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Bipolar disorder (BD) is a heritable disorder characterized by shifts in mood that manifest in manic or depressive episodes. Clinical studies have identified abnormalities of the circadian system in BD patients as a hallmark of underlying pathophysiology. Fibroblasts are a well-established in vitro model for measuring circadian patterns. We set out to examine the underlying genetic architecture of circadian rhythm in fibroblasts, with the goal to assess its contribution to the polygenic nature of BD disease risk. We collected, from primary cell lines of 6 healthy individuals, temporal genomic features over a 48 h period from transcriptomic data (RNA-seq) and open chromatin data (ATAC-seq). The RNA-seq data showed that only a limited number of genes, primarily the known core clock genes such as ARNTL, CRY1, PER3, NR1D2 and TEF display circadian patterns of expression consistently across cell cultures. The ATAC-seq data identified that distinct transcription factor families, like those with the basic helix-loop-helix motif, were associated with regions that were increasing in accessibility over time. Whereas known glucocorticoid receptor target motifs were identified in those regions that were decreasing in accessibility. Further evaluation of these regions using stratified linkage disequilibrium score regression analysis failed to identify a significant presence of them in the known genetic architecture of BD, and other psychiatric disorders or neurobehavioral traits in which the circadian rhythm is affected. In this study, we characterize the biological pathways that are activated in this in vitro circadian model, evaluating the relevance of these processes in the context of the genetic architecture of BD and other disorders, highlighting its limitations and future applications for circadian genomic studies. [ABSTRACT FROM AUTHOR]

Purpose: To systematically review current literature on the treatment of lymphatic malformations (LMs) of the head and neck to guide treatment strategy. Methods and materials: A systematic review and meta-analysis of literature until 16 November 2021 was performed on treatments of LMs in the head and neck. Results: Out of 9044 articles, 54 studies were eligible for inclusion with 26 studies providing detailed participant data. A total number of 1573 patients with a mean age of 21.22 months were analysed. Comparative meta-analysis did not reveal significant differences two proportions of volume reduction (≥ 50% and 100%) between sclerotherapy and surgical treatment. Regression demonstrated that positive predictors for volume reduction were surgery 17 (95% CI 0.26–34; p = 0.047) and treatment of macrocystic lesions 19 (95% CI 5.5–32; p = 0.006). Treatment of mixed lesions also demonstrated a trend towards achieving a greater volume reduction (p = 0.052). A higher de Serres stage of the lesion had a negative effect on the amount of volume reduction − 3.7 (95% CI − 7.0 to − 0.35; p = 0.030). Conclusion: This comprehensive meta-analysis demonstrated no significant difference in volume reduction between various treatment modalities at study level. However, individual patient data indicated that surgery and larger cyst types are associated with a significant higher percentage of volume reduction, whereas a higher de Serres stage negatively impacted the amount of volume reduction. These findings can be used for patient counseling and treatment planning based on cyst type and de Serres stage. However volume reduction constitutes just one objective within a more complex treatment spectrum. [ABSTRACT FROM AUTHOR]

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Mast cells (MCs) are commonly recognized for their crucial involvement in the pathogenesis of allergic diseases, but over time, it has come to light that they also play a role in the pathophysiology of non-allergic disorders including atherosclerosis. The involvement of MCs in the pathology of atherosclerosis is supported by their accumulation in atherosclerotic plaques upon their progression and the association of intraplaque MC numbers with acute cardiovascular events. MCs that accumulate within the atherosclerotic plaque release a cocktail of mediators through which they contribute to neovascularization, plaque progression, instability, erosion, rupture, and thrombosis. At a molecular level, MC-released proteases, especially cathepsin G, degrade low-density lipoproteins (LDL) and mediate LDL fusion and binding of LDL to proteoglycans (PGs). Through a complicated network of chemokines including CXCL1, MCs promote the recruitment of among others CXCR2+ neutrophils, therefore, aggravating the inflammation of the plaque environment. Additionally, MCs produce extracellular traps which worsen inflammation and contribute to atherothrombosis. Altogether, evidence suggests that MCs actively, via several underlying mechanisms, contribute to atherosclerotic plaque destabilization and acute cardiovascular syndromes, thus, making the study of interventions to modulate MC activation an interesting target for cardiovascular medicine. [ABSTRACT FROM AUTHOR]

Human biomonitoring can add value to chemical risk assessment by reducing the assumptions regarding consumption rates, residue occurrence, and processing effects and by integrating exposures from different sources (diet, household use, environmental). However, the relationship between exposure and concentration in human matrices is unknown for most pesticides. Therefore, we conducted a pilot study to gain more insight into the qualitative and quantitative relationship between dietary intake of pesticides (external exposure) and urinary excretion (reflecting internal exposure). In this cross-sectional observational study, 35 healthy consumers aged 18–65 years from the region of Wageningen, Netherlands, collected an exact duplicate portion of their diets during 24 h. On the same day, they also collected all their urine. The duplicate diets were analyzed using target screening by GC- and LC-HRMS; each duplicate diet contained at least five, up to 21, pesticide residues. The 24 h urine samples were analyzed using LC-HRMS in a suspect screening workflow. Metabolites were tentatively detected in all 24 h urine samples, ranging from six metabolites corresponding to four pesticides up to 40 metabolites originating from 16 pesticides in a single urine sample. In total, 65 metabolites originating from 28 pesticides were tentatively detected. After prioritization and additional confirmation experiments, 28 metabolites originating from 10 pesticides were identified with confidence level 1 or 2b. Next, quantitative analysis was performed for a selection of pesticides in duplicate diets and their metabolites in 24 h urine to assess quantitative relationships. In the quantitative comparisons between duplicate diet and 24 h urine, it was found that some metabolites were already present in the duplicate diet, which may give an overestimation of exposure to the parent pesticide based on measurement of the metabolites in urine. Additionally, the quantitative comparisons suggest a background exposure through other exposure routes. We conclude that suspect screening of 24 h urine samples can disclose exposure to mixtures of pesticide on the same day in the general population. However, more research is needed to obtain quantitative relationships between dietary intake and exposure. [ABSTRACT FROM AUTHOR]

Biomass briquettes made from agricultural residues should be strongly recommended for household cooking in countries with high agricultural potential like Cameroon. This paper aims to evaluate the energy recoverable from crop residues by briquette manufacturing and to analyze the benefits and barriers of briquetting conversion of these residues in the country. Agricultural residues considered in this investigation are generated by rice, banana/plantain, maize, groundnut, cotton, coconut, sugarcane, palm oil, coffee, and cocoa. The residues generated by these crops are husks, shells, bagasse, leaves, peels, stalks, straw, and stems. The estimation was done using the Residues-to-Product Ratio method, and the results show that the annual crop residues production is 46,236,156 tons. The briquetting conversion of these residues could produce 7,706,260 tons of biomass briquettes with an annual energy potential of around 106 PJ year−1. It is concluded that the availability of agricultural residues in that country provides an important potential for briquette production. [ABSTRACT FROM AUTHOR]

Background: Ventriculoperitoneal (VP) shunt is the mainstay of surgical management of patients with hydrocephalus. The insertion of ventriculoperitoneal shunt may be accompanied by many potentially life-threatening complications including shunt infection. Concerted efforts have been made to reduce shunt infection rates, including use of saline- antibiotic solutions containing antibiotics such as Gentamicin, mixture of Gentamicin and Vancomycin in shunt system preparation. We therefore set out to determine the infection rates following the use of intraoperative Gentamicin and Vancomycin in ventriculoperitoneal shunt system preparation and compare the infection rates. Therefore, a randomized single blind comparative study was carried out for a period of seventeen months, among 56 patients that presented to 2 tertiary health centers in Nigeria diagnosed of hydrocephalus. Patients were randomized into Vancomycin- and Gentamicin-shunt preparation groups. The outcome measure was postoperative shunt infection rates. Statistical analysis was performed using SPSS software (version) 21. Group comparisons were made using the Student's t-test for numerical variables, and chi-square test or fisher's exact test for categorical variables. Statistical significance was inferred at p-value < 0.05. Result: Fifty-six patients were included in the study. One patient was lost to follow-up in Vancomycin group. Another patient died in Gentamicin group of sudden death without the patient exhibiting symptoms of shunt infection leaving a total of 54 for analysis. All the patients included in the study were followed up for six months. Their mean ages were between 1688.5 ± 665.3 (days) for Vancomycin group and 10,222 ± 6635.8 (days) for Gentamicin group. There was male preponderance of 55.6% as against female of 44.4%. Majority of the hydrocephalus were of congenital cause accounting for 64.8%. There was one shunt infection in the Gentamicin group giving rise to an infection rate of 1.9% which was not statistically significant (P –value—0.313). The organism isolated was Pseudomonas species. Conclusion: Ventriculoperitoneal shunt infection rates can be reduced to the barest minimum if standard concentration of antibiotics is used to prepare the shunt hardware employing a standard surgical technique. [ABSTRACT FROM AUTHOR]

Biofuel briquettes were prepared using banana peels, rattan waste, coconut shells and sugarcane bagasse through a conventional method that involved drying, carbonizing, crushing, mixing with cassava starch as binder, compacting and drying. Briquettes produced were evaluated by proximate analysis using American Society for Testing and Materials (ASTM) standard and European Committee for Standardization (CEN) standard. Results of mass reduction study show that the losses are more important for banana peels (97.98%) and sugarcane bagasse (96%). Bulk density of briquettes produced is in the range 0.470–0.851 cm3/g; results of proximate analysis show that high calorific values of briquettes produced are 16.98, 30.07, 32.16 and 25.93 MJ/kg for banana peels, rattan waste, coconut shells and sugarcane bagasse respectively; of the four different residues used, volatile matters are slowly lower to the recommendation of literature, ash content has values in the range 7.44–11.95%, and moisture content is relatively higher than other agricultural residues especially banana peels and sugarcane bagasse. [ABSTRACT FROM AUTHOR]

Background: The multidisciplinary management of patients with brain metastases consists of surgical resection, radiation treatment and systemic treatment. Tailoring and timing these treatment modalities is challenging. This study presents real-world data from consecutively treated patients and assesses the impact of all treatment strategies and their relation with survival. The aim is to provide new insights to improve multidisciplinary decisions towards individualized treatment strategies in patients with brain metastases. Methods: A retrospective consecutive cohort study was performed. Patients with brain metastases were included between June 2018 and May 2020. Brain metastases of small cell lung carcinoma were excluded. Overall survival was analyzed in multivariable models. Results: 676 patients were included in the study, 596 (88%) received radiotherapy, 41 (6%) awaited the effect of newly started or switched systemic treatment and 39 (6%) received best supportive care. Overall survival in the stereotactic radiotherapy group was 14 months (IQR 5–32) and 32 months (IQR 11–43) in patients who started or switched systemic treatment and initially did not receive radiotherapy. In patients with brain metastases without options for local or systemic treatment best supportive care was provided, these patients had an overall survival of 0 months (IQR 0–1). Options for systemic treatment, Karnofsky Performance Score ≥ 70 and breast cancer were prognostic for a longer overall survival, while progressive extracranial metastases and whole-brain-radiotherapy were prognostic for shorter overall survival. Conclusions: Assessing prognosis in light of systemic treatment options is crucial after the diagnosis of brain metastasis for the consideration of radiotherapy versus best supportive care. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyse the economic viability of cooking biomass briquettes made from coconut shells, rattan waste, banana peels, and sugarcane bagasse by replacing conventional fuels such as fuelwood, charcoal and Liquefied Petroleum Gas (LPG). The life cycle cost method and the sensitivity analysis based on a 10-year lifetime are applied to a typical Cameroonian household with an annual cooking energy requirement of 950 kWh. According to the results, briquettes made from coconut shells have the lowest life cycle cost (384.6€), while those made from banana peels have the highest cost (729.6€). The fuelwood replacement has the highest present value of net benefit. Among the three conventional fuels investigated, wood charcoal is the cheapest. Changes in the price of conventional fuels and the market discount rate affect the economic feasibility of biomass briquettes. With the exception of the banana peel briquettes, briquettes are more cost-effective than fuelwood, wood charcoal and Liquefied Petroleum Gas. Decision makers should consider ways to include massive household use of biomass briquettes in sustainable development because they could be a leading mover in sustainable development. [ABSTRACT FROM AUTHOR]

Background: Huntington's disease (HD) is a genetic, neurodegenerative disease. Due to the progressive nature of HD and the absence of a cure, (health-related) quality of life ((HR)QoL) is an important topic. Several studies have investigated (HR)QoL in HD, yet a clear synthesis of the existing literature is lacking to date. We performed a systematic review on self-reported (HR)QoL, and factors and intervention effects associated with (HR)QoL in premanifest and manifest HD gene expansion carriers (pHDGECs and mHDGECs, respectively). Methods: PubMed, EMBASE, Web of Science, and PsycINFO were searched systematically from September 17th, 2021, up to August 11th, 2022. Methodological and conceptual quality of the included studies was assessed with two appraisal tools. Results: 30 out of 70 eligible articles were included. mHDGECs experienced lower (HR)QoL compared to pHDGECs and controls, whereas mixed findings were reported when compared to other neurological diseases. Several factors were associated with (HR)QoL that might contribute to lower (HR)QoL in mHDGECs, including depressive symptoms, physical and psychological symptoms, lower functional capacity, lower support, and unmet needs. Multidisciplinary rehabilitation programs and a respiratory muscle training were beneficial for (HR)QoL in mHDGECs. Discussion: (HR)QoL is experienced differently across the course of the disease. Although (HR)QoL is key for understanding the impact of HD and the effect of symptomatic treatment, there is a need to improve the methodological and conceptual shortcomings that were found in most studies, especially regarding the conceptual clarity when reporting on QoL and HRQoL. Suggestions for strengthening these shortcomings are provided in this review. [ABSTRACT FROM AUTHOR]

Purpose: To relate [18F]fluoride uptake on PET with abnormalities on magnetic resonance imaging (MRI) and conventional radiography (CR) in ankylosing spondylitis (AS) patients. Methods: Ten clinically active AS patients (female 6/10, age 38 ± 11 years) were included, and both spine and SI-joints were examined. PET scans were dichotomously scored for enhanced [18F]fluoride uptake, MRI scans were scored for fatty lesions, erosions, ankylosis, and bone marrow edema (BME), and CR was scored for erosions, syndesmophytes, and ankylosis. The overlap of lesions across all modalities was evaluated through univariate and multivariate analyses using a generalized mixed model. Results: In the spine, 69 lesions with enhanced [18F]fluoride uptake, 257 MRI lesions, and 88 CR lesions were observed. PET lesions were mostly located in costovertebral and facet joints, outside the field of view (FOV) of the MRI and CR. However, PET lesions inside the FOV of MRI and CR partially showed no abnormality on MRI and CR. In lesions with abnormalities on multiple modalities, both univariate and multivariate analysis showed that PET activity had the strongest association with BME on MRI and ankylosis on CR. In the SI joints, 15 lesions (75%) with PET uptake were found, with 87% showing abnormalities on MRI and CR. Conclusion: [18F]fluoride PET lesions are often found outside the scope of MRI and CR, and even in the same location show only partial overlap with abnormalities on MRI (especially BME) and CR (especially ankylosis). This suggests that [18F]fluoride PET partially visualizes aspects of AS separate from MRI and CR, providing novel information. Clinical trial registration: NL43223.029.13 registered at 02-05-2013. https://www.toetsingonline.nl/to/ccmo_search.nsf/fABRpop?readform&unids=C1257BA2002CC066C1257B4E0049A65A [ABSTRACT FROM AUTHOR]

The effects of hydrolysis by commercial food-grade proteases on the physicochemical and techno-functional properties of lentil protein concentrate were investigated. Lentil protein concentrate was hydrolysed with Alcalase, Novozym 11028 or Flavourzyme, and a control was prepared without enzyme addition under the same conditions. Differences in specificity between the three proteases were evident in the electrophoretic protein profile, reversed-phase HPLC peptide profile, and free amino acid composition. Alcalase and Novozym were capable of extensively degrading all the major protein fractions. Alcalase or Novozym treatment resulted in considerably higher solubility under acidic conditions compared to the control. Flavourzyme treatment resulted in moderately improved solubility in the acidic range, but slightly lower solubility at pH 7. Alcalase treatment resulted in slightly larger particle size and slightly higher viscosity. The foaming properties of the protein concentrate were not significantly affected by hydrolysis. Increased solubility in acidic conditions with hydrolysis could broaden the range of food and beverage applications for lentil protein concentrate. [ABSTRACT FROM AUTHOR]

Mast cells have been associated with the progression and destabilization of advanced atherosclerotic plaques. Reducing intraplaque mast cell accumulation upon atherosclerosis progression could be a potent therapeutic strategy to limit plaque destabilization. Leukotriene B4 (LTB4) has been reported to induce mast cell chemotaxis in vitro. Here, we examined whether antagonism of the LTB4-receptor BLT1 could inhibit mast cell accumulation in advanced atherosclerosis. Expression of genes involved in LTB4 biosynthesis was determined by single-cell RNA sequencing of human atherosclerotic plaques. Subsequently, Western-type diet fed LDLr−/− mice with pre-existing atherosclerosis were treated with the BLT1-antagonist CP105,696 or vehicle control three times per week by oral gavage. In the spleen, a significant reduction in CD11b+ myeloid cells was observed, including Ly6Clo and Ly6Chi monocytes as well as dendritic cells. However, atherosclerotic plaque size, collagen and macrophage content in the aortic root remained unaltered upon treatment. Finally, BLT1 antagonism did not affect mast cell numbers in the aortic root. Here, we show that human intraplaque leukocytes may be a source of locally produced LTB4. However, BLT1-antagonism during atherosclerosis progression does not affect either local mast cell accumulation or plaque size, suggesting that other mechanisms participate in mast cell accumulation during atherosclerosis progression. [ABSTRACT FROM AUTHOR]

Unexpectedly, granular materials can fail, the structure even destroyed, spontaneously in simple isotropic compression with stick-slip-like frictional behaviour. This extreme behaviour is conceptually impossible for saturated two-phase assembly in classical granular physics. Furthermore, the triggering mechanisms of these laboratory events remain mysterious, as in natural earthquakes. Here, we report a new interpretation of these failures in under-explored isotropic compression using the time-frequency analysis of Cauchy continuous wavelet transform of acoustic emissions and multiphysics numerical simulations. Wavelet transformation techniques can give insights into the temporal evolution of the state of granular materials en route to failure and offer a plausible explanation of the distinctive hearing sound of the stick-slip phenomenon. We also extend the traditional statistical seismic Gutenberg–Richter power-law behaviour for hypothetical biggest earthquakes based on the mechanisms of stick-slip frictional instability, using very large artificial isotropic labquakes and the ultimate unpredictable liquefaction failure. [ABSTRACT FROM AUTHOR]

Twenty-five patients with reflux cholangitis (RC) defined as acute cholangitis (AC) with normal abdominal imaging occurring > 3 months after bilioenteric anastomosis were described and compared to 116 AC patients with biliary obstruction (tumoral, lithiasis). RC episodes occurred a median 4.5 months after surgery; 18 (72%) had recurrent RC (n ≥ 3). RC episodes were less severe than obstructive AC; the outcome was favorable with short antibiotic courses and no selection of antibiotic-resistance. However, multiple recurrent RC occurred in 20 patients (80%). Prophylactic or pre-emptive antibiotics were successful in 3 and 11 patients. Revision surgery for jejunal loop lengthening was successful in 2/4 patients. [ABSTRACT FROM AUTHOR]

Remote health assessments that gather real-world data (RWD) outside clinic settings require a clear understanding of appropriate methods for data collection, quality assessment, analysis and interpretation. Here we examine the performance and limitations of smartphones in collecting RWD in the remote mPower observational study of Parkinson's disease (PD). Within the first 6 months of study commencement, 960 participants had enrolled and performed at least five self-administered active PD symptom assessments (speeded tapping, gait/balance, phonation or memory). Task performance, especially speeded tapping, was predictive of self-reported PD status (area under the receiver operating characteristic curve (AUC) = 0.8) and correlated with in-clinic evaluation of disease severity (r = 0.71; P < 1.8 × 10−6) when compared with motor Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Although remote assessment requires careful consideration for accurate interpretation of RWD, our results support the use of smartphones and wearables in objective and personalized disease assessments. Smartphone sensors that monitor disease symptoms enable remote assessment of Parkinson's patients. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to investigate the associations of dispositional mindfulness and its facets with diet quality in Dutch adults with type 1 diabetes and type 2 diabetes and to evaluate the potential mediating role of emotional distress in these associations. Methods: This was a cross-sectional study using data from the Diabetes MILES-The Netherlands. In total, 296 adults with type 1 diabetes and 364 with type 2 diabetes completed questionnaires. We assessed dispositional mindfulness by the Five Facet Mindfulness Questionnaire-Short Form, including total mindfulness and five facets: observing, describing, acting with awareness, being non-judgmental, and being non-reactive, and diet quality by the Dutch Healthy Diet 2015-index. Linear regression models were used to estimate the association. Mediation effects of depressive symptoms, anxiety symptoms, and diabetes-related distress were evaluated using the PROCESS macro with bias-corrected bootstrapped confidence intervals. Results: Higher scores on the total mindfulness (β = 0.14, p = 0.02) and the observing facet (β = 0.15, p = 0.01) were significantly associated with higher diet quality in people with type 1 diabetes only, after adjustment for demographic factors. These associations were not mediated by depressive symptoms, anxiety symptoms, or diabetes-related distress. In adults with type 1 diabetes (but not type 2), higher dispositional mindfulness levels were associated with more optimal diet quality. Conclusions: Higher mindfulness in general and observing in particular were related to a healthier diet with higher quality in Dutch adults with type 1 diabetes. Further longitudinal studies are warranted to understand the temporal relationship between mindfulness and diet quality. [ABSTRACT FROM AUTHOR]

We conducted an observational retrospective study of all adults hospitalized for documented varicella-zoster virus (VZV) meningitis or encephalitis during years 2000–2015 in one referral centre. Thirty-six patients (21 males, 15 females) were included, with meningitis (n = 21), or meningoencephalitis (n = 15). Median age was 51 years [interquartile range, 35–76], and 6 patients (17%) were immunocompromised. Aciclovir was started in 32 patients (89%), with a median dose of 11 mg/kg/8 h [10–15]. No patient died, but 12 (33%) had neurological sequelae at discharge. Age was the only variable associated with adverse outcome (OR 1.98 [1.17–3.35] per 10-year increment, P = 0.011). [ABSTRACT FROM AUTHOR]

Summary: This systematic review and meta-analysis suggests that fracture liaison service (FLS) is associated with a significantly lower probability of subsequent fractures and mortality although the latter was only found in studies comparing outcomes before and after the introduction of an FLS. Introduction: To systematically review and evaluate the impact of fracture liaison services (FLSs) on subsequent fractures and mortality using meta-analysis. Methods: A literature search was performed within PubMed and Embase to identify original articles published between January 1, 2010, and April 30, 2020, reporting the effect of FLSs on subsequent fractures and/or mortality. Only studies comparing FLS to no-FLS were included. A meta-analysis using random-effects models was conducted. The quality of studies was appraised after combining and modifying criteria of existing quality assessment tools. Results: The search retrieved 955 published studies, of which 16 studies fulfilled the inclusion criteria. Twelve studies compared outcomes before (pre-FLS) and after (post-FLS) FLS implementation, two studies compared outcomes between hospitals with and without FLS, and two other studies performed both comparisons. In total, 18 comparisons of FLS and no-FLS care were reported. Follow-up time varied from 6 months to 4 years. Sixteen comparisons reported on subsequent fractures and 12 on mortality. The quality assessment revealed methodological issues in several criteria. Excluding studies with very high selection bias, the meta-analysis of nine comparisons (in eight papers) revealed that the FLS care was associated with a significantly lower probability of subsequent fractures (odds ratio: 0.70, 95% CI: 0.52–0.93, P=0.01). In studies with a follow-up > 2 years, a significantly lower probability of subsequent fractures was captured for FLS care (odds ratio: 0.57, 95% CI: 0.34–0.94, P=0.03), while in studies ≤ 2 years, there was no difference in the odds of subsequent fractures. No significant difference in the odds of mortality was observed (odds ratio: 0.73, 95% CI: 0.49–1.09, P=0.12) in the meta-analysis of eight comparisons (in seven papers). However, a significantly lower probability of mortality was identified in the six pre-post FLS comparisons (odds ratio: 0.65, 95% CI: 0.44–0.95, P=0.03), but not in studies comparing hospitals with and without FLS. No difference was observed in mortality stratified by follow-up time. Conclusion: This systematic review and meta-analysis suggests that FLS care is associated with a significantly lower probability of subsequent fractures and mortality although the latter was only found in studies comparing outcomes before and after the introduction of an FLS. The quality assessment revealed that some important methodological issues were unmet in the currently available studies. Recommendations to guide researchers to design high-quality studies for evaluation of FLS outcomes in the future were provided. [ABSTRACT FROM AUTHOR]

Precise stereotactic targeting of the dorsolateral motor part of the subthalamic nucleus (STN) is paramount for maximizing clinical effectiveness and preventing side effects of deep brain stimulation (DBS) in patients with advanced Parkinson's disease. With recent developments in magnetic resonance imaging (MRI) techniques, direct targeting of the dorsolateral part of the STN is now feasible, together with visualization of the motor fibers in the nearby internal capsule. However, clinically relevant discrepancies were reported when comparing STN borders on MRI to electrophysiological STN borders during microelectrode recordings (MER). Also, one should take into account the possibility of a 3D inaccuracy of up to 2 mm of the applied stereotactic technique. Pneumocephalus and image fusion errors may further increase implantation inaccuracy. Even when implantation has been successful, suboptimal lead anchoring on the skull may cause lead migration during follow-up. Meticulous pre- and intraoperative imaging is therefore indispensable, and so is postoperative imaging when the effects of DBS deteriorate during follow-up. Thus far, most DBS centers employ MRI targeting, multichannel MER, and awake test stimulation in STN surgery, but randomized trials comparing surgery under local versus general anesthesia and additional studies comparing MER-STN borders to high-field MRI-STN may change this clinical practice. Further developments in imaging protocols and improvements in image fusion processes are needed to optimize placement of DBS leads in the dorsolateral motor part of the STN in Parkinson's disease. [ABSTRACT FROM AUTHOR]

Purpose: The SARS-CoV-2 infection can lead to a severe acute respiratory distress syndrome (ARDS) with prolonged mechanical ventilation and high mortality rate. Interestingly, COVID-19-associated ARDS share biological and clinical features with sepsis-associated immunosuppression since lymphopenia and acquired infections associated with late mortality are frequently encountered. Mechanisms responsible for COVID-19-associated lymphopenia need to be explored since they could be responsible for delayed virus clearance and increased mortality rate among intensive care unit (ICU) patients. Methods: A series of 26 clinically annotated COVID-19 patients were analyzed by thorough phenotypic and functional investigations at days 0, 4, and 7 after ICU admission. Results: We revealed that, in the absence of any difference in demographic parameters nor medical history between the two groups, ARDS patients presented with an increased number of myeloid-derived suppressor cells (MDSC) and a decreased number of CD8pos effector memory cell compared to patients hospitalized for COVID-19 moderate pneumonia. Interestingly, COVID-19-related MDSC expansion was directly correlated to lymphopenia and enhanced arginase activity. Lastly, T cell proliferative capacity in vitro was significantly reduced among COVID-19 patients and could be restored through arginine supplementation. Conclusions: The present study reports a critical role for MDSC in COVID-19-associated ARDS. Our findings open the possibility of arginine supplementation as an adjuvant therapy for these ICU patients, aiming to reduce immunosuppression and help virus clearance, thereby decreasing the duration of mechanical ventilation, nosocomial infection acquisition, and mortality. [ABSTRACT FROM AUTHOR]

The present study investigates the effect of oil type on the formation, morphology and mechanical properties of phytosterol-based organogels. The formation of organogels can be satisfactorily predicted with a criterion based on Hansen Solubility Parameters (HSPs), provided that the sterol and sterol ester in these systems assemble as tubules. When structures other than tubules are formed, the predictability of the HSP-based criterion becomes void. In cases where organogelling occurred, the morphology and mechanical properties of the tubular network of the gels and water-in-oil emulsions were investigated. The findings revealed that the structure of the tubular network formed in oils with different compositions, could be grouped based on the dielectric constants of the oils. Curly and bundled tubules which formed networks, were observed in gels prepared with low dielectric constant oils (i.e. decane and limonene). For oils with a moderate dielectric constant (i.e. castor oil and sunflower oil), the tubules became less curly and straighter. Upon increasing the dielectric constant of the oil (eugenol), individual tubules were observed next to the bundled tubules. The results showed that straighter, bundled tubules are associated with firmer gels, whereas less straight (i.e. curly) tubules rendered weaker gels. The tubular network of the water-in-oil emulsions obtained for oils with a low dielectric constant appeared more open with straighter tubules. For oils with relatively high dielectric constant, the water-in-oil emulsions lost most of their tubular structure and only a few tubules could be observed. In the presence of emulsion droplets fewer tubules are formed, resulting in weaker networks. [ABSTRACT FROM AUTHOR]

We report high-temporal-resolution observations of the spontaneous instability of model granular materials under isotropic and triaxial compression in fully drained conditions during laboratory tests representative of earthquakes. Unlike in natural granular materials, in the model granular materials, during the first stage of the tests, i.e., isotropic compression, a series of local collapses of various amplitudes occurs under random triggering cell pressures. During the second stage, i.e., shearing under triaxial compression, the model granular samples exhibit very large quasiperiodic stick-slip motions at random deviatoric triggering stresses. These motions are responsible for very large stress drops that are described by power laws and are accurate over more than 3 decades in logarithmic space. Then, we identify the quasideterministic nature of these stick-slip events, assuming that they are fully controlled by the cell pressure and solid fraction. Finally, we discuss the potential mechanisms that could explain these intriguing behaviors and the possible links with natural earthquakes. [ABSTRACT FROM AUTHOR]

Background: Considering the heavy economic burden of osteoporotic fractures, the limits of healthcare resources, and the recent availability of new anti-osteoporosis drugs, there is continuing interest in economic evaluation studies of osteoporosis management strategies. Objectives: This study aims to (1) systematically review recent economic evaluations of drugs for osteoporosis and (2) to apply an osteoporosis-specific guideline to critically appraise them. Methods: A literature search was undertaken using PubMed, EMBASE, National Health Service Economic Evaluation database, and the Cost-Effectiveness Analysis Registry to identify original articles containing economic evaluations of anti-osteoporosis drugs, published between 1 July, 2013 and 31 December, 2019. A recent European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases-International Osteoporosis Foundation (ESCEO-IOF) guideline for the conduct and reporting of economic evaluations in osteoporosis was used to assess the quality of included articles. Results: The database search retrieved 3860 records, of which 27 studies fulfilled the inclusion criteria. These studies were conducted in 15 countries; 12 active drugs were assessed, including various traditional pharmacological treatments such as bisphosphonates, raloxifene, strontium ranelate, denosumab, and teriparatide, and new agents such as abaloparatide, romosozumab, and gastro-resistant risedronate. Eight out of 12 studies that compared traditional oral bisphosphonates to other active interventions (denosumab, zoledronic acid, gastro-resistant risedronate, and teriparatide) suggested that the other active agents were generally cost-effective or dominant. Additionally, the cost-effectiveness of sequential therapy has recently been assessed and indications are that it can lead to extra health benefits (larger gains in quality-adjusted life-year). The key drivers of cost effectiveness included baseline fracture risk, drug effect on the risk of fractures, drug cost, and medication adherence/persistence. The current average score for quality assessment was 17 out of 25 (range 2–15); room for improvement was observed for most studies, which could potentially be explained by the fact that most studies were published prior to the osteoporosis-specific guideline. Greater adherence to guideline recommendations was expected for future studies. The quality of reporting was also suboptimal, especially with regard to treatment side effects, treatment effect after discontinuation, and medication adherence. Conclusions: This updated review provides an overview of recently published cost-effectiveness analyses. In comparison with a previous review, recent economic evaluations of anti-osteoporosis drugs were conducted in more countries and included more active drugs and sequential therapy as interventions/comparators. The updated economic evidence could help decision makers prioritize health interventions and the unmet/unreported quality issues indicated by the osteoporosis-specific guideline could be useful in improving the transparency, quality, and comparability of future economic evaluations in osteoporosis. [ABSTRACT FROM AUTHOR]

Purpose: Food-based dietary guidelines are proposed to not only improve diet quality, but to also reduce the environmental impact of diets. The aim of our study was to investigate whether food-related behavioral activation therapy (F-BA) applying Mediterranean-style dietary guidelines altered food intake and the environmental impact of the diet in overweight adults with subsyndromal symptoms of depression. Methods: In total 744 adults who either received the F-BA intervention (F-BA group) or no intervention (control group) for 12 months were included in this analysis. Food intake data were collected through a food frequency questionnaire at baseline and after 6 and 12 months. Greenhouse gas emissions (GHGE), land use (LU), and fossil energy use (FEU) estimates from life-cycle assessments and a weighted score of the three (pReCiPe score) were used to estimate the environmental impact of each individual diet at each timepoint. Results: The F-BA group reported increased intakes of vegetables (19.7 g/day; 95% CI 7.8–31.6), fruit (23.0 g/day; 9.4–36.6), fish (7.6 g/day; 4.6–10.6), pulses/legumes (4.0 g/day; 1.6–6.5) and whole grains (12.7 g/day; 8.0–17.5), and decreased intake of sweets/extras (− 6.8 g/day; − 10.9 to − 2.8) relative to control group. This effect on food intake resulted in no change in GHGE, LU, and pReCiPe score, but a relative increase in FEU by 1.6 MJ/day (0.8, 2.4). Conclusions: A shift towards a healthier Mediterranean-style diet does not necessarily result in a diet with reduced environmental impact in a real-life setting. Trial registration: ClinicalTrials.gov. Number of identification: NCT02529423. August 2015. [ABSTRACT FROM AUTHOR]

Parasitic diseases of dogs are now major economic and public health issues in Nigeria due to indiscriminate reproduction of dogs, lack of appropriate policies on pet ownership and diseases control as well as inadequate veterinary care. In order to understand the prevalence, seasonal variation and distribution of parasitic diseases of dogs in this region of Nigeria, the present study conducted a 30-year retrospective analysis in the referral veterinary centre, Vom, and analysed data using the Chi square test and the factor analysis. Of the 26,844 dogs handled between January 1986 and December 2015, 17,663 (65.8%) had different parasitic diseases. Yearly distribution of parasitic diseases varied significantly (p < 0.0001) and ranged between 52.0 and 85.4%. Age, seasonal and disease specific prevalence rates ranged between 2.8 and 80.5%. Prevalence rates in females 78.2% (95% CI 77.6–78.9) and indigenous breed 70.0% (95% CI 69.2–70.7) were significantly higher (p < 0.0001) from those of the males 47.2% (95% CI 46.2–48.1) and exotic breeds of dogs 60.7% (95% CI 59.8–61.6), respectively. Ancylostomosis was the most prevalent (15.9%) disease while Barkin Ladi recorded the highest regional prevalence. It is pertinent to enact appropriate disease control policies and observe control programmes including vector control and improved hygiene to curtail the economic and public health threats associated with these diseases. [ABSTRACT FROM AUTHOR]

Most studies on sediment transport and bedforms migration consider unlimited sediment supply conditions. However, areas where the sediment supply is limited are common in coastal and fluvial environments. The present paper, based on physical modelling in a flume and on a re-analysis of field data obtained in the Eastern English Channel by Ferret (Morphodynamique des dunes sous-marines en contexte de plate-forme mégatidale (manche orientale). approche multi-échelles spatio-temporelles, 2011), considers the effects of sediment supply limitation on bedload transport and bedforms migration velocity. The bedload transport is found to be proportional to the fraction of the bed covered by sediments for a bed exhibiting bedforms. The migration velocity of bedforms depends on the dominant mode of sediment transport. A new formulation showing a good agreement with experimental tests and observations in the field is proposed for the dimensionless migration velocity of these bedforms when sediment transport is dominated by bedload, under unlimited sediment supply conditions. For limited sediment supply conditions and sediment transport dominated by bedload, an adaptation of the formulation is suggested from flume data sets, based on the fraction of the bed covered by sediment. [ABSTRACT FROM AUTHOR]

Cost-effective preventive interventions are necessary for tackling the increasing number of hip fractures, which are frequently occuring as a serious consequence of osteoporosis. Several interventions have been available for preventing and treating osteoporosis. The aim of this study was to systematically review and critically appraise studies that assessed cost-effectiveness of hip protectors for the prevention of hip fractures and to investigate the effects of age, gender and residence situation on cost-effectiveness. A systematic review was conducted in order to identify economic evaluation studies examining the hip protector solely or compared to no treatment according to the Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Synthesis of results was performed to observe trends between the studies. Methodological quality of the studies was assessed by the use of the Quality of Health Economic Studies (QHES) instrument. A total of 15 economic evaluation studies were included for analysis. The methodological quality was high in most studies (13/15). The hip protector was solely evaluated in three studies and within 12 other studies compared with no intervention. All studies that investigated the cost-effectiveness in long-term care facilities revealed that hip protector use is a cost-effective strategy for the prevention of hip fractures in elderly. Cost-effectiveness was also observed in two studies that provided hip protectors in a geriatric hospital ward. Four studies included both community-dwelling residents and residents living in a long-term care facility in their study. These studies showed more variability regarding cost-effectiveness. One study did not report information regarding the residence situation of their cohort, but also observed cost-effectiveness. In conclusion, this review suggests that hip protectors are a cost-effective approach in the prevention of hip fractures in populations with high risk of hip fractures especially in long-term care facilities and a geriatric ward in a hospital. [ABSTRACT FROM AUTHOR]

Objective: To prevent complications following decompressive craniectomy (DC), such as sinking skin flap syndrome, studies suggested early cranioplasty (CP). However, several groups reported higher complication rates in early CP. We studied the clinical characteristics associated with complications in patients undergoing CP, with special emphasis on timing. Methods: A single-center observational cohort study was performed, including all patients undergoing CP from 2006 to 2018, to identify predictors of complications. Results: 145 patients underwent CP: complications occurred in 33 (23%): 18 (12%) epi/subdural hemorrhage, 10 (7%) bone flap infection, 4 (3%) hygroma requiring drainage, and 1 (1%) post-CP hydrocephalus. On univariate analysis, acute subdural hematoma as etiology of DC, symptomatic cerebrospinal fluid (CSF) flow disturbance (hydrocephalus) prior to CP, and CP within three months after DC were associated with higher complication rates. On multivariate analysis, only acute subdural hematoma as etiology of DC (OR 7.5; 95% CI 1.9–29.5) and symptomatic CSF flow disturbance prior to CP (OR 2.9; 95% CI 1.1–7.9) were associated with higher complication rates. CP performed within three months after DC was not (OR 1.4; 95% CI 0.5–3.9). Pre-CP symptomatic CSF flow disturbance was the only variable associated with the occurrence of epi/subdural hemorrhage. (OR 3.8; 95% CI 1.6–9.0) Conclusion: Cranioplasty has high complication rates, 23% in our cohort. Contrary to recent systematic reviews, early CP was associated with more complications (41%), explained by the higher incidence of pre-CP CSF flow disturbance and acute subdural hematoma as etiology of DC. CP in such patients should therefore be performed with highest caution. [ABSTRACT FROM AUTHOR]

Purpose: Adherence to the Mediterranean diet has been associated with fewer depressive symptoms, however, it is unknown whether this is attributed to some or to all components. We examined the association between the individual food groups of the Mediterranean Diet Score (MDS), in isolation and in combination, with depression and anxiety (symptom severity and diagnosis). Methods: Data from 1634 adults were available from the Netherlands Study of Depression and Anxiety. Eleven energy-adjusted food groups were created from a 238-item food frequency questionnaire. In regression analysis, these were associated in isolation and combination with (1) depressive and anxiety disorders (established with the Composite International Diagnostic Interview) (current disorder n = 414), and (2) depression and anxiety severity [measured with the Inventory of Depressive Symptomatology (IDS), the Beck Anxiety Inventory (BAI) and the Fear Questionnaire (FEAR)]. Results: Overall, the MDS score shows the strongest relationships with depression/anxiety [Diagnosis: odds ratio (OR) 0.77 per SD, 95% confidence interval (95% CI) 0.66–0.90, IDS: standardised betas (β) − 0.13, 95% CI − 0.18, − 0.08] and anxiety (BAI: β − 0.11, 95% CI − 0.16, − 0.06, FEAR: β − 0.08, 95% CI − 0.13, − 0.03). Greater consumption of non-refined grains and vegetables was associated with lower depression and anxiety severity, whilst being a non-drinker was associated with higher symptom severity. Higher fruit and vegetable intake was associated with lower fear severity. Non-refined grain consumption was associated with lower odds and being a non-drinker with greater odds of current depression/anxiety disorders compared to healthy controls, these associations persisted after adjustment for other food groups (OR 0.82 per SD, 95% CI 0.71–0.96, OR 1.26 per SD 95% CI 1.08–1.46). Conclusion: We can conclude that non-refined grains, vegetables and alcohol intake appeared to be the driving variables for the associated the total MDS score and depression/anxiety. However, the combined effect of the whole diet remains important for mental health. It should be explored whether an increase consumption of non-refined grains and vegetables may help to prevent or reduce depression and anxiety. [ABSTRACT FROM AUTHOR]

The expected increase of maritime activities in the North Sea and the growing awareness of its natural environmental value require enhanced science-based environmental advice for more efficient and effective marine management. The North Sea Open Science Conference organised by the Royal Belgian Institute of Natural Sciences and the Belgian Biodiversity Platform in 2016 aimed to take stock of the present-day scientific knowledge on the North Sea ecosystem, its interactions with human activities and its management. The conference was structured along three themes: (1) 'the scientific backbone of the North Sea ecosystem: adequacy of the knowledge base?', (2) 'A new era in environmental monitoring and assessment: what is at stake?', and (3) 'Sustainability: one for all, all for one?'. Focusing on 'open science', we welcomed about 200 participants from around the North Sea with different backgrounds and interests in environmental sciences. The participants were challenged to reflect on current and future challenges for the North Sea management and, in particular, to explore possible nature-friendly solutions for addressing these challenges during a series of introductory oral (69) and poster (59) presentations, and World Café and Fish Bowl participatory sessions. The participants agreed on six main actions to (1) provide a solid scientific base for marine management decisions; (2) develop society-driven research; (3) increase interdisciplinary science; (4) recognise the need for system knowledge; (5) improve communication, knowledge exchange, and collective implementation of scientific knowledge; and (6) build integrated knowledge bases. For each of these, concrete action points were identified, and this review gives the most important and relevant ones for creating the knowledge base and managerial framework for a sustainable North Sea. [ABSTRACT FROM AUTHOR]

Soil abiotic factors and plant traits are able to trigger bottom-up effects along the tri-trophic plant–herbivore–natural enemy interactions. The consequences could be useful for controlling the insect herbivores. The South American tomato pinworm, Tuta absoluta Meyrick (Lepidoptera: Gelechiidae), a devastating invasive leaf-mining pest on tomato and other solanaceous plants, is currently threatening the tomato production worldwide. Recent knowledge of bottom-up effects on this pest has been gained, with fertilization, irrigation, plant resistance traits, as well as their interactions, being the major sources of these effects. Evidence is now emerging on how they impact on the performance of the moth from the perspective of tri-trophic interactions. In this review, we summarize the essential experiments studying the bottom-up effects on T. absoluta and discuss the implications of those findings for the Integrated Pest Management programs. Future promising research directions are then proposed. [ABSTRACT FROM AUTHOR]

Recycled and vanadium-doped materials prepared from the recycling waste electrodes of spent car battery and V2O5 powder produce excellent electrochemical performances when used as a negative electrode in a car battery. The recycled and vanadium-doped samples having different V2O5 compositions (x = 0, 1, 5, 8, 10, 15, and 20%) were characterized by the analysis of X-ray diffraction (XRD), SEM, and spectroscopic investigations: IR, Raman, UV-Vis, PL, and EPR. The electrochemical characterizations of the recycled and vanadium-doped materials as anodic electrodes in a lead acid battery are performed by cyclic voltammetry measurements. The results of this study indicate that the V2O5 addition in the suitable proportion at recycled lead exerts a positive effect on the hydrogen gas evolutions, the passivation phenomena and electrochemical processes of self-discharge, and charge and discharge in lead acid battery. This, in turn, has the most beneficial impact on the life cycle of car batteries. The excellent electrochemical performance of recovered lead material may be attributed to the presence of a PbO2 crystalline phase which can accommodate high amounts of hydrogen and the presence of vanadium ions which increase the residual current and the effective conductive area in the potential range of 0 and 2 V. The vanadium-lead electrodes can significantly improve the stability and electrical performance of batteries and have great potential in energy storage and conversion applications. [ABSTRACT FROM AUTHOR]

Background: Melanoma-associated antigen-A (MAGE-A) and programmed-death ligand 1 (PD-L1) are present in urothelial carcinoma (UC). We assessed survival outcomes in patients with MAGE-A and PD-L1 expression. Methods: MAGE-A and PD-L1 expression on neoplastic cells was analyzed using tissue microarrays from patients with UC. We compared differential expression between disease stage and grade. MAGE-A and PD-L1 co-expression was subcategorized. Fisher's exact test was done for categorical variables followed by univariable and multivariable analysis of recurrence-free survival (RFS) and progression-free survival (PFS). Results: Co-expression of MAGE+/PD-L1+ was higher in advanced disease; however, only MAGE+/PD-L1− was associated with shorter RFS [hazard ratio (HR) 1.89; 95% confidence interval (CI) 1.19–2.99; p =.006]. MAGE+/PD-L1+ was associated with the worst PFS (HR 17.1; 95% CI 5.96–49.4; p ≤.001). MAGE-A expression was more prevalent with high-grade (p =.015), and higher-stage ≥ pT2 (p =.001) disease. The 5-year RFS was 44% for MAGE+ versus 58% for MAGE− patients. On multivariable analysis, MAGE+ was also associated with shorter RFS (HR 1.55; 95% CI 1.05–2.30; p =.03). Similarly, MAGE+ was associated with shorter PFS (HR 3.12; 95% CI 1.12–8.68; p =.03). Conclusion: MAGE-A and PD-L1 expression is increased in advanced disease and associated with shorter PFS. Furthermore, MAGE-A expression was significantly associated with higher-grade and -stage disease and associated with shorter RFS and PFS. The worse prognosis associated with MAGE-A+/PD-L1+ provides evidence that a combinatorial treatment strategy co-targeting MAGE/PD-L1 might be feasible. Further studies are needed to validate these findings. [ABSTRACT FROM AUTHOR]

With interest we took notice of the recent paper by Hickman and colleagues on the over-representation of Amyotrophic Lateral Sclerosis (ALS) pathology in Huntington Disease (HD) brains [[4]]. One could argue that reassessment of the I initial i neuropathology reports, of both HD and ET brains, gives a higher a priori likelihood of finding ALS neuropathology in HD brains than in ET brains, based on their clinical overlap and common neurodegenerative pathomechanisms. Comment on: Amyotrophic lateral sclerosis is over-represented in two Huntington's disease brain bank cohorts: further evidence to support genetic pleiotropy of pathogenic HTT gene expansion. [Extracted from the article]