Search

Glioblastoma multiforme (GBM) is the most common and invasive form of malignant brain tumors and despite advances in surgery, radiotherapy, and chemotherapy, the survival of patients with GBM still remains poor. Temozolomide (TMZ) is the chemotherapy drug that is most commonly given orally after surgical resection of these tumors. In this study, the effects of solvents (i.e., dichloromethane and acetonitrile) used for the fabrication of electrosprayed TMZ-loaded poly(lactic-co-glycolic acid) (PLGA) on drug loading, loading efficiency, drug release kinetics, surface morphology, and particle size were investigated. The results from this study demonstrated that by using a larger volume of a solvent with higher polarity (i.e., acetonitrile) which allows for a higher amount of hydrophilic TMZ to dissolve into the polymer solution, higher drug loading could be achieved. However, the particles fabricated with high amount of acetonitrile, which has a lower vapor pressure, had large pores and a smaller diameter which led to an initial burst release and high cumulative release at the end of the study. An optimal combination of the two solvents is needed to result in particles with a good amount of loading and minimal initial burst release. The electrosprayed microparticles were able to illicit a cytotoxic response in U-87 MG glioblastoma cells at a lower concentration of drug compared to the free drug. This work indicated that electrospraying is a promising method for the fabrication of TMZ-loaded PLGA microparticles for the treatment of GBM and solvent composition can be altered to control drug loading and release kinetics. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2317-2324, 2019.

Introduction and aims Learning is most effective when it is active, enjoyable and incorporates feedback. Past research demonstrates that serious games are prime candidates to utilise these principles, however the potential benefits of this approach for delivering drug education are yet to be examined in Australia, a country where drug education in schools is mandatory. Design and methods The serious game 'Pure Rush' was developed across three stages. First, formative consultation was conducted with 115 students (67% male, aged 15-17 years), followed by feasibility and acceptability testing of a prototype of the game (n = 25, 68% male). In the final stage, 281 students (62% female, aged 13-16 years) were randomly allocated to receive a lesson involving Pure Rush or an active control lesson. The lessons were compared in terms of learning outcomes, lesson engagement and future intentions to use illicit drugs. Results Students enjoyed playing Pure Rush, found the game age-appropriate and the information useful to them. Both the Pure Rush and the active control were associated with significant knowledge increase from pre to post-test. Among females, multi-level mixed-effects regression showed knowledge gain was greater in the Pure Rush condition compared to control (β = 2.36, 95% confidence interval 0.36-4.38). There was no evidence of between condition differences in lesson engagement or future intentions to use illicit drugs. Discussion and conclusions Pure Rush is an innovative online drug education game that is well received by students and feasible to implement in schools. [Stapinski LA, Reda B, Newton NC, Lawler S, Rodriguez D, Chapman C, Teesson M. Development and evaluation of 'Pure Rush': An online serious game for drug education. Drug Alcohol Rev 2017].

This study evaluates the use of tiles to estimate the effects of surface heterogeneities in simulations of local climate in a landscape-fragmented region of Amazonia. Three experiments using the Eta/Noah-MP model were designed as follows: two experiments with a spatial resolution of 5 km with and without the use of the tile approach. The third experiment used a finer spatial resolution of 2 km without the use of the tile approach (high-resolution experiment). Simulations were carried out for the rainy and dry seasons, which correspond to the months of March and September 2003, respectively. In general, the magnitude of surface fluxes is significantly affected by the introduction of tiles. In the dry season, the use of tiles in the simulation increases the magnitude of precipitation (about 7 mm day−1), skin temperature (about 4 °C), sensible heat flux (about 80 W m−2) and surface albedo (about 0.7). It reduces the latent heat flux (about 30 W m−2) and net radiation (about 40 W m−2). On the other hand, in the rainy season, the model produces excessive precipitation. This may have partly masked the signs of the land fragmentation impact. The tile experiment generates a warmer and drier boundary layer during the dry season. The impact of the surface heterogeneity representation is higher in the dry season than in the rainy season. The results suggest that the degree of impact of the subgrid process representation on the local climate is related to the spatial scale of the fragmentation. The use of the tile approach improves the representation of the effects of landscape heterogeneity on the spatial distribution of surface flux variability in fragmented areas. Comparison against measured data from flux towers in the region show that the model can simulate diurnal and seasonal variations in the local fluxes, despite the biases.

Aims To evaluate gender differences in the role of positive and negative affect on smoking uptake.

Since motor vehicles are a major air pollution source, urban designs that decrease private automobile use could improve air quality and decrease air pollution health risks. Yet, the relationships among urban form, air quality, and health are complex and not fully understood. To explore these relationships, we model the effects of three alternative development scenarios on annual average fine particulate matter (PM2.5 ) concentrations in ambient air and associated health risks from PM2.5 exposure in North Carolina's Raleigh-Durham-Chapel Hill area. We integrate transportation demand, land-use regression, and health risk assessment models to predict air quality and health impacts for three development scenarios: current conditions, compact development, and sprawling development. Compact development slightly decreases (-0.2%) point estimates of regional annual average PM2.5 concentrations, while sprawling development slightly increases (+1%) concentrations. However, point estimates of health impacts are in opposite directions: compact development increases (+39%) and sprawling development decreases (-33%) PM2.5-attributable mortality. Furthermore, compactness increases local variation in PM2.5 concentrations and increases the severity of local air pollution hotspots. Hence, this research suggests that while compact development may improve air quality from a regional perspective, it may also increase the concentration of PM2.5 in local hotspots and increase population exposure to PM2.5 . Health effects may be magnified if compact neighborhoods and PM2.5 hotspots are spatially co-located. We conclude that compactness alone is an insufficient means of reducing the public health impacts of transportation emissions in automobile-dependent regions. Rather, additional measures are needed to decrease automobile dependence and the health risks of transportation emissions.

Objective To examine longitudinal associations of the neighborhood built environment with objectively measured body mass index (BMI) and waist circumference (WC) in a geographically and racial/ethnically diverse group of adults. Methods This study used data from 5,506 adult participants in the Multi-Ethnic Study of Atherosclerosis, aged 45-84 years in 2000 (baseline). BMI and WC were assessed at baseline and four follow-up visits (median follow-up 9.1 years). Time-varying built environment measures (population density, land-use, destinations, bus access, and street characteristics) were created using Geographic Information Systems. Principal components analysis was used to derive composite scores for three built environment factors. Fixed-effects models, tightly controlling for all time-invariant characteristics, estimated associations between change in the built environment, and change in BMI and WC. Results Increases in the intensity of development (higher density of walking destinations and population density, and lower percent residential) were associated with less pronounced increases or decreases over time in BMI and WC. Changes in connected retail centers (higher percent retail, higher street connectivity) and public transportation (distance to bus) were not associated with changes in BMI or WC. Conclusions Longitudinal changes in the built environment, particularly increased density, are associated with decreases in BMI and WC.

Issues.Serious educational games (SEG) have been shown to be effective in educating young people about a range of topics, including languages and maths.This paper identifies the use of computerised SEGs in education about alcohol and other drugs and reviews their impact on the prevention of alcohol and drug use. Approach. The Cochrane Library, EMBASE, MEDLINE, ERIC, Scopus, psychINFO, pubMED and DRUG databases were searched in February 2013. Additional publications were obtained from the reference lists of the relevant papers. Studies were included if they described an evaluation of a computerised SEG that targeted alcohol and/or other drugs and had been trialled with adolescents. Key Findings.Eight SEGs were identified targeting tobacco, alcohol, cannabis, methamphetamine, ecstasy, inhalants, cocaine and opioids. Six reported positive outcomes in terms of increased content knowledge and two reported increased negative attitudes towards the targeted drugs. Only one reported a decrease in the frequency of drug use. Implications and Conclusion.This is the first review of the efficacy of computerised SEGs for alcohol and other drugs for adolescents.Results suggest that SEGs can increase content knowledge of alcohol and other drugs. Evidence concerning impacts on negative attitudes and alcohol and drug use is limited, with few studies examining these outcomes. [Rodriguez DM, Teesson M, Newton NC. A systematic review of computerised serious educational games about alcohol and other drugs for adolescents. Drug Alcohol Rev 2013]

Purpose: Rural residents are less likely to obtain optimal care for many serious conditions and have poorer health outcomes than those residing in more urban areas. We determined whether rural vs urban residence affected postdischarge medication persistence and 1 year outcomes after stroke. Methods: The Adherence eValuation After Ischemic Stroke-Longitudinal (AVAIL) study is a multicenter registry of stroke patients enrolled in 101 hospitals nationwide. Medications were recorded at hospital discharge and again after 3 and 12 months. Persistence was defined as continuation of prescribed discharge medications. Participants were categorized as living in rural or urban settings by cross-referencing home ZIP code with metropolitan statistical area (MSA) designation. Findings: Rural patients were younger, more likely to be white, married, smokers, and less likely to be college graduates. There was no difference in stroke type or working status compared to urban patients, and there were minor differences in comorbid conditions. There were no differences based on rural vs urban residence in medication persistence at 3 or 12 months postdischarge and no differences in outcomes of recurrent stroke or rehospitalization at 12 months. Conclusion: Despite differences in patient characteristics, there was no difference in medication persistence or outcomes between rural and urban dwellers after hospitalization for ischemic stroke or transient ischemic attack (TIA).

In many legal, political, and social settings, people must reach a consensus before particular outcomes can be achieved and failing to reach a consensus may be costly. In this article, we present a theory and conduct experiments that take into account the costs associated with communicating, as well as the difficulty of the decisions that groups make. We find that when there is even a small cost (relative to the potential benefit) associated with sending information to others and/or listening, groups are much less likely to reach a consensus, primarily because they are less willing to communicate with one another. We also find that difficult problems significantly reduce group members’ willingness to communicate with one another and, therefore, hinder their ability to reach a consensus.

This article describes the origins and characteristics of an interdisciplinary multinational collaboration aimed at promoting and disseminating actionable evidence on the drivers of health in cities in Latin America and the Caribbean: The Network for Urban Health in Latin America and the Caribbean and the Wellcome Trust funded SALURBAL (Salud Urbana en América Latina, or Urban Health in Latin America) Project. Both initiatives have the goals of supporting urban policies that promote health and health equity in cities of the region while at the same time generating generalizable knowledge for urban areas across the globe. The processes, challenges, as well as the lessons learned to date in launching and implementing these collaborations, are described. By leveraging the unique features of the Latin American region (one of the most urbanized areas of the world with some of the most innovative urban policies), the aim is to produce generalizable knowledge about the links between urbanization, health, and environments and to identify effective ways to organize, design, and govern cities to improve health, reduce health inequalities, and maximize environmental sustainability in cities all over the world.

The frequent consumption of energy-dense fast food is associated with increased body mass index. This systematic review aims to examine the methodology and current evidence on fast food access and its associations with outcomes. Six databases were searched using terms relating to fast food. Only peer-reviewed studies published in English during a 10-year period, with data collection and analysis regarding fast food access were included. Forty articles met the aforementioned criteria. Nearly half of the studies (n = 16) used their own set of features to define fast food. Studies predominantly examined the relationship between fast food access and socioeconomic factors (n = 21) and 76% indicated fast food restaurants were more prevalent in low-income areas compared with middle- to higher-income areas. Ten of 12 studies found fast food restaurants were more prevalent in areas with higher concentrations of ethnic minority groups in comparison with Caucasians. Six adult studies found higher body mass index was associated with living in areas with increased exposure to fast food; four studies, however, did not find associations. Further work is needed to understand if and how fast food access impacts dietary intake and health outcomes; and if fast food access has disparate socioeconomic, race/ethnicity and age associations.

Context: Rapid diagnosis and treatment of ischemic stroke can lead to improved patient outcomes. Hospitals in rural and frontier counties, however, face unique challenges in providing diagnostic and treatment services for acute stroke. Purpose: The aim of this study was to assess the availability of key diagnostic technology and programs for acute stroke evaluation and treatment in Montana and northern Wyoming. Methods: In 2004, hospital medical directors or their designees were mailed a survey about the availability of diagnostic technology, programs, and personnel for acute stroke care. Findings: Fifty-eight of 67 (87%) hospitals responded to the survey. Seventy-nine percent (46/58) of responding hospitals were located in frontier counties, with an average bed size of 18 (11 SD). Of the hospitals in frontier counties, 44% reported emergency medical services prehospital stroke identification programs, 39% had 24-hour computed tomography capability, 44% had an emergency department stroke protocol, and 61% had a recombinant tissue plasminogen activator protocol. Thirty percent of hospitals in frontier counties reported that they met 6-10 of the criteria established by the Brain Attack Coalition to improve acute stroke care compared to 67% of hospitals in the nonfrontier counties. Conclusion: A stroke network model could enhance care and improve outcomes for stroke victims in frontier counties.

It is well known that land use and land-cover changes (LUCC), particularly deforestation, have the potential to modify the hydrological response. Although those signals are relatively well documented in worldwide microcatchment studies, conflicting results reported in literature indicate that those signals can be sometimes difficult to detect and isolate in basins at larger scales. In order to detect signals in the hydrological response potentially, related to LUCC, streamflow records from Ji-Paran´ a Basin located in SW Amazonia are analysed in conjunction with deforestation maps derived from remote sensors. The basin has a drainage area greater than 30 000 km 2 and has been through severe LUCC in the last decades. Statistical descriptors of daily streamflow series were correlated with landscape indices using non-parametric methodologies. To take into account scale effects, statistical analyses were repeated in different sub-basins. Results showed that the impact of LUCC on the hydrological response is time lagged at larger scales. The flow paths are clearly affected, depending on basin characteristics such as topography. In general, LUCC impacts lead to higher peak streamflows, the reduction of minimal values and the increment of stormflow. In agreement with previous studies, the detection of signals associated with LUCC was clearly detected at the smallest basin, but proved to be difficult at larger scales, suggesting the existence of non-linear effects, which aggregate across scale compensating small scale effects. Such behaviour indicates a challenge for mathematical models, which are usually developed to represent immediate hydrological response to basin wide LUCC. Copyright  2010 John Wiley & Sons, Ltd.