Rapid estrogen signaling in the brain

Estrogen has multiple actions in the brain to modulate homeostasis, synaptic plasticity/cognition and neuroprotection. While many of these actions undoubtedly involve mediation via the classical genomic mechanism of regulation of transcription of genes via estrogen nuclear receptors, there has been growing interest in the rapid nongenomic effects of estrogen and the role they may play in the neural actions of estrogen. In this review, we will focus on these rapid nongenomic actions of estrogen in the brain and discuss the potential physiological significance of these actions. The evidence for rapid estrogen regulation of cell signaling pathways, including calcium, ion channel and kinase signaling pathways in the brain will be reviewed, as will evidence derived from plasma-membrane impermeable estrogen-peptide conjugates in the regulation of these cell signaling pathways. Evidence supporting classical and nonclassical estrogen receptor localization to the plasma membrane of neurons will also be reviewed, including the putative new membrane estrogen G-protein-coupled receptor, GPR30. Precisely how membrane estrogen receptors couple to kinase signaling pathways is unclear, but we will discuss the latest findings on estrogen receptor-interacting scaffold proteins, such as MNAR/PELP1, striatin and p130Cas, which are capable of linking estrogen receptors and kinases such as Src and PI3K, to potentially mediate estrogen-induced kinase signaling. Finally, we will review the growing evidence that rapid membrane-mediated effects of estrogen play an important physiological role in the neural actions of estrogen in the brain, including estrogen feedback control and modulation of homeostasis, regulation of synaptic plasticity/cognition, and estrogen-mediated neuroprotection.

Computer vision for microscopy diagnosis of malaria

This paper reviews computer vision and image analysis studies aiming at automated diagnosis or screening of malaria infection in microscope images of thin blood film smears. Existing works interpret the diagnosis problem differently or propose partial solutions to the problem. A critique of these works is furnished. In addition, a general pattern recognition framework to perform diagnosis, which includes image acquisition, pre-processing, segmentation, and pattern classification components, is described. The open problems are addressed and a perspective of the future work for realization of automated microscopy diagnosis of malaria is provided.

Risk factors related to the global burden of disease in Brazil and its Federated Units, 2015

Objective:

To analyze the global burden of disease related to disability adjusted life years (DALYs) attributed to selected risk factors in Brazil and its 27 Federated Units.

Methods:

Databases from the Global Burden of Disease study in Brazil and its Federated Units were used, estimating the summary exposure value (SEV) for selected environmental, behavioral, and metabolic risk factors (RFs), and their combinations. The DALYs were used as the main metric. The ranking of major RFs between 1990 and 2015 was compiled, comparing data by sex and states.

Results:

The analyzed RFs account for 38.8% of the loss of DALYs in the country. Dietary risks was the main cause of DALYs in 2015. In men, dietary risks contributed to 12.2% of DALYs and in women, to 11.1%. Other RFs were high systolic blood pressure, high body mass index, smoking, high fasting plasma glucose and, among men, alcohol and drug use. The main RFs were metabolic and behavioral. In most states, dietary risks was the main RF, followed by high blood pressure.

Conclusion:

Dietary risks leads the RF ranking for Brazil and its Federated Units. Men are more exposed to behavioral risk factors, and women are more exposed to metabolic ones.

Contemporary generic market in Japan - key conditions to successful evolution

The Japanese pharmaceutical market, the world's second largest, is traditionally renowned for the domination of patented drugs and the weakest generics share among major established economies. An in-depth observation of published evidence in Japanese/English language provided closer insight into current trends in Japanese domestic legislation and pharmaceutical market development. Recent governmental interventions have resulted in significant expansion of the generic medicines market size. Substantial savings due to generic substitution of patent-protected drugs have already been achieved and are likely to increase in future. Nationwide population aging threatening sustainable healthcare funding is contributing to the relevance of generic policy success. Serious long-term challenges to the modest Japanese generic manufacturing capacities will be posed by foreign pharmaceutical industries particularly the ones based in emerging BRIC economies.

Prevalence of myopia in Taiwanese schoolchildren: 1983 to 2000

INTRODUCTION

To determine time trends in myopia over a 20-year period in Taiwan, we conducted 5 nationwide surveys pertaining to the ocular refraction of schoolchildren in 1983, 1986, 1990, 1995 and 2000.

MATERIALS AND METHODS

The sampling technique used herein involved the assessment of stratified systematic clusters, with the unweighted myopic rate being represented using data derived from different sectors of the population, such as metropolitan, city, town, and aboriginal. The mean values for the spherical equivalent of the cycloplegic refractive status and the dimension of corneal radii as determined by the autorefractometer were used for the calculation.

RESULTS

In our review of 5 nationwide myopia surveys, we found that the mean prevalence of myopia among 7 year olds increased from 5.8% in 1983 to 21% in 2000. At the age of 12, the prevalence of myopia was 36.7% in 1983 increasing to 61% in 2000, corresponding figures for 15-year-olds being 64.2% and 81%, respectively. The prevalence of myopia increased from 74% in 1983 to 84% in 2000 for children aged between 16 and 18 years, and, in addition, the prevalence of high myopia (over -6.0 D) increased from 10.9% in 1983 to 21% of 18-year-old students of Taiwan in 2000. The mean refractive status at the age of 12 deteriorated from -0.48 D in 1983 to -1.45 D in 2000, and from -1.49 D to -2.89 D for children aged 15, whilst for individuals aged 18, it deteriorated from -2.55 D in 1983 to -3.64 D in 2000. The mean ocular refraction began to progress to a myopic condition at the age of 11 in 1983, this becoming an age of 8 years in 2000. There appeared to be significant difference in both the prevalence and the degree of myopia between study participants residing in cities and villages.

CONCLUSIONS

We conclude that the cause of the relative increasing severity of myopia among the schoolchildren was due to the onset of myopia at a very young, and progressively-decreasing, age over the study period. Thus, to reduce the prevalence and severity of myopia, we should pay more attention to the eye care of pre-schoolchildren.

Causas de morte e razões para eutanásia de cães da Mesorregião do Centro Ocidental Rio-Grandense (1965-2004)

Este estudo teve como objetivo principal determinar a prevalência das doenças que culminam em morte ou que fazem com que os cães da Mesorregião do Centro Ocidental Rio-Grandense sejam submetidos à eutanásia. Para isso, foram revisados todos os protocolos de necropsia de cães, arquivados no Laboratório de Patologia Veterinária (LPV) da Universidade Federal de Santa Maria (UFSM), realizadas entre janeiro de 1965 e dezembro de 2004. Nos arquivos do LPV-UFSM foram encontrados 4.844 protocolos de necropsia de cães. A distribuição dos casos em relação às categorias de doenças diagnosticadas foi a seguinte: doenças infecciosas e parasitárias (1.693 [35,0%]), neoplasmas (378 [7,8%]), distúrbios causados por agentes físicos (369 [7,6%]), doenças degenerativas (342 [7,1%]), intoxicações e toxiinfecções (112 [2,3%]), eutanásia por conveniência (101 [2,1%]), doenças metabólicas e endocrinológicas (97 [2,0%]), distúrbios iatrogênicos (83 [1,7%]), distúrbios do desenvolvimento (25 [0,5%]), doenças imunomediadas (10 [0,2%]) e doenças nutricionais (6 [0,1%]). Outros distúrbios, que incluem doenças multifatoriais ou idiopáticas, contribuíram com 80 (1,6%) casos. Dos 4.844 casos, em 1.548 (32,0%) não foi possível estabelecer a causa da morte ou a razão para a eutanásia. Doenças infecciosas e parasitárias (principalmente cinomose, parvovirose e verminose intestinal), neoplasmas (principalmente neoplasmas mamários e linfoma), distúrbios causados por agentes físicos (principalmente atropelamento por veículos automotivos) e doenças degenerativas (principalmente insuficiência renal crônica, cirrose e insuficiência cardíaca congestiva) foram as principais categorias de doenças relacionadas com morte ou eutanásia de cães dessa mesorregião. Entretanto, quando os cães são avaliados de acordo com suas idades, tais categorias possuem prevalências diferentes. As principais causas de morte em filhotes foram as doenças infecciosas e parasitárias, principalmente parvovirose, cinomose e verminose intestinal. Em adultos, as causas de morte mais importantes foram cinomose, neoplasmas e trauma. Em idosos, neoplasmas e doenças degenerativas foram responsáveis por aproximadamente a metade das mortes.

Silver nanoparticles synthesized from Pseudomonas aeruginosa pyoverdine: Antibiofilm and antivirulence agents

The increasing incidence of antimicrobial resistance exhibited by biofilm-forming microbial pathogens has been recognized as one of the major issues in the healthcare sector. In the present study, nanomaterial-based controlling the biofilm and virulence properties has been considered an alternative approach. Pyoverdine (PVD) isolated from the Pseudomonas aeruginosa was utilized as a biological corona to synthesize silver nanoparticles (AgNPs), which will be helpful in a targeted action to microbial pathogens due to the recognition of the corona of the nanoparticles by the pathogenic membrane. Synthesized PVD-AgNPs were spherical to irregular, with an average size value of 251.87 ± 21.8 nm and zeta potential with a value of -36.51 ± 0.69 mV. The MIC value of PVD-AgNPs towards P. aeruginosa, Listeria monocytogenes, Staphylococcus aureus, Streptococcus mutans, Escherichia coli, and Candida albicans in the standard and host-mimicking media were observed in decreasing order in a multi-fold, such as standard growth media > sputum > synthetic human urine > saliva. Both the initial stage and the well-established biofilms of these microbial pathogens have been effectively inhibited and eradicated by PVD-AgNPs. PVD-AgNPs increase the susceptibility of tetracycline, PVD, and amphotericin B towards established mature mono- and mixed-species biofilms of S. aureus and C. albicans. Additionally, PVD-AgNPs attenuate several virulence properties, such as inhibition of protease activity, motility, and PVD and pyocyanin production in P. aeruginosa. The inhibition of gene expression of biofilm and virulence-associated genes in P. aeruginosa validates its phenotypic effects.

Morphology and distribution of nasal telangiectasia in HHT-patients with epistaxis

BACKGROUND

Epistaxis in hereditary hemorrhagic telangiectasia (HHT; Rendu-Osler-Weber syndrome) is a frequent symptom that may be caused by a multitude of different genetic and epigenetic phenomena. This investigation analyzes the distribution of nasal telangiectasia in 21 patients with HHT.

METHODS

The patients were examined for endonasal telangiectasia by videoendoscopy with rigid endoscopes; in addition, the anterior portion of the nose was examined under the operating microscope. The endonasal findings were recorded on videotape and then evaluated in the media laboratory.

RESULTS

Morphology of the nasal telangiectasia showed wide variations: the vessels were shaped like spots, loops, or spiders or they clustered and resembled raspberries. Gender did not have an influence on the phenotype of telangiectasia, whereas advancing age correlated with a higher density of telangiectasia. Patients with an intact nasal septum exhibited the bulk of telangiectasia in the anterior nasal cavity but also on the middle turbinates, the floor of the nose, and within the valve area. Patients with septal perforations displayed the majority of telangiectasia around the edge of the perforations, on the floor of the nose, and on the turbinates. Scattered telangiectasia also could be found in the profound parts of the nasal cavity and in the nasopharynx, especially in patients with septal perforations.

CONCLUSION

The shapes of endonasal telangiectasia in HHT patients are very heterogeneous; predilection sites could first of all be found within the anterior portion of the nose. Morphology and distribution of endonasal telangiectasia change as a result of therapeutic interventions, development of septal perforations, and with advancing age. Therefore, repeat endoscopies are recommended to assess the actual stage of the disease before epistaxis therapy.

Seasonal variation of retinal detachment in Lebanon

BACKGROUND

The literature remains controversial regarding seasonal variation of rhegmatogenous retinal detachment (RRD).

METHODS

In this retrospective chart review, seasonal variation of RRD was examined based on the records of 211 consecutive patients operated for idiopathic RRD in one referral medical center over a 13-year period.

RESULTS

The number of eyes with RRD recorded per season was 46 in autumn, 46 in winter, 62 in spring and 57 in summer. There was a significant seasonal variation (p < 0.05) with an increase in RRD in the warm seasons (spring and summer) compared to the cold seasons (winter and autumn; 56 vs. 44%). Right eyes were more likely to be affected than left eyes (54 vs. 46%), and cases presented with a significantly younger age at onset in the warm than in the cold seasons (47 vs. 54 years, p = 0.007). A literature review of 8,533 cases including the present case series established further the seasonal variation of RRD (p < 0.001).

CONCLUSION

There is convincing evidence for a seasonal variation of RRD in Lebanon and in the literature. This is likely to be related to sun exposure and outdoor activities in the warm seasons.

Memristors with Biomaterials for Biorealistic Neuromorphic Applications

Electronic devices with biomaterials have paved a way toward "green electronics" to create a sustainable future. Memristors are drawing growing attention with integrated sensing, memory, and computing for future artificial intelligence applications. Biomaterial is an emerging class of memristive materials (the device is called as biomemristor) for transient and/or biodegradable purpose. Importantly, several unique features such as faithful synaptic behaviors, bimodal switching, and biovoltage operations are observed in biomemristors. Moreover, the biomemristors are suitable for human-related applications due to the inherent biocompatibility of biomaterials and flexibility of the device with ultrathin thickness. These features make the biomemristors promising for biorealistic neuromorphic applications. Herein, the state of the art of biomemristors are comprehensively summarized and systematically discussed with particular attention on their unique biorealistic features. Challenges and prospects toward the further development of biomemristors are also provided and discussed.

Sanitary and Hygienic Aspects of the COVID-19 Self-isolation

Introduction:

Self-isolation during the COVID-19 pandemic is a temporary measure to limit the spread of infection. All citizens arriving from abroad to Russia must comply with the rules of self-isolation. Since April 2, 2020, almost all citizens of the Russian Federation have followed the rules of self-isolation. Also, this month in the Russian capital, Moscow, about 6 million citizens have isolated themselves. In general, in the territory of Russia, the number of citizens on self-isolation reached 100 million. Billions of citizens around the world are staying at home due to the self-isolation regime, so a sanitary assessment must be considered. Self-isolation, characterized by physical inactivity, hypoxia, diet disturbances, lifestyle changes during work / rest, mental stress; this provides an opportunity to identify the presence of public health risk factors and contributes to an increase in the incidence of No Communicable Diseases (NCDs).

Purpose of the Study:

Carrying out a sanitary-hygienic assessment of COVID-19 self-isolation, determining priority risk factors causing non-infectious diseases, and proposing preventive measures.

Objectives:

To Identify public health risk factors during self-isolation. To conduct a comprehensive hygienic assessment of self-isolation according to the priority criteria. To develop a pointing system (hygiene index for self-isolation). To propose measures to minimize health risks during self-isolation.

Materials and Methods:

We used analytical, and systematization approaches. Information from the legal documents of the hygienic-sanitary laws of the Government of the Russian Federation (nutrition hygiene, hygiene of workforce, children, and teenagers). World Health Organization COVID-19 documents.

Research Results:

We assessed the sanitary-hygienic aspects of self-isolation to identify the leading risk factors on public health, and as a result, we proposed hygienic criteria for self-isolation. We developed a hygienic self-isolation index point score (HSIPS) that considers the Russian law-based requirements for diet, work, rest, and physical activities. Thus, the usage of those hygienic standards is beneficial to prevent public health risks in ordinary and extremely challenging conditions of self-isolation. We proposed measures to minimize risks during self-isolation, and we based them on adequate sanitary-hygienic standards. The main sanitary-hygienic risk factors of self-isolation are: sedentary lifestyle, hypoxia, nutritional deficiencies (malnutrition), and work/rest imbalance.

Conclusion:

We proposed a sanitary-hygienic definition of self-isolation. We identified leading risk factors for public health of the self-isolated population. We proposed sanitary-hygienic criteria for assessing self-isolation based on the regulations and standards of the Government of the Russian Federation. We developed a hygienic self-isolation index point score (HSIPS), which determines that the optimal mode is directly proportional to the coefficients of a person’s physical activity (D), indoor area (air cubic capacity) per isolated (S), time spent in fresh air (T) and inversely proportional to the calorie intake. We proposed measures to prevent noncommunicable diseases (NCD) for citizens on self-isolation.

A nonlinear mixed effects modelling analysis of topiramate pharmacokinetics in patients with epilepsy

Topiramate pharmacokinetics is influenced by individual factors such as patient age, renal function and co-treatment. The aim of this study was to develop a population pharmacokinetic model of topiramate to assist dosage adjustments in individual patients. Steady-state topiramate plasma concentrations in patients with epilepsy were determined by HPLC using fluorescent labelling. Demographic, biochemical data and dosing history including concomitant drug therapy were collected from patients' charts. Nonlinear mixed effects modelling was used to fit a one-compartment pharmacokinetic model. The influence of patient weight and gender, body surface area, age, creatinine clearance, serum transaminases, topiramate daily dose and co-treatment with carbamazepine, valproic acid, benzodiazepines, and risperidone on topiramate pharmacokinetics was evaluated. Additionally, the relationship between topiramate plasma concentration and clinical response was investigated. Volume of distribution of topiramate was 0.518 l/kg. For a typical patient oral clearance was estimated at 1.47 l/h, with interindividual variability of 39.2%. Clearance was 70% higher in patients co-treated with carbamazepine and was found to increase with patient age. Somnolence was the most frequently observed adverse event. Incidence of headache was associated with topiramate plasma concentration. Somnolence, ataxia, tremor, speech disorders and fatigue were associated with adjunctive therapy with carbamazepine, valproic acid, benzodiazepines, risperidone, and clozapine. No association of topiramate plasma concentration with frequency of seizures or patient quality of life was observed. The developed model can be used for Bayesian estimation of pharmacokinetic parameters based on sparse plasma samples and for selection of optimum dosing in routine patient care.

Ultrasound remission after biologic induction and long-term endoscopic remission in Crohn's disease: a prospective cohort study

BACKGROUND

The Bowel Ultrasound Score (BUSS) accurately detects therapy-related changes by using the Simple Endoscopic Score for Crohn's disease (SES-CD) as the reference standard. We aimed to evaluate ultrasound remission as a treatment target and its prediction for long-term endoscopic remission.

METHODS

This single-centre prospective observational study, based at a tertiary referral centre in Milan, Italy, enrolled, between March 1, 2018, and January 31, 2021, adult patients with active CD (SES-CD >2) who were starting biologics. Colonoscopy and IUS was performed at baseline and at 12 months (mean 12.8 ± 4.2). The primary outcome was the predictive value of ultrasound remission at week 12 (BUSS ≤3.52) for long-term endoscopic remission at 12 months. The International Bowel Ultrasound Segmental Activity Score (IBUS-SAS) was also calculated and optimal cut-point to detect endoscopic remission was identified through ROC analysis.

FINDINGS

93 patients with CD were included. Of these, 22 patients (24%) achieved endoscopic remission. Week 12 ultrasound remission predicted endoscopic remission (59% compared with 41% of the patients who were not in ultrasound remission; OR 9.93, 95% CI 3.10-31.80; p < 0.001), while week 12 calprotectin values (<50, <100, <250 μg/g) did not. Week 12 ultrasound activity was associated with failure to achieve long-term endoscopic remission (NPV 87%, PPV 54%). IBUS-SAS cut-off to discriminate endoscopic remission was 22.8 (AUC 0.906). ROC curve comparison showed no-significant difference between BUSS and IBUS-SAS (p = 0.46) for detecting endoscopic remission.

INTERPRETATION

Early ultrasound remission predicts long-term endoscopic remission, making it a valuable early treatment target for clinical practice and in clinical trials. Larger multicentre validation studies are warranted to confirm these findings.

FUNDING

None.

Regulate transportation of ions and polysulfides in all-solid-state Li-S batteries using ordered-MOF composite solid electrolyte

A dilemma arises when striving to balance the maximum desired ion conductivity and minimize the undesired lithium polysulfide shuttling effect for all-solid-state lithium-sulfur batteries (ASSLSBs). Here, we introduce a strategy of using ordered MIL-125-NH2 as fillers for poly(ethylene oxide)-based electrolytes to simultaneously regulate the transportation of lithium ions and polysulfides. When compared to electrolytes lacking metal-organic frameworks (MOFs) and those containing disordered MOFs, the electrolyte featuring an ordered-MOF structure, denoted as three-dimensional (3D) MPPL composite solid electrolyte (CSE), exhibits the highest ion conductivity of 8.3 × 10-4 siemens per centimeter at 60°C. As a result, pouch-type ASSLSBs with 3D MPPL CSE maintains stable cycling for 400 cycles at 0.5 C at 60°C, showcasing the successful implementation of this strategy in simultaneously regulating ion and polysulfide transport. This approach opens up alternative avenues to achieve high-performance ASSLSBs with exceptional energy density.

Sustainable Health Care Provision Worldwide: Is There a Necessary Trade-Off between Cost and Quality?

Quality health care is an essential human right, on the agenda of sustainable development and presents a challenge in the twenty-first century. There are different perspectives regarding the price and quality of health care, and it is necessary to review the quality health care issue and how it influenced by price. The aim of this study is to explore the different dimensions of health care quality, examine the association with technology, health care market characteristics, additional and optional services of health care, sustainability, and some exceptional situations. We performed the narrative review searching by key words by main search engine Google and followed by their mother publication and or any first web database. We found that health care is a service industry, needs basic standards and specialized human resources to perform the procedure, and quality health care is not associated with an extra price. The quality of health care assures sustainability. Likewise, there are some additional choices during certain procedures, and those may have different price options and would be linked with quality. So, those optional health care and basic health need to define separately.

Macroeconomic Policy Impact On Oncology-Related Public Expenditure In An Emerging European Market – Signs Of Early Recovery

Healthcare financing in Serbia has faced many challenges over the past few decades. One of the most severe challenges is a global macroeconomic recession whose far-reaching consequences deserve particular attention from policymakers in cases of the most demanding major prosperity diseases, such as cancer. The objective of the study was to assess the precise cost matrix of oncology medical care and its chronological evolution during the key years of the macroeconomic recessionary period during 2010-2013.

A retrospective database of hospital discharge invoices was analysed, encompassing 37, 978 hospital admissions and 12, 505 patients during a four-year period. Insight into microeconomic patterns of consumption across groups of medical services was provided. A payer's perspective and one-year time horizon have been adopted.

Total hospital direct medical costs of cancer diagnostics and treatment in the observed tertiary care facility decreased from €7, 411, 446 in 2010 to €5, 715, 884 in 2012 and then increased to an extraordinary €8, 536, 364 in 2013. The costs of oncology nursing care, imaging diagnostics and radiotherapy have increased considerably while those of pharmaceuticals and surgery have decreased radically - completely transforming the resource allocation landscape of public cancer care.

The financial burden of cancer in Serbia is considerable and, unfortunately, expected to increase further in the coming years. Worldwide economic recession and consecutive domestic policy constraints of reimbursement limitations have heavily affected the affordability of cancer treatment for ordinary citizens. Promising signs of market recovery are clearly visible in 2013, which will likely improve both access and equity of medical care in Serbian oncology clinics.

Comparison of subjective and objective tools in transoral laser cordectomy for early glottic cancer: importance of voice handicap index

Several studies in recent years have already reported good oncologic results with laser microsurgery in the treatment of early glottic carcinoma. We conducted a longitudinal voice evaluation, in patients with early glottic cancer who underwent transoral laser cordectomy, in order to assess the voice quality outcome and its relationship with objective and subjective (voice handicap index questionnaire and GIRBAS scale) means. Twenty-four previously untreated patients underwent transoral laser cordectomy for early glottic cancer. All patients underwent subjective and objective voice assessment according to the multidimensional voice protocol recommended by the European Laryngological Society including acoustic, perceptual and stroboscopic analysis combined to patient self assessment of voice (voice handicap index-VHI). These evaluations were performed before treatment and 6 months after the treatment. Vocal fold healing was complete in all cases by 6 months following surgery. Main voice parameters (subjective and objective) resulted improved at the 6-month control after surgery. In particular, voice handicap index (VHI) and GIRBAS scale resulted reliable for voice assessment and for the postoperative follow-up. In conclusion, VHI, GIRBAS, multidimensional voice program (MDVP) and spectroacoustic parameters showed a close trend in the present study, and this confirms the validity of the voice analysis performed by each tool.