Spousal order of migration, gender, and hospitalization among immigrants in Denmark

Background: Certain migration contexts that may help clarify immigrants' health needs are understudied, including the order in which married individuals migrate. Research shows that men, who are healthier than women across most populations, often migrate to a host country before women. Using Danish register data, we investigate descriptive patterns in the order that married men and women arrive in Denmark, as well as whether migration order is related to overnight hospitalizations. Methods: The study base includes married immigrants who lived in Denmark between January 1, 1980 and December 31, 2014 (N = 13,680). We use event history models to examine the influence of spousal migration order on hospitalizations. Results: The order that married individuals arrive in Denmark is indeed highly gendered, with men tending to arrive first, and varies by country of origin. Risk of hospitalization after age 50 does not depend on whether an individual migrated before, after, or at the same time as their spouse among either men or women. However, among those aged 18+, men migrating before their wives are more likely to experience hospitalizations within the first 5 years of arrival. Conclusions: These findings provide the first key insights about gendered migration patterns in Denmark. Although spousal order of migration is not related to overnight hospitalization among women, our findings provide preliminary evidence that men age 18+ who are first to arrive experience more hospitalization events in the following 5 years. Future research should explore additional outcomes and whether other gendered migration contexts are related to immigrants' health.

State of the Art and Recent Developments of Radiopharmaceuticals for Pancreatic Neuroendocrine Tumors Imaging

Background:

Neuroendocrine Tumors (NETs) are relatively rare tumors, mainly originating from the digestive system, that tend to grow slowly and are often diagnosed when metastasised. Surgery is the sole curative option but is feasible only in a minority of patients. Among them, pancreatic neuroendocrine tumors (pancreatic NETs or pNETs) account for less than 5% of all pancreatic tumors. Viable therapeutic options include medical treatments such as biotherapies and more recently Peptide Receptor Radionuclide Therapies (PRRT) with radiolabeled somatostatin analogues. Molecular imaging, with main reference to PET/CT, has a major role in patients with pNETs.

Objective:

The overexpression of specific membrane receptors, as well as the ability of cells to take up amine precursors in NET, have been exploited for the development of specific targeting imaging agents.

Methods:

SPECT/CT and PET/CT with specific isotopes such as [68Ga]-1,4,7,10-tetra-azacyclododecane- N,N’,N’’,N’’’-tetra-acetic acid (DOTA)-somatostatin analogs, [18F]-FDG and [18F]-fluorodopa have been clinically explored.

Results:

To overcome the limitations of SSTR imaging, interesting improvements are connected with the availability of new radiotracers, activating with different mechanisms compared to somatostatin analogues, such as glucagon-like peptide 1 receptor (GLP-1 R) agonists or antagonists.

Conclusion:

This paper shows an overview of the RPs used so far in the imaging of pNETs with insight on potential new radiopharmaceuticals currently under clinical evaluation.

Trends in Hospital Deaths in Denmark from 1980 to 2014, at Ages 50 and Older

OBJECTIVES

To explore temporal trends and individual-level determinants of hospital deaths at ages 50 and older in Denmark from 1980 to 2014.

DESIGN

Individual-level register-based retrospective study.

SETTING

Denmark, 1980 to 2014.

PARTICIPANTS

All deaths that occurred in Denmark from 1980 to 2014 among individuals 50 years or older (N = 1 834 437), extracted from population registers.

MEASUREMENTS

A death was defined as a hospital death if the individual was admitted to the hospital as an inpatient and the date of discharge from the hospital is equal to the date of death.

RESULTS

The percentage of hospital deaths decreased in both sexes (all ages combined, men: 56% to 44%; women: 49% to 39%) and at ages 50 to 79, remained almost unchanged at ages 80 to 89, and increased in the oldest age group (90+ men: 27% to 32%; women: 18% to 24%). We observed increasing trends of hospital deaths for three groups, people 90 years and older, dying from respiratory diseases, and who had terminal hospitalizations lasting 1 to 3 days. Subanalysis of all hospital deaths according to length of the terminal hospitalizations suggests that the overall reduction of hospital deaths might be driven by a reduction in hospitalizations that were longer than 1 week. Persons who are married, have middle or high income, have a history of hospitalizations in the year before death, or die because of respiratory diseases have higher odds of dying in a hospital.

CONCLUSION

Results provide evidence that Danes 50 years and older are increasingly dying outside the hospital context. We find three age-specific patterns in the proportion of hospital deaths. Changes in healthcare and social systems implemented in Denmark during the observation period may underlie the broader reduction in hospital deaths in the country. J Am Geriatr Soc 67:471-476, 2019.

Lutetium-177 Labeled Peptides: The European Institute of Oncology Experience

Peptide receptor radionuclide therapy (PRRT) using radiolabeled somatostatin analogues has shown encouraging results in various somatostatin receptor positive tumors. Partial remission rates up to 30% have been documented as well as significant improvements in quality of life and survival. This treatment takes advantage of the high specific binding of the radiolabeled peptide to somatostatin receptors overexpressed by the tumors thus being more effective on the tumor cells with less systemic side-effects. The development of macrocyclic chelators conjugated to peptides made possible the stable binding with various radionuclides. In particular 177Lu features favourable physical characteristics with a half-life of 6.7 days, emission of β- with energy of 0.5 MeV for treatment and γ-emissions suitable for imaging. The present contribution describes the learning process achieved at the European Institute of Oncology (IEO) since the first application of 90Y labeled peptides to the therapy of neuroendocrine tumors back in 1997. Continuous improvements led to the preparation of a safe 177Lu labeled peptide for human use. Our learning curve began with the identification of the optimal characteristics of the isotope paying attention to its chemical purity and specific activity along with the optimization of the parameters involved in the radiolabeling procedure. Also the radiation protection issues have been improved along the years and recently more and more attention has been devoted to the pharmaceutical aspects involved in the preparation. The overall issue of the quality has now been completed by drafting an extensive documentation with the goal to deliver a safe and reliable product to our patients.

Design and solid phase synthesis of new DOTA conjugated (+)-biotin dimers planned to develop molecular weight-tuned avidin oligomers

Oligomeric architectures of avidin generated by a new class of bis-biotins.

Coping and parental role competence of mothers of preterm infant

AIM

The study was aimed at obtaining knowledge about mothers' experiences of preterm birth. The objective of the study is to explore coping strategies and self- perceived parental competence, in mothers of infant born moderately and severely preterm and admitted to the Neonatal Intensive Care Unit (NICU).

METHODS

The study involved a group of 16 mothers of moderately preterm children (weeks' gestational age: mean=34, SD=2 and birth weight: mean=2000 g, SD=200 g) and a group of 14 mothers of severely preterm children (weeks' gestational age: mean=29, SD=2 and birth weight: mean=1700 g, SD=350 g). The following instruments were used with mothers to investigate focus areas of research: Coping Orientation to the Problems Experienced-New Italian Version (COPE-NVI), to analyse coping strategies of mothers, and a Q-sort, a self report on maternal competence.

RESULTS

Data did not show statistically significant differences between the two groups of mothers, both in regard to considered coping strategies (social support, avoidance, problem focused orientation, transcendent orientation, positive aptitude), and the indicators of maternal self-perceived competence (coping, scaffolding, caregiving) (Mann-Whitney U test(n1=16 and n2=14)>0.05).

CONCLUSION

This study, highlighting the lack of differences between the two groups of mothers involved, seems to point out that, beyond the levels of prematurity, the condition of preterm birth itself is precisely the main stressor factor for mothers.

Spin-1/2 geometric phase driven by decohering quantum fields

We calculate the geometric phase of a spin-1/2 system driven by one and two mode quantum fields subject to decoherence. Using the quantum jump approach, we show that the corrections to the phase in the no-jump trajectory are different when considering adiabatic and nonadiabatic evolutions. We discuss the implications of our results from both fundamental as well as quantum computational perspectives.

Geometric phase in open systems

We calculate the geometric phase associated with the evolution of a system subjected to decoherence through a quantum-jump approach. The method is general and can be applied to many different physical systems. As examples, two main sources of decoherence are considered: dephasing and spontaneous decay. We show that the geometric phase is completely insensitive to the former, i.e., it is independent of the number of jumps determined by the dephasing operator.

Vacuum induced spin-1/2 Berry's phase

We calculate the Berry phase of a spin-1/2 particle in a magnetic field considering the quantum nature of the field. The phase reduces to the standard Berry phase in the semiclassical limit and the eigenstate of the particle acquires a phase in the vacuum. We also show how to generate a vacuum induced Berry phase considering two quantized modes of the field which has an interesting physical interpretation.

Long-lasting handling affects behavioural reactivity in adult rats of both sexes prenatally exposed to diazepam

Environmental stressors can substantially affect the adaptive response of rats to novelty in a sexually dimorphic manner. Gender-related differences are also observed in neurochemical and behavioural patterns of adult rats following prenatal exposure to diazepam (DZ). In the present study the behavioural reactivity to novelty is investigated in open field (OF) and in acoustic startle reflex (ASR) tests, in non handled (NH), short-lasting handled (SLH) and long-lasting handled (LLH) adult male and female rats prenatally exposed to DZ. A single daily s.c. injection of DZ (1.5 mg/kg) over gestation days 14-20 decreases GABA/BDZ receptor function in both sexes, as shown by the decreased electrographic hippocampal response to DZ and the increased response to picrotoxin, after intra-locus coeruleus injection of the two compounds. In OF NH DZ-exposed males display a lower total distance travelled (TDT), a higher rearing frequency (RF) and a greater number of transitions in the centre of the arena (CNT) compared to NH rats prenatally exposed to vehicle. Conversely, NH DZ-exposed females show slight changes in TDT and RF and a greater reduction in CNT and in the amount of time spent in the centre of the arena (CAT). These effects are associated with an increase in the peak amplitude of the ASR in both sexes. Short-lasting handling slightly influences DZ-evoked effects in animals of both sexes. In DZ-exposed males long-lasting handling attenuates the reduction in TDT and the enhancement in RF, prevents the increase in CNT and reduces the peak amplitude of ASR. In DZ-exposed females, long-lasting handling increases TDT and RF, induces a lower avoidance of the centre of the arena, and does not modify the peak amplitude of ASR, when compared to controls. These findings indicate that prenatal exposure to DZ differently affects behavioural reactivity in adult male and female rats, and suggest that a long-lasting handling is able to attenuate some behavioural deficits induced by prenatal DZ exposure.

[Fuzzy logic and postoperative pain]

OBJECTIVE

To apply a fuzzy logic expert control system for the treatment of postoperative pain in a clinical setting.

MATERIAL AND METHODS

A system was designed consisting of a perfusion pump guided by a fuzzy logic computer interface to regulate the perfusion of alfentanil in accordance with the patient's pain response. The system was also equipped with a safety device that halted perfusion in case of desaturation, bradypnea or heart rate or blood pressure variations greater than 25%. The system was used in the first 90 minutes after surgery in a patient who underwent bilateral saphenectomy.

RESULTS

All system functions worked properly, maintaining the target analgesic values (visual analog scale < or = 2) 77% of the time.

CONCLUSION

It is possible to use fuzzy logic to obtain adequate treatment of postoperative pain.

A rule-based postoperative pain controller: simulation results

We describe a system for controlling postoperative pain, a phenomenon that is difficult to treat by conventional control methods due to interpatient variability, interferences, non-linearity and the lack of a plausible, well-defined mathematical model. The system consists of two phases. In Phase 1 a closed-loop fuzzy controller implementing a suitable control strategy brings the patient to a zero-pain state. In Phase 2, an open-loop computer-assisted continuous infusion controller maintains a constant concentration of the analgesic (alfentanil) in plasma, subject to an upper safety limit on infusion rate; the set-point of this controller is periodically revised (either maintained or reduced) on the basis of feedback on the duration of zero pain (set-point reduction is necessary because the open-loop system has no means of knowing whether analgesic is accumulating in the patient). Pain is quantified by the patient on a numerical scale of 1 to 10 at 1.5-min intervals during Phase 1 and 9-min intervals during Phase 2. In simulation trials in which a fixed approximate model was used for the effect of sedation on pain while the pharmacokinetics of alfentanil were varied from one simulated patient to another, zero pain was achieved in under 15 min with minimal overshoot in plasma drug concentration and was maintained, with only minor deviation, by means of low drug concentrations.

Effects of the removal of olfactory bulbs on the appearance and then on the latency of the "mouse-killing reaction" in the rat of the Wistar SM strain

The 20% of male 5-6 month-old Wistar rats SM prove to be natural killers. A four-month long insulation of "surely non-killer" rats has not allowed to notice a mouse-killing behaviour in any animal. The total bilateral removal of olfactory bulbs in "non-killer rats" causes a "mouse-killing behaviour" in all the animal 24 hours after the operation, but with a latency of response that has proved different in the various rats. Precisely, while 24 hours and 15 days after the bulb operation the rats can be distinguished into "rapid killers" and "slow killers", after 30 days all the animals become "rapid killers" with a remarkably shortened period of mouse-killing latency (1 - 60 seconds).

The effect of thermic stress on the somatic reaction of rage and on rapid circling turns, in the cat

An investigation was made of the effect of thermic stress on the somatic rage reaction and on rapid circling turns in cats awake and free to move in a behavioural cage. An increase in room temperature had a two-phase effect on the excitability of the nervous structures stimulated that is able to evoke the somatic rage reaction and rapid circling turns. The first phase, at room temperature 25 degrees-30 degrees C, was characterized by hypoexcitability; the second phase, appearing after longer periods of exposure and at temperatures above 30 degrees C, was characterized by the onset panting, hyperexcitability of the nervous structures stimulated and then by lowering of the somatic rage reaction threshold and a very significant increase in the number of circling turns. Experimentation on the action of cold external temperature on the excitability of structures involved in evoking the somatic rage reaction and rapid circling turns indicated an increase in their excitability, corresponding to an increase in spontaneous and evoked somatic motor activity.

A study of the feeding and social behaviour of the "Macacus rhesus" monkey after direct electrical stimulation and telestimulation of different points of the amygdala and the hippocampus

We examined first the behavior of a single animal (Macacus Rhesus), partially free to move on a Brady chair, before and after direct electrical stimulation of the amygdala and the hippocampus; then the social behavior of two animals, completely free to move in a large behavioral cage, before and after stimulation, by radio, of the amygdala. Certain ventromedial areas of the amygdala have a short and long term inhibitory effect on feeding and social behavior and the hippocampus has a short and long term facilitating effect on feeding behavior, especially during the after discharge.