Culture-centered approaches: the relevance of assessing emotional health for Latinos with type 2 diabetes

Objective Within Latino culture, there is a belief that strong emotions can cause diabetes. Because of this belief and evidence regarding the bi-directional relationship between depression and diabetes, the objectives of this study were to determine if medical doctors are asking Latinos with diabetes about emotional problems and to assess attitudes toward professional help for emotional problems. Research design and methods Data come from the nationally representative National Latino and Asian American Study and the National Comorbidity Survey Replication study. Only Latino subsamples were included (n=3076). A smaller subsample with complete data (n=2568) was used for the inquiry outcome variable. Weighted χ2 analysis and logistic regression were conducted to determine the likelihood of being asked about emotional problems and attitudes toward professional help. Results Latinos with mood disorders or anxiety (MD/AX; OR 2.84, 95% CI 2.02 to 4.00), diabetes only (OR 1.69, 95% CI 1.06 to 2.69), and co-occurring diabetes and MD/AX (OR 6.67, 95% CI 2.33 to 19.04) were more likely to be asked about emotional problems, relative to Latinos without diabetes or MD/AX. A minority of respondents with diabetes (32%) were asked about emotional problems. Respondents with diabetes only were more likely to feel comfortable talking to a professional for personal problems compared with those without diabetes or MD/AX (OR 1.44, 95% CI 0.99 to 2.09). Although the relationship between having diabetes and feeling comfortable taking to a professional is not statistically significant, z-test statistics indicate that having diabetes influences attitudes about discussing emotional problems. Conclusions Among Latinos, having diabetes is associated with greater likelihood of being asked about emotional problems and feeling comfortable talking to a professional about personal problems. Consistent with the cultural relevance of emotions as a cause of diabetes, asking about emotional problems may be a useful approach for engaging Latinos into a discussion about their diabetes self-care activities

Patient with hepatocellular carcinoma related to prior acute arsenic intoxication and occult HBV: epidemiological, clinical and therapeutic results after 14 years of follow-up

Little is known about the long-term survivors of acute arsenic intoxication. We present here a clinical case report of a man with chronic hepatitis B virus (HBV) infection who developed hepatocellular carcinoma four years after acute arsenic poisoning. HBsAg was detected in serum in 1990 when he voluntarily donated blood. In 1991, the patient suffered from severe psychological depression that led him to attempt suicide by massive ingestion of an arsenic-containing rodenticide. He survived with polyneuropathy and paralysis of the lower limbs, and has been wheelchair-bound since then. During participation in a follow-up study conducted among HBV carriers, abdominal ultrasound detected a two-centimeter liver mass consistent with hepatocellular carcinoma. The tumor was confirmed by computed tomography (CT) and magnetic resonance image (MRI). Because of his significant comorbidity, the patient received palliative treatment with transarterial lipiodol chemoembolization (TACE) on three occasions (1996, 1997 and 1999). At his most recent visit in May 2005, the patient was asymptomatic, liver enzymes were normal and the tumor was in remission on ultrasound

Data descriptor: freshwater macroinvertebrate samples from a water quality monitoring network in the iberian peninsula

This dataset gathers information about the macroinvertatebrate samples and environmental variables collected on rivers of the Ebro River Basin (NE Iberian Peninsula), the second largest catchment in the Iberian Peninsula. The collection is composed of 1,776 sampling events carried out between 2005 and 2015 at more than 400 sampling sites. This dataset is part of a monitoring network set up by the Ebro Hydrographic Confederation, the official body entrusted with the care of the basin, to fulfill the requirements of the European Water Framework Directive. Biological indices based on the freshwater macroinvertebrate communities were used to evaluate the ecological status of the water bodies within the basin. Samples were qualitatively screened for all occurring taxa. Then, all individuals from all taxa in a quantitative subsample of each sample were counted. Biological indices were calculated to estimate water quality at each sampling site. All samples are kept at the Museum of Zoology of the University of Navarra

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

Interaction of Copper-Based Nanoparticles to Soil, Terrestrial, and Aquatic Systems: Critical Review of the State of the Science and Future Perspectives

In the past two decades, increased production and usage of metallic nanoparticles (NPs) has inevitably increased their discharge into the different compartments of the environment, which ultimately paved the way for their uptake and accumulation in various trophic levels of the food chain. Due to these issues, several questions have been raised on the usage of NPs in everyday life and has become a matter of public health concern. Among the metallic NPs, Cu-based NPs have gained popularity due to their cost-effectiveness and multifarious promising uses. Several studies in the past represented the phytotoxicity of Cu-based NPs on plants. However, comprehensive knowledge is still lacking. Additionally, the impact of Cu-based NPs on soil organisms such as agriculturally important microbes, fungi, mycorrhiza, nematode, and earthworms are poorly studied. This review article critically analyses the literature data to achieve a more comprehensive knowledge on the toxicological profile of Cu-based NPs and increase our understanding of the effects of Cu-based NPs on aquatic and terrestrial plants as well as on soil microbial communities. The underlying mechanism of biotransformation of Cu-based NPs and the process of their penetration into plants has also been discussed herein. Overall, this review could provide valuable information to design rules and regulations for the safe disposal of Cu-based NPs into a sustainable environment

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402

Fish passage assessment at the most downstream barrier of the Ebro River (NE Iberian Peninsula)

Fish passage at artificial barriers is necessary for the conservation of healthy fish stocks. The first barrier that migratory fish encounter when ascending the Ebro River is the Xerta Weir, where a pool-type fishway was constructed in 2008. From 2007 to 2010, boat electrofishing surveys were conducted in the Ebro River downstream of the Xerta Weir to assess the potential pool of species that could use the fishway. Nine native and 12 exotic species were captured, the latter comprising 62 % of the relative abundance and 70 % of the biomass. A combination of video recording, electrofishing and trapping was used to assess the effectiveness of the fishway in facilitating the passage of fish. Eight species were detected using the fishway, of which five were native (Liza ramada, Anguilla anguilla, Barbus graellsii, Gobio lozanoi and Salaria fluviatilis) and three exotic (Alburnus alburnus, Cyprinus carpio and Rutilus rutilus). Only L. ramada used the fishway in substantial numbers. The rate of fish passage was the highest from June to August and decreased afterwards. The effectiveness of the fishway might be lowered by areas of turbulence within the fishway and by distraction flows from a nearby hydropower station.El paso de peces a través de barreras artificiales es necesario para la conservación en buen estado de las poblaciones de peces. La primera barrera que los peces migratorios encuentran ascendiendo el Río Ebro es el Azud de Xerta, donde en 2008 se construyó una escala de peces del tipo de estanques sucesivos. Para determinar el conjunto de especies que potencialmente podrían usar la escala se llevaron a cabo muestreos mediante pesca eléctrica desde embarcación aguas abajo del azud. Nueve especies nativas y 12 exóticas fueron capturadas, representando estas últimas el 62 % de la abundancia relativa y el 70 % de la biomasa. Se usó una combinación de grabaciones de video, pesca eléctrica y trampeo para evaluar la efectividad de la escala de peces. Ocho especies fueron detectadas en la escala, de las cuales cinco eran nativas (Liza ramada, Anguilla anguilla, Barbus graellsii, Gobio lozanoi y Salaria fluviatilis) y tres exóticas (Alburnus alburnus, Cyprinus carpio y Rutilus rutilus). Sólo L. ramada usó la escala en un número destacado. La tasa de paso de peces fue más alta de Junio a Agosto y descendió posteriormente. La efectividad de la escala puede estar limitada por areas de turbulencia dentro de la escala y caudales de distracción desde una central hidroeléctrica cercana

Fish passage assessment at the most downstream barrier of the Ebro River (NE Iberian Peninsula)

Fish passage at artificial barriers is necessary for the conservation of healthy fish stocks. The first barrier that migratory fish encounter when ascending the Ebro River is the Xerta Weir, where a pool-type fishway was constructed in 2008. From 2007 to 2010, boat electrofishing surveys were conducted in the Ebro River downstream of the Xerta Weir to assess the potential pool of species that could use the fishway. Nine native and 12 exotic species were captured, the latter comprising 62 % of the relative abundance and 70 % of the biomass. A combination of video recording, electrofishing and trapping was used to assess the effectiveness of the fishway in facilitating the passage of fish. Eight species were detected using the fishway, of which five were native (Liza ramada, Anguilla anguilla, Barbus graellsii, Gobio lozanoi and Salaria fluviatilis) and three exotic (Alburnus alburnus, Cyprinus carpio and Rutilus rutilus). Only L. ramada used the fishway in substantial numbers. The rate of fish passage was the highest from June to August and decreased afterwards. The effectiveness of the fishway might be lowered by areas of turbulence within the fishway and by distraction flows from a nearby hydropower stationEl paso de peces a través de barreras artificiales es necesario para la conservación en buen estado de las poblaciones de peces. La primera barrera que los peces migratorios encuentran ascendiendo el Río Ebro es el Azud de Xerta, donde en 2008 se construyó una escala de peces del tipo de estanques sucesivos. Para determinar el conjunto de especies que potencialmente podrían usar la escala se llevaron a cabo muestreos mediante pesca eléctrica desde embarcación aguas abajo del azud. Nueve especies nativas y 12 exóticas fueron capturadas, representando estas últimas el 62 % de la abundancia relativa y el 70 % de la biomasa. Se usó una combinación de grabaciones de video, pesca eléctrica y trampeo para evaluar la efectividad de la escala de peces. Ocho especies fueron detectadas en la escala, de las cuales cinco eran nativas (Liza ramada, Anguilla anguilla, Barbus graellsii, Gobio lozanoi y Salaria fluviatilis) y tres exóticas (Alburnus alburnus, Cyprinus carpio y Rutilus rutilus). Sólo L. ramada usó la escala en un número destacado. La tasa de paso de peces fue más alta de Junio a Agosto y descendió posteriormente. La efectividad de la escala puede estar limitada por áreas de turbulencia dentro de la escala y caudales de distracción desde una central hidroeléctrica cercan