Application of an autogenous fascia lata graft in the treatment of keratomalacia in the horse has not been reported. The present case describes the use of an autologous fascia lata graft to surgically treat a complicated corneal ulcer in a horse.A 12-year-old Arabian mare was admitted to Sharjah Equine Hospital with a history of right eye ulcerative keratitis of unknown duration. Following a week of aggressive medical treatment, the condition deteriorated and a keratectomy and pedicle conjunctival graft were performed. A week later, the conjunctival graft partially dehisced and the ulcer continued to degrade.In attempting to preserve the integrity of the globe a second grafting procedure was performed when a segment of fascia lata harvested from the ipsilateral hind leg was grafted onto the corneal lesion.Response to surgery was positive and the mare was discharged from the hospital on Day 31 post diagnosis (17 days after the second surgery) with a comfortable eye.Follow-up12 months later revealed a comfortable but only partially visual eye due to corneal scarring.Although the graft actually failed from the point of view of tissue integration, fascia lata appears to be a readily available, effective and affordable autografting material and we believe this technique has potential for short term physical and structural support of severe malacic or other complex corneal ulcers. Corneal ulceration occurs commonly in equids  usually The goal of corneal grafting is to preserve the integrity of the globe, provide tectonic support, reduce ocular pain, optimize the visual outcome and minimize scarring. The ideal biomaterial for such corneal reconstruction would provide optical clarity, provide resistance to endogenous corneal proteases, and promote epithelial growth , 11.Although the application of an autogenous fascia lata graft to repair a traumatic scleral defect has been reported in the dog , its appA 12-year-old, 425-kg Arabian broodmare was at pasture when right eye blepharospasm and a focal corneal opacity were noted by the keeper, leading to referral to Sharjah Equine Hospital for evaluation and treatment.On presentation, general physical examination was unremarkable. Moderate right eye blepharospasm, mild epiphora with mucopurulent ocular discharge, an obvious corneal lesion and conjunctival hyperemia were noted to be present.The findings of the ophthalmic examination included right eye normal ocular adnexa, normal menace responses, dazzle and palpebral reflexes in both eyes. Consensual and direct pupillary light reflexes were elicited from the left eye but not accurately evaluated on the right eye due to extent of the corneal disease and intraocular inflammation. Following sedation with xylazine  , subcutaneous auriculopalpebral and supraorbital nerve blocks using lidocaine hydrochloride 2%  (0.5–1 mL) were used to facilitate ocular examination and before any topical medication, the corneal lesion was swabbed for aerobic bacterial and fungal culture. Fluorescein staining was then performed  and the eye was closely evaluated under magnification . A 10-mm-diameter lesion, which retained fluorescein stain, was evident in the central aspect of the cornea. This defect was seen as a peripheral epithelial lesion surrounding the malacic stroma  with loss of the anterior quarter of the stroma. A shallow furrow was present at the border of the infected and non-infected cornea. There was a 7 mm long, peripheral (360°) vascular fringe or neovascularization from the limbus indicating the chronic nature of the lesion, and the cornea surrounding it was diffusely oedematous. Moderate aqueous flare, but no hypopyon, was present in the anterior chamber. It was not possible to exam the right eye fundus due to the extent of the corneal disease and intraocular inflammation. No left eye anterior segment or fundus abnormalities were seen. A Schirmer tear test (STT) was within normal limits . TonometAspergillus spp. No sensitivity testing was performed.The cytological findings revealed severe neutrophilic inflammation and mycotic keratitis, with degenerative neutrophils, epithelial cells and fungal hyphae. No intracellular bacteria were visible. The complete blood count and serum biochemistry findings were within normal limits. At 24 and 48 h, the bacterial and fungal cultures showed no growth, but at 1 week the fungal culture yielded A subpalpebral lavage system  was placed in the superior conjunctival fornix to facilitate the administration of medicines. Prior to acquiring the culture results 0.2 ml each of voriconazole drops  (q 4 h), ciprofloxacin drops  (q 4 h), 1% atropine drops  (q 12 h) and autologous serum were instilled into the lavage system (q 2 h). Systemic treatment included flunixin meglumine  , and omeprazole  . All the topical medications were delivered via a subpalpebral lavage system using 0.2 ml of the medication solutions followed by 3 ml of air to flush the tubing.Despite this intensive therapy, the ulcer continued to worsen so that by Day 7 after admission it had degraded into a 25 mm diameter cornea lesion with the loss of approximately 60% of the stroma at the deepest aspect, and characterized by a dry, white, caseous exudate (“cake-frosting” appearance) typical of mycotic infections  with a sThe mare was sedated with xylazine  and general anaesthesia was induced with ketamine   and diazepam  . The mare was positioned in left lateral recumbency and general anaesthesia was maintained using isoflurane in a circle line system. Subcutaneous auriculopalpebral and supraorbital nerve blocks were then performed using 0.5-1 mL 2% lidocaine hydrochloride. In addition, a retrobulbar nerve block was carried out using 15 mL 2% lidocaine hydrochloride. To further expose the globe, a lateral canthotomy was performed by making a full-thickness incision 5 mm in length, extending laterally from the lateral canthus. To ensure removal of all the necrotic stroma, a keratectomy was then carried out on the ulcerated cornea by dissection, using a No. 64 Beaver blade and Colibri corneal forceps (Eickemeyer Veterinary Inc.). The keratectomy was greater than 1/2 of the corneal thickness and was completed to leave a large (25 mm diameter) corneal defect as the bed for grafting. The infected tissues were removed and submitted for cytological examination. A large conjunctival pedicle graft was created using Westcott tenotomy scissors and Bishop-Harmon forceps (Eickemeyer Veterinary Inc.) to cover the ulcer. The conjunctiva was then sutured to the cornea using 6–0 polyglactin 910 in a simple interrupted suture pattern  and liquefaction (melting) was present with approximately 85% of corneal stroma loss, and a central lateral focal descemetocele of 5 mm diameter Fig. . At thisThe mare was sedated with xylazine  prior to induction, and anesthesia was induced using ketamine  and diazepam . The mare was positioned in left lateral recumbency and general anaesthesia was maintained using isoflurane  in a circle line system. To harvest the facia graft, the skin over the lateral aspect of the right thigh was clipped and prepared for surgery. A 5 cm long proximodistal incision was made through the skin on the craniolateral aspect of the mid-thigh and the subcutaneous tissues were bluntly dissected to reveal the fascial sheath tissue surrounding the right thigh muscles Figs. , 5. A ciThe dorsal borders of the previous flap were well attached to the underlying cornea, so the remaining adherent conjunctiva was left in situ. The fascia lata flap was then used as an autologous free graft to cover the ulcer. It was positioned on the cornea, trimmed to size, and seated into the corneal defect. The graft was sutured into position using 6–0 polyglactin 910 in a simple interrupted pattern , the tarsorrhaphy was opened and the eye assessed. The graft was intact, and the horse seemed appreciably more comfortable showing only mild blepharospasm and epiphora. Fourteen days after the second graft , the fascia graft started to degrade while tissue repair was taking place over the corneal defect. The mare seemed comfortable with only mild blepharospasm and epiphora. Hence, the subpalpebral lavage system and the sutures from the donor site were removed, and the topical medications and flunixin meglumine were discontinued. Over the next 2 days, the graft continued to degrade and the eye remained comfortable Fig. . On day Follow-up examinations performed at 1, 4 and 12 months after the fascia lata grafting surgery consisted of STT, slit-lamp biomicroscopy, fluorescein staining, and ocular ultrasonography. No IOP measurements or indirect ophthalmoscopy were available at the time.At 1 month post-surgery, the mare was comfortable and the appearance of the right eye continued to improve. Ophthalmic examination demonstrated that corneal vascularisation was still present and fluorescein staining showed a 10 mm diameter epithelial defect over the grafted area. Some vision was evident from normal menace responses, dazzle reflex and the presence of consensual and direct pupillary light responses (PLR) in the injured eye . Assessment of the anterior chamber from the temporal aspect of the eye revealed minimal flare. A Schirmer tear test was within normal limits  and no sAt the second recheck examination, 4 months postoperatively, there was evidence that the horse still had some vision in the affected eye, as demonstrated by a positive dazzle reflex and consistent menace response on the temporal side. Fluorescein staining was negative and the periphery of the cornea showed minimal and regressing vascularisation. Ocular ultrasonography was within normal limits. Apart from the poor visual outcome due to central opaque corneal scarring, the results of the ophthalmic examination were within normal limits, and without signs of ocular discomfort.By 12 months postoperatively, results of the ophthalmic examination, including ocular ultrasonography, were within normal limits. The mare remained comfortable and the eye partially visual due to the central opaque corneal scarring. The owner was pleased to have saved the globe, despite this low visual outcome Fig. .Fig. 9TThis report documents a new technique for repair of complex defects of the equine cornea. Treatment of collagenolytic keratitis is either medical, surgical or both. Initial medical therapy for infectious keratitis has been routinely based on treatment of the cornea with topical antimicrobials, cycloplegics to dilate the pupil and reduce ciliary spasm, systemic anti-prostaglandin synthetase inhibitors for pain relief and anticollagenase medications all applied topically . In caseAdditionally, intra-stromal and subconjunctival injection of voriconazole solution under standing sedation have been recommended , 18. CorIntraocular inflammation with associated anterior uveitis, or iridocyclitis, is always present in cases of equine keratomalacia caused by infection. In particular with fungal keratitis, it can escalate in intensity following death of hyphae after antifungal therapy is initiated . In the When medical therapy is unsuccessful, progressive melting and necrosis of the corneal stroma may lead to descemetocele formation and perforation of the cornea. Therefore, any corneal defect deep enough to threaten corneal integrity warrants surgical repair by corneal reconstruction/grafting . The goaCorneal transplantations, including fresh or frozen corneal allografts and autografts, have been documented in the veterinary literature and have met with some success. However in cases of infections and collagenolytic keratitis the incidence of graft rejection is high . AlthougCorneoconjunctival transpositions are autologous partial-thickness corneal grafts in which peripheral cornea is grafted into the axial cornea, so as to maintain its conjunctival vascular attachments. The procedure is indicated for axial stromal defects of < 30% of the corneal diameter , 23. In A commonly performed grafting procedure in horses is the conjunctival pedicle graft in which the base of the graft retains a connection to the bulbar conjunctiva . ConjuncOther biomaterials commonly used for corneal reconstruction in veterinary patients include amniotic membrane, porcine small intestine submucosa, porcine urinary bladder extracellular matrix, and bovine pericardium , 6, 10.Commercially available porcine urinary bladder extracellular matrix and small intestine submucosa grafts act as scaffolds that first promote cell proliferation and regeneration, then degrade as local tissues replace the graft . An advaCommercially available bovine pericardium grafts offer a promising option for surgical reconstruction of the cornea to manage deep melting corneal ulcers . This biTransplants of amniotic membrane have been described as an alternative to conjunctival pedicle grafting which may provide some tectonic support as well as improved postoperative optical clarity resulting from less fibrotic scarring, and less iatrogenic trauma when compared to conjunctival pedicles , 4. In aIn the present case, a pedicle conjunctival graft was carried out during the first surgical intervention. Unfortunately, dehiscence was observed at removal of the tarsorrhaphy on Day 7 post operatively. Dehiscence was attributed to the aggressive nature of the ulcerative process and at that time, enucleation of the eye or a second ocular salvage procedure were given as surgical options. The client elected for the horse to have a second ocular surface reconstruction and so the decision was made to harvest a segment of fascia lata from the ipsilateral hind limb and use this as an autologous graft, primarily due to a lack of other biomaterials at the hospital but also due to its great strength, ready availability, ease of harvesting, and relatively low cost.Initial and postoperative medical treatment included systemic administration of flunixin meglumine while local therapy included voriconazole drops, ciprofloxacin drops, atropine drops, and autogenous serum instilled into the lavage system. Topical ciprofloxacin was empirically chosen based on the hospital general infectious keratitis antibiotic sensitivity patterns. However, fluoroquinolones have been shown to have severe cytopathological effects on corneal epithelium that could have impaired further healing . SystemiTwo weeks after the fascia lata graft, the mare seemed comfortable with mild blepharospasm and epiphora so at that point, topical medications and systemic flunixin meglumine were discontinued. In hindsight, continuation of the topical anti-inflammatory therapy would have been beneficial to minimise residual corneal vessels and inflammatory infiltration .Autologous grafts are free of antigenicity problems and fascia lata, in particular, is an excellent scaffolding graft that functions as an inductive template to help tissue regeneration . This biIn the present case, the harvested fascial material proved to be substantially thicker and stronger than the traditional conjunctival flap, or commonly used amnion, and it was therefore expected to show greater tectonic properties. However, while the fascia graft failed to provide tissue integration due to insufficient vascularity, it did endure over time and it gave additional physical support to protect the cornea during the first weeks after surgery while tissue repair was taking place . The facIt is recognised that there were problems with certain aspects of this case report. The follow-up of clinical cases in veterinary practice is often limited by financial and practical constraints. The fact that no veterinary ophthalmologist was involved in the case was due to accessibility, and potentially impacted the quality of the initial and follow-up ocular examinations. Intraocular pressure was not monitored in this mare due to the unavailability of tonometry. The onset of glaucoma is a known serious complication of inflammatory ocular disease and should have been monitored throughout the horse’s recovery . SurgicaAlthough the fascia lata corneal grafting technique is considered effective to protect and support a severely malacic cornea, additional cases and longer follow-up times are needed to further justify its use, together with further refinement of the technique, and a better description of its potential short- and long- term complications.In summary, fascia lata appears to be an effective and affordable autografting material, with minimal donor site morbidity, that may be considered for tectonic support of severe malacic or other complex corneal ulcers. This may be particularly relevant in cases where other types of grafting biomaterials are not available.


The magnitude of the noncommunicable epidemic is difficult to overstate. The projected cost of the epidemic is substantial. It disproportionately affects people in low- and middle-income countries as well as poorer and marginalised communities in high-income countries. The international community has taken various steps to address the four modifiable risk factors causing the majority of noncommunicable diseases (NCDs), however, action has so far fallen short of expectations. Both analysts and international institutions are advocating the adoption of a new international legal norm to address the NCD crisis.process of normative emergence and change, and draws on empirical examples to highlight overlooked aspects of normative development and how they relate to NCD politics. The second engages with the critique of legal principles. Critical approaches to law seek to expose the myths that legal principles are neutral, objective, good. The third section discusses the characteristics of practice in the NCD field and its implications on process and principles for the pursuit of a legal solution to the NCD crisis.Drawing on existing knowledge from international relations and international legal studies, this article argues that a new international treaty is not only currently improbable, but also not strictly desirable. In-depth critical analysis and reflection is needed regarding the strengths and weaknesses of a legal approach to addressing the NCD pandemic. The argument is set out in three sections - the first reviews contributions of agentic constructivism, which focus on the Any advocacy for an international norm to address NCDs needs to be nuanced and demonstrate awareness of the nature and character of both the norm development process and resulting international legal principles. As analysts, we are responsible for advocating inclusive and ethical norms, but also for highlighting the implications of inequalities and differences between and within states and societies. There may be a viable international legal instrument that would support dedicated policies to curb the NCD epidemic, but such an instrument needs to be actively advocated for and negotiated with a wide range of stakeholders, navigating a complex international framework of existing norms and conflicting, powerful interests. Ansee for example UN  class and managerial elites set the terms upon which others are to lead their lives’ . Csee : 210–1). lives’ (: 209). Tsee [To the extent that we can talk about recurring themes, both CLS and CILT highlight the political nature of law and legal decisions, underpinned by the inherent indeterminacy of law . This esee : 354–5).see : 16). SuCritical views of law prompt us to consider international norms from a different angle and encourage us to foster an awareness of the way such norms affect different states, communities and individuals. This is not to say that law cannot or should not be used as part of the approach to curbing the global NCD pandemic, but that its utility and appropriateness and embeddedness in a system of profound power inequalities ought to be critically evaluated. Law can be used for example to affect structural determinants of health and promote joined-up cross-sectoral policy, or as an instrument creating a framework for action, supporting states in taking on corporate power. Norm advocates, therefore ought to evaluate whether and how international law can deliver regulation, which does not itself become an instrument of oppression of the weaker, voiceless and marginalised states and communities within states. If law cannot achieve this, then alternative options ought to be considered – such as for example policy responses based on broader consultation and consensus, bottom-up community-based initiatives, alternative mechanisms that can put pressure on corporate actors. Learning from other fields of global policy-making, further research and some ingenuity is needed to consider viable alternatives.Applying insight from studies of norm development and from critical legal analysis to the politics of curbing the global noncommunicable disease pandemic provides a useful lens on normative processes and principles. On the one hand, it enables a more nuanced, practice-oriented understanding of these politics and on the other, it prompts critical reflection on the principles that are being advocated. Much like other global problems, NCD morbidity and mortality disproportionately affects low- and middle-income countries, as well as the poorest and often most disadvantaged strata of societies in high-income countries . PreventThe discrepancies between the urgency highlighted by analysts and advocates, the high levels of NCD-related morbidity and mortality globally, but specifically amongst the poorest states and communities, the inertia amongst policy makers, but also the ways in which existing norms and principles are affected by harmful power hierarchies, and whether the former do or do not address poverty, inequalities and underdevelopment both as causes and consequences of the NCD crisis, need further reflection in the process of devising and advocating potential solutions and policy options. This section will briefly discuss the characteristics of practice and the politics of NCD, and the implications emerging from these in the context of the preceding discussion of insight from agentic constructivism and critical legal studies.see [Agentic constructivists note that campaigns for new norms tend to follow disasters or crises on a significant scale, where norm entrepreneurs are willing to drive forward a campaign for action . Whiociety’ . Th example : 11 and International law is premised on an outdated state-centric paradigm while operating in a world where states no longer enjoy absolute sovereignty or power. A key deficiency of international law is that it applies directly only to states, and only indirectly to non-state actors - including multinational corporations (MNCs), which makes it very difficult for individual states to govern these entities. As previously noted, MNCs wield an enormous amount of power over governments and communities - not only through the resources that they have at their disposal, but also through their power to disinvest or relocate - threatening jobs, local investment, trade and tax revenue. Creating a new type of global regulatory regime capable of countering corporate power at least in part, is a task of a very high order.A number of proposals have been put forward by analysts about possible action, offering a range of possibilities to governments and advocates of change. There is a strong emphasis, for example, on a comprehensive approach to the problem of NCDs that addresses individual choices and behaviours along with structural inequalities, social and economic determinants of health , 76, 95.To be effective and increase the chance of having an impact on policy-makers, as demonstrated by empirical research, communities of scientists (aka epistemic communities) need to reach out to broader networks of activists and norm entrepreneurs. It is of course necessary to remember that political processes are inherently indeterminate, contingent, organic, open-ended, influenced by practitioners, activists, policy-makers, industry, public opinion and a myriad of contextual factors. This means that once a normative process is underway no one actor is in a position to control the outcome, this includes corporate actors, even though they are in a strong position to exercise much influence on policy-makers, as previously discussed.Research on the politics of noncommunicable diseases is rich and expanding. Analysts are examining the field from a variety of different angles and there is no shortage of expert opinion not only on possible avenues for action, but also on specific programmes of action. There is significant advocacy for the development of an international legal agreement to stimulate and support action globally to address the noncommunicable disease crisis. This article sought to bring insight from the fields of international relations and international law to bear on such advocacy and highlight potential pitfalls of a legal approach to the politics of NCDs. Drawing on conceptual and empirical research by agentic constructivists, a number of observations were made - around the typical time-frames of norm development; the central importance of appropriately and effectively framing the problem(s), which require regulation in a way that is current, relevant and pressing and manages to sustain policy-makers’ attention; and the concern about the role of corporate influence in global negotiations, particularly when their interests are directly at stake. These observations based on empirical studies of the development of other norms are corroborated by analysis in the NCD literature, meaning that they are of significance to this particular norm development process as well. Initial analysis, premised on the model of norm development, demonstrates that the process of developing a new international norm on NCDs is still very much at a nascent stage. Using this model has highlighted areas that are still open for advocacy and others that require strong input to keep potential future normative negotiations on course to maintain a strong equity focus in line with other global health norms.The article then discussed contributions of critical legal scholars, whose observations about the nature and character of law in general and international law in particular align with the empirical research of agentic constructivists and raise important questions about the desirability of adopting a legal approach to the politics of NCDs. These scholars are critical of the influence of unequal power relations on both legal doctrine and practice, and are concerned about the way in which law is often portrayed as both the best possible mechanism to guide behaviour and a product of the natural evolution of political discourse, thus obscuring the politics of law, laws’ subjectivity, historicity and dynamism. These contributions were introduced to provide a counter-argument to mainstream advocacy for legal mechanisms to address the problem of non-communicable diseases for current and future generations. Critical legal scholars problematise and de-naturalise law, suggesting that other orders are possible, and that legal mechanisms can be designed differently or other mechanisms may be more effective altogether if the flaws of legal mechanisms are too profound.The combined criticisms and caution expressed by critical legal scholars and observers of norm development raise important questions - e.g. whether international law offers the most desirable approach or the most effective mechanism to address the global NCD crisis. Short of radical new ways of global concerted action, possible ways to counteract some of the problematic characteristics of international law as a policy instrument - such as its bias towards powerful interests or its indeterminacy - may be to demand more inclusive, representative and transparent negotiations; to support activists and civil society organisations from the Global South to attend and participate in negotiations; for advocates of a new norm to use carefully crafted language; to promote cross-sectoral rather than siloed negotiations that evaluate the combined influence of existing international norms; to consider the resources available to commit to operationalising potential new international agreements; and commitments to secure assistance with implementation.The estimated opportunity cost of inaction is £30 trillion over the next 20 years  and that


Alcedo atthis), 17,892 bp  and 17,223 bp (Megaceryle lugubris).Each mitogenome contained one control region and 37 genes that were common invertebrate mitogenomes. The organization of three mitogenomes was identical tothe putative ancestral gene order in Aves. Among 13 available Coraciiformmitogenomes, 12 protein coding genes showed indications of negative selection,while the MT-ND6 presented sign of positive selection or relaxed purifyingselection. The phylogenetic results supported that Upupidae and Bucerotidaeshould be separated from Coraciiformes, and that Coraciiformes is more closelyrelated to Piciformes than to Strigiformes, Trogoniformes and Cuculiformes. Ourstudy provide valuable data for further phylogenetic investigation ofCoraciiformes.Coraciiformes contains more than 200 species with great differences on externalmorphology and life-style. The evolutionary relationships within Coraciiformesand the phylogenetic placement of Coraciiformes in Aves are still questioned.Mitochondrial genome (mitogenome) sequences are popular markers in molecularphylogenetic studies of birds. This study presented the genome characteristicsof three new mitogenomes in Coraciiformes and explored the phylogeneticrelationships among Coraciiformes and other five related orders with mitogenomedata of 30 species. The sizes of three mitogenomes were 17,383 bp( Bucerosbicornis) is about three to four kilograms in weight and 119 to1 28centimeters in body length. However, the smallest species (Alcedoatthis) is only about 30 to 40 grams in weight and 150 to 170millimeters in length  .However. The separatedposition of Leptosomatidae was also supported by molecular phylogeneticinvestigations , because of their advantageous characteristics, have been extensively applied in phylogenetic studies of birds sincethe report of chicken mitogenome e.g. .HoweverAlcedo atthis), White-throated Kingfisher and Crested Kingfisher (Megacerylelugubris). This study aims to 1) elucidate the structuralcharacteristics of three mitogenomes and compare our data with other Coraciiformmitogenomes available in GenBank; 2) explore the phylogenetic relationships among 12families of six orders  with mitogenome data of 30 species.Here, we provide three new mitogenome data in Alcedinidae of Coraciiformes: CommonKingfisher ,Halcyon pileata (NC_024198)  , Todirhamphus sanctus (NC_011712)  (Bycanistesbrevis (NC_015201) (Penelopidespanini (HQ834451)  (Merops viridis(NC_034642) (Upupa epops (NC_028178) . Gene annotations were conducted with the MITOSwebserver (http://lowelab.ucsc.edu/tRNAscan-SE/) . The boundaries of rRNA genes and protein codinggenes (PCGs) were detected by aligning our sequences with other availableCoraciiform mitogenomes in GenBank: Gallus gallus (NC_001323) was chosen as outgroup.The mitogenome information of all species involved were shown inTableS1.To investigate the phylogenetic relationships among Coraciiformes and otherrelated orders that have been referred in previous studies  of all mitogenomes were deleted, because the greatdifferences in CRs would lead to stochastic errors or the effect of homoplasy.The second set of data included the sequences of 12 protein coding genes (PCGs).MT-ND6 was excluded because of the very different evolutionary tendency fromother 12 PCGs based on the dN/dS ratios.MrBayes 3.2.7a  was applA. atthis, H. smyrnrnsis andM. lugubris are circular and double-strandedmacromolecules, with the size of 17,383 bp, 17,892 bp and 17,223 bp,respectively . The accession numbers of the threemitogenomes in GenBank are NC_035868 ,NC_035746  and NC_035658 . Among 13 available Coraciiform mitogenomes(H. coromanda), and the largest one is 22,737 bp (P.panini). Great variation in lengths of control regions (CRs) is themain reason for size difference of these mitogenomes(TableS3).The mitogenomes of ogenomes, the smaA. atthis, H. smyrnrnsis andM. lugubris contain 37 genes  and one CR (Table S2). Twenty-eight genes  are located on the H strand, and theremaining nine genes are located on the L strand (Table S2). All genes are compactlyarranged, and gene overlaps exist at several gene junctions(TableS2). Gene arrangement of the threemitogenomes is identical to the putative ancestral gene order in avianmitogenomes (The mitogenomes of ogenomes .Table S3), which suggest that the contentof adenine is higher than that of thymine, and the content of cytosine is higherthan that of guanine. Except the MT-RNR1 in five species , other fragments in13 mitogenomes present nucleotide bias toward A and T. The A + T bias in CRs aremore significant (Table S3).All 13 Coraciiform mitogenomes show nucleotide bias toward A+T in both strands,and display slight positive AT-skews and negative GC-skews  (Table S3).CRs of different species are highly variable and distinctive. The length of CR inhte mitogenomes of A. waldeni and P.panini), and duplicate CR for one mitogenome (M.viridis).In addition to great variation in length, complex rearrangements have happenedaround CRs and flanking genes in some species. To date, at least seven geneorders have been identified in avian mitogenomes: (1) ancestral avian CR; (2)duplicate CR; (3) duplicate TT-CR; (4) duplicate TT-TP and CR; (5) duplicateTE-CR; (6) remnant CR; (7) erroneous gene order , with anet al., 2015; A. atthis, H. smyrnensis, and M.lugubris were divided into three different domains: the peripheraland highly variable domains (I and III), and the conserved domain II. In Domain I, there are two extendedblocks (ETAS1-2) including sequences that are responsible for the termination ofreplication  . A CSBI-LIKE block (sequence thatis similar to the conserved block) also exists in Domain I. There are sevenconserved blocks  in Domain II of H.smyrnensis and M. Lugubris, while B-box is absentin Domain II of A. atthis . Domain III includes a conservedblock (CBS1) that is responsible for the regulation of mtDNA replication, aheavy strand replication origin (OH), bi-directional transcriptionpromoter of L- and H- strand (LSP/HSP), and a poly (T) sequence at downstream ofthe CSB1 . Besides, there are tandemrepeats near the 3’ terminal of Domain III. There are two types of repeats inA. atthis  and M. lugubris, and three types of repeats in H.smyrnensis . Thedifference in repeat sequences lead to different size of CRs in three species.The origination and evolutionary history of different types of repeat sequencesin CRs of animal mitogenomes have not been fully solved . All 22 tRNAs can fold into normalclover-leaf secondary structure . Apparent length difference andnucleotide variations exist in the TΨC and DHU loops and stems, while theanticodon loop, anticodon stem, and acceptor stem are more conserved in length.Atypical pairings of G-U and unmatched base pairs of A-C, A-A, U-U, and U-C arescattered throughout the stems . These kinds of mismatched pairsor unmatched base pairs have also been found in other vertebrate andinvertebrate mitogenomes (All 22 tRNA genes that are common in vertebrate mitogenomes are found in themitogenomes of lugubris . The lenTableS2). The lengths of the MT-RNR1 in 13Coraciiform mitogenomes range from 966 bp (M. lugubris) to 981bp (H. coromanda) (Table S3). The secondary structures ofMT-RNR1 for A. atthis, H. Smyrnensis andM. lugubris are similar, comprising three main domains and46 helices . Nucleotide substitutions aremainly located at H609, H768, H814 and loops near H307, H655, H683, and H884.The sizes of the MT-RNR2 in 13 Coraciiform mitogenomes range from 1,578 bp(U. epops) to 1,614 bp (M. viridis)(TableS3). The secondary structures of MT-RNR2 forA. atthis, H. Smyrnensis and M.lugubris contain six domains and 59 helices. The sequences for Domain IV areconserved, while there are many nucleotide substitutions in Domain I-III, V andVI. The secondary structures of two rRNAs in many avian species were similar,while there were obvious differences in secondary structures of mitochondrialrRNAs between birds and bees . The lengths of each PCGs in the threemitogenomes are almost the same (Table S5). MT-ND5  is the longestone, and MT-ATP8 (168 bp) is the shortest one. Twelve PCGs show nucleotide biastoward A+T, while the MT-ND6 displays slight nucleotide bias toward G+C. Exceptthe MT-ND1, MT-ND3, and MT-CYB of A. atthis, other PCGs show apositive AT skews and a great negative GC skew (Table S5). The AT skews for MT-ND6 aresignificantly greater than those for other PCGs.All 13 PCGs that are typical in animal mitogenomes are identified in themitogenomes of A.atthis is TAA (Table S2). Ten PCGs terminate with AGG,TAA, or TAG, and the remaining three PCGs  haveincomplete stop codons (T), which can be adjusted to a TAA terminal codon byposttranscriptional polyadenylation  and 3,793 (H. smyrnensis and M.lugubris) codons, respectively. The content of A+T in all threecodon positions are larger than or equal to 50%. For other 10 Coraciiformmitogenomes, the content of A+T in the second codon positions are greater than50%, whereas the nucleotide bias toward A+T or G+C in the first and third codonpositions are varied in different species (Table S6). The G content in the second andthird codons are low, especially, the G content in the third codons are only3.6% – 6.0% in 13 Coraciiform mitogenomes. The low G content in third codonpositions of mitochondrial PCGs is a common feature in mammalian and avianmitogenomes (TableS6).The nucleotide composition of MT-ND6 is very different from those of other PCGs,so it is not included in the codon usage analyses. Except the stop codons, 12PCGs of the three Coraciiform mitogenomes contain 3,796 , the frequently used codons areNNA and NNC . Eight types of amino acids  are frequently used, among which the leucine is themost frequently used amino acids.Relative synonymous codon frequencies (RSCU) was applied to calculate the codonusage of 12 PCGs of the three Coraciiform mitogenomes, and the results areshowed in A. atthis, H. smyrnensis and M.lugubris .The extra insertion of “C” in MT- ND3 (position 174) that was identified in someavian mitogenomes , and there are 5,483 variable sites . Based oetal., 2015; Combining our results and previously published data  is used as outgroup (Table S1).The relationships among Coraciiformes and several related orders were in debateboth in morphological taxonomic studies , 2005anThe phylogenetic trees inferred from two sets of data have the same topologies. The topThe relationships among three families of Coraciiformes  displayed in our trees  are congPrevious investigations involving different taxa and gene markers (nuclear DNA:The limitation on taxa in this study would be one of the reasons for inconsistentresults between our study and previous researches. More Coraciiform mitogenomedata are necessary to resolve the phylogenesis of Coraciiformes and to test theresults in previous studies. The new mitogenome data presented in this paperrepresent a contribution to this long-term goal.


Starch is a non-fibrous carbohydrate that represents an important percentage of pet food composition. The degree of its gelatinization, due to the cooking process, can be a useful indicator of starch digestibility in the diet. Moreover, fiber fractions are important for animals’ health and nutritional status, so pet food industry is interested in the development of an easy and cost-effective method to measure these parameters. Results of this study revealed the applicability of visible/near-infrared spectroscopy to predict total and gelatinized starch, neutral detergent fiber, acid detergent fiber, and acid detergent lignin in pet food. On the other hand, near-infrared transmittance technology showed a scarce accuracy. The developed prediction models for total and gelatinized starch and fiber fractions using visible/near-infrared spectroscopy could be applied during the manufacturing process to perform quality controls.CrV = 6.33; RPDExV = 4.43), gelatinized starch , neutral detergent fiber , and acid detergent fiber . With NIT, RPDCrV ranged from 1.75 (ADF) to 2.61  and RPDExV from 1.71 (ADL) to 2.16 . In conclusion, results of the present study demonstrated the feasibility of at-line Vis-NIR spectroscopy in predicting total and gelatinized starch, NDF, and ADF, with lower accuracy for ADL, whereas results do not support the applicability of NIT spectroscopy to predict those traits.This study aimed to assess the feasibility of visible/near-infrared reflectance (Vis-NIR) and near-infrared transmittance (NIT) spectroscopy to predict total and gelatinized starch and fiber fractions in extruded dry dog food. Reference laboratory analyses were performed on 81 samples, and the spectrum of each ground sample was obtained through Vis-NIR and NIT spectrometers. Prediction equations for each instrument were developed by modified partial least squares regressions and validated by cross- (CrV) and external validation (ExV) procedures. All studied traits were better predicted by Vis-NIR than NIT spectroscopy. With Vis-NIR, excellent prediction models were obtained for total starch (residual predictive deviation; RPD Starch is a polymer organized in concentric semi-crystalline or amorphous layers constituted by amylose and amylopectin . In compMost of the uncooked cereal starch presents a low digestibility in dogs . TherefoExtrusion reduces apparent nitrogen digestibility, enhances colonic fermentation—as revealed by a decrease in fecal pH associated to the assumption of extruded food —slightlyDue to the importance of both fibrous fractions and non-fibrous carbohydrates for the animals’ health and nutritional status, a further interest of the pet food industry is the development of an on-line or at-line rapid and cost-effective method to measure these parameters in order to monitor food composition. The common reference analyses to quantify starch, gelatinized starch, and fiber fractions  are time-consuming, expensive, and need qualified analysts to be performed. On the other hand, near-infrared spectroscopy is already routinely used in most of pet food factories for the determination of gross composition of their products. This method offers a rapid, objective, easy to manage, chemical-free, and non-destructive analysis of several traits simultaneously at a lower cost than the common reference analyses ,16,17, fInfrared spectroscopy capacity to predict food compounds is based on the bonds between hydrogen and elements like C, O, and N , making total starch, gelatinized starch, and fibrous fractions good candidates to be accurately predicted with this technology. Infrared spectroscopy has already demonstrated its ability to predict proximate composition parameters—such as moisture, protein, and fat—of dog food ,19,20, sA total of 81 sealed commercial packages of 2, 2.5, and 3 kg of extruded dog food intended for puppies and adults of several breed sizes  were colAspergillus niger  with an aliquot of deionized water , dissolved in an ultrasonic bath for 10 min, and made up to volume with deionized water. Two milliliters of the amyloglucosidase solution were added to the sample solution and incubated over night at 40 °C for the enzymatic hydrolysis. After cooling, the whole solution was transferred to a 100-mL glass flask , diluted with deionized water to capacity, and shaken. Then, an aliquot of 10 mL was transferred into a 10-mL PYREX glass tube , centrifuged at 2700× g for 10 min at room temperature (20 °C), and the supernatant was filtered through a 0.45-µm filter. Finally, 10 µL of the filtered supernatant was injected in a high-performance liquid chromatography spectra system equipped with an Aminex HPX 87H column  and aqueous solution of sulfuric acid 0.0025 N as the mobile phase, for the quantification of glucose. The working conditions were: flow rate of 0.6 mL/min and cell internal temperature of 38 °C. A glucose standard solution and a calibration line were made for the quantitative determination of glucose. To prepare the glucose standard solution, 200 mg of D-(+)-glucose anhydrous  were weighed in a 50-mL glass flask and were made up to volume with deionized water. Afterwards, for each calibration level, a known aliquot of the glucose standard solution was put in a 25-mL flask making up to volume with sulfuric acid 0.1 N. Starch quantification was performed in duplicate.Milled samples were analyzed for the total amount of starch using an internal method. Briefly, 500 mg of sample were weighed in a 100-mL PYREX glass tube  and added 50 mL of KOH  0.5 M; the mixture was quickly mixed with an electric vortex mixer, heated in an shaking water bath oscillating 80 times/min at 60 °C for 60 min, and then cooled to room temperature. Thereafter, glacial acetic acid of a high degree of purity (>95%)  was added by pipetting to the solution until reaching a pH between 4.6 and 4.8, measured by pH-meter with temperature probe correction. Subsequently, amyloglucosidase solution was produced by adding in a 50-mL PYREX glass flask  22.5 mg of amyloglucosidase standard from Damaged starch quantification was performed using a Megazyme kit  following the method 76-31.01 of the American Association of Cereal Chemists (AACC) that consists in an enzyme digestion procedure with purified fulgal α-amylase that only affects damaged starch. The oligosaccharides formed were treated with purified amyloglucosidase to obtain the glucose. Even if quantified damaged starch does not completely correspond to gelatinized starch, considering the extrusion process conditions, we assume that all the damaged starch in the matrix undergo gelatinization, and thus, in this case, the two parameters present comparable values ,25. The Each sample was analyzed using two infrared instruments: a visible/near-infrared spectrophotometer in reflectance mode (Vis-NIR) and a near-infrared spectrophotometer in transmittance mode (NIT). Both instruments worked at room temperature (20 °C) and were located in the same laboratory. The same sample was scanned consecutively with both instruments. Spectra were collected using ISIscan Nova and Mosaic software .For the Vis-NIR instrument, 50 g of ground sample were placed in a large FOSS cup  and scanned by NIRS DS2500  from 400 to 2500 nm every 0.5 nm. Each spectrum was the average of 32 subspectra collected during the automatic rotation of the FOSS cup and recorded as log(1/reflectance). For the NIT instrument, the same 50-g ground sample was placed in a sample cup  and scanned by FoodScan  from 850 to 1050 nm every 2 nm. Each spectrum was the average of 16 subspectra collected during the automatic rotation of the cup and recorded as log (1/transmittance).n = 81) and then tested by leave-one-out cross-validation, and (ii) a subset as the calibration set using 75% of the samples (n = 60) and then tested on the remaining 25% of the samples performing an external validation (n = 21). To establish the calibration and the validation set, the complete dataset was randomly divided into two subsets with similar mean and standard deviations for each trait. In the calibration procedure, to increase the accuracy in terms of the coefficient of determination and residual predictive deviation, three passes of outliers elimination were applied. The critical T-statistic value set for T-outliers detection was 2.5, removing the samples whose predicted value deviated more than 2.5 standard errors of cross-validation from the reference value. In order to develop the most accurate calibration models, different combinations of scatter corrections  and mathematical treatments  through modified partial least square regression analysis. The prediction equations for each trait were developed using (i) the complete dataset (moothing ) were ap2C), cross-validation (R2CrV), and external validation (R2ExV); the standard error of calibration (SEC), cross-validation (SECrV), and external validation (SEP); and the residual predictive deviation of cross-validation (RPDCrV) and of external validation (RPDExV), calculated as the ratio of SD to SECrV or SEP, respectively [The best calibrations were assessed based on the number of latent factors (LF), the coefficient of determination of calibration  and the worst for ADL . On the other hand, considering the complete dataset (CrV of the prediction models with NIT ranged from 1.75 (ADF) to 2.61 (ADL). When performing an external validation  and the worst for ADL . On the other hand, in external validation (ExV of the prediction models obtained with NIT ranged from 1.71 (ADL) to 2.16 . Residuals of prediction equations obtained performing cross- and external validations were normally distributed, and bias did not differ statistically from zero.For the complete dataset , all pre dataset , RPDCrV lidation , all prelidation , RPDExV Gross composition  of the sTotal starch content  in the pThe average raw absorbance spectrum for Vis-NIR a is cons2CrV was obtained for total starch using a near-infrared instrument working between 1100 and 2500 nm [2CrV for fiber fractions than the cited authors  [2ExV has been reported for total starch, NDF, ADF, and ADL  using a near-infrared instrument that worked between 1100 and 2500 nm [Fitting statistics of the best prediction models were similar for cross-  and exte 2500 nm . Howeverctively) . When pr 2500 nm  in compaCrV or RPDExV < 2.5; On the other hand, prediction models using NIT were, in general, unsatisfactory (RPDOverall, Vis-NIR resulted to be better than NIT to predict total starch, gelatinized starch, and fiber fractions in extruded dry dog food. The better performance of infrared in reflectance than in transmittance mode has been already reported in meat  and fresThe results obtained demonstrated that total and gelatinized starch, as well as NDF, ADF, and ADL, can be successfully predicted with Vis-NIR spectroscopy. On the other hand, prediction models when using NIT spectroscopy presented low accuracy, which suggests that this instrument is not adequate to predict starch and fiber fractions in extruded dry dog food. A prediction model to determine gelatinized starch during the manufacture of dry dog food could be useful to monitor its proportion with respect to total starch. Moreover, to the best of our knowledge, this is the first time that near-infrared prediction models have been developed to determine gelatinized starch in pet food. Considering the good prediction models for total starch, gelatinized starch, NDF, ADF, and ADL, further studies are needed to confirm the feasibility of Vis-NIR to perform on-line or at-line quality control.


We sought to develop diagnostic models incorporating mpMRI examination to identify PCa (Gleason score≥3+3) and CSPCa (Gleason score≥3+4) to reduce overdiagnosis and overtreatment.We retrospectively identified 784 patients according to inclusion criteria between 2016 and 2020. The cohort was split into a training cohort of 548 (70%) patients and a validation cohort of 236 (30%) patients. Age, PSA derivatives, prostate volume, and mpMRI parameters were assessed as predictors for PCa and CSPCa. The multivariable models based on clinical parameters were evaluated using area under the curve (AUC), calibration plots, and decision curve analysis (DCA).p≤0.001). PSAD has the highest diagnostic accuracy in predicting PCa (AUC=0.79) and CSPCa (AUC=0.79). The multivariable models for PCa  and CSPCa  were significantly higher than the combination of derivatives for PSA  or mpMRI (each p<0.001) in diagnostic accuracy. And the multivariable models for PCa and CSPCa illustrated better calibration and substantial improvement in DCA at threshold above 10%, compared with PSA or mpMRI derivatives. The PCa model with a 30% cutoff or CSPCa model with a 20% cutoff could spare the number of biopsies by 53%, and avoid the number of benign biopsies over 80%, while keeping a 95% sensitivity for detecting CSPCa.Univariate analysis showed that age, tPSA, PSAD, prostate volume, MRI-PCa, MRI-seminal vesicle invasion, and MRI-lymph node invasion were significant predictors for both PCa and CSPCa (each Our multivariable models could reduce unnecessary biopsy without comprising the ability to diagnose CSPCa. Further prospective validation is required. Prostate cancer (PCa) is the most common malignancy of the male reproductive system, and the fifth leading cause of cancer death among men worldwide, with over one million new cases and 358,989 deaths in 2018  with Gleason score (GS) ≥3+4 had been developed in Western countries –9. ReseaStudies have validated the clinical utility of multiparametric magnetic resonance imaging (mpMRI) for the detection and localization of International Society of Urological Pathology (ISUP) grade ≥2 cancers , and demThis retrospective study was approved by the Institutional Ethics Review Board, and a waiver of informed consent was obtained. Between April 2016 and March 2020, mpMRI examination and TRUS-guided prostate biopsy was performed among 903 consecutive patients without a prior PCa diagnosis. The 25 patients diagnosed with other type of tumor/cancer and 94 patients with incomplete data were excluded leaving 784 cases available for analysis Figure 1The clinical variables including the age at prostate biopsy, serum tPSA and fPSA level, PV, reports of mpMRI examination, and results of prostate biopsy were extracted from clinical records. PV was measured by 3.0-T MRI system  using the exact prolate ellipsoid formula: PV = transversal diameter × anteroposterior diameter × vertical diameter × π/6 . The f/tAll mpMRI examinations were performed using the 3.0-T MRI system with a pelvic phased-array coil, complied with European Society of Urology Radiology guidelines. The scan protocol for all patients included T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCE). Additionally, 513 patients included the magnetic resonance spectroscopic imaging (MRSI). The prostate mpMRI images were interpreted by two experienced genitourinary radiologists with at least three years of prostate mpMRI experience. The mpMRI results were divided into groups according to the reports: “negative”, “equivocal”, and “suspicious” for the presence of PCa (MRI-PCa), seminal vesicle invasion (MRI-SVI), and lymph node invasion (MRI-LNI). The “negative”, “equivocal”, and “suspicious” for MRI-PCa corresponded to the PI-RADS 1 or 2, PI-RADS 3, and PI-RADS 4 or 5 according to the latest Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) guideline. The suspicious MRI-SVI was defined as loss of normal high signal within and/or along the seminal vesicles . The susAll patients underwent TRUS-guided systematic 12-point biopsy according to the same protocol by three surgeons. If suspected malignant nodules by mpMRI and/or ultrasound, additional 1–5 needles were performed in regions with cognitive MRI-TURS fusion and/or abnormal ultrasound echoes. Biopsy cores were analyzed according to the standards of ISUP .2 test or Fisher’s exact test was used to analyze categorical data. The Bonferroni method for multiple comparisons was used if significant difference between groups was noted. The univariable and multivariable logistic regression were performed to identify significant predictors of PCa and CSPCa on biopsy. The models were examined with the receiver operating characteristics (ROC) curve and calibration plots, and the clinical utility was evaluated with a decision-curve analysis (DCA) , PV, and mpMRI parameters  of enrolled patients by pathological diagnosis. Student’s t test or ANOVA was used to analyze continuous data. The Mann-Whitney U test was used to analyze ranked data. The χis (DCA) . The ROC2, and 51 (34–74) ml, respectively. The MRI-PCa, -SVI, and -LNI were classified as “suspicious” in 355 (45%), 118 (15%), and 32 (4%) patients, respectively. Prostate biopsy results were negative for 457 (58%) cases and positive for 327 (42%) cases. Of the 327 PCa patients, 46 (14%) were with GS≤3+3, 50 (15%) were with GS=3+4, 88 (27%) were with GS=4+3, and 143 (44%) were with GS≥4+4  and 236 (30%) men, respectively (p<0.001), tPSA , and PSAD  were significantly higher in PCa patients compared with no-PCa (p<0.001) and PV  was smaller in CSPCa compared with patients without CSPCa .In univariable logistic regression analysis, all clinical variables excepting f/tPSA were significant predictors for PCa and CSPCa (each p≤0.001). The multivariable model for CSPCa was established including age (p=0.002), tPSA (p<0.001), PV (p<0.001), MRI-PCa (p<0.001), MRI-SVI (p<0.001), and MRI-LNI (p<0.001)  or mpMRI examination (each p<0.001) in diagnostic accuracy  Table 3.To further assess potential clinical benefit of the multivariable models, we performed DCA using the predicted risk in the validation cohort. It was observed that the multivariable model for PCa had the highest net benefit across the threshold probabilities above 10% Table 4.In our study, we assessed the performance of age, PSA derivatives, PV, and mpMRI parameters in diagnostic of PCa and CSPCa. This study revealed that age, tPSA, PSAD, PV, MRI-PCa, MRI-SVI, and MRI-LNI were significant predictors for both PCa and CSPCa. Additionally, we developed multivariable models based on clinical parameters including mpMRI derivatives, which outperformed the combination of PSA or mpMRI derivatives in diagnostic of PCa and CSPCa. Use the multivariable PCa model with a cutoff of 30% or CSPCa model with a cutoff of 20% could spare the number of prostate biopsies by 53%, avoid the number of benign biopsies over 80%, and reduce the number of low-risk PCa diagnosis by 50%. Importantly, this can be achieved without compromising the ability to detection of CSPCa.In this study, we analyzed the relationship between clinical characteristics and GS, and found the non-linear pattern between f/tPSA and PV, and GS. This may explain the inconsistent performance of f/tPSA in detecting of PCa , 24, andThe mpMRI improved the detection of CSPCa due to its anatomic detail, emerging accessibility, and addition of functional data. A growing body of literatures has validated the clinical utility of mpMRI in the detection and localization of CSPCa , 27, 28.Furthermore, we developed multivariable models, which outperformed PSA and mpMRI derivatives in prediction of PCa and CSPCa. Using a PCa risk threshold of 30% or CSPCa risk threshold of 20% would spare 53% of prostate biopsies and avoid over 80% of benign biopsies at the cost of missing 5% of CSPCa. Although cross-study comparisons are challenging, the multivariable models based on clinical parameters performed better than Huashan risk calculators  , CRCC-PCOur study was subject to several limitations. First, this study was a single center study and limited by the inherent drawbacks of its retrospective design. Second, the PI-RADS v2 scores were not used in our study and no central review of mpMRI examination was present. However, the combination of mpMRI parameters including MRI-PCa, -SVI, and -LNI performed similar with PI-RADS v2 in diagnostic of PCa (AUC=0.84 vs 0.83–0.86) , 36, andOur study found the non-linear pattern between f/tPSA and PV, and GS, and demonstrated that age, tPSA, PSAD, PV, and mpMRI parameters were significant predictors for both PCa and CSPCa. The multivariable model for PCa with a 30% cutoff or the CSPCa model with a 20% cutoff, could spare the number of unnecessary biopsies by 53%, avoid the number of benign biopsies over 80%, and reduce the number of low-risk PCa diagnosis by 50%, while missing only a minimal number (5%) of CSPCa. Further prospective validation is required.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.The studies involving human participants were reviewed and approved by Ethics Review Committee of life sciences, Zhengzhou University. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.XZ and SY conceptualized, designed, and supervised the study. GH, SY, JT, YS, JL, BD, YF, ZL, and AZ coordinated and participated data collection. SY and YS carried out the statistical analysis and drafted the manuscript. XZ and JT provided guidance on data analysis. XZ and YS revised the manuscript. All authors contributed to the article and approved the submitted version.This work was supported by grants from the Henan Medical Science and Technology Project [grant no. LHGJ20190181] and the Henan Science and Technology Project [grant No. 162102310204].The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Difficulty in primary fascial closure of the abdomen in transplant patients is a common challenge. Abdominal wall tension may have detrimental effects on the newly transplanted graft due to compression, and blood flow hindrance, potentially leading to ischemia or thrombosis and possibly graft failure. Furthermore, patients will be at risk of developing fascial ischemia and dehiscence. Myocutaneous flaps, temporary closure with silastic mesh, abdominal wall transplants, and even graft reduction, bowel resection, and splenectomies have been practiced with varying degrees of success. In this study, we present four cases of patients who underwent orthotopic liver transplantation (OLT) with bridging Vicryl knitted mesh (ETHICON VKML VICRYL-Polyglactin 910-30 × 30 cm) to relieve the tension during the closure. Our results show that these patients, despite having a high average Model End-Stage Liver Disease (MELD) score of 25, had a good liver function at the time of discharge and continue to upon follow-up. They had a relatively short length of stay (LOS) in both the intensive care unit (ICU) and in the hospital, an average of 3.5 days and 9 days, respectively. Our case series successfully show that utilizing a bridging Vicryl knitted mesh is a reasonable approach to attain tension-free abdominal closure in OLT with satisfying results. Tension-free abdominal closure is a well-described concept for a successful postoperative course in surgery. Large-for-size liver transplants present a challenge to achieving a tension-free primary abdominal closure. Even in cases of closely matched liver size, edema of the graft or the bowel may develop after intraoperative resuscitation, portal vein clamping, and organ reperfusion, making primary tension-free closure impossible . The risSeveral techniques have been described to allow tension-free abdominal closure, including myocutaneous flaps, temporary closure with silastic mesh, component separation, abdominal wall transplants, graft reduction, and even splenectomies and bowel resection. However, not all of these methods are advantageous in OLT patients. For example, component separation is another option to relieve tension but is commonly done with vertical incisions instead of the transverse incision used in OLT . Myocuta3) (as estimated by donor preoperative CT volumetric studies) and was deemed to be large relative to the patient's abdomen. At the end of the transplant, the fascia could not be closed primarily without risking compression of the graft. A Vicryl knitted mesh was used as a bridge to close the fascia without tension. She did well postoperatively and was discharged on postoperative day 6. During the course of her follow up, she developed a right anterolateral ventral hernia. The repair has been delayed due to concerns of recurrence given her BMI of 33. Her transplanted liver is doing well, with normal liver function tests at 21 months postoperatively.Patient 1 is a 69-year-old female whose primary cause of the liver disease was nonalcoholic steatohepatitis complicated by hepatocellular carcinoma (HCC). Her preoperative Model End-Stage Liver Disease (MELD) score was 9 and 28 after the addition of HCC points. She also had multiple medical comorbidities including hypertension, obstructive sleep apnea, and obesity and a past surgical history of Cesarean section and hysterectomy. She received a deceased donor orthotopic liver transplant, performed with piggyback technique of veno-veno bypass with an arterial reconstruction of donor celiac artery to recipient right replaced hepatic artery and choledocho-choledochostomy. Patient 1 had a height of 154.9 cm and a weight of 84.4 kg, while the donor had a height of 170.2 cm and a weight of 122.6 kg, giving a donor-weight-to-recipient-weight ratio of 1.45. The liver had a volume of 2049 cubic centimeters (cm3 (as estimated by donor preoperative CT volumetry.) His height was 165 cm and his weight was 66.9 kg, and his donor's height and weight were 172.2 cm and 70.7 kg, respectively. His donor-weight-to-recipient-weight ratio was 1.05. The transplant was performed using a piggyback technique of veno-venous bypass with a choledocho-choledochostomy and recipient ductoplasty. Primary fascial closure was not possible due to the large liver size, so a bridging Vicryl knitted mesh was inserted in the right subcostal region to prevent abdominal compartment syndrome. On postoperative day 4, the patient's liver enzymes were elevated, requiring a transjugular liver biopsy that showed mild acute cellular rejection. This was resolved with three days of pulse steroids. The patient recovered well and was discharged on postoperative day 11. MRI performed 4 months postoperatively demonstrated a hernia in the lateral abdominal wall. The patient remains asymptomatic and does not wish to pursue repair. Graft function remains excellent at 26 months post-op.Patient 2 is a 54-year-old male with hepatitis C with subsequent hepatocellular carcinoma as a primary cause of liver disease, complicated by esophageal varices, portal hypertension, and ascites requiring paracentesis. His preoperative MELD score was 17. He received a deceased donor orthotopic liver transplant with a graft volume of 1670 cm3 (as estimated by donor preoperative CT volumetry). At the time of surgery, her height was 167.6 cm, and her weight was 78.1 kg. Her donor height and weight were 165.1 cm and 92 kg, respectively, giving a donor-weight-to-recipient-weight ratio of 1.18. The transplant was performed using the piggyback technique on veno-venous bypass with choledocho-choledochostomy and recipient ductoplasty. A large amount of ascites was evacuated intraoperatively. Due to large graft size, a bridging Vicryl knitted mesh was placed in the right lateral part of the chevron incision to avoid compartment syndrome. On postoperative day 4, the level of her liver enzymes was acutely elevated. Liver ultrasound showed normal resistive indices, and she was started on stress dose steroids for suspected acute cellular rejection. Her liver enzymes responded appropriately to the steroids. Her postoperative course was also complicated by hypotension requiring pressors for 48 hours, acute kidney injury, and ileus, all of which resolved by her discharge on postoperative day 10. She is currently five months postoperatively, and her liver enzymes remain within normal limits.Patient 3 is a 59-year-old female whose primary cause of the liver disease was nonalcoholic steatohepatitis with a preoperative MELD score of 29. Her liver disease was complicated by hepatic encephalopathy and ascites requiring paracentesis. Her comorbidities included depression, anxiety, colitis, and tricuspid regurgitation, and history of roux-en-y gastric bypass. She received a deceased donor orthotopic liver transplant with a graft volume of 1977 cm3 (as estimated by donor preoperative CT volumetry) using the piggyback technique of veno-venous bypass with a choledocho-choledochostomy and portal vein eversion thrombectomy. Her height was 154.9 cm, and her weight was 56.5 kg, while her donor's height and weight were 157.5 cm and 63.3 kg, respectively, giving a donor-weight-to-recipient-weight ratio of 1.12. Due to concerns of compartment syndrome because of large graft size, a bridging mesh was utilized to achieve a tension-free fascial closure. Her postoperative course was complicated by possible acute rejection evidenced by elevated alkaline phosphatase, which responded to 3 days of stress-dose steroids. She was discharged on postoperative day 8. She is currently 8 months postoperatively and doing well with good graft function.Patient 4 is a 61-year-old female whose cause of the liver disease was primary biliary cirrhosis complicated by ascites not requiring paracentesis and esophageal varices, with a preoperative MELD of 26. Her medical history also included diffuse alveolar lung disorder and fibromyalgia. She received a deceased donor orthotopic liver transplant with a graft volume of 1909 cmn = 4) with three females and one male. The average MELD score of our four patients was 25. The average donor weight-to-recipient ratio in our patients was 1.20. Length of stay (LOS) in the intensive care unit (ICU) and in the hospital was an average of 3.5 days and 9 days, respectively.Our case series had four patients (Various methods of abdominal wall closure have been proposed especially in patients undergoing visceral transplantations , 4, 7. MThe concept of tension-free closure is well-known in the surgical world for successful repairs and healing , 5. Thisp < 0.005 [The average donor weight-to-recipient ratio in our patients was 1.20. This disparity can be compared with a study by Carlsen and colleagues. They found in their study that patients with difficulty in primary abdominal closure had a significantly higher donor weight-to-recipient weight ratio, 1.09 vs. 0.64,  < 0.005 . Body we < 0.005 . As suchAs briefly discussed earlier, there are multiple methods of achieving tension-free abdominal closure. Benedetto et al. demonstrated 3 patients that underwent myocutaneous flaps and one patient that underwent abdominal wall transplantation . AlthougOther methods to compensate for the loss of domain have included graft reduction, splenectomy, bowel resection, complete adhesiolysis to maximize intraperitoneal space, and optimizing fluid resuscitation by utilizing colloid fluids . NeedlesAs discussed, the aforementioned methods of achieving tension-free abdominal closures have advantages and disadvantages. We elected for a bridging Vicryl mesh at the time of the surgery for our patients. Our patient population had not only multiple comorbidities but also a high MELD score. The risk of patients having postoperative complications is increased with increased MELD, and the average MELD score of our four patients was 25. The patients are generally frail, debilitated, and ill at the time of surgery. Our goal was to perform a safe surgery to salvage and optimize graft function and minimize the operation time and recovery time for these patients. We were able to achieve these goals, as represented by the short LOS in the ICU and in the hospital. The average operation times for these patients were also approximately 8.7 hours. All of these patients, at current follow-up, have excellent graft function with 0% mortality. Moreover, utilizing a Vicryl mesh is advantageous as re-exploration in the immediate postoperative period would be easily achieved, and replacing the Vicryl mesh is technically feasible and cost-effective.Due to the well-known risks of closing the fascia under tension, we elected to use a bridging Vicryl mesh. Although two patients in our case series developed incisional hernias, their overall recovery and improved clinical status due to functioning graft would allow a safe and more controlled condition for an elective incisional hernia repair in the future. There was no need for reoperations in any of our patients which expedited recovery and shortened hospital stay.The two patients in our group have not undergone repair for distinct reasons. Patient 1 has a high BMI of 33 that will drastically increase her likelihood of recurrence despite repair. Patient 2, on the other hand, has no adverse effects from the hernia and has chosen the nonoperative management. The justification for Vicryl mesh as our choice for reconstruction is based on the fact that it is an absorbable mesh. By incorporating a mesh that will eventually be absorbed, the risk of infection due to a foreign object in the body is minimized. Even though absorbable mesh may have a higher incidence of developing hernia when used as a bridging mesh, if and when repairs are pursued in the future, this will be technically less challenging. Moreover, we always inserted the mesh in the right subcostal region lying directly on the liver surface so that there would be no contact between the mesh and other viscera preventing any fistula formation. Furthermore, utilizing a permanent mesh in immunocompromised transplant patients will have a potential increased risk of infection, which may be detrimental in the outcome. They are also at higher risk of erosion into abdominal viscera, adhesions, fistula formation, and infections due to the nonabsorbable nature .The incidence of incisional hernia after OLT has been reported to range between 1% and 32.4% –16. The We have demonstrated four patients that have safely undergone OLT despite concerns of donor-recipient size mismatch with a satisfactory postoperative course with the utilization of Vicryl bridging mesh. Even with higher MELD score and multiple comorbidities, their LOS in the ICU and the hospital was short. Also, all of the grafts are functioning well at most recent follow-up appointments. All patients underwent OLT with a piggyback technique despite the large size of the graft without any signs of caval compression by the large graft. In our experience, Vicryl bridging mesh can serve as an effective and safe tool for preventing graft compromise in recipients that are at risk of abdominal closure with tension at the time of transplant.Multiple methods of achieving a tension-free abdominal wall have been proposed in the literature in transplant candidates. The experience at our institution shows that using Vicryl bridging mesh is a safe and acceptable method to prevent abdominal compartment syndrome in these patients, without the need for multiple immediate operative interventions and with excellent graft and patient survival.


The values of density and internal bond strength meet the standard requirements of general-purpose lightweight boards for use in dry conditions according to CEN/TS 16368 specification. Moreover, the susceptibility of the formulations with best results was established against subterranean termites and one decay fungi.In the present work, and for the first time, totally biosourced low-density particleboards were produced using cardoon particles , bound with a potato starch adhesive. Different starch/cardoon ratios  were tested and the effect of different bio-based additives  on the performance of the adhesive system was evaluated. The best result was obtained for a formulation with a starch/cardoon mass ratio of 0.8, a chitosan/starch mass ratio of 0.05 and a water/starch mass ratio of 1.75. The particleboards produced had a density of 323 kg·m Particleboards with a density below 600 kg·m systems .In general, the adhesives used in the production of particleboards are based in formaldehyde in combination with urea and/or melamine or phenol, due to their good adhesive performance, high reactivity and lower price ,3,4. HowStarch has been one of the most studied natural products due to its low cost, biodegradability, renewability and good binding properties, in particular for cellulosic substrates ,7,8,9. TCynara cardunculus L.) is native to the Mediterranean basin and belongs to Asteraceae Dumortier family. Its main components, cellulose and lignin, are present in varying amounts, depending on the part of the plant considered [−3 for stalk particles with 20–30 mm. The authors further determined densities of 218 kg·m−3 for depithed stalks  and 75 kg·m−3 for the pith material. Quilhó et al. [−3 for whole stalks and 160 kg·m−3 for the depithed stalks. Gil et al. [−3 for milled stalks and branches.Cardoon  and good mechanical properties - CEN/TS 16368) [The goal of the present work is therefore to evaluate the viability of producing low-density particleboards with cardoon particles, instead of wood particles and a potato starch-based adhesive. The effect of adding other components to the adhesive system  is also studied. This type of formulation has been used successfully in our previous works ,25 but tS 16368) . FurtherS 16368) ) the susPinus pinaster Ait.) fibers were provided by Valbopan-Fibras de Madeira S.A .Potato starch was supplied by Diverembal Lda. . Glycerol (99.59%) and propionic acid (99%) were supplied by José Manuel Gomes dos Santos Lda. . Chitosan . Cardoon was provided by Casa da Ínsua  and chipped and sifted at Polytechnic Institute of Viseu (IPV). The fraction retained corresponded to mesh sizes between 0.25 and 4 mm. The moisture content of the particles was 10%. Maritime pine (Pinus pinaster Ait.) fibers and glycerol were added and stirring was maintained for 5 min.A cassava starch-based binder formulation described in our previous works with pine wood particleboards ,25 was uThe determination of the contact angle on the surface of the different cardoon stalk fractions  was done using a mobile surface analyzer—MSA—Kruss . The analysis was performed at 20 °C. And the test liquid used was distilled water. The drop volume was 2 μL for the cortex and epidermis. The MSA doses the drop automatically, followed by the direct analysis of the contact angle within milliseconds.3. A computer controlled laboratory-scale press, equipped with a linear variable displacement transducer (LVDT), pressure transducer and thermocouples, was used to produce the particleboards.Cardoon particles were blended manually with the adhesive system. All the particleboards produced were prepared with 200 g dry solids content . Single layer particleboards were hand formed in square aluminum deformable containers, with dimensions of 220 × 220 × 80 mmThe adhesive/cardoon mixture was placed on the bottom platen and pressed to 16 mm thickness for 60 seconds. After this, the top platen was raised to 22 mm thickness and the panel was maintained in the press for 240 seconds. The press platen temperature was 190 °C. After pressing, panels were dried at (20 ± 2) °C and relative humidity of (65 ± 5)% till constant mass. During this process boards suffer shrinkage, due to loss of water, attaining thickness between of 16 and 20 mm, depending on the adhesive formulation, which results in different final densities. Seven boards were produced for each adhesive formulation tested.Density measurements were performed according to EN 323 . The sam2.Moisture content was measured according to EN 322 . It is t2. The test pieces are glued to the metal loading block using a hot-melt glue (ethylene vinyl acetate). The specimen is subject to a tensile force at constant speed until rupture occurs.Determination of tensile strength perpendicular to the plane of the board, also known as internal bond strength, was performed according to EN 319 . The spe2, was evaluated after complete immersion in water for 24 h.Thickness swelling was determined according to the method described in EN 317 [Reticulitermes grassei Clément) was tested according to an adaptation of EN 117 [Gloeophyllum trabeum (Pers.) Murrill.Samples (approx. 30 mm × 10 mm × board thickness) were cut from three of the boards with best results . The susceptibility to subterranean termites (f EN 117  with smaf EN 117  was usedPinus pinaster Ait.) untreated solid wood samples with similar dimensions (30 mm × 10 mm × 10 mm) were included as virulence controls on both tests.Maritime pine (All specimens were conditioned at (20 ± 1) °C and relative humidity of (65 ± 5)% for at least 2 weeks prior to testing. The average initial moisture content measured with an extra set of 4 replicates was 13% for maritime pine and 15% for the cardoon boards.Contact angles were measured using the sessile drop method. A droplet of water was placed on the surface of the central pith, cortex and epidermis in order to determine relative wettability. The results are shown in In the present work, different binder compositions were tested for the production of particleboards. Firstly, the impact of different starch/cardoon ratio on the physico-mechanical properties of the panels was evaluated. The starch/cardoon dry mass ratios tested were 0.6, 0.8, 1 and 1.2. The water/starch mass ratio was 2 and chitosan and wood fiber were not present in the formulation at this point.The particleboards produced had a moisture content between (19.0 ± 0.4)% and (19.1 ± 0.6)%. The internal bond strength and the final densities of the particleboards produced with the different starch/cardoon ratios are shown in −3. The lowest densities were achieved for panels produced with the lowest starch/cardoon ratio, 0.6. This is an expected result taking into account that cardoon is less dense than potato starch. A decrease in starch/cardoon ratio leads to a decrease in the particleboard density, since it is increasing the fraction of the component with lower density.The obtained densities vary between 290 and 372 kg·m−2. The goal of the present work is to produce particleboards with the lowest density possible, maintaining good bond quality  is known to have good affinity towards starch, both due to hydrogen bonding and electrostatic interaction between the amine groups of chitosan and the phosphate groups of potato starch . The comChitosan was added to the previous formulations in order to obtain chitosan/starch ratios of 0.05. The results of internal bond strength and the densities for the particleboards produced are shown in −3, which is similar to the range obtained for particleboards produced without chitosan. On the other hand, a significant improvement is observed in internal bond strength—the values are, in some cases, about twice the ones obtained without chitosan. This confirms the predicted positive effect of the polysaccharide in the particleboard’s cohesion. The internal bond strength is observed to increase with density, as expected.The densities vary between 273 and 407 kg·mThe thickness swelling results are shown in −2.Starch/cardoon ratios of 0.6 and 0.8 were selected to the ensuing studies, since these yielded the lowest densities, with mechanical resistances around the target threshold of 0.30 N·mmWood fiber has been reported as being an effective reinforcing filler for starch foam . In the −3, while those produced with a starch/cardoon ratio of 0.8 had densities between 286 and 334 kg·m−3 (The panels produced had a moisture content between (16.9 ± 0.1)% and (20.2 ± 0.2)%. The particleboards with a starch/cardoon ratio of 0.6 exhibit densities between 247 and 290 kg·m4 kg·m−3 .The combination of wood fiber with starch decreases very significantly the internal bond strength of the panels. When chitosan is added, the performance decay is less notorious. Wood fiber is not easily dispersible in the starch suspension, tending to form agglomerates. This has a detrimental effect of mechanical resistance, since these act as defects with low cohesion. Chitosan was seen to facilitate significantly fiber deagglomeration/dispersion. This results from the joint effect of high shear, due to higher viscosity of the medium when chitosan is present and the possible action of chitosan as a surfactant for the fibers dispersion in water. Nevertheless, the combination of chitosan and fibers does not provide better strength than chitosan alone. It must be noted that this binder formulation has very high viscosity and it is difficult to guarantee a homogeneous mixture with the cardoon particles.The thickness swelling results are shown in Glycerol is an effective plasticizer for starch, as the intermolecular chain interactions (strong hydrogen bonding and chain entanglements) are replaced by stronger interactions with glycerol. This results in higher chain mobility, therefore decreasing stiffness ,42. This−3 for starch/cardoon ratio of 0.6, while for panels produced with starch/cardoon ratio of 0.8 the densities vary between 312 and 333 kg·m−3.The density of the particleboards produced with different glycerol/starch ratios  are shown in The addition of glycerol had no positive effect on the internal bond strength of the particleboards. In fact, it is possible to observe a decreasing trend on the resistance of the panels. Glycerol molecule, as efficient starch plasticizer, builds between polysaccharide molecules, what results in decreasing brittleness but also tensile strength of the polysaccharide matrix.The thickness swelling results are shown in Water plays a key role on the binder performance, since it is responsible for starch gelatinization, which is paramount for the adhesion process, so that interaction of starch chains with the particles surface is maximized. On the other hand, too much water lengthens the drying time of the particleboards . Differe−2) was achieved for particleboards with a ratio water/starch of 2.25. This results from the more effective starch gelatinization process under excess water. Complete gelatinization is essential for starch’s crystalline double-helix chains to dissociate, breaking up the granules and therefore exposing the hydroxyl groups for interaction with the substrate.Bond resistance increases steadily with the amount of water in the adhesive formulation. The best internal bond performance (0.49 N·mm−3) and internal bond strength ≥ 0.30 N·mm−2. However, in order to minimize the drying time, the particleboards produced with a water/starch ratio of 1.75 satisfy the goal of this work. An example of a panel produced in these conditions is shown in The particleboards produced with starch/cardoon ratio of 0.8 and water/starch ratio of 2.25 meet the proposed objectives, density ≤ 400 kg·mThickness swelling results are shown in −3 with internal bond strength of 0.35 N·mm−2 and thickness swelling of 15.2%.The work’s goals were attained with the adhesive formulation contained starch/cardoon ratio of 0.8, a cs/starch ratio of 0.05 and water/starch ratio of 1.75. The particleboards produced with this adhesive formulation have a density of 323 kg·mAs can be seen in G. trabeum, the test-specimens were carefully removed from the test flasks and the external visible fungal hyphae cleaned as much as possible. The specimens were then weighed and final dry mass determined by the oven method at 103 °C. The final moisture content and mass loss was calculated and is presented in After the six weeks exposure period to In this case, the cardoon/starch panels show higher susceptibility towards fungi attack, yielding about twice the mass loss of maritime pine wood. This is probably a consequence of fungi attack on starch, the starch may serve as nutrition supplement for the fungi.−3 and internal bond strength of at least 0.30 N·mm−2.This work proposes the use of cardoon particles bound with potato starch adhesive for production of lightweight particleboards appropriate for interior furniture. The aim was to produce totally biosourced panels with density below 400 kg·m−3. Density increases with the relative amount of potato starch. The internal bond strength follows the increase of density. The values obtained varied between 0.13 and 0.40 N·mm−2.The particleboards produced with starch/cardoon ratios ranging from 0.6 to 1.2 had densities between 290 and 372 kg·m−2), with practically no change in density. The enhancement in mechanical properties may result from electrostatic interaction between amine groups of chitosan and phosphate groups of starch, as well as from hydrogen bonding between chitosan and cellulose.The addition of chitosan to the starch adhesive leads to a notorious improvement in internal bond strength of the panels for all starch/cardoon ratios studied (0.19 to 0.89 N·mmThe introduction of wood fiber in the formulation was detrimental to the mechanical properties of the particleboards due to poor dispersibility of fibers. The presence of chitosan was seen to improve the dispersion and consequently the mechanical performance of the panels. However, better results were obtained with chitosan alone, so it was concluded that the fibers do not provide a reinforcement effect in this system.Glycerol, which is a well-known plasticizer for starch, was tested, since a reduction in the stiffness of the binder could be beneficial for the particleboards’ mechanical resistance. However, no improvement was observed.The amount of water proved to be an important component in the adhesive system. The internal bond strength of the cardoon panels improved with the increase of the water to starch ratio, probably due to more effective starch gelatinization, leading to better binder cohesion.The starch-based panels showed the same behavior towards termite attack as maritime pine wood. On the other hand, exposure to fungi caused about two times more mass loss on the composite panels than on the reference maritime pine, certainly due to starch’s susceptibility towards microbial attack.−3, with an internal bond strength of 0.35 N·mm−2 and thickness swelling of 15.2%. The combination of cardoon particles with starch-based binder is therefore a promising biosourced solution for low-density particleboards appropriate for interior furniture where the problems related to possible biological deterioration are minimized.The best adhesive formulation consisted of a starch/cardoon ratio of 0.8, chitosan/starch ratio of 0.05 and water/starch ratio of 1.75. The particleboards produced with this adhesive formulation presented density of 323 kg·m