Potential Negative Side Effects Research Articles

Development of a New Non-Invasive Approach to Treat of Infantile Hemangioma with Growth-Inhibiting Endogenous Factors (Non-Invasive Approach to Treat of Infantile Hemangioma with Endogenous Factors)

Background: Infant hemangioma is a benign vascular tumor, the main reason for the development of which is genetic disorders occurring in embryogenesis. It should be noted that all methods of treating the disease, both general and local, have potential negative risks and side effects. The identification of endogenous regulatory factors and researching the possibilities of using them for treatment is relevant. There is the thermostable proteins complex (TPC) which has been identified in the cells of phylogenetically distant almost all organisms, which has the ability to decrease the mitotic activity of cells by inhibition of transcription. In the experimental model of hemangioma, it has been established that inhibition of capillary growth can only be achieved by injection. The aim of the work was to develop a new, less invasive method of hemangioma treatment with endogenous factors.

Marine carbon dioxide removal by alkalinization should no longer be overlooked

To achieve the Paris climate target, deep emissions reductions have to be complemented with carbon dioxide removal (CDR). However, a portfolio of CDR options is necessary to reduce risks and potential negative side effects. Despite a large theoretical potential, ocean-based CDR such as ocean alkalinity enhancement (OAE) has been omitted in climate change mitigation scenarios so far. In this study, we provide a techno-economic assessment of large-scale OAE using hydrated lime (‘ocean liming’). We address key uncertainties that determine the overall cost of ocean liming (OL) such as the CO2 uptake efficiency per unit of material, distribution strategies avoiding carbonate precipitation which would compromise efficiency, and technology availability (e.g., solar calciners). We find that at economic costs of 130–295 $/tCO2 net-removed, ocean liming could be a competitive CDR option which could make a significant contribution towards the Paris climate target. As the techno-economic assessment identified no showstoppers, we argue for more research on ecosystem impacts, governance, monitoring, reporting, and verification, and technology development and assessment to determine whether ocean liming and other OAE should be considered as part of a broader CDR portfolio.

Disrupted one-carbon metabolism in heifers negatively affects their health and physiology.

The objective of this study was to determine the dose-dependent response of one-carbon metabolite (OCM: methionine, choline, folate, and vitamin B12) supplementation on heifer dry matter intake on fixed gain, organ mass, hematology, cytokine concentration, pancreatic and jejunal enzyme activity, and muscle hydrogen peroxide production. Angus heifers (n = 30; body weight [BW] = 392.6 ± 12.6kg) were individually fed and assigned to one of five treatments: 0XNEG: total mixed ration (TMR) and saline injections at days 0 and 7 of the estrous cycle, 0XPOS: TMR, rumen-protected methionine (MET) fed at 0.08% of the diet dry matter, rumen-protected choline (CHOL) fed at 60g/d, and saline injections at days 0 and 7, 0.5X: TMR, MET, CHOL, 5-mg B12, and 80-mg folate injections at days 0 and 7, 1X: TMR, MET CHOL, 10-mg vitamin B12, and 160-mg folate at days 0 and 7, and 2X: TMR, MET, CHOL, 20-mg vitamin B12, and 320-mg folate at days 0 and 7. All heifers were estrus synchronized but not bred, and blood samples were collected on days 0, 7, and at slaughter (day 14) during which tissues were collected. By design, heifer ADG did not differ (P = 0.96). Spleen weight and uterine weight were affected cubically (P = 0.03) decreasing from 0XPOS to 0.5X. Ovarian weight decreased linearly (P < 0.01) with increasing folate and B12 injection. Hemoglobin and hematocrit percentage were decreased (P < 0.01) in the 0.5X treatment compared with all other treatments. Plasma glucose, histotroph protein, and pancreatic α-amylase were decreased (P ≤ 0.04) in the 0.5X treatment. Heifers on the 2X treatment had greater pancreatic α-amylase compared with 0XNEG and 0.5X treatment. Interleukin-6 in plasma tended (P = 0.08) to be greater in the 0XPOS heifers compared with all other treatments. Lastly, 0XPOS-treated heifers had reduced (P ≤ 0.07) hydrogen peroxide production in muscle compared with 0XNEG heifers. These data imply that while certain doses of OCM do not improve whole animal physiology, OCM supplementation doses that disrupt one-carbon metabolism, such as that of the 0.5X treatment, can induce a negative systemic response that results in negative effects in both the dam and the conceptus during early gestation. Therefore, it is necessary to simultaneously establish an optimal OCM dose that increases circulating concentrations for use by the dam and the conceptus, while avoiding potential negative side effects of a disruptive OCM, to evaluate the long-term impacts of OCM supplementation of offspring programming.

Spermidine treatment: induction of autophagy but also apoptosis?

Machado-Joseph disease (MJD), also known as spinocerebellar ataxia type 3, is a fatal neurodegenerative disease that causes loss of balance and motor co-ordination, eventually leading to paralysis. It is caused by the autosomal dominant inheritance of a long CAG trinucleotide repeat sequence within the ATXN3 gene, encoding for an expanded polyglutamine (polyQ) repeat sequence within the ataxin-3 protein. Ataxin-3 containing an expanded polyQ repeat is known to be highly prone to intraneuronal aggregation, and previous studies have demonstrated that protein quality control pathways, such as autophagy, are impaired in MJD patients and animal models of the disease. In this study, we tested the therapeutic potential of spermidine on zebrafish and rodent models of MJD to determine its capacity to induce autophagy and improve functional output. Spermidine treatment of transgenic MJD zebrafish induced autophagy and resulted in increased distances swum by the MJD zebrafish. Interestingly, treatment of the CMVMJD135 mouse model of MJD with spermidine added to drinking water did not produce any improvement in motor behaviour assays, neurological testing or neuropathology. In fact, wild type mice treated with spermidine were found to have decreased rotarod performance when compared to control animals. Immunoblot analysis of protein lysates extracted from mouse cerebellar tissue found little differences between the groups, except for an increased level of phospho-ULK1 in spermidine treated animals, suggesting that autophagy was indeed induced. As we detected decreased motor performance in wild type mice following treatment with spermidine, we conducted follow up studies into the effects of spermidine treatment in zebrafish. Interestingly, we found that in addition to inducing autophagy, spermidine treatment also induced apoptosis, particularly in wild type zebrafish. These findings suggest that spermidine treatment may not be therapeutically beneficial for the treatment of MJD, and in fact warrants caution due to the potential negative side effects caused by induction of apoptosis.

When smoking is the smallest problem: A qualitative study of smoking prevention in Danish vocational schools

Objective: In Denmark, more students smoke in vocational schools than in upper secondary schools. Smoking-prevention initiatives may reduce the prevalence of smoking but may also introduce unforeseen challenges. This study examined the significance of smoking and dilemmas related to smokefree school hours (SFSH) among established smokers in Danish vocational schools. Design: Qualitative research design. Setting: Data collection took place in a vocational education and training (VET) school in Denmark. The subject area was care, health and pedagogy (CHP). Method: Participant observation and focus groups were conducted with students and teachers. Two classes were observed for 2 weeks in total. The data analysed consisted of participant observation field notes ( n = 10 school days), transcripts from student focus groups ( n = 6; aged 18–56) and transcripts from teacher focus groups ( n = 11). Results: Two dilemmas were described as faced by established smokers in relation to the implementation of smokefree school hours: (1) The school is entitled to make rules versus the right to decide for oneself; and (2) life and schoolwork are challenging and demanding versus school work is more important than smoking. Conclusion: The findings illustrate how smoking, as an ingrained everyday practice for established smokers, represents a means of coping with difficult school demands and everyday challenges, particularly for vulnerable students, and how regulations such as SFSH create dilemmas for those students. These dilemmas are important to consider when designing and implementing smoking-prevention initiatives to prevent potential negative side effects and an unintended increase in social inequality in smoking.

Female High School Athletes Regularly Consume Energy Drinks with Moderate and High Caffeine Content

Introduction: The consumption of energy drinks can result in unhealthy caffeine intake for children. The objective of this study was to better understand energy drink consumption in young female athletes.Methods: A cross-sectional questionnaire-based study on self-reported energy drink prevalence and perception of a convenience sample (n=203) of U.S. female high school athletes (age 15.9±1.1 years). Results: Of the athletes responding, 64.5% reported use of an energy drink at some time during the last 12-months. Of this group, &gt;25% reported using energy drinks 3-4 times a week or more. Roughly half of the athletes reported using energy drinks with a high caffeine content (~150-300 mg/serving), and they reported more positive opinions about caffeine's potential (negative) side effects compared to athletes not using energy drinks.Conclusions: A majority of female high school athletes reported the regular use of energy drinks, including those with a high caffeine content, and athletes that reported higher dose usage expressed more positive opinions about the side effects of energy drinks. High schools should include discussion about energy drinks as part of healthy lifestyle education, allowing athletes to make safe choices about the use of such products.

Carbon nitride dots do not impair the growth, development, and telomere length of tadpoles

Carbon nanoparticles, or carbon dots, can have many beneficial uses. However, we must consider whether they may have any potential negative side effects on wildlife or the ecosystem when these particles end up in wastewater. Early development stages of amphibians are particularly sensitive to contaminants, and exposure to carbon dots could disrupt their development and cause morbidity or death. Past studies have investigated short-term exposure to certain types of nanoparticles, but if these particles get into wastewater exposure may not be short term. Therefore, we tested whether chronic exposure to different concentrations of carbon dots affects the growth, metamorphosis, and telomere length of Cuban tree frog (Osteopilus septentrionalis) tadpoles. We exposed 12 groups of five tadpoles each to different concentrations of carbon dots and a control for three months and tracked survival, growth and metamorphosis. We used carbon nitride dots approximately 2 nm in size at concentrations of 0.01 mg/ml and 0.02 mg/ml, known to interrupt development in zebrafish embryos. After three months, we measured telomere length from tissue samples. We found no difference in tadpole survivorship, growth, development rate, or telomere length among any of the groups, suggesting that carbon dots at these concentrations do not disrupt tadpole development.

Targeting tau in Alzheimer's disease: from mechanisms to clinical therapy.

Alzheimer's disease is the most prevalent neurodegenerative disease affecting older adults. Primary features of Alzheimer's disease include extracellular aggregation of amyloid-β plaques and the accumulation of neurofibrillary tangles, formed by tau protein, in the cells. While there are amyloid-β-targeting therapies for the treatment of Alzheimer's disease, these therapies are costly and exhibit potential negative side effects. Mounting evidence suggests significant involvement of tau protein in Alzheimer's disease-related neurodegeneration. As an important microtubule-associated protein, tau plays an important role in maintaining the stability of neuronal microtubules and promoting axonal growth. In fact, clinical studies have shown that abnormal phosphorylation of tau protein occurs before accumulation of amyloid-β in the brain. Various therapeutic strategies targeting tau protein have begun to emerge, and are considered possible methods to prevent and treat Alzheimer's disease. Specifically, abnormalities in post-translational modifications of the tau protein, including aberrant phosphorylation, ubiquitination, small ubiquitin-like modifier (SUMO)ylation, acetylation, and truncation, contribute to its microtubule dissociation, misfolding, and subcellular missorting. This causes mitochondrial damage, synaptic impairments, gliosis, and neuroinflammation, eventually leading to neurodegeneration and cognitive deficits. This review summarizes the recent findings on the underlying mechanisms of tau protein in the onset and progression of Alzheimer's disease and discusses tau-targeted treatment of Alzheimer's disease.

Functional Additives in a Selected European Sea Bass (Dicentrarchus labrax) Genotype: Effects on the Stress Response and Gill Antioxidant Response to Hydrogen Peroxide (H2O2) Treatment.

Functional ingredients have profiled as suitable candidates for reinforcing the fish antioxidant response and stress tolerance. In addition, selective breeding strategies have also demonstrated a correlation between fish growth performance and susceptibility to stressful culture conditions as a key component in species domestication processes. The aim of the present study is to evaluate the ability of a selected high-growth genotype of 300 days post-hatch European sea bass (Dicentrarchus labrax) juveniles to use different functional additives as endogenous antioxidant capacity and stress resistance boosters when supplemented in low fish meal (FM) and fish oil (FO) diets. Three isoenergetic and isonitrogenous diets (10% FM/6% FO) were supplemented with 200 ppm of a blend of garlic and Labiatae plant oils (PHYTO0.02), 1000 ppm of a mixture of citrus flavonoids and Asteraceae and Labiatae plant essential oils (PHYTO0.1) or 5000 ppm of galactomannan-oligosaccharides (GMOS0.5). A reference diet was void of supplementation. The fish were fed the experimental diets for 72 days and subjected to a H2O2 exposure oxidative stress challenge. The fish stress response was evaluated through measuring the circulating plasma cortisol levels and the fish gill antioxidant response by the relative gene expression analysis of nfΚβ2, il-1b, hif-1a, nd5, cyb, cox, sod, cat, gpx, tnf-1α and caspase 9. After the oxidative stress challenge, the genotype origin determined the capacity of the recovery of basal cortisol levels after an acute stress response, presenting GS fish with a better pattern of recovery. All functional diets induced a significant upregulation of cat gill gene expression levels compared to fish fed the control diet, regardless of the fish genotype. Altogether, suggesting an increased capacity of the growth selected European sea bass genotype to cope with the potential negative side-effects associated to an H2O2 bath exposure.

(022) Men with History of Depression Are More Likely to Continue Use of Antidepressants If Erectile Dysfunction is Treated with Testosterone or Phosphodiesterase-5 Inhibitors

Abstract Introduction Erectile dysfunction (ED) affects an estimated 30 million men in the United States with an estimated 82% of men with erectile dysfunction experiencing depressive symptoms. Prior literature has shown that initiation of therapy for ED is associated with a decrease in depressive symptoms; however, the rates of antidepressant continuation following initiation of erectile dysfunction has not been analyzed. Objective Our goal was to analyze the rate of antidepressant continuation for depression after prescribing testosterone or PDE-5 inhibitors for erectile dysfunction. Methods We queried the TriNetX Diamond network database, a health research network including 212 million patients, including healthcare encounters, insurance claims data, and prescription data between 2009-2021. We identified men with a diagnosis of depression (ICD-10: F32-33), 12 consecutive prior months of antidepressant prescriptions (VA Formulary: CN609), and a diagnosis of erectile dysfunction (ICD-10: N52). We then compared rates of antidepressants continuation over the following year in men who were prescribed PDE5i or testosterone for their erectile dysfunction versus men who had never been prescribed testosterone or PDE5i for their erectile dysfunction. The two cohorts were matched on age, race, and ethnicity. Rates of antidepressant discontinuation were compared with risk ratios (RR) and 95% confidence interval (95% CI). Results We identified 31,306 men that were prescribed a PDE-5 inhibitor without testosterone and an equal number of men that weren't prescribed testosterone nor PDE5i. We found that 54% of men receiving PDE5i continued using antidepressants after 12 months; while, 49% of men that weren't prescribed testosterone nor PDE5i continued using antidepressants (RR: 1.11, 95% CI: 1.10-1.13). We identified 4,468 patients who were prescribed testosterone without a PDE5i and an equal number of men that weren't prescribed testosterone nor PDE5i prescriptions. We found that 61% of men receiving testosterone prescriptions continued the use of antidepressants over subsequent 12 months; while 49% of men that weren't prescribed testosterone nor PDE5i continued using antidepressants (RR: 1.24, 95% CI: 1.20-1.29). Conclusions We conclude that patients who were prescribed PDE-5 inhibitors or testosterone were more likely to continue usage of antidepressants after 1 year despite the potential negative sexual dysfunction side effects that they may cause. The patient's psychiatric conditions and comorbidities should be considered when prescribing medications for sexual wellbeing in order to more holistically treat patients. Disclosure No

Changes in sexual thoughts and behaviors in a clinical sample of child sexual abuse material users under the COVID-19 pandemic

In this article, we describe a qualitative study in which we examined perceived effects of the COVID-19 pandemic on help-seeking individuals who access child sexual abuse material (CSAM, legally referred to as child pornography). The study recruited 18 participants who were part of the internet based Prevent It Cognitive Behavior Therapy (CBT) clinical trial, which aims to reduce CSAM use and child exploitation, and were willing to answer questions during a semi-structured interview about the perceived impact of the pandemic restrictions on their lives, including their sexual thoughts and behaviors. Key themes that were identified from the participants’ answers included changes in day-to-day life, mental health, sexual thoughts, behaviors or urges, responses and coping strategies used to deal with sexual urges, changes on the forums, positive changes, and how they could best be assisted with coping in this situation. Our qualitative analysis also suggested that the pandemic affected urges to use CSAM, therefore potentially increasing the risk of online sexual offending. These results support that there is a need to investigate this potential negative side effect of quarantines or lockdowns before future pandemics.

Uncompensated claims to fair emission space risk putting Paris Agreement goals out of reach

Addressing questions of equitable contributions to emission reductions is important to facilitate ambitious global action on climate change within the ambit of the Paris Agreement. Several large developing regions with low historical contributions to global warming have a strong moral claim to a large proportion of the remaining carbon budget (RCB). However, this claim needs to be assessed in a context where the RCB consistent with the long-term temperature goal (LTTG) of the Paris Agreement is rapidly diminishing. Here we assess the potential tension between the moral claim to the remaining carbon space by large developing regions with low per capita emissions, and the collective obligation to achieve the goals of the Paris Agreement. Based on scenarios underlying the IPCC’s 6th Assessment Report, we construct a suite of scenarios that combine the following elements: (a) two quantifications of a moral claim to the remaining carbon space by South Asia, and Africa, (b) a ‘highest possible emission reduction’ effort by developed regions (DRs), and (c) a corresponding range for other developing regions (ODR). We find that even the best effort by DRs cannot compensate for a unilateral claim to the remaining carbon space by South Asia and Africa. This would put the LTTG firmly out of reach unless ODRs cede their moral claim to emissions space and, like DRs, pursue highest possible emission reductions, which would also constitute an inequitable outcome. Furthermore, regions such as Latin America would need to provide large-scale negative emissions with potential risks and negative side effects. Our findings raise important questions of perspectives on equity in the context of the Paris Agreement including on the critical importance of climate finance. A failure to provide adequate levels of financial support to compensate large developing regions to emit less than their moral claim will put the Paris Agreement at risk.

User types, psycho-social effects and societal trends related to the use of consumer health technologies.

The term consumer health technologies we use in this paper refers to fitness and health apps, wearables and other self-tracking devices that collect health-related data. Our paper aims to bridge the gap between the growing literature base of sociological research and ethical reflection on the (non-intended) effects of consumer health technology use on the psycho-social level, such as stress, responsibilization or a loss of intuitive sense for signs of health or illness. Special consideration should be given to vulnerable individuals, as the positive and negative effects of consumer health technology use may be unequally distributed. This perspective may help to guide policymaking and the responsible development of consumer health technologies. Using a narrative review approach, we refer to empirical and theoretical studies dealing with user types and effects related to the use of consumer health technologies. We provide an overview of consumer health technology user typologies and evidence of the unintended psycho-social effects of consumer health technology use. On this basis, we propose a user typology that may serve as a future tool for ethical reflection on negative side effects. Evidence of the potential negative side effects of consumer health technology use, as presented in the literature, is inconclusive due to the high diversity of consumer health technology users and the way they use consumer health technologies. Our proposed user typology aims to more comprehensively document the diversity of users by incorporating the way in which users identify with and use their self-tracked data, attitudes towards the new technology and social interactions via consumer health technologies, and the purpose and self-determinedness of consumer health technology use. More systematic and quantitative empirical research on the effects of consumer health technology use in diverse settings and with diverse user types is necessary to inform public health policy. In addition to evidence-based certification of medical consumer health technologies, more practical and flexible ways to protect users from side effects may have to be developed and adopted, especially regarding the increasing number of non-medical consumer health technologies.

10-Hz tACS up-regulates a visual attention network and down-regulates the rich club

Abstract Synchronization of oscillatory brain activity may play a critical role in linking distributed neuronal populations into transient functional networks, with up-regulation of engaged networks during task performance accompanied by down-regulation of less salient networks. Can tACS be used to elicit network-specific changes in brain function, given that the distributed nodes of a network may experience varying amplitudes of exogenous current flow? We utilized MEG to characterize brain dynamics following bilateral parietal 10-Hz tACS during a visual attention task (8 healthy adults; 1 mA, verum/sham 20 min/30 s). Regions of interest included a cortico-cerebellar sensory processing network (SP: frontal, parietal, temporal cortex, hippocampus, cerebellum) and the Rich Club (bilateral superior parietal and frontal cortex, precuneus, hippocampus). Persistent changes in local oscillatory dynamics were seen in the SP network across a broad spectrum of frequency bands. Changes in alpha-band activity extended before, during, and after presentation of global/local letter images, consistent with a tonic influence of the 10-Hz tACS on alpha-band dynamics. Up-regulation of alpha and down-regulation of theta throughout the SP network was consistent with results seen in previous working memory studies. Moreover, increases in alpha were accompanied by increased gamma-band activity, consistent with a cross-frequency relationship between these rhythms. In contrast, down-regulation of alpha was characteristic of regions in Rich Club, with the exception of up-regulation in superior parietal cortex. Interestingly, despite a lack of consistency of a reciprocal relationship between alpha and theta in the Rich Club, the stimulation also reduced both theta and gamma-band activity, suggesting a role for theta-gamma coupling in the Rich Club. Our results suggest that tACS may provide a method for identifying and up-/down- regulating individual brain networks. Importantly, identifying tACS parameters that maximize changes to specific networks may be critical to increase efficacy and reduce potential negative side-effects of tACS. Research Category and Technology and Methods Basic Research: 8. Transcranial Alternating Current Stimulation (tACS) Keywords: tACS, MEG, Network, Visual Attention

Potential Risks and Drawbacks of Long-Term Proton Pump Inhibitors Use

In today's world, proton pump inhibitors (PPIs) are one of the most commonly prescribed pharmacological types. Many gastrointestinal diseases such as gastroesophageal reflux or Barrett's esophagus, as well as laryngopharyngeal reflux, may benefit from these. However, numerous studies have been published that link PPIs to a variety of dangers and problems, including bone fractures, infection, myocardial infarction, renal illness, and dementia. By examining key articles and addressing the debates around those findings, this review exposes several of these potential negative side effects. To provide proper counseling of their patients, the diligent otolaryngologist should be aware of the current status of the literature and the hazards associated with prescribing PPIs. PPIs must be prescribed correctly in order to optimize outcomes and reduce risks and costs to the healthcare system. Overuse and misuse of PPIs, on the other hand, raises the risk of side effects. Because most gastric-acid-related illnesses necessitate long-term treatment, patients taking additional drugs in addition to a PPI are likely to experience clinically significant adverse drug interactions. Clinicians must only administer PPIs when they are proved to be required.

Overheating Risks and Adaptation Strategies of Energy Retrofitted Historic Buildings under the Impact of Climate Change: Case Studies in Alpine Region

Energy retrofits can enhance the liveability and efficiency of historic buildings while preserving their historic and aesthetic values. However, measures like improved insulation and airtightness may increase their vulnerability to overheating and climate change may further worsen their performance in the future. This paper investigates indoor overheating risks brought by climate change in retrofitted historic buildings and proposes effective adaptation strategies. Firstly, local weather conditions are analysed to identify homogenous climatic zones. For each climatic zone, “a business-as-usual” emissions scenario is adopted, and most representative regional climate models are selected to obtain hourly output of future climate projection. A comparative study is adopted where typical alpine residential buildings, “Portici house”, are simulated with regard to future energy use and indoor thermal state using the dynamic model in EnergyPlus. Energy use and indoor thermal conditions are compared before and after energy retrofit, as well as under present and future climate conditions. The results demonstrate that retrofit interventions could significantly improve energy efficiency of historic buildings in both present and future scenarios. A change in climate together with retrofit interventions will, however, result in higher risk of indoor overheating in South Tyrol. Potential negative side effects of energy retrofit could be controlled by adopting adequate shading and ventilation approaches that minimise, or eliminate, the risk of overheating during high temperature periods while optimising historic buildings’ energy performance.

Planning to Avoid Side Effects

In sequential decision making, objective specifications are often underspecified or incomplete, neglecting to take into account potential (negative) side effects. Executing plans without consideration of their side effects can lead to catastrophic outcomes -- a concern recently raised in relation to the safety of AI. In this paper we investigate how to avoid side effects in a symbolic planning setting. We study the notion of minimizing side effects in the context of a planning environment where multiple independent agents co-exist. We define (classes of) negative side effects in terms of their effect on the agency of those other agents. Finally, we show how plans which minimize side effects of different types can be computed via compilations to cost-optimizing symbolic planning, and investigate experimentally.

Eligibility of extracorporeal cardiopulmonary resuscitation on in-hospital cardiac arrests in Sweden: a national registry study

Extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest (CA) is used in selected cases. The incidence of ECPR-eligible patients is not known. The aim of this study was to identify the ECPR-eligible patients among in-hospital CAs (IHCA) in Sweden and to estimate the potential gain in survival and neurological outcome, if ECPR was to be used. Data between 1 January 2015 and 30 August 2019 were extracted from the Swedish Cardiac Arrest Register (SCAR). Two arbitrary groups were defined, based on restrictive or liberal inclusion criteria. In both groups, logistic regression was used to determine survival and cerebral performance category (CPC) for conventional cardiopulmonary resuscitation (cCPR). When ECPR was assumed to be possible, it was considered equivalent to return of spontaneous circulation, and the previous logistic regression model was applied to define outcome for comparison of conventional CPR and ECPR. The assumption in the model was a minimum of 15 min of refractory CA and 5 min of cannulation. A total of 9209 witnessed IHCA was extracted from SCAR. Depending on strictness of inclusion, an average of 32-64 patients/year remains in refractory after 20 min of cCPR, theoretically eligible for ECPR. If optimal conditions for ECPR are assumed and potential negative side effects disregarded of, the estimated potential benefit of survival of ECPR in Sweden would be 10-19 (0.09-0.19/100 000) patients/year, when a 30% success rate is expected. The benefit of ECPR on survival and CPC scoring was found to be detrimental over time and minimal at 60 min of cCPR. The number of ECPR-eligible patients among IHCA in Sweden is dependent on selection criteria and predicted to be low. There is an estimated potential benefit of ECPR, on survival and neurological outcome if initiated within 60 min of the IHCA.

Genetic parentage reconstruction as a practical tool applied to aquaculture and restoration programs for the European flat oyster,Ostrea edulis

Preserving and maximizing genetic diversity in conservation programs, including for restocking, are of high importance. The threatened European flat oyster (Ostrea edulis) is currently the subject of several applied conservation and restocking programs, but concerns have been raised over potential negative side effects of these programs, for example due to our limited knowledge about the genetic effects in natural populations of releasing offspring of hatchery origin. Here, we developed an effective, easily applicable and highly reliable method to assess the genetic diversity and parental contributions in flat oyster hatchery production based on analyses of 17 microsatellite loci. We analysed four broodstocks and their hatchery-reared spat (totaln = 354) and compared diversity to that in wild samples of adults and spat from the broodstock source in the Limfjorden (totaln = 138). Based on four hatchery tank experiments with fully resolved parentage assignments, we found that five swarming events (larval releases) were characterized by a single maternal and multiple paternal contributions, and that the number of contributing parents varied greatly both among individual tanks, and between swarming events within tank. On average, the effective number of breeders was only one third of the actual broodstock size. Although the broodstock exhibited high genetic variation, the high reproductive skew resulted in produced offspring representing only a relatively small subset of this variation. The work demonstrates potential impact of hatchery reared offspring on decreasing genetic diversity in wild populations, but also that genetic monitoring can be integrated in conservation programs to minimize negative effects on restoration and supplementary restocking programs that utilize hatchery reared spats to support natural populations.

Up-to-Date Knowledge on Osteoporosis Treatment Selection in Postmenopausal Women.

The concept of a super-aged society has led to a steady increase in the average lifespan and hence, interest in a healthy life has increased. Aging is a major risk factor for many diseases, including osteoporosis. Osteoporotic fractures have a significant impact on the quality of life of the elderly and hence, it is pivotal to provide effective treatment of osteoporosis after menopause. Osteoporosis requires proper management and the treatment must be centered on long-term goals. New drugs with diverse mechanisms have been developed for treating osteoporosis. Current management of osteoporosis generally focuses on the importance of risk-based strategies to maximize the effectiveness of existing treatments and mitigate potential negative side-effects. Additionally, there is a need for sequential treatment of osteoporosis in the future. This review discusses the dynamic strategies for osteoporosis treatment and the importance of long-term management in postmenopausal women.