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Study Design: A narrative review of the literature. Objective: This article reviews the general principles of treatment and investigation for primary bone tumors of the spine. Furthermore, it explores the emerging alternatives. Methods: A review was performed using Medline, Embase, and Cochrane databases. Results: Primary bone tumors of the spine are rare entities that general spine surgeons may encounter only a few times in their career. The treatment algorithm of these complex tumors is filled with nuances and is evolving constantly. For these reasons, patients should be referred to experienced tertiary or quaternary centers who can offer a comprehensive multidisciplinary approach. For most malignant spinal bone tumors, surgery remains the cornerstone of treatment. Respecting oncologic principles has been associated with improved survival and decreased local recurrence in multiple settings. However, even in experienced centers, these surgeries carry a significant risk of adverse events and possible long-term neurologic impairment. The associated morbidity of these procedures and the challenges of local recurrence have encouraged professionals caring for these patients to explore alternatives or adjuncts to surgical treatment. Conclusions: Over the past few years, several advances have occurred in medical oncology, radiation oncology and interventional radiology, changing the treatment paradigm for some tumors. Other advances still need to be refined before being applied in a clinical setting.

Study Design: Literature review. Objective: To provide an overview of the recent advances in spinal oncology, emphasizing the key role of the surgeon in the treatment of patients with spinal metastatic tumors. Methods: Literature review. Results: Therapeutic advances led to longer survival times among cancer patients, placing significant emphasis on durable local control, optimization of quality of life, and daily function for patients with spinal metastatic tumors. Recent integration of modern diagnostic tools, precision oncologic treatment, and widespread use of new technologies has transformed the treatment of spinal metastases. Currently, multidisciplinary spinal oncology teams include spinal surgeons, radiation and medical oncologists, pain and rehabilitation specialists, and interventional radiologists. Consistent use of common language facilitates communication, definition of treatment indications and outcomes, alongside comparative clinical research. The main parameters used to characterize patients with spinal metastases include functional status and health-related quality of life, the spinal instability neoplastic score, the epidural spinal cord compression scale, tumor histology, and genomic profile. Conclusions: Stereotactic body radiotherapy revolutionized spinal oncology through delivery of durable local tumor control regardless of tumor histology. Currently, the major surgical indications include mechanical instability and high-grade spinal cord compression, when applicable, with surgery providing notable improvement in the quality of life and functional status for appropriately selected patients. Surgical trends include less invasive surgery with emphasis on durable local control and spinal stabilization.

Background Spinal chordomas, a subtype of primary spinal column malignancies (PSCM), are rare tumors with poor prognosis, and we have limited understanding of the molecular drivers of neoplasia. Methods Study design was a retrospective review of prospectively collected data with cross-sectional survival. Archived paraffin embedded pathologic specimens were collected for 133 patients from 6 centers within Europe and North America between 1987 and 2012. Tumor DNA was extracted and the human telomerase reverse transcriptase (hTERT) promoter was sequenced. The hTERT mutational status was correlated with overall survival (OS) and time to first local recurrence. Results Ninety-two chordomas, 26 chondrosarcomas, 7 osteosarcomas, 3 Ewing’s sarcomas, and 5 other malignant spinal tumors were analyzed. Median OS following surgery was 5.8 years (95% CI: 4.6 to 6.9) and median time to first local recurrence was 3.9 years (95% CI: 2.5 to 6.7). Eight chordomas, 2 chondrosarcomas, 1 Ewing’s sarcoma, and 1 other malignant spinal tumor harbored either a C228T or C250T mutation in the hTERT promoter. In the overall cohort, all patients with hTERT mutation were alive at 10 years postoperative with a median OS of 5.1 years (95% CI: 4.5 to 6.6) (P = 0.03). hTERT promoter mutation was observed in 8.7% of spinal chordomas, and 100% of chordoma patients harboring the mutation were alive at 10 years postoperative compared with 67% patients without the mutation (P = 0.05). Conclusions We report for the first time that hTERT promoter mutations C228T and C250T are present in approximately 8.7% of spinal chordomas. The presence of hTERT mutations conferred a survival benefit and could potentially be a valuable positive prognostic molecular marker in spinal chordomas.

Given the moderate efficacy of the currently available antidepressants (ADs) in the treatment of major depressive disorder (MDD), the identification of agents that are both able to enhance the effectiveness of ADs and have a good safety profile is a reasonable task for current psychopharmacology. In addition to the well-known drugs (second-generation antipsychotics, levothyroxine, dopaminergic agents, etc.) for augmentation, investigations suggest that several nutraceuticals and over-the-counter (OTC) drugs may be effective and safe as adjunct therapeutic agents to conventional ADs. To identify such active ingredients we first performed a systematic literature search using PubMed and then conducted both backward and forward citation searches. For the PubMed search, we used the following combinations of keywords: 1) "adjunctive" + "therapy" + "antidepressant"; 2) "add-on" + "therapy" + "antidepressant"; 3) "supplementation" + "therapy" + "antidepressant". As a result of those efforts, we found more than 20 agents (e.g. S-Adenosyl-L-Methionine; folate; ω-3 fatty acids; curcumin; N-acetylcysteine; saffron; 5-hydroxytryptophan; NSAIDs) that are supposedly effective in the augmentation of standard AD treatment. We discussed the possible mechanisms of the antidepressant actions of those agents, as well as the preclinical and clinical evidence for their efficacy as stand-alone and adjunct treatments for MDD.

Study Design: Ambispective cohort study design. Objectives: Cervical spine metastases have distinct clinical considerations. The aim of this study was to determine the impact of surgical intervention (± radiotherapy) or radiotherapy alone on health-related quality of life (HRQOL) outcomes in patients treated for cervical metastatic spine tumours. Methods: Patients treated with surgery and/or radiotherapy for cervical spine metastases were identified from the Epidemiology, Process, and Outcomes of Spine Oncology (EPOSO) international multicentre prospective observational study. Demographic, diagnostic, treatment, and HRQOL (numerical rating scale [NRS] pain, EQ-5D (3L), SF-36v2, and SOSGOQ) measures were prospectively collected at baseline, 6 weeks, 3 months, and 6 months postintervention. Results: Fifty-five patients treated for cervical metastases were identified: 38 underwent surgery ± radiation and 17 received radiation alone. Surgically treated patients had higher mean spinal instability neoplastic scores compared with the radiation-alone group (13.0 vs 8.0, P < .001) and higher NRS pain scores and lower HRQOL scores compared to the radiation alone group ( P < .05). From baseline to 6 months posttreatment, surgically treated patients demonstrated statistically significant improvements in NRS pain, EQ-5D (5L), and SOSGOQ2.0 scores compared with nonsignificant improvements in the radiotherapy alone group. Conclusions: Surgically treated cervical metastases patients presented with higher levels of instability, worse baseline pain and HRQOL scores compared with patients who underwent radiotherapy alone. Significant improvements in pain and HRQOL were noted for those patients who received surgical intervention. Limited or no improvements were found in those treated with radiotherapy alone.

3D technologies (3D virtual and physical model, 3D printing, computer aided engineering, finite element analysis based simulations) play an important role in personalized spine surgery. Objective - In collaboration with AOSpine a global, online survey-based study was performed in order to determine the acceptance rate and the factors which stand against the wider spread of 3D technologies.A survey containing 21 questions was developed and divided into five pages, every page corresponding to one chapter. Our analysis is based on the responses of 282 spine surgeons from 57 countries. To interpret our results in a global context, we used the Human Development Index of the respondent's countries in comparisons.Significant difference between the AOSpine regions (p ≤ 0.05) was found, with the highest acceptance in Asia-Pacific region. There was no significant difference in acceptance score according to the field of spine surgery, or the surgical experience in years (p=0.77, and p=0.19). In the case of public practice, we found significantly higher acceptance compared to private and mixed (public and private) surgical practice (p ≤ 0.05). The acceptance of the technology varied based on the respondent's resident country's Human Development Index and was significantly different between "Medium" vs "Very high" (p = 0.0005) and "High" vs "Very high" (p=0.019) category. Significant positive correlation was found between the acceptance score and the HDI score (Spearman test, ρ = 0.37, p = 0.007). The main limitation factor was identified as the lack of information.There is high interest among spine surgeons towards the incorporation of 3D technologies into the clinical practice. Education, the healthcare system, and the economic environment plays a major role in acceptance. Our results provide the basis of a strategy to promote the application of 3D technologies.A 3D technológiák (háromdimenziós virtuális és fizikai modellek, háromdimenziós nyomtatás, mérnöki digitális tervezés, végeselem-analízisre épülő szimuláció) kulcsszerepet játszanak az egyénre szabott gerincsebészeti beavatkozások megvalósításában. Célkitűzés - A 3D technológiák klinikai alkalmazását elősegítő és limitáló tényezők meghatározása érdekében nemzetközi, online felmérést végeztünk az AOSpine közreműködésével.Kifejlesztettünk egy 21 kérdésből álló kérdőívet. A vizsgálat során 57 ország 282 gerincsebésze által kitöltött kérdőíveket használtunk fel. A kérdőívek számszerűsítve mérték az elfogódottságot különböző paraméterek mellett. Az adatok értékelésében a válaszadók származási országainak megfelelő humán fejlettségi indexet is figyelembe vettük.A 3D technológiák elfogadottsága az AOSpine-régiók között szignifikánsan eltért (p ≤ 0,05), a legnagyobb elfogadottságot az Ázsia/Csendes-óceáni régió mutatta. A gerincsebészeten belüli szakterület, illetve a gerincsebészként eltöltött évek szerint történő csoportosítás esetén nem találtunk szignifikáns különbséget (p = 0,77, illetve p = 0,19). A finanszírozást figyelembe véve, a 3D technológiák elfogadottsága szignifikánsan magasabb a kizárólag közfinanszírozott ellátásban dolgozó ge­rinc­sebészek esetén, a privát vagy mindkét (közfinanszírozott és privát) ellátáshoz viszonyítva (p ≤ 0,05). Az elfogadottság a humán fejlettségi index értéke alapján eltérő volt: szignifikáns különbséget találtunk a „Közepes” vs. „Nagyon magas” (p = 0,0005) és a „Magas” vs. „Nagyon magas” (p = 0,019) csoportba tartozó válaszadók közt; továbbá szignifikáns, pozitív korrelációt igazoltunk a technológia elfogadottsága és a humán fejlettségi index értéke közt (Spearman-teszt, ρ = 0,37, p = 0,007). A legfontosabb limitáló tényezőnek az ismerethiány bizonyult.Vizsgálatunk a 3D technológiák széles körű elfogadottságát bizonyítja. Az eredmény alátámasztja az oktatás, a gazdasági környezet, valamint a klinikai környezet/az egészségügy általános helyzetének szerepét. Vizsgálatunk alapul szolgálhat a 3D technológiák fejlesztésével és terjedésével kapcsolatos fő feladatok meghatározására.

The effects of abscisic acid (ABA) on plant growth, development and response to the environment depend on local ABA concentrations. Here, we exploited a genome-scale amiRNA screen, targeting theArabidopsistransportome, to show that ABA homeostasis is regulated by two previously unknown ABA transporters. ABCG17 and ABCG18 are localized to the plasma membranes of leaf mesophyll and stem cortex cells to redundantly promote ABA import, leading to conjugated inactive ABA sinks, thus restricting stomatal closure.ABCG17andABCG18double knockdown revealed that the transporters encoded by these genes not only limit stomatal aperture size, conductance and transpiration while increasing water-use efficiency but also control ABA translocation from the shoot to the root to regulate lateral root emergence. The proposed ABCG17- and ABCG18-dependent ABA glucosyl ester shoot sink mechanism is restrained under abiotic stress conditions to further activate the ABA responses.

Patients' attitude towards treatment is one of the most signifi cant factors which has determining eff ect on suffi cient adherence. Data are lacking on Hungarian patients' attitude towards psychiatric treatment, however, high prevalence of suicide suggests that eff ectiveness of psychiatric treatments need to be improved. To pave the way for such studies, we performed the validation of the recently developed Patients' Health Belief Questionnaire on Psychiatric Treatment (PHBQPT) in a sample of Hungarian psychiatric patients.We enrolled 188 Hungarian patients diagnosed with psychiatric disorders. The PHBQPT was translated into Hungarian by our group. Comparison of item and subscale mean scores with the original data are presented. Internal consistency, item-total and item-item correlations were calculated and factorial structure was analysed.Single item means, the highest item score and subscale mean scores were similar to data published in the original article. The factorial analysis confi rmed the validity of a fi ve-subscale structure in our sample. The eff ects of gender and age were not signifi cant on any of the subscales.The PHBQPT is a valid, reliable instrument with replicable psychometric properties. The Hungarian version is suitable for clinical practice and for further investigations on attitudes towards psychiatric treatment.

Description, ABCG17 and ABCG18 ABA importers redundantly regulate ABA homeostasis and long-distance translocation., The effects of abscisic acid (ABA) on plant growth, development, and response to the environment depend on local ABA concentrations. Here, we show that in Arabidopsis, ABA homeostasis is regulated by two previously unknown ABA transporters. Adenosine triphosphate–binding cassette subfamily G member 17 (ABCG17) and ABCG18 are localized to the plasma membranes of leaf mesophyll and cortex cells to redundantly promote ABA import, leading to conjugated inactive ABA sinks, thus restricting stomatal closure. ABCG17 and ABCG18 double knockdown revealed that the transporters encoded by these genes not only limit stomatal aperture size, conductance, and transpiration while increasing water use efficiency but also control ABA translocation from the shoot to the root to regulate lateral root emergence. Under abiotic stress conditions, ABCG17 and ABCG18 are transcriptionally repressed, promoting active ABA movement and response. The transport mechanism mediated by ABCG17 and ABCG18 allows plants to maintain ABA homeostasis under normal growth conditions.

OBJECTIVE Oncological resection of primary spine tumors is associated with lower recurrence rates. However, even in the most experienced hands, the execution of a meticulously drafted plan sometimes fails. The objectives of this study were to determine how successful surgical teams are at achieving planned surgical margins and how successful surgeons are in intraoperatively assessing tumor margins. The secondary objective was to identify factors associated with successful execution of planned resection. METHODS The Primary Tumor Research and Outcomes Network (PTRON) is a multicenter international prospective registry for the management of primary tumors of the spine. Using this registry, the authors compared 1) the planned surgical margin and 2) the intraoperative assessment of the margin by the surgeon with the postoperative assessment of the margin by the pathologist. Univariate analysis was used to assess whether factors such as histology, size, location, previous radiotherapy, and revision surgery were associated with successful execution of the planned margins. RESULTS Three hundred patients were included. The surgical plan was successfully achieved in 224 (74.7%) patients. The surgeon correctly assessed the intraoperative margins, as reported in the final assessment by the pathologist, in 239 (79.7%) patients. On univariate analysis, no factor had a statistically significant influence on successful achievement of planned margins. CONCLUSIONS In high-volume cancer centers around the world, planned surgical margins can be achieved in approximately 75% of cases. The morbidity of the proposed intervention must be balanced with the expected success rate in order to optimize patient management and surgical decision-making.

The coronavirus pandemic (COVID-19) required the declaration of a state of emergency in Hungary from 11 March 2020 to 18 June 2020. These governmental actions led to changes in everyday life, implementation of new rules, and reduced access to healthcare. Hospital beds were reserved for emergency use, face-to-face ambulatory care was mainly replaced by telemedicine. In our study we assessed opinion of the patients in two outpatient psychiatric care units in Budapest regarding the state of emergency.We enrolled 438 patients in the survey (305 women and 133 men, mean age: 51.9±16.2 years). The patients completed a short questionnaire on a voluntary and anonymous basis following verbal informed consent. The questionnaire was comprised of 10 items and a 12-item "Problem Evaluation Scale" (fear, isolation and healthcare subscales). The comparison of groups was done using general linear models (GLM), pairwise comparison was performed using Tukey's test for post hoc analysis. The data set was analyzed with SPSS software, version 24.0.Up to 34% of enrolled patients believed that their condition worsened during the state of emergency, but 12% of these patients thought that this worsening was not related to the state of emergency. Twice as many patients (12.8%) were concerned about their financial situation than about their health status (6.1%). Loneliness and the implementation of specific regulations didn't cause relevant distress in almost half of the patients, isolation was the most frequently (55.2%) reported difficulty. The worsening of health status was reported more frequently (p=0.001) by the patients younger than 50 years, the sensation of fear was stronger (p=0.045), and they reported more serious adaptation difficulties (p=0.003) than subjects older than 50 years. Isolation caused significantly (p=0.003) more serious distress among women. The abundance of pandemic-related information caused more distress in the case of patients treated for anxiety than participants treated for psychotic disorders (p=0.024). Patients suffering from affective disorders perceived more pronounced feelings of vulnerability compared to patients treated for psychotic disorders (p=0.004).Approximately half of the enrolled psychiatric patients was able to adapt to this situation without major difficulties, the other half of this sample was more or less distressed by these circumstances. Unfortunately, depletion of emotional, psychological, social and material resources can be expected during the next stage of the pandemic. As a result, we can expect further worsening of the above presented aspects.

The COVID-19 pandemic causes psychological trauma in the whole society, thus investigation of the epidemiology of psychiatric symptoms is an outstanding research field during this period. Fear of infection, exposure to updated data on death figures, social isolation, adaptation to new restricting rules, existential crisis, reduction of health care availability poses dangers for mental health. Currently published papers focus on the acute effect of first wave of COVID-19 pandemic, however, further studies on long-term consequences can make this picture more complex and sophisticated. In this review a summary is provided on the most important results concerning frequency of psychiatric symptoms during the first lockdown of COVID-19. In light of the results it can be stated that psychiatric patients showed more common and more intensive symptoms, the number of relapses is increased and the adherence is reduced. Notably, more than the half of the general population produced measurable psychiatric symptoms. Furthermore, a worrying portion of frontline healthcare workers started manifesting mental symptoms. The overall picture suggests that the mental health state shows a global decline on the level of the general society which highlights the urgent need for targeted and complex mental support programs.

The assessment of risk of vertebral fracture in patients with lytic metastases is challenging, due to the complexity in modelling the mechanical properties of this heterogeneous material. Currently clinical assessment of patients at high risk of fracture is based on the Spinal Instability Neoplastic Score (SINS), which however in many cases does not provide clear guidelines. The goal of this study was to develop a computational approach to provide a comparative biomechanical assessment of vertebrae with lytic lesions with respect to the adjacent controls and highlight the critical vertebrae. The computed tomography images of the thoracolumbar spine of eight patients suffering of vertebral lytic metastases with SINS between 7 and 12 (indeterminate unstable) were analysed. For each patient one or two vertebrae with lytic lesions were modelled and the closest vertebrae without lesions were considered as control. Metastatic vertebrae (N = 12) and controls (N = 18) were converted to subject-specific, heterogeneous, isotropic, nonlinear finite element models for simulating uniaxial compression. Densitometric and mechanical properties were computed for each vertebra. In average, similar mechanical properties were found for vertebrae with lytic lesions and controls (e.g. ultimate force equal to 6.2 ± 2.7 kN for vertebrae with lytic lesions and to 6.2 ± 3.0 kN for control vertebrae). Only in three patients the vertebrae with lytic lesions were found to be mechanically weaker (−19% to −75% difference for ultimate stress) than the controls. In conclusion, in this study we presented an approach to estimate the mechanical competence of vertebrae with lytic metastases. It remains to be investigated in a clinical study if this method, together with the SINS, can better classify patients with vertebrae with lytic lesions at high risk of fracture.

RESUMOAo serem desconsideradas como cidadãs, as pessoas em situação de rua parecem ser invisíveis no que diz respeito aos seus direitos, enquanto que no cotidiano a presença delas causa incômodo, gerando o inverso da invisibilidade. Este trabalho, ao empreender o turismo como um direito social, descreve como decorreram as experiências turísticas de um grupo de pessoas em situação de rua - atendidas por um órgão público de assistência social, em parceria com um programa de extensão da Universidade Federal Fluminense -, que visitou atrativos turísticos da região metropolitana do Rio de Janeiro. Além do contato com autores/pesquisas que se debruçaram sobre a realidade das pessoas em situação de rua, o embasamento teórico entrelaçou os temas do Direito ao Lazer e à Cidade, da Experiência Turística e do Turismo Social. As análises realizadas a partir de bases etnográficas, incluindo a observação participante e entrevistas com roteiro semiestruturado, indicaram que as experiências turísticas parecem ter despertado memórias afetivas que funcionam para esse grupo como meio de resistência à condição na qual se encontram. Ainda assim, algumas experiências foram atravessadas por situações graves de preconceito e discriminação, direcionadas por visitantes convencionais ao grupo.PALAVRAS-CHAVETurismo Social; Direito ao Lazer; População em Situação de Rua; Rio de Janeiro, RJ, Brasil. ABSTRACTWhen they are disregarded as citizens, people on the street seem to be invisible with regard to their rights, while in their daily lives their presence causes discomfort, generating the inverse of invisibility. This work, when undertaking tourism as a social right, describes how the tourist experiences of a group of homeless people - assisted by a public social assistance agency, in partnership with a UFF extension program - took place, which they visited tourist attractions in the metropolitan region of Rio. In addition to contact with authors / research that dealt with the reality of people living on the streets, the theoretical basis intertwined the themes of the Right to Leisure and the City, the Tourist Experience and Social Tourism. The analyzes carried out from ethnographic bases, including participant observation and interviews with a semi-structured script, indicated that tourist experiences seem to have aroused affective memories that work for this group as a means of resistance to the condition in which they find themselves. Even so, some experiences were crossed by serious situations of prejudice and discrimination, directed by conventional visitors to the group.KEYWORDSSocial Tourism; Right to Leisure; Homeless Population; Rio de Janeiro, RJ, Brazil. AUTORIAJordania de Oliveira Eugenio – Doutoranda. Programa de Pós-Graduação Interdisciplinar em Estudos do Lazer, Universidade Federal de Minas Gerais, Minas Gerais, Brasil. Currículo: http://lattes.cnpq.br/6752199442222274 E-mail: jordaniaeugenio@ufmg.br Bernardo Lazary Cheibub – Doutor. Professor na Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil. Currículo: http://lattes.cnpq.br/3403295501230221 E-mail: bernardocheibubu@id.uff.br REFERÊNCIASAndré. M. (2005). Etnografia da prática escolar. São Paulo: Papirus. Alves, V. F.N., Miranda Júnior, M. C., & Martins, R. D. (12 a 15 de setembro de 2004). Turismo e Lazer: em Busca da Cidadania e da Inclusão Social. 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O texto resenha a tese de doutorado de Valéria Guimarães no campo da história do turismo. Apresenta as reflexões da autora que se dedica a estudar discursos e práticas turísticas produzidos no Brasil e na Argentina, entre os anos de 1933 e 1946, quando os dois países passaram pela experiência de governos autoritários. As principais contribuições da pesquisa foram identificadas, especialmente a crítica a uma história do turismo linear, descritiva, amparada em relações de causa-efeito, consolidada em cronologias e pautada por mitos fundadores. Outra contribuição que se destaca é a refutação de duas ideias: a de que a II Guerra Mundial paralisou por completo os fluxos turísticos mundiais e a de que a primeira expressão de política de turismo no Brasil foi a criação da Comissão Brasileira de Turismo (Combratur). As potencialidades tanto do método da história comparada quanto dos periódicos como fontes documentais nas pesquisas sobre história do turismo foram igualmente analisadas.

Backgorund Increasing experimental data confirm the crucial role of the endocannabinoid (eCB) system in the regulation of stress response and emotional processes. Despite of the fact, that genetically determined vulnerability for stress is a widely accepted concept in the pathomechanism of affective disorders, replicable human genetic results with interaction analyses of early life trauma and eCB genes are rare. The aim of this study is to test the associations between genetic variants of the eCB pathway, childhood trauma and affective phenotypes. Methods We selected 18,897 SNPs in the eCB pathway of a GWAS dataset in two general population cohorts (BP sample N = 837; MN sample N = 988). Association analyses were performed on the anxious and depressive subscales of the Brief Symptom Inventory (BSI-ANX and BSI-DEP, respectively). Childhood trauma was assessed by the Childhood Adversity Questionnaire (CAQ). Association analyses were performed in the R 2.0. statistical program using the SNPassoc package. Reults Genetic effect was more robust in the BP sample than in the MN sample. The most comprehensive results showed that SNPs in the CACNA1C gene associated with depressive phenotype in interaction with CAQ in both BP (p = 1.2 × 10−4) and MN samples (p = 1.6 × 10−4). Direct association analyses (without interaction) provided significant associations between SNPs in different genesets of the two study populations. SNPs in KCNJ3 and GNB5 genes on the BSI-DEP (p = 6.1 × 10−5; p = 7.1 × 10−4) and GNG12 gene on the BSI-ANX (p = 7.4 × 10−6) in the BP sample, while GABAergic, ADCY1 and HTR2A gene variants can be outlined from results of MN sample with less strong p-values. Conclusion Our results confirmed the prominent role of CACNA1C gene in the pathogenic effect of early life stress in the development of affective vulnerability in two different study populations using GxE interaction analysis. CACNA1C gene, as it encodes for L-type voltage-gated calcium channel, contributes to neuronal excitability, plasticity and neurogenesis being a crucial effector of both eCB signaling and the BDNF-CREB pathway as well. Our findings suggest that childhood trauma related depression may have more robust genetically determined basis than without early life stress.

The STarT Back Tool was developed to identify the specific modifiable prognostic factors for non-specific low back pain and to classify the patients into risk groups; low, medium and high risk of chronicity. Applied therapeutic approaches often involve group physical therapy. The aim of this study was the cross-cultural adaptation and validation of the Hungarian version of the STarT Back Tool and to investigate the predictive ability for global treatment outcome. A prospective cohort study (N = 133) was carried out involving non-specific low back pain patients. Internal consistency, construct validity, reliability and prognostic discriminative ability have been investigated. After 3 months of treatment global outcome was evaluated. A 2-factor structure was found, with moderate internal consistency (Cronbach α = 0.89 for the total and psychosocial subscale 0.62). Between the Hungarian STarT Back Tool, the Oswestry Disability Index, leg pain, low back pain, Tampa Scale for Kinesiophobia, Fear Avoidance Beliefs Questionnaire and the physical subscale of the quality of life questionnaire, significant good to excellent- correlation was found (r > 0.41). The test-retest analysis showed excellent reliability (Intraclass Correlation Coefficient = 0.93) with standard error measurement being 0.49 (minimal detectable change = 1.37). The Area Under the Curve for baseline STarT Back Tool scores was 0.7 and 0.8 for global treatment outcome and distress, respectively. The Area Under the Curve for global treatment outcome versus STarT risk groups proved to be 0.76 representing adequate discriminative ability. The successful cross-cultural adaptation was followed by the validity analysis and as a result the Hungarian version of the STarT Back Tool proved to be a reliable and valid tool in the identification of risk groups of chronicity for patients with low back pain. Patients allocated to the high-risk group were more likely experiencing poor outcome at 3 months follow up, thus it can be used to predict outcome if treated with group physical therapy.Implication for rehabilitationLow back pain is a multifactorial disease where physical and psychosocial risk factors play a role in the development and prognosis of the disease.The STarT-H can be considered as a reliable, valid measurement tool in the identification of risk groups of chronicity for patients with low back pain.Clinical relevance of the STarT-H is that it can be used to stratify patients into risk groups of chronicity in different Hungarian speaking healthcare settings.According to our findings the STarT-H can also be applied to predict global treatment outcome in low back pain patients if treated with group physical therapy. Low back pain is a multifactorial disease where physical and psychosocial risk factors play a role in the development and prognosis of the disease. The STarT-H can be considered as a reliable, valid measurement tool in the identification of risk groups of chronicity for patients with low back pain. Clinical relevance of the STarT-H is that it can be used to stratify patients into risk groups of chronicity in different Hungarian speaking healthcare settings. According to our findings the STarT-H can also be applied to predict global treatment outcome in low back pain patients if treated with group physical therapy.

The health locus of control has been extensively analyzed in diff erent patient populations suff ering from chronic somatic illnesses due to its infl uence on adherence to long-term therapies. Despite of the fact that adherence is one of the most important factors which needs to be taken into consideration in the oupatient care of psychiatric patients, there is a scarcity of studies regarding HLOC in this population. In this review we provide an overview of study results regarding HLOC in somatic and psychiatric patients. Based on these results we conclude that in the case of patients suff ering from chronic illnesses, a higher internal HLOC is associated with less severe depressive symptoms and better adherence and quality of life. Nevertheless, the results of the follow-up studies indicate that change of HLOC (from internal to external) can be adaptive when the outcome is not favourable or the treatment is not eff ective. The continuous evaluation of HLOC of psychiatric patients in treatment may provide necessary information for the planning of interventions to help this process. Taking into consideration that the patients' perception of control is often impaired due to the nature of psychiatric illnesses we propose evaluation of psychobiological factors infl uencing health locus of control in order to facilitate the planning of these interventions.

Este artigo tem por objetivo geral levantar questões a respeito dos significados das palavras “comunidade” e “favela” - compreendidas enquanto categorias sociológicas - buscando articular os pontos de convergência e divergência deste par, refletindo sobre as formas de apropriação dos termos por parte de alguns agentes sociais que interagem com a favela “turística” Santa Marta, no Rio de Janeiro. Concernente à metodologia, inicialmente foi feita a análise de diversos trabalhos de autores que falam direta e indiretamente sobre o tema; adicionalmente, foi realizada uma pesquisa de natureza qualitativa, aplicando-se roteiros semiestruturados de entrevistas com guias de turismo local, moradores, líderes comunitários e turistas/visitantes, com a finalidade de compreender como tais agentes se apropriam das palavras favela e comunidade. A partir dos resultados da pesquisa, concluímos que, de maneira maniqueísta e majoritária, a comunidade é concebida como o local da sociabilidade e da solidariedade, enquanto que a favela se apresenta como o lugar do caos urbano. Todavia, os termos podem se aproximar ou se afastar, dependendo do contexto em que são empregados e de quem o está usando, a partir de diferentes pretextos.

Background: Surgical site infection (SSI) is a serious complication after routine lumbar spinal operations, and its effect on global treatment outcome (GTO) is less reported. The aim of the current...