Assessment of Douro and Ave River (Portugal) lower basin water quality focusing on physicochemical and trace element spatiotemporal changes

Water quality of Douro and Ave lower basin was evaluated regarding physicochemical parameters (pH, conductivity, dissolved oxygen and temperature), nutrient compounds (nitrates, nitrites, ammonium and orthophosphates), chlorophyll a and occurrence of trace elements (Li, Be, Al, Ti, V, Cr, Co, Ni, Cu, Zn, Se, Mo, Ag, Cd, Sb, Ba, Tl, Pb, Th and U). To study spatiotemporal variations and possible anthropogenic sources, estuarine samples were collected at nine sampling sites in Douro and five in Ave distributed along the estuaries at four sampling campaigns (spring, summer, fall and winter). According to the water quality standards for aquatic life and recreation, Douro and Ave river water quality was found out of safe limits regarding several parameters. Nitrate levels were systematically high (> 50 mg L^-1 in a significant number of samples) and mean levels of trace elements were higher than the established values of Canadian Environmental Quality Guidelines for aquatic life protection for Al, Cu, Se, Ag, Cd and Pb in Douro and Ave, and also Zn in Ave. Significant spatial differences were found in Ave river estuary for trace elements with a clear trend for higher values from upstream to downstream found. Seasonal differences were also observed particularly in Douro river estuary with higher levels in spring for most elements.

New Ventilator Strategies: High-Frequency Oscillatory Ventilation Combined with Volume Guarantee

High-frequency oscillatory ventilation (HFOV) has been proposed as an alternative method of invasive ventilation in immature infants to prevent ventilator lung injury. To better control the size of the high-frequency tidal volume and to prevent large tidal volumes, a new strategy of controlling the tidal volume during HFOV (VThf) has been developed, HFOV-volume guarantee (VG). Data from preclinical, neonatal animal studies in normal and surfactant-depleted lungs have demonstrated the feasibility of this technique to directly control the VThf in the normal compliance and low compliance situations. Different I:E ratios also can modify the effect of CO₂ washout during HFOV combined with VG in a different way as without the VG modality. Finally, clinical use of this technique in newborn infants has demonstrated the possibility of using very high frequency combined with constant very low VThf to decrease the risk of lung trauma related to the ventilator.

Testing ground for fluctuation theorems: The one-dimensional Ising model

In this paper we determine the nonequilibrium magnetic work performed on a Ising model and relate it to the fluctuation theorem derived some years ago by Jarzynski. The basic idea behind this theorem is the relationship connecting the free energy difference between two thermodynamic states of a system and the average work performed by an external agent, in a finite time, through nonequilibrium paths between the same thermodynamic states. We test the validity of this theorem by considering the one-dimensional Ising model where the free energy is exactly determined as a function of temperature and magnetic field. We have found that the Jarzynski theorem remains valid for all the values of the rate of variation of the magnetic field applied to the system. We have also determined the probability distribution function for the work performed on the system for the forward and reverse processes and verified that predictions based on the Crooks relation are equally correct. We also propose a method to calculate the lag between the current state of the system and that of the equilibrium based on macroscopic variables. We have shown that the lag increases with the sweeping rate of the field at its final value for the reverse process, while it decreases in the case of the forward process. The lag increases linearly with the size of the chain and with a slope decreasing with the inverse of the rate of variation of the field.

Abstract P5-22-19: Nipple sparing mastectomy in unselect patients: Experience of an academic center in the south of Brazil

INTRODUCTION: Nipple sparing mastectomy (NSM) consists in the complete excision of the breast gland, mantaining the subcutaneous tissue, skin and nipple-areola complex (NAC). Recently, the NSM was developed as a therapeutic option not just for the patients that need risk-reducing surgery, but also for patients that have tumors not involving the NAC.

OBJECTIVES: Evaluate the overall survival, disease-free survival and local recurrence of the patients that underwent NSM. The only exclusion criteria for NSM was lesion at the NAC.

MATERIAL AND METHODS: Retrospective study that evaluate the number of cases of NSM performed between 2003 and 2015 in a private sector in the south of Brazil.

RESULTS: A total of 224 patients underwent NSM during the period of 2003-2015. The mean age was 47 years. From the total, 43 patients underwent risk-reducing NSM and 181 therapeutic NSM (64 unilateral and 117 bilateral). In those cases of bilateral procedures all of them underwent risk-reducing surgery on the contralateral breast (there were no bilateral cancers). Of this 181 cases, 108 (59%) have familiar history of breast cancer, considering first, second and third-degree relatives. Twenty six patients (14%) have history of previous breast cancer diagnosed. In this group of 181 patients with therapeutic NSM, 29 (16%) developed any unfavorable outcomes, 13 (7%) local recurrence, 4 (2%) ipsilateral node recurrence, 3 (1,6%) contralateral recurrence and 9 (5%) distant metastasis. None of the local recurrences occurred at the NAC, neither the cited unfavorable outcomes occurred in the risk-reducing setting. In a median follow-up of 47,7 months, the overall survival was 95% (8 deaths related to breast cancer) and the disease-free survival was 83,7%.

CONCLUSIONS: The overall survival rates of 95% at 47 months of follow-up is similar to the literature rates, that range from 93 to 97% in 5 years, depending on study's inclusion criterias. In our study, 14% of patients had previous breast cancer and 59% of patients treated for breast cancer by NSM had positive familiar history of breast cancer. This results in an unselected group of patients confirms the safety of this therapeutic method as an option for breast cancer patients.

Citation Format: Frasson A, Zerwes F, Souza A, Rossato N, Miranda I, Trindade V, Vollbrecht B, Santos M, Viegas J. Nipple sparing mastectomy in unselect patients: Experience of an academic center in the south of Brazil [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-22-19.

Rare and Common Variants Conferring Risk of Tooth Agenesis

We present association results from a large genome-wide association study of tooth agenesis (TA) as well as selective TA, including 1,944 subjects with congenitally missing teeth, excluding third molars, and 338,554 controls, all of European ancestry. We also tested the association of previously identified risk variants, for timing of tooth eruption and orofacial clefts, with TA. We report associations between TA and 9 novel risk variants. Five of these variants associate with selective TA, including a variant conferring risk of orofacial clefts. These results contribute to a deeper understanding of the genetic architecture of tooth development and disease. The few variants previously associated with TA were uncovered through candidate gene studies guided by mouse knockouts. Knowing the etiology and clinical features of TA is important for planning oral rehabilitation that often involves an interdisciplinary approach.

Phase diagram and criticality of the two-dimensional prisoner's dilemma model

The stationary states of the prisoner's dilemma model are studied on a square lattice taking into account the role of a noise parameter in the decision-making process. Only first neighboring players-defectors and cooperators-are considered in each step of the game. Through Monte Carlo simulations we determined the phase diagrams of the model in the plane noise versus the temptation to defect for a large range of values of the noise parameter. We observed three phases: cooperators and defectors absorbing phases, and a coexistence phase between them. The phase transitions as well as the critical exponents associated with them were determined using both static and dynamical scaling laws.

Uranium mining wastes: The use of the Fish Embryo Acute Toxicity Test (FET) test to evaluate toxicity and risk of environmental discharge

Active and abandoned uranium mining sites often create environmentally problematic situations, since they cause the contamination of all environmental matrices (air, soil and water) with stable metals and radionuclides. Due to their cytotoxic, genotoxic and teratogenic properties, the exposure to these contaminants may cause several harmful effects in living organisms. The Fish Embryo Acute Toxicity Test (FET) test was employed to evaluate the genotoxic and teratogenic potential of mine liquid effluents and sludge elutriates from a deactivated uranium mine. The aims were: a) to determine the risk of discharge of such wastes in the environment; b) the effectiveness of the chemical treatment applied to the uranium mine water, which is a standard procedure generally applied to liquid effluents from uranium mines and mills, to reduce its toxicological potential; c) the suitability of the FET test for the evaluation the toxicity of such wastes and the added value of including the evaluation of genotoxicity. Results showed that through the FET test it was possible to determine that both elutriates and effluents are genotoxic and also that the mine effluent is teratogenic at low concentrations. Additionally, liquid effluents and sludge elutriates affect other parameters namely, growth and hatching and that water pH alone played an important role in the hatching process. The inclusion of genotoxicity evaluation in the FET test was crucial to prevent the underestimation of the risks posed by some of the tested effluents/elutriates. Finally, it was possible to conclude that care should be taken when using benchmark values calculated for specific stressors to evaluate the risk posed by uranium mining wastes to freshwater ecosystems, due to their chemical complexity.

Immunocytochemical study of canine lymphomas and its correlation with exposure to tobacco smoke

Aim:

Canine lymphoma is one of the most common canine neoplasms, but little is known regarding the effects of exposure to tobacco smoke on their biologic behavior. As cytology is the most frequent diagnostic method of canine lymphoma, the aims of this study were to perform an immunocytochemical study of canine lymphomas, including subtyping and cell proliferation analysis, and to establish their correlation with tobacco smoke exposure.

Materials and Methods:

A total of 23 dogs diagnosed with lymphoma were subjected to careful fine-needle biopsies of enlarged lymph nodes. The smears were air-dried, fixed with cold acetone, and immunocytochemically stained using CD3, PAX5, and Ki-67. Owners were requested to complete an epidemiologic questionnaire.

Results:

According to the updated Kiel classification, 65% were B-cell lymphomas - three low grade (LG) and 12 high grade (HG) and 35% were T-cell -two LG and six HG. Thirteen tumors presented high Ki67 indexes (>40%) (11 HG and 2 LG), two revealed moderate ones (20-40%) (1 HG and 1 LG), and three had low indexes (≤20%) (1 HG and 2 LG). Both a significant positive correlation and a significant linear-by-linear association (p=0.018) were observed between high Ki67 indexes and smoking owners (r=0.753, p=0.002) as well as with the number of smokers in the household (r=0.641, p=0.001). Moreover, the mean percentage of Ki67⁺ cells from the group of “smoker owners” was statically higher (p=0.011) than that from the “non-smoker owners.”

Conclusion:

The results suggest that cytological diagnosis of canine lymphomas benefits from being complemented with immunocytochemical studies that include subtyping and assessment of proliferative activity, both contributing for the prognosis and therapeutic planning. Furthermore, exposure to tobacco smoke seems to be related to the biological behavior of canine lymphomas.

ASSESSMENT OF RADIUM ACTIVITY CONCENTRATION AND RADON EXHALATION RATES IN IBERIAN PENINSULA BUILDING MATERIALS

Radium (226Ra) is a natural radioactive element of the uranium decay series, which could also be present in building materials. Radon (222Rn) is continuously produced by the decay of 226Ra and its presence inside buildings can contribute to the increase of the population exposure to ionizing radiation. In this work, the amount of radium activity concentration and radon exhalation rates in several types of building materials that are commonly used in the Iberian Peninsula have been tested. The radium activity concentration was measured by gamma-ray spectrometry, whereas the radon exhalation rates were carried out using a continuous radon monitor (active measuring technique) and a solid state nuclear track detectors (passive measuring technique). The 226Ra mean values range from 5.0 to 123.4 Bq kg-1. As expected, the results show that the radon exhalation rate is higher in granites samples relatively to others building materials analysed. A positive correlation was found between radium activity concentration and radon exhalation rates in both techniques. The emanation fraction and alpha index were also calculated.

Leishmania infantum exerts immunomodulation in canine Kupffer cells reverted by meglumine antimoniate

Kupffer cells (KC) are the liver macrophage population that resides in the hepatic sinusoids and efficiently phagocyte pathogens by establishing an intimate contact with circulating blood. KC constitute the liver host cells in Leishmania infection, nevertheless little is described about their role, apart from their notable contribution in granulomatous inflammation. The present study aims to investigate how canine KC sense and react to the presence of Leishmania infantum promastigotes and amastigotes by evaluating the gene expression of specific innate immune cell receptors and cytokines, as well as the induction of nitric oxide and urea production. Complementarily, the impact of a leishmanicidal drug - meglumine antimoniate (MgA) - in infected KC was also explored. KC revealed to be susceptible to both parasite forms and no major differences were found in the immune response generated. L. infantum parasites seem to interact with KC innate immune receptors and induce an anergic state, promoting immune tolerance and parasite survival. The addition of MgA to infected KC breaks the parasite imposed silence and increased gene expression of Toll-like receptors (TLR) 2 and TLR4, possibly activating downstream pathways. Understanding how KC sense and react to parasite presence could bring new insights into the control or even elimination of canine leishmaniasis.

Recommendations of the Spanish brachytherapy group (GEB) of Spanish Society of Radiation Oncology (SEOR) and the Spanish Society of Medical Physics (SEFM) for high-dose rate (HDR) non melanoma skin cancer brachytherapy

Clinical indications of brachytherapy in non-melanoma skin cancers, description of applicators and dosimetry recommendations are described based on the literature review, clinical practice and experience of Spanish Group of Brachytherapy and Spanish Society of Medical Physics reported in the XIV Annual Consensus Meeting on Non Melanoma Skin Cancer Brachytherapy held in Benidorm, Alicante (Spain) on October 21st, 2016. All the recommendations for which consensus was achieved are highlighted in blue. Regular and small surfaces may be treated with Leipzig, Valencia, flap applicators or electronic brachytherapy (EBT). For irregular surfaces, customized molds or interstitial implants should be employed. The dose is prescribed at a maximum depth of 3-4 mm of the clinical target volume/planning target volume (CTV/PTV) in all cases except in flaps or molds in which 5 mm is appropriate. Interstitial brachytherapy should be used for CTV/PTV >5 mm. Different total doses and fraction sizes are used with very similar clinical and toxicity results. Hypofractionation is very useful twice or 3 times a week, being comfortable for patients and practical for Radiotherapy Departments. In interstitial brachytherapy 2 fractions twice a day are applied.

Flavonoid rich dark cocoa may improve fatigue in people with multiple sclerosis, yet has no effect on glycaemic response: An exploratory trial

CONTEXT

Current research suggests that dark cocoa may reduce fatigue; however, the effect on fatigue in people with MS (pwMS) has never been established. The objective of this feasibility study was to explore the acute effect of high flavonoid cocoa on measures of fatigue and glycaemic response.

METHODS

This was a randomised crossover participant blind exploratory study in 12 participants (2 male and 10 female) with MS-related fatigue (>4 on the Fatigue Severity Scale; FSS). After fasting overnight, participants consumed the high flavonoid cocoa drink (350 mg gallic acid equivalents {GAE}/g) or a low flavonoid cocoa control (120 mg GAE/g), consuming the alternative drink on the next visit. Fatigue was self-reported on a 100 mm visual analogue scale at 30-min time intervals for 2 h post cocoa consumption and every 2 h for the rest of the day. Fatigability was monitored using a 6 min walk test (6MWT) at the end of the visit (2 h), and activity monitors worn for 24 h commencing at 12 noon on the day of testing. The feasibility of performing the trial including outcome measures was documented.

RESULTS

A moderate effect was found in self-reported fatigue throughout the day in favour of the high flavonoid group (Cohen's d 0.32, 95% non-central t CI -0.57 to 1.20). Fatigability measures did not change. Participants consumed and enjoyed the cocoa, all participants completed the study and outcome measures were accepted.

CONCLUSION

The results of this study support further trials to investigate the feasibility and efficacy of pure cocoa as a dietary supplement for fatigue in pwMS.

Metabolic syndrome contributes to renal injury mediated by hyperoxaluria in a murine model of nephrolithiasis

Metabolic syndrome (MS) individuals have a higher risk of developing chronic kidney disease through unclear pathogenic mechanisms. MS has been also related with higher nephrolithiasis prevalence. To establish the influence of MS on renal function, we designed a murine model of combined metabolic syndrome and hyperoxaluria. Four groups of male Sprague-Dawley rats were established: (1) control group (n = 10) fed with standard chow; (2) stone former group (SF) (n = 10) fed with standard chow plus 0.75% ethylene glycol administered in the drinking water; (3) metabolic syndrome group (MS) (n = 10), fed with 60% fructose diet; (4) metabolic syndrome + stone former group (MS + SF) (n = 10), 60% fructose diet and 0.75% EG in the drinking water. MS group showed a significant injury to renal function when hyperoxaluria was induced. It was demonstrated by a significant decrease of creatinine clearance (p < 0.001), with higher tubular damage (34.3%, CI 95% 23.9-44.7, p < 0.001), produced by deposition of crystals, and increased tubular synthesis of osteopontin as a response to tubular damage. Induction of hyperoxaluria in rats with MS causes severe morphological alterations with a significant impairment of renal function. This impairment is not produced in rats without MS. Therefore, this model can be useful for the study of the influence of MS in stone formation.

Are we using mass media to raise awareness about psychiatric disorders?

Introduction

The global burden of mental disorders is large and continues to grow. Depression is the leading cause of disability worldwide. Every 40 seconds somebody dies from suicide. People with mental disorders are amongst the most marginalized in society. The stigma they experience puts them at an increased risk of poverty, discrimination and human right violations.

Objectives

To study the presence of psychiatric disorders in the media.

Methods

We selected and analyzed the top media Twitter accounts of general news outlets, based on their number of followers. Our research strategy focused on the search of several psychiatric terms of interest (ex: “insomnia”) on each Twitter account. The search includes tweets from the beginnings of Twitter in 2007 up to May 2016, and yielded a database of more than 10,000 news.

Results

The terms with the highest impact in mass media referred to suicide, depression, addictions and gender dysphoria. Disorders related to anxiety (Generalized anxiety, phobias, panic disorder, obsessive-compulsive disorder), dysthymia and bipolar disorder were the psychiatric disorders with the lowest impact. We noticed that the presence of psychiatric disorders in the media is increasing. However, it does not accurately reflect the actual impact it has on society.

Conclusions

The media can be a useful tool for the implementation of strategies for the promotion and prevention of mental disorders. However, we are not fully taking advantage of the benefits that mass media has to offer in order to educate and raise awareness about said disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Is von Willebrand disease linked to cholesteatoma aetiology?

Cholesteatoma is a common clinical picture seen by otolaryngologists. The disease is characterised by an abnormal grow "of skin in the wrong place". Specifically, in acquired cholesteatoma, the main causative issue is associated with ventilatory deficits within the middle ear and results in chronic infection. Molecular science has associated the presence of specific molecules with its development, and moreover recent research suggests that deregulated angiogenesis is a crucial process in the development of cholesteatoma and its recurrence. Further, haematologists have linked von Willebrand factor and its defects (both quantitative and qualitative) to augmented angiogenesis through upregulation of the vascular endothelial growth factor and angiogenic cytokines. Thus, herewith we probed whether a relationship between von Willebrand disease and the etiopathogenesis of cholesteatoma, plays a potential role for anti-angiogenic molecules for the advent of cholesteatoma surgery adjuvant treatment.