Elevated cholesterol in ATAD3 mutants is a compensatory mechanism that leads to membrane cholesterol aggregation.

Aberrant cholesterol metabolism causes neurological disease and neurodegeneration, and mitochondria have been linked to perturbed cholesterol homeostasis via the study of pathological mutations in the ATAD3 gene cluster. However, whether the cholesterol changes were compensatory or contributory to the disorder was unclear, and the effects on cell membranes and the wider cell were also unknown. Using patient-derived cells, we show that cholesterol perturbation is a conserved feature of pathological ATAD3 variants that is accompanied by an expanded lysosome population containing membrane whorls characteristic of lysosomal storage diseases. Lysosomes are also more numerous in Drosophila neural progenitor cells expressing mutant Atad3, which exhibit abundant membrane-bound cholesterol aggregates, many of which co-localize with lysosomes. By subjecting the Drosophila Atad3 mutant to nutrient restriction and cholesterol supplementation, we show that the mutant displays heightened cholesterol dependence. Collectively, these findings suggest that elevated cholesterol enhances tolerance to pathological ATAD3 variants; however, this comes at the cost of inducing cholesterol aggregation in membranes, which lysosomal clearance only partly mitigates.

Interplay between nitric oxide and gonadotrophin-releasing hormone in the neuromodulation of the corpus luteum during late pregnancy in the rat.

BACKGROUND: Nitric oxide and GnRH are biological factors that participate in the regulation of reproductive functions. To our knowledge, there are no studies that link NO and GnRH in the sympathetic ganglia. Thus, the aim of the present work was to investigate the influence of NO on GnRH release from the coeliac ganglion and its effect on luteal regression at the end of pregnancy in the rat. METHODS: The ex vivo system composed by the coeliac ganglion, the superior ovarian nerve, and the ovary of rats on day 21 of pregnancy was incubated for 180 min with the addition, into the ganglionic compartment, of L-NG-nitro arginine methyl ester (L-NAME), a non-selective NO synthase inhibitor. The control group consisted in untreated organ systems. RESULTS: The addition of L-NAME in the coeliac ganglion compartment decreased NO as well as GnRH release from the coeliac ganglion. In the ovarian compartment, and with respect to the control group, we observed a reduced release of GnRH, NO, and noradrenaline, but an increased production of progesterone, estradiol, and expression of their limiting biosynthetic enzymes, 3ß-HSD and P450 aromatase, respectively. The inhibition of NO production by L-NAME in the coeliac ganglion compartment also reduced luteal apoptosis, lipid peroxidation, and nitrotyrosine, whereas it increased the total antioxidant capacity within the corpora lutea. CONCLUSION: Collectively, the results indicate that NO production by the coeliac ganglion modulates the physiology of the ovary and luteal regression during late pregnancy in rats.

Intra- and Interrater Reliability of the Spanish Version of the Gross Motor Function Measure (GMFM-SP-88).

PURPOSE: To assess intra- and interrater reliability of the Spanish version of the 88-item Gross Motor Function Measure (GMFM-SP-88), and its correlation to age and severity of children with cerebral palsy. METHODS: Six raters assessed 50 videotapes and 4 viewed 50 recordings to determine intra- and interrater reliability, respectively. Intraclass correlation coefficients (ICCs), standard error of measurement (SEm), smallest real difference (SRD), and limits of agreement (LoA) were calculated. RESULTS: Intra- and interrater reliability were excellent for both total (ICC2,1 = 1.00, 95% confidence interval [CI] 0.99-1.00) and dimension scores (ICC2,1 = 0.99, 95% CI 0.99-1.00). The SEm and the SRD for the total score were acceptable (1.60 and 3.14, respectively). The average differences in dimension scores were below 1 and 0.1 points (95% LoA: -1.65 to 1.94, -1.06 to 0.86 for intra- and interrater reliability, respectively). CONCLUSIONS: The results support the potential use of the GMFM-SP-88 as a reliable tool, having correlation with age and severity. WHAT THIS ADDS TO THE EVIDENCE: The GMFM-SP-88 is a reliable outcome measure to assess gross motor function in cerebral palsy. The GMFM-SP is the only tool available in Spanish to assess gross motor function in children and adolescents with cerebral palsy. The GMFM-SP-88 is a valuable resource for both Spanish physical therapists and researchers.

[Housing support after long-term psychiatric hospitalization: Resources and strategies in three experiences in Buenos Aires Province, Argentina]. / Los apoyos a la vivienda tras internaciones psiquiátricas prolongadas: recursos y estrategias en tres experiencias de la Provincia de Buenos Aires, Argentina.

INTRODUCTION: Housing is one of the main supports needed to guarantee community life of people who had long-term psychiatric hospitalizations. In Argentina, housing support experiences have been developed for decades, although their systematization is scarce. The objective of this paper is to describe three housing support experiences developed in the province of Buenos Aires, Argentina, which have continuity over time for more than 20 years. MATERIALS AND METHODS: Document analysis and interviews with workers from the three experiences were carried out, as part of a broader project on community life and neighborhood relations of people discharged after long-term psychiatric hospitalizations. The material was analyzed qualitatively, using a time dimension and a structure and functioning one which included financing, technical resources, housing devices and support provided. RESULTS: Although the types of support provided are somehow similar between the three experiences, heterogeneity in structure and functioning is observed. DISCUSSION AND CONCLUSIONS: Despite the fact that the human rights framework proposes the provision of flexible and adequate support according to the needs of people, it is worth reflection on whether the reduced systematization of experiences such as those presented is due to the difficulties of the heterogeneity mentioned, or is due to a scarce evaluation culture that obstacles the learning from those experiences.

Neuromodulatory effect of GnRH from coeliac ganglion on luteal regression in the late pregnant rat.

The GnRH/GnRH receptor system has been found in several extrapituitary tissues, although its physiological significance has not yet been well established. Taking into account that the peripheral neural system can act as a modulator of pregnancy corpus luteum, the objective was to physiologically investigate the presence of the GnRH system in coeliac ganglion (CG) and to analyse its possible involvement in luteal regression through the superior ovarian nerve (SON) at the end of pregnancy in the rat. The integrated ex vivo CG-SON-Ovary system of rats on day 21 of pregnancy was used. Cetrorelix (CTX), a GnRH receptor antagonist, was added into the ganglionic compartment while the control systems were untreated. Ganglionic GnRH release was detected under basal conditions. Then, the CTX addition in CG increased it, which would indicate the blockade of the receptor. In turn, CTX in CG caused an increase in ovarian progesterone release. Furthermore, the luteal cells showed an increase in the expression of Hsd3b1 and a decrease in the expression of Akr1c3 (progesterone synthesis and degradation enzymes, respectively), reduced TUNEL staining according to an increase in the antioxidant defence system activity and low lipid peroxide levels. The ovarian and ganglionic nitric oxide (NO) release increased, while the luteal nitrotyrosine content, measured as nitrosative stress marker, decreased. CTX in CG decreased the ovarian noradrenaline release. The present study provides evidence that GnRH from CG may trigger neuronal signals that promote the luteal regression in late pregnancy by affecting the release of NO and noradrenaline in the ovary.

Clinical and laboratory parameters in blunt pelvic trauma not associated with subsequent positive conventional angiography in patients with positive CTA.

PURPOSE: This study evaluates clinical and laboratory parameters, as well as extravasation and hematoma size on CTA as potential predictors of conventional angiogram (CA) results. METHODS: This is a retrospective study of 380 adult patients presenting with pelvic trauma over a 9-year period. Of these patients, 91 were found to have active arterial extravasation on initial CTA. Statistical analysis between the two groups +CA versus -CA was performed to determine whether clinical and laboratory parameters, as well as extravasation size and hematoma size could predict CA results. RESULTS: There were no significant differences in all clinical and laboratory data, including hemodynamic instability (defined as systolic blood pressure < 90 mmHg) on presentation (22.2% vs. 21.4%), except for Glasgow Coma Scale (p = 0.015) when comparing the two groups. Extravasation size and hematoma size as continuous or categorical variables were not predictive of subsequent positive CA. Secondary analysis demonstrated no association between select parameters (i.e., hematocrit, systolic blood pressure, and lactate) and subsequent positive CA while controlling for extravasation size or hematoma size. CONCLUSION: Clinical and laboratory parameters in blunt pelvic trauma with arterial hemorrhage were not significantly associated with subsequent conventional angiography results, once accounting for degree of hemorrhage. The area of the foci of active extravasation and hematoma size in the axial plane were not significantly associated with the need for embolization. We conclude from these findings that catheter angiography should be considered in patients with blunt pelvic trauma found to have active arterial extravasation, regardless of size of bleed or the patient's clinical or laboratory values.

[Subjective impact of COVID-19 pandemic among mental health service workers in Argentina]. / Impacto subjetivo de la pandemia de COVID-19 en los trabajadores de salud mental de la Argentina.

INTRODUCTION: The impact of the COVID-19 pandemic on health workers has been studied on an international level. However, mental health workers, who are also called upon to address such ailments both in the general population as well as in the health personnel, have not been asked about their experiences. METHODS: Seventy mental health workers in five regions of Argentina were interviewed between May and June 2020 regarding the subjective impact of changes in their work due to the pandemic. The responses were analyzed quantitatively and qualitatively. RESULTS: The results indicate emotions and experiences associated with a negative impact, in connection to feelings of tiresome, uncertainty, fear, anguish and anxiety and, to a lesser extent, some positive impacts are also described. More than a third of participants mentioned mixed feelings (i.e., being surprised, ambivalent, alert and sensitive). CONCLUSIONS: The personnel who are supposed to support the rest of the health workers are affected and experience having been relegated one more time to other aspects within the health care system. Focusing on learnings, having management roles, counting on colleagues, and agreeing with macro policies could be protective factors against the difficulties associated with the changes in work that the pandemic has imposed.

Mammary gland-specific regulation of GNRH and GNRH-receptor gene expression is likely part of a local autoregulatory system in female vizcachas (Rodentia: Chinchillidae).

In addition to key mammotrophic hormones such as the pituitary prolactin (PRL) and the ovarian steroids progesterone and estradiol, there are local factors that modulate the tissue dynamics of the mammary glands during pregnancy and lactation. By immunohistochemistry and RT-PCR, we found local transcription and translation of gonadotropin-releasing hormone (GNRH), GNRH receptor (GNRHR), PRL and PRL receptor (PRLR) in mammary glands of adult vizcachas during pregnancy and lactation. Both GNRH and GNRHR showed a lag between protein expression and gene transcription throughout the gestational period: while the highest transcription levels of these genes were recorded at early-pregnancy, the epithelial immunoexpressions of both showed their maximum during lactation. RIA results corroborated the presence of GNRH in mammary glands at all the analyzed stages and confirmed the maximum amount of this peptide in the lactating group. Significant amounts of GNRH were detected in milk samples as well. Conversely, PRL and PRLR shared similar protein and gene expression profiles, all exhibiting maximum values during lactation. GNRH peptide content in mammary glands of females with sulpiride-induced hyperprolactinemia (HP) was significantly lower than that of control females (CT). Although PRL mRNA levels remained unchanged, there was a marked increase in theα-lactalbumin (LALBA) transcription in mammary glands of HP- vs CT-females. These results suggest that after targeting mammary glands, PRL stimulates the expression of milk protein genes, but also, tempers the local expression of GNRH. Mammary gland-explantssupplemented with a GNRH analogue (GN-explants) had no differences in terms of PRLR orLALBA transcription levels compared to CT-explants, so the mammary PRLR signaling would not appear to be modulated by GNRH. Yet, mRNA expression levels of both GNRH and the GNRHR-downstream factor, EGR1, were significantly higher in GN-explants compared to that of CT which would point to a GNRH-positive feedback mechanism. In summary, the local coupled expression of GNRH, GNRHR and EGR1 in the mammary gland throughout pregnancy of vizcachas, the PRL-dependent mammary GNRH secretion as well as the GNRH positive feedback on its own transcription suggest an autocrine-paracrine regulatory mechanism and propose an active role for GNRH in mammary gland tissue remodeling.

Measures of Motor and Functional Skills for Children With Cerebral Palsy: A Systematic Review.

PURPOSE: To review the level of evidence of the psychometric properties of outcome measures for motor or functional skills for children with cerebral palsy classified across I to V levels of the Gross Motor Function Classification System. METHODS: A systematic search was completed in PubMed/MEDLINE, ISI Web of Science, CINAHL, and 4 complementary databases. The COSMIN Risk of Bias checklist and the updated criteria for good measurement properties were applied to assess the quality. RESULTS: Four outcome measures were identified from 12 articles: Gross Motor Function Measure, Gross Motor Performance Measure, Pediatric Evaluation of Disability Inventory, and Functional Independence Measure for Children. Evidence levels for validity, reliability, and responsiveness varied among measures. CONCLUSIONS: Gross Motor Function Measure in all versions was the most investigated measure providing the best results, with the strongest evidence for validity and responsiveness properties. Reliability evidence should be improved to determine stability.

Retrospective Comparison of Fluticasone Propionate and Oral Viscous Budesonide in Children With Eosinophilic Esophagitis.

BACKGROUND: Eosinophilic esophagitis (EoE) is treated with dietary modification and/or pharmacologic management with swallowed topical steroids. Swallowed fluticasone propionate (FP) and oral viscous budesonide (OVB) have proven to be effective in resolving symptoms and reversing histologic changes in children and adults with EoE. There are minimal comparative studies between the 2 agents. OBJECTIVE: The aim of the study was to retrospectively compare endoscopic and histologic outcomes after FP versus OVB therapy in children with EoE in our center. METHODS: We performed a retrospective chart review of subjects diagnosed with EoE at a tertiary care center between 2010 and 2015. Inclusion criteria were FP or OVB therapy for ≥8 weeks along with pre- and post-treatment endoscopic evaluation. Demographic and clinical features and endoscopic and histologic assessment were recorded for comparative analysis. Histologic response was defined as <15 eos/hpf and remission as <5 eos/hpf. RESULTS: The study included 68 EoE patients (20 FP and 48 OVB) with a mean age of 10.6 ±â€Š5.2 years (range 1-20 years); 81% were boys and 68% were Caucasian. No significant demographic or clinical differences were noted between the 2 study groups. Overall histologic response to topical steroids was seen in 44 of 68 (65%) patients. A significantly greater number of patients achieved histologic response with OVB (36/48, 75%) than with FP (8/20, 40%) (P = 0.0059). Mean pretreatment peak eos/hpf was 46 ±â€Š19 in the FP group versus 45 ±â€Š23 in the OVB group. Mean post-treatment peak eos/hpf was 20 ±â€Š29 in the FP group versus 12 ±â€Š16 in the OVB group (P = 0.002). There was also a significantly greater difference in the change of absolute eos/hpf from pre- to post-treatment in the OVB group (-33) versus FP (18) (P = 0.047). A greater number of OVB-treated patients without asthma had a histologic response compared to those with asthma (P = 0.031). The response to OVB was not affected by the delivery vehicle, namely sucralose (Splenda) versus Neocate Duocal. CONCLUSIONS: Our data suggest that treatment with OVB leads to better endoscopic and histologic outcomes than FP. Adherence to treatment and history of asthma are major determining factors in the response to treatments. Using Neocate Duocal as the OVB delivery vehicle is just as effective as sucralose.

Satisfaction with psychiatric in-patient care as rated by patients at discharge from hospitals in 11 countries.

PURPOSE: There is disregard in the scientific literature for the evaluation of psychiatric in-patient care as rated directly by patients. In this context, we aimed to explore satisfaction of people treated in mental health in-patient facilities. The project was a part of the Young Psychiatrist Program by the Association for the Improvement of Mental Health Programmes. METHODS: This is an international multicentre cross-sectional study conducted in 25 hospitals across 11 countries. The research team at each study site approached a consecutive target sample of 30 discharged patients to measure their satisfaction using the five-item study-specific questionnaire. Individual and institution level correlates of 'low satisfaction' were examined by comparisons of binary and multivariate associations in multilevel regression models. RESULTS: A final study sample consisted of 673 participants. Total satisfaction scores were highly skewed towards the upper end of the scale, with a median total score of 44 (interquartile range 38-48) out of 50. After taking clustering into account, the only independent correlates of low satisfaction were schizophrenia diagnosis and low psychiatrist to patient ratio. CONCLUSION: Further studies on patients' satisfaction should additionally pay attention to treatment expectations formed by the previous experience of treatment, service-related knowledge, stigma and patients' disempowerment, and power imbalance.

Social perceptions about community life with people with mental illness: study of a discharge program in Buenos Aires province, Argentina.

Effects of living near people with mental illness in community settings have been researched as part of psychiatric reform evaluation. However, these studies have been carried out mostly in industrialized countries, where social contexts differ from those in which psychiatric reform is now being implemented. To analyze the effects of community life with people with mental illness in the neighborhoods in which they live, in Buenos Aires, Argentina. A questionnaire was administered to randomly-selected neighbors of group homes of a discharge program and an equivalent control area (n = 236). Data was analyzed both quantitatively and qualitatively. Significant differences were found between being a neighbor and having a high degree of acceptance toward people with mental illness. In addition, significant associations were found between neighbors having a high-perceived social cohesion and having a high level of acceptance toward the mentally ill. Living near people with mental illness is associated with better acceptance toward them; these results are congruent with those results found in other cultural contexts.

Distinctive colonic mucosal cytokine signature in new-onset, untreated pediatric Crohn disease.

OBJECTIVE: The aim of the study was to compare the colonic mucosal immune response in children with new, untreated Crohn disease (CD-New), CD in remission (CD-Remission), and unaffected children (CTRL [controls]). METHODS: We performed flow cytometry of mitogen-stimulated colonic lamina propria mononuclear cells isolated from colonic biopsies and 72-hour biopsy explant cultures, and analyzed the supernatant by an unbiased multiplex cytokine array of 45 analytes. RESULTS: Thirty-six children were studied (mean age 14 ± 3 years, 14 girls): 12 CD-New, 11 CD-Remission, and 13 CTRL. We found that stimulation of lamina propria mononuclear cells isolated from colonic biopsies induced comparable intracellular cytokine levels of interferon (IFN-γ), interleukin (IL)-17, and tumor necrosis factor (TNF)-α in T cells from CD-New, CD-Remission, and CTRL, suggesting that mucosal innate inflammation plays a larger role than activated T cells in CD-New. To measure factors released during the ongoing inflammatory response in CD-New, we cultured colonic biopsy explants and uncovered 13/45 factors that were significantly higher in CD-New versus CD-Remission, whereas 10 were increased in CD-New over CTRL. Ingenuity Pathway Analysis software revealed the anticipated interconnectivity of TNF-α, IL-6, and CSF-2 in CD-New of the colon. A novel subnetwork of chemokines was, however, evident, whereas IL-17a appeared as a peripheral factor. Principal component analysis and hierarchal clustering showed that CD-New and CD-Remission separated into distinct subgroups based on the 13 factors. CONCLUSIONS: At diagnosis of inflammatory bowel disease, the colonic cytokine response contains a predominance of innate immune factors, with chemoattractants and vascular adhesion molecules playing a central role.

Hydroids from a reef system under the influence of the Amazon River plume, Brazil.

The Amazon Reef System (ARS) is one of the most important shallow and mesophotic reef ecosystems in the South Atlantic Ocean. The ARS consists mainly of extensive beds of calcareous algae interspersed by assemblages of octocorals and sponges. The enormous freshwater discharge from the Amazon River forms a plume along the extensive Amazon continental shelf, for which the hydroid community is still largely unknown. The aim of this study is to document the diversity and distribution of hydroids from the ARS, as well as to infer the influence of the plume on species composition in the different zones. Samples were collected at ninety-six stations between 15 and 240 m deep on the Amazon shelf. A total of 37 species were recorded in the studied area. Hydroid assemblages are richer in zones under lower river plume influence, and species composition differs significantly between zones with and without plume influence (PERMANOVA, p = 0.0025). The dissolved oxygen and nitrate ranges were the environmental variables significantly correlated with the hydroid distribution. This study is the first surveying the hydroid species composition and richness in the ARS, highlighting the presence of a typical reef biota and that further faunal studies in underexplored areas of the Atlantic should reveal the distribution of many poorly known hydroids species.

'We see they are abandoned': Social support between people discharged from long-term psychiatric hospitalizations and their neighbors in Argentina.

BACKGROUND: Neighbors are an important component of personal social network (PSN) and despite their peripheral role and being considered as familiar strangers, they typically provide instrumental support. For people who is discharged after long-term psychiatric hospitalizations, neighbors would offer other types of social support and play a different role fostering the process of becoming full member of a given community. AIMS: To analyze the effects of neighboring on both, those who have had long-term psychiatric hospitalizations and their neighbors. METHOD: Data was collected between 2020 and 2021, including interviews with formal care staff of three housing support experiences in Argentina, and short testimonies from formerly discharged mental health service users living in the community and their neighbors. We analyzed the data using the Framework Method with a focus on the different aspects of social support and equity and reciprocity theories. RESULTS: Results suggest that emotional support was a frequent function displayed by neighbors toward people with a history of long-term psychiatric hospitalizations, which differs from typical neighboring relationships. CONCLUSIONS: Despite reciprocity was observed, users and neighbors displayed an unbalanced helping relationship.

Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project.

Background: Polypharmacy is a growing phenomenon among elderly individuals. However, there is little information about the frequency of polypharmacy among the elderly population treated in emergency departments (EDs) and its prognostic effect. This study aims to determine the prevalence and short-term prognostic effect of polypharmacy in elderly patients treated in EDs. Methods: A retrospective analysis of the Emergency Department Elderly in Needs (EDEN) project's cohort was performed. This registry included all elderly patients who attended 52 Spanish EDs for any condition. Mild and severe polypharmacy was defined as the use of 5-9 drugs and ⩾10 drugs, respectively. The assessed outcomes were ED revisits, hospital readmissions, and mortality 30 days after discharge. Crude and adjusted logistic regression analyses, including the patient's comorbidities, were performed. Results: A total of 25,557 patients were evaluated [mean age: 78 (IQR: 71-84) years]; 10,534 (41.2%) and 5678 (22.2%) patients presented with mild and severe polypharmacy, respectively. In the adjusted analysis, mild polypharmacy and severe polypharmacy were associated with an increase in ED revisits [odds ratio (OR) 1.13 (95% confidence interval (CI): 1.04-1.23) and 1.38 (95% CI: 1.24-1.51)] and hospital readmissions [OR 1.18 (95% CI: 1.04-1.35) and 1.36 (95% CI: 1.16-1.60)], respectively, compared to non-polypharmacy. Mild and severe polypharmacy were not associated with increased 30-day mortality [OR 1.05 (95% CI: 0.89-2.26) and OR 0.89 (95% CI: 0.72-1.12)], respectively. Conclusion: Polypharmacy was common among the elderly treated in EDs and associated with increased risks of ED revisits and hospital readmissions ⩽30 days but not with an increased risk of 30-day mortality. Patients with polypharmacy had a higher risk of ED revisits and hospital readmissions ⩽30 days after discharge.

Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project Management elderly patients with polypharmacy is becoming a major challenge to the emergency services. The progressive aging of the population is producing a progressive increase in the number of patients treated with multiple comorbidities and chronic medications. It's well known that polypharmacy is associated with an increase in hospital admissions and health care system costs. However, the impact of polypharmacy over the risk of new visits to the emergency rooms is not well defined. Understanding the impact of polypharmacy on the frequency of new visits to the emergency room and on patient mortality is the first step to establish prevention measures for new visits, proposing improvements in chronic treatment at discharge. This study aimed to determine the prevalence and effect on short-term prognosis of polypharmacy in elderly patients treated in Emergency departments. The authors used a retrospective multipurpose registry in 52 hospitals in Spain. This study includes 25,557 patients with a mean age of 78 years. On admission, the median number of drugs was 6 (IQR: 3­9), with 10,534 (41.2%) patients taking 5­9 drugs and 5,678 (22.2%) taking ⩾10 drugs. In these patients comorbidities were associated with an increase in the number of drugs. In the patients with severe polypharmacy (⩾10 drugs), diuretics were the most frequently drugs prescribed, followed by antihypertensives and statins. The results obtained indicate that polypharmacy is a frequent phenomenon among the elderly population treated in Emergency departments, being antihypertensives the most frequently used drugs in this population. Those patients who takes ⩾10 drugs have a higher risk of new visits to the emergency room and hospital readmissions in short term period.

Use of diagnostic tests in elderly patients consulting the emergency department. Analysis of the emergency department and elder needs cohort (EDEN-8).

OBJECTIVE: Analyse the association between the use of diagnostic tests and the characteristics of older patients 65 years of age or more who consult the emergency department (ED). METHODS: We performed an analysis of the EDEN cohort that includes patients who consulted 52 Spanish EDs. The association of age, sex, and ageing characteristics with the use of diagnostic tests (blood tests, electrocardiogram (ECG), microbiological cultures, X-ray, computed tomography, ultrasound, invasive techniques) was studied. The association was analysed by calculating the adjusted odds ratios (aOR) and their 95 % confidence intervals (CI) using a logistic regression model. RESULTS: A total of 25,557 patients were analysed. There was an increase in the use of diagnostic tests based on age, with an aOR for blood test of 1.805 (95 %CI 1.671 - 1.950), ECG 1.793 (95 %CI 1.664 - 1.932) and X-ray 1.707 (95 %CI 1.583 - 1.840) in the group of 85 years or more. The use of diagnostic tests is lower in the female population. Most ageing characteristics (cognitive impairment, previous falls, polypharmacy, dependence, and comorbidity) were independently associated with increased use of diagnostic tests. CONCLUSIONS: Age, and the characteristics of ageing itself are generally associated with a greater use of diagnostic tests in the ED.

Laboratory evidence of norwalk virus contamination on the hands of infected individuals.

Human norovirus (NoV) outbreak investigations suggest that the hands of infected individuals play an important role in NoV transmission. However, there is no experimental evidence documenting the likelihood and degree of NoV contamination on hands. As part of a clinical trial designed to evaluate the efficacy of high-pressure processing for Norwalk virus (NV) inactivation in oysters, 159 hand rinse samples were collected from 6 infected and 6 uninfected subjects. NV was concentrated from the samples by polyethylene glycol precipitation, followed by RNA extraction using an automated guanidinium isothiocyanate-silica method. NV RNA was detected and quantified using multiple NV-specific reverse transcription-quantitative PCR (RT-qPCR) assays. A total of 25.4% (18/71) of the hand rinse samples collected from 6 infected volunteers were presumptively positive for NV, with an average of 3.86 log10 genomic equivalent copies (GEC) per hand. Dot blot hybridization of PCR products obtained using a different primer set, and DNA sequencing of selected amplicons, provided further confirmation of the presence of NV in the hand rinses. NV contamination was also detected in two hand rinse samples obtained from one uninfected subject. These findings provide definitive evidence of NV contamination on the hands of infected subjects observed under controlled clinical research conditions. Such data support the need for better hand hygiene strategies to prevent NoV transmission.

The Global Plastics Treaty: An Endocrinologist's Assessment.

Plastics are everywhere. They are in many goods that we use every day. However, they are also a source of pollution. In 2022, at the resumed fifth session of the United Nations Environment Assembly, a historic resolution was adopted with the aim of convening an Intergovernmental Negotiating Committee to develop an international legally binding instrument on plastic pollution, including in the marine environment, with the intention to focus on the entire life cycle of plastics. Plastics, in essence, are composed of chemicals. According to a recent report from the secretariat of the Basel, Rotterdam, and Stockholm conventions, around 13 000 chemicals are associated with plastics and plastic pollution. Many of these chemicals are endocrine-disrupting chemicals and, according to reports by members of the Endocrine Society and others, exposure to some of these chemicals causes enormous costs due to the development of preventable diseases. The global plastics treaty brings the opportunity for harmonized, international regulation of chemicals with endocrine disrupting properties present in plastic products.

Influence of dairy products consumption on oral cancer risk: A meta-analysis.

Background: The role of dairy product consumption on oral cancer risk is not yet fully clarified. Some studies have observed an inverse association between dairy consumption and oral cancer risk. This study aimed to determine the influence of dairy product consumption (milk, cheese, yogurt, butter) on oral cancer risk. Methods: A search for studies on dairy products and oral cancer was conducted in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS), and Scopus. The estimation of the odds ratio (OR) effect was performed with the generic inverse variance method using the logarithm of the effect with the standard error (SE) and 95% confidence intervals. Results: Twenty-one studies with 59271 participants (8,300 oral cancer patients and 50971 controls) were included in this meta-analysis. All dairy products significantly reduced oral cancer risk except butter (P=0.16). Milk intake reduced oral cancer risk by 27% (OR: 0.73; P<0.001); yogurt consumption by 25% (OR: 0.75; P<0.001), and cheese consumption by 21% (OR:0.79; P<0.01). Conclusion: Regular consumption of dairy products reduces oral cancer risk between 21% and 27%.