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Reliable biomechanical methods to assess interlimb coordination during the double-support phase in post-stroke subjects are needed for assessing movement dysfunction and related variability. The data obtained could provide a significant contribution for designing rehabilitation programs and for their monitorisation. The present study aimed to determine the minimum number of gait cycles needed to obtain adequate values of repeatability and temporal consistency of lower limb kinematic, kinetic, and electromyographic parameters during the double support of walking in people with and without stroke sequelae. Eleven post-stroke and thirteen healthy participants performed 20 gait trials at self-selected speed in two separate moments with an interval between 72 h and 7 days. The joint position, the external mechanical work on the centre of mass, and the surface electromyographic activity of the tibialis anterior, soleus, gastrocnemius medialis, rectus femoris, vastus medialis, biceps femoris, and gluteus maximus muscles were extracted for analysis. Both the contralesional and ipsilesional and dominant and non-dominant limbs of participants with and without stroke sequelae, respectively, were evaluated either in trailing or leading positions. The intraclass correlation coefficient was used for assessing intra-session and inter-session consistency analysis. For most of the kinematic and the kinetic variables studied in each session, two to three trials were required for both groups, limbs, and positions. The electromyographic variables presented higher variability, requiring, therefore, a number of trials ranging from 2 to >10. Globally, the number of trials required inter-session ranged from 1 to >10 for kinematic, from 1 to 9 for kinetic, and 1 to >10 for electromyographic variables. Thus, for the double support analysis, three gait trials were required in order to assess the kinematic and kinetic variables in cross-sectional studies, while for longitudinal studies, a higher number of trials (>10) were required for kinematic, kinetic, and electromyographic variables.

Nicotinamide adenine dinucleotide (NAD⁺) is a vital molecule found in all living cells. NAD⁺ intracellular levels are dictated by its synthesis, using the de novo and/or salvage pathway, and through its catabolic use as co-enzyme or co-substrate. The regulation of NAD⁺ metabolism has proven to be an adequate drug target for several diseases, including cancer, neurodegenerative or inflammatory diseases. Increasing interest has been given to NAD⁺ metabolism during innate and adaptive immune responses suggesting that its modulation could also be relevant during host–pathogen interactions. While the maintenance of NAD⁺ homeostatic levels assures an adequate environment for host cell survival and proliferation, fluctuations in NAD⁺ or biosynthetic precursors bioavailability have been described during host–pathogen interactions, which will interfere with pathogen persistence or clearance. Here, we review the double-edged sword of NAD⁺ metabolism during host–pathogen interactions emphasizing its potential for treatment of infectious diseases.

Stroke leads to significant impairment in upper limb (UL) function. The goal of rehabilitation is the reestablishment of pre-stroke motor stroke skills by stimulating neuroplasticity. Among several rehabilitation approaches, functional electrical stimulation (FES) is highlighted in stroke rehabilitation guidelines as a supplementary therapy alongside the standard care modalities. The aim of this study is to present a comprehensive review regarding the usability of FES in post-stroke UL rehabilitation. Specifically, the factors related to UL rehabilitation that should be considered in FES usability, as well a critical review of the outcomes used to assess FES usability, are presented. This review reinforces the FES as a promising tool to induce neuroplastic modifications in post-stroke rehabilitation by enabling the possibility of delivering intensive periods of treatment with comparatively less demand on human resources. However, the lack of studies evaluating FES usability through motor control outcomes, specifically movement quality indicators, combined with user satisfaction limits the definition of FES optimal therapeutical window for different UL functional tasks. FES systems capable of integrating postural control muscles involving other anatomic regions, such as the trunk, during reaching tasks are required to improve UL function in post-stroke patients.

Postural control mechanisms have a determinant role in reaching tasks and are typically impaired in post-stroke patients. Functional electrical stimulation (FES) has been demonstrated to be a promising therapy for improving upper limb (UL) function. However, according to our knowledge, no study has evaluated FES influence on postural control. This study aims to evaluate the influence of FES UL assistance, during turning on the light task, in the related postural control mechanisms. An observational study involving ten post-stroke subjects with UL dysfunction was performed. Early and anticipatory postural adjustments (EPAs and APAs, respectively), the weight shift, the center of pressure and the center of mass (CoM) displacement were analyzed during the turning on the light task with and without the FES assistance. FES parameters were adjusted to improve UL function according to a consensus between physiotherapists’ and patients’ perspectives. The ANOVA repeated measures, Paired sample t and McNemar tests were used to compare postural control between the assisted and non-assisted conditions. When the task was assisted by FES, the number of participants that presented APAs increased (p = 0.031). UL FES assistance during turning on the light task can improve postural control in neurological patients with UL impairments.

In response to infection, macrophages adapt their metabolism rapidly to enhance glycolysis and fuel specialized antimicrobial effector functions. Here we show that fungal melanin is an essential molecule required for the metabolic rewiring of macrophages during infection with the fungal pathogen Aspergillus fumigatus . Using pharmacological and genetic tools, we reveal a molecular link between calcium sequestration by melanin inside the phagosome and induction of glycolysis required for efficient innate immune responses. By remodeling the intracellular calcium machinery and impairing signaling via calmodulin, melanin drives an immunometabolic signaling axis towards glycolysis with activation of hypoxia-inducible factor 1 subunit alpha (HIF-1α) and phagosomal recruitment of mammalian target of rapamycin (mTOR). These data demonstrate a pivotal mechanism in the immunometabolic regulation of macrophages during fungal infection and highlight the metabolic repurposing of immune cells as a potential therapeutic strategy. Macrophages undergo a Warburg-like switch from oxidative phosphorylation to glycolysis in response to inflammatory stimulus. Here the authors show that fungal melanin can trigger this switch in human macrophages by sequestering calcium in the phagosome and enabling protection against Aspergillus fumigatus infection.

The disturbance of host metabolic pathways by Leishmania parasites has crucial consequences for the activation status of immune cells and the outcome of infection. Glutamine has been described as an immunomodulatory amino acid, yet its role during Leishmania infection is still unknown. We performed transcriptomics in uninfected and L. donovani-infected macrophages 6 hours post-infection. Glutamine quantification by HPLC was assessed in the supernatant of macrophages throughout the infection course. For experimental L. donovani infections, mice were infected with 1.0 x 108 stationary L. donovani promastigotes. Glutaminase (GLS) chemical inhibition was performed using BPTES and glutamine was administered throughout infection. For combined therapy experiment, a daily administration of miltefosine and glutamine was performed by oral gavage. Parasite burden was determined using a Taqman-based assay. Immune cell phenotyping and cytotoxicity were performed in splenic cells using flow cytometry. We show that glutamine is essential for the control of L. donovani infection. Transcriptomic analysis of L. donovani-infected macrophages demonstrated an upregulation of genes involved in glutamine metabolism. Pharmacological inhibition of glutaminolysis significantly increased the susceptibility to infection, accompanied by an increased recruitment of anti-inflammatory myeloid cells and impaired T cell responses. Remarkably, the supplementation of glutamine to mice infected with L. donovani during miltefosine treatment potentiates parasite clearance through the development of a more effective anti-Leishmania adaptive immune response. Our data indicates that dietary glutamine supplementation may act as a promising adjuvant for the treatment of visceral leishmaniasis.

•Reliable functional electrical stimulation parameters assisted the drinking task;•Functional electrical stimulation parameters presented high to very high repeatability;•Upper limb kinematics presented moderate to very high repeatability. No specific guidelines for the management of functional electrical stimulation (FES) parameters in post stroke patients have been defined yet, despite its frequent use. The purpose of this study is to characterize the optimal FES parameters that assist the reaching phase of drinking task (“drinking task - reaching phase”) on post stroke subjects and to analyze the related upper limb (UL) movement quality indicators repeatability. An observational study with a test and re-test design involving ten post stroke subjects with UL dysfunction was performed. End-point and joint kinematics of contralesional UL were assessed during the “drinking task - reaching phase” with FES through a test and retest design. FES parameters were adjusted to improve UL function according to a consensus between physiotherapists and patients’ perspective. It was possible to establish reliable FES parameters that assisted the “drinking task - reaching phase”. All FES parameters presented high to very high repeatability and led to moderate to very high repeatability in almost UL movement quality indicators during the “drinking task - reaching phase”. These findings show that the main characteristics of FES parameters that improves patient perception of change are quite stable, which facilitate its implementation in clinical practice by allowing consistence between intervention sessions.

Gout is a metabolic disease resulting from the deposition of monosodium urate crystals in joints, tissues, and organs. Nowadays, the treatment of hyperuricemia is easily accessible and widespread and mainly consists of xanthine oxidase inhibitors and uricosurics. In refractory and advanced cases of gout, amputation surgery may be required. The authors present the case of an 85-year-old man who is non-compliant with hypouricemic medication, has exuberant gout, and has refused amputation surgery several times. The patient went to the emergency department with a triad of acute kidney injuries, acute gout, and poorly controlled pain. Cases of tophaceus gout such as the one presented are very rare nowadays.

The present report emerges in the context of the curricular internship, part of the Integrated Master's Degree in Veterinary Medicine at the University of Évora, held at VetOeiras Veterinary Hospital, in Portugal, from 14th September 2020 until 12th February of 2021 and from 1st of April 2021 and 30thof July of the same year.The report is divided into two sections. In the first part, a descriptive quantitative analysis of the cases presented to the author throughout the internship is given. In the second part, a five-case report series is presented regarding the management of pseudoptosis due to reluctant skin in the dog using a novel rhytidectomy surgical technique.

Drawing has been one of humanity's most widely used forms of expression. It has been used for communication since the prehistoric period, long before written communication was developed, and for artistic purposes, both as final objects and as drafts for the development of other pieces. Although many abandon it in adulthood as a primary tool of expression and communication, everyone experiences it at some point in their life, especially during childhood. Children use it as part of their play, to create narratives from simple characters or actions, and to express their perceptions of the world around them. With this in mind, this research work’s aim was to study the aspects of cognitive and visual development that represent children from 6 to 9 years old, the impact of creativity and imagination on their artistic activity and the playful way in which children face the act of drawing and their own drawings. Furthermore, this research focused on the characteristics of children’s visual representation and how their drawings could be incorporated in an animated project.The research was developed in two distinct components, a theoretical and a practical one. After a continuous observation and monitoring of the drawing process of children between 6 and 9 years old, the research evolved through a literary review of the various theories of children’s drawing and art, as well as the role of artistic education and external influences for children’s artistic development. At a cognitive level, perception, symbolic thought, the concepts of imagination, creativity and play were studied, and a revision of the drawing and denotative systems and the canonical views was also addressed. Some of the main characteristics common to most of the drawings corresponding to this age group were compiled. Then, through the organisation of drawing sessions with a group of children between 6 and 9 years old, a careful observation was led, making it possible to verify some of the theoretical investigation in practice. These drawing sessions were organised reflecting the various authors previously reviewed, with the aim of presenting activities that were not limiting to the child or with some defined endpoint. Although only three sessions were organised specifically for the project, the monitoring of these children was continuous, taking place throughout the year, so practice and theory were constantly nurturing one another. Afterwards, the drawings and audio recordings resulting from the sessions presented the starting point for the making of animated experiments. In this way, considering that animation and drawing are closely related, we approached animation as a tool to reflect on the children’s drawing process, as well as to praise and value some of its characteristics.This research allowed us to achieve an understanding about the impact of drawing and artistic activities in children’s development: that drawing, combined with play, works as a means for children to investigate and get to know the world, to understand the relationships that are established around them, as well as exploring the possibilities of representation and meaning. In addition, it allowed us to understand the role of the environment and that external adult support should be guiding and assisting in artistic activities, without, however, limiting and restricting children to their adult vision. Moreover, the fact that the vocabulary and terms used to describe children’s art are generally comparable to adult art helps to propagate the theory that children’s drawings are fraught with errors and faults.