Long-term use of prescription opioids for non-cancer pain and mortality: a population-based, propensity-weighted cohort study.

OBJECTIVE: The objective of this study was to identify factors associated with long-term opioid use and to assess the association between long-term use and death. STUDY DESIGN: Retrospective cohort study combining several population-wide databases and covering a population of five million inhabitants, including all adults who were initiated on opioid treatment from 2014 to 2018 for non-cancer pain. METHODS: We used logistic regression models to identify factors associated with chronic opioid use and carried out survival analyses using multivariable Cox regression modelling for all-cause mortality during follow-up using inverse probability of treatment weighting (IPTW) and propensity scores based on the probability of using opioids chronically. RESULTS: Among 760,006 patients, 82,423 (10.85%) used opioids for 90 days or more after initiation. Initial therapy characteristics associated with higher risk for long-term use were initiating with long- and short-acting opioids (when compared to tramadol, odds ratio [OR]: 2.63, 95% confidence interval [CI]: 2.57, 2.69 and OR: 1.60, 95%CI: 1.46, 1.76, respectively), using higher daily doses (when compared to 50 morphine milligramme equivalent [MME] or less, prescribing 50 to 89 daily MME, OR: 1.76, 95%CI: 1.65, 1.87; 90 to 119 daily MME, OR: 2.44, 95%CI: 1.99, 3.01; and more than 120 daily MME, OR: 1.77, 95%CI: 1.64, 1.91), and overlapping with gabapentinoids (OR: 2.26, 95%CI: 2.20, 2.32), benzodiazepines (OR: 1.32, 95%CI: 1.30, 1.35), and antipsychotics (OR: 1.21, 95%CI: 1.16, 1.26). After IPTW, chronic opioid use was associated with higher risk of all-cause mortality when compared to short-term use (Hazard Ratio (HR): 1.37, 95%CI: 1.32, 1.42). Sensitivity analyses provided similar results. CONCLUSION: These findings may help healthcare managers to identify and address patients at higher risk of long-term use and riskier prescription patterns.

Osteogenic differentiation of human mesenchymal stem cells on electroactive substrates.

This study investigates the effect of electroactivity and electrical charge distribution on the biological response of human bone marrow stem cells (hBMSCs) cultured in monolayer on flat poly(vinylidene fluoride), PVDF, substrates. Differences in cell behaviour, including proliferation, expression of multipotency markers CD90, CD105 and CD73, and expression of genes characteristic of different mesenchymal lineages, were observed both during expansion in basal medium before reaching confluence and in confluent cultures in osteogenic induction medium. The crystallisation of PVDF in the electrically neutral α-phase or in the electroactive phase ß, both unpoled and poled, has been found to have an important influence on the biological response. In addition, the presence of a permanent positive or negative surface electrical charge distribution in phase ß substrates has also shown a significant effect on cell behaviour.

Metallothionein expression in the central nervous system in response to chronic heavy metal exposure: possible neuroprotective mechanism.

It has been reported that volcanoes release several tonnes of mercury per year among other heavy metals through eruptions, fumaroles, or diffuse soil degassing. Since a high percentage of the world's population lives in the vicinity of an active volcano, the aim of this study is to evaluate the accumulation of these metals in the central nervous system and the presence of cellular mechanisms of heavy metal detoxification such as metallothioneins. To carry out this study, wild mice (Mus musculus) chronically exposed to an active volcanic environment were captured in Furnas village (Azores, Portugal) and compared with those trapped in a reference area (Rabo de Peixe, Azores, Portugal). On the one hand, the heavy metal load has been evaluated by analyzing brain and cerebellum using ICP-MS and a mercury analyzer and on the other hand, the presence of metallothionein 2A has been studied by immunofluorescence assays. Our results show a higher load of metals such as mercury, cadmium and lead in the central nervous system of exposed mice compared to non-exposed individuals and, in addition, a higher immunoreactivity for metallothionein 2A in different areas of the cerebrum and cerebellum indicating a possible neuroprotection process.

[ChatGPT: a novel tool for writing scientific articles, but not an author (for the time being)]. / ChatGPT: una novedosa herramienta de escritura para artículos científicos, pero no un autor (por el momento).

TITLE: ChatGPT: una novedosa herramienta de escritura para artículos científicos, pero no un autor (por el momento).

Occurrence of Volcanogenic Inorganic Mercury in Wild Mice Spinal Cord: Potential Health Implications.

Mercury accumulation has been proposed as a toxic factor that causes neurodegenerative diseases. However, the hazardous health effects of gaseous elemental mercury exposure on the spinal cord in volcanic areas have not been reported previously in the literature. To evaluate the presence of volcanogenic inorganic mercury in the spinal cord, a study was carried out in São Miguel island (Azores, Portugal) by comparing the spinal cord of mice exposed chronically to an active volcanic environment (Furnas village) with individuals not exposed (Rabo de Peixe village), through the autometallographic silver enhancement histochemical method. Moreover, a morphometric and quantification analysis of the axons was carried out. Results exhibited mercury deposits at the lumbar level of the spinal cord in the specimens captured at the site with volcanic activity (Furnas village). A decrease in axon calibre and axonal atrophy was also observed in these specimens. Given that these are relevant hallmarks in the neurodegenerative pathologies, our results highlight the importance of the surveillance of the health of populations chronically exposed to active volcanic environments.

The Health Hazards of Volcanoes: First Evidence of Neuroinflammation in the Hippocampus of Mice Exposed to Active Volcanic Surroundings.

Neuroinflammation is a process related to the onset of neurodegenerative diseases; one of the hallmarks of this process is microglial reactivation and the secretion by these cells of proinflammatory cytokines such as TNFα. Numerous studies report the relationship between neuroinflammatory processes and exposure to anthropogenic air pollutants, but few refer to natural pollutants. Volcanoes are highly inhabited natural sources of environmental pollution that induce changes in the nervous system, such as reactive astrogliosis or the blood-brain barrier breakdown in exposed individuals; however, no neuroinflammatory event has been yet defined. To this purpose, we studied resting microglia, reactive microglia, and TNFα production in the brains of mice chronically exposed to an active volcanic environment on the island of São Miguel (Azores, Portugal). For the first time, we demonstrate a proliferation of microglial cells and an increase in reactive microglia, as well an increase in TNFα secretion, in the central nervous system of individuals exposed to volcanogenic pollutants.

Opinión del alumnado sobre el uso de WhatsApp en el aprendizaje de la histología durante COVID-19 / Students' views about using WhatsApp for learning histology during COVID-19

RESUMEN: La pandemia de COVID-19 ha provocado importantes retos para el sistema de enseñanza superior. Las medidas adoptadas para prevenir la transmisión comunitaria han desplazado la enseñanza presencial frente a la virtual. Las nuevas prácticas de enseñanza y aprendizaje adoptadas han planteado la necesidad de reforzar la dimensión social del aprendizaje. En este contexto, hemos implementado el uso de WhatsApp para interactuar y compartir contenidos académicos en un pequeño grupo de estudiantes de un curso de Histología. El objetivo de este estudio fue evaluar la percepción de los estudiantes sobre la eficacia de esta red social para facilitar la comunicación y compartir información educativa, su utilidad en el aprendizaje y su capacidad para modificar la dimensión afectiva durante el proceso de enseñanza-aprendizaje. Los resultados mostraron que los estudiantes tenían una actitud positiva hacia el uso de WhatsApp en el entorno de aprendizaje, de modo que facilitó la comunicación y la cohesión del grupo, favoreció el aprendizaje y redujo la ansiedad ante la evaluación. Así, las redes sociales deberían integrarse en el proceso de aprendizaje teniendo en cuenta las características del alumnado.

SUMMARY: The COVID-19 pandemic has caused significant challenges for the higher education system. The adopted measures to prevent community transmission have shifted face-to-face teaching to virtual education. The new adopted teaching and learning practices have raised the need for reinforcing the social dimension of learning. In this context, we have implemented the use of WhatsApp to interact and sharing academic contents in a small group of students in a Histology course. The aim of this study was to evaluate the students' perceptions about the effectiveness of this social network in facilitating communication and sharing educational information, its usefulness in learning, and its ability to modify the affective dimension during the teaching- learning process. The results showed that students had a positive attitude towards the use of WhatsApp in the learning environment, so that it facilitated communication and group cohesion, favored learning and reduced anxiety in the face of evaluation. Thus, social networks must be integrated in learning process considering students' characteristics.

Chronic exposure to volcanic gaseous elemental mercury: using wild Mus musculus to unveil its uptake and fate.

Volcanoes are a natural source of gaseous elemental mercury (GEM) (Hg0). Monitoring GEM releases of volcanic origin has been widely studied; however, few studies have been performed about the biomonitoring of species exposed to GEM, rendering an unknown risk to the worldwide populations living in the vicinity of an active volcano. In this pilot study, we used Mus musculus as a bioindicator species to understand to what extent lungs are the main route of mercury uptake in populations chronically exposed to active volcanic environments. Autometallographic silver protocol was used to detect mercury deposits in the histological lung slides. Abundant mercury deposits were found in the lungs of specimens captured at the site with volcanic activity (Furnas Village, S. Miguel Island-Azores). The presence of mercury in the lungs could represent not only hazardous effects to the lung itself but also to other tissues and organs, such as brain and kidneys. This study confirms that the main uptake route for GEM is the lungs and that, even at very low concentrations in the environment, a chronic exposure to Hg0 results in its bioaccumulation in the lung tissue. These results reinforce that biomonitoring studies should be combined with monitoring classical approaches in order to better characterize the risks of exposure to Hg0 in volcanic environments.

First record on mercury accumulation in mice brain living in active volcanic environments: a cytochemical approach.

The health effects of mercury vapor exposure on the brain in volcanic areas have not been previously addressed in the literature. However, 10% of the worldwide population inhabits in the vicinity of an active volcano, which are natural sources of elemental mercury emission. To evaluate the presence of mercury compounds in the brain after chronic exposure to volcanogenic mercury vapor, a histochemical study, using autometallographic silver, was carried out to compare the brain of mice chronically exposed to an active volcanic environment (Furnas village, Azores, Portugal) with those not exposed (Rabo de Peixe village, Azores, Portugal). Results demonstrated several mercury deposits in blood vessels, white matter and some cells of the hippocampus in the brain of chronically exposed mice. Our results highlight that chronic exposure to an active volcanic environment results in brain mercury accumulation, raising an alert regarding potential human health risks. These findings support the hypothesis that mercury exposure can be a risk factor in causing neurodegenerative diseases in the inhabitants of volcanically active areas.