The Present and Future of Colorectal Cancer Screening.

There have been multiple recent updates for recommendations pertaining to colorectal cancer (CRC) screening. Among the most notable is the recommendation from several guideline-issuing bodies to initiate CRC screening examinations at 45 years of age for individuals at average risk for CRC. Current CRC screening methods include stool-based tests and colon visualization examinations. Currently recommended stool-based tests include fecal immunochemical testing, high-sensitivity guaiac-based fecal occult blood testing, and multitarget stool DNA testing. Visualization examinations include colonoscopy, computed tomography colonography, colon capsule endoscopy, and flexible sigmoidoscopy. Although these screening tests have shown encouraging results for CRC detection, there are important differences between these testing modalities for precursor lesion detection and management. In addition, emerging CRC screening methods are being developed and evaluated. However, additional large, multicenter clinical trials in diverse populations are needed to validate the diagnostic accuracy and generalizability of these new tests. This article reviews the recently updated CRC screening recommendations and current and emerging testing options.

Essential oil from Ocimum basilicum improves growth performance and does not alter biochemical variables related to stress in pirarucu (Arapaima gigas).

Diet supplementation with essential oil from sweet basil Ocimum basilicum (EOOB) can increase fish growth. So, this study aimed to evaluate the effect of EOOB in the diet on growth performance and plasmatic variables of pirarucu juveniles (Arapaima gigas) submitted to stressful condition (stocking density of 7.56 kg m-3per tank and limited space). Four diets (in triplicates) were evaluated with increasing levels of EOOB (0.0 control; 0.5; 1.0; and 2.0 mL kg diet-1) over 48 days. Linalool was the major constituent of EOOB (54.19%). The addition of 2.0 mL EOOB kg diet-1 improved final weight, weight gain, specific growth rate, condition factor and feed conversion ratio; it also decreased plasma urea levels and increased plasma albumin and total proteins levels. Plasma glucose, cortisol, and acid uric levels were not influenced by the addition of EOOB to the fish diet. In conclusion, the addition of 2.0 mL EOOBkg diet-1 is recommended for pirarucu juveniles, due to improved growth performance, and this supplementation did not compromise the homeostasis of fish rearing in a high stocking density.

Firearm access and adolescent health: Safety in numbers?

Access to firearms and perceived unsafe school environments are associated with negative adolescent health outcomes. Whether widespread acceptance of firearms alters these associations, however, is unknown. To address this literature gap, we examined whether peer acceptance of firearms moderates associations between personal firearm access and health outcomes. In 2018-2019, we analyzed Wave I of the National Longitudinal Study of Adolescent to Adult Health (collected 1994-1995) to assess personal firearm access and school-level percentage of firearm access, using weighted multilevel analyses with interactions to determine associations among personal access, school-level percentage of access, and adolescent depression, suicidality, general health, and perceived school safety. Models controlled for age, sex, race, region, urbanicity, family structure, parental income and education level, school type, school size, and school quality. Results showed that personal firearm access was associated with depression (OR 1.20 p = 0.03), suicidal ideation (OR 1.73, p < 0.001), and perceiving school as unsafe (OR 1.59, p < 0.001). A higher school-level percentage of access, however, was associated with lower rather than higher odds of perceiving school as unsafe (OR 0.83, p = 0.003). With interaction terms included, the association between personal access and suicidal ideation was weaker when school-level access was more common. Similarly, the association between school-level access and poor general health was negative among students with personal access but positive among students with no access. These findings suggest firearm access is a complex social phenomenon. In a low-access environment, personal firearm access may signify a high-risk physical and mental state. In schools where access is common, however, personal access may signify social belonging, possibly mitigating some potential negative health effects. Although evidence that firearm access is harmful remains clear, local norms may have a substantial moderating impact.

Growth and biochemical variables in Amazon catfish ( Pseudoplatystoma reticulatum ♀ x Leiarius marmoratus ♂) under different water pH.

Although fish may live in different aquatic environments, variations in the water quality parameters, mainly pH, may have a substantial impact in their development and welfare. The objective of this study was to test the effect of different pH levels on the growth performance and biochemical variables in Amazon catfish juveniles (Pseudoplatystoma reticulatum x Leiarius marmoratus). Fish were subjected to four different water pH levels (4.56, 6.0, 7.24, and 8.90) for 40 days. The total ammonia and alkalinity were higher and lower, respectively, in the treatments with water pHs 4.56 and 6.00 than at the other water pH levels. The un-ionized ammonia was higher at water pH 8.90 than at the other water pH levels. Amazon catfish exposed to water pH 4.56 presented specific growth rate and weight gain significantly higher than other water pH values. In general, fish under exposure to water pH 8.90 presented lower growth performance than other water pH values. Biochemical changes were recorded at all water pH. In conclusion, water pH 4.56 is recommended for an Amazon catfish production system, since fish presented higher growth and water quality variables were kept within adequate limits for aquaculture.

Factors affecting discharge destination following lung transplantation.

BACKGROUND: Lung transplant (LT) recipients requiring additional care may be referred to inpatient rehabilitation prior to discharge home. This study seeks to describe discharge destinations following LT, compare the characteristics of patients discharged to different destinations, and identify the predictors of discharge destination. METHODS: Retrospective study of 243 LT recipients who survived to hospital discharge between 2006 and 2009. LT recipients were compared based on discharge destination on data pertaining to demographics, clinical characteristics, and healthcare utilization. RESULTS: Of the 243 recipients, 197 (81%) were discharged home, 42 (17%) to inpatient rehabilitation, and 4 (2%) to other medical facilities. Age, pulmonary diagnosis, most recent six-minute walk distance (6 MWD) prior to transplant, pre-transplant mechanical ventilation, priority listing status, pre- and post-transplant intensive care unit length of stay (ICU LOS), post-transplant LOS, total LOS, and participation in pre-transplant rehabilitation were statistically different between patients that were discharged home versus inpatient rehabilitation. Age, most recent 6 MWD prior to transplant, pre-transplant mechanical ventilation, and total LOS were found to be independent predictors of discharge destination. CONCLUSION: Clinical factors can help identify patients more likely to require inpatient rehabilitation. Identification of these factors has the potential to facilitate early discharge planning and optimize continuity of care.