Increased Hepcidin Levels During a Period of High Training Load Do Not Alter Iron Status in Male Elite Junior Rowers.

Abstract: The liver-derived hormone hepcidin plays a key role in iron metabolism by mediating the degradation of the iron export protein ferroportin 1 (FPN1). Circulating levels of hepcidin and the iron storage protein ferritin are elevated during the recovery period after acute endurance exercise, which can be interpreted as an acute phase reaction to intense exercise with far-reaching consequences for iron metabolism and homeostasis. Since absolute and functional iron deficiency (ID) potentially lead to a loss of performance and well-being, it is surprising that the cumulative effects of training stress on hepcidin levels and its interplay with cellular iron availability are not well described. Therefore, the aim of this study was to determine serum levels of hepcidin at six time points during a 4-week training camp of junior world elite rowers preparing for the world championships and to relate the alterations in training load to overall iron status determined by serum ferritin, transferrin, iron, and soluble transferrin receptor (sTfR). Serum hepcidin levels increased significantly (p = 0.02) during the initial increase in training load (23.24 ± 2.43 ng/ml) at day 7 compared to the start of training camp (11.47 ± 3.92 ng/ml) and turned back on day 13 (09.51 ± 3.59 ng/ml) already, meeting well the entrance level of hepcidin at day 0. Serum ferritin was significantly higher at day 7 compared to all other timepoints with exception of the subsequent time point at day 13 reflecting well the time course pattern of hepcidin. Non-significant changes between training phases were found for serum iron, transferrin, and sTfR levels as well as for transferrin saturation, and ferritin-index (sTfR/log ferritin). Our findings indicate that hepcidin as well as ferritin, both representing acute phase proteins, are sensitive to initial increases in training load. Erythropoiesis was unaffected by iron compartmentalization through hepcidin. We conclude that hepcidin is sensitive to rigorous changes in training load in junior world elite rowers without causing short-term alterations in functional iron homeostasis.

Zügel|Martina|M|
Treff|Gunnar|G|
Steinacker|Jürgen M|JM|
Mayer|Benjamin|B|
Winkert|Kay|K|
Schumann|Uwe|U|

ferritin
exercise
transferrin
soluble transferrin receptor
inflammation
iron supplementation
rowing


A quantitative evaluation of a 2.5-kb rat tyrosine hydroxylase promoter to target expression in ventral mesencephalic dopamine neurons in vivo.

Abstract: Adeno-associated viruses (AAVs) have become powerful tools in neuroscience for both basic research and potential therapeutic use. They have become especially important tools for optogenetic experiments based on their ability to achieve transgene expression in postmitotic neurons with regional selectivity. With the use of appropriate promoter elements they can achieve cellular specificity as well. One population of neurons that plays a central role in human neurodegenerative and psychiatric diseases are the dopamine neurons of the midbrain. To study these neurons in vivo with advanced techniques it would be highly advantageous to characterize an appropriate specific promoter. To this end we have characterized a 2.5-kb sequence of the rat tyrosine hydroxylase (TH) promoter. The rTHp(2.5) promoter induced expression of the fluorescent reporter protein mCherry in SN dopamine neurons. Although it showed excellent specificity in cortex and striatum, where no reporter expression was observed, in the SN region many neurons expressed reporter but not TH. We show that some of the TH negativity is due to the suppression of its expression by the transgene. We conclude that rTHp(2.5) does preferentially label dopamine neurons but its specificity is not complete within the substantia nigra and caution must be used.

Rolland|Anne-Sophie|AS|
Kareva|Tatyana|T|
Kholodilov|Nikolai|N|
Burke|Robert E|RE|

tyrosine hydroxylase
promoter
dopamine
AAV
substantia nigra


Urinary iodine and sodium concentration and thyroid status in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Abstract:
OBJECTIVES
To evaluate urinary iodine concentration (UIC) in civil servants aged 35-74 years of the Brazilian Study of Adults Health (ELSA-Brasil) to analyze its relationship with sociodemographic, clinical risk factors, lifestyle, urinary Na and thyroid status.

DESIGN
Cross-sectional study in six Brazilian cities.

METHODS
This analysis included 792 participants with information about urinary iodine concentration (UIC). Thyroid status was defined by serum levels of TSH/FT4 and the current use of antithyroid drugs for treatment of overt hyperthyroidism or levothyroxine to treat overt hypothyroidism. The determination of UIC was carried out with an inductively coupled plasma mass spectrometer (ICP-MS) and was expressed as median with Interquartile Range (IQR).

RESULTS
In 792 participants, thereof 52% women, mean age was 51.9 (9.0) years. The median UIC was 219 (IQR, 166-291) for all persons studied, thereof 211 (IQR, 157-276) for women and 231 (IQR, 178-304) for men. According to the WHO classification, for all persons studied, 60% had more than adequate iodine-supply (UIC ≥200 μg/L), 37% were adequately supplied (UIC 100-199 μg/L) and <3% had a deficient iodine status (<100 μg/L). In the 35-44-year age strata, which includes women of childbearing age, 23.2% of women presented less than 150 μg/L of UIC. No differences in UIC were detected according to thyroid status. (P = 0.39) The correlation between Ur-Na and UIC showed a Spearman coefficient of 0.52 (P < 0.0001) and it was also found an association of Ur-Na with UIC: Beta of 1.76 (95% Confidence Interval (95% CI): 1.01 to 2.51. The urinary Na concentration showed a synergy with the UIC, that means medians of 57, 72, 107 and 141 mmol Na/L urine (P < 0.001) in the groups with the four UIC classes according to the WHO grading mentioned above. The very low Na content in the persons exhibiting <100 μg/L UIC seems to reflect also a higher urine volume due to the frequent use of diuretics. The strong relationship between the urinary Na concentration and the UIC points to a dependence of the UIC on the individual consumption of iodized salt, which should be more considered in future studies. The strong relationship between the urinary Na concentration and the UIC points to a dependence of the UIC on the individual consumption of iodized salt, which should be more considered in future studies.

CONCLUSIONS
Euthyroid persons were dominating by more than four fifths and no significant association was found between UIC and thyroid status. Although most of the persons studied present more than adequate iodine intake it was observed that nearly a quarter of women in childbearing age are iodine deficient.

Janovsky|Carolina Castro Porto Silva|CCPS|

de Fátima Haueisen Sander Diniz|Maria|M|

thyroid status
Urinary iodine concentration
risk factors
iodized salt
urinary sodium concentration.


Phantom pain as an adverse effect after maggot (Lucilia sericata) debridement therapy: a case study.

Abstract: Maggot debridement therapy, also known as larval therapy, is a well known method of treatment for hard-to-heal and intractable wounds. This case study describes severe phantom pain as a rare adverse event of maggot therapy in patients after post-traumatic amputation of the leg. We also hypothesise and discuss the possibility that the phantom pain may be a result of maggot activity, not only through tissue debridement but also through nerve nourishment and nerve regeneration.

Lipiński|Przemysław|P| Trzciński|Radzisław|R| Dziki|Łukasz|Ł| Mik|Michał|M|

phantom pain
treatment
maggot therapy
hard-to-heal wound
stump


Factors associated with treatment-seeking for malaria in urban poor communities in Accra, Ghana.

Abstract:
BACKGROUND
In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana.

METHODS
This cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15-59 years for men and 15-49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria.

RESULTS
Overall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment.

CONCLUSIONS
The findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria within the context of urban poverty.

Awuah|Raphael Baffour|RB|
Asante|Paapa Yaw|PY|
Sakyi|Lionel|L|
Biney|Adriana A E|AAE|
Kushitor|Mawuli Komla|MK|
Agyei|Francis|F|
de-Graft Aikins|Ama|A|

D007722:Health Knowledge, Attitudes, Practice

D010342:Patient Acceptance of Health Care

Malaria
Urban poor communities
Accra
Ghana
Treatment seeking


Nebulizing poractant alfa versus conventional instillation: Ultrastructural appearance and preservation of surface activity.

Abstract:
BACKGROUND
Nebulized surfactant therapy has been proposed as an alternative method of surfactant administration. The use of a perforated vibrating membrane nebulizer provides a variety of advantages over conventional nebulizers. We investigated the molecular structure and integrity of poractant alfa pre- and post-nebulization.

METHOD
Curosurf® was nebulized using an Investigational eFlow® Nebulizer System. Non-nebulized surfactant ("NN"), recollected surfactant droplets from nebulization through an endotracheal tube ("NT") and nebulization of surfactant directly onto a surface ("ND") were investigated by transmission electron microscopy. Biophysical characteristics were assessed by the Langmuir-Wilhelmy balance and the Captive Bubble Surfactometer.

RESULTS
Volume densities of lamellar body-like forms (LBL) and multi-lamellar forms (ML) were high for "NN" and "NT" samples (38.8% vs. 47.7% for LBL and 58.2% vs. 47.8% for ML). In the "ND" sample, we found virtually no LBL's, ML's (72.6%) as well as uni-lamellar forms (16.4%) and a new structure, the "garland-like" forms (9.4%). Surface tension for "NN" and "NT" was 23.33 ± 0.29 and 25.77 ± 1.12 mN/m, respectively. Dynamic compression-expansion cycling minimum surface tensions were between 0.91 and 1.77 mN/m.

CONCLUSION
The similarity of surfactant characteristics of nebulized surfactant via a tube and the non-nebulized surfactant suggests that vibrating membrane nebulizers are suitable for surfactant nebulization. Alterations in surfactant morphology and characteristics after nebulization were transient. A new structural subtype of surfactant was identified.

Minocchieri|Stefan|S|
Knoch|Stephan|S|
Schoel|W Michael|WM|
Ochs|Matthias|M|
Nelle|Mathias|M|

nebulizer
surface tension
aerosol drug therapy
neonatal respiratory distress syndrome
pulmonary surfactant


Toxicity and Antiviral Activity of the Extracts of Submerged Mycelium of Nematophagous Duddingtonia flagrans Fungus in Vero Cell Culture.

Abstract: We studied toxicity and antiviral activity of aqueous and ethanol extracts of bioactive substances from the biomass of nematophagous fungus Duddingtonia flagrans prepared by submerged culturing of the mycelium. It is found that both extracts were characterized by low toxicity for cultured Vero cells and inhibited reproduction of DNA-viruses in this cell line. Ethanol extract of the fungus exhibited higher in vitro antiviral activity against Herpes simplex virus type 2, ectromelia virus, and vaccinia virus than water extract, which can be due to higher content of proteins, polysaccharides, flavonols, catechins, or carotenes or more effective their combination. The extracts of cultured mycelium of Duddingtonia flagrans fungus containing a complex of bioactive substances can be used for creation of broad-spectrum antiviral drugs against DNA-viruses.

Ibragimova|Zh B|ZhB|
Anan'ko|G G|GG|
Kostina|N E|NE|
Teplyakova|T V|TV|
Mazurkova|N A|NA|

herpes simplex virus
nematophagous fungus extract
orthopoxviruses


Scratching the Surface: Using Informatics in Education.

Abstract: The health care system continues to evolve and develop new ways to provide for quality patient care. Many new platforms are being integrated into the current system, or will be implemented within the next few years, that will grossly change the way health care is performed and delivered. New data will emerge from these various avenues (i.e., computerized physician order entry, electronic health record [EHR], national health care) and provide a wealth of insights into pathological and epidemiological processes. Consequently, health care workers will need to be proficient in using these various platforms. Nursing educators must therefore have a strong understanding of the emerging technologies and be able to implement the use of research and EHRs as well as provide students with updated information on diseases and appropriate interventions. Data analytics will provide educators the necessary tools to teach nursing students the most current evidence-based practice. Transparency between all health care arenas will enable new information to be relayed quickly and appropriately.

informatics
education
education
educators
electronic health record (EHR)


Associations between biological markers of prenatal stress and infant negative emotionality are specific to sex.

Abstract:
PURPOSE
Fetal programming is the idea that environmental stimuli can alter the development of the fetus, which may have a long-term effect on the child. We have recently reported that maternal prenatal cortisol predicts infant negative emotionality in a sex-dependent manner: high prenatal cortisol was associated with increased negative emotionality in females, and decreased negative emotionality in males. This study aims to test for this sex-specific effect in a different cohort, and investigate whether sex differences in fetal programming may be specific to glucocorticoid mechanisms by also examining a maternal salivary alpha-amylase (sAA) by sex interaction.

METHODS
88 pregnant women (mean gestational age=27.4 weeks, SD=7.4) collected saliva samples at home over two working days to be assayed for the hormone cortisol (range=0.13-88.22nmol/l) and the enzyme alpha-amylase (range=4.57-554.8units/ml). Samples were collected at waking, 30-min post-waking and 12h post-waking. Two months after birth participants reported infant negative emotionality using the distress to limits subscale of the Infant Behavior Questionnaire.

RESULTS
The interaction between maternal prenatal cortisol and infant sex to predict distress to limits approached significance (p=0.067). In line with our previous finding there was a positive association between prenatal cortisol and negative emotionality in females, and a negative association in males. The interaction between sAA and sex to predict distress was significant (p=0.025), and the direction of effect was the same as for the cortisol data; high sAA associated with increased negative emotionality in females and reduced negative emotionality in males.

CONCLUSIONS
In line with our previous findings, this research adds to an emerging body of literature, which suggests that fetal programming mechanisms may be sex-dependent. This is the first study to demonstrate that maternal prenatal sAA may be an important biomarker for infant behavior, and the findings have implications for understanding sex differences in developmental psychopathology.

Braithwaite|Elizabeth C|EC|
Murphy|Susannah E|SE|
Ramchandani|Paul G|PG|
Hill|Jonathan|J|

D011297:Prenatal Exposure Delayed Effects

Prenatal stress
Fetal programming
Glucocorticoids
Alpha-amylase


Addressing the Whole Child: The Power of Data and Teams.

Abstract: As 21st-century school nurses, we address students holistically to meet their needs. The ASCD and the Centers for Disease Control and Prevention's coordinated school health model "Whole School, Whole Child, Whole Community" resonates with many school nurses. However, implementing the model can be challenging. This article explains how the school district of St. Johnsbury, Vermont, uses data to leverage their whole child team to meet their school district's needs.

Framework for 21st-Century School Nursing Practice


Soil tillage affects soybean growth and promotes heavy metal accumulation in seeds.

Abstract: When soybean is grown in soils with high heavy metal concentrations, it may introduce those contaminants into the human food chain, posing risks to human health. This study evaluated the effect of tilling the soil with high Cu, Zn, and Mn levels on soybean physiology and metal accumulation in seeds. Disturbed and undisturbed soil samples were collected in two different sites: a vineyard with high heavy metal concentration and a grassland area, containing natural vegetation. Two soybean cultivars were sown and grown in the greenhouse. Photosynthetic parameters and biochemical analysis of oxidative stress were performed. Cu, Zn, and Mn in leaves and seeds, dry mass, and weight of seeds were evaluated. Soil structure had a high influence on plant growth and physiology, while soil site had a high impact on heavy metal accumulation in leaves and seeds. Soybean plants that grown in vineyard soils with high heavy metal concentrations, accumulated 50% more Zn in leaves and seeds, 70% more Cu in leaves, and 90% more Cu in seeds, than those plants grown in grassland soils. Besides, Zn concentration in seeds was higher than the permissible limit. Moreover, the disturbance of both vineyard soil and grassland soil was not good for plant growth and physiology, which have increased TBARS and H2O2 concentration in plants, transpiration rate, metal concentration in leaves and seeds. Soil disturbance may have caused organic matter oxidation and changes in the composition and quantity of soil microorganisms and it affects the availability of other nutrients in the soil.

Schwalbert|Raíssa|R|
Stefanello|Lincon Oliveira|LO|
Schwalbert|Raí Augusto|RA|
Tarouco|Camila Peligrinotti|CP|
Drescher|Gerson Laerson|GL|
Trentin|Edicarla|E|
Tassinari|Adriele|A|
da Silva|Isley Bicalho|IB|
Brunetto|Gustavo|G|
Nicoloso|Fernando Teixeira|FT|

Soil Structure
Vineyard soil
Metal uptake
Physiological responses
Soil contamination
Trace metals


The effects of sclerostin antibody plus parathyroid hormone (1-34) on bone formation in ovariectomized rats.

Abstract: Previous studies have demonstrated the effects of sclerostin antibody (Scl-Ab) and parathyroid hormone (1-34, PTH) on healing in osteoporosis; however, reports about the combined effects of Scl-Ab plus PTH on osteoporosis are limited. This study was designed to investigate the impact of combined treatment with Scl-Ab and PTH on osteoporosis healing in ovariectomized (OVX) rats. After bilateral ovariectomy, 12 weeks were allowed to pass for the establishment of standard conditions for osteoporosis in animal models. The rats then randomly received a vehicle (control), Scl-Ab (25 mg/kg body weight, twice weekly), PTH (60 μg/kg, three times per week) or PTH plus Scl-Ab until death at 12 weeks. The blood and distal femurs of the rats were harvested for evaluation. The results of treatment for osteoporosis were evaluated by serum analysis, histology, microcomputed tomography (micro-CT) and biomechanical tests. Results from this study indicated that PTH + Scl-Ab had stronger effects on the prevention and treatment of osteoporosis than either of the monotherapies in OVX rats. The PTH + Scl-Ab produced the strongest effects on bone volume fraction (BV/TV), bone trabecular thickness (Tb.Th), trabecular number (Tb.N) and trabecular spacing (Tb.Sp), bone mineral density (BMD) and strength of distal femurs and increased the levels of procollagen type I N‑terminal propeptide (PINP) and osteocalcin. In contrast, monotherapy with PTH or Scl-Ab showed no differences between treated groups in the assessment of the metaphysis of contralateral femurs by histology, serum, biomechanical tests and micro-CT. These results seem to indicate that Scl-Ab plus PTH has an additive effect on osteoporosis in OVX rats.

Wu|Jian|J| Cai|Xian-Hua|XH| Qin|Xing-Xing|XX| Liu|Yan-Xi|YX|

Osteoporosis
Animal model
Distal femur
Bone mineral density
Cancellous bone


Identification of differentially expressed genes in the digestive gland of manila clam Ruditapes philippinarum exposed to BDE-47.

Abstract: Suppression subtractive hybridization (SSH) was used to identify alterations in gene transcription of the manila clam Ruditapes philippinarum after exposure to 5μg/L 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) for 15days. The ability to accumulate BDE-47 in digestive gland and gill was also evaluated in order to provide information for food safety. Analysis of tissue extracts indicated that digestive gland had the higher BDE-47 levels (12,463.1±1334.8 ng/g d.w.) compared to gill (6368.6±738.7ng/g d.w.) after a 15-day exposure period. Forward and reverse SSH libraries were made from pooled digestive glands of R. philippinarum, from which 75 high quality sequences were obtained by BLAST analysis. The expression of 39 genes with significant homology (E-value<10(-5)) out of the 75 sequences was investigated by quantitative RT-PCR. Among the 39 genes, 27 genes were found up-regulated while 12 genes were found down-regulated after the BDE-47 exposure. The 39 genes were involved in cellular cycle, cytoskeleton, substance and energy metabolism, stress response, innate immunity and cell signaling and transport which were extensively discussed. This study provides a preliminary basis for studying the response of marine bivalves upon exposure to PBDEs in terms of regulated gene expression.

Miao|Jingjing|J| Pan|Luqing|L| Zhang|Wenhao|W| Liu|Dong|D| Cai|Yuefeng|Y| Li|Zhen|Z|

Differentially expressed genes
Ruditapes philippinarum
Suppression subtractive hybridization
2,2′,4,4′-Tetrabromodiphenyl ether


The analgesic agent tapentadol inhibits calcitonin gene-related peptide release from isolated rat brainstem via a serotonergic mechanism.

Abstract:
AIMS
In this study we tested the hypothesis that tapentadol inhibits GGRP release from the rat brainstem through a mechanism mediated by the inhibition of NA reuptake; as a second alternative hypothesis, we investigated whether tapentadol inhibits GGRP release via the inhibition of 5-HT reuptake.

METHODS
Rat brainstems were explanted and incubated in short-term experiments. CGRP released in the incubation medium was taken as a marker of CGRP release from the central terminals of trigeminal neurons within the brainstem. CGRP levels were measured by radioimmunoassay under basal conditions or in the presence of tapentadol; NA, 5-HT, clonidine, yohimbine and ondansetron were used as pharmacological tools to investigate the action mechanism of tapentadol.

RESULTS
The α2-antagonist yohimbine failed to counteract the effects of tapentadol. Moreover, neither NA nor the α2-agonist clonidine per se inhibited K(+)-stimulated CGRP release, thereby indicating that the effects of tapentadol are nor mediated through the block of NA reuptake. Further experiments showed that 5-HT and tramadol, which inhibits both NA and 5-HT reuptake, significantly reduced K(+)-stimulated CGRP release. Moreover, the 5-HT3 antagonist ondansetron was able to counteract the effects of tapentadol in this system.

SIGNIFICANCE
This study provided pharmacological evidence that tapentadol inhibits stimulated CGRP release from the rat brainstem in vitro through a mechanism involving an increase in 5-HT levels in the system and the subsequent activation of 5-HT3 receptors.

Greco|Maria Cristina|MC|
Navarra|Pierluigi|P|
Tringali|Giuseppe|G|

Tapentadol
Calcitonin gene-related peptide
Rat
Brainstem
Ondansetron
5-hydroxytryptamine


Metabolic Dysregulation and Psychosocial Stress in Patients with Schizophrenia Spectrum Disorders: A Case-Control Study.

Abstract: Patients with schizophrenia spectrum disorders have a reduced life expectancy, which is largely the consequence of a high co-occurrence of cardiovascular diseases. To date, several intrinsic and environmental factors underlying this phenomenon have been found. However, the association with psychosocial stress has not been extensively addressed. In this study, we tested the relationship between a history of adverse childhood experiences (ACEs), lifetime stressors, perceived stress and metabolic parameters in patients with schizophrenia spectrum disorders and in healthy controls. The participants included 85 inpatients with schizophrenia spectrum disorders and 56 healthy controls. Serum levels of glucose, insulin, low- and high-density lipoproteins (LDL and HDL), triglycerides, total cholesterol and high-sensitivity C-reactive protein (hsCRP) were determined. After adjustment for potential confounding factors, patients had significantly higher levels of glucose (F = 4.856, p = 0.030), triglycerides (F = 4.720, p = 0.032) and hsCRP (F = 7.499, p = 0.007) as well as significantly lower levels of HDL (F = 5.300, p = 0.023) compared to healthy controls. There were also significant effects of interactions between diagnosis and a history of ACEs on the levels of insulin (F = 4.497, p = 0.036) and homeostatic model assessment of insulin resistance (HOMA-IR) (F = 3.987, p = 0.048). More specifically, the levels of insulin and HOMA-IR were significantly higher in the subgroup of patients with schizophrenia spectrum disorders and a positive history of ACEs compared to other subgroups of participants. No significant associations between lifetime stressors and perceived stress with metabolic parameters were found. Our findings indicate that a history of ACEs might be associated with insulin resistance in patients with schizophrenia spectrum disorders. Therapeutic strategies targeting early-life stress should be considered with early interventions that aim to manage cardiometabolic comorbidity in patients with schizophrenia spectrum disorders.

hormone
metabolic syndrome
obesity
physical health
psychosis


Firewood Transport as a Vector of Forest Pest Dispersal in North America: A Scoping Review.

Abstract: Native and nonnative insects and diseases can result in detrimental impacts to trees and forests, including the loss of economic resources and ecosystem services. Increases in globalization and changing human behaviors have created new anthropogenic pathways for long distance pest dispersal. In North America, literature suggests that once a forest or tree pest is established, the movement of firewood by the general public for recreational or home heating purposes is one of the primary pathways for its dispersal. Understanding human perceptions and behaviors is essential to inform the most effective strategies for modifying firewood and pest dispersal by humans. This scoping review seeks to assess trends and gaps in the existing literature, as well as patterns in behavior related to forest pest dispersal through firewood movement in North America. We identified 76 documents that addressed this topic to which we applied inclusion and exclusion criteria to select articles for further analysis. Twenty-five articles met the inclusion criteria and were categorized based on five identified themes: 1) insect incidence in firewood, 2) insect dispersal via firewood, 3) recreational firewood movement, 4) firewood treatments, and 5) behavior and rule compliance. The selected articles show trends that suggest that firewood movement presents a risk for forest insect dispersal, but that behavior can be modified, and compliance, monitoring, and treatments should be strengthened. This scoping review found limited research about western United States, Mexico, and Canada, various insect species and other organisms, regulation and management, awareness, and behavioral dimensions of firewood movement.

Solano|Angelica|A|
Rodriguez|Shari L|SL|
Greenwood|Leigh|L|
Dodds|Kevin J|KJ|
Coyle|David R|DR|

human behavior
firewood movement
regulations
Coleoptera
invasive species


Palliative Care in Latin America: Are We Making Any Progress? Assessing Development Over Time Using Macro Indicators.

Abstract:
BACKGROUND
Monitoring and reporting palliative care development serves to identify progress as well as remaining challenges for improvement.

AIM
To report on the updated status of palliative care development in Latin America, develop and apply a new index to measure progress, and enable cross-country comparisons.

METHODS
We conducted a secondary analysis of the data collected for the 1st (2012) and 2nd (2020) editions of the Atlas of Palliative Care in Latin America using indicators on Policy, Education, Access to Medicines and Service Provision. The ALCP indicators were reviewed and the ALCP Index-II was constructed adding the z-score for each indicator and used to rank the countries' development as High, Moderate or Low.

SETTING/PARTICIPANTS
Seventeen Latin American countries.

RESULTS
The number of countries with a national palliative care plan increased from five (29%) to nine (53%); Percentage of medical schools with palliative care as an independent subject at the undergraduate level grew from 4.2% to 17.1%; Distributed Opioid Morphine Equivalence increased from 6.6 to 7.1 mg/capita; and Number of services increased from 1.5 to 2.6/million. The number of palliative care services was correlated to the proportion of medical schools which included palliative care (Rs1 = 0.48; Rs2 = 0.34); and with morphine equivalence/capita (Rs1 = 0.61; Rs2 = 0.72), but not associated with the existence of a national plan (p1 = 0.234; p2 = 0. 074). Using the ALCP Index-II, Uruguay, Chile, Costa Rica, Panama, Brazil, and Argentina ranked the highest while the other ranked in the middle or lowest groups. Uruguay registered the highest score (7.5), Honduras the lowest (-3.59). The dispersal in the values was larger than the one registered in 2012, showing more heterogeneity.

CONCLUSION
Significant advances in palliative care development in Latin America have been achieved. The ALCP-II Index is useful for assessing and comparing palliative care development across countries.

Palliative care
Latin America
global health
health policy
health services
health status indicators
medical education
opioid analgesics


Innovative method to diagnose coronary Cameral fistula by contrast echocardiography.

Abstract:
INTRODUCTION
Coronary artery fistula (CAF) is a rare cardiac anomaly that typically presents as a continuous murmur in an otherwise asymptomatic patient. Occasionally, it can result in congestive heart failure or bacterial endocarditis.

OBJECTIVE
To better delineate the course of coronary artery fistula using an intracoronary injection of SonoVue contrast agent, while performing transthoracic echocardiography.

METHOD AND RESULTS
A referred 46-year-old man, with a history of exertional dyspnea for almost 3 months, was admitted to the hospital with progressive dyspnea and assessed under suspicion of CAF. CAF was seen with a coronary angiogram, but the exact entry point in the left ventricle or left atrial wall could not be determined. CT angiography also failed to establish the drainage site, so CAG (coronary angiography) was repeated with the SonoVue contrast agent injected into LM (Left main) while using a Siemens echocardiography machine. Multiple views were obtained during the injection and revealed unusual flow in the left ventricle just below the PML (posterior mitral leaflet) and passing through the fistula to LV.

CONCLUSION
Contrast-enhanced echocardiography by direct intracoronary injection of SonoVue contrast agent is safe and can aid in the delineation of fistula drainage.

Eldeib|Moustafa|M|0000-0002-5385-4064 Qaddoura|Fatema|F| Sadek|Marwan|M| Abuelatta|Reda|R| Nagib|Ayman|A|

contrast echocardiography
coronary artery fistula (CAF)
heart failure


The Hair in the Garland: Hair Loss and Social Stress Among Women in South India.

Abstract: Generations of scholars have debated hair's significance as a symbol of womanhood, fertility, and spiritual morality in South India. For contemporary Indian women, hair is a site of concern, often expressed as an everyday preoccupation with hair loss or "hair fall," as it is known in the subcontinent. This exploratory study investigated hair fall among Kannada-speaking Hindu women in the South Indian city of Mysuru, Karnataka. It used a series of focus group discussions to explore how women talk about the causes and consequences of hair fall, and how women cope with hair-related distress. Participants articulated clear, shared ideas about why hair falls and how it can be managed. They connected hair fall to broader stressors in their lives both directly and symbolically. Hair fall, therefore, appears to function idiomatically in this context, both as an idiom of distress in its own right, and as a symptom of other idioms and forms of distress. Additional research is needed to establish the importance of hair fall relative to other distress constructs, and to more directly assess its potential value in research and intervention.

Women
India
Hair fall
Distress
Idioms of distress
Cultural concepts of distress


Assessment of Dental Caries, Periodontal Status, and Personality Trait among Population of Dehradun, Uttarakhand, India.

Abstract:
AIM AND OBJECTIVE
Assessment of dental caries, periodontitis, and personality trait among population of Dehradun.

MATERIALS AND METHODS
This survey was conducted on 480 subjects age ranged 34-45 years of both genders (males-250, females-230). Decayed Missing, Filled Teeth (DMFT) index, periodontal status, and personality trait were recorded.

RESULTS
Age group 34-39 years is comprised of 130 males and 140 females and 40-45 years had 120 males and 90 females. Maximum males (120) were laborer and females were housewife (160). Commonly used method of oral hygiene practice was tooth powder by 80 males and 103 females. Maximum subjects of extroversion (180) was seen in age group 40-45 years, maximum females (110) were housewife with extroversion trait, maximum extroversion trait subjects were using tooth powder (113) and datum (100). Mean DMFT score in subjects was 2.52 and community periodontal index of treatment needs (CPITN) score was 3.41. There were 310 extroversion subjects, 120 neuroticism subjects, and 50 combinations of both extroversion and neuroticism. There was a significant difference in mean missing teeth and DMFT in subjects with different personality traits (p < 0.05). The post hoc test showed that mean missing teeth between group E and group E + N was found to be statistically significant (p < 0.05). The post hoc test showed that the mean sextant value for score 2 between group E vs N found to be statistically significant (p < 0.05). Neurotic individuals were found to have poorer periodontal health as compared to extroverts.

CONCLUSION
Authors found that personality trait such as psychological factors have greater impact on status of dental caries and periodontitis. Extroverts had less dental caries and better periodontal status when compared to other personality traits.

CLINICAL SIGNIFICANCE
Psychological factors have a great impact on status of dental caries and periodontitis. By assessing various psychological factors, the occurrence of both can be avoided. Thus by improving oral health, overall health of an individual can be improved.

Shveta|Jain|J|
Jagadeesh|Kyatsandra N|KN|
Sree|Sandhya|S|
Kochhar|Anuraj S|AS|
Kumar|Randhir|R|
Gupta|Jyoti|J|

Dental caries
Extroverts
Periodontitis Psychological.


High SGO2 Expression Predicts Poor Overall Survival: A Potential Therapeutic Target for Hepatocellular Carcinoma.

Abstract: Shugoshin2 (SGO2) may participate in the occurrence and development of tumors by regulating abnormal cell cycle division, but its prognostic value in hepatocellular carcinoma (HCC) remains unclear. In this study, we accessed The Cancer Genome Atlas (TCGA) database to get the clinical data and gene expression profile of HCC. The expression of SGO2 in HCC tissues and nontumor tissues and the relationship between SGO2 expression, survival, and clinicopathological parameters were analyzed. The SGO2 expression level was significantly higher in HCC tissues than in nontumor tissues (p < 0.001). An analysis from the Oncomine and Gene Expression Profiling Interactive Analysis 2 (GEPIA2) databases also demonstrated that SGO2 was upregulated in HCC (all p < 0.001). A logistic regression analysis revealed that the high expression of SGO2 was significantly correlated with gender, tumor grade, pathological stage, T classification, and Eastern Cancer Oncology Group (ECOG) score (all p < 0.05). The overall survival (OS) of HCC patients with higher SGO2 expression was significantly poor (p < 0.001). A multivariate analysis showed that age and high expression of SGO2 were independent predictors of poor overall survival (all p < 0.05). Twelve signaling pathways were significantly enriched in samples with the high-SGO2 expression phenotype. Ten proteins and 34 genes were significantly correlated with SGO2. In conclusion, the expression of SGO2 is closely related to the survival of HCC. It may be used as a potential therapeutic target and prognostic marker of HCC.

Deng|Min|M|0000-0002-6775-2210 Li|Shaohua|S| Mei|Jie|J| Lin|Wenping|W| Zou|Jingwen|J| Wei|Wei|W| Guo|Rongping|R|0000-0003-2799-3463

SGO2
survival
therapeutic target
hepatocellular carcinoma
bioinformatics
outcome


Laparoscopic Whipple's Operation for Locally Advanced Gastric Cancer Invading the Pancreas and Duodenum: a Case Report.

Abstract: Few surgeons have adopted pancreaticoduodenectomy (PD) for the treatment of advanced gastric cancer (AGC) invading the pancreas or duodenum because it remains controversial whether its prognostic benefits outweigh the high morbidity rates in such advanced cases. However, recent technical advances have revived diverse surgical procedures in minimally invasive approaches. Inspired by this trend, laparoscopic PD procedures have been performed for AGC in our institute since 2014. We recently performed a laparoscopic Whipple's operation in a case of cT4b gastric cancer with invasion of the pancreatic head and duodenum.

Laparoscopic
Gastric cancer
Pancreaticoduodenectomy


Ossified Posterior Longitudinal Ligament Existing at an Intervertebral Level Limits Compensatory Mechanism of Cervical Lordosis after Muscle-Preserving Selective Laminectomy.

Abstract:
Introduction
As C7 slope increases, lordotic change of C2-C7 angle compensates for adjustments in cervical sagittal balance. However, ossification of the posterior longitudinal ligament (OPLL) may affect the compensatory mechanism of the cervical spine. This study aims to evaluate the impact of OPLL on cervical lordotic compensation after muscle-preserving selective laminectomy (SL).

Methods
This study involved 235 patients with cervical spondylotic myelopathy (CSM) and OPLL who underwent ≥ 3 consecutive levels of SL. OPLL was classified into continuous, segmental, mixed, or localized type on the basis of the criteria previously reported. In this study, based on the motion preservation at the intervertebral level, patients were divided into CSM (n = 114), OPLL segmental type (OPLL-S; n = 44), and other types of OPLL (OPLL-O; i.e., continuous, mixed, and localized; n = 77). The cervical sagittal alignment, degree of spinal cord decompression, and surgical outcomes were compared among the three groups.

Results
The OPLL-O group had a larger postoperative C7 slope (p = 0.020), larger pre- (p = 0.021) and postoperative (p = 0.001) C2-C7 sagittal vertical axis, and greater pre- (p = 0.034) and postoperative (p = 0.002) C7 slope minus C2-C7 angle. Narrower postoperative spinal cord clearance (PSCC) from OPLL (p < 0.001) and more residual spinal cord compression (p < 0.001) were observed in the OPLL-O group. Correlation between postoperative C7 slope minus C2-C7 angle and PSCC was detected (r = -0.238, p < 0.001). The recovery rate of the Japanese Orthopedic Association score was slightly lower in the OPLL-O group (p < 0.001), and it was correlated with postoperative residual spinal cord compression (r = -0.305, p < 0.001).

Conclusions
OPLL-O limits cervical lordotic compensation, resulting in cervical sagittal balance mismatch. It affects the degree of spinal cord decompression, which might be related to surgical outcome.

Nori|Satoshi|S| Aoyama|Ryoma|R| Ninomiya|Ken|K| Suzuki|Satoshi|S| Anazawa|Ukei|U| Shiraishi|Tateru|T|


Cost of incorrect application of antithrombotic prophylaxis prior to invasive procedures.

Abstract:
BACKGROUND
We analyze the cost of an incorrect application, by the haematologist, of bridging anticoagulation in patients with low-risk atrial fibrillation (AF) needing interruption of treatment prior to a scheduled invasive procedure. Although not recommended, bridging therapy is widely used, resulting in avoidable costs and increased workload.

METHODS
Observational retrospective study. We recorded demographic and clinical data including age, sex, type of procedure, use of bridging therapy with low molecular weight heparin (LMWH), and haemorrhagic complications within 30 days of acenocoumarol withdrawal.

RESULTS
Acenocoumarol was stopped in 161 patients, 97 (60%) were male and 64 (40%) female. Average age was 76,11 ± 8,45 years. Procedures included: minor surgical intervention 58 (36%), colonoscopy 61 (38%), gastroscopy 11 (7%), breast biopsy 4 (2.5%), prostate biopsy 4 (2.5%), infiltration 5 (3%), and other 18 (11%). All patients received bridging anticoagulation with LMWH (40 mg enoxaparin per day) 3 days before and 3 days after the procedure (6 doses). We used a total of 966 doses, at €4.5 per unit, resulted in €4347 of total cost. No complications occurred in 156 patients (97%). Haemorrhage was observed in 5 cases: 1 major haemorrhage needing 6 days of hospital stay and transfusion, and 4 minor haemorrhages (2 patients needed emergency attendance and 2 required hospital admission for 3 and 2 days, respectively). The cost of emergency care was €237.36, and the cost of hospital stay was €6860.81 (€623.71 per day, for 11 days). The total cost of the incorrect application of the protocol was €11,445.17.

CONCLUSION
Guidelines about bridging anticoagulation in low risk AF patients undergoing scheduled invasive procedures were not followed. This practice increments the complications and supposes an increase in costs besides to an inadequate use of the human resources.

Cuevas|Ma Victoria|MV|
Martínez-Sancho|Ignacio|I|
Arribas|Jana|J|
García-Díaz|Covadonga|C|
Cuevas|Beatriz|B|

Atrial fibrillation
Bridging therapy
Avoidable costs
Workload
Guidelines


The Challenges of Informed Consent in High-Stakes, Randomized Oncology Trials: A Systematic Review.

Abstract: Importance. Oncology trials often entail high-stakes interventions where potential for morbidity and fatal side effects, and for life-prolongation or cure, intensify bioethical issues surrounding informed consent. These challenges are compounded in multistage randomized trials, which are prevalent in oncology. Objective. We sought to elucidate the major barriers to informed consent in high-stakes oncology trials in general and the best consent practices for multistage randomized trials. Evidence Review. We queried PubMed for original studies published from January 1, 1990, to April 5, 2018, that focused on readability, quality, complexity or length of consent documents, motivation and sickness level of participants, or interventions and enhancements that influence informed consent for high-stakes oncologic interventions. Exclusion criteria included articles focused on populations outside industrialized countries, minors or other vulnerable populations, physician preferences, cancer screening and prevention, or recruitment strategies. Additional articles were identified through comprehensive bibliographic review. Findings. Twenty-seven articles were retained; 19 enrolled participants and 8 examined samples of consent documents. Methodologic quality was variable. This body of literature identified certain challenges that can be readily remedied. For example, the average length of the consent forms has increased 10-fold from 1987 to 2010, and patient understanding was shown to be inversely proportional to page count; shortening forms, or providing a concise summary as mandated by the revised Common Rule, might help. However, barriers to understanding that stem from deeply ingrained and flawed sociocultural perceptions of medical research seem more difficult to surmount. Although no studies specifically addressed problems posed by multiple sequential randomizations (such as change in risk-benefit ratio due to time-varying treatment responses or organ toxicities), the findings are likely applicable and especially relevant in that context. Concrete suggestions for improvement are proposed.

Nathe|Julia M|JM|
Krakow|Elizabeth F|EF|

Informed consent
oncology
randomized trials
multistage trials


Elemental composition of edible nuts: fast optimization and validation procedure of an ICP-OES method.

Abstract:
BACKGROUND
An inductively coupled plasma-optical emission spectrometry method for the speedy simultaneous detection of 19 elements in edible nuts (walnuts: Juglans nigra; almonds: Prunus dulcis; hazelnuts: Corylus avellana; Brazil nuts: Bertholletia excelsa; cashews: Anacardium occidentalle; pistachios: Pistacia vera; and peanuts: Arachis hypogaea) available on the Serbian markets, was optimized and validated through the selection of instrumental parameters and analytical lines free from spectral interference and with the lowest matrix effects.

RESULTS
The analysed macro-elements were present in the following descending order: Na > Mg > Ca > K. Of all the trace elements, the tested samples showed the highest content of Fe. The micro-element Se was detected in all the samples of nuts. The toxic elements As, Cd and Pb were either not detected or the contents were below the limit of detection. One-way analysis of variance, Student's t-test, Tukey's HSD post hoc test and hierarchical agglomerative cluster analysis were applied in the statistical analysis of the results.

CONCLUSION
Based on the detected content of analysed elements it can be concluded that nuts may be a good additional source of minerals as micronutrients.

elemental composition
nuts
ICP-OES
statistics
method optimization and validation


Guideline-concordant treatment is associated with improved survival among women with non-endometrioid endometrial cancer.

Abstract:
BACKGROUND
Among women diagnosed with non-endometrioid endometrial carcinoma (EC), we investigated associations between race/ethnicity and receipt of guideline-concordant treatment (GCT), as well as relationships between GCT and survival.

METHODS
We used the National Cancer Database and identified 21,177 non-Hispanic White (NHW), 6657 non-Hispanic Black (NHB), 1689 Hispanic, and 903 Asian/Pacific Islander (AS/PI) women diagnosed with non-endometrioid EC between 2004 and 2014. Year-specific National Comprehensive Cancer Network (NCCN) guidelines were used to classify GCT. We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between race/ethnicity and GCT receipt. Multivariable-adjusted Cox proportional hazards models were used to estimate hazards ratios (HRs) and 95% CIs for relationships between GCT and overall survival in the total study population and stratified by race/ethnicity.

RESULTS
Overall, 43.8% of women with non-endometrioid EC received GCT. Compared to NHW women, NHB (OR = 1.01, 95% CI = 0.95-1.07), Hispanic (OR = 1.01, 95% CI = 0.91-1.12) and AS/PI women (OR = 1.10, 95% CI = 0.96-1.26) did not have significantly different odds of receiving GCT. GCT was significantly associated with improved survival among NHW (HR = 0.84, 95% CI = 0.80-0.87), NHB (HR = 0.85, 95% CI = 0.80-0.91), and Hispanic women (HR = 0.84, 95% CI = 0.72-0.98) but not among AS/PI women (HR = 0.97, 95% CI = 0.78-1.19).

CONCLUSIONS
While more than half of women with non-endometrioid EC did not receive GCT, no difference in GCT receipt by race/ethnicity was observed. When received, GCT was associated with improved survival in almost all racial groups. Interventions to improve GCT adherence may improve survival for most women with non-endometrioid EC.

Dholakia|Jhalak|J|
Llamocca|Elyse|E|
Quick|Allison|A|
Salani|Ritu|R|
Felix|Ashley S|AS|

Race
Chemotherapy
Disparities
Hospital-based cancer registry
Radiation treatment
Uterus neoplasm


On the Emergence of Candida auris: Climate Change, Azoles, Swamps, and Birds.

Abstract: The most enigmatic aspect of the rise of Candida auris as a human pathogen is that it emerged simultaneously on three continents, with each clade being genetically distinct. Although new pathogenic fungal species are described regularly, these are mostly species associated with single cases in individuals who are immunosuppressed. In this study, we used phylogenetic analysis to compare the temperature susceptibility of C. auris with those of its close relatives and to use these results to argue that it may be the first example of a new fungal disease emerging from climate change, with the caveat that many other factors may have contributed.

D026141:Drug Resistance, Multiple, Fungal


Measurement of Aerobic Capacity Using Mouthpiece vs. Mask for Data Collection.

Abstract: Measurement of aerobic capacity is an important task that must be done accurately in order for data to be worthwhile. Measurement is traditionally obtained through the use of a nose-clip, mouthpiece, and headgear apparatus. This method of collecting gas has proven to be difficult due to the high incidence of losing the nose clip during exercise, the awkwardness and discomfort of the apparatus, and the loss of oral communication. This study compares this method with using a gas collection mask for physiological measurement. Masks have been avoided due to leakage that causes errors in data. Maximal and submaximal values for Ve, VO2, HR, and RER were compared for both methods of collection. Results show that the mask produced values equal to those of the mouthpiece, nose clip, and headgear. Significantly more discomfort, as well as influence on running economy, was reported with the headgear. The data show that leakage is not a significant problem. Based on preliminary studies and data from this study, using the mask is recommended. Data suggests that further studies look at facial shape, as well as masks of different size and material, with regards to eliminating any data errors occurring in the mask.

Measurement
Aerobic capacity
Mask
Methods
Testing


Evidence of estrone-sulfate uptake modification in young and middle-aged rat prostate.

Abstract: High plasma exposure to estrogens is often associated with prostate cancer. Reducing this phenomenon may present therapeutic benefits. The involvement of estrone sulphate (E1S), the most abundant circulating estrogen in men, has been partially studied in this age-related pathology. To investigate the consequences of plasma E1S overload on blood and prostate sex steroid levels and inflammatory tissue responses, young and middle-aged male rats were treated with E1S with or without steroid sulfatase (STS) inhibitor STX64 for 21 consecutive days. A plasma and prostate tissue steroid profile was determined. STS activity, mRNA expression of E1S organic anion transporting polypeptides (slco1a2, slco2b1, slco4a1) and pro-inflammatory cytokines (Il1-beta, Il6, TNF-alpha) were evaluated in prostate tissue according to age and treatment group. A significant correlation between plasma and prostate steroid levels related to hormone treatment was observed in all rat age groups. However, while the E1S level in prostate tissue increased in middle-aged treated rats (p<0.0001), no significant variation was observed in young treated rats. The protective effect of STX64 during E1S infusion was observed by the maintenance of low free estrogen concentrations in both plasma and tissue. However, this protection was not associated with mRNA expression stability of pro-inflammatory cytokines in older rat prostate. These results suggest that E1S uptake in rat prostate cells increases during aging. Therefore, if a similar phenomenon existed in men, preventively reducing the STS activity could be of interest to limit uptake of estrogens in prostate when high E1S plasma level is assayed.

Giton|Frank|F|
Sirab|Nanor|N|
Franck|Grégory|G|
Gervais|Marianne|M|
Schmidlin|Fabien|F|
Ali|Tauhid|T|
Allory|Yves|Y|
de la Taille|Alexandre|A|
Vacherot|Francis|F|
Loric|Sylvain|S|
Fiet|Jean|J|

Estrogens
Prostate cancer
Organic anion transporting polypeptides
Pro-inflammatory cytokines
Estrone sulfate
Sulfatase inhibitor


Increased medical utilization and psychiatric comorbidity following a new diagnosis of methamphetamine use disorder.

Abstract:
BACKGROUND
Evidence of patterns of medical utilization and distribution of comorbidities among individuals using methamphetamine remains limited.

OBJECTIVE
This study aims to investigate changes in medical utilization and comorbidities before and after a diagnosis of methamphetamine use disorder.

METHODS
A total of 3321 cases (79% were male) of methamphetamine use disorder between January 1, 1996, and December 31, 2012, were identified from Psychiatric Inpatient Medical Claims database in Taiwan. Information was collected on demographics, diagnoses, and medical utilizations. The date of newly diagnosed with methamphetamine use disorder was defined as the baseline. Mirror-image study design was used to compare changes in medical utilization and comorbidities between the pre-baseline period (within 1 year before diagnosis) and the post-baseline period (within 1 year after diagnosis). Conditional logistic regression was used to estimate changes in medical utilization and comorbidities.

RESULTS
Most cases (77%) were first identified in a psychiatric department. There is a significant increase (P < .001) in psychiatric admission (odds ratio[OR] = 2.19), psychiatric emergency visits (OR = 1.31), and psychiatric outpatient visits (OR = 1.15) after diagnosis. Multivariable analysis revealed significantly increased risks (P < .001) of non-methamphetamine drug induced mental disorders (adjusted OR[aOR] = 29.47), schizophrenia (aOR = 2.62), bipolar disorder (aOR = 2.14), organic mental disorder (aOR = 1.82), and upper respiratory tract infection (aOR = 2.03) after diagnosis.

CONCLUSIONS
We found significant increases of medical utilization and psychiatric comorbidities after diagnosed with methamphetamine use disorder. These findings may reflect the problem of delayed diagnosis and treatment. Enhancement of early identification of methamphetamine use disorder in general practice is required for early intervention and decreased subsequent morbidities.

Lee|Wan-Chen|WC| Chang|Hu-Ming|HM| Huang|Ming-Chyi|MC| Pan|Chun-Hung|CH| Su|Sheng-Siang|SS| Tsai|Shang-Ying|SY| Chen|Chiao-Chicy|CC| Kuo|Chian-Jue|CJ|

medical utilization
psychiatric comorbidity
Methamphetamine
mirror-image study


Statin adherence and LDL cholesterol levels. Should we assess adherence prior to statin upgrade?

Abstract:
BACKGROUND
Adherence to statin therapy has been shown to be suboptimal. In statin-treated patients with residual elevated low density lipoprotein cholesterol (LDL-C) levels the physician must decide whether to switch to a more potent statin or try and achieve better adherence. We examined the association between adherence and LDL-C within low, moderate and high intensity statin groups in a "real world" setting.

METHODS
We assessed annual adherence by the mean MPR (Medication Possession Ratio = number of purchased/prescribed daily doses) in unselected patient group. Statins were stratified (ACC/AHA Guideline) into low, moderate and high intensity groups. The impact of adherence on LDL levels was assessed by LOESS (locally weighted scatter plot smoothing).

RESULTS
Out of 1183 patients 173 (14.6%) were treated with low, 923 (78.0%) with moderate and 87 (7.4%) with high intensity statins. Statin intensity was inversely associated with adherence (MPR 77±21, 73±22 and 69±21% for low, moderate and high intensity respectively, p=0.018). Non-adjusted LDL levels decreased with higher adherence: a 10% adherence increase resulted in LDL decrease of 3.5, 5.8 and 7.1mg/dL in low, moderate and high intensity groups. Analysis of the adherence effect on LDL levels adjusted for age, DM and ischemic heart disease showed that MPR above 80% was associated with an additional decrease in LDL levels only in the high intensity group.

CONCLUSIONS
Increased adherence to statins beyond an MPR of 80% improves LDL levels only among patients given high intensity therapy. Switching from lower to higher intensity therapy may be more effective than further efforts to increase adherence.

Vodonos|A|A| Ostapenko|I|I| Toledano|R|R| Henkin|Y|Y| Zahger|D|D| Wolak|T|T| Sherf|M|M| Novack|V|V|

Statins Adherence LDL Cholesterol Compliance


Seroprevalence Study of Anti-HEV IgG among Different Adult Populations in Corsica, France, 2019.

Abstract: Hepatitis E virus (HEV) is a major cause of acute hepatitis worldwide. In France, hyperendemic areas including Corsica have an anti-HEV Immunoglobulin G (IgG) prevalence higher than 50%. The aim of this study was to determine the seroprevalence of anti-HEV IgG in three adult populations in Corsica and the risk factors associated with antibody detection. Between 2017 and 2019, a total of 930 individuals, including 467 blood donors, 393 students or university staff members and 70 patients from general practice, were tested for the presence of anti-HEV IgG using the Wantai HEV IgG enzyme immunoassay kit and filled a questionnaire. The association between seropositivity and potential risk factors was tested with univariate and multivariate analyses. Out of the 930 samples, 52.3% (486/930) were seropositive-54.4% (254/467) among blood donors, 47.6% (187/393) among university students and 64.3% (45/70) among patients of general practice. Three main risk factors were identified: (i) skinning and butchering (Adjusted Odds Ratio aOR = 2.76, 95% confidence interval [95% CI] [1.51-5.37]; p-value < 10-3), (ii) consumption of a local pork live raw sausage (fittonu) (aOR = 1.95 95% CI [1.45-2.64]; p-value = 10-5), and (iii) increasing age (p-value = 0.003). Seropositivity rates between the different populations were homogeneous after age stratification. This cross-sectional study indicates a high anti-HEV IgG seroprevalence in the Corsican adult population, not significantly different between women and men and increasing with age. This serosurvey also showed homogeneity regarding the exposure to HEV among three different types of populations. Finally, we confirmed the endemicity of Corsica with respect to HEV and identified a strong association between consumption of figatellu/fittonu and the practice of skinning and butchering with the detection of anti-HEV IgG.

Capai|Lisandru|L|
Masse|Shirley|S|
Gallian|Pierre|P|
Souty|Cécile|C|
Isnard|Christine|C|
Blanchon|Thierry|T|
Peres|Brigitte|B|
de Lamballerie|Xavier|X|
Charrel|Rémi|R|
Falchi|Alessandra|A|

seroprevalence
IgG
corsica
France
hepatitis
hepatitis E
hyperendemic
risk factor


Deep Learning for Automated Delineation of Pediatric Cerebral Arteries on Pre-operative Brain Magnetic Resonance Imaging.

Abstract: Introduction: Surgical resection of brain tumors is often limited by adjacent critical structures such as blood vessels. Current intraoperative navigations systems are limited; most are based on two-dimensional (2D) guidance systems that require manual segmentation of any regions of interest (ROI; eloquent structures to avoid or tumor to resect). They additionally require time- and labor-intensive processing for any reconstruction steps. We aimed to develop a deep learning model for real-time fully automated segmentation of the intracranial vessels on preoperative non-angiogram imaging sequences. Methods: We identified 48 pediatric patients (10-months to 22-years old) with high resolution (0.5-1 mm axial thickness) isovolumetric, pre-operative T2 magnetic resonance images (MRIs). Twenty-eight patients had anatomically normal brains, and 20 patients had tumors or other lesions near the skull base. Manually segmented intracranial vessels (internal carotid, middle cerebral, anterior cerebral, posterior cerebral, and basilar arteries) served as ground truth labels. Patients were divided into 80/5/15% training/validation/testing sets. A modified 2-D Unet convolutional neural network (CNN) architecture implemented with 5 layers was trained to maximize the Dice coefficient, a measure of the correct overlap between the predicted vessels and ground truth labels. Results: The model was able to delineate the intracranial vessels in a held-out test set of normal and tumor MRIs with an overall Dice coefficient of 0.75. While manual segmentation took 1-2 h per patient, model prediction took, on average, 8.3 s per patient. Conclusions: We present a deep learning model that can rapidly and automatically identify the intracranial vessels on pre-operative MRIs in patients with normal vascular anatomy and in patients with intracranial lesions. The methodology developed can be translated to other critical brain structures. This study will serve as a foundation for automated high-resolution ROI segmentation for three-dimensional (3D) modeling and integration into an augmented reality navigation platform.

Quon|Jennifer L|JL|
Chen|Leo C|LC|
Kim|Lily|L|
Grant|Gerald A|GA|
Edwards|Michael S B|MSB|
Cheshier|Samuel H|SH|
Yeom|Kristen W|KW|

pre-operative magnetic resonance imaging


Complication and recurrence rate in laser CO2 versus traditional surgery in the treatment of Bartholin's gland cyst.

Abstract:
PURPOSE
The treatment of Bartholin's gland cysts by traditional surgery is characterized by some disadvantages and complications such as hemorrhage, postoperative dyspareunia, infections, necessity for a general anesthesia. Contrarily, CO2 laser surgery might be less invasive and more effective as it solves many problems of traditional surgery. The aim of our study is to describe CO2 laser technique evaluating its feasibility, complication rate and results vs traditional surgery.

METHODS
Among patients treated for Bartholin's gland cyst, we enrolled 62 patients comparing traditional surgical excision vs CO2 laser surgery of whom 27 patients underwent traditional surgery, whereas 35 patients underwent CO2 laser surgery. Mean operative time, complication rate, recurrence rate and short- and long-term outcomes were assessed.

RESULTS
The procedures required a mean operative time of 9 ± 5.3 min for CO2 laser surgery and 42.2 ± 13.8 for traditional surgery. Two patients (5.7 %) needed an hemostatic suture for intraoperative bleeding in the laser CO2 laser technique against 14.8 % for traditional surgery. Carbon dioxide allows a complete healing in a mean time of 22 days without scarring, hematomas or wound infections and a return to daily living in a mean time of 2 days. Instead, patients undergone traditional surgery required a mean time of 14 days to return to daily life with a healing mean time completed in 28 days.

CONCLUSIONS
The minimum rate of intra- and post-operative complications, the ability to perform it under local anesthesia in an outpatient setting make CO2 laser surgery more cost-effective than traditional surgery.

Frega|Antonio|A| Schimberni|Mauro|M| Ralli|Eleonora|E| Verrone|Antonella|A| Manzara|Federica|F| Schimberni|Matteo|M| Nobili|Flavia|F| Caserta|Donatella|D|

D001472:Bartholin's Glands
D002245:Carbon Dioxide
D002921:Cicatrix
D003560:Cysts
D005260:Female
D005500:Follow-Up Studies
D006801:Humans
D053685:Laser Therapy
D054020:Lasers, Gas
D008875:Middle Aged
D009364:Neoplasm Recurrence, Local
D061646:Operative Time
D011183:Postoperative Complications
D012008:Recurrence
D012189:Retrospective Studies
D016896:Treatment Outcome

CO2 laser surgery
Bartholin’s gland cyst
Cysts therapy
Outpatient surgical procedures


Metabolic Signatures of Human Breast Cancer.

Abstract: Metabolomics has emerged as a new discovery tool with the promise of identifying therapeutic targets in cancer. Recent discoveries described essential metabolomic pathways in breast cancer and characterized oncometabolites that drive tumor growth and progression. Oncogenes like MYC and tumor suppressor genes like TP53 prominently affect breast cancer biology through regulation of cell metabolism and mitochondrial biogenesis. These findings indicate that tumors with dominant mutations could be susceptible to inhibitors of disease metabolism. Moreover, various pre-clinical and clinical studies have linked tumor metabolism to therapeutic response and patient survival. Thus, recent advances suggest that metabolic profiling provides new opportunities to improve outcomes in breast cancer. In this review, we have summarized some of the identified roles of oncometabolites in breast cancer biology and highlight their clinical utility.

metabolism Cancer biomarker prognosis therapy


Risk factors of work-related upper extremity musculoskeletal disorders in male cameramen.

Abstract:
OBJECTIVE
The aim of this study is to determine the risk factors related to upper extremities work-related musculoskeletal disorders (WRMSDs) in cameramen.

METHODS
A questionnaire survey was performed on 166 cameramen in a broadcasting station. The questionnaire consisted of questions on the general characteristics, the health behavior, work type and duration, physical burden, ergonomic posture, and musculoskeletal symptoms. Definition of musculoskeletal disorders was based on NIOSH criteria.

RESULTS
The positive rate of WRMSDs symptoms by parts of the body was turned out to be the highest in the shoulder (14.5%) and the lowest in arm and elbow (6%). Logistic regression analysis revealed that symptoms in the shoulders increased with BMI (OR = 3.62, 95% CI = 1.03-12.71), physical burden (OR = 9.29, 95% CI = 1.72-61.78 in the very hard group) and ergonomic factors (OR = 4.50, 95% CI = 1.03-19.68). Ergonomic factors were only related to the symptoms of hand and wrist (OR = 10.21, 95% CI = 1.02-102.20). WRMSDs symptoms, in the whole upper extremities, were higher in the 50 or older age group (OR = 5.86, 95% CI = 1.03-33.26), higher BMI group (OR = 3.26, 95% CI = 1.28-13.53), non-exercise group (OR = 2.37, 95% CI = 1.24-12.59), high physical burden group (OR = 7.6, 95% CI = 1.34-52.74), and high grade ergonomic risk group (OR = 4.82, 95% CI = 1.29-16.06).

CONCLUSION
The most serious musculoskeletal disorders of male cameramen were shoulder pain. Ergonomic factors and physical burden were the most significant factors affecting WRMSDs in cameramen in this study. Cameramen should be educated to be able to improve the ergonomic occupational environment and to set up preventive measures against the risk factors during work.

Kim|Jung Ho|JH|
Suh|Byung Seong|BS|
Kim|Soo Geun|SG|
Kim|Won Sool|WS|
Shon|You Il|YI|
Son|Hee Seung|HS|

Cameramen
Physical burden
Ergonomics
BMI
Exercise
Occupational diseases


Smoking, Alcohol Consumption, and Risks for Biliary Tract Cancer and Intrahepatic Bile Duct Cancer.

Abstract:
BACKGROUND
Smoking and alcohol are established risk factors for several types of cancer, but the effects on biliary cancers, comprising biliary tract cancer (BTC) and intrahepatic bile duct cancer (IHBDC), have been inconclusive.

METHODS
In this population-based prospective cohort study in Japan, we investigated the association of smoking and alcohol consumption with the risks of BTC and its subtypes and IHBDC incidence in men and women. Furthermore, the association of smoking stratified by drinking status was investigated. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazard model.

RESULTS
A total of 48,367 men and 54,776 women aged 40-69 years were enrolled from 1990 through 1994 and followed up for 846,417 person-years in men and 1,021,330 person-years in women until 2012, during which 246 BTC and 80 IHBDC male cases and 227 BTC and 60 IHBDC female cases were identified. In men, smoking was significantly associated with an increased risk of IHBDC (HR 2.25; 95% CI, 1.19-4.25 for current smokers with ≥30 pack-years compared with non-smokers), and the risk was enhanced among regular drinkers compared with non/occasional-drinkers (HR 3.48; 95% CI, 1.41-8.61). A non-significant increase of IHBDC risk associated with alcohol was observed. Neither smoking nor alcohol consumption was associated with BTC risk. In women, the association of smoking and alcohol consumption with IHBDC and BTC was unclear because current smokers and regular drinkers were very few.

CONCLUSION
Our findings suggest that smoking increases IHBDC risk in men, especially among regular drinkers.


Duration and extent of bilingual experience modulate neurocognitive outcomes.

Abstract: The potential effects of bilingualism on executive control (EC) have been heavily debated. One possible source of discrepancy in the evidence may be that bilingualism tends to be treated as a monolithic category distinct from monolingualism. We address this possibility by examining the effects of different bilingual language experiences on brain activity related to EC performance. Participants were scanned (fMRI) while they performed a Flanker task. Behavioral data showed robust Flanker effects, not modulated by language experiences across participants. However, differences in duration of bilingual experience and extent of active language use predicted activation in distinct brain regions indicating differences in neural recruitment across conditions. This approach highlights the need to consider specific bilingual language experiences in assessing neurocognitive effects. It further underscores the utility and complementarity of neuroimaging evidence in this general line of research, contributing to a deeper understanding of the variability reported in the literature.

DeLuca|Vincent|V| Rothman|Jason|J| Bialystok|Ellen|E| Pliatsikas|Christos|C|

Bilingualism
Executive control
fMRI
Individual differences


Anxiety and Depression Affect Early Postoperative Pain Dimensions after Bariatric Surgery.

Abstract: Uncontrolled postoperative pain and prolonged immobilization after bariatric surgery have been associated with increased postoperative complications and prolonged hospitalization. The aim of our study was to evaluate the postoperative pain that follows bariatric surgery and identify any psychological factors that may affect the early postoperative perception of pain. The study included 100 patients with obesity (women, n = 61; age 37.4 ± 9.9 years, mean ± standard deviation; Body Mass Index (BMI) 47.6 ± 6.5 kg/m2) who underwent bariatric surgery. Preoperative anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale (HADS), and the quantitative and qualitative dimension of early postoperative pain were evaluated by the McGill Pain Questionnaire Short Form (MPQ-SF). Furthermore, the postoperative analgesia protocol was recorded for each patient. Pain declined gradually during the first 24 h postoperative. Although preoperative anxiety had no correlation with the overall pain of postoperative Day 0, patients with a higher level of preoperative anxiety had significantly more intense and more unpleasant pain at 1 h post operation. In addition, depression influences both the intensity and unpleasantness of pain at different time points (1 h, 4 h and 24 h postoperative). Preoperative pain correlated with educational level, but not with age, BMI, gender, marital status, smoking and surgery type. In conclusion, preoperative anxiety and depression influence the early postoperative pain after bariatric surgery, and their preoperative identification is of major importance to enhance the implementation of fast-track postoperative protocols to prevent complications and prolonged hospitalization.

postoperative pain
pain dimensions
bariatric surgery
obesity
preoperative anxiety
preoperative depression


Image analysis to evaluate the browning degree of banana (Musa spp.) peel.

Abstract: Image analysis was applied to examine banana peel browning. The banana samples were divided into 3 treatment groups: no treatment and normal packaging (Cont); CO2 gas exchange packaging (CO); normal packaging with an ethylene generator (ET). We confirmed that the browning of banana peels developed more quickly in the CO group than the other groups based on sensory test and enzyme assay. The G (green) and CIE L(∗), a(∗), and b(∗) values obtained from the image analysis sharply increased or decreased in the CO group. And these colour values showed high correlation coefficients (>0.9) with the sensory test results. CIE L(∗)a(∗)b(∗) values using a colorimeter also showed high correlation coefficients but comparatively lower than those of image analysis. Based on this analysis, browning of the banana occurred more quickly for CO2 gas exchange packaging, and image analysis can be used to evaluate the browning of banana peels.

Cho|Jeong-Seok|JS| Lee|Hyeon-Jeong|HJ| Park|Jung-Hoon|JH| Sung|Jun-Hyung|JH| Choi|Ji-Young|JY| Moon|Kwang-Deog|KD|

Image analysis
Browning degree
Banana peel
Correlation coefficient
MATLAB


Pneumomediastinum in the neonate.

Abstract: A pneumomediastinum is an air leak in which the free air is concentrated in the mediastinum. Although most neonatal pneumomediastinums do not require intervention, complications such as subsequent air leaks can arise. Proper radiologic identification, as well as an understanding of the anatomy and pathophysiology associated with a pneumomediastinum, are necessary for an accurate understanding and diagnosis. This article will review the interpretation of radiologic findings in a neonate with a pneumomediastinum.


Restoring one way traffic across the Roux loop: The Nakajo value.

Abstract: Roux-en-Y (RY) hepaticojejunostomy (HJ) is a critical component of complex hepatobiliary operations, and it is the treatment of choice for post-cholecystectomy biliary strictures (PCBS). Complications related to the Roux limb, particularly those leading to cholangitis, can severely compromise outcomes. We present a case of a 54-year-old lady who had previously undergone two HJ procedures for recurrent PCBS. The same Roux limb had been used in each of the operations. Short Roux/Roux reflux syndrome led to recurrent cholangitis in this patient, as proven by the reflux of oral contrast into the biliary tree on imaging. This was effectively treated by lengthening the Roux limb (60 cm) with a redo-jejunojejunostomy, and creation of a Nakajo type valve. One-year post surgery, the patient remains well at follow-up. Enteric reflux into the biliary tree may lead to refractory cholangitis. We present the first ever case in an adult, where a simple and effective modification to the HJ obviated this complication.

Rammohan|Ashwin|A|
Srinivas|Sripriya|S|
Al Azri|Yahya|Y|
Reddy|Mettu Srinivas|MS|
Rela|Mohamed|M|

Biliary strictures
Cholangitis
Nakajo valve
Roux-en-Y anastomosis


Self-Reported Recovery from 2-Week 12-Hour Shift Work Schedules: A 14-Day Follow-Up.

Abstract:
BACKGROUND
Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting of only day work.

METHODS
Sixty-one male offshore employees-20 night workers, 16 swing shift workers, and 25 day workers-rated six questions on fatigue (sleep quality, feeling rested, physical and mental fatigue, and energy levels; scale 1-11) for 14 days after an offshore tour. After the two night-work schedules, differences on the 1(st) day (main effects) and differences during the follow-up (interaction effects) were compared to day work with generalized estimating equations analysis.

RESULTS
After adjustment for confounders, significant main effects were found for sleep quality for night workers (1.41, 95% confidence interval 1.05-1.89) and swing shift workers (1.42, 95% confidence interval 1.03-1.94) when compared to day workers; their interaction terms were not statistically significant. For the remaining fatigue outcomes, no statistically significant main or interaction effects were found.

CONCLUSION
After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the 1(st) day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality.

Merkus|Suzanne L|SL|
Holte|Kari Anne|KA|
Huysmans|Maaike A|MA|
van de Ven|Peter M|PM|
van Mechelen|Willem|W|
van der Beek|Allard J|AJ|

fatigue
long working hours
night work
offshore workers
recovery after work


Walking pace and the risk of stroke: A meta-analysis of prospective cohort studies.

Abstract:
PURPOSE
The extent to which walking pace is associated with a reduced risk for stroke remains unclear. This study examined the association between walking pace and stroke risk based on prospective cohort studies.

METHODS
Databases of PubMed, EMBASE, Web of Science, Scopus, and China National Knowledge Internet were searched from the inception dates to January 31, 2019, for prospective cohort studies focusing on walking pace and risk of stroke in adults. Two reviewers independently extracted data and assessed the quality of the studies. The dependent measure was stroke incidence. Using random-effects models, a meta-analysis was performed to estimate the overall relative risks (RR) of stroke incidence and 95% confidence intervals (CIs) for the individuals with the fastest walking paces vs. individuals with the slowest walking paces. A dose-response relationship was also examined.

RESULTS
After screening 1294 titles/abstracts and 14 full-text studies identified in the search, 7 studies (from 8 cohorts) were included in the meta-analysis. The 7 studies included a total of 135,645 participants (95.2% women; mean age 63.6 years) and 2229 stroke events (median follow-up time = 8.0 years). Compared to individuals in the slowest walking-pace category (median = 1.6 km/h), individuals in the fastest walking-pace category (median = 5.6 km/h) had a 44% lower risk of stroke (pooled RR = 0.56, 95%CI: 0.48-0.65). There was also a linear dose-response relationship (RR = 0.87; 95%CI: 0.83-0.91), with the risk of stroke decreased by 13% for every 1 km/h increment in baseline walking pace. We observed similar results across walking-pace assessment, type of stroke ascertainment, stroke subtypes, sex, sample size, and duration of follow-up.

CONCLUSION
Findings from this meta-analysis indicate that walking pace is inversely associated with the risk of stroke.

Quan|Minghui|M| Xun|Pengcheng|P| Wang|Ru|R| He|Ka|K| Chen|Peijie|P|

Walking pace
Stroke incidence
Dose response
Meta-analytic review


Altered brain activity in the bilateral frontal cortices and neural correlation with cognitive impairment in schizophrenia.

Abstract: Cognitive impairments are core aspects of schizophrenia and are highly related to poor outcomes. However, the effect of therapy on cognitive impairments remains unsatisfactory as its biological mechanisms are not fully understood. The purpose of this study was to investigate the disrupted intrinsic neural activity of the frontal areas and to further examine the functional connectivity of frontal areas related to cognitive impairments in schizophrenia. We collected brain imaging data using a 3T Siemens Prisma MRI system in 32 patients with schizophrenia and 34 age- and sex-matched healthy controls. The mean fractional amplitude of low-frequency fluctuation (mfALFF) in the frontal regions was calculated and analyzed to evaluate regional neural activity alterations in schizophrenia. Seed regions were generated from clusters showing significant changes in mfALFF in schizophrenia, and its resting-state functional connectivity (rs-FC) with other brain regions were estimated to detect possible aberrant rs-FC indicating cognitive impairments in schizophrenia. We found that mfALFF in the bilateral frontal cortices was increased in schizophrenia. mfALFF-based rs-FC revealed that decreased rs-FC between left middle frontal gyrus (MFG) and left medial superior frontal gyrus (MFSG) was associated with poor delayed memory (r = 0.566, Bonferroni-corrected p = 0.012). These findings demonstrate increased neural activity in the frontal cortices in schizophrenia. FC analysis revealed a diminished rs-FC pattern between the left MFG and left MSFG that was associated with cognitive impairments. These findings have provided deeper insight into the alterations in brain function related to specific domains of cognitive impairment and may provide evidence for precise interventions for cognitive deficits in schizophrenia.

Resting-state functional magnetic resonance image


Photocarrier Dynamics in MoTe2 Nanofilms with 2H and Distorted 1T Lattice Structures.

Abstract: Molybdenum telluride (MoTe2), an emerging layered two-dimensional (2D) material, possesses excellent phase-changing properties. Previous studies revealed its reversible transition between 2H and 1T' phases with a transition energy as small as 35 meV. Since 1T'-MoTe2 is metallic, it can serve as an electrical contact for semiconducting 2H-MoTe2-based optoelectronic devices. Here, the photocarrier dynamics in MoTe2 nanofilms synthesized by a one-step method and with coexisting multiple phases are investigated by transient absorption measurements. Both the energy relaxation time and the recombination lifetime of the excitons are shorter in the 1T'-MoTe2 compared to its 2H phase. These results provide information on the different photocarrier dynamical properties of these two phases, which is important for future 2D optoelectronic and phase-change electronic devices based on MoTe2.

photocarrier dynamics
molybdenum telluride (MoTe2)
multiple phases
transient absorption
energy relaxation time
recombination lifetime


Synthesis and preliminary biological evaluation of 1,2,3-triazole-Jaspine B hybrids as potential cytotoxic agents.

Abstract: Two series of more available novel 1,2,3-triazole-Jaspine B hybrids were efficiently synthesized employing click chemistry approach and evaluated for their cytotoxic activities against three human cancer cell lines (EC-9706, MGC-803 and MCF-7). Among them, compound 14h showed excellent inhibition against MCF-7 (IC50 = 1.93 μM) and was more potent than 5-Fu and Jaspine B against all three cancer cell lines. Further investigation of apoptosis assay and cell cycle analysis demonstrated that compound 14h caused cellular early and late apoptosis and arrested the cell cycle at G2/M phase in a concentration- and time-independent manner. This was the first report about the synthesis and in vitro cytotoxic evaluation of 1,2,3-triazole-Jaspine B hybrids.

Xu|Jin-Mei|JM| Zhang|En|E| Shi|Xiao-Jing|XJ| Wang|Yan-Chao|YC| Yu|Bin|B| Jiao|Wei-Wei|WW| Guo|Ya-Zhuo|YZ| Liu|Hong-Min|HM|

D057927:Hydrophobic and Hydrophilic Interactions

Cytotoxicity
Jaspine B
Apoptosis
1,2,3-Triazole
Cell cycle arrest


What the internist should know about stem cell transplant in the elderly patient.

Abstract: Most hematological malignancies are increasing in frequency with age. Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapeutic option for patients with malignant and non-malignant hematological diseases. The treatment of elderly patients with advanced hematological malignancies has expanded to include reduced intensity conditioning allo-HCT. Physicians increasingly refer older patients for allo-HCT due to more experience and improved supportive care in allo-HCT. This review article discusses the available data regarding the feasibility, tolerability, toxicity, and effectiveness of allo-HCT in different hematological diseases in the elderly. Over the past decade, utilization and survival after allo-HCT have increased in patients ≥70 years. Selected adults ≥70 years with hematological diseases should be evaluated for transplantation.

D018380:Hematopoietic Stem Cell Transplantation

Elderly patients
Conditioning regimen
Donor choice
Geriatric assessment
Hematopoietic stem cell transplantation


The knee extensor moment arm is associated with performance in male sprinters.

Abstract:
PURPOSE
Although large knee extensor torque contributes to superior sprint performance, previous findings have indicated that the quadriceps cross-sectional area (CSA), a pivotal morphological regulator of knee extensor torque, is not correlated with performance in sprinters. We hypothesized that the knee extensor moment arm (MA), another main morphological regulator of knee extensor torque, may affect sprint performance. To test this hypothesis, we examined the relationship between knee extensor MA and sprint performance.

METHODS
The quadriceps CSA and knee extensor MA in 32 well-trained male sprinters and 32 male non-sprinters were measured using magnetic resonance imaging.

RESULTS
Knee extensor MA, but not quadriceps CSA, was greater in sprinters than in non-sprinters (P = 0.013). Moreover, knee extensor MA, but not the quadriceps CSA, was correlated with the personal best time in a 100-m race in sprinters (r = -0.614, P < 0.001). Furthermore, among 24 sprinters who participated in the 60-m sprint test, knee extensor MA was correlated with sprinting velocities in the acceleration (r = 0.717, P < 0.001) and maximum speed (r = 0.697, P < 0.001) phases.

CONCLUSION
The present study demonstrates that the knee extensor MA is greater in sprinters than in non-sprinters, and this morphological structure in sprinters is associated with sprint performance. Therefore, for the first time, we provided evidence that a greater knee extensor MA in sprinters may be an advantageous for achieving superior sprint performance.

Miyake|Yuto|Y| Suga|Tadashi|T| Otsuka|Mitsuo|M| Tanaka|Takahiro|T| Misaki|Jun|J| Kudo|Shoma|S| Nagano|Akinori|A| Isaka|Tadao|T|

Magnetic resonance imaging
Joint torque
Muscle cross-sectional area
Muscle strength
Resistance training


GLUT1 expression in pediatric adrenocortical tumors: a promising candidate to predict clinical behavior.

Abstract:
BACKGROUND
Discrimination between benign and malignant tumors is a challenging process in pediatric adrenocortical tumors. New insights in the metabolic profile of pediatric adrenocortical tumors may contribute to this distinction, predict prognosis, as well as identify new molecular targets for therapy. The aim of this work is to characterize the expression of the metabolism-related proteins MCT1, MCT2, MCT4, CD147, CD44, GLUT1 and CAIX in a series of pediatric adrenocortical tumors.

METHODS
A total of 50 pediatric patients presenting adrenocortical tumors, including 41 clinically benign and 9 clinically malignant tumors, were included. Protein expression was evaluated using immunohistochemistry in samples arranged in tissue microarrays.

RESULTS
The immunohistochemical analysis showed a significant increase in plasma membrane expression of GLUT1 in malignant lesions, when compared to benign lesions (p=0.004), being the expression of this protein associated with shorter overall and disease-free survival (p=0.004 and p=0.001, respectively). Although significant differences were not observed for proteins other than GLUT1, MCT1, MCT4 and CD147 were highly expressed in pediatric adrenocortical neoplasias (around 90%).

CONCLUSION
GLUT1 expression was differentially expressed in pediatric adrenocortical tumors, with higher expression in clinically malignant tumors, and associated with shorter survival, suggesting a metabolic remodeling towards a hyperglycolytic phenotype in this malignancy.

Pinheiro|Céline|C|
Granja|Sara|S|
Longatto-Filho|Adhemar|A|
Faria|André M|AM|
Fragoso|Maria C B V|MCBV|
Lovisolo|Silvana M|SM|
Bonatelli|Murilo|M|
Costa|Ricardo F A|RFA|
Lerário|Antonio M|AM|
Almeida|Madson Q|MQ|
Baltazar|Fátima|F|
Zerbini|Maria C N|MCN|

pediatric adrenocortical tumors
Warburg effect
glucose transporter
metabolic reprogramming
monocarboxylate transporter


A New Method to Develop the Primate Model of Knee Osteoarthritis With Focal Cartilage Defect.

Abstract: Objective: Osteoarthritis (OA) is a common degenerative joint disease, and animal models have proven pivotal in investigating this disease. This study aimed to develop a primate model of OA that may be more relevant to research studies on OA in humans. Method: Twelve female rhesus macaques were randomly divided into three groups. Four animals were untreated (Control group); four were subjected to the modified Hulth method, involving cutting of the anterior and posterior cruciate ligaments, and transecting the meniscus (Hulth group); and four were subjected to the modified Hulth method combined with cartilage defect (MHCD group). Each primate was subjected to motor ability tests, and underwent arthroscopic, radiographic, morphological, and pathological observation of the knee joints at various times for up to 180 days. Results: Motor ability on Day 180 was significantly lower in the MHCD group than in the Control (p＜0.01) and Hulth (p＜0.05) groups. Radiographic and morphological examination showed that the severity of knee joint deformity and articular cartilage injury were greater in the MHCD group than in the other groups. Pathological examination showed that cartilage thickness was significantly lower in the MHCD group than in the other groups at the same time points. The Mankin score on Day 180 was markedly higher in the MHCD group than in the Hulth (p＜0.05) and Control (p＜0.001) groups. Conclusion: The MHCD model of OA closely resembles the pathophysiological processes of spontaneous knee OA in humans. The time required to develop knee OA is shorter using the MHCD model than using the Hulth method.

Bi|Xin|X| Li|Tao|T| Li|Min|M| Xiang|Shutian|S| Li|Junhong|J| Ling|Bin|B| Wu|Zhaoxiang|Z| Chen|Zhong|Z|

knee
osteoarthritis
animal models
rhesus macaques
modified hulth method
cartilage injury


A Basic Course in Humanitarian Health Emergency and Relief: A Pilot Study from Saudi Arabia.

Abstract:
BACKGROUND
Political unrest in the Middle East heightens the possibility of catastrophe due to violent conflict and/or terrorist attacks. However, the disaster risk reduction strategy in the Saudi health care system appears to be a reactive approach focused more on flood hazards than other threats. Given the current unstable political situation in its neighboring countries and Saudi Arabia's key role in providing humanitarian assistance and disaster relief to those affected by internal conflicts and wars, it is essential to develop a framework for training standards related to complex humanitarian disasters to provide the requisite skills and knowledge in a gradual manner, according to local context and international standards. This framework could also support the World Health Organization's (WHO; Geneva, Switzerland) initiative for establishing a national disaster assistance team in Saudi Arabia.

PROBLEM
The main aim of this study is to provide Saudi health care providers with a competencies-based course in Basic Principles of Complex Humanitarian Emergency.

METHODS
The interactive, competencies-based course in Basic Principles of Complex Humanitarian Emergency was designed by five experts in disaster medicine and humanitarian relief in three stages, accordance to international standards and the local context. The course was piloted over five days at the Officers Club of the Ministry of Interior (MOI; Riyadh, Saudi Arabia). The 33 participants were from different health disciplines of the government sectors in-country. The participants completed the pre- and post-tests and attended three pilot workshops for disaster community awareness.

RESULTS
The overall knowledge scores were significantly higher in the post-test (62.9%) than the pre-test (44.2%). There were no significant differences in the pre- and post-knowledge scores for health care providers from the different government health disciplines. A 10-month, post-event survey demonstrated that participants were satisfied with their knowledge retention. Importantly, three of them (16.6%) had the opportunity to put this knowledge into practice in relation to humanitarian aid response.

CONCLUSION
Delivering a competencies-based course in Basic Principles of Complex Humanitarian Emergency for health care providers can help improve their knowledge and skills for humanitarian assistance and disaster relief, which is crucial for disaster preparedness augmentation in Saudi Arabia.

D003479:Curriculum
D004189:Disaster Planning
D004632:Emergency Medical Services
D006801:Humans
D007318:Inservice Training
D010865:Pilot Projects
D015397:Program Evaluation
D012066:Relief Work
D012529:Saudi Arabia

risk reduction
humanitarian assistance
competencies-based course
complex emergency
humanitarian response


COVID-19 related mortality in post-operative cardiac surgical patients.

Abstract:
BACKGROUND
COVID-19 has caused a global pandemic of unprecedented proportions. Elective cardiac surgery has been universally postponed with only urgent and emergency cardiac operations being performed. The National Health Service in the United Kingdom introduced national measures to conserve intensive care beds and significantly limit elective activity shortly after lockdown.

CASE PRESENTATION
We report two cases of early post-operative mortality secondary to COVID-19 infection immediately prior to the implementation of these widespread measures.

CONCLUSION
The role of cardiac surgery in the presence of COVID-19 is still very unpredictable and further studies on both short term and long term outcomes are warranted.


Improved production of fatty alcohols in cyanobacteria by metabolic engineering.

Abstract:
BACKGROUND
Fatty alcohols are widely used in industrial chemicals. The biosynthetic pathways for fatty alcohols are diverse and widely existing in nature. They display a high capacity to produce fatty alcohols by the metabolic engineering of different microbe hosts. Direct recycling of carbon dioxide to fatty alcohols can be achieved by introducing a fatty alcohol-producing pathway into photosynthetic cyanobacteria. According to our precious reports, a relatively low yield of fatty alcohols was obtained in the genetically engineered cyanobacterium Synechocystis sp. PCC 6803.

RESULTS
The photosynthetic production of fatty alcohols in Synechocystis sp. PCC 6803 was improved through heterologously expressing fatty acyl-Coenzyme A (acyl-CoA) reductase gene maqu_2220 from the marine bacterium Marinobacter aquaeolei VT8. Maqu_2220 has been proved to catalyze both the four-electron reduction of fatty acyl-CoA or acyl-Acyl Carrier Protein (acyl-ACP) and the two-electron reduction of fatty aldehyde to fatty alcohol. The knockout of the aldehyde-deformylating oxygenase gene (sll0208) efficiently blocked the hydrocarbon accumulation and redirected the carbon flux into the fatty alcohol-producing pathway. By knocking-out both sll0208 and sll0209 (encoding an acyl-ACP reductase), the productivity of fatty alcohols was further increased to 2.87 mg/g dry weight.

CONCLUSIONS
The highest yield of fatty alcohols was achieved in cyanobacteria by expressing the prokaryotic fatty acyl-CoA reductase Maqu_2220 and knocking-out the two key genes (sll0208 and sll0209) that are involved in the alka(e)ne biosynthesis pathway. Maqu_2220 was demonstrated as a robust enzyme for producing fatty alcohols in cyanobacteria. The production of fatty alcohols could be significantly increased by blocking the hydrocarbon biosynthesis pathway.

Yao|Lun|L| Qi|Fengxia|F| Tan|Xiaoming|X| Lu|Xuefeng|X|

Fatty alcohol
Cyanobacteria
Marinobacter aquaeolei VT8
Fatty acyl-CoA reductase


Descriptive epidemiology of Lassa fever in Nigeria, 2012-2017.

Abstract:
Introduction
Lassa fever, an acute viral hemorrhagic zoonotic disease is endemic in some parts of Nigeria. The disease alert and outbreak threshold are known; however, there has been a shift from the previous seasonal transmission pattern to an all year-round transmission. We described data on Lassa fever and highlighted the magnitude of the disease over a six-year period.

Methods
we conducted a secondary data analyses of Lassa fever specific surveillance data from the Integrated Disease Surveillance and Response (IDSR) records of all states in Nigeria over a six-year period (2012-2017).

Results
a total of 5974 suspected cases were reported within the study period; of these, 759 (12.7%) were confirmed by laboratory diagnosis. Highest number of cases was recorded in 2012. Edo and Ondo states in the southern region of the country were mostly affected within the study period. The seasonal trend of Lassa fever cases showed peaks within January to March, except for year 2015.

Conclusion
there was a high burden of Lassa fever in Nigeria especially in the southern part. Lassa fever transmission occurs all year-round with peaks in January and March. There is need to develop preparedness plans and define thresholds for Lassa fever epidemic.

Okoro|Onyebuchi Augustine|OA|
Bamgboye|Eniola|E|
Dan-Nwafor|Chioma|C|
Umeokonkwo|Chukwuma|C|
Ilori|Elsie|E|
Yashe|Rimamdeyati|R|
Balogun|Muhammad|M|
Nguku|Patrick|P|
Ihekweazu|Chikwe|C|