Correlation of Mercury Occurrence with Age, Elemental Composition, and Life History in Sea-Run Food Fish from the Canadian Arctic Archipelago's Lower Northwest Passage.

As mercury emissions continue and climate-mediated permafrost thaw increases the burden of this contaminant in northern waters, Inuit from a Northwest passage community in the Canadian Arctic Archipelago pressed for an assessment of their subsistence catches. Sea-run salmonids (n = 537) comprising Arctic char (Salvelinus alpinus), lake trout (S. namaycush), lake whitefish (Coregonus clupeaformis), and cisco (C. autumnalis, C. sardinella) were analyzed for muscle mercury. Methylmercury is a neurotoxin and bioaccumulated with fish age, but other factors including selenium and other elements, diet and trophic level as assessed by stable isotopes of nitrogen (δ15N) and carbon (δ13C), as well as growth rate, condition, and geographic origin, also contributed depending on the species, even though all the fish shared a similar anadromous or sea-run life history. Although mean mercury concentrations for most of the species were ~0.09 µg·g-1 wet weight (ww), below the levels described in several jurisdictions for subsistence fisheries (0.2 µg·g-1 ww), 70% of lake trout were above this guideline (0.35 µg·g-1 ww), and 19% exceeded the 2.5-fold higher levels for commercial sale. We thus urge the development of consumption advisories for lake trout for the protection of pregnant women and young children and that additionally, periodic community-based monitoring be initiated.

Systematic revision of the trans-Bassian moriomorphine genus Theprisa Moore (Coleoptera, Carabidae).

The Australian genus Theprisa Moore, 1963, is taxonomically revised to comprise five species, two newly described: Theprisadarlingtoni Liebherr & Porch, sp. nov. of Tasmania, and Theprisaotway Liebherr, Porch & Maddison, sp. nov. from the Otway Ranges, Victoria. Two previously described species, T.australis (Castelnau) and T.montana (Castelnau), are distributed in the mountains of Victoria. The third previously described species, T.convexa (Sloane) is found in Tasmania. A lectotype is designated for T.convexa because the various syntypes are ambiguously labelled. Cladistic analysis based on morphological characters establishes monophyly of Theprisa relative to the Australian genera Sitaphe Moore and Spherita Liebherr. This and a second clade of Australian genera (Pterogmus Sloane, Thayerella Baehr, and Neonomius Moore) do not form a natural group, but are cladistically interdigitated among two monophyletic New Zealand lineages (Tarastethus Sharp, and Trichopsida Larochelle and Larivière) suggesting substantial trans-Tasman diversification among these groups. Hypothesized relationships within Theprisa are consistent with two bouts of speciation involving the Bass Strait; an initial event establishing T.convexa as adelphotaxon to the other four species, and a more recent event establishing the sister species T.darlingtoni and T.montana. Geographic restriction of T.otway to the Otway Ranges is paralleled by Otway endemics in several other carabid beetle genera, as well as by endemics in numerous other terrestrial arthropod taxa. Whereas these numerous Otway endemics support the distinctive nature of the Otway Range fauna, their biogeographic relationships are extremely varied, illustrating that the Otways have accrued their distinctive biodiversity via various means.

Co-occurring Environmental Stressors have Emerging Impacts on Sensory-Motor Behavior.

Anthropogenic activities often lead to alterations in the natural environment via multiple routes. Simultaneous occurrence of interacting environmental perturbations may influence animals via more complex pathways than when being exposed to environmental stressors discretely. In our study, we investigated the interactive effects of poor visual environment and exposure to an environmentally realistic concentration of a common contaminant on the behavior of larval zebrafish, Danio rerio. Specifically, we tested the sensory-motor behavior of zebrafish larvae by exposing them to low-light conditions and a low concentration of bisphenol-A (BPA) for 7 days postfertilization. We found that zebrafish exposed to both BPA and low-light conditions had significantly weaker response to a moving-visual cue. However, those exposed to only one of these treatments did not have altered response to visual cues. Since the response to a moving, visual cue involves locomotion, we also examined the distance they traveled as a proxy for activity level of individuals across treatments. However, the distance traveled by individuals did not significantly differ across treatments, suggesting that the differences in response are linked to visual sensory pathways. Here, we emphasize that the adverse effects of environmental stressors, particularly of those that occur at environmentally relevant concentrations, may emerge only when they co-occur with another environmental stressor. These findings highlight the need to incorporate multiple environmental stressors to comprehensively assess impacts that human activities have on behavioral strategies of animals.

Intermittent Motivational Interviewing and Transdiagnostic CBT for Anxiety: A Randomized Controlled Trial.

Recent meta-analytic findings suggest that Motivational Interviewing (MI) used as an adjunct to Cognitive Behavior Therapy (CBT) for anxiety disorders improves overall treatment outcomes (Marker & Norton, 2018). However, when used as a prelude to CBT, MI significantly increases the length of treatment and numerous studies note that the effectiveness of pre-treatment MI subsides over time. The current study adapted an already established 12-session transdiagnostic CBT protocol (tCBT, Norton, 2012) to include one hour of MI spread across four sessions of tCBT (sessions 1, 3, 8, and 10) at 15 minutes each, with the option of including additional MI if resistance arose in therapy. Thirty-six treatment seeking adults with principal anxiety disorder diagnosis were randomly assigned to receive intermittent MI and tCBT (iMI + tCBT) or tCBT and psychoeducation. Results indicated that the iMI + tCBT condition significantly outperformed the tCBT condition on several primary outcome variables. While no significant difference was found between the two groups on clinician rated scores of participant principal anxiety disorder, differences were found on a composite index of participants' self-report measures of symptom improvement, and on clinician rated scores of global psychiatric functioning. These effects were not moderated by baseline motivation or baseline ambivalence. The study also found that the iMI + tCBT condition showed significantly greater improvement to comorbid conditions and greater reduction in self-report depressive symptoms. The inclusion of MI did not impact participant drop out. This study provides further support for integrating MI and tCBT and highlights that even small doses of MI can improve treatment outcomes, without increasing length of usual therapy. Limitations and future research options are also discussed.

Reversibility of Multimodal Shift: Zebrafish Shift to Olfactory Cues When the Visual Environment Changes.

Animals can shift their reliance on different sensory modalities in response to environmental conditions, and knowing the degree to which traits are reversible may help us to predict their chances of survival in a changing environment. Here, using adult zebrafish (Danio rerio), we found that 6 weeks in different light environments alone were sufficient to shift whether fish approached visual or chemical cues first, and that a subsequent reversal of lighting conditions also reversed their sensory preferences. In addition, we measured simple behavioral responses to sensory stimuli presented alone, and found that zebrafish housed in dim light for 6 weeks responded weakly to an optomotor assay, but strongly to an olfactory cue, whereas fish experiencing bright light for 6 weeks responded strongly to the visual optomotor stimulus and weakly in an olfactory assay. Visual and olfactory responses were equally reversible, and shifted to the opposite pattern when we reversed lighting conditions for 6 weeks. In contrast, we did not find a change in activity level, suggesting that changes in multiple sensory modalities can buffer animals from changes in more complex forms of behavior. This reversal of sensory response provides insight into how animals may use sensory shifts to keep up with environmental change.

Impact of Autologous Blood Transfusion on Survival and Recurrence among Patients Undergoing Partial Hepatectomy for Colorectal Cancer Liver Metastases.

BACKGROUND: Autologous transfusion (AT) has long been considered unsafe in major oncologic operations due to a theoretic risk of spreading metastatic disease, however, few data support this assumption. STUDY DESIGN: We conducted a retrospective analysis of 147 patients who underwent partial hepatectomy for colorectal cancer metastases at a single institution. Seventy-four patients received AT only and 73 received no transfusion (NT). We compared the overall survival and recurrence-free survival of these groups using Kaplan-Meier survival curves and adjusted hazard ratios. RESULTS: Patients who received AT had greater blood loss, more extensive resections, and longer procedure times. There were no differences in age, sex, proportion colon vs rectal cancer, or Fong Clinical Risk Score. Mean follow-up was 54 months. Median overall survival in the AT group was 59 months compared with 54 months in the NT group (p = 0.69) on log-rank test. No difference in overall survival was noted after adjusting for age, sex, Fong score, type of cancer (colon vs rectal), receipt of neoadjuvant therapy, receipt of adjuvant therapy, extent of resection and blood loss (hazard ratio AT vs NT 0.58; 95% CI 0.31 to 1.11; p = 0.10). Recurrence-free survival was also similar in the AT and NT groups (27% vs 37%; p = 0.22). The adjusted hazard ratio for recurrence-free survival was 0.95 (95% CI 0.54 to 1.65; p = 0.85). CONCLUSIONS: Autologous blood transfusion is not associated with an increased recurrence risk or a higher mortality rate. Surgeons performing liver resections for patients with colorectal cancer metastases can safely transfuse filtered autologous blood.

Targeted therapies in hepatocellular carcinoma.

The onset of hepatocellular carcinoma (HCC) is related to the development of non-neoplastic liver disease, such as viral infections and cirrhosis. Even though patients with chronic liver diseases undergo clinical surveillance for early diagnosis of HCC, this cancer is often diagnosed in advanced stage. In this case locoregional treatment is not possible and systemic therapies are the best way to control it. Until now sorafenib, a Raf and multi-kinase inhibitor has been the best, choice to treat HCC systemically. It showed a survival benefit in multicenter phase III trials. However the proper patient setting to treat is not well defined, since the results in Child-Pugh B patients are conflicting. To date various new target drugs are under developed and other biological treatments normally indicated in other malignancies are under investigation also for HCC. These strategies aim to target the different biological pathways implicated in HCC development and progression. The target drugs studied in HCC include anti-VEGF and anti-EGFR monoclonal antibodies, tyrosine kinase inhibitors and mTOR inhibitors. The most important challenge is represented by the best integration of these drugs with standard treatments to achieve improvement in overall survival and quality of life.

Chronic atrial fibrillation in presence of aortic stenosis in a patient with polysplenia syndrome.

We report a rare case of "situs viscerum ambiguous" with polysplenia syndrome, in a 69 year old female patient with aortic stenosis and chronic atrial fibrillation. The presenting symptom was dyspnoea on moderate exertion and an ECG showed supra ventricular arrhythmia. Patients trans-thoracic echocardiogram revealed a dilated left atrium, reduced ejection fraction, mild tricuspid regurgitation, moderate-severe pulmonary hypertension and severe aortic stenosis. The patient was successfully treated with a replacement of her aortic valve and ascending aorta.

[Cervical epidural anesthesia for carotid mycotic aneurysms]. / Anestesia epidural cervical para aneurismas micóticos carotídeos.

Extracranial mycotic aneurysms of the carotid are unusual. We present such an aneurysm of the right primary carotid caused by enteritis due to Salmonella in a 75-year-old patient at high risk for surgery (myocardial ischemia evolving over 3 months) and with coexisting stenosis of 75% of the left internal carotid. Endarterectomy of the left internal carotid, with shunting, was performed, after which the right primary carotid was tied during the same operation. Epidural anesthesia to C6-C7 was provided through a catheter supplemented with an intravenous propofol infusion. Neurological and hemodynamic variables monitored during surgery were stable. No neurological deficits or myocardial ischemic changes were recorded. Three months after discharge the patient was asymptomatic.