Smart shops: a survey of products, claimed effects and medical-toxicological relevance

During the last few years the use of herbal drugs of abuse, so-called 'smart products' and eco-drugs has increased. Many of these products have psychoactive effects. The variety of smart products sold in the so-called smart shops is enormous and this is still a growing market. The increased availability of these products and the continuing appearance of new products on the market, has led to increased awareness of the possible negative health aspects associated with the use of these products. At present, the Dutch Inspectorate for Health Protection, Commodities and Veterinary Public Health is testing the activities of these smart shops and the products for adherence to the regulations. This document, prepared by the National Poisons Control Centre (NVIC) of the National Institute of Public Health and the Environment (RIVM), serves as a practical aid to the Inspectorate in evaluating the various smart products. Four important groups of smart products can be discerned: the energizers, relaxing herbs, aphrodisiacs and products with hallucinogenic properties. For each of these groups the following items are described: the various product appearances, usage, the (desired) effects of the product according to smart shop information brochures, a description of the original plants (most of these products are derived from plants), the active ingredients in the product, and to the best of our knowledge, the pharmacology and medical toxicology of these ingredients and products. Further monitoring of the use of these smart products and the health effects they cause, should make clear to which specific group of smart products most attention should be paid from a medical point of view.Het gebruik van zogenaamde smartproducts en eco-drugs neemt de laatste jaren steeds meer toe. Het aanbod van producten die in de smartshops worden verkocht is zeer divers. Veel van de aangeboden middelen hebben psychoactieve effecten. Bovendien is het een uiterst dynamische markt, waar regelmatig nieuwe producten ontwikkeld en verkocht worden. Door deze groeiende markt wordt ook van overheidswege aandacht besteed aan de gezondheids- en maatschappelijke risico's van het gebruik en de verkoop van deze middelen. In het huidige beleid ten aanzien van deze middelen ligt de nadruk op gezondheidsbescherming met behulp van voorlichting, monitoring en onderzoek. In dit kader toetst in 1999 de Inspectie Gezondheidsbescherming, Waren en Veterinaire Zaken de activiteiten van smartshops en andere verkooppunten, alsmede de verhandelde waar, aan de warenwettelijke kaders. Zonodig wordt nieuwe jurisprudentie opgebouwd. Dit rapport, geschreven op verzoek van en in samenwerking met de Inspectie Gezondheidsbescherming, Waren en Veterinaire Zaken dient de Inspectie tot een praktisch hulpmiddel bij het evalueren van de vele verschillende producten die op de markt aanwezig zijn. Op grond van het belangrijkste beoogde effect dat deze middelen na gebruik zouden verschaffen, zijn de producten ingedeeld in een van de vier te onderscheiden functionele groepen, te weten de "energizers", "relaxing herbs", "afrodisiaca" en "hallucinogene producten". Per product(-groep) worden besproken: de verschillende productvoorkomens en wijze van gebruik, het in de smartshop gepropageerde doel van gebruik, de plantaardige herkomst van het product, en de samenstellende verbindingen met voor zover bekend hun farmacologische werkingsmechanismen en toxiciteit. Daarbij is gebruik gemaakt van de humaan medisch-toxicologische kennis zoals die op dit moment voorhanden is. Verdere monitoring naar de effecten van het gebruik zal inzichtelijk moeten maken naar welke productgroepen vanuit medisch oogpunt in de toekomst de meeste aandacht zal moeten uitgaan

Towards automatic pulmonary nodule management in lung cancer screening with deep learning

The introduction of lung cancer screening programs will produce an unprecedented amount of chest CT scans in the near future, which radiologists will have to read in order to decide on a patient follow-up strategy. According to the current guidelines, the workup of screen-detected nodules strongly relies on nodule size and nodule type. In this paper, we present a deep learning system based on multi-stream multi-scale convolutional networks, which automatically classifies all nodule types relevant for nodule workup. The system processes raw CT data containing a nodule without the need for any additional information such as nodule segmentation or nodule size and learns a representation of 3D data by analyzing an arbitrary number of 2D views of a given nodule. The deep learning system was trained with data from the Italian MILD screening trial and validated on an independent set of data from the Danish DLCST screening trial. We analyze the advantage of processing nodules at multiple scales with a multi-stream convolutional network architecture, and we show that the proposed deep learning system achieves performance at classifying nodule type that surpasses the one of classical machine learning approaches and is within the inter-observer variability among four experienced human observers.Comment: Published on Scientific Report

Computational modelling of energy balance in individuals with Metabolic Syndrome

Abstract Background A positive energy balance is considered to be the primary cause of the development of obesity-related diseases. Treatment often consists of a combination of reducing energy intake and increasing energy expenditure. Here we use an existing computational modelling framework describing the long-term development of Metabolic Syndrome (MetS) in APOE3L.CETP mice fed a high-fat diet containing cholesterol with a human-like metabolic system. This model was used to analyze energy expenditure and energy balance in a large set of individual model realizations. Results We developed and applied a strategy to select specific individual models for a detailed analysis of heterogeneity in energy metabolism. Models were stratified based on energy expenditure. A substantial surplus of energy was found to be present during MetS development, which explains the weight gain during MetS development. In the majority of the models, energy was mainly expended in the peripheral tissues, but also distinctly different subgroups were identified. In silico perturbation of the system to induce increased peripheral energy expenditure implied changes in lipid metabolism, but not in carbohydrate metabolism. In silico analysis provided predictions for which individual models increase of peripheral energy expenditure would be an effective treatment. Conclusion The computational analysis confirmed that the energy imbalance plays an important role in the development of obesity. Furthermore, the model is capable to predict whether an increase in peripheral energy expenditure – for instance by cold exposure to activate brown adipose tissue (BAT) – could resolve MetS symptoms

In Silico Analysis Identifies Intestinal Transit as a Key Determinant of Systemic Bile Acid Metabolism

Bile acids fulfill a variety of metabolic functions including regulation of glucose and lipid metabolism. Since changes of bile acid metabolism accompany obesity, Type 2 Diabetes Mellitus and bariatric surgery, there is great interest in their role in metabolic health. Here, we developed a mathematical model of systemic bile acid metabolism, and subsequently performed in silico analyses to gain quantitative insight into the factors determining plasma bile acid measurements. Intestinal transit was found to have a surprisingly central role in plasma bile acid appearance, as was evidenced by both the necessity of detailed intestinal transit functions for a physiological description of bile acid metabolism as well as the importance of the intestinal transit parameters in determining plasma measurements. The central role of intestinal transit is further highlighted by the dependency of the early phase of the dynamic response of plasma bile acids after a meal to intestinal propulsion

Расчёт напряженно-деформированного состояния виброизоляторов сложной формы

Розглянуто пружно-деформований стан гумових віброізоляторів з урахуванням контактної взаємодії з деталями конструкції.Stress-strain state of rubber vibroinsulators is considered, taking into account contact interaction with construction parts

Psychophysiological Responses to Stress after Stress Management Training in Patients with Rheumatoid Arthritis

Contains fulltext : 97274.pdf (publisher's version ) (Open Access)BACKGROUND: Stress management interventions may prove useful in preventing the detrimental effects of stress on health. This study assessed the effects of a stress management intervention on the psychophysiological response to stress in patients with rheumatoid arthritis (RA). METHODS: Seventy-four patients with RA, who were randomly assigned to either a control group or a group that received short-term stress management training, performed a standardized psychosocial stress task (Trier Social Stress Test; TSST) 1 week after the stress management training and at a 9-week follow-up. Psychological and physical functioning, and the acute psychophysiological response to the stress test were assessed. RESULTS: Patients in the intervention group showed significantly lower psychological distress levels of anxiety after the training than did the controls. While there were no between-group differences in stress-induced tension levels, and autonomic (alpha-amylase) or endocrine (cortisol) responses to the stress test 1 week after the intervention, levels of stress-induced tension and cortisol were significantly lower in the intervention group at the 9-week follow-up. Overall, the response to the intervention was particularly evident in a subgroup of patients with a psychological risk profile. CONCLUSION: A relatively short stress management intervention can improve psychological functioning and influences the psychophysiological response to stress in patients with RA, particularly those psychologically at risk. These findings might help understand how stress can affect health and the role of individual differences in stress responsiveness. TRIAL REGISTRATION: TrialRegister.nl NTR1193

Bariatric surgery improves postprandial VLDL kinetics and restores insulin mediated regulation of hepatic VLDL production

Dyslipidemia in obesity results from excessive production and impaired clearance of triglyceride-rich (TG-rich) lipoproteins, which are particularly pronounced in the postprandial state. Here, we investigated the impact of Roux-en-Y gastric bypass (RYGB) surgery on postprandial VLDL1 and VLDL2 apoB and TG kinetics and their relationship with insulin-responsiveness indices. Morbidly obese patients without diabetes who were scheduled for RYGB surgery (n = 24) underwent a lipoprotein kinetics study during a mixed-meal test and a hyperinsulinemic-euglycemic clamp study before the surgery and 1 year later. A physiologically based computational model was developed to investigate the impact of RYGB surgery and plasma insulin on postprandial VLDL kinetics. After the surgery, VLDL1 apoB and TG production rates were significantly decreased, whereas VLDL2 apoB and TG production rates remained unchanged. The TG catabolic rate was increased in both VLDL1 and VLDL2 fractions, but only the VLDL2 apoB catabolic rate tended to increase. Furthermore, postsurgery VLDL1 apoB and TG production rates, but not those of VLDL2, were positively correlated with insulin resistance. Insulin-mediated stimulation of peripheral lipoprotein lipolysis was also improved after the surgery. In summary, RYGB resulted in reduced hepatic VLDL1 production that correlated with reduced insulin resistance, elevated VLDL2 clearance, and improved insulin sensitivity in lipoprotein lipolysis pathways.</p

Evidence of a sudden increase in α-chloralose poisoning in dogs and cats in the Netherlands between 2018 and 2021

BACKGROUND: After changes in European Union biocide legislation, the Dutch Poisons Information Center observed a strong increase in information requests concerning dogs and cats exposed to α-chloralose. To investigate whether α-chloralose-based rodenticides are safe for non-professional use, additional information regarding poisoning scenarios and clinical course was collected. METHODS: Veterinarians reporting α-chloralose exposure over a 2.5-year period were contacted by mail for follow-up information concerning exposure scenario, product formulation, clinical course and treatment, and outcome. In total, information was collected for 96 dogs and 41 cats. RESULTS: Fifty-three of 96 dogs and 17 of 19 cats known to have been exposed to α-chloralose-based rodenticides developed signs of central nervous system (CNS) depression or sensory-induced CNS excitation. Mortality in dogs and cats following exposure was 1% and 18%, respectively. An additional 22 cats presented with clinical signs suggestive of α-chloralose poisoning, with a mortality of 5%. LIMITATIONS: Exposure to α-chloralose was not confirmed by biochemical analyses. CONCLUSION: Dogs and especially cats were at risk of poisoning from α-chloralose. If criteria such as acute toxicity and risk of (secondary) poisoning are applied during the approval of α-chloralose-based rodenticides, similar to anticoagulant-based rodenticides, it can be concluded that α-chloralose is also not safe for non-professional use

Maladaptive personality traits in adolescence: Psychometric properties of the Personality Diagnostic Questionnaire-4+

AbstractThe Personality Diagnostic Questionnaire-4+ (PDQ-4+) is a self-report used for the assessment of personality disorder traits, however, its psychometric characteristics have yet to be tested in community samples of adolescents. The main goal was to analyze the psychometric properties of the PDQ-4+ scores in a large sample of non-clinical adolescents (N=1,443; M=15.9 years; SD=1.2). The PDQ-4+ scores showed adequate psychometric properties. Reliability of the subscales, incorporating a Likert-type 5-point response format, ranged from .62 to .85. The study of the internal structure at item level revealed that the PDQ-4+ subscales were essentially one-dimensional. Analysis of the internal structure at the subscale level by means of exploratory factor analysis and exploratory structural equation modeling yielded a possible three-dimensional solution. The PDQ-4+ subscales correlated moderately with emotional and behavioural variables measured by the Strengths and Difficulties Questionnaire. The results have clear implications for the understanding of maladaptive personality traits in adolescents