medication Adherence Scale (MMAS-8) among diabetic patients attending the medical outpatients’ diabetes clinic of Ladoke Akintola University Teaching Hospital, in Ogbomosho, Oyo State in southwestern Nigeria, during a three-month period (October to December 2013). Results A total of 129 patients participated in the study with a male-to-female ratio of 1:1.5. Seventy-eight (60.5%) patients had systemic hypertension as a comorbid condition while the remaining were being managed for diabetes mellitus alone. Only 6 (4.7%) of the patients had type 1 DM while the remaining 123 (95.3%) were diagnosed with type 2 DM. Metformin was the most prescribed oral hypoglycaemic agent (n = 111, 58.7%) followed by glibenclamide (n = 49, 25.9%). Medication adherence was classified as good, medium, and poor for 52 (40.6%), 42 (32.8%), and 34 (26.6%) patients, respectively. Medication costs accounted for 72.3% of the total direct cost of DM in this study, followed by the cost of laboratory investigations (17.6%). Conclusion Adherence of diabetes patients in the study sample to their medications was satisfactory. There is a need for the integration of generic medicines into routine care as a way of further reducing the burden of healthcare expenditure on the patients.

L’ischémie des membres inférieurs chez les diabétiques : le rôle du récepteur AT2

Résumé : Les patients diabétiques ont plus de risques d’être amputés d’une jambe en raison d’une plus faible néovascularisation suite à une ischémie. Nous avons montré une association entre une plus faible réponse angiogénique du VEGF chez les souris diabétiques (DM) et une augmentation de l’expression de SHP-1, pouvant être activée par les récepteurs (AT[indice inférieur 1]/AT[indice inférieur 2]). La délétion du récepteur AT[indice inférieur 2] chez des souris favorise l’angiogenèse dans le muscle ischémique, mais son rôle en condition diabétique demeure inconnu. Notre objectif est de vérifier si la délétion du récepteur AT[indice inférieur 2] chez des souris DM favorise l’angiogenèse suivant l’induction d’une ischémie. Des souris DM de type 1 déficientes (KO) ou non pour le récepteur AT[indice inférieur 2] ont été utilisées. L’ischémie a été induite par la ligature de l'artère fémorale. La perfusion sanguine a été mesurée pendant 2 ou 4 semaines avant la récolte des tissus. Les effets de l’ischémie sur l’expression des récepteurs AT[indice inférieur 1] et AT[indice inférieur 2], des phosphatases SHP-1, SHP-2 et PTP1B, ainsi que l’état de la voie de signalisation du VEGF ont été mesurés. Un essai phosphatase a aussi été effectué suite à l’immunoprécipitation de SHP-1 chez des BAECs stimulés au CGP42112A. Quatre semaines après la chirurgie, le flot sanguin dans le muscle ischémique des souris DM AT[indice inférieur 2]KO s’est rétabli plus rapidement (80%) comparativement à une récupération de 47% chez les souris DM contrôles. L’expression des facteurs pro-angiogéniques (HIF-1α et VEGF) était similaire dans tous les groupes après 2 semaines d’ischémie, mais diminuée chez les DM et retournait à un niveau basal chez les DM-AT[indice inférieur 2]KO après 4 semaines, suggérant un reperfusion plus rapide chez ces souris. La phosphorylation de Akt était aussi plus faible chez les souris DM contrôles mais était rétablie chez les souris AT[indice inférieur 2]KO après 4 semaines d’ischémie. L'expression de SHP-1 était doublée dans le muscle ischémique des souris DM, en comparaison aux souris non DM, un effet absent chez les souris DM AT[indice inférieur 2]KO. L’expression de SHP-2 et PTP1B ne variait pas chez les souris DM sauvages et AT[indice inférieur 2]KO. De plus, l’expression des récepteurs AT[indice inférieur 1] et AT[indice inférieur 2] est augmentée chez les souris DM sauvages en comparaison aux souris NDM. La stimulation du récepteur AT[indice inférieur 2] chez les BAECs a permis d’augmenter l’activité phosphatase de SHP-1. Nos résultats suggèrent que l’expression élevée d’AT[indice inférieur 2] chez les souris DM mène à la surexpression et/ou l’activation de SHP-1, inhibant le signal angiogénique issu du VEGF et empêchant la reperfusion sanguine suite à l’ischémie.

Composição botânica e qualidade do pasto selecionado por ovelhas em caatinga raleada e enriquecida.

Resumo: O presente estudo foi conduzido com o objetivo de determinar a composição botânica e a qualidade da dieta selecionada por ovelhas, através da técnica de micro-histologia fecal, em caatinga raleada e enriquecida com capim massai (Panicum maximum cv. Massai), recebendo diferentes quantidades de concentrado (0; 200; 350 e 500 g de concentrado por dia), e em diferentes períodos do ano (águas, transição água-seca e seca). Foram estimados também o consumo e digestibilidade dos nutrientes, bem como a degradabilidade de espécies forrageiras ingeridas pelas ovelhas. Os experimentos foram realizados na Fazenda Crioula do Meio, pertencente a Embrapa Caprinos e Ovinos em Sobral, CE no período de março a novembro de 2013. No Experimento 1, para a determinação da composição botânica e qualidade da dieta selecionada, foram utilizadas dezesseis ovelhas Somalis brasileira, gestantes, multíparas e peso médio de 30,58+2,48 kg. O acompanhamento da ingestão do pasto pelas ovelhas foi feito em três períodos (águas, transição água-seca e seca), referentes aos meses de abril, junho e agosto de 2013, respectivamente. Amostras das plantas foram coletadas para o preparo das lâminas de referência, e posterior identificação e caracterização dos descritores epidérmicos. O mesmo foi feito para as fezes coletadas nas ovelhas. Com base na proporção de cada espécie identificada nas lâminas fecais que compuseram a dieta, e na composição química das forrageiras identificadas, foi possível determinar a qualidade da dieta ingerida. De 76 espécies observadas no pasto, 33 foram identificadas na dieta das ovelhas, destacando as espécies sabiá (Mimosa caesalpiniaefolia), centrosema (Centrosema sp.), ervanço (Alternanthera brasiliana), massai (Panicum maximum cv Massai) e paco-paco (Wissadula rostrata) como as mais selecionadas pelos animais ao longo dos períodos, chegando a compor mais de 50% da dieta selecionada. Com a chegada do período seco, espécies indesejáveis como o marmeleiro (Croton sonderianus) e o mofumbo (Combretum lepreosum), também fizeram parte das plantas selecionadas. Quanto ao valor nutritivo da dieta selecionada, os animais selecionaram uma dieta com valor nutritivo superior ao amostrado no pasto. No Experimento 2, na mesma condição do experimento anterior, trinta e duas ovelhas Somalis brasileira foram utilizadas para determinação do consumo e digestibilidade dos nutrientes, realizado em três ensaios (abril - terço final de gestação; junho - lactação e agosto - desmame). Para predição do consumo, o indicador LIPE® foi utilizado. Pesagens quinzenais foram realizadas para avaliação do desempenho das ovelhas e dos cordeiros nascidos. O concentrado oferecido favoreceu a maior ingestão e digestibilidade da MS e PB, com efeito substitutivo em relação ao consumo de pasto (P<0,05). Para o período seco, menores consumos foram observados em relação aos períodos das águas e de transição água-seca (P<0,05). Maiores consumos e digestibilidades dos constituintes fibrosos foram observados para as ovelhas não suplementados (P<0,05). Na avaliação do desempenho, a suplementação oferecida determinou os maiores pesos verificados durante a lactação, ao desmame e para os pesos ao nascer e ao desmame dos cordeiros (P<0,05). No Experimento 3, dois ovinos Morada Nova foram utilizados para determinação da degradabilidade da matéria seca (MS), proteína bruta (PB) e fibra em detergente neutro (FDN) de cinco das forrageiras selecionadas pelas ovelhas no Experimento 1: M. caesalpiniaefolia, A. brasiliana, P. maximum cv. Massai, jurema-preta (Mimosa tenuiflora), C. leprosum, nos tempos 0, 6, 24, 48, 72 e 96 horas de incubação. Para cada forrageira, foram determinadas equações para o desaparecimento da MS, PB e FDN. Também foi feito o fracionamento da proteína em suas porções degradáveis e não degradáveis no rúmen. Foi observado maior desaparecimento da MS, PB e FDN, além dos melhores níveis de proteína efetivamente degradada no rúmen para A. brasiliana, seguido pelo P. maximum cv. Massai e M. caesalpiniaefolia. Com as informações obtidas, conclui-se que a micro-histologia fecal apresenta-se como uma técnica viável para avaliações da composição botânica da dieta selecionada por ovinos na caatinga. Ovelhas na caatinga possuem uma grande habilidade de selecionar a dieta, modificando-a ao longo das fases fenológicas, sempre na tentativa de estabelecer uma dieta com melhor valor nutritivo. Forrageiras como A. brasiliana, M. caesalpiniaefolia e o P. maximum cv. Massai, podem ser consideradas um interessante recurso alimentar, em virtude de seu valor nutricional e aproveitamento por ovelhas criadas na caatinga. Abstract: This study was conducted in order to determine the botanical composition and diet quality selected by sheep through fecal micro-histological technique, in thinned and enriched caatinga with Massai grass (Panicum maximum cv Massai.), receiving different amounts of concentrate (0; 200; 350 and 500 g of concentrate per day) at different periods (wet, transition wet-dry and dry). Were also estimated the intake, digestibility, as well as the degradability of forage species eaten by sheep. The experiments were performed in the "Fazenda Crioula do Meio", owned by Embrapa Goats and Sheep, in Sobral, Ceará State, Brazil, from march to november 2013. In Trial 1, sixteen female, pregnant, multiparous, with average body weight of 30,58+2,48 kg Somalis brasileira breed sheep were used to determine the botanical composition and the quality of the selected diet. The monitoring of pasture intake of sheep were conducted in three phenological periods of the caatinga's pasture (wet season, transition wet-dry and dry season). Plant samples were collected for the preparation of the reference slides, with subsequent identification and characterization of epidermal descriptors. The same was done for the feces collected in sheep. Considering the proportion of each species identified in fecal slides which composed the diet, and the chemical composition of forage identified, it was possible to determine the quality of the selected diet. From 76 species observed in the pasture, 33 species was identified in the sheep selected diet, emphasizing the Sabiá (Mimosa caesalpiniaefolia), centrosema (Centrosema sp.), ervanço (Alternanthera brasiliana), massai (Panicum maximum cv Massai) e paco-paco (Wissadula rostrata) as the most selected species by sheep during the study, composing more than 50% of the selected diet. In the Dry Season, undesirable species like marmeleiro (Croton sonderianus) and mofumbo (Combretum leprosum), were also constituent of the diet. Regarding to the nutritional value of selected diet, the sheep selected a diet with more protein than the sampled in the pasture. In the final late gestation, the sheep without supplementation ate a diet above 16% of CP, higher than the selected diet by treatments 350 and 500 g of concentrate per day (P<0.05). Were also observed to the non supplemented sheep, less fiber content intake (P<0.05). In the Trial 2, in the same condition of the first Trial, thirty two Somalis brasileira female sheep were used to determine the intake and digestibility, conducted in three assays (April - third late pregnancy; June - lactation and August - weaning). To predict the intake, the marker LIPE was used. Sheep and lambs were weighted every two weeks to performance evaluation. The concentrate offered to sheep favored to higher intake and digestibility of DM and CP than non supplemented sheep, with inverse relationship to the pasture intake (P<0.05). For the Dry Season, lower intake were observed than for Wet Season and Transition Wet-Dry (P<0.05). Higher intakes and digestibility of the fiber constituents were verified to non supplemented sheep (P<0.05). To performance evaluation, the offered supplementation determined the higher weights observed during lactation and weaning of sheep, and to birth and weaning weights of lambs (P<0.05). In Trial 3, two male sheep were used to determine the degradability of dry matter (DM), crude protein (CP) and neutral detergent fiber (NDF) of five forages selected by sheep in Trial 1: M. caesalpiniaefolia, A. brasiliana, P. maximum cv. Massai, jurema-preta (Mimosa tenuiflora) and C. lepreosum, at zero, 6, 24, 48, 72 and 96 hours of incubation. For each forage, were determined equations for the disappearance of DM, CP and NDF. It was also realized the protein fractions in their degradable and non-degradable in the rumen parts. Was detected a higher disappearance of DM, CP and NDF, as also better proportion of the rumen degradable protein to A. brasiliana, followed by P. maximum cv. Massai and M. caesalpiniaefolia. With the information obtained, it is concluded that the fecal micro histological technique presents as a viable technique to evaluate the selected diet by sheep in caatinga's pasture. On this pasture, the sheep are skilled to select the diet, changing during the phenological phases, trying to form a diet of better nutritive value. Forages as A. brasiliana, P. maximum cv. Massai and M. caesalpiniaefolia, can be considered an interesting food source to ewes kept in the caatinga.

Age-related deregulation of Aire and peripheral tissue antigen genes in the thymic stroma of non-obese diabetic (NOD) mice is associated with autoimmune type 1 diabetes mellitus (DM-1)

Gene expression of peripheral tissue antigens (PTAs) in stromal medullary thymic epithelial cells (mTECs) is a key process to the negative selection of autoreactive thymocytes. This phenomenon was termed ""promiscuous gene expression"" (PGE), which is partially controlled by the Aire gene. Nevertheless, reasons for the correlation of Aire and PTAs with the emergence of autoimmune diseases are largely unknown, though it may be a result of a chronological effect. Although the effect of Aire mutations in pathogenic autoimmunity is well know, it could not be a unique cause for autoimmunity. Independently of mutations, temporal deregulation of Aire expression may imbalance Aire-dependent PTAs and/or wide PGE. This deregulation may be an early warning sign for autoimmune diseases as it guarantees autoantigen representation in the thymus. To assess this hypothesis, we studied the expression levels of Aire, Aire-dependent (Ins2) and Aire-independent (Gad67 and Col2a1) PTAs using real-time-PCR of the thymic stromal cells of NOD mice during the development of autoimmune type 1 diabetes mellitus (DM-1). Wide PGE was studied by microarrays in which the PTA genes were identified through parallel CD80(+) mTEC 3.10 cell line expression profiling. The results show that Aire gene was down-regulated in young pre-autoimmune (pre-diabetic) NOD mice. PGE and specific PTA genes were down-regulated in adult autoimmune diabetic animals. These findings represent evidence indicating that chronological deregulation of genes important to negative selection may be associated with the development of an autoimmune disease (DM-1) in mice.

Using data mining for prediction of hospital length of stay: an application of the CRISP-DM Methodology

Hospitals are nowadays collecting vast amounts of data related with patient records. All this data hold valuable knowledge that can be used to improve hospital decision making. Data mining techniques aim precisely at the extraction of useful knowledge from raw data. This work describes an implementation of a medical data mining project approach based on the CRISP-DM methodology. Recent real-world data, from 2000 to 2013, were collected from a Portuguese hospital and related with inpatient hospitalization. The goal was to predict generic hospital Length Of Stay based on indicators that are commonly available at the hospitalization process (e.g., gender, age, episode type, medical specialty). At the data preparation stage, the data were cleaned and variables were selected and transformed, leading to 14 inputs. Next, at the modeling stage, a regression approach was adopted, where six learning methods were compared: Average Prediction, Multiple Regression, Decision Tree, Artificial Neural Network ensemble, Support Vector Machine and Random Forest. The best learning model was obtained by the Random Forest method, which presents a high quality coefficient of determination value (0.81). This model was then opened by using a sensitivity analysis procedure that revealed three influential input attributes: the hospital episode type, the physical service where the patient is hospitalized and the associated medical specialty. Such extracted knowledge confirmed that the obtained predictive model is credible and with potential value for supporting decisions of hospital managers.