Significant Increase In Proportion Research Articles

Vitrifying expanded equine embryos collapsed by blastocoel aspiration is less damaging than slow-freezing

The cryotolerance of equine blastocysts larger than 300 μm can be improved by aspirating blastocoele fluid prior to vitrification; however, it is not known whether blastocoele aspiration also enables successful slow-freezing. The aim of this study was therefore to determine whether slow-freezing of expanded equine embryos following blastocoele collapse was more or less damaging than vitrification. Grade 1 blastocysts recovered on day 7 or 8 after ovulation were measured (>300–550 μm, n = 14 and > 550 μm, n = 19) and blastocoele fluid was aspirated prior to slow-freezing in 10% glycerol (n = 14), or vitrification (n = 13) in 16.5% ethylene glycol/16.5% DMSO/0.5 M sucrose. Immediately after thawing or warming, embryos were cultured for 24 h at 38 °C and then graded and measured to assess re-expansion. Control embryos (n = 6) were cultured for 24 h following aspiration of blastocoel fluid, without cryopreservation or exposure to cryoprotectants. Subsequently, embryos were stained to assess live/dead cell proportion (DAPI/TOPRO-3), cytoskeleton quality (Phalloidin) and capsule integrity (WGA). For 300–550 μm embryos, quality grade and re-expansion were impaired after slow-freezing but not affected by vitrification. Slow-freezing embryos >550 μm induced additional cell damage as indicated by a significant increase in dead cell proportion and disruption of the cytoskeleton; neither of these changes were observed in vitrified embryos. Capsule loss was not a significant consequence of either freezing method. In conclusion, slow-freezing of expanded equine blastocysts collapsed by blastocoel aspiration compromises post-thaw embryo quality more than vitrification.

The impact of the COVID-19 lockdown on birthweight among singleton term birth in Denmark.

In Denmark, a nationwide COVID-19 lockdown was implemented on March 12, 2020 and eased on April 14, 2020. The COVID-19 lockdown featured reduced prevalence of extremely preterm or extremely low birthweight births. This study aims to explore the impact of this COVID-19 lockdown on term birthweights in Denmark. We conducted a nationwide register-based cohort study on 27,870 live singleton infants, born at term (weeks 37-41), between March 12 and April 14, 2015-2020, using data from the Danish Neonatal Screening Biobank. Primary outcomes, corrected for confounders, were birthweight, small-for-gestational-age (SGA), and large-for-gestational-age (LGA), comparing the COVID-19 lockdown to the previous five years. Data were analysed using linear regression to assess associations with birthweight. Multinomial logistic regression was used to assess associations with relative-size-for-gestational-age (xGA) categories. Adjusted mean birthweight was significantly increased by 16.9 g (95% CI = 4.1-31.3) during the lockdown period. A dip in mean birthweight was found in gestational weeks 37 and 38 balanced by an increase in weeks 40 and 41. The 2020 lockdown period was associated with an increased LGA prevalence (aOR 1.13, 95% CI = 1.05-1.21). No significant changes in proportions of xGA groups were found between 2015 and 2019. The nationwide COVID-19 lockdown resulted in a small but significant increase in birthweight and proportion of LGA infants, driven by an increase in birthweight in gestational weeks 40 and 41.

Abstract NG03: Multiomics in disparities research: Identifying African ancestry-specific mechanisms in the triple negative breast cancer tumor microenvironment

Abstract NG03: Multiomics in disparities research: Identifying African ancestry-specific mechanisms in the triple negative breast cancer tumor microenvironment

Impact of three years of prohibition on extent and pattern of alcohol use in Bihar: Observations and insights from the National Family Health Survey.

Bihar Excise (Amendment) Act, 2016 was promulgated in the state and a complete prohibition on alcohol was declared within the state of Bihar. We aimed to assess the impact of the prohibition on extent and pattern of alcohol use in the state of Bihar using the National Family Health Survey data. We also compared the data from Bihar with the data for the whole country, its neighbouring states and the state of Gujarat. There was a 41.78% reduction in the proportion of men who reported alcohol use in Bihar. Among those who reported alcohol use proportion of those who used 'almost every day' reduced by 29.72%. There was a 69.56% reduction in the proportion of women in Bihar who reported alcohol use. There was a significant increase in proportion of men reporting use of tadi madi and country liquor. Since the prohibition of alcohol in the state of Bihar there has been a reduction in self-reported alcohol use among men and women. However, alcohol use continues to be reported in the state even after the prohibition. There are states in the country that have similar extent of alcohol use as compared to Bihar, despite lack of prohibition. This warrants a relook at the policy to address what the prohibition could not achieve.

MP76-20 TRENDS IN SURGICAL MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA: DATA FROM THE AUA QUALITY (AQUA) REGISTRY

You have accessJournal of UrologyCME1 Apr 2023MP76-20 TRENDS IN SURGICAL MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA: DATA FROM THE AUA QUALITY (AQUA) REGISTRY Charles Jones, Benjamin Breyer, Rachel Mbassa, William Meeks, Raymond Fang, and Matthew Cooperberg Charles JonesCharles Jones More articles by this author , Benjamin BreyerBenjamin Breyer More articles by this author , Rachel MbassaRachel Mbassa More articles by this author , William MeeksWilliam Meeks More articles by this author , Raymond FangRaymond Fang More articles by this author , and Matthew CooperbergMatthew Cooperberg More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003350.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The list of surgical options for benign prostatic hyperplasia (BPH) has exploded in recent years, but little is known about the uptake of these new procedures in community urology practice. In this study we aimed to examine surgical BPH practices and trends across the country using the American Urological Association Quality Registry (AQUA). METHODS: The AQUA Registry was launched in 2014 to centralize quality reporting and improvement, primarily among community-based urology practices. Data regarding surgical BPH management from 2014-2021 were accessioned directly from electronic health records at 245 practices across the country. Procedures were grouped by CPT code. These included prostatic urethral lift (Urolift), transurethral incision of the prostate (TUIP), transurethral resection of the prostate (TURP), repeat TURP, laser coagulation of the prostate, laser vaporization of the prostate, holmium laser enucleation of the prostate (HoLEP), transurethral microwave therapy (TUMT), transurethral needle ablation (TUNA), transurethral destruction of the prostate by water vapor thermal therapy (Rezum), simple prostatectomy, and other genitourinary procedure. Patients were characterized by race and age. Practice location was also examined. RESULTS: The mean age of BPH diagnosis was 66.4 years old. 72% were White, 7% Black, 1% Asian, and 20% unknown. A total of 300,215 BPH procedures were recorded from 2014-2021. TURP had the greatest overall decline from a relative incidence of 40.1% of total BPH procedures in 2016 to 25.6% in 2021. TURP was used for 32% of White patients, 34% of Black patients, and 26% of Asian patients. Urolift use grew from 0.7% of cases in 2014 to 30.1% in 2021. HoLEP comprised approximately 1% of procedures throughout the time period studied. CONCLUSIONS: There has been a large shift in the procedures of choice for surgical management of BPH within community urology practices in the United States, with Urolift having a significant increase in total and relative proportions of procedures performed since its FDA approval in 2013. There has been a concurrent decrease in TURP, while HoLEP has stayed relatively consistently uncommon in community practice. Source of Funding: AQUA Registry is funded by the American Urological Association © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1100 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Charles Jones More articles by this author Benjamin Breyer More articles by this author Rachel Mbassa More articles by this author William Meeks More articles by this author Raymond Fang More articles by this author Matthew Cooperberg More articles by this author Expand All Advertisement PDF downloadLoading ...

Tobacco use in students of the Third Faculty of Medicine of Charles University in the Czech Republic.

This study assessed trends in tobacco use in students of the Third Faculty of Medicine of Charles University in the Czech Republic between academic years 2012/13 and 2019/2020. Two cross-sectional surveys designed to obtain information on smoking history, smoking status, tobacco products use, and cessation were conducted among 382 students of the 6-year Master's Study Programme (General Medicine) and the 3-year Bachelor's Study Programme (Public Health) in 2012/2013; and among 580 students of General Medicine and of the Bachelor's Study Programmes (Public Health, Dental Hygiene and Nursing) in 2019/2020. Regular/daily smoking was reported by 4.4 ± 2.4% (with 95% CI) of General Medicine students and 4.8 ± 4.1% of Public Health students in 2012/2013, and 1.3 ± 1.1% of General Medicine students and 14.4 ± 4.8% of students of bachelor studies in 2019/2020. The share of regular and occasional smokers was higher among junior students in both academic years (23.9 ± 5.1% and 20.1 ± 4.7%, respectively) compared to senior students (23.6 ± 9.8% and 9.6 ± 5.7%). Cigarettes were the most common products used in both academic years (67.0 ± 4.7% and 45.5 ± 4.0%). There was a significant increase in proportion of students using more tobacco products in the course of the time (from 12.1 ± 3.1% to 53.7 ± 4.1%). The proportion of students who quitted smoking has risen from 11.4 ± 3.2% to 16.1 ± 3.0%. On the contrary, the proportion of students who started smoking has dropped from 15.9 ± 3.7% to 2.9 ± 1.4%. The proportion of non-smokers has risen from 57.6 ± 5.0% to 65.3 ± 3.9%. The study revealed some positive trends concerning tobacco use in students (decline in regular smokers among students of General Medicine, senior students, cigarette smokers, water pipe smokers; rise in non-smokers), but also negative ones (rise in regular smokers among students of Public Health, students who used more tobacco products).

Mohs Surgeons Dominate Cutaneous Reconstructions in Cosmetically and Functionally Sensitive Sites: Medicare Trends From 2013 to 2019.

Although dermatologists perform more cutaneous reconstructions than any other specialists for the Medicare population, the perception of dermatologists as surgeons may not be as fully recognized. Mohs surgeons are trained in complex reconstructions of cosmetically and functionally sensitive (CFS) sites, although the proportion they account for is unknown. To quantify the proportion of cutaneous reconstructions in CFS sites performed by Mohs surgeons compared with other specialists, and to identify trends from 2013 to 2019. A cross-sectional analysis was performed using the Medicare Public Use Files for 2013 to 2019. Data were stratified by physician specialty, with dermatologists further subdivided into Mohs surgeons and non-Mohs dermatologists. Mohs surgeons performed 75.3% of all reconstructions in 2019, a significant increase from 2013 ( p < .0001). Mohs surgeons dominated nearly every type of CFS cutaneous reconstruction, with significant increases in proportion ( p < .0001) from 2013 to 2019 for every category except interpolation flaps. Complex repairs were the most commonly performed cutaneous reconstruction type. Mohs surgeons perform far more cutaneous reconstructive surgeries in CFS sites than any other specialty for the Medicare population, with significant increases in their lead over the study period.

Casein calcium-binding peptides: Preparation, characterization, and promotion of calcium uptake in Caco-2 cell monolayers

In this study, casein calcium-binding peptides were isolated from casein hydrolysate using calcium-peptide binding properties and their banding properties were characterized. Subsequently, the promoted calcium absorption abilities of casein calcium-binding peptides in the Caco-2 cells monolayers were investigated. Amino acid composition analysis showed that casein calcium-binding peptide-calcium chelate are rich in Glu, Ser, and Asp, with a significant increase in proportion compared to the casein hydrolysate. Molecular weight analysis showed that approximately 90 % of the casein calcium-binding peptides are oligopeptides. Thirty-seven peptide sequences were identified by mass spectrometry, and the presence, quantity, and position of some specific amino acid residues were found to correlate with calcium-binding ability. Additionally, calcium-peptide binding properties were characterized by using Ultraviolet-Visible spectroscopy, Fourier transform infrared spectroscopy, and scanning electron microscopy, which indicated that calcium ions were mainly chelated with the amino nitrogen atoms and oxygen atoms on the carboxyl group of casein calcium-binding peptides, thus forming chelate with porous microstructures. Compared with the control group, the casein calcium-binding peptides treatment group showed a significant increase in calcium transport at 30, 60, 120 and 180 min, respectively, by 44.25 %, 31.21 %, 20.67 % and 24.08 %. Therefore, casein calcium-binding peptides are expected to be used as dietary calcium supplements.

Single-cell transcriptomics reveals the interaction between peripheral CD4+ CTLs and mesencephalic endothelial cells mediated by IFNG in Parkinson's disease

Parkinson's disease (PD) is characterized by dopaminergic neurons degeneration in the substantia nigra pars compacta. Increasing evidence indicates that peripheral CD4+ T cells, a vital pathological component of PD, have been implicated in systemic inflammation activation, blood-brain barrier (BBB) dysfunction, central nervous system infiltration, and consequent neurons degeneration. However, there is no consensus on CD4+ T cell types' exact phenotypic characteristics in systemic inflammation and the mechanism of CD4+ T cells traffic into the BBB in patients with PD. In this study, we employed single-cell RNA sequencing (scRNA-seq) to elucidate the potential mechanism of T cells on the breakdown of BBB. The PD-associated Cytotoxic CD4+ T cells (CD4+ CTLs) were characterized by a significant increase in proportion as well as enhancement of interferon-gamma (IFNG) response and cell adhesion. Meanwhile, TBX21, IRF1 and NFATC2, identified as the key transcription factors in effector CD4+ T cells differentiation, induced overexpression of target genes-IFNG in CD4+ CTLs. Interestingly, endothelial cells (ECs) in PD patients were discovered to be more responsive to IFNG than other cell types of midbrain. Furthermore, the cell-cell communication analysis between CD4+ T cells and midbrain cells identified IFNG/IFNGR1 and SPP1/ITGB1 as the ligand-receptor pairs to mediate CD4+ CTLs' infiltration into the central nervous system (CNS) through the weakened ECs' tight junction. Together, these results suggested that PD-specific peripheral CD4+ CTLs might influence BBB function by migrating to mesencephalic endothelial cells (ECs) and activating the IFNG response in ECs.

The Use of Crisis Services Following the Mass School Shooting in Uvalde, Texas: Quasi-Experimental Event Study.

Mass shootings result in widespread psychological trauma for survivors and members of the affected community. However, less is known about the broader effects of indirect exposure (eg, media) to mass shootings. Crisis lines offer a unique opportunity to examine real-time data on the widespread psychological effects of mass shootings. Crisis Text Line is a not-for-profit company that provides 24/7 confidential SMS text message-based mental health support and crisis intervention service. This study examines changes in the volume and composition of firearm-related conversations at Crisis Text Line before and after the mass school shooting at Robb Elementary School on May 24, 2022, in Uvalde, Texas. A quasi-experimental event study design was used to compare the actual volume of firearm-related conversations received by Crisis Text Line post shooting to forecasted firearm conversation volume under the counterfactual scenario that a shooting had not occurred. Conversations related to firearms were identified among all conversations using keyword searches. Firearm conversation volume was predicted using a seasonal autoregressive integrated moving average model trained on the 3 months of data leading up to the shooting. Additionally, proportions of issue tags (topics coded post conversation by volunteer crisis counselors at Crisis Text Line after the exchange) were compared in the 4 days before (n=251) and after (n=417) the shooting to assess changes in conversation characteristics. The 4-day window was chosen to reflect the number of days conversation volume remained above forecasted levels. There was a significant increase in the number of conversations mentioning firearms following the shooting, with the largest spike (compared to forecasted numbers) occurring the day after the shooting (n=159) on May 25, 2022. By May 28, the volume reverted to within the 95% CI of the forecasted volume (n=77). Within firearm conversations, "grief" issue tags showed a significant increase in proportion in the week following the shooting, while "isolation/loneliness," "relationships," and "suicide" issue tags showed a significant decrease in proportions the week following the shooting. The results suggest that the Uvalde school shooting may have contributed to an increase in demand for crisis services, above what would be expected given historical trends. Additionally, we found that these firearm-related crises conversations immediately post event are more likely to be related to grief and less likely to be related to suicide, loneliness, and relationships. Our findings provide some of the first data showing the real-time repercussions for the broader population exposed to school shooting events. This work adds to a growing evidence base documenting and measuring the rippling effects of mass shootings outside of those directly impacted.

Short-term exposure to norethisterone affected swimming behavior and antioxidant enzyme activity of medaka larvae, and led to masculinization in the adult population

Norethisterone (NET), one of the synthetic progestins, is detected with increasing frequency in the water environment and distributed in the ocean, with a potential toxicity risk to marine organisms. However, current studies on the adverse effects of progestins (including NET) in aquatic environments have focused on freshwater organisms, mainly fish. In the present, marine medaka (Oryzias melastigma) larvae were exposed to 91.31 ng/L NET for 10 days, and then the swimming behavior, oxidation-antioxidant-related enzyme activities, sex and thyroid hormone levels, and the gene transcription patterns of the larvae were measured. After NET treatment, medaka larvae were raised in artificial seawater until 5 months of age, and the sex ratio was counted. Ten-day exposure to 91.31 ng/L NET inhibited swimming behavior, of marine medaka larvae, which showed that the time in the resting state was significantly prolonged, while the time in the large motor state was significantly reduced; disrupted oxidative-antioxidant system, significantly up-regulated the enzymatic activities of reactive oxygen species (ROS), malondialdehyde (MDA), and glutathione peroxidase (GSH-Px); affected the hormone levels of larvae, lowered 11- keto testosterone (11-KT) and triiodothyronine (T3) concentrations. RNA-seq results showed that 91.31 ng/L NET exposure for 10 days changed the transcript levels of 275 genes, of which 28 were up-regulated and 247 were down-regulated. Differentially expressed genes (DEGs) were mainly significantly enriched in piwi interacting RNA (piRNA), gonadal development, gametogenesis, and steroidogenesis biological processes, etc. After removing NET exposure and returning to breeding for 140 days, a significant increase in male proportions (69.67%) was observed in sexually mature medaka populations in the NET-treated group. These results show that exposure to 91.31 ng/L NET for 10 days can lead to various adverse effects on marine medaka larvae. These findings shed light on the potential ecological risks of synthetic progestins to marine organisms.

Perceptual adaptation to a novel accent: Phonetic category expansion or category shift?

Listeners can rapidly adapt to an unfamiliar accent. For example, following exposure to a speaker whose /f/ sound is ambiguous between [s] and [f], they categorize more sounds along an [s]-[f] phonetic continuum as /f/. We investigated the adaptation mechanism underlying such perceptual changes-do listeners shift the target sound in phonetic space (category shift), or do they adopt a more general mechanism of broadening the category (category expansion)? In experiment 1, we trained listeners on an accent containing ambiguous /θ/ = [θ/s] and then tested them on categorizing phonetic continua spanning [θ]-[s] or [θ]-[f]. Listeners tested on the [θ]-[s] continua showed a significant increase in proportion of /θ/ responses vs controls, while those tested on [θ]-[f] did not. Experiment 2 investigated how acoustic-phonetic similarity may modulate the mechanism underlying recalibration. Listeners were trained on the same /θ/ = [θ/s] accent as in experiment 1 but were tested on a different continuum, [θ]-[ʃ]. This time, trained listeners showed a significant increase in proportion of /θ/ responses with the novel phonetic contrast. This suggests that phonetic recalibration involves some degree of non-uniform category expansion, constrained by phonetic similarity between training and test sounds.

Changes in rabbit lymphocyte subpopulations and activation following long-term administration of meloxicam

Meloxicam is a commonly used analgesic in rabbits. However, its possible impact on lymphocyte subpopulations remained unknown. The aim of the study was to investigate a possible effect of long-term administration of meloxicam on rabbit lymphocyte subpopulations. The study included 8 rabbits given meloxicam orally once daily (1 mg/kg BW) for 14 days and 8 rabbits as a control group. Peripheral blood samples were collected on day 0 (before the first dose of meloxicam), day 3, 7 and 14. Samples were evaluated with a haematology analyser and a flow cytometer. A significant decrease in T: B cell ratio was found in all samples taken during meloxicam administration compared to day 0, as well as in comparison with the control group (P < 0.01). A significant increase (P < 0.05) in proportion of CD5 +CD8 + lymphocytes occurred by day 3. Subsequently, although the values slightly decreased, they still remained elevated throughout all the experiment compared to the values from day 0 (P < 0.05). A slight decrease in T and B cell activation (CD5 +CD25 + and IgM+CD25 +) noticed by day 3, declined during the next days of administration and became more and more significant (finally, P = 0.0078). Since a high significant decrease (P < 0.01) in both T and B cell activation as well as a significant increase (P < 0.05) in CD5 +CD8 + T cells proportion were observed after meloxicam administration, a predicted effect of long-term administration of meloxicam on rabbit lymphocytes was confirmed.

Moderate physical activity against effects of short-term PM2.5 exposure on BP via myokines-induced inflammation

Exposure to PM2.5 increases blood pressure (BP) and cardiovascular morbidity and mortality. We conducted a randomized controlled panel study in Shijiazhuang, China among 55 healthy college students randomly assigned to either the control (CON) or SPORTS group with intervention of 2000 m jogging in 20 min for 3 times in 4 days, and 3-round health examinations from November 15, 2020 to December 6, 2020. We aimed to evaluate whether moderate physical activity (PA) protected BP health against PM2.5 exposure and explore potential mechanisms through myokines and inflammation. Individual PM2.5 exposure was calculated based on outdoor and indoor PM2.5 concentration monitoring data as well as time-activity diary of each subject. In the CON group, the exposure-response curve for SBP was linear with a threshold concentration of approximately 31 μg/m3, while an increment of SBP level was 4.38 mm Hg (95%CI: 0.17 mm Hg, 8.59 mm Hg) at lag03 for each 10-μg/m3 increase in PM2.5, using linear mixed-effect models. For inflammatory indicators, PM2.5 exposure was associated with significant increases in eosinophil counts and proportion in CON group, but decreases in MCP-1 and TNF-α in SPORTS group. Meanwhile, higher myokines including CLU and IL-6 were observed in SPORTS group compared to the CON group. Further mediation analyses revealed that eosinophil counts mediated the elevated BP in CON group, whereas MCP-1 and TNF-α were also crucial mediating cytokines for the SPORTS group, as well as CLU and IL-6 acted as mediators on BP and inflammation indicators in SPORTS group. This study suggests that moderate PA could counteract the elevated BP induced by PM2.5 exposure via myokines-suppressed inflammation pathways.

Ophthalmologic emergency room visits during COVID-19 lockdown-Characterization from Haifa, Israel.

PurposeTo characterize quantitative differences among ophthalmologic emergency room (OER) encounters at Rambam Health Care Campus during a 6-week complete lockdown at the peak of the first COVID-19 wave as compared to a corresponding uneventful period a year earlier.MethodsA retrospective chart analysis of all OER encounters during the lockdown and non-lockdown period was conducted. Patients were stratified into primary ophthalmological conditions (OER visits) and cases in which ophthalmologic consultations were requested by a non-ophthalmologist (OER consultations). The following parameters were compared: total number of cases, age, gender, chief complaint/diagnosis categorized into major entities, and discharge vs. hospitalization. For continuous variables a t-test was used and for categorical variables a chi-squared or Fisher’s exact test was used. A 2-sided p value <0.05 was considered statistically significant.ResultsThe total number of patients in the lockdown and non-lockdown groups was 486 and 992, respectively, showing a 51% decrease in visits during lockdown. In the non-lockdown and lockdown groups 56% and 61% of patients were male (p = 0.07), with an average age of 42 (range 0–97, SD 23) and 43 (range 0–90, SD 22) years, respectively (p = 0.44). No statistically significant proportional increase was found for any diagnostic category between the OER visits (p = 0.07) and OER consultation groups (p = 0.77). Nevertheless, analysis revealed a non-significant increase in the proportion of eye trauma from 14.8% to 21.2%, and reduction in eyelid conditions from 10.7% to 5.8%. The total number of OER visits demanding urgent intervention on admission was 43 (non-lockdown) and 24 (lockdown), while hospitalization ratio (hospitalizations/visits) was 8.8% and 10.6%, respectively (p = 0.44).ConclusionsDuring the COVID-19 lockdown the guideline for patients in Israel was to avoid unnecessary hospital visits. Since patients tended to avoid the OER rather uniformly regardless of their specific eye condition, determining the risk-benefit of such recommendations and identifying high-risk sub-populations are critical public health issues.

Boarding for Youth Mental Health Conditions: How Can Hospitalists Be Part of the Solution?

Boarding for Youth Mental Health Conditions: How Can Hospitalists Be Part of the Solution?

The changing epidemiology of opioid overdose in Baltimore, Maryland, 2012–2017: insights from emergency medical services

Introduction An estimated 100,306 people died from an overdose from May 2020 to April 2021. Emergency Medical Services (EMS) are often the first responder to opioid overdose, and EMS encounter records can provide granular epidemiologic data on opioid overdose. This study describes the demographic, temporal, and geographic epidemiology of suspected opioid overdose in Baltimore City using data from Baltimore City Fire Department EMS encounters with the administration of the opioid antagonist naloxone. Method The present analyses used patient encounter data from 2012 to 2017 from the Baltimore City Fire Department, the city’s primary provider of EMS services. The analytic sample included patient encounters within the city that involved naloxone administration to patients 15 years of age or older (n = 20,592). Negative binomial regression was used to calculate the incidence rates based on demographic characteristics, year, and census tract. Choropleth maps were used to show the geographic distribution of overdose incidence across census tracts in 2013, 2015, and 2017. Results From 2012 to 2017, the annual number of EMS encounters with naloxone administrations approximately doubled every 2 years, and the temporal pattern of naloxone administration was similar to the pattern of fatal opioid-related overdoses. For most census tracts, incidence rates significantly increased over time. Population-based incidence of naloxone administration varied significantly by socio-demographic characteristics. Males, non-whites, and those 25–69 years of age had the highest incidence rates. Conclusion The incidence of naloxone administration increased dramatically over the study period. Despite significant cross-sectional variation in incidence across demographically and geographically defined groups, there were significant proportional increases in incidence rates, consistent with fatal overdose rates over the period. This study demonstrated the value of EMS data for understanding the local epidemiology of opioid-related overdose. Key Messages Patterns of EMS encounters with naloxone administration appear to be an excellent proxy for patterns of opioid-related overdoses based on the consistency of fatal overdose rates over time. EMS plays a central role in preventing fatal opioid-related overdoses through the administration of naloxone, provision of other emergency services, and transportation to medical facilities. EMS encounters with naloxone administration could also be used to evaluate the impact of overdose prevention interventions and public health services.

Visible Light-Induced Room-Temperature Formaldehyde Gas Sensor Based on Porous Three-Dimensional ZnO Nanorod Clusters with Rich Oxygen Vacancies.

Oxygen vacancy (VO) is a kind of primary point defect that extensively exists in semiconductor metal oxides (SMOs). Owing to some of its inherent qualities, an artificial manipulation of VO content in one material has evolved into a hot research field, which is deemed to be capable of modulating band structures and surface characteristics of SMOs. Specific to the gas-sensing area, VO engineering of sensing materials has become an effective means in enhancing sensor response and inducing light-enhanced sensing. In this work, a high-efficiency microwave hydrothermal treatment was utilized to prepare a VO-rich ZnO sample without additional reagents. The X-ray photoelectron spectroscopy test revealed a significant increase in VO proportion, which was from 9.21% in commercial ZnO to 36.27% in synthesized VO-rich ZnO possessing three-dimensional and air-permeable microstructures. The subsequent UV–vis–NIR absorption and photoluminescence spectroscopy indicated an extension absorption in the visible region and band gap reduction of VO-rich ZnO. It turned out that the VO-rich ZnO-based sensor exhibited a considerable response of 63% toward 1 ppm HCHO at room temperature (RT, 25 °C) under visible light irradiation. Particularly, the response/recovery time was only 32/20 s for 1 ppm HCHO and further shortened to 10/5 s for 10 ppm HCHO, which was an excellent performance and comparable to most sensors working at high temperatures. The results in this work strongly suggested the availability of VO engineering and also provided a meaningful candidate for researchers to develop high-performance RT sensors detecting volatile organic compounds.

Selected Articles from This Issue

Central nervous system (CNS) metastases are a prominent cause of morbidity and mortality in patients with ALK-positive (ALK+) non-small cell lung cancer (NSCLC). ASCEND-7 was one of the first prospective studies designed to use homogenous eligibility criteria, and assessments to evaluate intra/extracranial responses and activity of an ALK targeted agent, in the presence or absence of prior treatment, in patients with ALK+ NSCLC with active brain metastases and leptomeningeal metastasis. The phase II ASCEND-7 (NCT02336451) study was designed to assess the efficacy and safety of ALK inhibitor (ALKi) ceritinib in patients with ALK+ NSCLC metastatic to the brain and/or leptomeninges. Chow and colleagues report that ceritinib showed antitumor activity in patients with ALK+ NSCLC with active CNS disease and could be considered in the management of intracranial metastasis.Results from cohort 1 of the phase II, open-label KEYNOTE-224 study demonstrated that pembrolizumab monotherapy was efficacious and tolerable in patients with advanced hepatocellular carcinoma previously treated with sorafenib. In this article, Verset and colleagues report on cohort 2 of the KEYNOTE-224 study that investigated pembrolizumab monotherapy as a therapeutic approach for patients with advanced hepatocellular carcinoma, which had not been previously treated with systemic therapy. The results showed that pembrolizumab monotherapy in this population had promising efficacy, including objective response rate with durable antitumor activity and no new safety signals. These findings support further evaluation of pembrolizumab alone or in combination with other agents for the treatment of hepatocellular carcinoma.Podoplanin (PDPN) is highly expressed in several types of tumors and is known to promote tumor growth and metastasis through binding with a C-type lectin-like receptor 2 (CLEC-2) on platelets. In osteosarcoma, PDPN-CLEC-2 binding induced PDGFs release from platelets and resulted in PDGFRs mediated growth promotion of osteosarcoma. In this study, Takemoto and colleagues developed a humanized anti-PDPN neutralizing antibody, named AP201, aiming for the clinical application for PDPN highly expressing cancer such as osteosarcoma. AP201 potently neutralized PDPN-CLEC-2 binding and inhibited tumor growth and metastasis in osteosarcoma xenograft models. Thus, targeting PDPN with a neutralizing antibody could be a novel therapeutic strategy for osteosarcoma treatment.Kaposi sarcoma (KS) remains among the most common malignancies occurring with HIV infection (HIV-KS). Oral anti-inflammatory, anti-angiogenic, and immunomodulatory agent, lenalidomide, is a potentially attractive alternative to standard chemotherapy for KS. Here, Reid and colleagues present results of a phase I/II trial to determine the maximum tolerated dose (MTD) and response rates for lenalidomide in HIV-KS. The MTD was not reached, but the authors recommended 25 mg as the phase II dose (RP2D). Reported adverse events were consistent with the established safety profile of lenalidomide and 60% of participants receiving RP2D obtained a partial response. Correlative analysis performed in a subset of participants demonstrated a significant increase in proportions of blood T cells with a regulatory phenotype, and plasma cytokines trended toward a less inflammatory pattern. Clinical response was associated with loss of KSHV transcription. Following on this study, multicenter domestic and international AIDS Malignancy Consortium trials are underway to confirm the tolerability and activity of immunomodulatory therapy in KS.

Modification of Artichoke Dietary Fiber by Superfine Grinding and High-Pressure Homogenization and Its Protection against Cadmium Poisoning in Rats.

This study was carried out to investigate the effects of superfine grinding (SP) and high-pressure homogenization (HPH) on the structural and physicochemical properties of artichoke dietary fiber (ADF), as well as the protective effects against cadmium poisoning in rats. The structural characteristics and physicochemical properties of ADF, HPH-ADF (ADF treated by HPH) and CM-ADF (ADF treated by SP and HPH) were determined, and cadmium chloride (CdCl2) was induced by exposing rats for 7 weeks. The amounts of creatinine and urea; the activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in serum; the quantity of red blood cells, hemoglobin, white blood cells and neutrophil proportion in blood samples; and the activity of glutathione peroxidase (GSH-Px) in liver tissue were analyzed. Hematoxylin-eosin (HE) staining was performed to analyze the tissue structure and pathology of the liver and testis. The results showed that ADF subjected to HPH and SP-HPH exhibited increased content of soluble dietary fiber (SDF) (p < 0.05). HPH and SP-HPH treatments increased oil-holding capacity (OHC), total negative charge (TNC) and heavy metal adsorption capacity (p < 0.05). The CdCl2 intervention led to a significant increase in AST, ALT, creatinine, urea, neutrophil proportion and white blood cell count, as well as a significant decrease in GSH-Px activity, red blood cell count and hemoglobin (HGB) (p < 0.05). In rats fed with ADF, HPH-ADF and CM-ADF significantly reduced creatinine, urea amounts, ALT, AST activity in serum, leukocyte count and the neutrophil ratio in blood and increased GSH-Px activity in the liver, in addition to increasing the erythrocyte count and hemoglobin count in blood (p < 0.05). H&E staining results showed that steatosis in the liver was significantly reduced, whereas testicular tissue edema was improved. These results indicate that ADF exhibited positive activity against cadmium poisoning in rats and that CM-ADF had a better protective effect than ADF and HPH-ADF. ADF has specific potential to be used in health foods or therapeutic drugs, providing a reference for the development and utilization of artichoke waste.