Changes in biomechanical properties of chemotherapy bone cement after a year in saline storage

Introduction: Acrylic based bone cements are a versatile treatment modality in Orthopaedic surgery due to their wide variety of uses and tolerance to high degree of customization. Bone cement can be used to repair and stabilize pathologic fractures and may potentially prevent recurrence post tumor resection. Chemotherapeutic bone cements are favorable because they can potentially minimize systemic side effects and the need for radiation. Cements can be combined with soluble fillers such as polyethylene glycol (PEG) to optimize drug elution. Even though studies have measured the mechanical properties of bone cement in dry state, the exact change in the mechanical properties of bone cement after drug/soluble filler elution is largely unknown. This study investigates the change in mechanical properties of commercially available bone cements modified with PEG fillers after one year of storage in drug elution medium. Methods: Confidence Ultra, Vertebroplastic, and Palacos cement were used and mixed with varying amounts (0–50%) of PEG and chemotherapy agents (methotrexate or doxorubicin). Bone cement specimens were stored in a saline solution for one year after which they were tested in compression at 1 mm/min until failure. Results: The modulus and compression strength of bone cements decreased with increase in soluble filler composition. Although soluble fillers were shown to weaken the mechanical properties of the bone cement, Palacos and Vertebroplastic cements retained their mechanical properties better than Confidence. Discussion: When using chemotherapeutic bone cements, combining soluble fillers enhances drug elution at the expense of mechanical properties. However, the results showed that mechanical properties of different commercially available bone cements behave differently with similar percentages of soluble filler and drug added making it difficult to predict changes in mechanical properties of bone cement intraoperatively. This elucidates the need for well characterized bone cement optimized for chemotherapy drug delivery

Hemodynamic features in patients with chronic heart failure and preserved ejection fraction

The aim of the study was to determine the clinical features and hemodynamics in patients with CHF with preserved ejection fraction depending on age

Childhood depression: Prevalence using DSM-III criteria and validity of parent and child depression scales

DSM-III criteria for major affective disorder were used to establish a reliable and valid prevalence estimate for depression among latency-aged children. The prevalence data, based on separate mother/child interviews, were then compared to two additional paper-and-pencil depression scales: the depression scale of the Personality Inventory for Children (PIC-D); and the Children's Depression Inventory (CDI). Results indicated that DSM-III crite

The Importance of Urban Eco-gardens for Biodiversity and Human Sustainability: A Case Study from Palestine

The situation in Palestine is of concern where global threats of climate change, overexploitation, habitat destruction, invasive species, and pollution are compounded by occupation and conflict. Thus, almost 1/3rd of vascular plant species are rare and over 50 are listed as endangered or rare based on their abundance and presence in grids studied earlier. Here, we describe the development of a conservation botanic garden that works via research, education, and direct in situ and ex situ conservation of plant species. The garden now boasts 381 species of vascular plants (63 are rare). The team scientifically and selectively introduced some rare and endemic species, developed educational modules, and engaged the community in all aspects of planning and growth of this garden. It has acted as a model for threatened and protected areas in the state of Palestine, as well as becoming a national oasis for both wildlife and humans. The lessons learned from this experience include: 1) principles of minimal intervention in eco-friendly ways producing zones of permaculture and gardening towards conservation (ex situ and in situ conservation), while allowing botanic garden functionality, 2) involvement of staff, volunteers, experts, and community in education and conservation efforts, 3) value of research in plants and animals for integrated ecosystem management. The outcome of this work is a maximally utilitarian garden for areas like education, direct conservation, research, and human satisfaction whilst ensuring long-term sustainability in a nascent state in the midst of a difficult political situation

Mental disorder prevalence in chronic pain patients using opioid versus non-opioid analgesics: A registry-linkage study

Background Chronic pain and mental disorders are leading causes of disability worldwide. Individuals with chronic pain are more likely to experience mental disorders compared to individuals without chronic pain, but large-scale estimates are lacking. We aimed to calculate overall prevalence of mental health diagnoses from primary and secondary care among individuals treated for chronic pain in 2019 and to compare prevalence among chronic pain patients receiving opioid versus non-opioid analgesics, according to age and gender. Methods It is a population-based cohort study. Linked data from nationwide health registers on dispensed drugs and diagnoses from primary (ICPC-2) and secondary (ICD-10) health care. Chronic pain patients were identified as all patients over 18 years of age filling at least one prescription of an analgesic reimbursed for non-malignant chronic pain in both 2018 and 2019 (N = 139,434, 69.3% women). Results Prevalence of any mental health diagnosis was 35.6% (95% confidence interval: 35.4%–35.9%) when sleep diagnoses were included and 29.0% (28.8%–29.3%) when excluded. The most prevalent diagnostic categories were sleep disorders (14% [13.8%–14.2%]), depressive and related disorders (10.1% [9.9%–10.2%]) and phobia and other anxiety disorders (5.7% [5.5%–5.8%]). Prevalence of most diagnostic categories was higher in the group using opioids compared to non-opioids. The group with the highest overall prevalence was young women (18–44 years) using opioids (50.1% [47.2%–53.0%]). Conclusions Mental health diagnoses are common in chronic pain patients receiving analgesics, particularly among young individuals and opioid users. The combination of opioid use and high psychiatric comorbidity suggests that prescribers should attend to mental health in addition to somatic pain. Significance This large-scale study with nation-wide registry data supports previous findings of high psychiatric burden in chronic pain patients. Opioid users had significantly higher prevalence of mental health diagnoses, regardless of age and gender compared to users of non-opioid analgesics. Opioid users with chronic pain therefore stand out as a particularly vulnerable group and should be followed up closely by their physician to ensure they receive sufficient care for both their mental and somatic symptoms.Mental disorder prevalence in chronic pain patients using opioid versus non-opioid analgesics: A registry-linkage studyacceptedVersionpublishedVersio

<i>Planothidium juandenovense</i> sp. nov. (Bacillariophyta) from Juan de Nova (Scattered Islands, Mozambique Channel) and other tropical environments: a new addition to the <i>Planothidium delicatulum</i> complex

Planothidium juandenovense sp. nov. (Bacillariophyta) is described from the marine tropical environments of Juan de Nova I. (Mozambique Channel), Rodrigues I. (Mascarene Archipelago) and from Guam (Northern Mariana Is., Pacific). This small and relatively rare taxon has short multiseriate striae on the sternum valve (SV), hooked raphe valve (RV) terminal raphe endings and no SV cavum or hoof–shaped area. This taxon has similarities with Planothidium delicatulum (Kütz.) Round et Bukht. and Planothidium septentrionale (Østrup) Round et Bukht. ex Rumrich et al., but also differences: e.g. a relatively narrow and rhombic SV sternum, void of areolae, with vestigial radiate structures and an uninterrupted marginal SV elevated crest or ‘crista marginalis’. P. juandenovense sp. nov. is compared to some other Achnanthales with short SV striae. Cocconeis quarnerensis var. lanceolata Jurilj and Planothidium quarnerense f. rhombica (Giffen) comb. nov. may be close to our new taxon

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation

Loss-of-function mutations in UDP-Glucose 6-Dehydrogenase cause recessive developmental epileptic encephalopathy

AbstractDevelopmental epileptic encephalopathies are devastating disorders characterized by intractable epileptic seizures and developmental delay. Here, we report an allelic series of germline recessive mutations in UGDH in 36 cases from 25 families presenting with epileptic encephalopathy with developmental delay and hypotonia. UGDH encodes an oxidoreductase that converts UDP-glucose to UDP-glucuronic acid, a key component of specific proteoglycans and glycolipids. Consistent with being loss-of-function alleles, we show using patients’ primary fibroblasts and biochemical assays, that these mutations either impair UGDH stability, oligomerization, or enzymatic activity. In vitro, patient-derived cerebral organoids are smaller with a reduced number of proliferating neuronal progenitors while mutant ugdh zebrafish do not phenocopy the human disease. Our study defines UGDH as a key player for the production of extracellular matrix components that are essential for human brain development. Based on the incidence of variants observed, UGDH mutations are likely to be a frequent cause of recessive epileptic encephalopathy.</jats:p