Higher Absolute Number Research Articles

Examining health literacy in the Danish general population: a cross-sectional study on the associations between individual factors and healthcare-seeking behaviour.

Knowledge about health literacy challenges among the general population is valuable for initiatives targeting social inequity in health. We investigated health literacy in various population groups and the impact of healthcare-seeking behaviour by analysing the associations between (i) lifestyle, socioeconomics, self-rated health, chronic disease, and health literacy and (ii) symptom burden, contact to general practitioner (GP), and health literacy. In total, 27488 individuals participated in a population-based survey. Questionnaire data comprised information about symptoms, GP contact, lifestyle, self-rated health, chronic disease, and four aspects of health literacy: feeling understood and supported by healthcare providers, having sufficient information about health, having social support for health, and being able to actively engage with healthcare providers. Socioeconomics were obtained from registers. Descriptive statistics and multivariable linear regression models were applied. Individuals who smoked, lived alone, had different ethnicity than Danish, and low self-rated health had more health literacy challenges reflected in lower scores for all aspects of health literacy. Individuals with high symptom burden and those who had presented a high absolute number of symptoms to their GP were less likely to have sufficient information about health and be able to actively engage, whereas individuals reporting GP contact with a high relative percentage of their symptoms were more likely to feel understood and supported by healthcare providers. Health literacy challenges are related to healthcare-seeking behaviour and several individual factors. To address social inequity in health and society, interventions aimed at both the individual and community-based health literacy are essential.

Retracted articles in scientific literature: A bibliometric analysis from 2003 to 2022 using the Web of Science

Retractions serve a crucial role in maintaining the integrity and accuracy of scientific literature. There has been growing interest in understanding the patterns behind retractions. This bibliometric study analyzed retracted articles published between 2003 and 2022, indexed by the Science Citation Index Expanded of the Web of Science Core Collection database. A total of 8466 retracted articles were identified, revealing an overall increase up to 2019, followed by a decline. A total of 109 countries contributed to the retracted articles, with China and the United States having the highest absolute numbers. In addition, the articles were published in 2347 different journals, with Tumor Biology recording the largest number of retracted articles. The top 10 most cited retracted articles indicated that data and image integrity issues were the main reasons for retraction. The primary reasons for retractions, identified by linking the retracted articles to the Retraction Watch Database, were data and results issues followed by plagiarism and duplication. In conclusion, the present bibliometric study offered an overview of the status of retracted articles indexed by the Web of Science Core Collection over the past two decades. These findings provide insight into areas where scientific integrity may be compromised and serve as a guide to foster a responsible research environment.

Impact of mediastinal tumor burden and lymphatic spread in locally advanced non-small-cell lung cancer: A secondary analysis of the multicenter randomized PET-Plan trial

PurposeThe aim of this secondary analysis of the prospective randomized phase 2 PET-Plan trial (ARO-2009-09; NCT00697333) was to evaluate the impact of mediastinal tumor burden and lymphatic spread in patients with locally advanced non-small-cell lung cancer (NSCLC). MethodsAll patients treated per protocol (n = 172) were included. Patients received isotoxically dose-escalated chemoradiotherapy up to a total dose of 60–74 Gy in 30–37 fractions, aiming as high as possible while adhering to normal tissue constraints. Radiation treatment (RT) planning was based on an 18F-FDG PET/CT targeting all lymph node (LN) stations containing CT positive LNs (i.e. short axis diameter > 10 mm), even if PET-negative (arm A) or targeting only LN stations containing PET-positive nodes (arm B). LN stations were classified into echelon 1 (ipsilateral hilum), 2 (ipsilateral station 4 and 7), and 3 (rest of the mediastinum, contralateral hilum). The endpoints were overall survival (OS), progression-free survival (PFS), and freedom from local progression (FFLP). ResultsThe median follow-up time (95 % confidence interval [CI]) was 41.1 (33.8 − 50.4) months. Patients with a high absolute number of PET-positive LN stations had worse OS (hazard ratio [HR] = 1.09; 95 % CI 0.99 − 1.18; p = 0.05) and PFS (HR = 1.12; 95 % CI 1.04 − 1.20; p = 0.003), irrespective of treatment arm allocation. The prescribed RT dose to the LNs did not correlate with any of the endpoints when considering all patients. However, in patients in arm B (i.e., PET-based selective nodal irradiation), prescribed RT dose to each LN station correlated significantly with FFLP (HR=0.45; 95 % CI 0.24–0.85; p = 0.01). Furthermore, patients with involvement of echelon 3 LN stations had worse PFS (HR = 2.22; 95 % CI 1.16–4.28; p = 0.02), also irrespective of allocation. ConclusionMediastinal tumor burden and lymphatic involvement patterns influence outcome in patients treated with definitive chemoradiotherapy for locally advanced NSCLC. Higher dose to LNs did not improve OS, but did improve FFLP in patients treated with PET-based dose-escalated RT.

Ethnodemographic Processes in the Border Regions of Asian Russia in the New Conditions of the Turn to the East

The analysis of ethnodemographic processes is relevant not only because of the negative demographic trends growing in the regions of Asian Russia, but also in connection with Russia’s turn to the East. The authors of the article give a detailed description of the modern ethnic composition of the population in the regions of the Ural, Siberian, and Far Eastern Federal Districts of the Russian Federation and the regions bordering them, those of Kazakhstan, China, and Mongolia. The object of the study were Russians, Kazakhs, Tuvinians, Mongols, and Chinese. Special attention is paid to the analysis of their number and location, and the identification of factors and consequences of changes in the ethnic composition of the population. A definitive feature of the border regions is the high proportion and absolute number of those peoples who make up the majority of the population of neighboring States. At the same time, the demographic behavior of the peoples living on different sides of the border differs. In studying the ethnodemographic processes, the increasing demographic asymmetry between the regions of Russia and neighboring states causes the greatest attention and certain concern. In the regions of the Asian part of Russia, the total population is decreasing, largely due to Russians who have a predominant model of reproduction of the population with a low birth rate and relatively high mortality. Kazakhs, Buryats, and Tuvinians in Russia are characterized by stable numbers and reproduction, although there is a tendency to decrease the birth rate. In the border areas of Kazakhstan, the tendency towards a decrease in the number of the Russian population and its replacement by a titular nationality does not weaken.

Differential responses of genotype × environment interaction on Agronomic interventions affect the yield and quality of essential oil of interspecific basil hybrid of Ocimum basilicum L. × Ocimum kilimandscharicum

The investigations on interspecific hybrid basil were carried out in two distinct agro-climatic regions of India: Lucknow (Uttar Pradesh) and Rangareddy (Telangana). The experiment used an RCBD replicated thrice in each trial in each of the three seasons/environments: Jaid, Karief, and Rabi. The morphological and chemical changes of an interspecific basil hybrid/variety were studied across environments/seasons, and locations. All morphological traits and essential oil production are affected by the environment/seasons and location. The essential oil production and linalool concentration were found to be consistent. A high-quality linalool essential oil was discovered throughout the environment and locales. The biplot contrasted the test seasons/environments, as well as the researched locations and their interactions, visually. The ‘r' correlation between measured (M) and predicted (P) values was 0.998, and the predicted (P), means, and instability values (I) were all calculated using ATC coordinates. The ‘r' between GGE distance (GD) and entry means was also −0.952. This means that a higher absolute number indicates less stability, whereas a lower absolute value indicates a high level of stability. In summary, significant amounts of linalool-rich essential oil were obtained in the Northern Region (Lucknow) during the Jaid season (69.76 %) and the Southern Region (Hyderabad) during the Rabi season (69.88 %). This hybrid/variety's linalool content and essential oil yield averaged 190.78 kg/ha across seasons/environments and locations, with a linalool content of 67.91 %. Due to its high yield of top-notch linalool essential oil, the basil hybrid/variety that is particularly stable in terms of essential oil yield with high linalool content across seasons and places should be suggested for large-scale cultivation.

Aarey conservation: A multifaceted opportunity for climate mitigation in an urban setting

Abstract Citizens of the world are bracing themselves to combat and mitigate cataclysmic climate crisis. Recurrent climate accidents are leaving behind millions of climate refugees, who flock to urban centers in search of safety and security. Overcrowded metropolitan cities are highly vulnerable due to their high human densities and absolute numbers of residents and migrants. A well-connected network of urban green zones (UGZs) provides multiple values that enable sustainable climate mitigation and adaptation. The metropolis of Mumbai, with over 24 million humans (Mumbaikars), is fortunate to also have a network of large UGZs and protected areas (PAs), viz. Sanjay Gandhi National Park, Aarey Milk Colony (AMC), Tungareshwar, Thane, Tansa, and Karnala Wildlife Sanctuaries, along with mangrove forests and public parks. However, most PAs restrict entry and climate mitigation actions. AMC, spread over 12.5 km2 provides a unique “mosaic” landscape, inhabited by indigenous communities (Warli and Mahadev Koli), locals, and migrants. The hills, farms, artificial meadows, and built-up complexes, with a good road network and proximity to Mumbai’s suburbs, provide numerous opportunities to achieve the 17 sustainable development goals set out by members of the United Nations Conference of the Parties. The path to achieve climate and resource stability, in the economic capital of the nation, is a precarious one and needs planning and engagement of all stakeholders. Long-term protection of AMC will provide socioeconomic equity as well as ecological and health security to current and future generations of Mumbaikars.

Adverse Events to SARS-CoV-2 (COVID-19) Vaccines and Policy Considerations that Inform the Funding of Safety Surveillance in Low- and Middle-Income Countries: A Mixed Methods Study.

Rapid global approval of coronavirus disease 2019 (COVID-19) vaccines and concurrent introduction in high-income countries and low- and middle-income countries (LMIC) highlights the importance of equitable safety surveillance of adverse events following immunization (AEFIs). We profiled AEFIs to COVID-19 vaccines, explored reporting differences between Africa and the rest of the world (RoW), and analyzed policy considerations that inform strengthening of safety surveillance in LMICs. Using a convergent mixed-methods design we compared the rate and profile of COVID-19 vaccines' AEFIs reported to VigiBase by Africa versus the RoW, and interviewed policymakers to elicit considerations that inform the funding of safety surveillance in LMICs. With 87,351 out of 14,671,586 AEFIs, Africa had the second-lowest crude number and a reporting rate of 180 adverse events (AEs) per million administered doses. Serious AEs (SAEs) were 27.0%. Death accounted for about 10.0% of SAEs. Significant differences were found in reporting by gender, age group, and SAEs between Africa and the RoW. AstraZeneca and Pfizer BioNTech vaccines were associated with a high absolute number of AEFIs for Africa and RoW; Sputnik V contributed a considerably high rate of AEs per 1 million administered doses. Funding decisions for safety surveillance in LMICs were not based on explicit policies but on country priorities, perceived utility of data, and practical implementation issues. African countries reported fewer AEFIs relative to the RoW. To enhance Africa's contribution to the global knowledge on COVID-19 vaccine safety, governments must explicitly consider safety monitoring as a priority, and funding organizations need to systematically and continuously support these programs.

People want to see people? Personalization on Facebook as a tool for corporate communications

PurposeSocial networks were created to connect with friends. Therefore, communication in social networks allows addressing individual contacts of each user and is often rather private by nature. Organizations can use this to communicate frequently and personally with their stakeholders. Therefore, this study investigates how organizations use personalization in their social media communication.Design/methodology/approachThis study uses a quantitative content analysis of Facebook posts from ten large companies (N = 500). The posts were analyzed regarding the sub dimensions of personalization, individualization and privatization, as well as type of post, tonality, emotions, user reactions and topics.FindingsCompanies at least partially personalize their communication on Facebook. Overall, 28% of all posts were personalized. Personalized posts were almost always positive regarding tonality and mostly positive regarding emotions. While the personalized posts in this study have fewer user reactions than non-personalized posts, they still have a rather high absolute number of reactions. Regarding personal characteristics, results show that professional competence and appearance were mainly addressed. Concerning privatization, only very few posts showed an individual in a private setting.Originality/valueThe present work gives an overview of how personalized posts differ from non-personalized posts and looks at depicted individuals as well as the use of private elements. By applying the conceptualization of Van Aelst et al. (2012) and by looking at organizations’ use of personalization on the social media platform Facebook, it sheds light on an area that has not been the center of attention so far and helps to expand the current state of personalization research.

Time-lagged effects of habitat fragmentation on terrestrial mammals in Madagascar.

Biodiversity is severely threatened by habitat destruction. As a consequence of habitat destruction, the remaining habitat becomes more fragmented. This results in time-lagged population extirpations in remaining fragments when these are too small to support populations in the long term. If these time-lagged effects are ignored, the long-term impacts of habitat loss and fragmentation will be underestimated. We quantified the magnitude of time-lagged effects of habitat fragmentation for 157 nonvolant terrestrial mammal species in Madagascar, one of the biodiversity hotspots with the highest rates of habitat loss and fragmentation. We refined species' geographic ranges based on habitat preferences and elevation limits and then estimated which habitat fragments were too small to support a population for at least 100 years given stochastic population fluctuations. We also evaluated whether time-lagged effects would change the threat status of species according to the International Union for the Conservation of Nature (IUCN) Red List assessment framework. We used allometric relationships to obtain the population parameters required to simulate the population dynamics of each species, and we quantified the consequences of uncertainty in these parameter estimates by repeating the analyses with a range of plausible parameter values. Based on the median outcomes, we found that for 34 species (22% of the 157 species) at least 10% of their current habitat contained unviable populations. Eight species (5%) had a higher threat status when accounting for time-lagged effects. Based on 0.95-quantile values, following a precautionary principle, for 108 species (69%) at least 10% of their habitat contained unviable populations, and 51 species (32%) had a higher threat status. Our results highlight the need to preserve continuous habitat and improve connectivity between habitat fragments. Moreover, our findings may help to identify species for which time-lagged effects are most severe and which may thus benefit the most from conservation actions.

Abstract 4198: Evaluation of a cancer immunotherapy with engineered arenavirus vectors and 4-1BB agonists in a preclinical tumor model

Abstract T cells play a central role in immune responses against cancer. Within the tumor, however, T cells are exposed to a plethora of inactivating factors causing various degrees of dysfunction, changes in metabolism and a generally reduced cellular fitness, eventually leading to tumor progression. To prevent or delay the onset of exhaustion and instead augment effector functions and persistence of functional T cells, costimulatory factors and cytokines are needed. Targeting 4-1BB (CD137), a member of the tumor necrosis factor receptor superfamily, has been shown to represent a promising strategy for inducing an activating signal in CD8+ T cells, resulting in increased pro-inflammatory cytokine secretion, cytotoxic function, and survival. Engineered arenavirus vectors based on lymphocytic choriomeningitis virus (LCMV) or Pichinde virus (PICV) have been shown previously to induce massive infiltration of tumor antigen specific CD8+ T cells into the tumor in several preclinical cancer models. To investigate whether enhanced co-stimulation via 4-1BB further improves T cell responses and/or tumor control, combination therapies with replicating LCMV based vectors (artLCMV) and 4-1BB agonists were explored. A single intravenous treatment of artLCMV encoding the tumor associated antigens (TAA) gp70 or Trp2 in B16.F10 tumor bearing mice induced TAA specific CD8+ T cells in both the periphery and the tumor, resulting in tumor growth delay and some complete responses. Combining artLCMV with agonistic anti-4-1BB significantly improved tumor control and increased the number of complete responders. Analysis of tumor infiltrating lymphocytes revealed higher absolute numbers of TAA specific CD8+ T cells in the combination group compared to the artLCMV alone group. Analyses of the TAA specific cells revealed that more cells expressed granzyme B, Ki67 and Bcl-XL when co-stimulated with anti-4-1BB compared to the group treated with artLCMV alone. Importantly, encoding 4-1BBL in addition to a TAA in artLCMV revealed similar outcomes as just summarized for the combination with agonistic antibodies. Overall, these experiments confirmed the strong antigenicity and T cell inducing capacity of the engineered arenavirus platform, leading to efficient tumor control in a stringent mouse model. Combination with 4-1BB agonists, either in form of antibodies or encoded within the vector genome, was shown to further augment TAA-specific T cell responses within the tumor, leading to better tumor growth control and a higher rate of complete responders. Citation Format: Judith Strauss, Marilies Scheinost, Theresa Kleissner, Diana Reckendorfer, Kimberly Pojar, Mohamed Habbeddine, Sarah Ahmadi-Erber, Daniela Deutschmann, Sarah Schmidt, Josipa Raguz, Igor Matushansky, Christoph Lampert, Klaus K. Orlinger, Henning Lauterbach. Evaluation of a cancer immunotherapy with engineered arenavirus vectors and 4-1BB agonists in a preclinical tumor model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 4198.

SURG-16. Pediatric oncology neurosurgery, four years after centralization in the Princess Máxima Center

Abstract INTRODUCTION: In 2018, the Princess Máxima Center officially opened its doors as a national referral center for pediatric oncology in the Netherlands. This centralization of pediatric oncology also reshaped the pediatric neurosurgery landscape. Almost four years after centralization it is time to make up the balance. METHODS: From the start in May 2018, a predesigned database was kept for all neurosurgical procedures performed in the Princess Máxima Center, Utrecht. Data was collected by a well-trained medical student and under close supervision of a pediatric neurosurgeon. Patient demographic data, tumor data (location, pathology), surgical data (approach, intended and obtained extent of resection), radiology data, and follow up data (complications, functional outcome) were collected. PRELIMINARY RESULTS: From May 2018 to December 2021, 783 oncology related surgeries have been performed in 472 individual patients (56% male; mean age 8 years). There were 316 cranial tumor resections, 279 of which were first resections. Pilocytic astrocytoma was the most frequent diagnosis (38%), followed by medulloblastoma (14%) and ependymoma (11%). Among the more rare tumors there were 29 diffuse midline gliomas and 29 craniopharyngiomas, reflecting the high volume after centralization. The extent of tumor resection and Clavien Dindo complication grading are correlated to time after centralization. CONCLUSION: Four years after the start of centralization, the pediatric oncology neurosurgery service in the Netherlands is well established. Clustering has resulted in high absolute numbers, even for rare tumor types, and growing experience. With this series we hope to create an international benchmark for pediatric oncology neurosurgery.

Geographical distribution of prostate cancer clinical trials across the United States.

e18561 Background: Prostate cancer is the second leading cause of cancer-related mortality among males in the United States after lung cancer. Among other factors, physical access to clinical trial site plays a pivotal role in the recruitment process and hence impact outcomes. We aim to study the geographical distribution of phase III and IV prostate cancer clinical trials in the United States. Methods: The United States Cancer Statistics Data Visualisation Tool was utilised to estimate the number of new cases of prostate cancer for the latest available years i.e., 2014-2018. An extensive search was carried out at ClinicalTrials.gov registry using advanced search fields – disease (prostate cancer), sex (male), study type (clinical trial), phase (III and IV), country (United States) and study start (from 01/01/2014 to12/31/2018). The trials which were terminated, withdrawn, or suspended were excluded from the study. Both these tools were further explored to provide state-wise distribution of new trials and cases. Results: Between 2014-2018 in the United States, 997, 454 new prostate cancer cases were reported and 59 phase III & IV clinical trials were made available across 51 states. The average number of new prostate cancer cases and trials per state was 19,558 and 17 (range 45-0) respectively. The states with maximum reported number of new cases were California, New York, Florida, and Texas. These accounted for 30.2% of total cases and only 15.5% of total trials. The states with least reported new cases were Alaska, Vermont, Wyoming, and North Dakota. These accounted for 0.84 % of total cases and 2% of total trials [Table]. The states with the minimum number of trials per case were Mississippi (0.00035), Texas (0.00041), Florida (0.00042), New York (0.00045) and California (0.00047) whereas the states with maximum number of trials per case were Alabama (0.2352), District of Colombia (0.0061), Alaska (0.0054) and Vermont (0.0024). Conclusions: Variation in the availability of phase III and IV clinical trials for newly diagnosed prostate cancer cases was noted across 51 states of the US during the study period from 2014-2018. The states with higher disease burden had a much lower ratio of trials available per case despite higher absolute number of clinical trials in comparison to the states with lower disease burden. This highlights the need for better geographical allocation of clinical trials in the future based on the cancer burden for efficient resource utilisation and improved healthcare delivery.[Table: see text]

The absolute number of leukocytes per vial as a major cause of early false positive blood cultures: proof-of-concept and application.

Blood cultures detected as positive by the automated system but negative by microscopy and subculture are considered as "false-positives." Several causes have been identified, including hyperleukocytosis or the presence of fastidious bacteria, but as many cases remain unexplained we aimed to investigate the false positives occurring in our laboratory. We retrospectively collected data on blood cultures received over a period of 12months to determine factors associated with the false-positive vials. We then prospectively validated our findings on the false-positive results occurring over a 3.5-month period. We finally applied scanning electron microscopy (SEM) on 63 false positives and molecular approaches on a subset of them. In the retrospective study, 154 (85%) of the 181 false-positive identified were positive following less than 4h of incubation and were considered as "early false-positives." By performing ROC curves on these early false positives, we demonstrate that the absolute number of leukocytes is in fact the most discriminating factor of early false positivity (p < 0.001). This phenomenon can be the consequence of either a high blood culture volume (p < 0.001) or hyperleukocytosis (p < 0.001). In the prospective study, the use of a threshold of 219 million of leukocytes per vial enabled the identification of 97% of the early false positives. Finally, SEM and specific qPCR enabled three additional identifications while 16S rRNA/nanopore sequencing enabled the detection of Helicobacter cinaedi bacteremia and a polymicrobial infection. A high absolute number of leukocytes in blood cultures explains most false positives, thereby making it possible to target additional microbiological investigations.

마이크로 가스터빈 엔진에 적용된 압축기 공력성능 특징

A centrifugal compressor is essentially applicable to a micro gas turbine because it can produce a high-pressure ratio over than 3.0 within a limited geometrical allowance. In this paper, aerodynamic design and internal flow characteristics of the centrifugal compressor were described in detail by comparing them with those of turbocharger compressors. Then a centrifugal compressor design procedure with a pressure ratio of 5.0 at the design point for a 1,000 N thrust micro gas turbine has been introduced and the internal flow field at the design point has been further investigated with CFD methods. High impeller pressure ratio led to high absolute Mach number at the impeller outlet, however, small gap between the impeller outlet and diffuser inlet did not sufficiently recover static pressure and it caused large flow separation region and corresponding total pressure at the diffuser hub. For this reason, it requires sophisticated matching between impeller and diffuser stages in micro gas turbines. Based on the internal flow analysis, ideas for further performance improvements have been proposed while maintaining essential compressor performances.

Subnational mapping for targeting anaemia prevention in women of reproductive age in Ethiopia: A coverage-equity paradox.

Anaemia in women of reproductive age (WRA) can be effectively addressed if supported by a better understanding of the spatial variations, magnitude, severity and distribution of anaemia. This study aimed to map the subnational spatial distribution of anaemia (any, moderate and severe forms) among WRA in Ethiopia. We identified and mapped (any, moderate and severe) anaemia hotspots in WRA (n = 14,923) at the subnational level and identified risk factors using multilevel logistic regression. Kulldorff scan statistics were used to identify hotspot regions. Ordinary kringing was used to predict the anaemia prevalence in unmeasured areas. The overall anaemia prevalence increased from 16.6% in 2011 to 23.6% in 2016, a rise that was mostly related to the widening of existing hotspot areas. The primary clusters of (any) anaemia were in Somali and Afar regions. The horn of the Somali region represented a cluster of 330 km where 10% of WRA were severely anaemic. The Oromia-Somali border represented a significant cluster covering 247 km, with 9% severe anaemia. Population-dense areas with low anaemia prevalence had high absolute number of cases. Women education, taking iron-folic-acid tablets during pregnancy and birth-delivery in health facilities reduced the risk of any anaemia (P < 0.05). The local-level mapping of anaemia helped identify clusters that require attention but also highlighted the urgent need to study the aetiology of anaemia to improve the effectiveness and safety of interventions. Both relative and absolute anaemia estimates are critical to determine where additional attention is needed.

The impact of the opioid crisis on U.S. state prison systems

BackgroundPrior studies have documented limited use of medications to treat opioid use disorders (OUD) for people incarcerated within state prisons in the United States. Using the framework of the criminal justice OUD service cascade, this study interviewed representatives of prison systems in states most heavily impacted by opioid overdose regarding the provision of medications for OUD (MOUD). MethodsA stratified sampling strategy included states with high indicators of opioid-overdose deaths. Two sampling strata targeted states with: 1) OUD overdose rates significantly higher than the per capita national average; or 2) high absolute number of OUD overdose fatalities. Interviews were completed with representatives from 21 of the 23 (91%) targeted states in 2019, representing 583 prisons across these states. Interviews assessed service provision across the criminal justice OUD service cascade, including OUD screening, withdrawal management, MOUD availability and provision, overdose prevention, re-entry services, barriers, and needs for training and technical assistance.ResultsMOUD (buprenorphine, methadone, or naltrexone) was available in at least one prison in approximately 90% of the state prison systems and all three medications were available in at least one prison in 62% of systems. However, MOUD provision was limited to subsets of prisons within these systems: 15% provided buprenorphine, 9% provided methadone, 36% provided naltrexone, and only 7% provided all three. Buprenorphine and methadone were most frequently provided to pregnant women or individuals already receiving these at admission, whereas naltrexone was primarily used at release. Funding was the most frequently cited barrier for all medications.ConclusionStudy findings yield a complex picture of how, when, and to whom MOUD is provided across prisons within prison systems in states most heavily impacted by opioid overdose in the United States and have implications for expanding availability.

Areas susceptible to defaunation? an assessment based in the illegitimate use of Brazilian wildlife

This study sought to identify potential areas susceptible to defaunation, in the different biomes and regions of Brazil. Therefore, we assessed records of 13,573 AIA (Environmental Violation Reports) tilled by Ibama from 2012 to 2016. The results showed that 194,335 wild animals were seized, generating US$ 57,140,139.13in administrative fines. The captures occurred in 1,255 Brazilian municipalities, especially Caicó (RN), Recife (PE) and Cáceres (MT), with 27,677, 17,347 and 11,751 animals, respectively. The Northeast region had the highest amount in fines (US$ 28.9 million) and an annual average of 28,753 specimen apprehended, with a record above 100%, when compared to the annual average from 1992 to 2000, in a past study. The states of Minas Gerais, Rio Grande do Norte and Pernambuco had the highest absolute numbers. In the distribution by Class, birds, mammals and reptiles ranked 90.21%, 1.16% and 8.63% of the captures, respectively. As to the threatened species, there were 2,257 specimens, of which 70.05% were birds, most in the 'Vulnerable' threat ranking. We have concluded that the large illegal use of wild animals may lead to defaunation in some areas of Brazil, especially in the northeast region.

Clinical and morphological differential diagnosis of congenital hyperinsulinism before the stage of immunohistochemical study of paraffin-embedded specimens of pancreas in children

Introduction.Differential diagnosis of various forms of congenital hyperinsulinism (CH) is required at the stage of urgent histological examination, but the difference between the exo- and endocrine parts of the pancreas in frozen sections is visualized very poorly.The objective was to search for differential diagnostic criteria of focal and diffuse forms of CH, suitable for urgent histological examination.Methods and materials. Pancreatic surgery material from 25 children with CH, of which 15 cases of focal form (FCH) and 10 cases of diffuse (DСH), and autopsy material from 10 children without CH (K). Frozen and paraffin sections stained with hematoxylin-eosin and histochemical stains were made from the tissue of the pancreas. The number of endocrinocytes with large nuclei was estimated in 10 fields of view for each case.Results. The average proportion of endocrinocytes with large nuclei was significantly (p &lt;0.01) higher compared to the control both with FCH (in the affected area) and DCH (FCH – (1.82±0.50) %, DCH – (4.68±1.66) %, K – (0.34±0.21) %). We found a tendency to detect a higher absolute number of cells with large nuclei in DCH ((4.95±1.24) DCH and (3.71±1.56) FCH). Staining with azure-eosin, picro Mallory and the PAS reaction gave unstable result, and staining with toluidine blue and May-Grunwald did not allow differentiating exo- and endocrine parts of the pancreas.Conclusion. An increase in the size of the endocrinocyte nuclei was the unsuitable criterion for the differential diagnosis of CH forms, and histochemical stains did not give a stable qualitative result. For urgent biopsy examination, new immunohistochemical methods are needed.

Immune factors and health of Antarctic explorers

The immune system plays a major role in human homeostasis, yet a body’s unique individuality complicates the diagnostic forecasting of unfavourable physiological states and diseases. Studying the immunophenotypic features of winterers of the Ukrainian Antarctic Expeditions before, during, and after their assignments might shed some light on the possible place of immune accentuations in the development of certain physiological states. To determine the natural-killer (NK) cytotoxicity and the immunophenotype in 52 applicants who wanted to take part in an expedition and nine participants who had come back, we used flow cytofluorometry. Blood serum samples taken before, during, and after the expeditions were also tested for hormones, anti-infective, anti-parasitic, and autoimmune antibodies. The high absolute and relative numbers of NK lymphocytes, high NK cytotoxicity, and high expression of HLA-DR on the CD3+CD8+ lymphocytes were correlated with a person’s unfavorable health status during the expedition. In Antarctica, cortisol levels sharply increased, yet they normalized upon return. In most winterers, there were no significant health complications during the expeditions. Neither reactivated nor primary viral infections were registered, as well as clinical autoimmune ones. Upon return, the winterers had significantly lower leukocytes and lymphocytes and increased expression of activation markers (HLA-DR) on the T-cells. The found risk factors can characterize the polar researchers’ immunophenotypes yet require validation on larger samples. The expedition environment causes increased stress, entailing, however, neither clinical manifestations nor elements of immunosuppression. The polar researchers bear the consequences of the prolonged stress that inhibit leucopoiesis as late as six months after their return, which should be considered while reviewing applications for the next season.

Some groups of Toll-like receptor gene polymorphisms and their clinical and pathogenetic manifestations in children with bronchial asthma

The prevalence of bronchial asthma has shown its steady increase in the world in recent years. Despite all the achievements of Allergology, control of the disease can be achieved only in two-thirds of patients even if all social risk factors and the influence of concomitant diseases are excluded. Thus, it is necessary to study endogenous factors that modify the pathogenesis of the disease. Toll-like receptors are the main molecules for recognizing pathogenic patterns in the human immune system. Since any Allergy is a recognition error, mutation of the genes of the recognizing molecules can have a direct and multidirectional effect on the nature of the inflammation and its clinical manifestations in bronchial asthma (BA). To detect this effect, 65 patients with BA were examined, and mutations of Toll-like receptor genes were detected: TLR2-Arg753Glu, TLR4- Asp299Gly, TLR4-Ghr399Ile, TLR9-T1237C, TLR9-A2848G, lymphocyte subpopulations CD3, CD19, CD4, CD8, CD16, phagocytosis indicators, levels of IgA, IgM, IgG, IgE and IL-6, IL-7, IL-9. The assessment of the severity of asthma and its level of control were conducted according to clinical recommendations of the Ministry of health of the Russian Federation in 2019 criteria. We have shown characteristic clinical manifestations of the studied mutations. A lighter course of the disease, more complete control over it and a better response to therapy were found in single-nucleotide substitutions in the Toll-like receptor 4 and 9 (TLR4-Asp299Gly, TLR4-Ghr399Ile, TLR9-T1237C, TLR9-A2848G). On the contrary, a heavier course and a worse response to therapy were detected in the TLR2 mutation with Arg753Glu replacement. In the studied groups, the features of immunity indicators characteristic of genotypes with a lighter and more controlled course of BA were determined: a higher absolute number of T-helpers, with multidirectional changes in the number of T-killers, but with invariably preserved higher ratio of CD4/CD8 in such genotypes. Higher levels of phagocytosis indicators (primarily characterizing chemotaxis) and IL-7, IL-9 were also detected. The exception is the TLR9-A2848G mutation, in which greater disease control and better response to therapy are combined with no changes in the studied laboratory characteristics. At the same time, a specific feature of the genotype of the studied patients with BA was revealed – a combination of Toll-like receptors 4 and 9 mutations. This suggests the presence of genetic patterns that characterize groups of patients with BA that differ in severity, response to therapy, and degree of control, which makes it possible to personalize approaches to diagnosis, prevention, and therapy of the disease.