A technique to quantify very low activities in regions of interest with a collimatorless detector

We present a new method to measure sub-microcurie activities of photon-emitting radionuclides in organs and lesions of small animals in vivo. Our technique, named the collimator-less likelihood fit, combines a very high sensitivity collimatorless detector with a Monte Carlo-based likelihood fit in order to estimate the activities in previously segmented regions of interest along with their uncertainties. This is done directly from the photon projections in our collimatorless detector and from the region of interest segmentation provided by an x-ray computed tomography scan. We have extensively validated our approach with 225Ac experimentally in spherical phantoms and mouse phantoms, and also numerically with simulations of a realistic mouse anatomy. Our method yields statistically unbiased results with uncertainties smaller than 20% for activities as low as ~111 Bq (3 nCi) and for exposures under 30 minutes. We demonstrate that our method yields more robust recovery coefficients when compared to SPECT imaging with a commercial pre-clinical scanner, specially at very low activities. Thus, our technique is complementary to traditional SPECT/CT imaging since it provides a more accurate and precise organ and tumor dosimetry, with a more limited spatial information. Finally, our technique is specially significant in extremely low-activity scenarios when SPECT/CT imaging is simply not viable.

Microwave-Assisted Synthesis of Pt/SnO2 for the Catalytic Reduction of 4-Nitrophenol to 4-Aminophenol

In this study, we present a new approach for the synthesis of Pt/SnO2 catalysts using microwave radiation. Pt(IV) and Sn(IV) inorganic precursors (H2PtCl6 and SnCl4) and ammonia were used, which allowed the controlled formation of platinum particles on the anisotropic SnO2 support. The synthesized Pt/SnO2 samples are mesoporous and exhibit a reversible physisorption isotherm of type IV. The XRD patterns confirmed the presence of platinum maxima in all Pt/SnO2 samples. The Williamson-Hall diagram showed SnO2 anisotropy with crystallite sizes of ~10 nm along the c-axis (< 00l >) and ~5 nm along the a-axis (< h00 >). SEM analysis revealed anisotropic, urchin-like SnO2 particles. XPS results indicated relatively low average oxidation states of platinum, close to Pt metal. 119Sn Mössbauer spectroscopy indicated electronic interactions between Pt and SnO2 particles. The synthesized samples were used for the catalytic reduction of 4-nitrophenol (4-NP) to 4-aminophenol (4-AP) in the presence of excess NaBH4. The catalytic activity of the Pt/SnO2 samples for the reduction of 4-NP to 4-AP was optimized by varying the synthesis parameters and Pt loading. The optimal platinum loading for the reduction of 4-NP to 4-AP on the anisotropic SnO2 support is 5 mol% with an apparent rate constant k = 0.59 × 10-2 s-1. The Pt/SnO2 sample showed exceptional reusability and retained an efficiency of 81.4% after ten cycles.

A high concentration CO2 pool over the Indo-Pacific Warm Pool

Anthropogenic emissions have produced significant amount of carbon dioxide (CO₂) in the atmosphere since the beginning of the industrial revolution. High levels of atmospheric CO₂ increases global temperature as CO₂ absorbs outgoing longwave radiation and re-emits. Though a well-mixed greenhouse gas, CO₂ concentration is not uniform in the atmosphere across different altitudes and latitudes. Here, we uncover a region of high CO₂ concentration (i.e. CO₂ pool) in the middle troposphere (500-300 hPa) over the Indo-Pacific Warm Pool (IPWP, 40° E-140° W, 25° S-25° N), in which the CO₂ concentration is higher than that of other regions in the same latitude band (20° N-20° S), by using CO₂ satellite measurements for the period 2002-2017. This CO₂ pool extends from the western Pacific to the eastern Indian Ocean. Much of the CO₂ pool is over the western Pacific Ocean (74.87%), and the remaining lies over the eastern Indian Ocean (25.13%). The rising branch of Walker circulation acts as a "CO₂ Chimney" that constantly transports CO₂ released from the natural, human-induced and ocean outgassing processes to the middle and upper troposphere. The CO₂ pool evolves throughout the year with an average annual trend of about 2.17 ppm yr^-1, as estimated for the period 2003-2016. Our analysis further reveals that La Niña (El Niño) events strengthen (weaken) the CO₂ pool in the mid-troposphere. The radiative forcing for the CO₂ pool suggests more warming in the region and is a grave concern for global warming and climate change.

Surface Functionalisation of Dental Implants with a Composite Coating of Alendronate and Hydrolysed Collagen: DFT and EIS Studies

The success of the osseointegration process depends on the surface characteristics and chemical composition of dental implants. Therefore, the titanium dental implant was functionalised with a composite coating of alendronate and hydrolysed collagen, which are molecules with a positive influence on the bone formation. The results of the quantum chemical calculations at the density functional theory level confirm a spontaneous formation of the composite coating on the titanium implant, ∆G*_INT = −8.25 kcal mol⁻¹. The combination of the results of X-ray photoelectron spectroscopy and quantum chemical calculations reveals the structure of the coating. The alendronate molecules dominate in the outer part, while collagen tripeptides prevail in the inner part of the coating. The electrochemical stability and resistivity of the implant modified with the composite coating in a contact with the saliva depend on the chemical nature of alendronate and collagen molecules, as well as their inter- and intramolecular interactions. The formed composite coating provides a 98% protection to the implant after the 7-day immersion in the artificial saliva. From an application point of view, the composite coating could effectively promote osseointegration and improve the implant’s resistivity in contact with an aggressive environment such as saliva.

The relationship of weather with daily physical activity and the time spent out of home in older adults from Germany – the ActiFE study

Background

There is a need for a comprehensive evaluation of the associations between varieties of weather conditions on the time spent out-of-home (TOH) and on walking duration (WD) among older adults. We aim to investigate the extent to which various weather parameters (temperature, solar radiation, sunshine duration, humidity, windspeed, and rain) determine daily WD the TOH in older adults.

Methods

The ActiFE (Activity and Function in Older People in Ulm) study is a prospective study of participants aged 65 years or older who wore an accelerometer and kept a movement diary in up to three temporally separated waves from 2009 to 2018 for a duration up to seven days per wave (up to three weeks in summary). We used weather data from a weather station near the participants‘ homes. Age-adjusted and gender-stratified generalized mixed models were used to predict WD and TOH (with 95% confidence interval (CI)) within and between weather categories. Generalized additive models were computed for the single predictions at the weather quartile boundaries. Cubic splines (with 95% pointwise confidence bands (CB)) visualized the continuous course of the weather values.

Results

Higher temperatures, solar radiation and more hours of sunshine, led to an increase in WD and TOH, while higher precipitation, humidities and windspeeds led to a decrease. Women had in general higher WD and TOH times than men.

Conclusions

Our data suggest that weather parameters have a considerable influence on PA and TOH. Future analyses and interpretation of PA data should therefore account for weather parameters.

Supplementary Information

The online version contains supplementary material available at 10.1186/s11556-022-00286-0.

[Outcome of a survey on antibiotic prescribing in veterinary medicine]

INTRODUCTION

As part of the national strategy on antibiotic resistance (StAR), a therapy guide for the prudent prescription of antimicrobial agents in animals was developed. To facilitate its implementation in the veterinary practice, the therapy recommendations contained therein have been translated to the user-friendly decision support AntibioticScout.ch. In this context, we conducted a non-representative survey to assess the level of awareness as well as usage of this guide and the AntibioticScout.ch decision support. Based on case studies with typical diseases in dogs, cats and cattle, it was shown that the veterinarians participating in the survey strive to handle antibiotics responsibly and to prescribe them with restraint. Nevertheless, the survey points to possible improvements in the antibiotic therapy. In particular, the StAR guidelines or AntibioticScout.ch can be useful to the practicing veterinarians for taking into account all relevant decision criteria in the optimal selection of a suitable antimicrobial agent.

Biomass bottom ash & dolomite similarly ameliorate an acidic low-nutrient soil, improve phytonutrition and growth, but increase Cd accumulation in radish

One of negative side-effects of usage of bio-renewables might be generation of mineral (ash) material, potential source of environmental pollution. A hypothesis was that bottom ash (BA; from biomass cogeneration facility) could be efficiently (re) used in soil chemical conditioning similarly to widely-used dolomite-based soil conditioner (DO; from Croatian Dinaric-coastal region) which we tested by: i) physicochemical characterisation of BA and DO, and ii) bioassay with Raphanus sativus cultivated in acidic soil amended with BA or DO. Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX) confirmed complex chemical/physical structures and morphology between amendments, X-ray diffraction (XRD) showed their distinctive mineralogy with predominantly dolomite (in DO) vs. quartz and calcite (in BA), while secondary ion mass spectrometry (SIMS) revealed their diverse elemental/isotopic composition. The BA or DO amendments ameliorated soil acidity, increased available P, K and most other nutrients, but not Cd. The BA or DO amendments improved vegetative growth and edible hypocotyl yield. However, both amendments also increased Cd accumulation in all radish tissues, which was unexpected given the alkaline matrix of bio-ash and dolomite that would be likely to facilitate retention and immobilisation of toxic Cd. Thus, thorough characterisation and evaluation of BA- and/or DO-based materials and relevant soils (with an emphasis on metal sorption/immobilisation) prior to application in (agro) ecosystems is crucial for producing food clean of toxic metals.

Strategies for Identity Testing of Therapeutic Oligonucleotide Drug Substances and Drug Products

A risk-based approach for routine identity testing of therapeutic oligonucleotide drug substances and drug products is described. Risk analysis of solid-phase oligonucleotide synthesis indicates that intact mass measurement is a powerful technique for confirming synthesis of the intended oligonucleotide. Further risk assessment suggests that the addition of a second, sequence-sensitive identity test, which relies on a comparison of some property of the sample to a reference standard of proven identity, results in a sufficient test of identity for most oligonucleotide drug substances and products. Alternative strategies for drug product identity testing are presented. The analysis creates a common way to communicate risk and should result in a harmonized approach to identity testing that avoids the unnecessary analytical burden associated with routine de novo sequencing, without compromising quality or patient safety.

A New Insight into Coating's Formation Mechanism Between TiO2 and Alendronate on Titanium Dental Implant

Organophosphorus compounds, like bisphosphonates, drugs for treatment and prevention of bone diseases, have been successfully applied in recent years as bioactive and osseoinductive coatings on dental implants. An integrated experimental-theoretical approach was utilized in this study to clarify the mechanism of bisphosphonate-based coating formation on dental implant surfaces. Experimental validation of the alendronate coating formation on the titanium dental implant surface was carried out by X-ray photoelectron spectroscopy and contact angle measurements. Detailed theoretical simulations of all probable molecular implant surface/alendronate interactions were performed employing quantum chemical calculations at the density functional theory level. The calculated Gibbs free energies of (TiO2)10-alendronate interaction indicate a more spontaneous exergonic process when alendronate molecules interact directly with the titanium surface via two strong bonds, Ti-N and Ti-O, through simultaneous participation common to both phosphonate and amine branches. Additionally, the stability of the alendronate-modified implant during 7 day-immersion in a simulated saliva solution has been investigated by using electrochemical impedance spectroscopy. The alendronate coating was stable during immersion in the artificial saliva solution and acted as an additional barrier on the implant with overall resistivity, R ~ 5.9 MΩ cm2.

'Sandwich'-like hybrid ZnO thin films produced by a combination of atomic layer deposition and wet-chemistry using a mercapto silane as single organic precursor

This study describes a straightforward preparation of hybrid organic-inorganic thin films containing a stable 'sandwich'-like structure of two atomic layer deposited (ALD) ZnO layers separated by a thin organosilane phase, which is built from a single organic component (3-mercaptopropyl)trimethoxysilane (MPTMS). Grafting of MPTMS on the first ALD ZnO layer was performed in solution and driven by the strong affinity of the terminal thiol functionality (-SH) towards ZnO. We demonstrate that under different reaction conditions, either MPTMS monolayers are prepared or a 5 nm thick cross-linked polymeric network is formed due to the self-condensation of silane, which covers the ALD ZnO surface. This film served as a soft template for the nucleation of an ALD ZnO top layer by creation of S-Zn and Si-O-Zn bonds at the upper interface, as confirmed by XPS measurements. An increase in surface roughness, as compared to the initial ZnO film, is observed after removal of the organic layer from the hybrid structure by calcination, which is accompanied by an improvement in UVA photocatalytic activity towards the degradation of methyl orange dye. Thus, MPTMS can be used as a sacrificial agent in combination with low temperature ALD processes for building rougher and photocatalytically efficient ZnO coatings.

Lazy Sundays: role of day of the week and reactivity on objectively measured physical activity in older people

Background

The aim of this study was to assess the effect of day of the week and wearing a device (reactivity) on objectively measured physical activity (PA) in older people.

Methods

Walking duration as a measure for PA was recorded from 1333 German community-dwelling older people (≥65 years, 43.8% women) over 5 days using accelerometers (activPAL). Least-square means of PA with 95%-confidence intervals (95%-CI) from multi-level analysis were calculated for each day of the week and each measurement day (days after sensor attachment).

Results

Walking duration on Sundays was significantly lower compared to working days (Sunday vs. Monday-Friday: − 12.8 min (95%-CI: − 14.7; − 10.9)). No statistically significant difference compared to working days was present for Saturdays. The linear slope for measurement day and walking duration was marginal and not statistically significant.

Conclusions

Studies using PA sensors in older people should assess Sundays and working days to adequately determine the activity level of the participants.

Introducing the concept of pulsed vapor phase copper-free surface click-chemistry using the ALD technique

We report for the first time on a pulsed vapor phase copper-free azide-alkyne click reaction on ZnO by using the atomic layer deposition (ALD) process technology. This reproducible and fast method is based on an in situ two-step reaction consisting of sequential exposures of ZnO to propiolic acid and benzyl azide.

[AntibioticScout.ch: Decision support for the prudent use of antimicrobials: Application in cattle]

INTRODUCTION

The administration of antibiotics in livestock has been criticized for many years, in particular because of an inappropriate use and the appearance of antibiotic residues in the environment, which can promote the emergence and spread of resistant bacteria. However, antibiotics are essential for the successful and sustainable control of bacterial pathogens. With the aim of optimizing the use of antibiotics in food animals and minimizing the prevalence of resistant bacteria, AntibioticScout. ch provides a decision aid for the prudent use of antimicrobial drugs. This approach emphasizes the importance of supportive therapy and the hallmarks of preventive concepts. Procedures to improve animal health and animal welfare in accordance with the principles of good veterinary practice are primary and effective tools to reduce the use of antimicrobial drugs. The necessary reduction in the use of antibiotics must, therefore, be accompanied by appropriate management strategies in animal husbandry. In particular, hygiene, animal welfare and biosecurity measures are crucial to ensure an optimal health status in farm animals.

Aberrant use and poor quality of trypanocides: a risk for drug resistance in south western Ethiopia

BACKGROUND

Trypanocidal drugs have been used to control African animal trypanosomosis for several decades. In Ethiopia, these drugs are available from both authorized (legal) and unauthorized (illegal) sources but documentation on utilization practices and quality of circulating products is scanty. This study looked at the practices of trypanocidal drug utilization by farmers and the integrity of active ingredient in trypanocides sold in Gurage zone, south western Ethiopia. The surveys were based on a structured questionnaire and drug quality determination of commonly used brands originating from European and Asian companies and sold at both authorized and unauthorized markets. One hundred farmers were interviewed and 50 drug samples were collected in 2013 (Diminazene aceturate = 33 and Isometamidium chloride = 17; 25 from authorized and 25 from unauthorized sources). Samples were tested at the OIE-certified Veterinary Drug Control Laboratory (LACOMEV) in Dakar, Senegal, by using galenic standards and high performance liquid chromatography.

RESULTS

Trypanosomosis was found to be a major threat according to all interviewed livestock keepers in the study area. Diminazene aceturate and isometamidium chloride were preferred by 79% and 21% of the respondents respectively, and 85% of them indicated that an animal receives more than six treatments per year. About 60% of these treatments were reported to be administered by untrained farmers. Trypanocidal drug sources included both unauthorized outlets (56%) and authorized government and private sources (44%). A wide availability and usage of substandard quality drugs was revealed. Twenty eight percent of trypanocidal drugs tested failed to comply with quality requirements. There was no significant difference in the frequency of non-compliance between diminazene-based and isometamidium chloride products (P = 0.87) irrespective of the marketing channel (official and unofficial). However, higher rates of non-compliant trypanocides were detected for drugs originating from Asia than from Europe (P = 0.029).

CONCLUSION

The findings revealed the presence of risk factors for the development of drug resistance, i.e. wide distribution of poor quality drugs as well as substandard administration practices. Therefore, it is strongly recommended to enforce regulatory measures for quality control of veterinary drugs, to expand and strengthen veterinary services and to undertake trypanocidal drug efficacy studies of wider coverage.

[AntibioticScout.ch: A decision supporting tool for antimicrobial stewardship: application to companion animal medicine]

INTRODUCTION

Bacterial resistances to antimicrobial drugs pose serious public health challenges. The observed increase of resistances is attributed to the uncontrolled, massive and often unnecessary administration of antibiotics both in human and veterinary medicine. To support the responsible use of antimicrobials in animals and help veterinarians selecting the most suitable antimicrobial drugs, we developed the AntibioticScout.ch as a comprehensive decision supporting tool providing online access to the current knowledge of rational antibiotic prescription practices. User-friendly search functions allow for the fast and efficient retrieval of information that is structured in this database by animal species, organ systems and therapeutic indications. In addition, an online form allows to report treatment failures in order to identify problematic cases as well as ensuing risks and take appropriate mitigation measures. The present report describes the workflow of this decision support system applied to the prudent use of antimicrobials in companion animal medicine.

[AntibioticScout: Online tool for antimicrobial stewardship in veterinary medicine]

INTRODUCTION

Resistances to antimicrobials pose serious public health challenges. This issue concerns both human and veterinary medicine and can only be solved by a multidisciplinary approach. A comprehensive concept is, therefore, being worked out within the StAR (strategy antibiotic resistance) program in order to preserve the effectiveness of antibiotics for humans as well as animals. In this context, the AntibioticScout (www.AntibioticScout. ch) offers a new online tool for the prudent use of antibiotics in veterinary medicine. By involving all stakeholders, the guidelines included in the AntibioticScout will result in a nationwide accepted standard for the treatment of bacterial infections in animals. An additional system for the rapid reporting of cases of suspected lack of efficacy of antimicrobials is integrated to allow early detection of emerging resistance and the immediate launch of risk mitigation measures. A first version of the AntibioticScout for the treatment of dogs, cats and horses is available by the end of 2016. All stakeholders are now invited to contribute to the development of the AntibioticScout decision support.

Multidrug resistance mediated by co-carriage of extended-spectrum beta-lactamases, AmpC and New Delhi metallo-beta-lactamase-1 genes among carbapenem-resistant Enterobacteriaceae at five Indian medical centres

In this study, we evaluated the coexistence of extended-spectrum beta-lactamases (ESBL), AmpC and New Delhi metallo-beta-lactamase-1 (NDM-1) genes among carbapenem-resistant Enterobacteriaceae (CRE) recovered prospectively from patients at multiple sites. The study included 285 CRE strains from 2782 Gram-negative Bacilli collected from multiple centres during 2007-2010, of which 87 were characterised. Standard and reference laboratory methods were used for resistance determination. Detection of blaNDM-1 , blaAmpC , blaTEM , blaSHV and blaCTX-M was done by polymerase chain reaction. High levels of antimicrobial resistance observed among study isolates. Co-carriage of ESBLs, AmpC and NDM-1 was 26.3%. Nosocomial origin among the co-carriage isolates was 64.3%, with 9.2% associated mortality.

Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: the European Project on OSteoArthritis

PURPOSE

Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH.

METHODS

Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index.

RESULTS

The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function.

CONCLUSIONS

Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care.

Long-term experiences in cryopreservation of mobilized peripheral blood stem cells using a closed-bag system: a technology with potential for broader application

BACKGROUND

In several European countries, preparation of cellular products with open manufacturing systems as used for cryopreservation of peripheral blood stem cells (PBSCs) needs to be performed in a clean-room facility. However, this form of manufacturing is highly expensive and laborious. Thus, safe techniques providing improved efficacy regarding time and material, which are in accordance with legal requirements are highly desirable.

STUDY DESIGN AND METHODS

We have developed, validated, and applied a simple method for cryopreservation of PBSCs within a functionally closed-bag system using the closed cryo freeze prep set. This process fulfills good manufacturing practice requirements and allows for the cryopreservation of PBSCs without a clean-room facility. In addition to cryopreservation of PBSCs, we have recently successfully modified our system for processing, portioning, and cryopreservation of allogeneic donor lymphocytes.

RESULTS

Since 2010, cryopreservation of PBSCs using a closed-bag system has been performed in our facility on a routine basis and 210 patients and healthy donors have been included in this analysis. No significant reduction in viability of CD34+ cells and no process-related contamination were observed. Outcome of hematopoietic stem cell transplantation regarding time of engraftment and infectious complications is comparable to products manufactured in conventional clean-room facilities.

CONCLUSION

Our data confirm that cryopreservation of PBSCs within a functionally closed-bag system is safe, effective, and economical. Furthermore, the system has the potential to be extended to other manufacturing processes of cellular products.

[Occupational gratification crisis and sickness absence in Germany: Cross-sectional results from the lidA-study]

BACKGROUND

Demographic change is leading to a shrinking and ageing workforce in industrialized nations. Therefore, sickness absence may become a relevant problem. Increasing absenteeism and retirement rates due to mental disorders raise the question of an association between work-related stress and sickness absence. Studies on this matter, particularly in older employees, are rare.

OBJECTIVES

We studied for the first time in Germany the relationship between effort-reward imbalance (ERI) and overall or long-term sickness absence.

MATERIALS AND METHODS

LidA ( "Living at Work") is a German cohort study on work, age, health, and work participation. A total of 6,339 employees born in 1959 and 1965 who were subject to social insurance contributions were interviewed nationwide using a representative sample concept. The response rate was 27.3 %. The sample showed high representativeness and no selectivity relating to 16 sociodemographic items. Sickness absence was defined as at least one long-term sickness absence with at least 43 days of absenteeism. Work-related stress was parameterized by ERI tertiles. Multiple logistic regression adjusting for age, sex, mental disorders, social status, and working time was performed.

RESULTS

High levels of work-related stress were significantly associated with overall and long-term sickness absence among older employees after adjusting for covariates.

CONCLUSIONS

Our unique findings on work-related stress and sickness absence in Germany are in agreement with the results of most international studies. Reducing work-related stress could help to preserve the workforce.

[Is the association between mental disorders and sickness absence independent of sociodemographic factors?]

AIM

Mental diseases are highly prevalent and of increasing meaning for absenteeism. The association of absenteeism with vertical and horizontal dimensions of socioeconomic status is well-known. Against this background we investigated the independent association between mental diseases and absenteeism or long-time absenteeism of socioeconomic aspects.

MATERIAL AND METHODS

Basis of this nationwide exploratory survey were the 6 339 employees born in 1959 or 1965 and subject to statutory health insurance of the first wave of the lidA-cohort study 2011. The stepwise logistic regression analysis was used for the investigation of the effects of mental diseases on absenteeism or long-term absenteeism after adjustment for education, occupational position, income, gender, age, working-time and -stress.

RESULTS

After adjustment for socioeconomic factors highly significant associations between mental diseases and absenteeism or even more long-term absenteeism were observed. These associations stayed significant after additional adjustment for work-related factors.

CONCLUSION

Mental diseases were independent of sociodemographic factors and work-related factors (working-time and -stress) associated with absenteeism or with long-term absenteeism. Unspecific programmes for the prevention and rehabilitation of mental diseases may contribute to the reduction of absenteeism. Apart from that causes of absenteeism in highly affected socioeconomic groups should be investigated.

A comparative assessment of small-head metal-on-metal and ceramic-on-polyethylene total hip replacement

Large-head metal-on-metal (MoM) total hip replacements (THR) have given rise to concern. Comparative studies of small-head MoM THRs over a longer follow-up period are lacking. Our objective was to compare the incidence of complications such as infection, dislocation, revision, adverse local tissue reactions, mortality and radiological and clinical outcomes in small-head (28 mm) MoM and ceramic-on-polyethylene (CoP) THRs up to 12 years post-operatively. A prospective cohort study included 3341 THRs in 2714 patients. The mean age was 69.1 years (range 24 to 98) and 1848 (55.3%) were performed in women, with a mean follow-up of 115 months (18 to 201). There were 883 MoM and 2458 CoP bearings. Crude incidence rates (cases/1000 person-years) were: infection 1.3 vs 0.8; dislocation 3.3 vs 3.1 and all-cause revision 4.3 vs 2.2, respectively. There was a significantly higher revision rate after ten years (adjusted hazard ratio 9.4; 95% CI 2.6 to 33.6) in the MoM group, and ten of 26 patients presented with an adverse local tissue reaction at revision. No differences in mortality, osteolysis or clinical outcome were seen. In conclusion, we found similar results for small-head MoM and CoP bearings up to ten years post-operatively, but after ten years MoM THRs had a higher risk of all-cause revision. Furthermore, the presence of an adverse response to metal debris seen in the small-head MOM group at revision is a cause for concern.

Synthesis and characterization of alkyl ester functionalized multiwall carbon nanotubes

Alkyl chains of different length were added onto surface of multiwall carbon nanotubes (MWCNT). Oxidized multiwall carbon nanotubes (MWCNT-COOH) were reacted with thionyl chloride (SOCl2) and further in esterification reaction with given alcohols gave corresponding methyl ester (MWCNT- COOCH3), n-butyl ester (MWCNT-COOC4H9) and n-dodecyl ester (MWCNT-COOC12H25) modified carbon nanotubes. Functionalization of MWCNTs was confirmed by FTIR, Raman and X-ray photoelectron spectroscopy as well as by thermogravimetric analysis. n-Butyl ester and n-dodecyl ester modified carbon nanotubes showed contact angle for water of about 142 and 150 degrees, while the oxidized and methyl ester modified carbon nanotubes showed seepage. Dispersibility of oxidized and alkyl ester modified carbon nanotubes in methanol and toluene was quantified by UV-Vis spectroscopy and differs significantly in both solvents for all systems.

[Popliteal cysts: etiologic and therapeutic approach]

In children and adults, a popliteal cyst frequently coexists with an intra-articular disorder of the knee. Its mode of presentation consists of a palpable mass at the level of the popliteal fossa. The cyst is a recess of the synovial cavity of the knee, often associated to a chronic effusion. In children, the etiology may be primary with a development directly from the medial gastrocnemius-semimembranous bursa. In adults, it is usually secondary to degenerative or inflammatory disease of the knee. A communication between the intraarticular space and the cystic cavity can be often found. The aim of this study is to review epidemiology, pathogenesis, symptomatology, diagnosis and treatment options.

Prospective evaluation of renal function, serum vitamin D level, and risk of fall and fracture in community-dwelling elderly subjects

SUMMARY

This prospective study in elderly showed that kidney function plays a minor role in explaining the high prevalence of vitamin D deficiency seen in noninstitutionalized elderly subjects. However, 25-hydroxyvitamin D levels were clearly inversely associated with risk for first fall, which was especially seen in subjects with calcium levels above median.

INTRODUCTION

Few prospective studies in elderly exist that have investigated the association of renal dysfunction and vitamin D status on risk of falls. The aim of this study is to evaluate the association of renal function with 25-hydroxyvitamin D (25-OH-D) levels and, secondly, to assess the role of both factors on the risk of falls and subsequent bone fractures.

METHODS

This is a prospective population-based cohort study among noninstitutionalized elderly subjects during a 1-year follow-up. 25-OH-D levels and renal function were estimated, the latter by cystatin C-based equations. Information on falls was assessed prospectively.

RESULTS

Overall, 1,385 subjects aged 65 and older were included in the study (mean age 75.6 years), of whom 9.2 % had a 25-OH-D serum level above 75 nmol/L (US units 30 ng/mL); 41.4 %, between 50 and 75 nmol/L (US units 20 to 29 ng/mL, insufficiency); and 49.4 %, <50 nmol/L (US units <20 ng/mL, deficiency). We found no association of chronic kidney disease with risk of first fall. In contrast, 25-OH-D serum categories were clearly associated with risk of first fall and we found evidence of effect modification with calcium levels. In the group with a calcium level above the median (≥ 9.6 mg/dL), subjects with 25-OH-D serum level between 50 and 75 nmol/L and with concentrations <50 nmol/L had a hazard rate ratio (HRR) of 1.75 (1.03-2.87) and 1.93 (1.10-3.37) for risk of first fall. 25-OH-D serum levels were also associated with several markers of inflammation and hemodynamic stress.

CONCLUSIONS

We demonstrated an association of 25-OH-D serum levels and risk of first fall, which was especially evident in subjects with serum calcium in upper normal, independent of renal function.

Rare case of obturator hernia in a patient with Marfan's syndrome

Obturator hernia is a very rare type of abdominal hernia which constitutes <1 % of all the hernias. It is an important cause of small bowel obstruction which is associated with a high mortality rate if left untreated. Obturator hernia typically occurs in an elderly women or patients with chronically raised intraabdominal pressure or previous multiple pregnancies. We report a case of obstructed obturator hernia in a young female patient with Marfan's syndrome complicated with dissecting aortic aneurysm and chronic kidney disease. Though recurrent and incisional hernia constitutes one of the minor diagnostic criteria of Marfan's syndrome, obturator hernia being a very rare entity, has been reported very rarely in a patient with Marfan's syndrome.

[Work, age, health, and work participation. A theoretical model]

Research into the associations between work, age, and health and the impact of these associations on employment status has focused on health as a crucial determinant of staying on the job. In our paper, we ask whether concentrating on health is still feasible, particularly when considering the change in demographics and the increasing proportion of older people in the workplace. We introduce a theoretical model describing health as a variable that indirectly influences leaving employment. According to our model, the immediate decision to leave employment is due to work motivation and work ability. These two factors may require intervention activities different from those needed to improve health. Our model explains employment participation as a result of complex associations between work, socioeconomic status, lifestyle, and health especially with work ability and work motivation. The complexity of these processes should be considered in studies by conducting longitudinal investigations like the German lidA study (http://www.lida-studie.de). If the model is verified in scientific studies like lidA, it can be used as a basis for preventive and intervening activities in practice, i.e., in politics, enterprises, and science.

Estimates of the relative and absolute diurnal contributions of fasting and post-prandial plasma glucose over a range of hyperglycaemia in type 2 diabetes

AIMS

To re-examine the relative and absolute contributions of fasting/pre-prandial glucose (FPG) and post-prandial glucose (PPG) to 24-h hyperglycaemia and HbA1c respectively in non-insulin treated subjects with type 2 diabetes (T2DM).

MATERIALS AND METHODS

A total of 52 T2DM subjects (37 men) had daytime 12h plasma glucose (PG) profiles determined in response to three serial identical test meals commencing at 08 00h with pre-prandial and frequent post-prandial blood samples collected. The overnight PG profile was derived by projecting the 20 00h glucose concentration to the pre-breakfast value at 08 00h. PPG exposure was calculated above fasting/pre-prandial value for each meal. Excess hyperglycaemia was calculated based on a PG>5.5mmol/L with fasting hyperglycaemia being the difference between the two measurements. The subjects were divided into five groups according to the HbA1c (Group 1<7.0%; Group 2: 7.0-<7.5; Group 3: 7.5-<8.0%; Group 4: 8.0-<9.0%; Group 5:≥9.0%). The 24h relative contribution of PPG exposure and fasting hyperglycaemia to excess hyperglycaemia and the absolute contribution of PPG and fasting hyperglycaemia to excess HbA1c (HbA1c - 5.1%) was calculated.

RESULTS

With deteriorating glycaemia, the relative contribution of PPG exposure decreased across the groups from 43.5% (HbA1c<7.0%) to 17.8% (HbA1c≥9.0%), whilst the contributions of fasting hyperglycaemia increased from 56.5% to 82.2% (P=0.004), respectively. The absolute contributions of PPG to excess HbA1c was 0.7%, which remained relatively stable across the spectrum of HbA1c, whilst fasting hyperglycaemia increased significantly from groups 1 to 5 (P<0.001).

CONCLUSIONS

Fasting hyperglycaemia contributes substantially in all groups, increasing as HbA1c deteriorates. The absolute contribution of PPG to excess HbA1c did not vary across the range of HbA1c, representing a significant relative contribution even in well-controlled subjects with a HbA1c<7.0%.