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Background. Up to a quarter of inpatients in high-income countries (HICs) self-report beta-lactam allergy (BLA), which if incorrect,increases the use of alternative antibiotics, worsening individual health outcomes and driving bacterial resistance. In HICs, up to 95% ofself-reported BLAs are incorrect. The epidemiology of BLA in low- and middle-income African countries is unknown.Objectives. To describe the epidemiology and de-labelling outcomes of self-reported BLA in hospitalised South African (SA) patients.Methods. Point-prevalence surveys were conducted at seven hospitals (adult, paediatric, government and privately funded, district andtertiary level) in Cape Town, SA, between April 2019 and June 2021. Ward prescription records and in-person interviews were conductedto identify and risk-stratify BLA patients using the validated PEN-FAST tool. De-labelling was attempted at the tertiary allergy clinic atGroote Schuur Hospital.Results. A total of 1 486 hospital inpatients were surveyed (1 166 adults and 320 children). Only 48 patients (3.2%) self-reported a BLA,with a higher rate in private than in government-funded hospitals (6.3% v. 2.8%; p=0.014). Using the PEN-FAST tool, only 10.4% (n=5/48)of self-reported BLA patients were classified as high risk for true penicillin hypersensitivity. Antibiotics were prescribed to 70.8% (n=34/48)of self-reported BLA patients, with 64.7% (n=22/34) receiving a beta-lactam. Despite three attempts to contact patients for de-labelling atthe allergy clinic, only 3/36 underwent in vivo testing, with no positive results, and 1 patient proceeded to a negative oral challenge.Conclusion. Unlike HICs, self-reported BLA is low among inpatients in SA. The majority of those who self-reported BLA were low risk fortype 1 hypersensitivity, but outpatient de-labelling efforts were largely unsuccessful.

Background Obesity is a risk factor for adverse outcomes in COVID-19, potentially driven by chronic inflammatory state due to dysregulated secretion of adipokines and cytokines. We investigated the association between plasma adipokines and COVID-19 severity, systemic inflammation, clinical parameters, and outcome of COVID-19 patients. Methods In this multi-centre prospective cross-sectional study, we collected blood samples and clinical data from COVID-19 patients. The severity of COVID-19 was classified as mild (no hospital admission), severe (ward admission), and critical (ICU admission). ICU non-COVID-19 patients were also included and plasma from healthy age, sex, and BMI-matched individuals obtained from Lifelines. Multi-analyte profiling of plasma adipokines (Leptin, Adiponectin, Resistin, Visfatin) and inflammatory markers (IL-6, TNFα, IL-10) were determined using Luminex multiplex assays. Results Between March and December 2020, 260 SARS-CoV-2 infected individuals (age: 65 [56–74] BMI 27.0 [24.4–30.6]) were included: 30 mild, 159 severe, and 71 critical patients. Circulating leptin levels were reduced in critically ill patients with a high BMI yet this decrease was absent in patients that were administered dexamethasone. Visfatin levels were higher in critical COVID-19 patients compared to non-COVID-ICU, mild and severe patients (4.7 vs 3.4, 3.0, and 3.72 ng/mL respectively, p p p Conclusion Circulating adipokine levels are associated with COVID-19 hospitalization, i.e., the need for oxygen support (general ward), or the need for mechanical ventilation and other organ support in the ICU, but not mortality.

Background Measuring calprotectin concentration in stool is increasingly important in monitoring disease activity and treatment response in inflammatory bowel disease. This study evaluates the impact of preanalytical storage conditions on reliability of calprotectin testing using 5 different calprotectin immunoassays. Methods Aliquots of homogenized fresh fecal samples in untreated or extracted form were stored at room temperature or 4°C. Calprotectin concentration was measured day 0 to 4 and 8. Five different immunoassays and accompanying extraction buffers were used (CALiaGold, Phadia EliA, Bühlmann fCal turbo, ELISA Bühlmann, Inova Quanta Flash). Repeated measurements of change from baseline calprotectin levels over time were analyzed using a mixed model analysis. Results Calprotectin concentrations declined over time under all preanalytical conditions with all assays, except for extracted feces stored at 4°C. The rate of decline was greatest in untreated stool kept at room temperature, reaching significant difference from baseline already after 1 day (P < 0.001). In extracted feces kept at room temperature, significant difference from baseline was reached after 2 days, and in untreated feces at 4°C, after 4 days. However, the results differed significantly between assays. After 4 days of storage at room temperature, the mean calprotectin decline from baseline differed between 30% and 60%, dependent on the assay used. Conclusions Fecal calprotectin concentration in stool samples declines over time, and the rate of decline is greater at higher temperatures. In extracted feces stored at 4°C, calprotectin is most stable. It is assay-dependent how long extracted feces stored at 4°C give reliable test results.

Les peptides RFamide ont une extrémité carboxyterminale Arg-Phe-NH2 conservée et indispensable à leur activité. Ils sont impliqués dans la modulation de divers mécanismes biologiques, dont la douleur. Cette revue résume les connaissances sur la localisation de ces neuropeptides et de leurs récepteurs ainsi que leur rôle dans la modulation de la douleur. Les stratégies et outils thérapeutiques innovants en développement pour étudier le rôle respectif de ces récepteurs sont abordés.

Background: Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer. However, most studies have used self-reported anthropometry which is prone to error.Methods: Among 363,094 participants in the European Prospective Investigation into Cancer and Nutrition study (EPIC) with measured anthropometry, there were 837 incident cases of head and neck cancer. Head and neck cancer risk was examined in relation to body mass index (BMI) [lean: 2, normal weight (reference): 22.5–24.9 kg/m2, overweight 25–29.9 kg/m2, obese: ≥30 kg/m2], waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) using Cox proportional hazards models.Results: Among men, a BMI < 22.5 kg/m2 was associated with higher head and neck cancer risk [HR 1.62; 95% confidence interval (CI), 1.23–2.12)]; BMI was not associated with head and neck cancer among women. WC and WHR were associated with greater risk of head and neck cancer among women (WC per 5 cm: HR, 1.08; 95% CI, 1.02–1.15; WHR per 0.1 unit: HR, 1.64; 95% CI, 1.38–1.93). After stratification by smoking status, the association for WHR was present only among smokers (Pinteraction = 0.004). Among men, WC and WHR were associated with head and neck cancer only upon additional adjustment for BMI (WC per 5 cm: HR 1.16; 95% CI, 1.07–1.26; WHR per 0.1 unit: HR, 1.42; 95% CI, 1.21–1.65).Conclusions: Central adiposity, particularly among women, may have a stronger association with head and neck cancer risk than previously estimated.Impact: Strategies to reduce obesity may beneficially impact head and neck cancer incidence. Cancer Epidemiol Biomarkers Prev; 26(6); 895–904. ©2017 AACR.

Prospective cohort studies have provided some evidence that circulating vitamin D is associated with risk of, and survival from, renal cell carcinoma (RCC), but it is unclear whether concentrations of vitamin D at the time of diagnosis of RCC are associated with prognosis. We conducted a case–cohort study of 630 RCC cases, including 203 deaths, from a multicenter case–control study in Eastern Europe. Vitamin D was assessed as 25-hydroxyvitamin D3 [25(OH)D3], and we used weighted Cox models to estimate hazard ratios (HR) and 95% confidence intervals (CI) by categories of season-adjusted 25(OH)D3. Higher concentrations of 25(OH)D3 were associated with lower risk of death after adjusting for stage, age, sex, and country (HR highest vs. lowest category 0.57; 95% CI, 0.34–0.97). The inverse associations of 25(OH)D3 with death were most notable among those who died from non-RCC causes and those diagnosed with early-stage disease. In summary, 25(OH)D3 concentration at diagnosis of RCC was inversely associated with all-cause mortality rates, but not specifically with RCC outcome. Cancer Epidemiol Biomarkers Prev; 24(8); 1277–81. ©2015 AACR.

Measures of adiposity and the risk of HNC among EPIC participants, by smoking status at baseline and second questionnaire

Purpose: Renal cell carcinoma (RCC) has the potential for cure with surgery when diagnosed at an early stage. Kidney injury molecule-1 (KIM-1) has been shown to be elevated in the plasma of RCC patients. We aimed to test whether plasma KIM-1 could represent a means of detecting RCC prior to clinical diagnosis.Experimental Design: KIM-1 concentrations were measured in prediagnostic plasma from 190 RCC cases and 190 controls nested within a population-based prospective cohort study. Cases had entered the cohort up to 5 years before diagnosis, and controls were matched on cases for date of birth, date at blood donation, sex, and country. We applied conditional logistic regression and flexible parametric survival models to evaluate the association between plasma KIM-1 concentrations and RCC risk and survival.Results: The incidence rate ratio (IRR) of RCC for a doubling in KIM-1 concentration was 1.71 [95% confidence interval (CI), 1.44–2.03, P = 4.1 × 10−23], corresponding to an IRR of 63.3 (95% CI, 16.2–246.9) comparing the 80th to the 20th percentiles of the KIM-1 distribution in this sample. Compared with a risk model including known risk factors of RCC (age, sex, country, body mass index, and tobacco smoking status), a risk model additionally including KIM-1 substantially improved discrimination between cases and controls (area under the receiver-operating characteristic curve of 0.8 compared with 0.7). High plasma KIM-1 concentrations were also associated with poorer survival (P = 0.0053).Conclusions: Plasma KIM-1 concentrations could predict RCC incidence up to 5 years prior to diagnosis and were associated with poorer survival. Clin Cancer Res; 24(22); 5594–601. ©2018 AACR.

Scatterplots of the associations between BMI (kg/m2) and WC (Fig 1a) and between BMI (kg/m2) and WHR (Fig 1b).

Supplementary Figure 1 caption

Measures of adiposity and the risk of HNC in the EPIC study, excluding Oxford participants with calibrated self-reported anthropometry

Supplementary Figure 1. Hazard ratios (HR) and 95% confidence intervals (CI) for a doubling in season-adjusted 25(OH)D3 concentration by potential effect modifiers.

Measures of adiposity and the risk of HNC among EPIC participants, including adjustment for weight change after baseline

Supplementary Table 1, Supplementary Figures 1 and 2

Introdução: ao longo dos anos, a busca pela melhora do autocuidado estendeu-se às farmácias com manipulação, onde o cosmético pode ser manipulado de acordo com as preferências de cada indivíduo. Dessa forma, é necessário prover a estabilidade para cada produto manipulado, garantindo que um cosmético seguro e eficaz será dispensado. O ácido hialurônico é um ativo que tem se tornado popular devido à sua capacidade de realizar a manutenção da elasticidade da pele e exercer função hidratante, além de atuar na redução de linhas de expressão. Objetivo: analisar a qualidade de dermocosméticos manipulados a base de ácido hialurônico de diferentes farmácias com manipulação no município de Campo Grande-MS, através de análises laboratoriais físico-químicas e de rotulagem. Material e métodos: quatro amostras de creme-gel à base de ácido hialurônico 5% foram adquiridas em farmácias magistrais, e realizadas as seguintes análises de controle de qualidade: análise organoléptica, determinação de pH, densidade, teste de centrífuga, espalhabilidade e análise de rotulagem. Resultados: em relação às análises, os resultados obtidos foram satisfatórios. A análise organoléptica, o teste de centrifugação e de espalhabilidade se encontraram dentro dos padrões estipulados; porém, destaca-se o ensaio de densidade, em que duas amostras obtiveram valores abaixo do estipulado; e para a análise de rótulos, nenhum produto continha lista de componentes da formulação. Conclusão: ao final das análises, pode ser apontado que os produtos apresentaram desempenho satisfatório em grande parte dos testes propostos e são uma opção segura, de boa qualidade e custo acessível ao público.

Biophysical models are often used to estimate larval dispersal patterns for the assessment of marine metapopulation spatial structure. However, comparisons of these models with field observations are relatively rare, and the extent to which models reproduce true marine connectivity patterns is unclear. We developed a biophysical model for larvae of the blacktail seabream Diplodus capensis (Sparidae), an abundant recreational and subsistence fishery species along the south-east coast of South Africa, and compared outputs from various configurations of that model to results from a field study conducted in a large regional embayment (Algoa Bay). Seasonal patterns of dispersal and recruitment produced by the model agreed best with field observations when thermal constraints on spawners and larvae were included. Spatial gradients in settling larvae also matched well, with the model capturing observed high settler densities within the lee of a major headland. Nevertheless, stronger spatial gradients were observed in larval densities from the field study when compared with model results, which may be explained by behavioural post-settlement processes. Model-based dispersal patterns revealed up to 5 subpopulations along the southern coast, with barriers to connectivity between subpopulations generally linked to hydrographic features. Overall, our results suggest that thermally mediated spawning behaviour, physical transport and post-settlement processes all play important roles in determining marine connectivity for the blacktail seabream. Refining physiological larval constraints may be an important component that needs to be considered going forward.

Vegetation demographic models (VDMs) endeavor to predict how global forests will respond to climate change. This requires simulating which trees, if any, are able to recruit under changing environmental conditions. We present a new recruitment scheme for VDMs in which functional-type-specific recruitment rates are sensitive to light, soil moisture and the productivity of reproductive trees. We evaluate the scheme by predicting tree recruitment for four tropical tree functional types under varying meteorology and canopy structure at Barro Colorado Island, Panama. We compare predictions to those of a current VDM, quantitative observations and ecological expectations. We find that the scheme improves the magnitude and rank order of recruitment rates among functional types and captures recruitment limitations in response to variable understory light, soil moisture and precipitation regimes. Our results indicate that adopting this framework will improve VDM capacity to predict functional-type-specific tree recruitment in response to climate change, thereby improving predictions of future forest distribution, composition and function.

Tree size shapes forest carbon dynamics and determines how trees interact with their environment, including a changing climate. Here, we conduct the first global analysis of among-site differences in how aboveground biomass stocks and fluxes are distributed with tree size. We analyzed repeat tree censuses from 25 large-scale (4-52 ha) forest plots spanning a broad climatic range over five continents to characterize how aboveground biomass, woody productivity, and woody mortality vary with tree diameter. We examined how the median, dispersion, and skewness of these size-related distributions vary with mean annual temperature and precipitation. In warmer forests, aboveground biomass, woody productivity, and woody mortality were more broadly distributed with respect to tree size. In warmer and wetter forests, aboveground biomass and woody productivity were more right skewed, with a long tail towards large trees. Small trees (1-10 cm diameter) contributed more to productivity and mortality than to biomass, highlighting the importance of including these trees in analyses of forest dynamics. Our findings provide an improved characterization of climate-driven forest differences in the size structure of aboveground biomass and dynamics of that biomass, as well as refined benchmarks for capturing climate influences in vegetation demographic models.

Tree mortality is a major control over tropical forest carbon stocks globally but the strength of associations between abiotic drivers and tree mortality within forested landscapes is poorly understood. Here, we used repeat drone photogrammetry across 1500 ha of forest in Central Panama over 5 years to quantify spatial variation in canopy disturbance rates and its predictors. We identified 11,153 canopy disturbances greater than 25 m

Context No consensus exists about the optimal duration of the low-iodine diet (LID) in the preparation of 131I therapy in differentiated thyroid cancer (DTC) patients. Objective This work aimed to investigate if a LID of 4 days is enough to achieve adequate iodine depletion in preparation for 131I therapy. In addition, the nutritional status of the LID was evaluated. Methods In this prospective study, 65 DTC patients treated at 2 university medical centers were included between 2018 and 2021. The patients collected 24-hour urine on days 4 and 7 of the LID and kept a food diary before and during the LID. The primary outcome was the difference between the 24-hour urinary iodine excretion (UIE) on both days. Results The median 24-hour UIE on days 4 and 7 of the LID were not significantly different (36.1 mcg [interquartile range, 25.4-51.2 mcg] and 36.5 mcg [interquartile range, 23.9-47.7 mcg], respectively, P = .43). On day 4 of the LID, 72.1% of the DTC patients were adequately prepared (24-hour UIE Conclusion The 24-hour UIE on day 4 of the LID did not differ from day 7, and therefore shortening the LID from 7 to 4 days seems justified to prepare DTC patients for 131I therapy in areas with sufficient iodine intake and may be beneficial to maintain a sufficient nutritional intake during DTC treatment.

Theology as a story of doubt and imagination is to be understood against the background of interdisciplinary social science and in contrast to the traditional paradigm of theology as a system of propositional certainty. The concepts of doubt and imagination are part and parcel of narrative research and can also be linked to postfoundational philosophy. The relevancy of this theological paradigm will be discussed on the basis of the following: (1) It is in touch with its own doubt, (2) It is in touch with its own story (tradition), (3) It can therefore interact with other stories, stories of hope and despair, stories of suffering, stories of power and of marginalisation, (4) It can also imagine alternative stories. Intradisciplinary and/or interdisciplinary implications: The interaction with 'other stories', which is one of the important outcomes of this postfoundational approach, makes it possible for theology to be a humble but important participant at the interdisciplinary conversational table.