Explore the vast range of titles available.

A series of recent acute blindness cases following non–complicated retinal detachment surgery caused the release of several health alerts in Spain. The blindness was attributed to certain lots of perfluoro-octane (PFO; a volatile and transient medical device). Similar cases have been reported in other countries. This has raised questions regarding the validity of cytotoxicity test methods currently used to certify the safety of PFO lots. The tests were performed according to the International Organization for Standardization (ISO) norms, using the extract dilution method or the indirect contact method as applied to L929 cells, a line derived from mouse fibroblasts. The limitations of those methods have been resolved in this study by proposing a new cytotoxicity test method for volatile substances. The new method requires direct contact of the tested substance with cells that are similar to those exposed to the substance in the clinical setting. This approach includes a few new technical steps that are crucial for detecting cytotoxicity. Our new method detected toxic PFO lots that corresponded to the lots producing clinical blindness, which previous methods failed to detect. The study suggests applying this new method to avoid occurrence of such cases of blindness.

Background In many resource-constrained settings, community health workers (CHW) often provide the initial care for children under five years of age. As part of integrated community case management (iCCM) programs, CHW frequently diagnose and treat acute respiratory illness (ARI), a leading cause of pediatric mortality and indication for antibiotic use globally. Yet knowledge and perceptions of antibiotic prescribing for ARI among CHW are not well-studied. The goal of this study was to assess knowledge, attitudes, and practices related to antibiotics among CHW implementing a stepped-wedge trial of an enhanced iCCM algorithm for children with ARI in rural Uganda to inform future antimicrobial stewardship strategies. Methods We conducted a nested mixed methods study with a convergent parallel design, administering surveys before and after the stepped wedge trial and individual semi-structured interviews at study end. We employed descriptive statistics, Wilcoxan rank sum tests, and thematic content analysis methods. Results A total of 63 of 67 (94.0%) CHW completed both baseline and follow-up surveys, and 15 CHW were interviewed. The median age of the full cohort was 40 (IQR: 35–47) years with 9.5 years of CHW experience (IQR: 4.0–14.0 years). Almost all CHW (95.2%) identified amoxicillin as an antibiotic at baseline, and most associated antibiotics with treating bacterial diseases (baseline: 82.5%, follow-up: 93.7%, p  = 0.05). Most perceived antibiotics as harmful to patients when prescribed unnecessarily. At follow-up, more CHW disagreed that antibiotics should be prescribed when in doubt. They welcomed additional education about antimicrobial resistance and diagnostic tools to advance antimicrobial stewardship (AMS). Conclusion CHW were overall familiar with antibiotics and their potential harms. They were eager to gain knowledge regarding AMS and AMR and share it with their communities. CHW represent an underutilized resource for AMS interventions and should be included in their design and implementation.

This study aimed to identify and characterise biosurfactant compounds produced by bacteria associated with a marine eukaryotic phytoplankton bloom. One strain, designated MCTG214(3b1), was isolated by enrichment with polycyclic aromatic hydrocarbons and based on 16S rDNA, and gyrB sequencing was found to belong to the genus Pseudomonas, however not related to P. aeruginosa. Cell-free supernatant samples of strain MCTG214(3b1) at stationary phase showed significant reductions in surface tension. HPLC-MS and NMR analysis of these samples indicated the presence of five different rhamnolipid (RL) congeners. Di-rhamnolipids accounted for 87% relative abundance and all congeners possessed fatty acid moieties consisting of 8–12 carbons. PCR screening of strain MCTG214(3b1) DNA revealed homologues to the P. aeruginosa RL synthesis genes rhlA and rhlB; however, no rhlC homologue was identified. Using the Galleria mellonella larvae model, strain MCTG214(3b1) was demonstrated to be far less pathogenic than P. aeruginosa. This study identifies for the first time a significantly high level of synthesis of short chain di-rhamnolipids by a non-pathogenic marine Pseudomonas species. We postulate that RL synthesis in Pseudomonas sp. MCTG214(3b1) is carried out by enzymes expressed from rhlA/B homologues similar to those of P. aeruginosa; however, a lack of rhlC potentially indicates the presence of a second novel rhamnosyltransferase responsible for the di-rhamnolipid congeners identified by HPLC-MS.

Serious intraocular toxicity cases have been reported worldwide after the use of different perfluorocarbon liquids. The current study reports for the first-time the clinical pictures of cases of acute intraocular toxicity caused by MEROCTANE, a perfluoro-octane commercialized by a Turkish company and distributed in many countries. A series of 18 cases from Chile and Spain was retrospectively analysed. To evaluate the impurity profile, a suspicious MEROCTANE sample (lot OCT.01.2013) was analysed by gas chromatography mass spectrometry and compared with a non-suspicious sample of the same commercial perfluoro-octane (lot OCT 722011). Cytotoxicity was tested following a direct-contact method, taking into consideration the high volatility and hydrophobicity of perfluoro-octane and following the ISO 10993 guideline. Cytotoxicity test showed clear cytotoxic effects of the analysed batch (less than 9% of cell viability). Moreover, chemical analysis demonstrated the presence of many contaminants, some highly toxic (acids and alcohols). Perfluorocarbon liquids are useful tools for intraocular surgery but companies and Agencies of Medical Devices must implement measures that guarantee the safety of these products based on both chemical and cytotoxicity analysis for every batch . Medical staff should be encouraged to report any suspected case to their respective National Agencies.

Background Mortality rates due to coronary heart disease (CHD) have decreased in most countries, but increased in low and middle-income countries. Few studies have analyzed the trends of coronary heart disease mortality in Latin America, specifically the trends in young-adults and the effect of correcting these comparisons for nonspecific causes of death (garbage codes). The objective of this study was to describe and compare standardized, age-specific, and garbage-code corrected mortality trends for coronary heart disease from 1985 to 2015 in Argentina, Colombia, and Mexico. Methods Deaths from coronary heart disease were grouped by country, year of registration, sex, and 10-year age bands to calculate age-adjusted and age and sex-specific rates for adults aged ≥25. We corrected for garbage-codes using the methodology proposed by the Global Burden of Disease. Finally, we fitted Joinpoint regression models. Results In 1985, age-standardized mortality rates per 100,000 population were 136.6 in Argentina, 160.6 in Colombia, and 87.51 in Mexico; by 2015 rates decreased 51% in Argentina and 6.5% in Colombia, yet increased by 61% in Mexico, where an upward trend in mortality was observed in young adults. Garbage-code corrections produced increases in mortality rates, particularly in Argentina with approximately 80 additional deaths per 100,000, 14 in Colombia and 13 in Mexico. Conclusions Latin American countries are at different stages of the cardiovascular disease epidemic. Garbage code correction produce large changes in the mortality rates in Argentina, yet smaller in Mexico and Colombia, suggesting garbage code corrections may be needed for specific countries. While coronary heart disease (CHD) mortality is falling in Argentina, modest falls in Colombia and substantial increases in Mexico highlight the need for the region to propose and implement population-wide prevention policies.

Coastal storms have consequences for human lives and infrastructure but also create important early successional habitats for myriad species. For example, storm-induced overwash creates nesting habitat for shorebirds like piping plovers (Charadrius melodus). We examined how piping plover habitat extent and location changed on barrier islands in New York, New Jersey, and Virginia after Hurricane Sandy made landfall following the 2012 breeding season. We modeled nesting habitat using a nest presence/absence dataset that included characterizations of coastal morphology and vegetation. Using a Bayesian network, we predicted nesting habitat for each study site for the years 2010/2011, 2012, and 2014/2015 based on remotely sensed spatial datasets (e.g., lidar, orthophotos). We found that Hurricane Sandy increased piping plover habitat by 9 to 300% at 4 of 5 study sites but that one site saw a decrease in habitat by 27%. The amount, location, and longevity of new habitat appeared to be influenced by the level of human development at each site. At three of the five sites, the amount of habitat created and the time new habitat persisted were inversely related to the amount of development. Furthermore, the proportion of new habitat created in high-quality overwash was inversely related to the level of development on study areas, from 17% of all new habitat in overwash at one of the most densely developed sites to 80% of all new habitat at an undeveloped site. We also show that piping plovers exploited new habitat after the storm, with 14-57% of all nests located in newly created habitat in the 2013 breeding season. Our results quantify the importance of storms in creating and maintaining coastal habitats for beach-nesting species like piping plovers, and these results suggest a negative correlation between human development and beneficial ecological impacts of these natural disturbances.

IntroductionThe Autonomous Sensory Meridian (ASMR) is a static or tingling sensation on the skin that usually starts on the scalp and runs through the back of the neck and upper spine. It has been compared to tactile auditory synesthesia and may overlap with shivering. It is a subjective experience of “low-grade euphoria”, characterized by “a combination of positive feelings and a static tingling sensation on the skin”. It is most commonly triggered by auditory or visual stimuli, and less commonly by intentional attentional control.ObjectivesTo determine the effects produced by the perception of ASMR in the population with mental disorders.MethodsA literature review was carried out in Pubmed using the descriptors: “ASMR” AND “mental”. 7 results are obtained. The results of a time limit of 10 years were filtered, obtaining 6 results and selecting all of them for their relevance to the PICO question. Subsequently, the search was repeated using the same descriptors and time limit in the Cochrane Library and NICE, in which no results were found.ResultsThe first result, an RCT of 475 people between the ages of 18 and 54, showed that 80% of the participants answered positively when asked if ASMR has an effect on their mood, while 14% were not sure and 6 % felt ASMR did not alter their mood. When subjected to a mixed ANOVA with factors for time (before, during, immediately after, and 3 h after ASMR) and for depression status (high, medium, or low as defined by the BDI), we found a significant main effect. of time in mood. [p<0.0005]In one of these studies, the default neural network (the one that works when the brain is relaxed) was analyzed in 11 volunteers in whom ASMR caused them to relax, in contrast to 11 individuals in the control group. At the end of the study, the ASMR volunteers generally showed less functional connectivity than the other volunteers. It also showed “increased connectivity between regions of the occipital, frontal, and temporal cortices,” suggesting that ASMR favors the association of those networks that are activated in the resting state.ConclusionsWith the available evidence it is concluded that ASMR could improve of the affective clinic reflected in the parameters of the Beck depression scale as well as a sense of calm and relaxation and it reduces the heart rate or increases the conductivity of the skin, something that happens when certain emotional states are altered.Disclosure of InterestNone Declared

IntroductionOmega-3 polyunsaturated fatty acids (PUFAs) have been studied in relation to mental illness. Among the most important omega 3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) stand out, both derived from alpha-linolenic acid. Both EPA and DHA are essential fatty acids. Consequently, mammals are not capable of synthesizing them and must incorporate them through the consumption of products such as fish oil. The interest about the role of omega 3 fatty acids for the treatment of patients with impulsiveness, hostility and aggressiveness is growing and originated from the finding of a low level of EPA and DHA in the central nervous system of these individuals.ObjectivesTo determine the evidence on the effectiveness of omega-3 acids in reducing severe symptoms in patients diagnosed with Borderline Personality Disorder.MethodsA literature review was carried out in Epistemonikos, using the descriptors: “borderline personality disorder” AND “Omega-3”. 7 results are obtained. The results of a time limit of 10 years with meta-analyses and systematic reviews were filtered, obtaining 7 results and selecting 3 of them for their relevance to the PICO question. Subsequently, the search was repeated using the same descriptors and time limit in the Cochrane Library, NICE, and Pubmed; no selection was made by coincidence of those previously selected.ResultsThe first systematic review studied the effectiveness of omega-3 fatty acids in symptomatology associated with BPD, with differentiation of the domains of affective, impulsive and cognitive-perceptual symptoms. Within the meta-analysis, 5 randomized controlled trials (RCTs) were included that compared omega-3 fatty acids with placebo or any active comparator, four of these RCTs verified the effect of omega-3 acids in 137 patients with BPD or behavior related to the BPD.The second systematic review, conducted in the Cochrane Collaboration, performed a meta-analysis of randomized comparisons of drug versus placebo. Twenty-seven trials testing first- and second-generation antipsychotics, mood stabilizers, antidepressants, and omega-3 fatty acids were included. For supplemental omega-3 fatty acids, significant effects were found in one study (n = 49 ) for reduction in suicidality (RR = 0.52, 95% CI 0.28 to 0.95) and depressive symptoms (RR = 0.48, 95% CI 0.28 to 0, 81).ConclusionsAvailable data indicate that marine omega-3 fatty acids improve BPD symptoms, particularly impulsive behavioral dyscontrol and affective dysregulation, reducing depressive symptoms and suicidal tendencies. Marine omega-3 fatty acids could be considered as a complementary therapy for the improvement of severe symptoms associated with patients with BPD.Disclosure of InterestNone Declared

The continued increase of the demand for seed of the Pacific oyster ( Crassostrea gigas ) has driven the aquaculture industry to produce land-based hatcheries using broodstock conditioning. This has led to the need to create closed systems to control the main factors involved in reproduction (temperature and food). Additionally, reproductive synchronization of broodstocks may be considered to ensure homogeneous maturation and spawning among the organisms. In this work, we synchronized the broodstock reproductive stage of Pacific oysters in a recirculating aquaculture system (RAS) using a “preconditioning” process and evaluated the effect of the water quality and the CO 2 -carbonate system on preconditioned broodstock. The oysters were kept at 12 °C for 45 days in a RAS containing a calcium reactor (C2) or without a calcium reactor (C1, control). Water quality parameters were measured daily, and the oyster’s condition and reproductive development were monitored using condition index, biometrics, and histology, on Days 0, 20, and 45. C1 and C2 systems kept the water quality within the ranges reported as favorable for bivalves. The calcium reactor kept the pH (8.03–8.10), alkalinity (200 mg/L as CaCO 3 ), CO 3 2− (≤ 80 µmol/kg), and Ω aragonite (≤ 1) closer to the ranges reported as optimal for bivalves. However, no significant differences were detected in the total weight and the condition index in C1 and C2. The preconditioning allowed to maintain the organisms in early reproductive development, allowing gametogenesis synchronization to start maturation.

Purpose To propose a simplified histological classification for core-needle biopsy (CNB) of thyroid nodules with four diagnostic categories (DC) and provide the risk of malignancy (ROM) and the expected incidence for each DC. There is no uniform scheme for categorizing CNB specimens, except for a Korean diagnostic classification similar to the Bethesda system for FNAC. Methods Data from a single institution using CNB as a routine diagnostic tool for thyroid nodules. Biopsies were classified as non-diagnostic, benign, follicular tumour (FT) or malignant. The frequency of each DC and the correlation with surgical pathology of nodules undergoing surgery after CNB were evaluated. Results Of 6284 CNBs on 5782 nodules [195 (3.1%) non-diagnostic, 5043 (80.3%) benign, 435 (6.9%) FT and 611 (9.7%) malignant], 1914 nodules (33.1%) underwent surgery after 2016 CNBs: 48 non-diagnostic, 1035 benign, 355 FT and 578 malignant. Malignancy was diagnosed after surgery in 11 non-diagnostic (ROM: 22.9%), 23 benign (ROM: 2.2%), 44 FT (ROM: 12.4%, 11.5% excluding low-grade malignancy) and 568 malignant CNBs (ROM: 98.3%, 93.8% excluding low-grade malignancy). Sensitivity and positive predictive value for malignancy of FT or malignant CNB were 94.7% and 65.6%, and for thyroid neoplasm (adenoma or carcinoma) were 93.2% and 92.6%. Conclusions Our diagnostic classification for CNB of thyroid nodules has a high diagnostic accuracy with a low rate of indeterminate categories. This classification, applied in a Western practice, shows a low ROM for nodules classified as follicular tumours, which could be improved with immunohistochemical studies.