Biofloc technology and immune response of penaeid shrimp: A meta-analysis and meta-regression.

Biological flocs develop as heterogenious communities of detritus, heterotrophic and autotrophic bacteria, algae, fungi and a variety of other things through appropriate management of the carbon-nitrogen ratio in aquaculture farming systems. These microbial communities improve the water quality, reduce the concentrations of toxic inorganic species, and act as a source of food and immunostimulants. However, the information about their role as immunostimulants is widely variable. To obtain a clearer view of the situation, it is necessary to summarize the current literature on this topic through a quantitative review analysis: a meta-analysis. The present work aims to evaluate the effect of biofloc technology (BFT) implementation on culture water quality through meta-analysis, meta-regression, and correlation analysis. Pubmed, Science Direct, Scopus, and Google Scholar were searched from 2000 to 2022 on the influence of BFT on immunological parameters. Three hundred and thirty-four of the scientific articles used BFT for penaeid shrimp, but only 25 articles met the inclusion criterion of using BFT to evaluate its effect on the shrimp's immunity. The current analysis found that the use of BFT stimulates all the evaluated immunological parameters. Also, meta-regression with fixed data of study parameters showed that slow-release carbon sources, probiotics, and an estimated carbon/nitrogen ratio of 10 potentiated a larger effect on BFT immune stimulation. The meta-analysis demonstrated that the volumes of the settleable solids (SS) and the total suspended solids (TSS) are crucial for the effect of BFT on the shrimp immune system. When TSS was higher than 294 mg/L, the respiratory metabolism of the shrimp was compromised. The analysis found evidence of publication biases, indicating that the data had to be interpreted carefully. Nonetheless, this meta-analysis shows that the data quality was sound and the approach used was appropriate; moreover, it also showed that BFT can be an environmentally friendly alternative culture method that enhances the shrimp's immune system.

Factor structure and psychometric properties of a multicultural Spanish-language version of the Eating Disorder-15 in a nonclinical sample of Chilean women.

OBJECTIVE: The Eating Disorder-15 (ED-15) is a brief measure developed for the routine assessment of eating disorder (EDs), despite its use in research settings having increased over the last few years. To assess the psychometric properties of the ED-15 in a nonclinical sample of Chilean women. METHOD: A multicultural Spanish-language version was developed through combined translation techniques. University female students (N = 380) (Mage 22.32, SD = 2.48) were recruited through social media. After providing their informed consent, participants completed a battery of questionnaires online. RESULTS: A bi-factor model replicating the bi-factor structure and providing support for the general factor showed the best fit to the data. Moderate-to-strong correlations with measures of EDs, physical comparison, body appreciation, social physique anxiety, and depressive symptoms are presented as evidence of concurrent and convergent validity. Items analyses revealed strong correlations between manifest variables, their correspondent latent variable and the general factor (rs  = .60 to .89, ps < .001). Additionally, current findings provide support for the internal consistency of the scale (Cronbach's alpha and Omega values were ≥ .80) and test-retest reliability (ICCs = .84 to .89, ps < .001). DISCUSSION: Like previous findings, the current study provides validity to the original bi-factor structure of the ED-15 and additional validity to a general factor. The availability of this multicultural Spanish-language version would provide session-by-session assessment, providing crucial information throughout treatment. Also, the availability of the current measure would contribute to further research efforts in a yet understudied population such as Hispanic women. PUBLIC SIGNIFICANCE: The Eating Disorder-15 (ED-15) is a promising measure meant to assess session-by-session change for clinical and research purposes. The availability of a Multicultural Spanish language version of the ED-15 allows for routine clinical assessment and represents a contribution for research efforts in a yet understudied populations such as Hispanic women.

OBJETIVO: El Eating Disorder-15 (ED-15) es una breve medida de trastornos alimentarios (TCA) diseñada para realizar una evaluación rutinaria, a pesar de que su uso en la investigación ha crecido en los últimos años. Evaluar las propiedades psicométricas del ED-15 en una muestra no clínica de mujeres chilenas. MÉTODO: Se desarrolló una versión multicultural al español mediante técnicas de traducción combinadas. Las estudiantes universitarias (N = 380) (Medad 22.32, DT = 2.48) fueron reclutadas en redes sociales. Después de dar su consentimiento, las participantes completaron cuestionarios en línea. RESULTADOS: un modelo bifactorial que replica la estructura de dos factores y proporciona soporte para un factor general mostró el mejor ajuste. Correlaciones moderadas a fuertes con medidas de TCA, comparación física, apreciación corporal, ansiedad social física y síntomas depresivos se presentan como evidencia de validez concurrente y convergente. Análisis de ítems revelaron fuertes correlaciones entre las variables manifiestas, su correspondiente variable latente y el factor general (rs  = .60 a .89, ps < .001). Los hallazgos actuales respaldan la consistencia interna (alfa Cronbach y Omega > .80) y la confiabilidad test-retest (ICC = .84 a .89, ps < .001). DISCUSIÓN: El estudio actual proporciona validez a la estructura original de 2 factores del ED-15 y validez adicional a un factor general. La disponibilidad de esta versión multicultural en español permitirá una evaluación sesión por sesión, brindando información clínica crucial al tratamiento. Su disponibilidad permitirá el desarrollo de investigaciones en una población aún poco estudiada como la de mujeres latinas.

Association Between Sense of Coherence and Tobacco Use Among Brazilian Adolescent Students.

Background: Investigating tobacco use and associated factors is essential to set priorities and health promotion strategies among adolescents. Several studies examined the relationship between this behavior and the psychosocial salutogenic construct Sense of Coherence (SOC), but the evidence is limited to adolescents in high-income countries. This study aimed to analyze the association between tobacco use and SOC among Brazilian adolescent students. Methods: A cross-sectional school-based survey was conducted in 2018. Dependent variables were categorical binary (Yes/No): (1) Smoking experimentation (at least one puff in a lifetime); (2) Current smoking (at least one cigarette smoked in the last 30 days); (3) Daily cigarette smoking; and (4) Experimentation with hookah and/or other tobacco products (at least once in a lifetime). Independent variable SOC was assessed with the SOC-13 item scale. Independent-samples t-Test and Logistic regression were used in the statistical analyses. Potential confounders were identified using a Directed Acyclic Graph. Results: Participants were 3034 adolescents aged 13-19. The mean SOC scores were higher among adolescents who answered no to each of the dependent variables than among those who answered yes (p < .05). In the regression analysis, those with higher SOC scores were less likely to report smoking experimentation, current use, daily use, and experimentation with hookah and/or other tobacco products, than those with lower SOC scores. The associations remained after controlling for sociodemographic and/or social-environmental factors. Conclusion: An inverse relationship between SOC and tobacco use was observed among Brazilian adolescent students.

The long journey towards standards for engineering biosystems: Are the Molecular Biology and the Biotech communities ready to standardise?

Synthetic biology needs to adopt sound scientific and industry-like standards in order to achieve its ambitious goals of efficient and accurate engineering of biological systems.

Religiosity is Associated with Motivation to Start and Stop Smoking Among Adolescent Students in Brazil.

This study aimed to estimate associations between adolescents' religiosity and their motivation to start and stop smoking. A school survey was carried out in Midwestern Brazil. Participants were never-smokers (n = 2073) and smokers (n = 116) aged 13-19 who answered a questionnaire. Religiosity was measured with the Duke Religion Index, and motivation with questions based on the Prime Theory of Motivation. Organizational, non-organizational, and intrinsic religiosity were associated with motivation to start smoking among never-smokers. Intrinsic religiosity was associated with smokers' motivation to quit. Findings indicate the protective role of religiosity in the motivational system that prompts smoking initiation and cessation during adolescence.

Biomarkers of homeostasis, allostasis, and allostatic overload in decapod crustaceans of distinct habitats and osmoregulatory strategies: an empirical approach.

The term "allostasis", meaning the assumption that homeostasis may not be as static as the term implies, has been vastly employed for mammals, and other vertebrates, for which the degree of internal stability is maximal, according to their higher complexity. We have here investigated how these states of homeostasis, allostasis, and allostatic overload could be diagnosed in decapod crustaceans, upon acute salinity challenges. Decapods of distinct lineages and habitats have been submitted to 3 salinity levels for 6 and 12 h. The first salinity was the habitat salinity (control), considered as the one that allows the homeostatic condition. The next salinity represented a mild challenge, that would potentially lead to allostasis, and the third salinity was intended to represent an overload, albeit not lethal. Species used were: the marine crab Hepatus pudibundus (Hp, osmoconformer, salinities 33, 25, and 20‰), the marine/estuarine swimming crab Callinectes danae (Cd, weak regulator, salinities 30, 20, and 10‰), and the diadromous freshwater prawn Macrobrachium acanthurus (Ma, strong regulator, salinities <0.5, 15, and 30‰). These 3 species follow a sequence of growing regulatory capacity (Hp

Environmental diagnosis of metals in streams near sugarcane cultivation areas: current and historical analysis in the central region of the State of São Paulo.

In Brazil, innumerable regions of native landcover have been removed and replaced by agricultural cultivation, especially of sugarcane. In this culture, the application of fertilizers containing metals has caused impacts on the water resources causing contamination of stream sediments and occasioning bioaccumulation of metals in aquatic invertebrates. In the year of 2006, an environmental diagnosis of metals in sediments of streams located near sugarcane cultivation areas and in streams located in preserved areas, was published. That study pointed to high concentrations of metals in stream sediments in agricultural areas. These streams have been monitored over the last 10 years conducting analyses of metals and monitoring possible changes in land use. In the present paper, a historical comparison of metals contamination in the sediments of the same streams is conducted, aiming to present a status of 10 years later, analyzing 5 metals (Zn, Cd, Mn, Cr and Fe) found in the sediments of 8 streams, five located in areas of sugarcane cultivation and three located in preserved areas. This study also shows that there is higher concentration of metals in the sediments of streams near sugarcane cultivation than in preserved areas. The temporal historical evaluation showed high concentrations of Cd in 2016 when compared to the year 2006 for streams near sugarcane cultivation.

Acute metabolic responses of two marine brachyuran crabs to dilute seawater: The aerobic cost of hyper regulation.

Hepatus pudibundus ("flecked box crab") is a stenohaline osmoconfomer, and restricted to marine habitats. Callinectes danae ("swimming crab Dana") lives in coastal/estuarine waters and is a weak hyper regulator. There is no consensus on which strategy is more expensive metabolically face salinity challenges: conformation with higher dependence on cell volume regulation, or hyper regulation, alleviating the need for intense cell volume regulation. Crabs were probed for their acute response to dilute seawater through exposures to salinities 35‰, 30‰, 25‰, and 20‰ for 2, 4, and 6 h. Hemolymph osmolality, lactate, and ions (chloride, sodium, magnesium, potassium) were assayed, as well as muscle water content. Water dissolved oxygen, ammonia, and pH levels were also measured. H. pudibundus conformed for osmolality and displayed increase in muscle hydration along the decrease in salinity down to 25‰, while C. danae efficiently maintained hemolymph osmo ionic stability, consumed more oxygen, acidified more the water, and released more ammonia. In 25‰, both species spent energy: H. pudibundus putatively controlling cell volume, and C. danae regulating hemolymph concentrations. In 20‰, H. pudibundus closed itself, avoiding the contact of the interface epithelia with the external environment and producing much lactate, whereas C. danae spent more energy (aerobic) in extracellular osmo ionic stability. Under these conditions, anisosmotic extracellular regulation (together with additional cell volume regulation) is more oxygen consuming than osmoconformation with a putatively more intense challenge to cell volume. The exposure to hyposalinity limits the occupation of estuarine environments by H. pudibundus in short and middle term.

Cell-based analysis of CLIC5A and SLC12A2 variants associated with hearing impairment in two African families.

We have previously reported CLIC5A and SLC12A2 variants in two families from Cameroon and Ghana, segregating non-syndromic hearing impairment (NSHI). In this study, biological assays were performed to further functionally investigate the pathogenicity of CLIC5 [c.224T>C; p.(L75P)] and SCL12A2 [c.2935G>A: p.(E979K)] variants. Ectopic expression of the proteins in a cell model shows that compared to wild-type, both the CLIC5A and SLC12A2 variants were overexpressed. The mutant CLIC5A protein appears as aggregated perinuclear bodies while the wild-type protein was evenly distributed in the cytoplasm. Furthermore, cells transfected with the wild-type CLIC5A formed thin membrane filopodia-like protrusions which were absent in the CLIC5A mutant expressing and control cells. On the other hand, the wild-type SLC12A2 expressing cells had an axon-like morphology which was not observed in the mutant expressing and control cells. A network analysis revealed that CLIC5A can interact with at least eight proteins at the base of the stereocilia. This study has generated novel biological data associated with the pathogenicity of targeted variants in CLIC5A and SLC12A2, found in two African families, and therefore expands our understanding of their pathobiology in hearing impairment.

Activation-Induced Cytidine Deaminase Promotes Proliferation and Enhances Chemoresistance and Migration in B-cell Lymphoma.

BACKGROUND/AIM: Activation-induced cytidine deaminase (AID) is a DNA modifying enzyme which has an essential function in promoting antibody diversification. Its overexpression is strongly associated with B-cell derived malignancies including Burkitt lymphoma, where AID is required for the characteristic c-MYC/IGH translocation. This study aimed at defining AID's oncopathogenic role which is still poorly understood. MATERIALS AND METHODS: We created over-expressing and knock-down cell culture models of AID, and used cellular assays to provide insight into its contribution to lymphomagenesis. RESULTS: We showed that AID expression is highly specific to, and abundantly expressed in B-cell-derived cancers and that ectopic overexpression of AID leads to rapid cell death. Using a knock-down model, we revealed that AID expression significantly impacts genomic stability, proliferation, migration and drug resistance. CONCLUSION: AID is an important driver of lymphoma, impacting multiple cellular events, and is potentially a strong candidate for targeted therapy in lymphoma.

HIV-1 Transactivator of Transcription (Tat) Co-operates With AP-1 Factors to Enhance c-MYC Transcription.

HIV-1 infection often leads to the development of co-morbidities including cancer. Burkitt lymphoma (BL) is one of the most over-represented non-Hodgkin lymphoma among HIV-infected individuals, and displays a highly aggressive phenotype in this population group, with comparatively poorer outcomes, despite these patients being on anti-retroviral therapy. Accumulating evidence indicates that the molecular pathogenesis of HIV-associated malignancies is unique, with components of the virus playing an active role in driving oncogenesis, and in order to improve patient prognosis and treatment, a better understanding of disease pathobiology and progression is needed. In this study, we found HIV-1 Tat to be localized within the tumor cells of BL patients, and enhanced expression of oncogenic c-MYC in these cells. Using luciferase reporter assays we show that HIV-1 Tat enhances the c-MYC gene promoter activity and that this is partially mediated via two AP-1 binding elements located at positions -1128 and -1375 bp, as revealed by mutagenesis experiments. We further demonstrate, using pull-down assays, that Tat can exist within a protein complex with the AP-1 factor JunB, and that this complex can bind these AP-1 sites within the c-MYC promoter, as shown by in vivo chromatin immunoprecipitation assays. Therefore, these findings show that in HIV-infected individuals, Tat infiltrates B-cells, where it can enhance the expression of oncogenic factors, which contributes toward the more aggressive disease phenotype observed in these patients.

Electrodeposited PEDOT:PSS-Al2O3 Improves the Steady-State Efficiency of Inverted Perovskite Solar Cells.

The atomic layer deposition (ALD) of Al2O3 between perovskite and the hole transporting material (HTM) PEDOT:PSS has previously been shown to improve the efficiency of perovskite solar cells. However, the costs associated with this technique make it unaffordable. In this work, the deposition of an organic-inorganic PEDOT:PSS-Cl-Al2O3 bilayer is performed by a simple electrochemical technique with a final annealing step, and the performance of this material as HTM in inverted perovskite solar cells is studied. It was found that this material (PEDOT:PSS-Al2O3) improves the solar cell performance by the same mechanisms as Al2O3 obtained by ALD: formation of an additional energy barrier, perovskite passivation, and increase in the open-circuit voltage (Voc) due to suppressed recombination. As a result, the incorporation of the electrochemical Al2O3 increased the cell efficiency from 12.1% to 14.3%. Remarkably, this material led to higher steady-state power conversion efficiency, improving a recurring problem in solar cells.

Modulation of Cellular MicroRNA by HIV-1 in Burkitt Lymphoma Cells-A Pathway to Promoting Oncogenesis.

Viruses and viral components have been shown to manipulate the expression of host microRNAs (miRNAs) to their advantage, and in some cases to play essential roles in cancer pathogenesis. Burkitt lymphoma (BL), a highly aggressive B-cell derived cancer, is significantly over-represented among people infected with HIV. This study adds to accumulating evidence demonstrating that the virus plays a direct role in promoting oncogenesis. A custom miRNA PCR was used to identify 32 miRNAs that were differently expressed in Burkitt lymphoma cells exposed to HIV-1, with a majority of these being associated with oncogenic processes. Of those, hsa-miR-200c-3p, a miRNA that plays a crucial role in cancer cell migration, was found to be significantly downregulated in both the array and in single-tube validation assays. Using an in vitro transwell system we found that this downregulation correlated with significantly enhanced migration of BL cells exposed to HIV-1. Furthermore, the expression of the ZEB1 and ZEB2 transcription factors, which are promotors of tumour invasion and metastasis, and which are direct targets of hsa-miR-200c-3p, were found to be enhanced in these cells. This study therefore identifies novel miRNAs as role players in the development of HIV-associated BL, with one of these miRNAs, hsa-miR-200c-3p, being a candidate for further clinical studies as a potential biomarker for prognosis in patients with Burkitt lymphoma, who are HIV positive.

A Monoallelic Variant in REST Is Associated with Non-Syndromic Autosomal Dominant Hearing Impairment in a South African Family.

Hearing impairment (HI) is a sensory disorder with a prevalence of 0.0055 live births in South Africa. DNA samples from a South African family presenting with progressive, autosomal dominant non-syndromic HI were subjected to whole-exome sequencing, and a novel monoallelic variant in REST [c.1244GC; p.(C415S)], was identified as the putative causative variant. The co-segregation of the variant was confirmed with Sanger Sequencing. The variant is absent from databases, 103 healthy South African controls, and 52 South African probands with isolated HI. In silico analysis indicates that the p.C415S variant in REST substitutes a conserved cysteine and results in changes to the surrounding secondary structure and the disulphide bonds, culminating in alteration of the tertiary structure of REST. Localization studies using ectopically expressed GFP-tagged Wild type (WT) and mutant REST in HEK-293 cells show that WT REST localizes exclusively to the nucleus; however, the mutant protein localizes throughout the cell. Additionally, mutant REST has an impaired ability to repress its known target AF1q. The data demonstrates that the identified mutation compromises the function of REST and support its implication in HI. This study is the second report, worldwide, to implicate REST in HI and suggests that it should be included in diagnostic HI panels.

Opinion of adolescent school smokers about smoking cessation counseling and treatment in health services: a cross-sectional study, Goiás, Brazil, 2018. / Opinião de escolares adolescentes fumantes sobre aconselhamento e tratamento para cessação do tabagismo em serviços de saúde: estudo transversal, Goiás, 2018.

Objective To know the opinion of adolescent school smokers about smoking cessation counseling and treatment, and to investigate whether negative opinion was associated with lack of motivation to stop smoking. Methods This was a cross-sectional study carried out in Goiás state, Brazil, with an intentional sample of adolescent students, in 2018. Poisson regression was used. Results One hundred and thirty adolescents took part. Most of them expressed a positive opinion on the three smoking cessation interventions surveyed: medical counseling (76.2%), dental counseling (70.0%), and smoking cessation treatment (66.2%). Negative opinions were more frequent among adolescents who were not motivated to stop smoking (p<0.05). Regression analyses revealed that lack of motivation to quit smoking was associated with a negative opinion about each intervention. Conclusion The adolescents had a positive opinion about counseling and treatment for smoking cessation in health services. Negative opinion was associated with lack of motivation to quit smoking.

Activation-induced cytidine deaminase: in sickness and in health.

Activation Induced cytidine Deaminase (AID) is an essential enzyme of the adaptive immune system. Its canonical activity is restricted to B lymphocytes, playing an essential role in the diversification of antibodies by enhancing specificity and changing affinity. This is possible through its DNA deaminase function, leading to mutations in DNA. In the last decade, AID has been assigned an additional function: that of a powerful DNA demethylator. Adverse cellular conditions such as chronic inflammation can lead to its deregulation and overexpression. It is an important driver of B-cell lymphoma due to its natural ability to modify DNA through deamination, leading to mutations and epigenetic changes. However, the deregulation of AID is not restricted to lymphoid cells. Recent findings have provided new insights into the role that this protein plays in the development of non-lymphoid cancers, with some research shedding light on novel AID-driven mechanisms of cellular transformation. In this review, we provide an updated narrative of the normal physiological functions of AID. Additionally, we review and discuss the recent research studies that have implicated AID in carcinogenesis in varying tissue types including lymphoid and non-lymphoid cancers. We review the mechanisms, whereby AID promotes carcinogenesis and highlight important areas of future research.

Altered expression of proteoglycan, collagen and growth factor genes in a TGF-ß1 stimulated genetic risk model for musculoskeletal soft tissue injuries.

OBJECTIVES: To investigate the functional effect of implicated variants within BGN and COL5A1 on gene expression of components of the extracellular matrix (ECM) in a TGF-ß-stimulated risk model for musculoskeletal soft tissue injuries. DESIGN: Experimental research, laboratory study. METHODS: Skin biopsies were obtained from nine healthy participants with either a combined increased or reduced risk profile for COL5A1 rs12722 C>T and BGN rs1126499 C>T - rs1042103 G>A, and primary fibroblast cell lines were established. Total RNA was extracted at baseline (10% FBS), after serum starvation (1% FBS) and TGF-ß1 treatment (1% FBS, 10ng/mL TGF-1ß). Relative mRNA levels of BGN, COL5A1, DCN and VEGFA was quantified using Taqman® array pre-spotted plate assays (Applied Biosystems, Foster city, CA, USA). RESULTS: At baseline, the reduced risk group had 2.5, 1.9 and 2 fold increases (p<0.001) in relative BGN, COL5A1 and VEGFA mRNA levels respectively. In the serum starved experiments, except for a significant 1.5 fold (p=0.017) increase in relative DCN mRNA expression in the reduced risk group, similar observations were noted for the other three genes. After TGF-1ß treatment, the reduced risk group had 1.3 (p=0.011) and 1.4 fold (p=0.001) increases in the relative COL5A1 and VEGFA mRNA levels, respectively. CONCLUSIONS: Altered mRNA levels associated with genetic risk profiles for musculoskeletal soft injury risk at baseline (BGN, COL5A1 and VEGFA), with serum starvation (DCN) and after TGF-ß1 treatment (COL5A1 and VEGFA) provide additional functional evidence to support the association of implicated genetic loci with several musculoskeletal soft tissue injuries. Implication of altered gene expression profiles underpinning these genetic risk associated loci potentially highlight key therapeutic targets for management of these injuries.

Prevalences of Stages of Change for Smoking Cessation in Adolescents and Associated Factors: Systematic Review and Meta-Analysis.

PURPOSE: To synthesize evidence on the prevalences of stages of change (Transtheoretical Model) for smoking cessation in adolescents and associated factors. METHODS: A systematic search of Web of Science (Thomson Reuters), SCOPUS (Elsevier), MEDLINE/PubMed, CINAHL (EBSCO) and PsycINFO (APA) was conducted to identify eligible studies. Two calibrated reviewers selected studies independently, extracted data, and appraised studies. A qualitative synthesis of the findings and meta-analysis of the prevalences of the stages of change for smoking cessation were carried out. A quality effects model was used to estimate the pooled prevalences. RESULTS: Eleven studies (N = 6469 adolescents) from five middle- to high-income countries were included in the review. Precontemplators accounted for 41% of smokers in earlier stages of change (95%CI: 34%-49%). In such a group, a lowered decisional balance, the lowest self-efficacy, and highest nicotine dependence were found (p < .05). CONCLUSIONS: A higher overall prevalence of adolescents in precontemplation stage for smoking cessation was observed. Such group displayed more unfavorable smoking-related behaviors and characteristics than adolescents in other stages. The evidence is limited due to the lack of studies in adolescents living in low-income countries.

Joint effects of intensity and duration of cigarette smoking on the risk of head and neck cancer: A bivariate spline model approach.

OBJECTIVES: This study aimed at re-evaluating the strength and shape of the dose-response relationship between the combined (or joint) effect of intensity and duration of cigarette smoking and the risk of head and neck cancer (HNC). We explored this issue considering bivariate spline models, where smoking intensity and duration were treated as interacting continuous exposures. MATERIALS AND METHODS: We pooled individual-level data from 33 case-control studies (18,260 HNC cases and 29,844 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. In bivariate regression spline models, exposures to cigarette smoking intensity and duration (compared with never smokers) were modeled as a linear piecewise function within a logistic regression also including potential confounders. We jointly estimated the optimal knot locations and regression parameters within the Bayesian framework. RESULTS: For oral-cavity/pharyngeal (OCP) cancers, an odds ratio (OR) >5 was reached after 30 years in current smokers of ∼20 or more cigarettes/day. Patterns of OCP cancer risk in current smokers differed across strata of alcohol intensity. For laryngeal cancer, ORs >20 were found for current smokers of ≥20 cigarettes/day for ≥30  years. In former smokers who quit ≥10  years ago, the ORs were approximately halved for OCP cancers, and ∼1/3 for laryngeal cancer, as compared to the same levels of intensity and duration in current smokers. CONCLUSION: Referring to bivariate spline models, this study better quantified the joint effect of intensity and duration of cigarette smoking on HNC risk, further stressing the need of smoking cessation policies.

I've got Toothache, I need Antibiotics: a UK Perspective on Rational Antibiotic Prescribing by Dentists.

Antibiotics do not cure toothache. This headline message of the United Kingdom's (UK) Dental Antimicrobial Stewardship (AMS) toolkit's posters and leaflets is aimed at patients; clinicians are expected to know this already. Evidence based clinical guidelines exist to set clear standards for good clinical practice yet there are barriers to compliance. The national AMS audit tool is designed for clinicians to review their management of acute dental conditions, including but not limited to the prescription of antibiotics. In this article we aim to help dental teams protect their patients and themselves from adverse events related to antibiotic prescription. It explores the emergent problem of Clostridium difficile, antibiotic resistance and severe sepsis, and considers some of the barriers, which clinicians have suggested, contribute to the unjustified prescription of antibiotics. Dentists must weigh the risks against the benefits before prescribing any antibiotic.