Sources of particulate-matter air pollution and its oxidative potential in Europe.

Particulate matter is a component of ambient air pollution that has been linked to millions of annual premature deaths globally1-3. Assessments of the chronic and acute effects of particulate matter on human health tend to be based on mass concentration, with particle size and composition also thought to play a part4. Oxidative potential has been suggested to be one of the many possible drivers of the acute health effects of particulate matter, but the link remains uncertain5-8. Studies investigating the particulate-matter components that manifest an oxidative activity have yielded conflicting results7. In consequence, there is still much to be learned about the sources of particulate matter that may control the oxidative potential concentration7. Here we use field observations and air-quality modelling to quantify the major primary and secondary sources of particulate matter and of oxidative potential in Europe. We find that secondary inorganic components, crustal material and secondary biogenic organic aerosols control the mass concentration of particulate matter. By contrast, oxidative potential concentration is associated mostly with anthropogenic sources, in particular with fine-mode secondary organic aerosols largely from residential biomass burning and coarse-mode metals from vehicular non-exhaust emissions. Our results suggest that mitigation strategies aimed at reducing the mass concentrations of particulate matter alone may not reduce the oxidative potential concentration. If the oxidative potential can be linked to major health impacts, it may be more effective to control specific sources of particulate matter rather than overall particulate mass.

[Antiphospholipid autoantibodies and Covid-19]. / Auto-anticorps anti-phospholipides et Covid-19.

Infection with Sars-CoV-2 is at the origin of a viral pandemic responsible for an unprecedented global health and economic crisis. Recently, an autoimmune process has been described in particular in severe forms of Covid-19. However, the role of autoimmunity in the disease remains to be defined. Thus, the presence of antiphospholipid autoantibodies (aPLs) is observed in patients with Covid-19 and a significant association is demonstrated between patients with a severe form and the presence of anticardiolipin autoantibodies (aCL) of IgG isotype.

Multi-acrylamides improve bond stability through collagen reinforcement under physiological conditions.

OBJECTIVES: Acrylamides were shown to significantly improve bonding stability in adhesive restorations, but the reinforcement mechanism has not been fully elucidated. We tested the hypothesis that hydrogen bonding reinforcement of the collagen network (with secondary or tertiary acrylamides), as well as degree of crosslinking of the polymer network (with di- or tri-functional acrylamides), can be two of the factors at play. METHODS: Two-step total etch adhesives comprising UDMA (60 wt%) and 40 wt% of: TAAEA, TMAAEA (secondary, tertiary tri-acrylamides), BAAP, DEBAAP (secondary, tertiary di-acrylamides) or HEMA (mono-methacrylate - control) were formulated. Simulated composite restorations (n = 5) were tested after cyclic mechanical and biological (S. mutans biofilm) challenges. Gap formation before and after aging was assessed with SEM imaging. Micro-tensile bond strength (µTBS, n = 6) was assessed after seven-day incubation in water or S. mutans-containing culture medium. Collagen reinforcement was assessed with hydroxyproline assay (n = 10) and rheology (n = 3). Data were analyzed with one-way/two-way ANOVA/Tukey's test (alpha=5%). RESULTS: Gap formation increased and bond strength decreased for all monomers after biofilm incubation (p < 0.001). Except for DEBAAP, secondary and tertiary di/tri-acrylamides showed lower occlusal gap width values, but no significant differences overall gap length compared to HEMA. µTBS increased for tri-acrylamides compared with HEMA. Samples treated with multi-acrylamides had lower concentration of hydroxyproline (by-product of collagen degradation) (p < 0.001), except for DEBAAP, which showed values close to HEMA (p > 0.05). Dentin shear modulus increased for all acrylamides after 72 h, especially TMAAEA. SIGNIFICANCE: In general, multi-acrylamides promote collagen reinforcement, leading to reduced gap formation, and stabilize the bond strength under physiological conditions.

Personal exposure to PM2.5 oxidative potential and its association to birth outcomes.

BACKGROUND: Prenatal exposure to fine particulate matter (PM2.5) assessed through its mass concentration has been associated with foetal growth restriction in studies based on outdoor levels. Oxidative potential of PM2.5 (OP) is an emerging metric a priori relevant to mechanisms of action of PM on health, with very limited evidence to indicate its role on birth outcomes. OBJECTIVES: We investigated the association of OP with birth outcomes and compared it with that of PM2.5 mass concentration. METHODS: 405 pregnant women from SEPAGES cohort (Grenoble area) carried PM2.5 personal dosimeters for one or two one-week periods. OP was measured using dithiothreitol (DTT) and ascorbic acid (AA) assays from the collected filters. Associations of each exposure metric with offspring weight, height, and head circumference at birth were estimated adjusting for potential confounders. RESULTS: The correlation between PM2.5 mass concentration and [Formula: see text] was 0.7. An interquartile range increase in .. was associated with reduced weight (adjusted change, -64 g, -166 to -11, p = 0.02) and height (-4 mm, -6 to -1, p = 0.01) at birth. PM2.5 mass concentration showed similar associations with weight (-53 g, -99 to -8, p = 0.02) and height (-2 mm, -5 to 0, p = 0.05). In birth height models mutually adjusted for the two exposure metrics, the association with [Formula: see text] was less attenuated than that with mass concentration, while for weight both effect sizes attenuated similarly. There was no clear evidence of associations with head circumference for any metric, nor for [Formula: see text] with any growth parameter. IMPACT: PM2.5 pregnancy exposure assessed from personal dosimeters was associated with altered foetal growth. Personal OP exposure was associated with foetal growth restrictions, specifically decreased weight and height at birth, possibly to a larger extent than PM2.5 mass concentration alone. These results support OP assessed from DTT as being a health-relevant metric. Larger scale cohort studies are recommended to support our findings.

Psychological distress among religious nonbelievers: a systematic review.

Studies of religious belief and psychological health are on the rise, but most overlook atheists and agnostics. We review 14 articles that examine differences between nonbelievers and believers in levels of psychological distress, and potential sources of distress among nonbelievers. Various forms of psychological distress are experienced by nonbelievers, and greater certainty in one's belief system is associated with greater psychological health. We found one well-documented source of distress for nonbelievers: negative perceptions by others. We provide recommendations for improving research on nonbelievers and suggest a model analogous to Pargament's tripartite spiritual struggle to understand the stresses of nonbelief.

Anti-cardiolipin IgG autoantibodies associate with circulating extracellular DNA in severe COVID-19.

Whereas the detection of antiphospholipid autoantibodies (aPL) in COVID-19 is of increasing interest, their role is still unclear. We analyzed a large aPL panel in 157 patients with COVID-19 according to the disease severity. We also investigated a potential association between aPL and extracellular DNA (exDNA, n = 85) or circulating markers of neutrophil extracellular traps (NET) such as citrullinated histones H3 (CitH3, n = 49). A total of 157 sera of patients infected by SARS-CoV-2 were collected. A large aPL panel including lupus anticoagulant, anti-cardiolipin and anti-beta-2 glycoprotein I (IgG, IgM and IgA), anti-phosphatidylethanolamine IgA, anti-prothrombin (IgG and IgM) was retrospectively analyzed according to the disease severity. We found a total aPL prevalence of 54.8% with almost half of the cases having aCL IgG. Within an extended panel of aPL, only aCL IgG were associated with COVID-19 severity. Additionally, severe patients displayed higher CitH3 levels than mild patients. Interestingly, we highlighted a significant association between the levels of aCL IgG and exDNA only in aCL positive patients with severe disease. In conclusion, we showed a significant link between aPL, namely aCL IgG, and circulating exDNA in patients with severe form of COVID-19, that could exacerbate the thrombo-inflammatory state related to disease severity.

Persistent IgG anticardiolipin autoantibodies are associated with post-COVID syndrome.

Persistence of various symptoms in patients who have recovered from coronavirus disease 2019 (COVID-19) was recently defined as 'long COVID' or 'post-COVID syndrome' (PCS). This article reports a case of a 58-year-old woman who, although recovering from COVID-19, had novel and persistent symptoms including neurological complications that could not be explained by any cause other than PCS. In addition to a low inflammatory response, persistence of immunoglobulin G anticardiolipin autoantibody positivity and eosinopenia were found 1 year after acute COVID-19 infection, both of which have been defined previously as independent factors associated with the severity of COVID-19. The pathophysiological mechanism of PCS is unknown, but the possibility of persistence of the virus, especially in the nervous system, could be suggested with a post-infectious inflammatory or autoimmune reaction.

Use of Mixed Amphetamine Salts in a Patient with Depersonalization/Derealization Disorder.

Depersonalization and derealization symptoms are common and often transient. Recurrent, persistent symptoms can result in a diagnosis of depersonalization/derealization disorder (DDD). This is a diagnosis with little evidence available regarding effective interventions, and there are currently no pharmacological treatments for DDD approved by the United States Food and Drug Administration (FDA). Here, we reported a case of an adult female whose presentation was consistent with DDD. Her DDD symptoms notably reduced after treatment with mixed amphetamine salts. We also reviewed the limited research examining the efficacy of lamotrigine, benzodiazepines, antidepressants, naltrexone, and antipsychotics in DDD. Given the lack of evidence-based interventions for patients with DDD, additional research into the potential benefit of using psychostimulants might be warranted.

Risks for cyanobacterial harmful algal blooms due to land management and climate interactions.

The frequency and severity of cyanobacteria harmful blooms (CyanoHABs) have been increasing with frequent eutrophication and shifting climate paradigms. CyanoHABs produce a spectrum of toxins and can trigger neurological disorder, organ failure, and even death. To promote proactive CyanoHAB management, geospatial risk modeling can act as a predictive mechanism to supplement current mitigation efforts. In this study, iterative AIC analysis was performed on 17 watershed-level biophysical parameters to identify the strongest predictors based on Sentinel-2-derived cyanobacteria cell densities (CCD) for 771 waterbodies in Georgia Piedmont. This study used a streamlined watershed delineation technique, a 1-meter LULC classification with ~88% accuracy, and a technique to predict CyanoHAB risk in small-to-medium sized waterbodies. Landscape characteristics were computed utilizing the Google Earth Engine platform that enabled large spatio-temporal scope and variable inclusion. Watershed maximum winter temperature, percent agriculture, percent forest, percent impervious, and waterbody area were the strongest predictors of CCD with a 0.33 R-squared. Warmer winter temperatures allow cyanobacteria to be photosynthetically active year-round, and trigger CyanoHABs when warmer temperatures and nutrients are introduced in early spring, typically referred to as Spring Bloom in southeast U.S. The risk models revealed an unexpected significant linear relationship between percent forest and CCD. It is due to the fact that land reclamation via reforestation in the piedmont have left legacy sediment and nutrients which are mobilized as surface runoff to the watershed after rain events. A Jenks Natural Break scheme assigned waterbodies to CyanoHAB risk groups, and of the 771 waterbodies, 24.38% were low, 37.35% and 38.26% were medium and high risk respectively. This research supplements existing cyanobacteria risk modeling methods by introducing a novel, scalable, and reproducible method to determine yearly regional risk. Future studies should include factors such as demographic, socioeconomic, labor, and site-specific environmental conditions to create more holistic CyanoHAB risk outputs.

CyanoTRACKER: A cloud-based integrated multi-platform architecture for global observation of cyanobacterial harmful algal blooms.

Over the past decade, the global proliferation of cyanobacterial harmful algal blooms (CyanoHABs) have presented a major risk to the public and wildlife, and ecosystem and economic services provided by inland water resources. As a consequence, water resources, environmental, and healthcare agencies are in need of early information about the development of these blooms to mitigate or minimize their impact. Results from various components of a novel multi-cloud cyber-infrastructure referred to as "CyanoTRACKER" for initial detection and continuous monitoring of spatio-temporal growth of CyanoHABs is highlighted in this study. The novelty of the CyanoTRACKER framework is the collection and integration of combined community reports (social cloud), remote sensing data (sensor cloud) and digital image analytics (computation cloud) to detect and differentiate between regular algal blooms and CyanoHABs. Individual components of CyanoTRACKER include a reporting website, mobile application (App), remotely deployable solar powered automated hyperspectral sensor (CyanoSense), and a cloud-based satellite data processing and integration tool. All components of CyanoTRACKER provided important data related to CyanoHABs assessments for regional and global water bodies. Reports and data received via social cloud including the mobile App, Twitter, Facebook, and CyanoTRACKER website, helped in identifying the geographic locations of CyanoHABs affected water bodies. A significant increase (124.92%) in tweet numbers related to CyanoHABs was observed between 2011 (total relevant tweets = 2925) and 2015 (total relevant tweets = 6579) that reflected an increasing trend of the harmful phenomena across the globe as well as an increased awareness about CyanoHABs among Twitter users. The CyanoHABs affected water bodies extracted via the social cloud were categorized, and smaller water bodies were selected for the deployment of CyanoSense, and satellite data analysis was performed for larger water bodies. CyanoSense was able to differentiate between ordinary algae and CyanoHABs through the use of their characteristic absorption feature at 620 nm. The results and products from this infrastructure can be rapidly disseminated via the CyanoTRACKER website, social media, and direct communication with appropriate management agencies for issuing warnings and alerting lake managers, stakeholders and ordinary citizens to the dangers posed by these environmentally harmful phenomena.

Etiological Observations in 36 Patients With Hodgkin's Lymphoma.

BACKGROUND/AIM: Hodgkin's lymphoma (HL) accounts for 1% of cancers and is of largely unknown pathogenesis. This study intended to find clues about potential causes (etiology) of HL through observations on patients and their families. PATIENTS AND METHODS: In 37 years of a medical oncology practice in Basel, Switzerland, 36 out of 2201 patients (1.6%) had HL. Etiological information has been obtained from the patients with the help of a German translation of the NCI Medical History Questionnaire for Cancer Etiology, and through the study of their medical charts. RESULTS: Findings of etiological interest were observed in the medical history of 26 out of the 36 patients with HL; these findings were grouped as follows: benign tumors (25%), carcinogenic exposures (19%), immunologic disorders (19%), secondary malignancies (14%), infections (11%), congenital disorders (8%) and tonsillectomies (6%). Twenty-two out of 36 patients had one or more relatives with cancer. CONCLUSION: Personal and family history of patients with HL is a readily available useful tool for etiology research. The fact that HL is frequently associated with other cancers in patients and their relatives points to causal genetic factors.

Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review.

Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients.

Prevalence of antipsychotic prescriptions among patients with anxiety disorders treated in inpatient and outpatient psychiatric settings.

BACKGROUND: An increasing number of prescribers are using antipsychotics for treatment of anxiety disorders, despite lack of FDA-approved indications and mixed efficacy results from clinical trials. The objective of this study was to examine the prevalence of antipsychotics prescription in psychiatric inpatients and outpatients with anxiety disorders. METHODS: This is a retrospective study of de-identified data from patients with a DSMIV-TR anxiety disorder diagnosis in an academic psychiatric setting in 2013. The final cohort of patients, after exclusion of bipolar/psychotic comorbidity, includes 1699 patients. Logistic regression models were used to explore associations between antipsychotic prescription and patient characteristics. RESULTS: Among non-psychotic/non-bipolar patients with anxiety disorder, 53.6% of inpatients and 16.6% of outpatients received antipsychotic medication. Rates varied with the disorder. Outpatients with post-traumatic stress disorder (OR: 2.24, 95% CI: 1.66-3.01) and obsessive compulsive disorder (OR: 2.80, 95% CI: 1.86-4.19) received antipsychotic prescriptions more often than those without these diagnoses. Comorbidity with depression was common while comorbidity with borderline personality disorder was rare; both increased odds of receiving prescription of antipsychotics (OR: 1.57, 95% CI: 1.16-2.12 for depression; OR: 2.63, 95% CI 1.42-4.88 for borderline personality disorder, respectively). Additionally, age was significantly associated with increased odds of being on an antipsychotic. Quetiapine and aripripazole were the most prescribed antipsychotics and very few patients received rescue medication for extrapyramidal symptoms. LIMITATIONS: Lack of specific indications for the psychotropic prescriptions. CONCLUSIONS: A substantial percentage of patients with anxiety disorders are prescribed antipsychotics, especially among inpatients. This practice may reflect the severity of the anxiety disorder or the high prevalence of comorbidity. Based on frequency of rescue medication prescription, treatment seemed well tolerated for extra-pyramidal neurological side-effects.

The role of religion and spirituality in mental health.

PURPOSE OF REVIEW: There has been increased interest in the relationship between religion and spirituality and mental health in recent years. This article reviews recent research into the capacity of religion and spirituality to benefit or harm the mental health of believers. We also examine the implications this may have for assessment and treatment in psychiatric settings. RECENT FINDINGS: Studies indicate that religion and spirituality can promote mental health through positive religious coping, community and support, and positive beliefs. Research also shows that religion and spirituality can be damaging to mental health by means of negative religious coping, misunderstanding and miscommunication, and negative beliefs. Tools for the assessment of patients' spiritual needs have been studied, and incorporation of spiritual themes into treatment has shown some promise. SUMMARY: Religion and spirituality have the ability to promote or damage mental health. This potential demands an increased awareness of religious matters by practitioners in the mental health field as well as ongoing attention in psychiatric research.

Use of services by community-dwelling patients with dementia: a systematic review.

Dementia is a complicated disease requiring medical, psychological, and social services. Services to address these needs include medical care (outpatient physician/specialist, inpatient, emergency) and community care (home health, day care, meal preparation, transportation, counseling, support groups, respite care, physical therapy). This systematic review of articles published in English from 1991 to the present examines studies of ambulatory, community-dwelling dementia patients with established dementia diagnoses. Searches of the Medline database using 13 combinations of search terms, plus searches of Embase and PsycINFO databases using 3 combinations of terms and examination of reference lists of related articles, resulted in identification of 15 studies dealing with healthcare utilization among community-dwelling dementia patients in both medical and community care settings. Patients with dementia frequently use the full spectrum of medical services. Community resources are used less frequently. Community healthcare services may be a valuable resource in alleviating some burden of dementia care for physicians.

CHD7 gene polymorphisms are associated with susceptibility to idiopathic scoliosis.

Idiopathic scoliosis (IS) is the most common spinal deformity in children, and its etiology is unknown. To refine the search for genes underlying IS susceptibility, we ascertained a new cohort of 52 families and conducted a follow-up study of genomewide scans that produced evidence of linkage and association with 8q12 loci (multipoint LOD 2.77; P=.0028). Further fine mapping in the region revealed significant evidence of disease-associated haplotypes (P<1.0 x 10-4) centering over exons 2-4 of the CHD7 gene associated with the CHARGE (coloboma of the eye, heart defects, atresia of the choanae, retardation of growth and/or development, genital and/or urinary abnormalities, and ear abnormalities and deafness) syndrome of multiple developmental anomalies. Resequencing CHD7 exons and conserved intronic sequence blocks excluded coding changes but revealed at least one potentially functional polymorphism that is overtransmitted (P=.005) to affected offspring and predicts disruption of a caudal-type (cdx) transcription-factor binding site. Our results identify the first gene associated with IS susceptibility and suggest etiological overlap between the rare, early-onset CHARGE syndrome and common, later-onset IS.