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The major female ovarian hormone, 17β-estradiol (E 2 ), can alter neuronal excitability within milliseconds to regulate a variety of physiological processes. Estrogen receptor-α (ERα), classically known as a nuclear receptor, exists as a membrane-bound receptor to mediate this rapid action of E 2 , but the ionic mechanisms remain unclear. Here, we show that a membrane channel protein, chloride intracellular channel protein-1 (Clic1), can physically interact with ERα with a preference to the membrane-bound ERα. Clic1-mediated currents can be enhanced by E 2 and reduced by its depletion. In addition, Clic1 currents are required to mediate the E 2 -induced rapid excitations in multiple brain ERα populations. Further, genetic disruption of Clic1 in hypothalamic ERα neurons blunts the regulations of E 2 on female body weight balance. In conclusion, we identified the Clic1 chloride channel as a key mediator for E 2 -induced rapid neuronal excitation, which may have a broad impact on multiple neurobiological processes regulated by E 2 .

Objective: The aim of the study was to determine the response rate to a mixed-mode survey using email compared with that to a paper survey in survivors of critical illness., Design: This is a prospective randomised controlled trial., Setting: The study was conducted at a single-centre quaternary intensive care unit (ICU) in Adelaide, Australia., Participants: Study participants were patients admitted to the ICU for ≥48 h and discharged from the hospital., Interventions: The participants were randomised to receive a survey by paper (via mail) or via online (via email, or if a non-email user, via a letter with a website address). Patients who did not respond to the initial survey received a reminder paper survey after 14 days. The survey included quality of life (EuroQol-5D-5L), anxiety and depression (Hospital Anxiety and Depression Scale), and post-traumatic symptom (Impact of Event Scale-Revised) assessment., Main Outcome Measures: Survey response rate, extent of survey completion, clinical outcomes at different time points after discharge, and survey cost analysis were the main outcome measures. Outcomes were stratified based on follow-up time after ICU discharge (3, 6, and 12 months)., Results: A total of 239 patients were randomised. The response rate was similar between the groups (mixed-mode: 78% [92/118 patients] vs. paper: 80% [97/121 patients], p = 0.751) and did not differ between time points of follow-up. Incomplete surveys were more prevalent in the paper group (10% vs 18%). The median EuroQol-5D-5L index value was 0.83 [0.71-0.92]. Depressive symptoms were reported by 25% of patients (46/187), anxiety symptoms were reported by 27% (50/187), and probable post-traumatic stress disorder was reported by 14% (25/184). Patient outcomes did not differ between the groups or time points of follow-up. The cost per reply was AU$ 16.60 (mixed-mode) vs AU$ 19.78 (paper)., Conclusion: The response rate of a mixed-mode survey is similar to that of a paper survey and may provide modest cost savings., Competing Interests: Conflict of interest None., (Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.)

Objective: Dental and medical practitioners play a pivotal role in detecting early stages of oral cancers. Hence, future dental and medical practitioners need to have adequate knowledge of oral cancer. This study was conducted to assess the current level of knowledge, attitude and practices regarding oral cancer among dental and medical students of a Malaysian private university., Methods: A cross-sectional study was conducted on third-, fourth- and final-year students of the dental and medical courses of MAHSA University, Malaysia. A total of 557 students participated in the survey. Oral cancer awareness, knowledge about risk factors, signs and symptoms of oral cancer, attitude and practices towards oral cancer were assessed using 43 questions. The questionnaire was pretested, and internal consistency, assessed using Cronbach's alpha, was acceptable (α > 0.7). The data were analysed using IBM SPSS version 21. The chi-square test was used to analyse the difference in oral cancer awareness between medical and dental students., Results: Among 557 participants, there were 351 (63%) medical students and 206 (37%) dental students. Based on the results obtained, dental students had a higher level of knowledge than medical students regarding oral cancer (P < 0.05). More than 90% of the dental students were able to identify smoking, alcohol consumption, betel quid chewing, human papilloma virus infection and exposure to radiation as risk factors associated with oral cancer compared to more than 50% of medical students (P < 0.05)., Conclusions: Through education and training, awareness amongst medical students can be reinforced, which will promote early detection of precancerous lesions and oral cancers., (© 2019 FDI World Dental Federation.)

Introduction: This study assessed the health screening behaviour of Singaporeans and evaluated factors associated with low uptake of screening tests., Materials and Methods: Data from the 2010 National Health Survey, which was conducted on Singapore citizens and permanent residents, was used in this analysis. Multivariate Cox regression was used to evaluate the relationship between sociodemographics and health screening behaviour for selected chronic diseases (hypertension, diabetes and hypercholesterolaemia) and cancers (cervical, breast and colorectal). National recommendations for age at which screening should be initiated and appropriate screening interval were used to define appropriate screening behaviour., Results: More respondents have had their last chronic disease screening done within the recommended time period compared to cancer screening. A total of 77.8%, 63.4% and 54.9% of the respondents had their last hypertension, diabetes and hypercholesterolaemia done within the recommended time period respectively, while less than 50% of the respondents had their cervical (45.8%), breast (32.9%) and colorectal (20.2%) cancer screenings done within the recommended time period. Respondents with higher household income or more years of education were more likely to have undergone screening within the recommended time period. Indians, who are at higher risk of chronic diseases such as diabetes and hypercholesterolaemia, were also more likely to have been screened. A total of 69.9% and 79.5% of the respondents with previously undiagnosed diabetes and hypertension had reported to have done diabetes and hypertension screenings respectively, within the recommended time period., Conclusion: Sociodemographic factors that could be associated with a lower uptake of screening tests include: 1) low household income, 2) low education level, and 3) Malay ethnicity. Health promotion programmes and outreach to these groups can be enhanced to further improve screening uptake.

We present a retrospective study to evaluate the outcome of postoperative radiotherapy for biochemical or clinical recurrent prostate cancer. Twenty-six patients (median age 60 years) underwent radiotherapy after radical prostatectomy between January 1997 and January 2004. Seven patients received adjuvant radiotherapy and 19 received salvage radiotherapy. The median prostate-specific antigen at diagnosis was 8.6 (0.9-89) and most (23 patients) presented with T(3)N(0) disease. The median follow up was 19.5 months (5-84 months). All patients received a dose of 61.2 Gy at 1.8 Gy per fraction, 20 initially receiving 45 Gy to the lesser pelvis. The median dose to the bladder, rectum and left femoral head were 55.6, 57.5 and 33.8 Gy, respectively. All patients were managed radiotherapeutically by the first author. Twenty-four patients are alive. Two patients have died, one from oesophageal cancer and the second from metastatic prostate cancer. Two other patients also developed metastatic disease. Four asymptomatic patients with a rising prostate-specific antigen are under observation. None of the 26 patients has developed a local recurrence. Seven patients have developed grade 1 late bowel effects and three a grade 2 late effect. Eight patients suffer from grade 1 late genitourinary effects and two from grade 2 effects. One patient developed impotence, whereas 23 patients were rendered impotent postoperatively. There were no grade 3/4 late effects. Postoperative radiotherapy is well tolerated and provides effective local control.

In 1969 and 1973, 598 and 474 randomly selected students at a large midwestern university reported their present and past use, and extent of use of substances taken without medical prescription. Ten of the 18 substances showed a significant increase in percentage of users over time with greatest increases for marijuana, hashish, and alcohol. These three plus tobacco are those substances most used by students and used most frequently. Other substances are used by less than 7 per cent presently and by less than 4 per cent on an often or regular basis. The percentage of tobacco users has not diminished, but smokers report lower frequencies of use in 1973. Single undergraduates reported highest percentage of substance users, and sex differences were not evident. Methodological issues in survey research on substance use are discussed as well as implications for substance educational programming.