The Value of a Longitudinal Human Immunodeficiency Virus Track for Medical Students: 10-Year Program Evaluation

We surveyed graduates of a longitudinal medical school human immunodeficiency virus curriculum to evaluate its impact. Respondents felt comfortable caring for people with human immunodeficiency virus (PWH) and found value from the curriculum regardless of ultimate career path. Programs like this contribute to the development of culturally sensitive clinicians comfortable caring for PWH

Análise da correção atmosférica de imagens Landsat em estudo multitemporal na região de Mata Atlântica, Estado do Rio de Janeiro.

Multitemporal, remotely sensed data applied to land use land cover dynamic studies require radiometric correction of images, in addition to geometric correction. This allow the analysis of temporal variation of targets without the influence of others factors such as the atmospheric effects. This study aims to apply the dark-object subtraction technique to correct atmospheric effects and to analyze the results on multitemporal images of rivers Macacu and Caceribu watersheds, in Rio de Janeiro state, in Atlantic Forest region. Images without clouds from sensors TM/Landsat-5 and ETM+/Landsat-7 were selected for analysis of land use land cover dynamic of two periods: 1997 to 2002 and 2002 to 2007. The results indicated that the correction method did not reduce the atmospheric effects in a satisfactory manner. These effects continued to influence in any significant way in the spectral response of the targets. The major differences between the levels of gray of the corrected images were among the images of different sensors, indicating likely influence of the response of the sensors on the final results. o objetivo do presente trabalho é analisar o efeito da correção atmosférica aplicando método de subtração de nível de ci nza em imagens multitemporais da região das bacias hidrográficas dos rios Macacu e Caceribu, no Estado do Rio de Janeiro, em região de Mata Atlântica

Steroid-Induced Sigmoid Diverticular Perforation in a Patient with Temporal Arteritis: A Rare Clinical Pathology

Corticosteroids are used in the treatment of many rheumatological diseases including temporal arteritis. The gastrointestinal perforation during corticosteroid treatment is a serious complication. Colon perforation after steroid use was first reported by Beck et al in 1950.1 Although the pathophysiological mechanism is not understood clearly, it is claimed that steroids probably by disturbing the intestinal mucosal barrier, facilitate the intestinal perforation. The long term treatment with corticosteroids increases the risk of colon perforation. We are presenting a patient who was taking corticosteroid due to temporal arteritis for two years and operated with sigmoid diverticular perforation

Site Selection for Coral Reef Restoration Using Airborne Imaging Spectroscopy

Over the past decade, coral restoration efforts have increased as reefs continue to decline at unprecedented rates. Identifying suitable coral outplanting locations to maximize coral survival continues to be one of the biggest challenges for restoration practitioners. Here, we demonstrate methods of using derivatives from imaging spectroscopy from the Global Airborne Observatory (GAO) to identify suitable coral outplant sites and report on the survival rates of restored coral at those sites. Outplant sites for a community-based, citizen science outplant event in Bávaro, Dominican Republic, were identified using expert-defined criteria applied to a suitability model from data layers derived from airborne imagery. Photo quadrat analysis of the benthic community confirmed the accuracy of airborne remote sensing maps with live coral cover averaging 3.5–4% and mean algal cover (macro algae and turf) ranging from 28 to 32%. Coral outplant sites were selected at 3–7 m depth with maximized levels of habitat complexity (i.e., rugosity) and live coral cover and minimized levels of macroalgal cover, as predicted by the imaging spectrometer data. In November 2019, 1,722 Acropora cervicornis fragments (80–180 mm in length) were outplanted to these sites. Surveys conducted in January 2020 in four of these sites confirmed that 92% of outplants survived after 3 months. By October 2020 (11 months after outplanting), survivorship remained above 76%. These results demonstrate higher than average success rates for coral outplant survival for this species. An online tool was developed to enable replication and facilitate future selection of coral restoration sites. Our objective is to present a case study that uses GAO-derived map products within a suitability model framework to provide a quantitative and replicable method for selecting coral restoration sites with the goal of increasing outplant survival over time

Periodontal Treatment Practice and Referral Profile of General Dentists – A Cross-sectional Questionnaire Survey

BACKGROUND: Because of medical advancement, the mean age of the general population is increasing gradually. This increase in the mean age of patients has led to its implications on oral health. Hence, it is logical to assume an increase in the figure of referrals to specialists and the complexity of treatments provided. AIM: The aim of the survey was to assess the current status of periodontal treatment provided, awareness of referral profile, and criteria taken into consideration for the referral to the periodontist by general dentists. MATERIALS AND METHODS: This cross-sectional questionnaire study was conducted among 318 general dentists. The relevant work related to the status of periodontal procedures provided by dentists and their referral relationships were studied. The questionnaire consisting of six questions was designed. Descriptive statistics, including frequency distributions and measures of central tendency and Chi-square test, were used. RESULTS: The study showed that majority of the general dentists do non-surgical procedures by their own. However, around 85% of respondents did not provide surgical periodontal treatment by themselves. About 25% of the responding general dentists thought that they had inadequate education and experience in the field of periodontics which was a major reason for the referral to specialists. CONCLUSION: It was concluded that the general dentists are comfortable in carrying out the non-surgical procedures, but they had some reservations about the periodontal surgical procedures. Inadequate experience and facilities were the major reasons for the referral to periodontists. More of this type of study should be conducted to know the basic level of periodontal practices carried out among the general dentists and about the referral to the specialists

NDRG2 Expression Correlates with Neurofibrillary Tangles and Microglial Pathology in the Ageing Brain.

Astrocytes play a major role in the pathogenesis of a range of neurodegenerative diseases, including Alzheimer's disease (AD), undergoing dramatic morphological and molecular changes that can cause potentially both beneficial and detrimental effects. They comprise a heterogeneous population, requiring a panel of specific phenotype markers to identify astrocyte subtypes, changes in function and their relation to pathology. This study aimed to characterise expression of the astrocyte marker N-myc downstream regulated gene 2 (NDRG2) in the ageing brain, investigate the relationship between NDRG2 and a panel of astrocyte markers, and relate NDRG2 expression to pathology. NDRG2 specifically immunolabelled the cell body and radiating processes of astrocytes in the temporal cortex of the Cognitive Function and Ageing Study (CFAS) neuropathology cohort. Expression of NDRG2 did not correlate with other astrocyte markers, including glial fibrillary acidic protein (GFAP), excitatory amino acid transporter 2 (EAAT2) and glutamine synthetase (GS). NDRG2 showed a relationship to AT8+ neurofibrillary tangles (p = 0.001) and CD68+ microglia (p = 0.047), but not β-amyloid plaques or astrocyte nuclear γH2AX immunoreactivity, a marker of DNA damage response. These findings provide new insight into the astrocyte response to pathology in the ageing brain, and suggest NDRG2 may be a potential target to modulate this response

Ovarian Cancer Progression is Controlled by Phenotypic Changes in Dendritic Cells

We characterized the initiation and evolution of the immune response against a new inducible p53-dependent model of aggressive ovarian carcinoma that recapitulates the leukocyte infiltrates and cytokine milieu of advanced human tumors. Unlike other models that initiate tumors before the development of a mature immune system, we detect measurable antitumor immunity from very early stages, which is driven by infiltrating dendritic cells (DCs) and prevents steady tumor growth for prolonged periods. Coinciding with a phenotypic switch in expanding DC infiltrates, tumors aggressively progress to terminal disease in a comparatively short time. Notably, tumor cells remain immunogenic at advanced stages, but anti-tumor T cells become less responsive, whereas their enduring activity is abrogated by different microenvironmental immunosuppressive DCs. Correspondingly, depleting DCs early in the disease course accelerates tumor expansion, but DC depletion at advanced stages significantly delays aggressive malignant progression. Our results indicate that phenotypically divergent DCs drive both immunosurveillance and accelerated malignant growth. We provide experimental support for the cancer immunoediting hypothesis, but we also show that aggressive cancer progression after a comparatively long latency period is primarily driven by the mobilization of immunosuppressive microenvironmental leukocytes, rather than loss of tumor immunogenicity

Regional High-Resolution Benthic Habitat Data From Planet Dove Imagery For Conservation Decision-Making and Marine Planning

High-resolution benthic habitat data fill an important knowledge gap for many areas of the world and are essential for strategic marine conservation planning and implementing effective resource management. Many countries lack the resources and capacity to create these products, which has hindered the development of accurate ecological baselines for assessing protection needs for coastal and marine habitats and monitoring change to guide adaptive management actions. The PlanetScope (PS) Dove Classic SmallSat constellation delivers high-resolution imagery (4 m) and near-daily global coverage that facilitates the compilation of a cloud-free and optimal water column image composite of the Caribbean’s nearshore environment. These data were used to develop a first-of-its-kind regional thirteen-class benthic habitat map to 30 m water depth using an object-based image analysis (OBIA) approach. A total of 203,676 km2 of shallow benthic habitat across the Insular Caribbean was mapped, representing 5% coral reef, 43% seagrass, 15% hardbottom, and 37% other habitats. Results from a combined major class accuracy assessment yielded an overall accuracy of 80% with a standard error of less than 1% yielding a confidence interval of 78–82%. Of the total area mapped, 15% of these habitats (31,311.7 km2) are within a marine protected or managed area. This information provides a baseline of ecological data for developing and executing more strategic conservation actions, including implementing more effective marine spatial plans, prioritizing and improving marine protected area design, monitoring condition and change for post-storm damage assessments, and providing more accurate habitat data for ecosystem service models

Transcriptomic Analysis of Age-Associated Periventricular Lesions Reveals Dysregulation of the Immune Response.

White matter lesions (WML) are a common feature of the ageing brain associated with cognitive impairment. The gene expression profiles of periventricular lesions (PVL, n = 7) and radiologically-normal-appearing (control) periventricular white matter cases (n = 11) obtained from the Cognitive Function and Ageing Study (CFAS) neuropathology cohort were interrogated using microarray analysis and NanoString to identify novel mechanisms potentially underlying their formation. Histological characterisation of control white matter cases identified a subgroup (n = 4) which contained high levels of MHC-II immunoreactive microglia, and were classified as "pre-lesional." Microarray analysis identified 2256 significantly differentially-expressed genes (p ≤ 0.05, FC ≥ 1.2) in PVL compared to non-lesional control white matter (1378 upregulated and 878 downregulated); 2649 significantly differentially-expressed genes in "pre-lesional" cases compared to PVL (1390 upregulated and 1259 downregulated); and 2398 significantly differentially-expressed genes in "pre-lesional" versus non-lesional control cases (1527 upregulated and 871 downregulated). Whilst histological evaluation of a single marker (MHC-II) implicates immune-activated microglia in lesion pathology, transcriptomic analysis indicates significant downregulation of a number of activated microglial markers and suggests established PVL are part of a continuous spectrum of white matter injury. The gene expression profile of "pre-lesional" periventricular white matter suggests upregulation of several signalling pathways may be a neuroprotective response to prevent the pathogenesis of PVL