Social Play Behavior Is Critical for the Development of Prefrontal Inhibitory Synapses and Cognitive Flexibility in Rats

Sensory driven activity during early life is critical for setting up the proper connectivity of the sensory cortices. We ask here whether social play behavior, a particular form of social interaction that is highly abundant during postweaning development, is equally important for setting up connections in the developing prefrontal cortex (PFC). Young male rats were deprived from social play with peers during the period in life when social play behavior normally peaks [postnatal day 21-42] (SPD rats), followed by resocialization until adulthood. We recorded synaptic currents in layer 5 cells in slices from medial PFC of adult SPD and control rats and observed that inhibitory synaptic currents were reduced in SPD slices, while excitatory synaptic currents were unaffected. This was associated with a decrease in perisomatic inhibitory synapses from parvalbumin-positive GABAergic cells. In parallel experiments, adult SPD rats achieved more reversals in a probabilistic reversal learning (PRL) task, which depends on the integrity of the PFC, by using a more simplified cognitive strategy than controls. Interestingly, we observed that one daily hour of play during SPD partially rescued the behavioral performance in the PRL, but did not prevent the decrease in PFC inhibitory synaptic inputs. Our data demonstrate the importance of unrestricted social play for the development of inhibitory synapses in the PFC and cognitive skills in adulthood and show that specific synaptic alterations in the PFC can result in a complex behavioral outcome.SIGNIFICANCE STATEMENT This study addressed the question whether social play behavior in juvenile rats contributes to functional development of the prefrontal cortex (PFC). We found that rats that had been deprived from juvenile social play (social play deprivation - SPD) showed a reduction in inhibitory synapses in the PFC and a simplified strategy to solve a complex behavioral task in adulthood. Providing one daily hour of play during SPD partially rescued the cognitive skills in these rats, but did not prevent the reduction in PFC inhibitory synapses. Our results demonstrate a key role for unrestricted juvenile social play in PFC development and emphasize the complex relation between PFC circuit connectivity and cognitive function.

Patient-Reported Experience Measures in Stroke Care: A Systematic Review

BACKGROUND AND PURPOSE

Patient-reported experience measures (PREMs) assess patients' perception of health care. We aimed to identify all reported PREMs for stroke care and critically appraise psychometric properties of PREMs validated for patients with stroke.

METHODS

Studies on the development, validation, or utilization of PREMs for adult patients with stroke were systematically identified. The Consensus-Based Standards for the Selection of Health Measurement Instruments criteria were used to appraise psychometric performance.

RESULTS

We included 18 studies, examining 13 PREMs. Two PREMs had been developed for stroke care: Consumer Quality Index: Cerebrovascular Accident and Riksstroke. Consumer Quality Index: Cerebrovascular Accident was given a positive psychometric assessment, but its length and limited language applicability impede clinical implementation. Riksstroke was appraised as doubtful. Eleven PREMs were generic. The psychometric performance of 5 generic PREMS, validated for patients with stroke, received conflicting assessments. Six generic PREMs had not been validated in patients with stroke and were therefore not assessed for instrument performance.

CONCLUSIONS

Thirteen PREMs have been published for use in stroke care. The stroke-specific Consumer Quality Index: Cerebrovascular Accident has favorable psychometric performance but lacks practical feasibility. Other PREMs have inadequate or unknown psychometric properties. This indicates the need for developing stroke-specific PREMs to support quality improvement and enhance patient-centered care.

Alcohol-related emergency department admissions among adolescents in the Ghent and Sint-Niklaas areas

Alcohol abuse is a major health concern. The aim of this retrospective study was to analyse the alcohol-related emergency department (ED) admissions among adolescents in all hospitals of distinct areas during a 1-year period. In each hospital, all ED patients with a blood alcohol concentration (BAC) of at least 0.5 g/l were surveyed in a standardised way. Of the 3918 included patients, only 146 (3.7%) were < 18  years. The male-to-female ratio was 1.5:1. There was a strong preponderance of weekend and night time admissions. Most of the patients were transported by ambulance (77% of 138 patients with information on this item). The main reason for ED admittance was depressed level of consciousness (64%), trauma (12%), vomiting and/or abdominal pain (12%), agitation or aggression (4%), syncope (4%) and psychological problems (4%). The context of the alcohol intoxication was related to some kind of festivity in 85%, mental problems in 14% and chronic abuse in 1%. Median BAC values (and range) were 2.08 g/l (0.73-3.70 g/l) for boys and 1.51 g/l (0.73-2.90 g/l) for girls. Most patients (87%) could be discharged home within 24  hours. Our study confirms that problematic alcohol use leading to ED admissions starts in adolescence. Although the numbers of cases below 18 years are low when compared to adults, the phenomenon is alarming as it is associated with substantial health problems. Therefore, Belgium urgently needs a global national alcohol plan, with youngsters being one of the target groups.

A semi-probabilistic modelling approach for the estimation of dietary exposure to phthalates in the Belgian adult population

In this study, a semi-probabilistic modelling approach was applied for the estimation of the long-term human dietary exposure to phthalates--one of world's most used families of plasticisers. Four phthalate compounds were considered: diethyl phthalate (DEP), di-n-butyl phthalate (DnBP), benzylbutyl phthalate (BBP) and di(2-ethylhexyl) phthalate (DEHP). Intake estimates were calculated for the Belgian adult population and several subgroups of this population for two considered scenarios using an extended version of the EN-forc model. The highest intake rates were found for DEHP, followed by DnBP, BBP and DEP. In the Belgian adult population, men and young adults generally had the highest dietary phthalate intake estimates. Nevertheless, predicted dietary intake rates for all four investigated phthalates were far below the corresponding tolerable daily intake (TDI) values (i.e. P99 intake values were 6.4% of the TDI at most), which is reassuring because adults are also exposed to phthalates via other contamination pathways (e.g. dust ingestion and inhalation). The food groups contributing most to the dietary exposure were grains and grain-based products for DEP, milk and dairy products for DnBP, meat and meat products or grains and grain-based products (depending on the scenario) for BBP and meat and meat products for DEHP. Comparison of the predicted intake results based on modelled phthalate concentrations in food products with intake estimates from other surveys (mostly based on measured concentrations) showed that the extended version of the EN-forc model is a suitable semi-probabilistic tool for the estimation and evaluation of the long-term dietary intake of phthalates in humans.

Modelling the environmental transfer of phthalates and polychlorinated dibenzo-p-dioxins and dibenzofurans into agricultural products: the EN-forc model

This study aimed to predict the occurrence of four phthalates, two polychlorinated dibenzo-p-dioxins and two polychlorinated dibenzofurans in environmental and agricultural media from observed concentrations in air, sludge, manure and concentrate. For the environmental and agricultural fate modelling, the newly developed multimedia model "EN-forc" (ENvironmental Food transfer model for ORganic Contaminants) was used. To validate EN-forc calculations, the predicted concentrations of the considered chemicals in soil, groundwater, drinking water, plants and animal products were compared with both observed and modelled concentrations available in the literature. For the majority of the considered matrices, predicted phthalate and dioxin levels differed one order of magnitude at most with observed concentrations. Unfortunately, the transfer models implemented in EN-forc lacked power to predict levels of some phthalates and dioxins in pasture, root crops and/or tubers. Concentrations of phthalates and dioxins in offal could not be predicted due to the absence of suitable models that have an acceptable level of complexity to implement in EN-forc. For this type of food products, further research is highly encouraged. In a next step, the modelling framework of EN-forc will be extended in order to be able to predict human dietary exposure to organic chemicals like phthalates and dioxins.

The need for ethical reflection on the use of molecular microbial characterisation in outbreak management

Current thinking on the development of molecular microbial characterisation techniques in public health focuses mainly on operational issues that need to be resolved before incorporation into daily practice can take place. Notwithstanding the importance of these operational challenges, it is also essential to formulate conditions under which such microbial characterisation methods can be used from an ethical perspective. The potential ability of molecular techniques to show relational patterns between individuals with more certainty brings a new sense of urgency to already difficult ethical issues associated with privacy, consent and a moral obligation to avoid spreading a disease. It is therefore important that professionals reflect on the ethical implications of using these techniques in outbreak management, in order to be able to formulate the conditions under which they may be applied in public health practice.

First assessment of population exposure to perfluorinated compounds in Flanders, Belgium

With the objective to evaluate exposure of the population in Flanders (Belgium) to perfluorinated compounds (PFCs), we measured perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) in settled dust in homes and offices, in a selection of food items from local origin, in drinking-water and in human serum. We complemented the data with results from a literature survey. Based on this dataset we calculated intake by children and adults from food, drinking-water, settled dust and soil, and air. Dietary exposure dominated overall intake. For adults, average dietary intake equalled 24.2 (P95 40.9) ng PFOS kg(-1) d(-1) and 6.1 (P95 9.6) ng PFOA kg(-1)d(-1), whereas for children the dietary intake was about 3 times higher. Predicted intake is high when compared to assessments in other countries, and to serum levels from Flanders, but comparable to the intakes published by The European Food Safety Authority (EFSA) in 2008. Intake of PFOS and PFOA remained below the Tolerable Daily Intake.

Predicting blood lead levels from current and past environmental data in Europe

The present case study on lead in Europe illustrates the use of the Integrated Monitoring Framework Strategy to assess the health outcome of environmental pollution by evaluating the associations between lead in various environmental compartments (air, soil, dust, drinking water and diet) and lead concentrations in blood (B-Pb) for various age-related sub-populations. The case study was aimed to investigate whether environmental, exposure and biomonitoring data at general population level, covering all EU member states, could be integrated. Although blood lead has been monitored extensively in Europe, consistent datasets are not yet available. Data diverge with regard to objectives, regional scale, sampling years, gender, age groups and sample size. Significant correlations were found between B-Pb and the concentrations of Pb in air and diet. The significant decrease of the Pb in air over time from 0.31 μg/m(3) (P95: 0.94; n=98) prior to 1990 to 0.045 μg/m(3) (P95: 0.11; n=256) in 2007 (latest observations included) (Δ=-85%) corresponds to a decline in B-Pb by 48% and 57% in adult women and adult men, respectively. For pre-school children a more shallow decline in B-Pb of 16% was calculated over the same period. Similarly, the reduction in Pb-dietary intake from on average 68.7 μg/d (P95: 161.6; n=19) in 1978 to 35.7 μg/d (P95: 82.3; n=33) in the years post 2000 (Δ=-48%) is paralleled by a decline in B-Pb of 32, 33 and 19% in adult women, primary- and pre-school children, respectively. Insufficient data exist for other age groups to calculate statistically significant correlations. Although regression models have been derived to predict B-Pb for different sub-populations in Europe based on Pb concentrations in air and soil as well as dietary intake, it is concluded that the available data are insufficient to accurately predict actual and future simultaneous exposure to Pb from various environmental compartments, and as a consequence the health impact of Pb for various target populations at EU scale. At least due to data availability, air Pb remains the best predictor of B-Pb in the population. However, lead emission sources have largely been reduced and inhalation of lead in air is not causal to B-Pb levels. Therefore, there is a need of adequate data for Pb in soil and house dust, and in diet and drinking water as these are causal exposure sources with a longer Pb half-life than air. An extended and more harmonized surveillance system monitoring B-Pb, especially in children, is urgently required in order to identify, quantify and reduce still remaining sources of Pb exposure.

Dietary cadmium intake by the Belgian adult population

The aim of this study was to estimate the dietary cadmium (Cd) intake of the Belgian adult population, to compare this dietary Cd exposure to the tolerable weekly intake (TWI) recently established by the European Food Safety Authority (EFSA) and to determine the major food groups that contribute to dietary Cd exposure in Belgium. Food consumption data were derived from the 2004 Belgian food consumption survey (two 24 h recalls, 3083 participants). Cadmium concentrations in food items (n = 4000) were gathered from the control program of the Belgian Federal Agency for the Safety of the Food Chain for the period 2006-2008. Dietary intake per individual was calculated from consumption data and median Cd concentrations. The population mean, median and 95th percentile of the dietary intake values were 0.98, 0.85 and 2.02 µg kg⁻¹ body weight per week respectively. Two percent of the Belgian adult population has a dietary Cd intake above the recent TWI of 2.5 µg kg⁻¹ body weight established by EFSA in 2009. Cereal products and potatoes contribute for more than 60% to Cd intake.

Characterisation and treatment of roads covered with zinc ashes, muffle furnace fragments and lead slags from former non-ferrous metal industries in Belgium

Zinc ashes, muffle furnace fragments and lead slags from non-ferrous industries were applied to pave roads in the North of Belgium. From an inventory it appeared that there are at least 490 km of such roads. In our survey the materials on these roads were characterised. The total metal concentration, the availability and the leaching as a function of time were determined. It appeared that these materials contain high concentrations of heavy metals, some of which are readily available. The high leaching of some metals makes them as such unsuitable as secondary construction material. Methods for the application of these materials for road construction were examined where the materials replaced part of the sand and gravel fraction in lean concrete and in bituminous mixtures, or where they replaced the sand in sand-cement mixtures, all these to be used for road foundations, cycle tracks, etc. When lead slags were applied in lean concrete, a material was obtained complying with the standards for secondary construction materials and with sufficient compressive strength for road foundations. When zinc ashes or muffle fragments were used to replace sand in sand-cement mixtures, again a suitable construction material was obtained. The other combinations tried out were rather unsuccessful, because of high metal leaching and/or poor compressive strength.

Grid lysimeter study of steady state chloride transport in two Spodosol types using TDR and wick samplers

Solute transport in soils is affected by soil layering and soil-specific morphological properties. We studied solute transport in two sandy Spodosols: a dry Spodosol developed under oxidizing conditions of relatively deep groundwater and a wet Spodosol under periodically reducing conditions above a shallow groundwater table. The wet Spodosol is characterized by a diffuse and heterogeneous humus-B-horizon (i.e., Spodic horizon), whereas the dry Spodosol has a sharp Spodic horizon. Drainage fluxes were moderately variable with a coefficient of variation (CV) of 25% in the wet Spodosol and 17% in the dry Spodosol. Solute transport in 1-m-long and 0.8-m-diameter soil columns was investigated using spatial averages of solute concentrations measured by a network of 36 Time Domain Reflectometry (TDR) probes. In the dry Spodosol, solute transport evolves from stochastic-convective to convective-dispersive at a depth of 0.25 m, coinciding with the depth of the Spodic horizon. Chloride breakthrough at the bottom of the soil columns was adequately well predicted by a convection-dispersion model. In the wet Spodosol, solute transport was heterogeneous over the entire depth of the column. Chloride breakthrough at 1 m depth was predicted best using a stochastic-convective transport model. The TDR sampling volume of 36 probes was too small to capture the heterogeneous flow and concomitant transport in the wet Spodosol.

Aging effects on cadmium transport in undisturbed contaminated sandy soil columns

Limited information is available on the effects of contaminant aging (i.e., the contact time of Cd with the soil) on Cd transport in soils. We conducted displacement experiments in which indigenous Cd and freshly applied Cd were leached simultaneously from undisturbed samples of three Spodosol horizons. Sorption of Cd was described using Freundlich isotherms, whereas transport was described as a convection-dispersion process. Parameter optimization analysis using a mobile-immobile transport model applied to nonsorbing tracer displacement data showed that 16 to 22% of the water in the columns was immobile. The low dimensionless mass transfer coefficients in the mobile-immobile model were indicative of diffusion-limited transfer between mobile and immobile water, and hence physical nonequilibrium. A two-site kinetic sorption model could be fitted closely to breakthrough curves of the non-aged Cd for three soil horizons. No conclusive evidence was found that contaminant aging in soil affects cadmium transport. On the one hand, predictions of aged Cd leaching, using parameters estimated from displacement experiments with nonaged Cd, differed from those for the aged Cd in the E horizon. On the other hand, no meaningful differences in transport behavior between aged and non-aged Cd were found for the humus Bh and Bh/C horizons. The two-site kinetic rate coefficient alphac was found to depend on water flux, further indicating that mass transfer between sorption sites and the liquid is limited by diffusion rather than by kinetic sorption.

Health risk assessment of dioxin emissions from municipal waste incinerators: the Neerlandquarter (Wilrijk, Belgium)

Two municipal waste incinerators in the vicinity of a residential area close to the city of Antwerp caused concern to local habitants. Risk assessment was performed combining chemical, toxicological measurements and model calculations. As the first step in risk assessment an inventory was made of historic emissions from both incinerators with emphasis on dioxins. The operational atmospheric transport and deposition model for priority substances (OPS) was used to calculate the deposition of dioxins in the vicinity of incinerators. The observed soil contamination pattern did not correspond to the calculated deposition pattern, indicating that other sources may contribute at least partly to the local PCDD/PCDF contamination of the area. Dioxin exposure of people in the Neerlandquarter as a function of the food consumption behavior was calculated using a mathematical model (VLIER-HUMAAN) combined with transfer factors. According to the results of these calculations, just residing in the impact area does not result in a meaningful risk. Only if locally produced food was consumed (milk, meat and vegetables), exposure in the Neerlandquarter was enhanced compared to the average dioxin exposure estimated for the Flemish population. Exposure in 1997 was below the exposure in 1980. As a consequence of different eating habits and lower bodyweight, children are subjected to significantly higher exposure than adults. Adverse health outcomes from dioxin exposure in the past cannot be excluded. There was no evidence for enhanced exposure to genotoxicants based on a comparison of chromosomal damage to blood cells of children from the study area to those from a control group.

Androgens as adjuvant treatment in postmenopausal female patients with rheumatoid arthritis

OBJECTIVE

To examine the possible beneficial effect of androgens in postmenopausal women with active rheumatoid arthritis.

METHODS

107 women participated in a double blind placebo controlled trial to evaluate the effect of 50 mg testosterone propionate intramuscularly every two weeks for one year.

RESULTS

An improvement in ESR, Dutch health assessment questionnaire, and pain was noted. In addition, 21% of patients treated with testosterone fulfilled the ACR improvement criteria after one year, versus only 4% of the placebo group. The treatment was well tolerated.

CONCLUSIONS

Testosterone may improve the general wellbeing of postmenopausal women with active rheumatoid arthritis.

[Comparative clinical study of 2 antibiotic injectable preparations in the treatment of airway infections in veal calves]

The results of a comparative clinical study in which two injectable antibiotic preparations, containing enrofloxacin or neomycin-procaine penicillin were used, are reported. Four outbreaks of pneumonia in 186 calves on two farms were included in the study. Both preparations were used at a dose rate of 1 ml per 20 kg body weight for five, consecutive days. The clinical efficacy of both preparations was high (cure rates of 96 and 98%) and the clinical scores following treatment for each preparation were very much the same throughout the trial period. After the first treatment, more than 50% of the animals were considered to be healthy, after three treatments this percentage had increased to more than 80%.