Prevalence and factors associated with active cybersexuality among teenagers between 15 and 17 years old: a cross sectional study in Normandy, France

OBJECTIVE

Teenagers use the Internet to obtain and exchange information in multiple fields, including about taboo subjects such as sexuality. Our objectives were to determine the prevalence and vulnerability factors related to active cybersexuality among teenagers aged between 15 and 17 years in western Normandy.

MATERIAL AND METHODS

This was an observational, cross-sectional, multicenter study integrated into sexual education classes for teenagers between 15 and 17 years old. An anonymous questionnaire, designed for the study, was given at the beginning of each session.

RESULTS

The study had a 4-month duration and involved 1,208 teenagers. The results revealed that 66% of them engaged in cybersex, with sexting being the most widespread practice: 21% sent such sexts, 60% received such sexts, and 12% of boys shared such texts with others. Other practices, such as dedipix, dating websites, and skin parties, were more marginal, but 12% of teenagers had met someone in real life after meeting them first online. A history of experiencing violence, a lack of parental control, female gender, poor self-esteem, and consuming toxic drugs were associated with a higher risk of cybersexuality with an odds ratio (OR) of 1.63, 1.95, 2.07, 2.27, and 2.66, respectively. Number of friends on social networks >300 and daily viewing of pornography were also strongly associated with cybersexuality with an OR of 2.83 and 6.18, respectively.

CONCLUSIONS

This study shows that cybersex is practiced by two thirds of teens. Vulnerability factors most strongly associated with cybersexuality were female gender, poor self-esteem, consuming toxic drugs, number of friends on social networks >300, and daily viewing of pornography. Cybersexuality involves risks (social exclusion, bullying, dropout, poor self-esteem, breakdown) that are possible to prevent by highlighting this theme during sexual education classes.

Methods used by Canadian dairy farmers for on-farm euthanasia and the emotions associated with the decision and the practice of euthanasia

On-farm euthanasia is complicated in that farmers have to make the decision to end the life of an animal they are caring for. Studies have shown that some culling decisions are made too late, which results in animal welfare issues. However, information about on-farm euthanasia methods and the decision process leading to the euthanasia of an animal is limited. Additionally, emotions and feelings are involved in the decision and the act of euthanasia. The objectives of this study were to describe current practices related to on-farm euthanasia performed by Canadian dairy farmers and to assess the emotions and complex feelings surrounding the act. A cross-sectional study design was used to gather this information through an online questionnaire completed exclusively by Canadian dairy farmers. Data were analyzed descriptively using frequencies, and associations between the participants' characteristics and their practices and emotions regarding on-farm euthanasia were assessed using logistic regression models. A total of 479 dairy farmers from 5 provinces answered the survey. The most commonly used primary method of on-farm euthanasia was a firearm (>70%). Unacceptable euthanasia methods, such as standard 0.22-caliber long rifle for adult cows or no adjunct method following the use of captive bolt, were used by 25%, 18%, and 58% of the participants for calves, replacement animals, and dairy cows, respectively. Ninety-four percent of the participants reported that the farm owner was the person who always or often made the euthanasia decisions. In addition, 32% of the participants reported that the veterinarian always examined the animal before performing euthanasia, 51% reported at least one person received training to perform euthanasia, and 16% reported having a decision tree for euthanasia. Some participants (17%) were troubled with the responsibility for ending the life of their animals, and 19% perceived other people on the farm to be uncomfortable with performing euthanasia. Half of the participants reported that people performing euthanasia on the farm felt at least one related painful emotion or complex feeling, and half reported they had at least one reason to feel anxiety or unease concerning euthanasia. The results of this study showed gaps such as the limited use of acceptable euthanasia methods and decision trees by Canadian dairy farmers, low availability of on-farm training for euthanasia, and variable involvement of veterinarians.

Development of a multivariable prediction model to identify dairy calves too young to be transported to auction markets in Canada using simple physical examination and body weight

Calves born on Eastern Canadian dairy farms that are not kept in the herds are traditionally sold through auction markets and are raised for meat purposes such as veal calves. Since February 2020, a new Canadian federal regulation has forbidden calves <9 d old to be sold through auction markets. However, in the absence of a real-time birth registry consultation system, it would be of interest to look for predictors that could be associated with age to allow identification of calves too young to be transported. In the current retrospective cross-sectional study, 1,178 calves with a declared birth date (411 calves aged <9 d old; 34.9%) were assessed in 2 large Québec auction sites. Easy-to-record covariates [body weight (BW), breed phenotype, and presence of an umbilical cord remnant] as well as other clinical signs (umbilical swelling, enlargement, umbilical pain, wet umbilicus, skin tent, sunken eyes, ocular and nasal secretion, and hide cleanliness) were assessed. Two logistic regression models using age as a dichotomous dependent variable (<9 d old vs ≥9 d old) were built. The first model (model 1) considered all covariates, which were selected after univariable analyses and a backward stepwise selection process, whereas a more pragmatic model (model 2) only included the 3 easy-to-record variables (i.e., BW, breed, umbilical cord). Both models had similar accuracy to detect calves <9 d old (sensitivity of 38.4 and 37.5%, and specificity of 85.7 and 84.6% for model 1 and 2, respectively). Model 2 was subsequently more specifically studied as it employs a faster and easier assessment. Decision thresholds were tested for their robustness based on misclassification cost term (MCT) analysis with various prevalence of calves <9 d old and various costs of false-negative:false-positive ratio. Despite statistical significance, model accuracy, even if refined with MCT analysis, was limited at the individual level, showing the limits of using physical signs and BW or their combination as a reliable proxy of age. The sensitivity of these models to find calves <9 d old was not to be used for monitoring compliance with the Canadian federal regulation. The relatively high model specificity may help to use this model as a rule-in test (i.e., targeting positive calves for further investigation) rather than a rule-out test (due to its low sensitivity).

Evolution des facteurs de risque de forme grave de la COVID-19 à travers les trois vagues à partir des données du PMSI

Introduction

De nombreuses études ont établi une typologie des patients à risque de développer une forme grave de COVID-19. La grande majorité de ces études ne portent que sur la première vague de la COVID-19 alors que les profils à risque de développer des formes graves évoluent après les campagnes de vaccination. Cette étude a pour but d'analyser l’évolution des facteurs de risque cliniques de COVID-19 graves lors des différentes vagues afin d'ajuster l'offre de soins au contexte actuel.

Méthodes

Les données du PMSI du Centre hospitalier intercommunal de Créteil ont été analysées pendant les trois premières vagues de l'épidémie. Les variables cliniques disponibles étaient l’âge, le sexe et les comorbidités connues comme à risque de forme grave. Les formes graves étaient définies par le passage en réanimation, le recours à un support ventilatoire non invasif ou le décès du patient. L'évolution de la typologie des patients à risque a été analysée avec des méthodes classiques comme la régression multivariée ainsi qu'avec des techniques provenant de l'apprentissage automatique et de son sous-domaine qu'est l'explicabilité.

Résultats

Sur 1076 patients hospitalisés, les formes sévères concernaient 29 % (123/429) des patients de la vague 1, 31 % (66/214) de la vague 2 et 18 % (79/433) de la vague 3. Les facteurs de risque de la vague 1 étaient l'âge élevé ( ≥ 70 ans), le sexe masculin, le diabète et l'obésité, tandis que les problèmes cardiovasculaires apparaissaient comme des facteurs protecteurs. Les impacts de l'âge, du sexe étaient moins marqués pour la vague 3, de même que l'interaction entre l'âge et les comorbidités.

Discussion/Conclusion

Le profil des patients à risque a rapidement évolué au cours des vagues, la troisième vague ayant eu un écart bien moins net entre les formes sévères et non-sévères. Cette évolution peut provenir des changements des procédures médicales hospitalières ainsi que du début de la campagne de vaccination ciblant en premier lieu les personnes avec un risque élevé telles les personnes âgées ou présentant certaines comorbidités.

Randomized controlled trial of reinsemination strategies in dairy cows diagnosed nonpregnant using color flow Doppler ultrasonography on d 21 after insemination

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We compared 4 reinsemination strategies for use after a Doppler nonpregnancy diagnosis.

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Two of these strategies provided better results than the others.

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Benefiting from an early nonpregnancy diagnosis allowed improvements in subsequent reproduction.

The objective of this study was to quantify the reproductive performance of 4 reinsemination strategies in cows diagnosed nonpregnant using corpus luteum color flow Doppler ultrasonography on d 21 after last insemination. A total of 2,140 color flow Doppler ultrasonography exams from 845 Holstein cows from 10 commercial dairy herds were used in this study. Farms were visited every 2 wk by the research team. On d 7 after insemination, cows were enrolled in a randomized controlled trial to be assigned 1 of 4 treatments if they were subsequently diagnosed nonpregnant on d 21. All cows were then examined on d 21 using Doppler ultrasonography to diagnose nonpregnancy. Treatment A (CON) was the control group: nonpregnant cows were programmed to receive a standard Ovsynch protocol starting on d 32. Nonpregnant cows in treatment B (GnRH) were injected i.m. with GnRH on d 21 after insemination and reinseminated immediately. Cows in treatment C (2×GnRH) received an i.m. injection of GnRH on d 11 after insemination. If diagnosed nonpregnant on d 21 after insemination, they were injected i.m. with GnRH on d 21 after insemination and inseminated immediately. Cows in treatment D (Resynch) received an i.m. injection of GnRH on d 14 after insemination. If diagnosed nonpregnant on d 21 after insemination, they were injected i.m. with PGF_2α on d 21 after insemination and injected i.m. with GnRH on d 24. Then, a standard Ovsynch protocol was started on d 32. Statistical analyses were performed using mixed logistic regression models accounting for cow clustering and herd effect. A theoretical simulation was performed for each treatment to quantify the proportion of cows remaining nonpregnant 42 d after initial insemination. Of the 2,140 color flow Doppler ultrasonography exams in the study, 870 (40.6%) had a Doppler score of D0 (n = 444) or D1 (n = 426), which were indicative of nonpregnancy and used for data analysis. Overall, the number of exams assigned to each treatment was as follows: CON = 223 (25.6%), GnRH = 214 (24.6%), 2×GnRH = 220 (25.3%), and Resynch = 213 (24.5%). The final mixed multivariable logistic regression model included treatment, parity, days in milk at enrollment, and herd. Conception risk at first insemination following enrollment was 31.4, 20.6, 31.9, and 48.7% for treatments CON, GnRH, 2×GnRH, and Resynch, respectively. Based on the simulation, if 100 cows were diagnosed nonpregnant at their color flow Doppler ultrasonography exam on d 21 after last insemination, the total number of cows remaining nonpregnant 42 d after the initial insemination would be 69, 72, 58, and 51 for treatments CON, GnRH, 2×GnRH, and Resynch, respectively. Thus, the treatments used in groups 2×GnRH and Resynch for cows diagnosed nonpregnant on d 21 after insemination yielded better results than those used in the other groups.

Randomized controlled trial of pegbovigrastim as an adjunct therapy for naturally occurring severe clinical mastitis cases in dairy cows

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Treatment with pegbovigrastim increased survival after a case of severe clinical mastitis.

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Treatment with pegbovigrastim had no effect on subsequent bacteriological cure.

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Treatment with pegbovigrastim had no effect on subsequent milk production.

The main objective of this study was to quantify the effect of pegbovigrastim (PEG) as an adjunct therapy for naturally occurring severe mastitis cases on survival, intramammary bacteriological cure, and subsequent milk production. A double-blinded, randomized controlled trial was conducted on a single commercial dairy farm. During the study period, all cows having a case of severe clinical mastitis, defined as the presence of abnormal milk and inflammation in one quarter or more combined with the presence of systemic signs (pyrexia, dehydration, or recumbency), were enrolled in the study. In addition to a standardized therapy combining systemic and intramammary antimicrobials as well as systemic anti-inflammatory drugs, cows received a subcutaneous injection of either 2.7 mL of 0.9% sterile saline (control group; CON) or 2.7 mL of PEG (PEG group). A milk sample for bacteriological analysis was taken before treatment was administered and a second sample was taken 14 d after enrollment. Survival (30 d post-treatment) and bacteriological cure (14 d post-treatment) were analyzed by survival analysis and chi-squared tests, respectively, whereas daily milk production was treated as a repeated measure in mixed regression models. The 77 cows enrolled in the study were of parity 2 to 4 (mean = 3) and between 3 and 302 d in milk (mean = 154). The bacteria identified in milk at enrollment were Klebsiella spp. (n = 48; 62%), Escherichia coli (n = 16; 21%), Enterobacter spp. (n = 10; 13%), or no growth (n = 3; 4%). The probability of survival during the first 30 d after treatment was higher in the PEG group (84%) than in the control group (46%). Daily milk production over the 30-d period following treatment and bacteriological cure 14 d post-treatment did not differ between groups. Overall, cows treated with PEG as an adjunct therapy for naturally occurring cases of severe clinical mastitis had a better survival than cows treated with saline.

An 8-week freeze-dried blueberry supplement impacts immune-related pathways: a randomized, double-blind placebo-controlled trial

Background

Blueberries contain high levels of polyphenolic compounds with high in vitro antioxidant capacities. Their consumption has been associated with improved vascular and metabolic health.

Purpose

The objective was to examine the effects of blueberry supplement consumption on metabolic syndrome (MetS) parameters and potential underlying mechanisms of action.

Methods

A randomized double-blind placebo-controlled intervention trial was conducted in adults at risk of developing MetS. Participants consumed 50 g daily of either a freeze-dried highbush blueberry powder (BBP) or a placebo powder for 8 weeks (n = 49). MetS phenotypes were assessed at weeks 0, 4 and 8. Fasting blood gene expression profiles and plasma metabolomic profiles were examined at baseline and week 8 to assess metabolic changes occurring in response to the BBP. A per-protocol analysis was used.

Results

A significant treatment effect was observed for plasma triglyceride levels that was no longer significant after further adjustments for age, sex, BMI and baseline values. In addition, the treatment*time interactions were non-significant therefore suggesting that compared with the placebo, BBP had no statistically significant effect on body weight, blood pressure, fasting plasma lipid, insulin and glucose levels, insulin resistance (or sensitivity) or glycated hemoglobin concentrations. There were significant changes in the expression of 49 genes and in the abundance of 35 metabolites following BBP consumption. Differentially regulated genes were clustered in immune-related pathways.

Conclusion

An 8-week BBP intervention did not significantly improve traditional markers of cardiometabolic health in adults at risk of developing MetS. However, changes in gene expression and metabolite abundance suggest that clinically significant cardiometabolic changes could take longer than 8 weeks to present and/or could result from whole blueberry consumption or a higher dosage. BBP may also have an effect on factors such as immunity even within a shorter 8-week timeframe.

Clinical trial registration

clinicaltrials.gov, NCT03266055, 2017

Supplementary Information

The online version contains supplementary material available at 10.1186/s12263-021-00688-2.

Short communication: Efficacy of a second intrauterine cephapirin infusion for the treatment of purulent vaginal discharge and endometritis in postpartum dairy cows

The objective of this study was to quantify the efficacy of a second intrauterine cephapirin treatment administered 14 d after the initial one on subsequent reproductive performance of postpartum dairy cows affected by purulent vaginal discharge (PVD) or endometritis (ENDO). In total, 4,140 Holstein cows from 30 commercial herds were enrolled in a randomized clinical trial. At 36 (±7) d in milk, cows were examined using the Metricheck device to diagnose PVD. An endometrial cytology sample was also collected from each cow to perform a leukocyte esterase test for diagnosing ENDO. Diagnosis of PVD and ENDO was done cow-side. Cows diagnosed with PVD or ENDO were assigned to receive 1 of 2 treatments: (1) a single intrauterine cephapirin infusion (500 mg of cephapirin benzathin; Metricure, Merck Animal Health, Kirkland, QC, Canada) at the time of initial examination or (2) a single intrauterine infusion at the time of initial examination and a second one 14 d later. Subsequent reproductive and culling events were collected until 200 d in milk. Statistical analyses were performed using univariable and multivariable mixed logistic regression models. In cows affected by PVD, a second intrauterine cephapirin infusion increased the pregnancy risk at first insemination in comparison with cows that only received one treatment (28.0 vs. 38.8%). In cows affected by ENDO, a second treatment also increased the pregnancy risk at first insemination compared with cows that only received one treatment (30.3 vs. 39.2%). Overall, these results demonstrate that administering a second intrauterine cephapirin infusion 14 d after the initial treatment in postpartum cows affected by PVD or ENDO did improve their subsequent reproductive performance.

Short communication: Accuracy of corpus luteum color flow Doppler ultrasonography to diagnose nonpregnancy in dairy cows on day 21 after insemination

The main objective of this study was to determine the accuracy of corpus luteum color flow Doppler ultrasonography (CLCFDU) to diagnose nonpregnant dairy cows 21 d after insemination. A secondary objective was to determine the accuracy of other indirect tests such as corpus luteum size and progesteronemia. Data from 1,632 Holstein cows (10 commercial herds) were used for the analysis in this prospective cohort study. The herds were visited weekly by a veterinarian and an animal health technician. During farm visits, cows were examined on d 21 after insemination using transrectal B-mode ultrasonography to quantify the presence and size of the corpus luteum. After identification of the corpus luteum, CLCFDU was performed and scored as D0, D1, D2, or D3 when 10% or less, between 11 and 30%, between 31 and 60%, or 61% or more of the corpus luteum surface was colored, respectively. A blood sample from coccygeal vessels was also collected to quantify progesteronemia. Farmers were blinded to these findings and no intervention was performed following examination. On d 32 after insemination, the cows were examined by the regular herd veterinarian using transrectal palpation and B-mode ultrasonography to determine whether the cows were pregnant or not (the reference test). Statistical analyses were conducted using 2 × 2 contingency tables. The apparent prevalence, sensitivity, specificity, positive predictive value, and negative predictive value of CLCFDU for predicting nonpregnancy were 22.0, 36.6, 99.0, 98.1, and 52.0%, respectively, when using D0 only as the diagnostic criterion; they were 47.2, 76.4, 94.8, 93.5, and 73.8%, respectively, for D0+D1 criteria. The same measures for cows with a corpus luteum <15 mm were 8.0, 11.7, 97.5, 86.9, and 43.4%, respectively, and they were 51.9, 67.4, 70.4, 76.6, and 60.0%, respectively, for progesteronemia <1 ng/mL. The measures of accuracy of CLCFDU to identify nonpregnant cows on d 21 after insemination were high, and the apparent prevalence varied depending on the diagnostic criteria used. The measures of accuracy of corpus luteum size (<15 mm) for the same purpose were high; however, apparent prevalence was low. The measures of accuracy of progesteronemia (<1 ng/mL) were low. In conclusion, CLCFDU had excellent accuracy to diagnose nonpregnancy in dairy cows on d 21 after insemination.

P08.03 Separation and divorce after the diagnosis of child’s brain tumor

BACKGROUND

The diagnosis of a child’s brain tumor is a terrible situation for every member of the family. Numerous are the case of separations and divorces in Italy after a diagnosis of a child’s cancer. In particular, it happens with parents of children affected with brain tumor, being the most frequent solid tumor and the first cause of a tumor child’s death. The crisis related to the discovery of a tumor consists of four phases: shock, reaction, processing and re-orientation. It can happen that the diagnosis, experienced as a traumatic experience, can unite the family members as well as separate them. If there is already a process of family disintegration, a trauma can be a cause for breakup. The aim of our study was to investigate the possible correlation between brain tumor diagnosis in children and parental separations/divorces.

MATERIAL AND METHODS

We considered 427 patients afferent from 2012 to 2018 to the Neuro-Oncology Unit of the Meyer Children’s Hospital. Brain tumors are the 55–60% of all the tumors of our hospital, with an extra-regionality greater than 65%. The data analysis was conducted through information obtained directly from the families during follow-up visits or by telephone interviews.

RESULTS

Consistent with literature data in our series, the most frequent brain tumors were low-grade gliomas medulloblastomas, high-grade gliomas, ependymomas, midline diffuse gliomas, craniopharyngiomas, germ cell tumors and other rare pediatric tumors. The population was divided in 16 females and 18 males from different Italian regions: 65% from Central Italy, 23% from the South and Islands, 12% from the North. Data analysis showed 34 cases of separation and/or divorce, equal to 7% of our whole population, during treatment and more frequently at the end of treatment or after death. The median age of the 34 patients at the diagnosis of brain tumor was 9.5 years (range 1–19 years), with a higher percentage of cases of separations (41%) for parents of patients aged 10 years-14 years; 7 were the cases of separation and/or divorce when the diagnosis of brain tumor was made around 12–48 months after the child birth.

CONCLUSION

The diagnosis of a child’s brain tumor can generate stress in the family leading to different reactions, such as conflicts between parents or a real family crisis. The results of our study suggest a possible correlation between the diagnosis of a child’s brain tumor and the cases of separation and/or divorce. High risk medulloblastomas and high-grade gliomas that are likely to have a shorter path due to the unfavorable prognosis of the disease, appear to be the pathologies more often related to situations of family disputes. However, further investigations are necessary to verify the trend emerged from our study respect to the normal population.

Associations Between Dietary Protein Sources, Plasma BCAA and Short-Chain Acylcarnitine Levels in Adults

Elevated plasma branched-chain amino acids (BCAA) and C3 and C5 acylcarnitines (AC) levels observed in individuals with insulin resistance (IR) might be influenced by dietary protein intakes. This study explores the associations between dietary protein sources, plasma BCAA levels and C3 and C5 ACs in normal weight (NW) or overweight (OW) individuals with or without metabolic syndrome (MS). Data from 199 men and women aged 18⁻55 years with complete metabolite profile were analyzed. Associations between metabolic parameters, protein sources, plasma BCAA and AC levels were tested. OW/MS+ consumed significantly more animal protein (p = 0.0388) and had higher plasma BCAA levels (p < 0.0001) than OW/MS- or NW/MS- individuals. Plasma BCAA levels were not associated with BCAA intakes in the whole cohort, while there was a trend for an association between plasma BCAA levels and red meat or with animal protein in OW/MS+. These associations were of weak magnitude. In NW/MS- individuals, the protein sources associated with BCAA levels varied greatly with adjustment for confounders. Plasma C3 and C5 ACs were associated with plasma BCAA levels in the whole cohort (p < 0.0001) and in subgroups based on OW and MS status. These results suggest a modest association of meat or animal protein intakes and an association of C3 and C5 ACs with plasma BCAA levels, obesity and MS.

A rheological model for immersed corrugated elastic plates

The influence of surface imperfections on the propagation of guided waves in an immersed elastic plate can be interpreted by means of a rheological model. The corrugated surface is modeled by a very thin interface, similar to a Jones spring model, which replaces the continuity boundary conditions at the liquid - corrugated solid-plate interface. As the surrounding liquid is considered to be perfect, only one complex stiffness is used for the model of Jones. The selection of the plate guided mode and the test frequency are motivated by the detectability and non-interference with other modes. The spring stiffness is obtained by a best fit procedure, between the analytical solution and the results obtained by the finite elements method (FEM). One way ensuring the agreement of the two approaches, rheological and FEM, is to consider angular resonances provided by the transmission coefficients. Small changes in the parameters of the roughness keep the positions of the angular resonances of the plate practically unchanged, while at the same time large variations of the half width of the transmission coefficient curve is observed. The effect of corrugation parameters on the guided modes in the plate can be predicted by using the rheological model with the deduced spring complex stiffness.

[Medico-economic impact of an innovative management of CHF by HF unit]

Chronic heart failure remains a frequent, severe and costly disease. Despite encouraging data from different countries, heart failure clinics are scarce in France. We have analyzed the impact of a heart failure clinic (UTIC of Pontoise) in terms of reduction of rehospitalizations and in hospitalization costs in 4855 consecutive patients. In our study, heart failure clinic management dramatically reduces HF related hospitalizations (RRR: -28 %, P=0.001) and HF related costs (55% reduction, P<0.001) regardless of comorbidities or disease severity. HF clinics have to be developed in France in order to optimize management of CHF and reduce the HF related costs.

Determinants of Physicians' Intention to Collect Data Exhaustively in Registries: an Exploratory Study in Bamako's Community Health Centres

BACKGROUND

The incomplete collection of health data is a prevalent problem in healthcare systems around the world, especially in developing countries. Missing data hinders progress in population health and perpetuates inefficiencies in healthcare systems.

OBJECTIVE

This study aims to identify the factors that predict the intention of physicians practicing in community health centres of Bamako, Mali, to collect data exhaustively in medical registries.

DESIGN

A cross sectional study.

METHOD

In January and February 2011, we conducted a study with a random sample of thirty two physicians practicing in community health centres of Bamako, using a questionnaire. Data was analyzed by using descriptive statistics, correlations and linear regression.

MAIN OUTCOMES MEASURES

Trained investigators administered a questionnaire measuring physicians' sociodemographic and professional characteristics as well as constructs from the Theory of Planned Behaviour.

RESULTS

Our results showed that physicians' intention to collect data exhaustively is influenced by subjective norms and by the physician's number of years in practice.

CONCLUSIONS

the results of this study could be used as a guide for health workers and decision makers to improve the quality of health information collected in community health centers.

Quantitative proton imaging from multiple physics processes: a proof of concept

Proton imaging is developed in order to improve the accuracy of charged particle therapy treatment planning. It makes it possible to directly map the relative stopping powers of the materials using the information on the energy loss of the protons. In order to reach a satisfactory spatial resolution in the reconstructed images, the position and direction of each particle is recorded upstream and downstream from the patient. As a consequence of individual proton detection, information on the transmission rate and scattering of the protons is available. Image reconstruction processes are proposed to make use of this information. A proton tomographic acquisition of an anthropomorphic head phantom was simulated. The transmission rate of the particles was used to reconstruct a map of the macroscopic cross section for nuclear interactions of the materials. A two-step iterative reconstruction process was implemented to reconstruct a map of the inverse scattering length of the materials using the scattering of the protons. Results indicate that, while the reconstruction processes should be optimized, it is possible to extract quantitative information from the transmission rate and scattering of the protons. This suggests that proton imaging could provide additional knowledge on the materials that may be of use to further improve treatment planning.

Melissa officinalis extract induces apoptosis and inhibits proliferation in colon cancer cells through formation of reactive oxygen species

PURPOSE

Efficient strategies for the prevention of colon cancer are extensively being explored, including dietary intervention and the development of novel phytopharmaceuticals. Safe extracts of edible plants contain structurally diverse molecules that can effectively interfere with multi-factorial diseases such as colon cancer. In this study, we describe the antiproliferative and proapoptotic effects of ethanolic lemon balm (Melissa officinalis) leaves extract in human colon carcinoma cells. We further investigated the role of extra- and intracellular reactive oxygen species (ROS).

METHODS

Antitumor effects of lemon balm extract (LBE) were investigated in HT-29 and T84 human colon carcinoma cells. Inhibition of proliferation was analyzed by DNA quantification. The causal cell cycle arrest was determined by flow cytometry of propidium iodide-stained cells and by immunoblotting of cell cycle regulator proteins. To investigate apoptosis, cleavage of caspases 3 and 7 was detected by immunoblotting and fluorescence microscopy. Phosphatidylserine externalization was measured by Annexin V assays. Mechanistic insights were gained by measurement of ROS using the indicator dyes CM-H2DCFDA and Cell ROX Green.

RESULTS

After 3 and 4 days of treatment, LBE inhibited the proliferation of HT-29 and T84 colon carcinoma cells with an inhibitory concentration (IC50) of 346 and 120 µg/ml, respectively. Antiproliferative effects were associated with a G2/M cell cycle arrest and reduced protein expression of cyclin dependent kinases (CDK) 2, 4, 6, cyclin D3, and induced expression of cyclin-dependent kinase inhibitor 2C (p18) and 1A (p21). LBE (600 µg/ml) induced cleavage of caspases 3 and 7 and phosphatidylserine externalization. LBE-induced apoptosis was further associated with formation of ROS, whereas quenching of ROS by antioxidants completely rescued the colon carcinoma cells from LBE-induced apoptosis.

CONCLUSIONS

Lemon balm (Melissa officinalis) extract inhibits the proliferation of colon carcinoma cells and induces apoptosis through formation of ROS. Taken together, LBE or subfractions thereof could be used for the prevention of colon cancer.

The impact of tracking system properties on the most likely path estimation in proton CT

Proton CT nowadays aims at improving hadron therapy treatment planning by mapping the stopping power of materials. In order to optimize a spatial resolution of the reconstructed images, the most likely path (MLP) of each proton can be computed. We investigated the errors in the computation of this path due to the configuration of the system, i.e. the spatial resolution of the tracking planes, their material budget, and their positioning. A method for computing the uncertainty in the estimated paths for a given system was derived. The uncertainties upon the entrance and exit of the object were propagated analytically in the path computation. This procedure was then used to evaluate the impact of each parameter, and to compare different systems. We show that the intrinsic characteristics of the system generate an uncertainty in the positions and directions of the particles propagated during the MLP computation. The spatial resolution and material budget of the trackers in particular may affect the path estimation, and thus the spatial resolution of an image.

Ultrasonographic fetal parameters and neonatal survival in somatic cell nuclear transfer-derived beef calves

The objectives of this study were to identify prognostic indicators of calf survival in SCNT-derived beef calves. Ultrasonographic parameters of fetal well-being and development, maternal clinical parameters, and neonatal parameters were evaluated as predictors of calf survival in cows carrying SCNT-derived beef fetuses (n = 38). Calf survival was 61.5% (88.2% female and 40.9% male calves; P = 0.0026). Cow respiratory rate and cow temperature were significantly greater in the nonsurviving (NS) group 1 week prepartum. In surviving (S) calves, fetal heart rate (FHR) decreased during the last 2 weeks of gestation (P < 0.01). However, this final deceleration was not observed in NS calves, resulting in higher FHRs in this group (P < 0.0001). Fetal movement and fluid scores did not differ with calf classification. Mean amniotic fluid depth was smaller in S (5.5 ± 0.7 cm) than NS (8.7 ± 1.4 cm) calves (P = 0.0398). However, mean allantoic fluid depth did not differ (P = 0.6120). There was a significant association between the body weight of calf and the diameter of the fetal aorta (P = 0.0115; r(2) = 0.3762). Surviving calves were lighter at birth (P = 0.0028) and were born later (P = 0.007) than NS calves. Calves born vaginally had a smaller fetal aorta (2.1 ± 0.1 cm vaginal and 2.4 ± 0.1 cm Cesarean) (P = 0.0487) and a lighter birth weight (41.4 ± 4.2 kg vaginal and 60.4 ± 2.1 kg Cesarean) (P = 0.0001) than calves born by Cesarean. Also, calves that underwent spontaneous labor (52.2% S and 0% NS; P = 0.0029) had a lighter birth weight (44.9 ± 3.8 kg) than calves that did not initiate labor (61.6 ± 2.2 kg) (P = 0.0004). Frequent ultrasonographic fetal monitoring allowed identification of differences between S and NS calves. Calves without a final decrease in FHR or with a large aortic diameter were more likely to require a Cesarean because of failure to initiate labor or fetomaternal disproportion. Parameters of fetal well-being and development during the last 3 weeks of gestation were first described in SCNT-derived beef calves.

[Pharmacovigilance of calcineurin inhibitor in peidatric kidney and liver transplantation]

AIM

To develop a pharmacovigilance program of calcineurin inhibitors used in pediatric renal and liver transplant patients at Hospital de Pediatría JP Garrahan, Argentina.

METHODS

Adverse drug reactions (ADRs) of pediatric patients with kidney and liver transplantation treated with calcineurin inhibitors (cyclosporine and tacrolimus) were evaluated by retrospective review of medical records of patients transplanted between 2010 and 2011. In addition, we carried out active pharmacovigilance since March, 2011. ADRs were reported to the National Health Authority.

RESULTS

A total of 59 patients, 28 kidney transplant and 31 liver tarnsplant patients were analyzed. In both transplants, 60 ADRs to cyclosporine were reported including (number of cases), hypertension (19) and nephrotoxicity (6). In addition, 46 ADRs to tacrolimus were registered as hypomagnesemia (25), hypertension (7) and nephrotoxicity (5). A total of 95% and 96% of the adverse events to cyclosporine and tacrolimus, respectively, were defined as probable or definitive. Lastly, 70% and 98% of the events to cyclosporine and tacrolimus respectively, have been moderately severe or severe.

CONCLUSIONS

This is the first study in Latin America that developed an intensive qualitative and quantitative analysis of the ADRs to calcineruin inhibitors in pediatric kidney and liver transplant patients. Spontaneous reporting should be motivated as well as monitoring ADRs should continue in the medium and long term for improving patient's quality of life.

Proton computed tomography from multiple physics processes

Proton CT (pCT) nowadays aims at improving hadron therapy treatment planning by mapping the relative stopping power (RSP) of materials with respect to water. The RSP depends mainly on the electron density of the materials. The main information used is the energy of the protons. However, during a pCT acquisition, the spatial and angular deviation of each particle is recorded and the information about its transmission is implicitly available. The potential use of those observables in order to get information about the materials is being investigated. Monte Carlo simulations of protons sent into homogeneous materials were performed, and the influence of the chemical composition on the outputs was studied. A pCT acquisition of a head phantom scan was simulated. Brain lesions with the same electron density but different concentrations of oxygen were used to evaluate the different observables. Tomographic images from the different physics processes were reconstructed using a filtered back-projection algorithm. Preliminary results indicate that information is present in the reconstructed images of transmission and angular deviation that may help differentiate tissues. However, the statistical uncertainty on these observables generates further challenge in order to obtain an optimal reconstruction and extract the most pertinent information.

Corrigendum: Systematic review and meta-analysis of the effect of North American working hours restrictions on mortality and morbidity in surgical patients

No

SHG as a new modality for large field of view imaging to monitor tissue collagen network

For this study, we have considered a new large field of view imaging dedicated to matrix collagen (no stained samples). To integrate a multidimensional scale (non-sliced samples), a femtosecond oscillator (two photon excitation laser) has been coupled with a large field optical setup to collect SHG signal. We introduced an index (F-SHG) based on decay time response measured by TCSPC for, respectively, Fluorescence (F) and Second Harmonic Generation (SHG) values. For samples where protein collagen is the major component of extracellular matrix (skin) or not (nacre), we compared the index distribution (from 2 to 12) obtained with large field optical setup. In this work, we showed for the first time that multiscale large field imaging combined to multimodality approaches (SHG-TCSPC) could be an innovative and non invasive technique to detect and identify some biological interest molecules (collagen) in biomedical topics.

Systematic review and meta-analysis of the effect of North American working hours restrictions on mortality and morbidity in surgical patients

Background

Short duty hours, imposed by the Accreditation Council of Graduate Medical Education (ACGME) regulations, have been claimed to be associated with loss of continuity of care among surgical patients, leading to a potentially increased risk of adverse surgical outcomes. This systematic review and meta-analysis assessed the strength of associations between duty hour restrictions and morbidity and mortality of various surgical procedures.

Methods

MEDLINE, Embase, BIOSIS Previews®, the Education Resources Information Center and the Cochrane Central Register of Controlled Trials (January 2000 to September 2009) were searched, and reports screened to identify comparative studies of mortality and morbidity before and after the introduction of ACGME regulation periods. Random-effects (RE) and quality-effects (QE) meta-analyses were performed to determine the risk of morbidity or death associated with long duty hours compared with shorter duty hours. Results are presented as odds ratio (OR) with 95 per cent confidence interval.

Results

A total of 19 data sets (10 articles), including 730 648 subjects in the mortality studies and 64 346 in the morbidity studies, were analysed. Long duty hours were associated with a non-significantly increased risk of death compared with shorter duty hours (OR 1·28, 0·94 to 1·73). There was no difference in morbidity between the two groups (OR 1·03, 0·67 to 1·57). Mortality associations were generally stronger for general surgery, more recent studies and higher-quality studies. Heterogeneity was evident among the studies included.

Conclusion

The reduction in working hours has not affected patient care negatively in terms of demonstrable differences in morbidity and mortality. However, it cannot be distinguished whether this effect is actually due to a non-detrimental effect of the reduction in working hours or whether any such detriment is offset by continually improving patient care and increased surgical supervision.