ECHO OEM virtual community of learning for primary care.

BACKGROUND: Health issues caused and/or exacerbated by work are common in patients seeking primary health care. Yet, primary care providers generally receive little or no training in the assessment and management of occupational injuries and illnesses. AIMS: To conduct a pilot project to develop, implement and evaluate a programme to teach occupational and environmental medicine to primary healthcare providers. METHODS: We followed the Extensions for Community Healthcare Outcomes (ECHO) model to connect primary healthcare providers with experts in Occupational and Environmental Medicine (OEM). We employed an observational pre-post study design to assess changes in self-efficacy, knowledge, attitudes and beliefs towards OEM. RESULTS: From September 2021 to June 2022, we offered two cycles of 12 sessions each. Participants came from medicine, nursing, psychology, occupational and physical therapy, chiropractic, kinesiology, social work, and pharmacy. Sixty-seven participants completed both pre- and post-ECHO questionnaires. Self-efficacy and knowledge ratings significantly increased after attendance at ECHO compared to the pre-ECHO responses. Attitudes and beliefs were unchanged in most of the items assessed. Participants rated their satisfaction with ECHO between 59% and 97%. CONCLUSIONS: Our pilot study demonstrated the challenges in implementing the first ECHO OEM in Canada. Findings show acceptability and satisfaction, improved self-efficacy, and small increases in knowledge, but not overall attitudes and beliefs. There is a need to understand barriers to participation and to target participants with less knowledge and experience in occupational and environmental medicine.

Day and blue light modify growth, cell physiology and indole-3-acetic acid production of Azospirillum brasilense Az39 under planktonic growth conditions.

AIM: In this work, we evaluated the effects of light on growth, cell physiology and stress response of Azospirillum brasilense Az39, a non-photosynthetic rhizobacteria, under planktonic growth conditions. METHODS AND RESULTS: Exponential cultures of Az39 were exposed to blue (BL), red (RL) and daylight (DL) or maintained in darkness for 24, 48 and 72 h. The biomass production and indole 3-acetic acid (IAA) biosynthesis increased by exposition to DL. Conversely, BL decreased IAA concentration through a direct effect on the molecule. The DL increased superoxide dismutase activity, hydrogen peroxide and thiobarbituric acid reactive substances levels, but the last one was also increased by BL. Both DL and BL increased cell aggregation but only BL increased biofilm formation. CONCLUSIONS: We demonstrated that both BL and DL are stress effectors for A. brasilense Az39 under planktonic growth conditions. The DL increased biomass production, IAA biosynthesis and bacterial response to stress, whereas BL induced cell aggregation and biofilms formation, but decreased the IAA concentration by photooxidation. SIGNIFICANCE AND IMPACT OF THE STUDY: Blue light and DL changes growth capacity, cell physiology and plant growth promotion ability of A. brasilense Az39 and these changes could be considered to improve the production and functionality of biofertilizers.

Levels of supplementation of inorganic selenium and vitamin E for meat quail aged 0 to 14 and 14 to 35 days.

Two experiments were carried out to determine the levels of supplementation of inorganic selenium (Se) and vitamin E (VE) in diets of quails aged 0-14 and 14-35 days old. A completely randomized design was used in a factorial design (Se = 0.1125; 0.2250; 0.3375 and 0.4500 mg kg-1  diet-1  × VE = 10; 23; 36 and 49 IU kg-1  diet-1 ). In experiment 1, quail (n = 2,400) were aged 0-14 days and were divided into 16 treatments, with three replicates of 50 birds. In experiment 2, quail (n = 1,680) were aged 14-35 days and were divided into the same treatments, with three replicates of 35 birds. At age 0-14 days, the levels of VE did not affect performance (p > .05); however, the feed conversion (FC) was influenced by a quadratic effect (p = .0515), according to the level of Se, with a higher level estimated at 0.29 mg Se kg-1  diet-1 . At age 14-35 days, there was a linear effect with interaction (Se × VE), for FC (p = .0150) and weight gain (WG; p = .0266). FC (Se, p = .0048 and VE, p = .0019) and WG (Se, p = .0049 and VE, p = .0068) improved linearly with increasing levels of Se and VE. The feed intake (FI) decreased linearly (p = .0582) as a function of VE. The carcass yield showed a quadratic effect (p = .0056) on the levels of VE, with a higher yield estimation of 27.24 IU VE/kg of diet. It can be concluded that the optimum level of supplementation at age 0-14 days was 0.29 mg Se kg-1  diet-1 and 10 IU VE kg-1  diet-1 and at age 14-35 days, it was 0.4500 mg Se kg-1  diet-1 and 49 IU of VE kg-1  diet-1 .

Role of bone marrow biopsy in staging of patients with classical Hodgkin's lymphoma undergoing positron emission tomography/computed tomography.

Several studies suggested that staging bone marrow biopsy (BMB) could be omitted in patients with classical Hodgkin's lymphoma (cHL) when a positron emission tomography/computed tomography (PET/CT) is performed at baseline.To address the concordance between BMB and PET/CT in the detection of bone marrow involvement (BMI) and the BMB role in determining the Ann Arbor stage, we retrospectively collected data on 1244 consecutive patients with cHL diagnosed from January 2007 to December 2013. One thousand eighty-five patients who had undergone both BMB and PET/CT were analyzed, comparing the Ann Arbor stage assessed with PET/CT only to that resulting from PET/CT combined with BMB.One hundred sixty-nine patients (16%) showed at least one focal skeletal lesion (FSL) at PET/CT evaluation. Only 55 patients had a positive BMB (5.1%); 34 of them presented at least one FSL at PET/CT. To the contrary, 895 out of 1030 patients with a negative BMB did not show any FSL (86.9%). Positive and negative predictive values of PET/CT for BMI were 20 and 98%, respectively; sensitivity and specificity were 62 and 87%, respectively. Fifty-four out of 55 patients with a positive BMB could have been evaluated as an advanced stage just after PET/CT; only one patient (0.1%) would have been differently treated without BMB.Our data showed a very high negative predictive value of PET/CT for BMI and a negligible influence of BMB on treatment planning, strengthening the recent indications that BMB could be safely omitted in cHL patients staged with PET/CT.

Respiratory-motion artefacts in liver MRI following injection of gadoxetate disodium and gadobenate dimeglumine: an intra-individual comparative study in cirrhotic patients.

AIM: To perform an intra-individual comparison of the frequency of respiratory-motion artefacts on magnetic resonance imaging (MRI) in cirrhotic patients following injection of gadoxetate disodium and gadobenate dimeglumine. MATERIALS AND METHODS: Ninety-five cirrhotic patients (61 men and 34 women, mean age 58 years) underwent liver MRI with intravenous administration of gadoxetate disodium and gadobenate dimeglumine at different times (interval between studies, 189±83 days). Three readers scored the severity of respiratory-motion artefacts on the three-dimensional (3D) gradient-echo (GRE) images acquired before and after contrast medium injection. McNemar's test was used to assess the difference in frequency of new respiratory-motion artefacts and transient severe motion (TSM) artefacts between gadoxetate disodium and gadobenate dimeglumine MRI studies. The association between clinical and technical features and the occurrence of TSM on gadoxetate disodium MRI studies was investigated. RESULTS: On arterial phase images, new respiratory-motion artefacts were present in 32/95 (34%) cases after injection of gadoxetate disodium, while only seen in 2/95 (2%) cases after injection of gadobenate dimeglumine (p<0.0001). TSM was present in 6/95 (6%) cases after injection of gadoxetate disodium, and in 0/95 (0%) case after injection of gadobenate dimeglumine. No clinical or technical features were associated with the occurrence of TSM. CONCLUSIONS: In cirrhotic patients, respiratory-motion artefacts on arterial phase 3D GRE images are more frequently seen after injection of gadoxetate disodium than after injection of gadobenate dimeglumine.

Temperature of maximum density and excess properties of short-chain alcohol aqueous solutions: A simplified model simulation study.

We perform an extensive computational study of binary mixtures of water and short-chain alcohols resorting to two-scale potential models to account for the singularities of hydrogen bonded liquids. Water molecules are represented by a well studied core softened potential which is known to qualitatively account for a large number of water's characteristic anomalies. Along the same lines, alcohol molecules are idealized by dimers in which the hydroxyl groups interact with each other and with water with a core softened potential as well. Interactions involving non-polar groups are all deemed purely repulsive. We find that the qualitative behavior of excess properties (excess volume, enthalpy, and constant pressure heat capacity) agrees with that found experimentally for alcohols such as t-butanol in water. Moreover, we observe that our simple solute under certain conditions acts as a "structure-maker," in the sense that the temperature of maximum density of the bulk water model increases as the solute is added, i.e., the anomalous behavior of the solvent is enhanced by the solute.

Lattice model for water-solute mixtures.

A lattice model for the study of mixtures of associating liquids is proposed. Solvent and solute are modeled by adapting the associating lattice gas (ALG) model. The nature of interaction of solute/solvent is controlled by tuning the energy interactions between the patches of ALG model. We have studied three set of parameters, resulting in, hydrophilic, inert, and hydrophobic interactions. Extensive Monte Carlo simulations were carried out, and the behavior of pure components and the excess properties of the mixtures have been studied. The pure components, water (solvent) and solute, have quite similar phase diagrams, presenting gas, low density liquid, and high density liquid phases. In the case of solute, the regions of coexistence are substantially reduced when compared with both the water and the standard ALG models. A numerical procedure has been developed in order to attain series of results at constant pressure from simulations of the lattice gas model in the grand canonical ensemble. The excess properties of the mixtures, volume and enthalpy as the function of the solute fraction, have been studied for different interaction parameters of the model. Our model is able to reproduce qualitatively well the excess volume and enthalpy for different aqueous solutions. For the hydrophilic case, we show that the model is able to reproduce the excess volume and enthalpy of mixtures of small alcohols and amines. The inert case reproduces the behavior of large alcohols such as propanol, butanol, and pentanol. For the last case (hydrophobic), the excess properties reproduce the behavior of ionic liquids in aqueous solution.

Comparison of growth curve parameters of organs and body components in meat- (Coturnix coturnix coturnix) and laying-type (Coturnix coturnix japonica) quail show interactions between gender and genotype.

1. The objective of this study was to estimate growth parameters of carcass components (wing, thighs and drumsticks, back and breast) and organs (heart, liver, gizzard and gut) in males and females of one meat-type quail strain (Coturnix coturnix coturnix) and two laying strains (Coturnix coturnix japonica) designated either yellow or red. 2. A total of 1350 quail from 1 to 42 d old were distributed in a completely randomised design, with 5 replicates of each strain. The carcass component weights and body organs were analysed weekly and evaluated using the Gompertz function; growth rates were evaluated through derivative equations. 3. The meat-type strain presented the highest growth rates in carcass components and organs. Across strains, females showed the highest weight of internal organs at maturity compared to males. 4. Females had greater growth potential in breast, wings and back than males for both yellow and red laying quail.

MDCT of acute conditions affecting the mesenteric vasculature.

Acute conditions affecting the mesenteric vessels can cause abdominal pain and result in significant morbidity and mortality if not diagnosed and treated quickly. As bowel viability depends on patency of the mesenteric vessels, prompt diagnosis is essential. Helical multidetector computed tomography (MDCT) provides a rapid, widely available, non-invasive method to promptly evaluate the mesenteric arteries, veins, and abdominopelvic viscera. Given the value of MDCT in diagnosing vascular disease, it is important the radiologist understand technical and imaging findings of mesenteric vascular injury. Therefore, successful diagnosis hinges on familiarity with MDCT angiography and the extended capabilities of volume rendering and multiplanar reformation. In this review, we illustrate and describe key MDCT findings of congenital, inflammatory, traumatic, infectious, and thromboembolic conditions affecting the mesenteric vasculature in adult patients.

Dietary glycine+serine responses of male broilers given low-protein diets with different concentrations of threonine.

1. The objective of this study was to determine the optimum glycine+serine (Gly+Ser) concentration in low-crude protein (CP) diets that have adequate or high concentrations of dietary threonine (Thr) for broiler chickens in the initial growth phase. 2. Treatments consisted of four concentrations of dietary Gly+Ser (18.4; 19.8; 21.2 and 22.6 g/kg) and two concentrations of dietary Thr (9.3 and 10.7 g/kg, corresponding to 100 and 115% of the required Thr, respectively). 3. At 21d, interactions were observed between dietary Gly+Ser and Thr concentrations for the feed conversion ratio, creatine content in the pectoral muscles and serum concentrations of uric acid. There was a quadratic effect of the concentrations of Gly+Ser in the diets with 9.3 g Thr/kg on the feed conversion ratio and creatine content in the pectoral muscles, with an optimisation concentration of 20.8 and 21.1 g Gly+Ser/kg, respectively. 4. Diets containing 10.7 g Thr/kg negatively affected the feed conversion ratio, relative breast weight, creatine content in the pectoral muscles, serum concentrations of uric acid and ammonia in poultry compared to diets containing 9.3 g Thr/kg. 5. The need for Gly+Ser in diets with low-protein concentration (190 g CP/kg) and adequate concentration of Thr (9.3 g/kg) is 20.8 g/kg for broilers in the 1- to 21-d phase.

The revised Atlanta classification for acute pancreatitis: a CT imaging guide for radiologists.

Accurate diagnosis and description of the various findings in acute pancreatitis is important for treatment. The original Atlanta classification for acute pancreatitis sought to create a uniform system for classifying the severity of acute pancreatitis as well as common language to describe the various events that can occur in acute pancreatitis. The goal was to allow accurate communication between physicians using standardized language so correct treatment options could be used. Since that time, advances in the understanding of acute pancreatitis as well as improvements in both interventions and imaging have led to criticisms of the system and its abandonment by physicians. A 2007 revision of the Atlanta classifications sought to address many of these issues. This article will explain the changes to the Atlanta classification system and provide pictorial examples of the findings in acute pancreatitis as described by the Atlanta classification system.

Skull Base Registries: A Roadmap.

Hospitals, payors, and patients increasingly expect us to report our outcomes in more detail and to justify our treatment decisions and costs. Although there are many stakeholders in surgical outcomes, physicians must take the lead role in defining how outcomes are assessed. Skull base lesions interact with surrounding anatomy to produce a complex spectrum of presentations and surgical challenges, requiring a wide variety of surgical approaches. Moreover, many skull base lesions are relatively rare. These factors and others often preclude the use of prospective randomized clinical trials, thus necessitating alternate methods of scientific inquiry. In this paper, we propose a roadmap for implementing a skull base registry, along with expected benefits and challenges.

The wide spectrum of hyperechoic lesions of the breast.

Although breast lesions are commonly detected because of their hypoechogenicity, some lesions may present with hyperechogenicity due to their histological components. Hyperechogenicity has been shown to be highly predictive of benignity; however, hyperechoic lesions can occasionally be malignant. This article reviews hyperechoic lesions of the breast, describes the underlying histological causes associated with hyperechogenicity, and the sonographic features useful for the differential diagnosis between benign and malignant hyperechoic lesions.

Phase diagram and critical properties of a two-dimensional associating lattice gas.

We revisit the associating lattice gas (ALG) introduced by Henriques et al. [Phys. Rev. E 71, 031504 (2005)PLEEE81539-375510.1103/PhysRevE.71.031504] in its symmetric version. In this model, defined on the triangular lattice, interaction between molecules occupying nearest-neighbor sites depends on their relative orientation, mimicking the formation of hydrogen bonds in network-forming fluids. Although all previous studies of this model agree that it has a disordered fluid (DF), a low-density liquid (LDL), and a high-density liquid (HDL) phase, quite different forms have been reported for its phase diagram. Here, we present a thorough investigation of its phase behavior using both transfer matrix calculations and Monte Carlo (MC) simulations, along with finite-size scaling extrapolations. Results in striking agreement are found using these methods. The critical point associated with the DF-HDL transition at full occupancy, identified by Furlan et al. [Phys. Rev. E 100, 022109 (2019)2470-004510.1103/PhysRevE.100.022109] is shown to be one terminus of a critical line separating these phases. In opposition to previous simulation studies, we find that the transition between the DF and LDL phases is always discontinuous, similar to the LDL-HDL transition. The associated coexistence lines meet at the point where the DF-HDL critical line ends, making it a critical-end-point. Overall, the form of the phase diagram observed in our simulations is very similar to that found in the exact solution of the model on a Husimi lattice. Our results confirm that, despite the existence of some waterlike anomalies in this model, it is unable to reproduce key features of the phase behavior of liquid water.

Human FEZ1 protein forms a disulfide bond mediated dimer: implications for cargo transport.

The human proteins FEZ1 (fasciculation and elongation protein zeta 1) and FEZ2 are orthologs of the protein UNC-76 from C. elegans, involved in the growth and fasciculation of the worms axon. Pull down assays showed that the protein FEZ1 interacts with other proteins (e.g., the protein SCOCO, short coiled-coil protein), mitochondria, and vesicles. These components may therefore represent cargoes to be transported along the microtubule, and the transport may be mediated through FEZ1 reported binding to kinesins (KIF3A). We previously showed that FEZ1 dimerizes in its N-terminal region and interacts with other proteins, including the candidate cargoe proteins, through its C-terminus. Here, we studied the fragment FEZ1(92-194) as well as full-length 6xHis-FEZ1 (1-392) in vitro and endogenous FEZ1 isolated from HEK 293 cells and were able to demonstrate the formation of an intermolecular disulfide bond through FEZ1 Cys-133, which appears to be essential for dimerization. This disulfide bond may be important for the FEZ1 role as a dimeric and bivalent transport adaptor molecule, since it establishes a strong link between the monomers, which could be a prerequisite for the simultaneous binding of two cargoes.

Common structural domains in the sarcoplasmic reticulum Ca-ATPase and the transverse tubule Mg-ATPase.

Transverse tubule (TT) membranes isolated from chicken skeletal muscle possess a very active magnesium-stimulated ATPase (Mg-ATPase) activity. The Mg-ATPase has been tentatively identified as a 102-kD concanavalin A (Con A)-binding glycoprotein comprising 80% of the integral membrane protein (Okamoto, V.R., 1985, Arch. Biochem. Biophys., 237:43-54). To firmly identify the Mg-ATPase as the 102-kD TT component and to characterize the structural relationship between this protein and the closely related sarcoplasmic reticulum (SR) Ca-ATPase, polyclonal antibodies were raised against the purified SR Ca-ATPase and the TT 102-kD glycoprotein, and the immunological relationship between the two ATPases was studied by means of Western immunoblots and enzyme-linked immunosorbent assays (ELISA). Anti-chicken and anti-rabbit SR Ca-ATPase antibodies were not able to distinguish between the TT 102-kD glycoprotein and the SR Ca-ATPase. The SR Ca-ATPase and the putative 102-kD TT Mg-ATPase also possess common structural elements, as indicated by amino acid compositional and peptide mapping analyses. The two 102-kD proteins exhibit similar amino acid compositions, especially with regard to the population of charged amino acid residues. Furthermore, one-dimensional peptide maps of the two proteins, and immunoblots thereof, show striking similarities indicating that the two proteins share many common epitopes and peptide domains. Polyclonal antibodies raised against the purified TT 102-kD glycoprotein were localized by indirect immunofluorescence exclusively in the TT-rich I bands of the muscle cell. The antibodies substantially inhibit the Mg-ATPase activity of isolated TT vesicles, and Con A pretreatment could prevent antibody inhibition of TT Mg-ATPase activity. Further, the binding of antibodies to intact TT vesicles could be reduced by prior treatment with Con A. We conclude that the TT 102-kD glycoprotein is the TT Mg-ATPase and that a high degree of structural homology exists between this protein and the SR Ca-ATPase.

[Utility of denaturing high performance liquid chromatography (DHPLC) for the diagnosis of mevalonate kinase deficiency in periodic disease]. / Utilità della tecnica denaturing high performance liquid chromatography (DHPLC) per la diagnosi di deficit di mevalonato chinasi nelle febbri periodiche di sospetta natura autoinfiammatoria.

OBJECTIVES: We developed a genetic investigation using denaturing high performance liquid chromatography (DHPLC), in order to identify polymorphisms of the gene MVK in patients with autoinflammatory syndrome suspicion. METHODS: We evaluated 19 patients affected by recurrent fevers and other clinical manifestations usually found in autoinflammatory syndromes and not correlated with infections or autoimmune disease and 10 healthy controls. IgD level was measured in all patients. Molecular testing was performed in DNA extracted from PBMC and MVK gene was analysed either with DHPLC or with automatic sequencer. Primers for PCR amplifications, amplicon lengths and PCR conditions were designed in our laboratory. RESULTS: IgD level was normal in 14 patients. Healthy controls did not show any alteration of the DHPLC-profiles and of the DNA sequences. Twelve patients had at least one altered DHPLC-profile and these data have been confirmed by sequencing. In particular we detected the polymorphisms c.78+61A>G, S52N, S135S, D170D, c.632-18A>G, c.885+24G>A already described in the database INFEVERS. With DHPLC we got the results in shorter time (10 hours/patient) and with lower cost (40 euro/patient) in comparison to direct sequencing (25 hours and 150 euro/patient). CONCLUSIONS: High IgD levels do not represent an essential marker for diagnosis of MKD, as already reported in literature. DHPLC is a rapid low cost technique in order to screen mutations in patients with MKD suspicion. Twelve patients carried at the same time D170D and c.632-18A>G: such event suggests that these SNPs could be in linkage disequilibrium and that such polymorphisms could predispose to MKD.

Order-disorder transition in a two-dimensional associating lattice gas.

We study an associating lattice gas (ALG) using Monte Carlo simulation on the triangular lattice and semianalytical solutions on Husimi lattices. In this model, the molecules have an orientational degree of freedom and the interactions depend on the relative orientations of nearest-neighbor molecules, mimicking the formation of hydrogen bonds. We focus on the transition between the high-density liquid (HDL) phase and the isotropic phase in the limit of full occupancy, corresponding to chemical potential µâ†’∞, which has not yet been studied systematically. Simulations yield a continuous phase transition at τ_{c}=k_{B}T_{c}/γ=0.4763(1) (where -γ is the bond energy) between the low-temperature HDL phase, with a nonvanishing mean orientation of the molecules, and the high-temperature isotropic phase. Results for critical exponents and the Binder cumulant indicate that the transition belongs to the three-state Potts model universality class, even though the ALG Hamiltonian does not have the full permutation symmetry of the Potts model. In contrast with simulation, the Husimi lattice analyses furnish a discontinuous phase transition, characterized by a discontinuity of the nematic order parameter. The transition temperatures (τ_{c}=0.51403 and 0.51207 for trees built with triangles and hexagons, respectively) are slightly higher than that found via simulation. Since the Husimi lattice studies show that the ALG phase diagram features a discontinuous isotropic-HDL line for finite µ, three possible scenarios arise for the triangular lattice. The first is that in the limit µâ†’∞ the first-order line ends in a critical point; the second is a change in the nature of the transition at some finite chemical potential; the third is that the entire line is one of continuous phase transitions. Results from other ALG models and the fact that mean-field approximations show a discontinuous phase transition for the three-state Potts model (known to possess a continuous transition) lends some weight to the third alternative.

Sequential development of large B cell lymphoma in a patient with peripheral T-cell lymphoma.

Lymphomas of different histologic type can occur in the same patient. Two types of lymphomas can be diagnosed in the same lymph node (composite lymphoma) or in different sites. In the latter case, terms as simultaneous and sequential have been proposed to define the detection of two lymphomas at the same time or at different times, respectively.