Unraveling the Heterointegration of 3D Semiconductors on Graphene by Anchor Point Nucleation.

The heterointegration of graphene with semiconductor materials and the development of graphene-based hybrid functional devices are heavily bound to the control of surface energy. Although remote epitaxy offers one of the most appealing techniques for implementing 3D/2D heterostructures, it is only suitable for polar materials and is hugely dependent on the graphene interface quality. Here, the growth of defect-free single-crystalline germanium (Ge) layers on a graphene-coated Ge substrate is demonstrated by introducing a new approach named anchor point nucleation (APN). This powerful approach based on graphene surface engineering enables the growth of semiconductors on any type of substrate covered by graphene. Through plasma treatment, defects such as dangling bonds and nanoholes, which act as preferential nucleation sites, are introduced in the graphene layer. These experimental data unravel the nature of those defects, their role in nucleation, and the mechanisms governing this technique. Additionally, high-resolution transmission microscopy combined with geometrical phase analysis established that the as-grown layers are perfectly single-crystalline, stress-free, and oriented by the substrate underneath the engineered graphene layer. These findings provide new insights into graphene engineering by plasma and open up a universal pathway for the heterointegration of high-quality 3D semiconductors on graphene for disruptive hybrid devices.

Myosteatosis in multiple myeloma: a key determinant of survival beyond sarcopenia.

OBJECTIVE: Fatty infiltration of skeletal muscle (Myosteatosis) is associated with increased frailty, decreased muscle and mobility function, which seems fairly prevalent in multiple myeloma (MM) patients. This study aimed to determine the prognostic value of myosteatosis assessed by CT for progression-free survival (PFS) and overall survival (OS). MATERIALS AND METHODS: This IRB-approved cohort study included patients with newly diagnosed MM who were treated at a single university hospital and received CT at baseline. Geriatric assessment was performed via International Myeloma Working Group frailty score and Revised Myeloma Comorbidity Index. Myosteatosis was determined through measurement of paravertebral muscle radiodensity. Statistical analyses included uni- and multivariable Cox proportional hazard models and the Kaplan-Meier-method. RESULTS: A total of 226 newly diagnosed MM patients (median age: 65 years [range: 29-89], 63% males, mean BMI: 25 [14-42]) were analyzed. The prevalence of myosteatosis was 51%. Muscle radiodensity was significantly decreased in individuals with International Staging System stage III vs. I (p < 0.001), indicating higher fatty muscle infiltration in patients with advanced disease. Both PFS and OS were significantly decreased in patients with myosteatosis (PFS: median 32.0 months (95% CI 20.5.5-42.2) vs. 66.4 months without myosteatosis (95% CI 42.5-not reached), p < .001); OS: median 58.6 (95% CI 51.3-90.2) vs. not reached, p < .001). Myosteatosis remained an independent predictor of OS in multivariable analyses (HR: 1.98; 95%-CI: 1.20-3.27). CONCLUSION: Myosteatosis seems fairly prevalent in patients with newly diagnosed MM and associated with impaired overall survival. Prospective clinical trials are required to better understand the role of myosteatosis in MM patients.

Photon-counting detector computed tomography for metal artifact reduction: a comparative study of different artifact reduction techniques in patients with orthopedic implants.

PURPOSE: Artifacts caused by metallic implants remain a challenge in computed tomography (CT). We investigated the impact of photon-counting detector computed tomography (PCD-CT) for artifact reduction in patients with orthopedic implants with respect to image quality and diagnostic confidence using different artifact reduction approaches. MATERIAL AND METHODS: In this prospective study, consecutive patients with orthopedic implants underwent PCD-CT imaging of the implant area. Four series were reconstructed for each patient (clinical standard reconstruction [PCD-CTStd], monoenergetic images at 140 keV [PCD-CT140keV], iterative metal artifact reduction (iMAR) corrected [PCD-CTiMAR], combination of iMAR and 140 keV monoenergetic [PCD-CT140keV+iMAR]). Subsequently, three radiologists evaluated the reconstructions in a random and blinded manner for image quality, artifact severity, anatomy delineation (adjacent and distant), and diagnostic confidence using a 5-point Likert scale (5 = excellent). In addition, the coefficient of variation [CV] and the relative quantitative artifact reduction potential were obtained as objective measures. RESULTS: We enrolled 39 patients with a mean age of 67.3 ± 13.2 years (51%; n = 20 male) and a mean BMI of 26.1 ± 4 kg/m2. All image quality measures and diagnostic confidence were significantly higher for the iMAR vs. non-iMAR reconstructions (all p < 0.001). No significant effect of the different artifact reduction approaches on CV was observed (p = 0.26). The quantitative analysis indicated the most effective artifact reduction for the iMAR reconstructions, which was higher than PCD-CT140keV (p < 0.001). CONCLUSION: PCD-CT allows for effective metal artifact reduction in patients with orthopedic implants, resulting in superior image quality and diagnostic confidence with the potential to improve patient management and clinical decision making.

Integrating nutrition assessments and seasonal malaria chemoprevention: Results from a mixed-methods feasibility study in Guinea.

BACKGROUND: Seasonal malaria chemoprevention (SMC) has become a critical intervention for malaria prevention and control. There is a growing interest to generate evidence that health campaigns such as SMC can be leveraged for integration or co-administration of other health efforts such as nutritional supplements, immunizations, or vitamin A. OBJECTIVE: We conducted a pilot study to assess whether nutrition assessments could be integrated into existing SMC programming in two districts in Guinea. METHODS: Of 106,480 children under 5 years of age (CU5) who received sulfadoxine-pyrimethamine plus amodiaquine as part of SMC by community drug distributors (CDDs), 2210 had their mid-upper arm circumference (MUAC) assessed by CDD supervisors. RESULTS: Of these, 177 (8.0%) had a MUAC < 125 mm and were therefore classified as acutely malnourished; 161 CU5 were referred to health facilities for follow-up. Importantly, no drop in SMC programmatic coverage was observed in districts conducting MUAC on top of SMC. Key informant interviews with district officials and focus group discussions with CDD supervisors showed a generally positive effect of integrating MUAC into SMC, although CDD supervisors had concerns about workload with added responsibilities of MUAC assessments. CONCLUSION: Integrating other health interventions with SMC is accepted-and indeed welcomed-by the population and health workers, and does not result in a drop in SMC programmatic coverage.

Application of diffusion microstructure imaging in musculoskeletal radiology - translation from head to shoulders.

OBJECTIVES: Quantitative MRI techniques, such as diffusion microstructure imaging (DMI), are increasingly applied for advanced tissue characterization. We determined its value in rotator cuff (RC) muscle imaging by studying the association of DMI parameters to isometric strength and fat fraction (FF). METHODS: Healthy individuals prospectively underwent 3T-MRI of the shoulder using DMI and chemical shift encoding-based water-fat imaging. RC muscles were segmented and quantitative MRI metrics (V-ISO, free fluid; V-intra, compartment inside of muscle fibers; V-extra, compartment outside of muscle fibers, and FF) were extracted. Isometric shoulder strength was quantified using specific clinical tests. Sex-related differences were assessed with Student's t. Association of DMI-metrics, FF, and strength was tested. A factorial two-way ANOVA was performed to compare the main effects of sex and external/internal strength-ratio and their interaction effects on quantitative imaging parameters ratios of infraspinatus/subscapularis. RESULTS: Among 22 participants (mean age: 26.7 ± 3.1 years, 50% female, mean BMI: 22.6 ± 1.9 kg/m2), FF of the individual RC muscles did not correlate with strength or DMI parameters (all p > 0.05). Subjects with higher V-intra (r = 0.57 to 0.87, p < 0.01) and lower V-ISO (r = -0.6 to -0.88, p < 0.01) had higher internal and external rotation strength. Moreover, V-intra was higher and V-ISO was lower in all RC muscles in males compared to female subjects (all p < 0.01). There was a sex-independent association of external/internal strength-ratio with the ratio of V-extra of infraspinatus/subscapularis (p = 0.02). CONCLUSIONS: Quantitative DMI parameters may provide incremental information about muscular function and microstructure in young athletes and may serve as a potential biomarker. KEY POINTS: • Diffusion microstructure imaging was successfully applied to non-invasively assess the microstructure of rotator cuff muscles in healthy volunteers. • Sex-related differences in the microstructural composition of the rotator cuff were observed. • Muscular microstructural metrics correlated with rotator cuff strength and may serve as an imaging biomarker of muscular integrity and function.

Impact of different metal artifact reduction techniques in photon-counting computed tomography head and neck scans in patients with dental hardware.

OBJECTIVES: Metal artifacts remain a challenge in computed tomography. We investigated the potential of photon-counting computed tomography (PCD-CT) for metal artifact reduction using an iterative metal artifact reduction (iMAR) algorithm alone and in combination with high keV monoenergetic images (140 keV) in patients with dental hardware. MATERIAL AND METHODS: Consecutive patients with dental implants were prospectively included in this study and received PCD-CT imaging of the craniofacial area. Four series were reconstructed (standard [PCD-CTstd], monoenergetic at 140 keV [PCD-CT140keV], iMAR corrected [PCD-CTiMAR], combination of iMAR and 140 keV monoenergetic [PCD-CTiMAR+140keV]). All reconstructions were assessed qualitatively by four radiologists (independent and blinded reading on a 5-point Likert scale [5 = excellent; no artifact]) regarding overall image quality, artifact severity, and delineation of adjacent and distant anatomy. To assess signal homogeneity and evaluate the magnitude of artifact reduction, we performed quantitative measures of coefficient of variation (CV) and a region of interest (ROI)-based relative change in artifact reduction [PCD-CT/PCD-CTstd]. RESULTS: We enrolled 48 patients (mean age 66.5 ± 11.2 years, 50% (n = 24) males; mean BMI 25.2 ± 4.7 kg/m2; mean CTDIvol 6.2 ± 6 mGy). We found improved overall image quality, reduced artifacts and superior delineation of both adjacent and distant anatomy for the iMAR vs. non-iMAR reconstructions (all p < 0.001). No significant effect of the different artifact reduction approaches on CV was observed (p = 0.42). The ROI-based analysis indicated the most effective artifact reduction for the iMAR reconstructions, which was significantly higher compared to PCD-CT140keV (p < 0.001). CONCLUSION: PCD-CT offers highly effective approaches for metal artifact reduction with the potential to overcome current diagnostic challenges in patients with dental implants. CLINICAL RELEVANCE STATEMENT: Metallic artifacts pose a significant challenge in CT imaging, potentially leading to missed findings. Our study shows that PCD-CT with iMAR post-processing reduces artifacts, improves image quality, and can possibly reveal pathologies previously obscured by artifacts, without additional dose application. KEY POINTS: • Photon-counting detector CT (PCD-CT) offers highly effective approaches for metal artifact reduction in patients with dental fillings/implants. • Iterative metal artifact reduction (iMAR) is superior to high keV monoenergetic reconstructions at 140 keV for artifact reduction and provides higher image quality. • Signal homogeneity of the reconstructed images is not affected by the different artifact reduction techniques.

Association of lumbar vertebral bone marrow and paraspinal muscle fat composition with intervertebral disc degeneration: 3T quantitative MRI findings from the population-based KORA study.

OBJECTIVE: To assess the association of lumbar bone marrow adipose tissue fat fraction (BMAT-FF) and paraspinal muscle proton density fat fraction (PDFF) and their interplay with intervertebral disc degeneration (IVDD). METHODS: In this retrospective cross-sectional study based on a prospective population-based cohort, BMAT-FF and PDFF of asymptomatic individuals were calculated based on 3T-MRI dual-echo and multi-echo Dixon VIBE sequences. IVDD was assessed at motion segments L1 to L5 and dichotomized based on Pfirrmann grade ≥ 4 and/or presence of other severe degenerative changes or spinal abnormalities at least at one segment. Pearson's correlation coefficients were calculated for BMAT-FF and PDFF. Univariable and multivariable logistic regression models for IVDD were calculated. RESULTS: Among 335 participants (mean age: 56.2 ± 9.0 years, 43.3% female), the average BMI was 27.7 ± 4.5 kg/m2 and the prevalence of IVDD was high (69.9%). BMAT-FF and PDFF were significantly correlated (r = 0.31-0.34; p < 0.001). The risk for IVDD increased with higher PDFF (OR = 1.45; CI 1.03, 2.04) and BMAT-FF (OR = 1.56; CI 1.16, 2.11). Pairwise combinations of PDFF and BMAT-FF quartiles revealed a lower risk for IVDD in individuals in the lowest BMAT-FF and PDFF quartile (OR = 0.21; CI 0.1, 0.48). Individuals in the highest BMAT-FF and PDFF quartile showed an increased risk for IVDD (OR = 5.12; CI 1.17, 22.34) CONCLUSION: Lumbar BMAT-FF and paraspinal muscle PDFF are correlated and represent both independent and additive risk factors for IVDD. Quantitative MRI measurements of paraspinal myosteatosis and vertebral bone marrow fatty infiltration may serve as imaging biomarkers to assess the individual risk for IVDD. KEY POINTS: • Fat composition of the lumbar vertebral bone marrow is positively correlated with paraspinal skeletal muscle fat. • Higher fat-fractions of lumbar vertebral bone marrow and paraspinal muscle are both independent as well as additive risk factors for intervertebral disc degeneration. • Quantitative magnetic resonance imaging measurements of bone marrow and paraspinal muscle may serve as imaging biomarkers for intervertebral disc degeneration.

Photon-Counting Computed Tomography (PC-CT) of the spine: impact on diagnostic confidence and radiation dose.

OBJECTIVES: Computed tomography (CT) is employed to evaluate surgical outcome after spinal interventions. Here, we investigate the potential of multispectral photon-counting computed tomography (PC-CT) on image quality, diagnostic confidence, and radiation dose compared to an energy-integrating CT (EID-CT). METHODS: In this prospective study, 32 patients underwent PC-CT of the spine. Data was reconstructed in two ways: (1) standard bone kernel with 65-keV (PC-CTstd) and (2) 130-keV monoenergetic images (PC-CT130 keV). Prior EID-CT was available for 17 patients; for the remaining 15, an age-, sex-, and body mass index-matched EID-CT cohort was identified. Image quality (5-point Likert scales on overall, sharpness, artifacts, noise, diagnostic confidence) of PC-CTstd and EID-CT was assessed by four radiologists independently. If metallic implants were present (n = 10), PC-CTstd and PC-CT130 keV images were again assessed by 5-point Likert scales by the same radiologists. Hounsfield units (HU) were measured within metallic artifact and compared between PC-CTstd and PC-CT130 keV. Finally, the radiation dose (CTDIvol) was evaluated. RESULTS: Sharpness was rated significantly higher (p = 0.009) and noise significantly lower (p < 0.001) in PC-CTstd vs. EID-CT. In the subset of patients with metallic implants, reading scores for PC-CT130 keV revealed superior ratings vs. PC-CTstd for image quality, artifacts, noise, and diagnostic confidence (all p < 0.001) accompanied by a significant increase of HU values within the artifact (p < 0.001). Radiation dose was significantly lower for PC-CT vs. EID-CT (mean CTDIvol: 8.83 vs. 15.7 mGy; p < 0.001). CONCLUSIONS: PC-CT of the spine with high-kiloelectronvolt reconstructions provides sharper images, higher diagnostic confidence, and lower radiation dose in patients with metallic implants. KEY POINTS: • Compared to energy-integrating CT, photon-counting CT of the spine had significantly higher sharpness and lower image noise while radiation dose was reduced by 45%. • In patients with metallic implants, virtual monochromatic photon-counting images at 130 keV were superior to standard reconstruction at 65 keV in terms of image quality, artifacts, noise, and diagnostic confidence.

Low bone mineral density is a prognostic factor for elderly patients with HCC undergoing TACE: results from a multicenter study.

OBJECTIVES: Low bone mineral density (BMD) was recently identified as a novel risk factor for patients with hepatocellular carcinoma (HCC). In this multicenter study, we aimed to validate the role of BMD as a prognostic factor for patients with HCC undergoing transarterial chemoembolization (TACE). METHODS: This retrospective multicenter trial included 908 treatment-naïve patients with HCC who were undergoing TACE as a first-line treatment, at six tertiary care centers, between 2010 and 2020. BMD was assessed by measuring the mean Hounsfield units (HUs) in the midvertebral core of the 11th thoracic vertebra, on contrast-enhanced computer tomography performed before treatment. We assessed the influence of BMD on median overall survival (OS) and performed multivariate analysis including established estimates for survival. RESULTS: The median BMD was 145 HU (IQR, 115-175 HU). Patients with a high BMD (≥ 114 HU) had a median OS of 22.2 months, while patients with a low BMD (< 114 HU) had a lower median OS of only 16.2 months (p < .001). Besides albumin, bilirubin, tumor number, and tumor diameter, BMD remained an independent prognostic factor in multivariate analysis. CONCLUSIONS: BMD is an independent predictive factor for survival in elderly patients with HCC undergoing TACE. The integration of BMD into novel scoring systems could potentially improve survival prediction and clinical decision-making. KEY POINTS: • Bone mineral density can be easily assessed in routinely acquired pre-interventional computed tomography scans. • Bone mineral density is an independent predictive factor for survival in elderly patients with HCC undergoing TACE. • Thus, bone mineral density is a novel imaging biomarker for prognosis prediction in elderly patients with HCC undergoing TACE.

Approaches to determine pesticides in marine bivalves.

Due to agricultural runoff, pesticides end up in aquatic ecosystems and some accumulate in marine bivalves. As filter feeders, bivalves can accumulate high concentrations of chemicals in their tissue representing a potential risk to the health of human and aquatic ecosystems. So far, most of the studies dealing with pesticide contamination in marine bivalves, for example, in the French Atlantic and English Channel coasts, have focused on the old generation of pesticides. Only a few investigated the newly emerging pesticides partly due to methodological challenges. A better understanding of the most sensitive and reliable methods is thus essential for accurately determining a wide variety of environmentally relevant pesticides in marine bivalves. The review highlighted the use of more environmentally friendly and efficient materials such as sorbents and the "quick easy cheap effective rugged safe" extraction procedure to extract pesticides from bivalve matrices, as they appeared to be the most efficient while being the safest. Moreover, this method combined with the high-resolution mass spectrometry (MS) technique offers promising perspectives by highlighting a wide range of pesticides including those that are not usually sought. Finally, recent developments in the field of ultra-high-performance liquid chromatography coupled to MS, such as two-dimensional chromatography and ion mobility spectrometry, will improve the analysis of pesticides in complex matrices.

Mediating effects of sleep on mental health in older adolescents: Findings from the Burn 2 Learn randomized controlled trial.

PURPOSE: Our study explored the mediating effect of sleep-related variables on older adolescents' mental health in the context of a school-based physical activity intervention. METHODS: We evaluated the Burn 2 Learn (B2L) intervention using a cluster randomized controlled trial, which included two cohorts. Participants for this sub-study were from the second cohort, which included 292 older adolescents (16.0 ± 0.5 years) from 10 secondary schools in New South Wales, Australia. Teachers at intervention schools delivered two high-intensity activity breaks (approximately 10 mins) per week to students during academic lessons. Participants completed measures of mental health (i.e., perceived stress and internalizing problems) and hypothesized mediators (i.e., sleep duration, sleep latency, awakenings, and daytime sleepiness) at baseline (February-April 2019) and post-intervention (August-September 2019). Single mediation analyses were conducted to explore the potential mediating effects of sleep variables on mental health outcomes using a product-of-coefficient test. RESULTS: We observed a small statistically significant effect for perceived stress (ß = -0.11, SE = 0.034, p = 0.002), but not for internalizing problems (ß = 0.02, SE = 0.051, p = 0.760). There were no significant intervention effects for sleep-related variables. Several sleep-related variables were associated with mental health outcomes but no mediated effects were found. CONCLUSION: The B2L intervention had a small beneficial effect on perceived stress, however our mediation analyses suggest this was not explained by changes in sleep-related variables. Markers of sleep were associated with mental health constructs, highlighting the importance of sleep for good psychological health. However, in the context of a physical activity intervention, effects on mental health may be driven by other behavioral, neurobiological, or psychosocial mechanisms.

Factors associated with inadequate receipt of components and non-use of antenatal care services in India: a regional analysis.

BACKGROUND: Failure to use antenatal care (ANC) and inadequate receipt of components of ANC pose a significant risk for the pregnant woman and the baby. This study aimed to examine a regional analysis of factors associated with receiving no ANC and inadequate receipt of components of ANC services among Indian women. METHOD: Information from 173,970 women of reproductive age 15-49 years from the 2019-21 India National Family Health Survey (NFSH-5) was analysed. Logistic regression analyses that adjusted for cluster and survey weights were conducted to assess the socio-demographic and other factors associated with receiving non-use of ANC and inadequate receipt of components of ANC, respectively, in the six regions and 28 states, and 8 union territories in India. RESULTS: Across regions in India, 7% of women reported no ANC, and the prevalence of inadequate and adequate receipt of components of ANC in all six regions ranged from 67 to 89% and 8% to 24%, respectively. Of all the 36 federated entities, the prevalence of inadequate receipt of ANC components was less than two-thirds in Tamil Nadu, Puducherry, Andaman and the Nicobar Islands, Odisha, and Gujarat. Our analyses revealed that associated factors vary by region, state, and union territories. Women from poor households reported increased odds of receiving no ANC in North, East and North-eastern regions. Women who reported no schooling in South, East and Central regions were associated with increased odds of receiving no ANC. Women from poor households in Himachal Pradesh, Bihar, Uttar Pradesh, Nagaland, Manipur, Uttar Pradesh, and Madhya Pradesh states reported significantly higher odds of inadequate components ANC than women from rich households. The receipt of inadequate components of ANC was significantly higher among women who never read magazines in Delhi, Ladakh, Karnataka, Telangana, Jharkhand, Maharashtra, Uttar Pradesh, Chhattisgarh, Arunachal Pradesh, Manipur, and Mizoram states in India. CONCLUSION: A better understanding of the factors associated with and incorporating them into the short- and long-term intervention strategies, including free financial support from the Indian government to encourage pregnant women from lower socioeconomic groups to use health services across all regions, states and union territories.

In-Situ Transmission Electron Microscopy Observation of Germanium Growth on Freestanding Graphene: Unfolding Mechanism of 3D Crystal Growth During Van der Waals Epitaxy.

Breakthroughs in cutting-edge research fields such as hetero-integration of materials and the development of quantum devices are heavily bound to the control of misfit strain during heteroepitaxy. While remote epitaxy offers one of the most intriguing avenues, demonstrations of functional hybrid heterostructures are hardly possible without a deep understanding of the nucleation and growth kinetics of 3D crystals on graphene and their mutual interactions. Here, the kinetics of such processes from real-time observations of germanium (Ge) growth on freestanding single layer graphene (SLG) using in-situ transmission electron microscopy are unraveled. This powerful technique provides a unique opportunity to observe new and yet unexplored phenomena, which are not accessible to the standard ex situ characterizations. Through direct observations, remote interactions are elucidated between Ge crystals through the graphene layer in double heterostructures of Ge/graphene/Ge. Notably, the data show real-time evidence of vertical Ge atoms diffusion through the graphene layer. This phenomenon is attributed to the remote interactions of Ge atoms through the graphene lattice, due to its interatomic interaction transparency. Additionally, key mechanisms governing nucleation and initial growth in graphene were systematically determined. These findings enlighten the growth mechanism of graphene and provide a new pathway for disruptive hybrid semiconductor-graphene devices.

Overall and central obesity and prostate cancer risk in African men.

PURPOSE: African men are disproportionately affected by prostate cancer (PCa). Given the increasing prevalence of obesity in Africa, and its association with aggressive PCa in other populations, we examined the relationship of overall and central obesity with risks of total and aggressive PCa among African men. METHODS: Between 2016 and 2020, we recruited 2,200 PCa cases and 1,985 age-matched controls into a multi-center, hospital-based case-control study in Senegal, Ghana, Nigeria, and South Africa. Participants completed an epidemiologic questionnaire, and anthropometric factors were measured at clinic visit. Multivariable logistic regression was used to examine associations of overall and central obesity with PCa risk, measured by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), respectively. RESULTS: Among controls 16.4% were obese (BMI ≥ 30 kg/m2), 26% and 90% had WC > 97 cm and WHR > 0.9, respectively. Cases with aggressive PCa had lower BMI/obesity in comparison to both controls and cases with less aggressive PCa, suggesting weight loss related to cancer. Overall obesity (odds ratio: OR = 1.38, 95% CI 0.99-1.93), and central obesity (WC > 97 cm: OR = 1.60, 95% CI 1.10-2.33; and WHtR > 0.59: OR = 1.68, 95% CI 1.24-2.29) were positively associated with D'Amico intermediate-risk PCa, but not with risks of total or high-risk PCa. Associations were more pronounced in West versus South Africa, but these differences were not statistically significant. DISCUSSION: The high prevalence of overall and central obesity in African men and their association with intermediate-risk PCa represent an emerging public health concern in Africa. Large cohort studies are needed to better clarify the role of obesity and PCa in various African populations.

Safety and Side Effects of Rifampin versus Isoniazid in Children.

BACKGROUND: The treatment of latent infection with Mycobacterium tuberculosis is important in children because of their vulnerability to life-threatening forms of tuberculosis disease. The current standard treatment - 9 months of isoniazid - has been associated with poor adherence and toxic effects, which have hampered the effectiveness of the drug. In adults, treatment with 4 months of rifampin has been shown to be safer and to have higher completion rates than 9 months of isoniazid. METHODS: In this multicenter, open-label trial, we randomly assigned 844 children (<18 years of age) with latent M. tuberculosis infection to receive either 4 months of rifampin or 9 months of isoniazid. The primary outcome was adverse events of grade 1 to 5 that resulted in the permanent discontinuation of a trial drug. Secondary outcomes were treatment adherence, side-effect profile, and efficacy. Independent review panels whose members were unaware of trial-group assignments adjudicated all adverse events and progression to active tuberculosis. RESULTS: Of the children who underwent randomization, 829 were eligible for inclusion in the modified intention-to-treat analysis. A total of 360 of 422 children (85.3%) in the rifampin group completed per-protocol therapy, as compared with 311 of 407 (76.4%) in the isoniazid group (adjusted difference in the rates of treatment completion, 13.4 percentage points; 95% confidence interval [CI], 7.5 to 19.3). There were no significant between-group differences in the rates of adverse events, with fewer than 5% of the children in the combined groups with grade 1 or 2 adverse events that were deemed to be possibly related to a trial drug. Active tuberculosis, including 1 case with resistance to isoniazid, was diagnosed in 2 children in the isoniazid group during 542 person-years of follow-up, as compared with no cases in the rifampin group during 562 person-years (rate difference, -0.37 cases per 100 person-years; 95% CI, -0.88 to 0.14). CONCLUSIONS: Among children under the age of 18 years, treatment with 4 months of rifampin had similar rates of safety and efficacy but a better rate of adherence than 9 months of treatment with isoniazid. (Funded by the Canadian Institutes of Health Research and Conselho Nacional de Pesquisa; ClinicalTrials.gov number, NCT00170209 .).

Distribution patterns of intramyocellular and extramyocellular fat by magnetic resonance imaging in subjects with diabetes, prediabetes and normoglycaemic controls.

AIM: To evaluate the distribution of intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs) as well as total fat content in abdominal skeletal muscle by magnetic resonance imaging (MRI) using a dedicated segmentation algorithm in subjects with type 2 diabetes (T2D), prediabetes and normoglycaemic controls. MATERIALS AND METHODS: Subjects from a population-based cohort were classified with T2D, prediabetes or as normoglycaemic controls. Total myosteatosis, IMCLs and EMCLs were quantified by multiecho Dixon MRI as proton-density fat-fraction (in %) in abdominal skeletal muscle. RESULTS: Among 337 included subjects (median age 56.0 [IQR: 49.0-64.0] years, 56.4% males, median body mass index [BMI]: 27.2 kg/m2 ), 129 (38.3%) were classified with an impaired glucose metabolism (T2D: 49 [14.5%]; prediabetes: 80 [23.7%]). IMCLs were significantly higher than EMCLs in subjects without obesity (5.7% [IQR: 4.8%-7.0%] vs. 4.1% [IQR: 2.7%-5.8%], P < .001), whereas the amounts of IMCLs and EMCLs were shown to be equal and significantly higher in subjects with obesity (both 6.7%, P < .001). Subjects with prediabetes and T2D had significantly higher amounts of IMCLs and EMCLs compared with normoglycaemic controls (P < .001). In univariable analysis, prediabetes and T2D were significantly associated with both IMCLs (prediabetes: ß: 0.76, 95% CI: 0.28-1.24, P = .002; T2D: ß: 1.56, 95% CI: 0.66-2.47, P < .001) and EMCLs (prediabetes: ß: 1.54, 95% CI: 0.56-2.51, P = .002; T2D: ß: 2.15, 95% CI: 1.33-2.96, P < .001). After adjustment for age and gender, the association of IMCLs with prediabetes attenuated (P = 0.06), whereas for T2D, both IMCLs and EMCLs remained significantly and positively associated (P < .02). CONCLUSION: There are significant differences in the amount and distribution ratio of IMCLs and EMCLs between subjects with T2D, prediabetes and normoglycaemic controls. Therefore, these patterns of intramuscular fat distribution by MRI might serve as imaging biomarkers in both normal and impaired glucose metabolism.

L'évaluation d'impact sur la santé, un outil pour promouvoir des politiques climatiques favorables à la santé.

INTRODUCTION: Potential impacts of climate change on health are increasingly studied due to the diversity of the associated risks (heatwaves, air pollution, water- and vector-borne diseases). Consequently, adaptation and mitigation strategies, including tools, have been developed by different cities, states, and organizations to assess the effects of climate change on health. OBJECTIVE: Health impact assessment (HIA) is a tool that could be used to assess the potential health impacts of climate change policies before their implementation. The objective of this study is therefore to analyze the way HIA is used in the development of these policies. METHOD: A scoping review of grey and scientific literature in French and English (period: 1990-2019) allowed us to identify 35 articles and reports, with 6 using HIA specifically. The areas of HIA application related to transport, urban planning or the building sector. The main health issues addressed in these HIAs concerned air, noise, physical activity, urban heat islands, green spaces, and functional diversity. RESULTS: These studies have shown that HIA is an approach that can facilitate cross-sectoral collaboration, and its flexibility allows for its application to adaptation and mitigation policies, as well as at several spatial scales (cities, regions). DISCUSSION: The principal limitation in this approach relates to uncertainties associated with quantifying projected impacts.

Cardiorespiratory fitness, muscular fitness and mental health in older adolescents: A multi-level cross-sectional analysis.

Physical activity interventions that promote cardiorespiratory (CRF) and muscular fitness (MF) may improve mental health in young adolescents. However, less is known about the links between fitness and mental health in older adolescents, as they are an understudied population. In addition, the association between MF and adolescents' mental health is less clear than it is for CRF. Our primary aim was to investigate whether MF is independently associated with mental health in a sample of older adolescents. Our secondary aim was to determine if the association between fitness and mental health was moderated by sex, socio-economic status (SES) or weight status. Participants were 670 students (16.0 [0.4] years, 44.6% female) from 20 secondary schools in New South Wales, Australia. Mental health (well-being and internalizing problems) was self-reported using the Short Warwick-Edinburgh Mental Wellbeing Scale and the Strengths and Difficulties Questionnaire. We assessed CRF using the Progressive Aerobic Cardiovascular Endurance Run and MF using the push-up and standing long jump tests. After controlling for CRF, MF was not associated with mental health. CRF was associated with well-being (ß = 0.20, p < .001) and internalizing problems (ß = -0.27, p < .001). The strength of association between CRF and mental health was stronger in girls, than boys. No interaction effects were observed for SES or weight status. Although cross-sectional, our findings provide further evidence of the potential benefits of CRF for adolescents' mental health (i.e., well-being and internalizing problems), particularly girls. However, MF may be less relevant for mental health among this population.

Impact of the Ebola virus disease outbreak (2014-2016) on tuberculosis surveillance activities by Guinea's National Tuberculosis Control Program: a time series analysis.

BACKGROUND: Most countries in Subsaharan Africa have well-established National Tuberculosis Control Programs with relatively stable routine performances. However, major epidemiological events may result in significant disruptions. In March 2014, the World Health Organization announced the outbreak of Ebola virus disease in Guinea, a country with a high incidence of TB and HIV. Our study aimed to assess the impact of the Ebola virus disease outbreak on TB notification, treatment, and surveillance, using main indicators. METHODS: This is a retrospective cohort study that compared TB trends using surveillance data from the periods before (2011-2013), during (2014-2016), and after (2017-2018) Ebola virus disease outbreak. A time-series analysis was conducted to investigate the linkages between the decline in TB notification and the Ebola virus disease outbreak through cross-correlation. The lag in the cross-correlation test was evaluated using ANCOVA type II delayed variable dependent model. The surveillance system was assessed using TB surveillance standards and benchmarks and vital registration systems recommended by WHO, compared with those of 2015 during the Ebola virus disease. RESULTS: The rate of reporting of TB declined from 120 cases per 100,000 in 2011 to 100 cases per 100,000 in 2014, at the peak of the Ebola virus disease outbreak. The time-series cross-correlation test of all notified cases of TB and Ebola showed a significant lag of - 0.4 (40%), reflecting a drop in the rate of notification (F-value = 5.7 [95% CI: 0.2-21.3]). The Ebola virus disease had no negative impact on patient treatment outcomes (F-value = 1.3 [95% CI: 0.0-8.8]). Regarding the surveillance system, five out of 13 WHO standards and benchmarks were met following their evaluation in 2019, after the Ebola virus disease outbreak, compared to three in 2015. CONCLUSION: Major epidemics such as the Ebola virus disease outbreak may have a significant impact on well-established TB control programs as shown in the example of Guinea. Sudden disruptions of routine performance may lead programs to improve their surveillance system. The experience acquired in the fight against EVD and the investments made should make it possible to prepare the health system in a coherent manner for the other probable episodes.

Development and Evaluation of the High-Intensity Interval Training Self-Efficacy Questionnaire.

This study involved the design and evaluation of the High-Intensity Interval Training Self-Efficacy Questionnaire (HIIT-SQ). Phase 1: Questionnaire items were developed. Phase 2: Australian adolescents (N = 389, 16.0 ± 0.4 years, 41.10% female) completed the HIIT-SQ, and factorial validity of the measurement model was explored. Phase 3: Adolescents (N = 100, age 12-14 years, 44% female) completed the HIIT-SQ twice (1 week apart) to evaluate test-retest reliability. Confirmatory factor analysis of the final six items (mean = 3.43-6.73, SD = 0.99-25.30) revealed adequate fit, χ2(21) = 21, p = .01, comparative fit index = .99, Tucker-Lewis index = .99, root mean square of approximation = .07, 90% confidence interval [.04, .11]. Factor loading estimates showed that all items were highly related to the factor (estimates range: 0.81-0.90). Intraclass coefficients and typical error values were .99 (95% confidence interval [.99, 1.00]) and .22, respectively. This study provides preliminary evidence for the validity and reliability of scores derived from the HIIT-SQ in adolescents.